My father was diagnosed with dementia almost 6 years ago. In December 2018 we had to move him into a memory care facility due to several issues but mainly because he was attacking my mother several times a day. Sometimes it would be verbal attacks and other times he would actually go at her with a knife trying to kill her. When he would come out of these moments he had no recollection of what he had done only that he knew he had done something awful, he would cry for hours after finding out what had happened.
Since moving in to the memory care unit six months ago, he has had several altercations with staff and residents. I've begged to have his meds adjusted but basically I am told there is nothing else they can do. This morning I received a call that he had again assaulted a staff member and another resident over the weekend. I was told that he is being evicted and that I must remove him from the facility within 24 hours.
I have no idea what to do or where to take him. The other facilities I have called all refuse to take him due to his violent history.
Can anyone offer any suggestions, I'm desperate.
I have a suggestion but first.....
In my experience it’s only skilled nursing facilities aka a NH that is required by how they are licensed & regulated by the state to provide for safe continuity of care for residents; so if they need to move, the NH must find a new bed for them at the level of care needed. AL do NOT have to do this as the resident is viewed as able to do their ADLs for themselves with some assistance. MC are a bit more of a grey area as they are more than AL but usually not viewed as skilled nursing aka a NH, so they too can evict without setting up proper placement for his transfer. MC fully knows no other MC or NH will take him with his history. MC will do whatever to pressure you to get him. So the monkey shifts from being their problem to yours and they will deny pressuring you. It’s not a cute but naughty lil Capuchin but a seriously scary silver back ape.
Stay firm, resolute AND refuse.
You cannot provide the level of safety and security that he needs nor can your mother AND the degree of health care & 24/7 oversight needed AND as such you will not and cannot pick him up.
Make this your mantra.
You cannot go and visit him either as they will hound / guilt or even threaten you to get you to put dad in your car. Whatever in his room at the MC, forgetaboutit. If you need to, please do a “role play” for this. If you have a bad witch strong personality friend have her play the MC staffer role. Really after you get that first panic filled crying fit behind you, you’ll be much better & prepared to speak with the MC.
What will likely happen is this..... dad will not be kicked to the curb as that’s lousy public relations and MC liability if he goes and knives somebody when he escaped. But what they likely will do is call EMS to come and take him to the ER under some plausible reason. A good one is that they seem to have had a TIA - transient ischemic Attack. TIAs are kinda subjective in symptoms, (google it, you’ll see what I mean) & really if they give him tranquilizer and another med in close succession could look like TIA symptoms. Then once whisked off in the EMS, off to the ER, the MC will refuse to take him back. In the ER, if he’s up in age and hyper aggressive, he will get hospitalized.
OR Another option if he pulls a serious threatening behavior at the MC is for them to call police and cops Baker Act him...... he’s sent on a 48 (?) hour hold for psych observation at the hospital.
Then hospital discharge planner - usually a Social worker - will contact you or mom as next of kin about coming to take him home. Again you go into your mantra.... you cannot provide yada yada. SW will have to find a closed ward unit for him somewhere. Could take a bit of time so he’ll stay sedated at the hospital till then. Good part is that the hospitalization is a Medicare benefit. It gives you & your mom a bit of time to figure out how to pay for his eventual LTC in a Locked ward facility. If he’s not on Medicaid, unless mom had oodles of $, he will end up applying for Medicaid. Or mom relinquishes her role as wife & you as POA and you all allow him to become a ward of the state. He’d get a state appointed guardian. It’s harsh but getting a good psych placement is really hard as not enough beds or facilities or trained staff nationwide. Sometimes ward of the state is best.
First big big step is he needs to get into a psych ward at a hospital to be evaluated & started on medication trials. MC will call EMS or cops pronto once they know you are not gonna get him. Good luck and stay focused.
again imho you really can’t go to visit him no matter how much you want to at the MC as they will do whatever to coerce you to just take him home as he’ll be happier & better off there. Nonsense.
Out of curiosity, how old is dad, mom & yourself?
All that said, again without your guidance I would be in such a mess right now. THANK YOU THANK YOU THANK!!
You're not his guardian, are you? - I'm assuming not, because if you'd been through the rigmarole of obtaining guardianship I think you'd have said so.
The contract is, then, straightforwardly between the facility and your father. If the facility wishes to terminate the contract, which they entered into knowing his history, it is for them to find a place to discharge him to.
It's also just common sense - they are experienced professionals with a wide range of skills and qualifications and a whole network of contacts. Who stands a better chance of finding the right option for your Dad, them or you?
When you say you've begged them to adjust his medications, who have you actually talked to? Are you getting the brush-off from members of staff, or have you had a formal care review with senior managers and the facility's qualified medics or psychiatrists?
In some states there are state hospitals for the mentally ill with violent behavior. Some are long term care facilities. I see that you are in FL. The places that I am referring to are in NC. If your father is in NC, you might explore them. One is called Longleaf Neuro-medical center in NC. You can check out their website for details. There are several of those facilities in our state. I would think that FL would have something similar in their state.
You have been given excellent advice. Refuse, Refuse, Refuse.
I have seen on this site before that the words “ Unsafe Discharge” are key.
I agree transfer to hospital then to their psyche or geriatric psyche floor, wing, ward is where you would hope your Dad would land. Even a psyche facility would work.
A good Geriatric Psychiatrist should be able to get your Dad’s mood stabilized.
Dad’s mood may become stabilized but still no, no, no, to a discharge back to you or Mom. The discharge planner at the psyche facility should assist finding an appropriate place for Dad. I agree a NH environment.
Dad’s meds might have to be tweaked often and this is best done ( imo ) within a NH environment that has a visiting psych service. The psych service is basically a phone call away should staff need assistance.
Combative Dementia patients can be scary and unpredictable.
My heart goes out to you and your Mom.
People refer to the contract, if the contract says it, that is it.
No! That is not necessarily true, most states have a law that says you can not change state laws by contract. If the law says as a facility you must ensure a safe discharge, period. Then the contract can not be enforced if it says they can just throw someone out because of... The law takes over and the contract is unenforceable because it is contradictory to state law. The contract can say whatever, but it doesn't matter if it is in violation of state law. Make the facility provide you with the state statute that allows them to do what they are trying to do.
In writing is always best, then you have proof of what has been said or done. If anyone sends you something in writing, respond, because no response in 30 days is seen as agreement with what was written. By not disputing what is in writing you are agreeing to it.
Just for information, because I have seen big companies try to intimidate individuals who don't know any better and it fries my cookies when that happens. So these are 2 pieces of law that everyone should know, it takes a lot of fear out of intimidation methods used.
I don't think they can legally boot him out with a 24 hour notice. He has rights as a tenant of the facility.
He needs to go to a psychiatric hospital and get some meds on board that calm him down. That they are saying nothing else to do shows what a crummy facility they are.
I would tell them that you picking him up is a no go. You know he has rights and they have responsibilities and they need to step up and take care of him until you can find a place for him or they need to request a psychiatric admission directly from their facility. The psych hospital won't just dump him, they will help you find a more appropriate facility.
Right now, I can't blame dad. I want to smack the administrator of his facility, what a pos. He's supposed to be being cared for by people that know how to deal with this situation. That's why he is in a facility.
Don't let them bully you. Stand up and say NO! If they argue make them show you, not tell you the law that allows them to kick a resident out with 24 hour notice, not their contract, the law that allows them to do this.
May God give you strength and guidance. Hugs!
See All Answers