As a family we've been dealing with mom's gradual decline with dementia. The past two weeks have been especially challenging with hallucinations taking over most of her days/nights. It started last year with a little girl that would come to her and sing. Pleasant and caused no problems. Now it has escalated to this "child" being abused by her mother with fingers getting cut off with a knife. Tonight she lashed out at my dad by hitting him and scratching his arms because he wasn't saving this child. She has also been opening doors and trying to leave the house to get the girls father. I took her to her PC on Monday to rule out a UTI and she was prescribed Seroquel to help with night time wanderings. Didn't help. I called an ambulance after her outburst and am now at wits end. The ER doctor called and said physically she's in excellent health at 92. She will be evaluated mentally tomorrow. She has been diagnosed in the past with LBD. I might also add she is difficult, controlling and demanding to family (this is her personality, not new to dementia) but sweet as can be to others (dr. said she is joking with staff and being very pleasant overall). My question is.....up until now we've been able to keep her at home, by not arguing (futile) and just letting her be as ADL's are not a concern. But with these intense hallucinations and the fact she is acting out violently, I worry about my dad and his safety. Can I be forced to bring her home when I feel there is a risk factor? Will Medicare pay for a short term stay at a facility until her behavior is under control? I just feel we are in crisis mode right now and any suggestions will be more than helpful.
Once you've tried medications, and various precautions etc and you see there is no change, but instead an escalation in this behavior TRUST YOUR GUT. I actual put a alarm on my moms bed so I be aware when she got up. This gave me a chance to be alert and capable of reacting if need be.
Unfortunately unintended bodily harm is often the outcome of these episodes. I am aware of a husband being severely harmed by his spouse after family members begged him to allow his spouse return to their home after being evaluated ( against his better judgement) he felt guilt and pressure. Of course, the resulting mental state of the person caused this to happen. But love and care must be something you give to yourself as well as your loved one. Every ones well being is at stake.
People that do not live daily with your loved one can not properly asses the danger. This situation is always hard...but proper care for you and them vital.
If your mother is able to walk & wanders…I addition to violence, this …if it was me, wouldn’t bring her back home.
Facility will get your mother stabilized & calmer…& let Social Worker get her placed while she’s in hospital. After she is stabilized, you can look for a different place. Hugs 🤗
Before your sister takes this on, make sure she spends a full 24 hours with mom, to see what her care entails.
You have a golden opportunity to place her directly after this in-patient stay. Please consider the toll bringing her home will take on everyone.
In short, nobody can "make you" take her home if you feel threatened,
Tell dr that she already attacked your dad so her being released to live where he does is just not an option. You can't let her violence harm him. Other than placing her temporarily to get meds straight, ask dr what kind of a nursing facility he would recommend. Memory care, nursing home, etc? And ask that he start the process of completing paperwork to support that kind of transfer. Make sure social worker at hospital is aware of same info because they can help you w/transfer and perhaps offer some suggestions.
You may have to do this for your mother. Get the doctor on board with this decision. Then tell the social worker at the hospital there is no way she can come home there is no help for her there it will put her life in danger.
They cannot force you to receive her into your home. And the best way to work through what is needed for placement is now, with the help of hospital social services.
I am wishing you good luck. Let the nurses know TODAY that you need social services, that you cannot accept your mother. The fact you didn't tell the doctor who spoke with you that this is the case is going to make this much more difficult, but not impossible.
Just keep saying no, and make it clear that if an ambulance comes to the home you will refuse entry into the home.
They may go with some rehab to put it off a bit, just keep requesting social services and a way to work toward her placement.
LBD in particular is difficult as it is one of the dementia's that is more prone to violence. Added to that it is one that medications are difficult. Many of the drugs that are given to quell anxiety in other dementia's can not be given to people with LBD, The results can be fatal.
This in not anyone's fault, it is the disease.
Talk to the Doctor, talk to the Social Worker. Explain that it is not safe for her to be discharged to home.
It is not safe for your dad, or other caregiver, and it may not be safe for mom if she is trying to "search" for this child or the person "harming" her.
Finding a facility that will accept someone that has been violent can be a challenge but once the correct medication is found, the correct dose she should do well. Most facilities will want 90 days without incident. (some more, some less) The Social Worker may be able to help in this search.
Find out if admission to a psychiatric unit-- perhaps there is a "senior behavioral unit" nearby--so that different meds can be trialed.
At least within my family, when wandering and violence set in (my sweet uncle was beating my poor aunt black and blue so he could get the keys to go take a walk on the highway), placement in a locked Memory Care unit was the only option. He thrived there!
Steadfastly refuse any suggestions that your mom should return home. It's an "unsafe discharge". And make sure she is admitted and not "under observation".