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Mother is in rehab and refusing to be compliant. She must go in long-term care, but all the facilities are turning her down because of behavior. She has never gotten physical, but refuses to take her medicine and has become rude, loud, foul-mouthed, and impossible to please. I’m fearful she will end up someplace horrible.

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Well, honestly, they can't just kick her out. And you won't be taking her on. So......often what happens is that the unruly one is transferred off on a 5150 to a behavioral unit in hospital or rehab.
There is then the Medication cocktail business to try to bring happiness, control, or BOTH in.
But yes, finally there can be the "someplace horrible". Without 24/7 care, and who can do that, that can happen.

I am so sorry. To the extent she has any ability at all to have any control over these things, I would explain this. Otherwise ask doc to put her on a mild anti depressant. That can sometimes help. Of course it can sometimes make things worse as well. Again, I am so sorry.
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Vladtheimpaler Feb 2, 2025
This answer is the most reasonable one..
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Has anyone talked to the hospital about a psychiatric evaluation? Or given them permission to administer calming meds via IV?

If she has a brain injury they will speak with the legal next of kin to decide a path of treatment.

I am so sorry for all of you, being in the crisis, decisions with a noncompliant person is a trial for certain. May The Lord give you all guidance, strength and wisdom.
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Dstnd2win Feb 2, 2025
Thank you
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Has anyone asked her why she's doing these things? The "WHY" might be key to what needs to be done next. Perhaps she does not want to be anywhere but home, and anger, confusion or intentional misbehavior is her reaction to feeling loss of control of her life. She definitely needs some tender intervention from family and probably a mental health professional. Calming her down first is essential, then perhaps she'll be more willing to comply and regain acceptance to long term care facilities. She needs lots of talk therapy....she needs to be heard. Sadly, that can take time to be effective but ultimately might be the only answer. Meanwhile maybe she could receive her meds through an IV line if it can be inserted and reused. I'm not a medical professional, but I think that can be done. Also, has the facility checked her for a physical reason for her behavior? Something as simple as a UTI can make seniors react this way....saw it with my own mother.
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Igloocar Feb 3, 2025
Jannycare, her godmother apparently had a brain injury related to her fall. Some of her behaviors may reflect the brain injury. If so, unfortunately, talk therapy may not be useful.
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Hi there , sorry you and your mom are going through this . My dad has recently passed after years of dementia that started out extremely aggressive and non compliant behaviours that led to him being refused at homes and had him in a facility for a period of time that was the only option and one I don’t like to think about .
your mom’s behaviour is standard dementia and isn’t anything I didn’t see daily in regular LTC homes in Canada , so the fact they aren’t willing to deal with this for me would be a red flag and you wouldn’t want her there even if it seems like a nice place on the outside .
here is what helped us, hope it helps you :
the Alzheimer’s society offers videos and classes online on how to approach love ones with techniques in a gentle manner that diffuse behaviours . Learn how to approach your mom and what specifically works for her in diffusing her , so you can show homes which techniques work . In my dad’s case we would have to give him a treat that he liked after he was willing to take meds like pudding or ice-cream. This wasn’t needed for years , but for sometime until he became compliant and eventually became agreeable on his own.
2) it’s ok to have to re approach at a different time if she doesn’t want it at that exact moment . It means staff would have to come back and try later . If a home is not willing to do this , it’s a red flag for me . I would worry this unwillingness to reapproval would be taken for bathing , dressing and eating . It’s her new home , not a jail where she should have to do Everything on their time frame . Of course with meds there is a window when they need to be taken but sometimes even re approaching 20-30 mins later is enough to make it happen.
When you try to re approach , try approaching from a different physical side ( I know it sounds strange but can often work ) . So if you approached from her right side , try the left next time . This was passed to us from the hospital and is a known technique .
For my dad verbal approach was everything . It was the difference between him being someone pleasant or combative . He still wanted to be treated with dignity and wanted to be asked or told what was going to happen before it happened . So often staff would come in and just start working on him without having said why or what was happening . Spoon in the mouth while telling him it’s meds and no chance to react but startled and extremely. What helped was stating the purpose before they did it . For example , I am here to help you change your shirt . Is that ok for you right now? Then he would answer yes or not right now . If we needed to revisit we would and tell him why it was a good idea or why we were doing it . This almost always got him to understand and rewards after were sometimes needed to create routines . I know this sounds like a lot of work and it was. But over time he became more and more agreeable and less effort was actually needed .
Can you or can you hire a bit of private care for a bit to help in her current setting to help her adjust . If you can figure out what her triggers are and give her the approach she needs to be more agreeable , it may open your options up . At first we had to spend A lot of time with my dad figuring this out ours selves and it also meant hiring a bit of help to help keep him calm by ensuring approach was consistent till it calmed him down and he was then deemed ok to go to a regular home .
But overall I would be searching for homes that don’t think her behaviour is a big deal . What your describing is basic 101 dementia and shouldn’t be a problem for homes who use behavioural techniques to help settle her , otherwise their tattics may end up being using drugs to drug her out so she isn’t a problem and I assure you , you don’t want that .
I know this feels overwhelming and a mountain to climb but I want you to know with work and research it’s amazing what you can change for her .
wishing you both peaceful roads ahead .
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Vladtheimpaler Feb 2, 2025
Wow…that was a lot to read…it’s already a difficult situation..doing all this just compounds it..
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First let me say that we are talking about my godmother - the only remaining parental force in my life. She has one birth child - my godsister - she and I are very close. My godmother was always a difficult, challenging, controlling woman. Like many elders able to just barely function on their own, at 88 she insisted on staying in her house and doing everything her way, with no one living there, and no intervention. We were never allowed to talk to her doctors and knew nothing about any of her affairs. On Christmas morning she fell, broke a bone in her shoulder, hit her head and had a minor brain bleed. There was very little blood so the hope was that taking her off the blood thinners would ensure no more bleeding, and it did, but she continued to decline mentally. She has since been diagnosed with brain injury disorder which is akin to dementia, and difficult, challenging, controlling behaviors have increased to the 10th power. While she seems to know who everyone is she has made up many stories in her mind, mostly about everyone being out to get her - and all of a sudden she refuses to take her meds. We think that’s because that’s the only thing she can control that seems to affect other people. Because she has refused PT in rehab (where she is now) LTC is the only option. Impossible to satisfy, and foul mouthed (a new trait), no one wants to be around her, and after each assessment, every admission director denies her. We’ve tried to convey how her behaviors are only harming her. She doesn’t seem to get it at all.
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Vladtheimpaler Feb 2, 2025
Sounds like my dad..I’m very sorry you are going through this..
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You can try a group home. But as suggested in another comment you may need a medication to subdue the rough behavior.
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Simply put, we saw a marked improvement/acceptance once Mother's pain and ANXIETY was controlled, while in hospice care. It became "comfort care" for her & family.
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Has she done anything that seem harmful to herself, or does she have any signs that may constitute "a medical emergency?" If so, you can take her to the ER to get care started. Either she'll get admitted, or they can help find a geripsych hospital to transfer her to. You'll have much better luck once she has calmed down with the right meds. And in the hospital environment, they can inject meds and restrain a violent person as appropriate. A social worker may be able to help you find a care home for her once she's ready for discharge. As far as I understand it, by law, unlike hospitals and psych wards, Assisted Living and/or LTC facilities are not allowed to force a person to take meds if they refuse, can't constrain them either. When my husband refused to take his meds in the MCF, they hid his meds in apple sauce or ice cream. Hope you find a good solution. I wish I had known about what I just wrote when I needed it. Hope it will help you, too.
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Any1haveanswers Feb 3, 2025
I know this will sound extreme, as it scared me so much I put it off too long. My mom was on a set of psych meds for depression/anxiety that, when they became less effective, and the dosages were increased, caused her to say awful things, throw things at residents and caregivers and her own TV(!). First thought was to check her for a UTI (negative) Her MC manager suggested I end her to the Psych hospital to have her meds evaluated. It scared me as I wouldn't be able to see her, but only could call and hope she would talk to me. I put it off due to that hesitancy, and I am sorry I did as she did not get better. Things 'came to a head' when she had a tantrum - tearing down the community Christmas tree, trashing hanging art, etc. The MC manager insisted -or she would have to move. So I admitted her to the Psych hospital recommended as the best in the area. It was THE BEST thing I could have done or her. She did fine, enjoyed being around the other patients, was taken off all her psych meds and reintroduced to some lower dose alternatives that are still working for her over 18 months later. SO - to the point - if she is on meds -perhaps it is time to re-evaluate them. Clearly not the psych hospital if she is in rehab, but maybe working with hospital staff? Just a thought.
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Obtain an ombudsman to talk with her. Her doctor can prescribe medication to calm her. More information in your profile will be useful for advice from our forum.
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Vladtheimpaler Feb 2, 2025
Did you miss the part that says ..”she refuses “..and how exactly do you propose this patient voluntarily takes their medication?
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It’s amazing that I constantly come across suggestions that offer..”prescribed medication to calm them down “.. the people who give this answer always miss the part where it says..”they refuse to take the medication “..smh
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