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My 93-year-old mother has Alzheimer's and aggressive behavior. She previously spent a month in a psyche center to get her med's under control. They finally found med's to help her, so she is less anxious during the day and no longer violent, although she is also lethargic from the drugs. Unfortunately, she is still not sleeping at night and is disturbing the other residents. The Memory Care center where she lives wants to keep her so drugged at night that she is a zombie during the day and cannot even hold her head up. I don't want her to be this drugged during the day, so the facility is giving up on her after trying everything else (melatonin, moving her bed next to a wall because she says she is falling out of bed even though she is not, weighted blanket, etc.) and they want her out. They told me that they are not sure any other facility will take Mom. I am not sure where to go from here. Does anyone else have any ideas on what the next step is for us? Does skilled nursing take care of patients like this? I am at a loss.

Quality of life issues. What kind of life is it to have to be up all night disturbing others? Everything is give and take. To maintain health care in a group setting requires the meds. No matter where you take her this will hold true. If you take her home you will be up against the exact same issue but with no support for yourself. One must often look at the choices and decide which is best even when neither is good. It is better to leave her where she can get good care, give them permission to medicate her nights, ask that they use the least required, and she be a zombie in the day. You cannot have it all. You have to decide what is best for everyone. Your mother, YOU, and the care staff. Unless you have the funds to staff a full time individual care giver who is certified to deal with such behaviors, it is better to reduce the behaviors.
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Reply to RetiredBrain
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Bulldog54321 Jan 17, 2025
Exactly. Moving her would be the more invasive action.
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Thanks for the suggestions. I have a meeting scheduled with the Executive Director and Director of Nursing on Monday at the place where Mom is now. I am expecting them to put the pressure on me to remove my mother, but as you say, until she has a place to go, I'm not sure what I can do.

I did contact another facility today called Silverado that specializes in Memory Care only. I think there are several of these facilities across the US. They have a different approach to treatment. They are also the most expensive. The staff member I talked with today was so kind and helpful, I could have cried. I briefly explained the situation and asked what they would do differently and she explained some of the methods they use. Redirection is one of those things. She said, "we find out what they are anxious about and comfort them, and redirect them." This is what I think is missing where Mom is now. One staff member who complained to me recently about Mom not sleeping at night, said Mom was yelling that there were spiders in her room, and the staff member said the night staff "actually had to pretend they were stomping spiders!!" I thought what's wrong with that? If Mom thought she saw spiders, just pretend you killed them. No big deal.

When I asked the new place I called today what would happen if Mom went there, but she did not improve and continued to wake up anxiously calling for help at night, disturbing other residents, this woman told me that they "don't give up on people with dementia" and that they "meet them where they are." It almost sounded too good to be true. Has anyone else ever heard of Silverado Memory Care?
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Reply to Lee188
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Cruiseforever Jan 10, 2025
Our Silverado facility is $10,000/ month with $4000 down!
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My husband was "kicked out" of 2 facilities due to behavior. The first was a memory care unit in a retirement place. The second was a place that specialized in dementia/Alzheimer's. The only place that would take him was a SNF which had a memory care unit. He's been there 2 1/2 years. His dementia is so advanced now that when they moved the memory care unit they didn't move him. ( I wanted a private room and they didn't have any in the new unit). He is non-communicative and very rarely gets up on his own or walks around. It's not the best SNF but when he was in the memory care unit, he was taken care of and loved on. It's been a week since they've moved things and we're still working on getting to know all the staff and make connections with them.
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The way these facilities work, at least in our area, is that the doctors rotate among them and don't have set appointments or even necessarily set days. They go to a facility and might have one patient to see there on that day, or six, and don't know how long it will take to see each one. It is frustrating but on the other hand the patients are seen there rather than having to be taken out, and the doctor can leave instructions for the facility staff.

Also, some residents don't have involved family members who want to be kept in the loop, or there are HIPPA issues/lack of POA, etc., so it's not automatic for the doctors to communicate with family the way it would be if you were going with your mother to an appointment.

The staff should definitely give you an email or phone number at which you can talk with whichever doctor(s) sees your mother so you can find out from him or her whether they're aware of the nighttime issues. It's possible that your mother hasn't been seen by a doctor since this issue arose, or that the doctor did prescribe the meds but hasn't been made aware of the excessive effects, and could change the dosage or the medication. Based on what you learn from them you can be better informed when you get her an outside appointment. But more immediately, this doctor might be able to adjust the meds to be more effective and appropriate for her, and resolve the issue so you don't have to find a new place.
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Reply to MG8522
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Frankly, I’d try the heavy night time meds for a week or so. Even if she will be gorked out during the day, maybe if you do it for a week straight, it might interrupt this cycle of disruptive behaviors at night.

After a week or so, you can wean her off and see if it helped. This would be a heck of a lot easier than moving her elsewhere.
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Reply to Bulldog54321
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Speak to her doctor
mention your concerns about the zombified tablet state
and I think you’ll have a better steer on which way to proceed afterwards
end of day it looks like your mother needs medication
maybe a different one
We can all sympathise but also being neutral we can also if our parents were in there getting disturbed every night
so I think you’ll need to speak to your mothers doctor and find out what else can help
maybe she doesn’t need so much in the daytime
maybe she isn’t eating enough to justify the dose levels
her doctor shd be first call
surprised the centre have r suggested this but in a way not as no one seems to really care much nowadays
speak to her doctor and tell the centre you are seeking medical advice so will get back to them
good luck
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Reply to Jenny10
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The memory care facility specializes in taking care of patients with dementia, and I'm sure they have seen this kind of behavior before.
If their way of dealing with it is to keep her heavily medicated, it is because they don't have the staffing resources to spend more time managing her behavior.

Unfortunately, she may be heavily medicated wherever she goes. The alternate nursing home you spoke with sounds promising. Perhaps they have the extra time and staff to manage her care differently. It may be a much higher cost.

If you decide to make the move, make sure you stop by frequently to check on her, and ensure the care home is meeting the quality of care you expected.

I try to avoid doping up my difficult husband during the days, because sleeping all day will only lead to anxious, awake nights. So, I reserve the calming meds for bedtime only unless he is particularly agitated. It seems her current memory care facility is keeping her so drugged during the day, she is now agitated at night. If they are not managing her well, and want to kick her out, I wouldn't want to leave her there. It's time to make a move.
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Reply to CaringWifeAZ
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BurntCaregiver Jan 17, 2025
@CaringWifeAZ

No memory care facility is going to assign aides to keep an aggressive dementia resident quiet all night. They're going to heavily medicate someone regardless of what facility they're in.
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Maybe a LTC. NH where behaviors can be better handled. My mom actually prefers the NH and added staffing. We found a MC just locked the doors..we never saw added care or behavior control.
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Reply to Sadinroanokeva
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There are genetics tests to determine which meds a patient can and can not take.
There are some that are just cheek swabs (vs blood draws) so they are easy to do with almost anyone (and usually covered by insurance).
The wrong meds can make one very violent and aggressive.
So maybe that would be helpful going forward, as you would not have so much trial and error with medications.
I wish you luck. That’s so difficult:(
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Reply to UTdtr2
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Bulldog54321 Jan 18, 2025
Yes, several of my friends and my son have found these genetic tests very helpful in choosing what med to use.
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Here's a late answer to your question. I don't know if this helps, but my mom is in memory care. She was bothering her neighbors at night with delusions and aggressiveness. The visiting nurse practitioner switched her from seroquel, which she took at night, to olanzapine 5mg tablet every morning.
She has been relatively calm ever since. No disturbances for weeks. Is that due to adding the olanzapine or removing the seroquel? Who knows. Maybe both. Maybe neither.
Drugs affect everyone differently though.
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