looking for recommendation for dementia facility that can handle abusive/behavioral health issues

[Anonymous]

Hello,,

I am full guardian and conservator of my mother, who currently lives in Arizona. She has mid stage Alzheimer's and has become repeatedly verbally, and now, as of yesterday, physically abusive of staff. i hvae moved her twice in the past 18 months and current place is angling to get her discharged/moved elsewhere. She will probably go into a behavioral health center [covered by medical insurance] for a couple of weeks, and then will probably need to find her another new place to live. i don't feel capable of caring for her day to day, but maybe it is time to move her to DC. Cost is a concern and i'd rather find some place that is DC exurbs that might be able to care for her, with the likelihood that she will, at some point, again be verbally and even physically abusive of staff [she can't remember much, but gets triggered and acts out]. So far neurologists have not been willing to up her medication and need recommendation for facilities that might be able to handle this sort of situation. thank you.

[Anonymous]

Anonymous wrote:Hello,,

I am full guardian and conservator of my mother, who currently lives in Arizona. She has mid stage Alzheimer's and has become repeatedly verbally, and now, as of yesterday, physically abusive of staff. i hvae moved her twice in the past 18 months and current place is angling to get her discharged/moved elsewhere. She will probably go into a behavioral health center [covered by medical insurance] for a couple of weeks, and then will probably need to find her another new place to live. i don't feel capable of caring for her day to day, but maybe it is time to move her to DC. Cost is a concern and i'd rather find some place that is DC exurbs that might be able to care for her, with the likelihood that she will, at some point, again be verbally and even physically abusive of staff [she can't remember much, but gets triggered and acts out]. So far neurologists have not been willing to up her medication and need recommendation for facilities that might be able to handle this sort of situation. thank you.

OP, I am not in the DMV and do not have suggestions, but want to send you some good vibrations while trying to work this out. It really is quite tough having BTDT (but had good luck).

Maybe someone on here has suggestions of a neurologist in the DMV or in AZ. Seems like there has to be someone in AZ with all the seniors - this can't be the first time they've observed this.

Take care and hoping for the best.

[Anonymous]

Why is the neurologist unwilling to up medications or add a new one? How many neurologists have you seen? Have you tried a psychiatrist? Is the concern due to seizure or fall risk? I would get another opinion on the meds. No place wants to deal with an abusive elder in our experience and you are better off adding meds or increasing dose. Ideally, you need someone with expertise in challenging elderly, but if you can't find that you need someone a little more open minded. The behaviors will just get worse so the person needs to be able to weight risks to her health vs. risk to the health of those who interact with her.

Also, what meds is she on? Is there an anti-psychotic in the mix?

[Anonymous]

My dad had frontotemporal dementia and was at Arbor Place, which was absolutely wonderful. But not low cost. He needed a geriatric psychiatrist for medication to keep him a reasonably good citizen. Plus a good routine, enough sleep, activities etc. As he got older he settled down and the psychiatrist was able to wean him off some of the medicines. Hopefully you can get help for your mom!

[Anonymous]

I don’t have recommendations for facilities she can go to but find a new dr who will properly medicate her. My MIL who has dementia was getting violent and aggressive and her dr put her on seroquel and it has done a world of difference. She is so much happier and calmer now.

[Anonymous]

Marian Manor in Stafford

[Anonymous]

OP was she in a locked memory care ward at her last home? That's probably the solution, unfortunately, and they will work with their doctors to medicate her so they can manage the situation. I'm so sorry. I know it's torture.

[Anonymous]

Went through this with a family member. She is in memory care and their on-site psychiatrist has prescribed medicine to keep her calm and compliant. It feels horrible because the meds have side effects and safety risks, but she needs care and the staff need to feel safe around her. It’s awful, but meds are the only answer I think.

[Anonymous]

OP here --- thanks for the helpful comments so far.

Yes, she was most recently [as of yesterday] in a locked memory care facility. They transferred her to an emergency room [which i agreed to], and she is officially not welcome back to the memory care place. MOst contracts that i see do have a provision saying if there is physical aggression it is cause for terminating the rental contract.

My mom is on Sequoqel, and we'd increased the dosage about 6 months ago the last time this happened. it has definitely helped her sleep better, but the aggression continues/is back, and the caretakers last week thought perhaps she was 'getting used to' the meds and a change would be needed.

Neurologist is offiically saying he knows of no place to send her, to ask the ER.

I've asked the hospital to 1) make sure she sees a psychiatist, who hopefully will significantly increase if not overhaul her meds [lest this happen yet again] and for 2) referrals to a dementia place that can handle behavioral health issues. She will probably be in geriatric psych ward for a couple weeks.

My thoughts are to have the social worker and 'guru' i work with pick out three places in AZ, have my brother pick the place [brother is almost, but not entirely, out of the picture having removed himself from years of nasty behavior from my parents [father is deceased 5 years ago], but does respond to my specific requests], transfer her there, and meanwhile line up something similar in DC exurbs for the next time this happens. i'd love to have more faith that this won't happen again, but am not optimistic as of today. fun times.

thanks all for continued ideas on DC area care places, and words of support, and ideas on how to handle.

[Anonymous]

Went through this with my mother in another state. Her geriatrician recommended having her admitted to hospital to do comprehensive testing to rule out physical problems as source of aggression and, when none were found, to develop a medication plan to relieve the aggression. Sadly she ended up having to be very very heavily medicated, and even then it was difficult to find a placement. The hospital staff were our best resource for finding a facility that could accommodate people with a history of aggression; there were only 2 options within an hour of our home, and it was very expensive (7k per month).But we had no choice so she was eventually released to one of the two facilities.

[Anonymous]

I assume she is at the maximum dose of seroquel? It's a shame because that is often used in these situations. My grandmother had to heavily medicated on multiple drugs for aggression, but they did get it under control. The problem is adjusting to a move can worsen behavior even more. What other drugs is she on for mood? Often it's a cocktail of drugs when aggressive.

I would not ask your brother to pick the place unless he has requested to help. You said he endured years of nasty behavior. He is likely not in the right state of mind to be visiting places to find the ideal setting for hostile and abusive mom. Might be better to have the guru pick the place. Staff change a lot. You just need a place she is safe with a good reputation.

[Anonymous]

There are least two other anti-psychotic drugs that doctors can prescribe to reduce aggression in Alzheimer's patients. My mother ended up on risperidone; seroquel did not work for her.