I'm not sure if this is a side effect of an increase in dosage on her Exelon Patch, or if her dementia is getting worse. The facility has asked if I mind her seeing their on site psychologist/psychiatrist, not sure which he is. Of course I said I didn't mind. I have a feeling it is just mom, though. She had issues when I cared for her at home, and this is the 3rd incident since she has been in the nursing home. Just wondering if they can make her leave if the behavior continues.
The next probability is that she may be in the combative stage of her disease which will eventually pass. I suggest that you find a facility with a unit that deals with theses specific stages. Visit often so that everyone is kept on their toes. Bring familiar items she had at home to orientate her to the surroundings.
Residents at a skilled nursing facility have their days structured dressing bathing meals, activities and early evening entertainment including physical therapy is provided .The complete acclimation period is about 2 weeks until they adjust and become familiar with the environment and schedule. A structured environment tends to soothe and calm dementia patients.( READ WHAT IT'S LIKE TO HAVE ALTZHEIMERS) on this site.
The community can certainly ask her to leave. They have to protect their staff, other residents, and even visitors. They are telling you that they aren't equipped to handle aggressive behaviors and you should take that very seriously.
However, it sounds like they're willing to try to turn the situation around and you should work closely with them on that if you like the community and would prefer that she stay there. But, it may be time to look for a specialized dementia unit. Look specifically for one that claims it uses a "resident-led" style of care, where residents aren't forced to adhere to a rigid schedule. That can eliminate at least some of the situations that may incite your mom's aggression – no one forcing her to bathe, go to bed at a certain time, eat on a set schedule, etc. Also, dementia staff are trained and experienced (at least some are) in all the techniques of persuasion that mitigate negative behaviors.
We did a search for a new community and moved mom to a community geared to deal with individuals with dementia.
I know you are dealing with a lot, but it might be a signal that mom isn't in the community.
I would work closely with the facilty and their staff. If they frequenly work with dementia patients, they've seen this behavior before. Of course, if she needs more specialized psychiatric care, I'm sure they'll let you know that.