Geriatric psych admission

Reaching Out

My husband has been admitted to geriatric psych center due to aggression.  Discharge postponed due to exacerbation of aggressive behavior.

M1

I'm very sorry, I recently went through this too, a very difficult three week hospitalization followed by memory care placement that has also proven to be (still is) a very difficult situation. Hope he responds well to treatment.

Pat6177

I’m guessing you’re on a bit of a roller coaster ride. I hope they find a the right medication soon (assuming they are treating him with meds).

JoseyWales

I'm so sorry. I'm also sorry to say that it doesn't seem that uncommon. my DH had a 10 day stay.  On the positive side, things are better for him now.

Jo C.

Sometimes this can be what is needed to get 24 hour assessment, get meds underway while observing for effectiveness and any side effects; especially when aggression is a significant problem.

It is also a place that gives us a bit of respite while making plans for discharge.   Make the psychiatric Social Worker your new best friend.  If the plan is not to return home, it would be best to have the alternate living situatioin in place and transfer from the GeriPsych Unit by amblance to the new setting.

Aggression is horrible as well as being unsafe.   By the time my LO was admitted to GeroPsych, I felt as though I was vibrating like a piano tuning fork.

I so hope that this admission makes a positive differerence, let us know how it goes and how you are doing.

J.

riajean

Jo C, how does this type of admittance help someone with late stage dementia?  My husband is going off the rails again; Thursday was a nightmare and MC was refusing his return but had no choice due to the hospital of referral having no beds.  Another call last night.  I don't know where this is going?  He's on more meds than ever in his life.  Does this type of admittance remove all those and try new things?  How does it work?  There is no other place my husband can go if the MC facility he's in now won't take him back after one more episode.  Spent all day Thursday on the phone and no facility would take him without that behavioral stay.

Please help me understand this process and what good it might do?  Also, recently I connected with a Gerontologist.  Would she be the right person to assist?  Thank you.

dayn2nite2

How far out was the radius search?  Sometimes the geri-psych stay has to be hundreds of miles away in order to find a bed.  When he was in the hospital, there should have been a social worker looking for a bed for him anywhere, not just locally.  He can't just be referred to 1 hospital, no bed and oh well.  At this point, you need to do whatever it takes to satisfy the current facility if you are depending on him returning there.

Are they going to send him to the hospital again today?  If so, request that the hospital social worker get in touch with you and tell that person to look as many miles away as it takes to find a geri-psych hospital that will admit him for stabilization.  

I am not addressing any insurance restrictions, of course - if he is on a Medicare Advantage plan or another restrictive type of plan you are going to have to jump through many hoops to get help for him.

jfkoc

riajean...a common sequence would be PCP (internist or genertologist)> neurologist specializing in dementia who very likely would defer  with a referal to a psychiatric neurologist for drugs.

What Dr(s) are in charge of your hysbands care presently? What is their opinion of the situation?

I am not familar with  geriatric psych centers but having one would suggest that you are in or near a large metropolitan area whic would have many more choices than being in a rural location...a good thing.

riajean

My husband was in the ER.  There was no social worker offered, nor did I know or was I told there was one who could direct me.  It seemed all up to me.  That's why I spent Thursday, literally on the phone.  We are 1.5 hours south of Buffalo and we have no doctor that's interested other than the one at the local VA. There is a consult scheduled with her on the 19th - by phone. We are trying to reconnect to the neurologist in Buffalo at the VA. He was the ONLY doctor on the planet in the last 8 years who I could even get on the phone and more importantly, actually "asked how my husband was doing". We only stopped seeing him due to a switch to Medicaid who forced us to see another doctor, a nice man, but never once even checked my husband.  Only filled out paperwork.  He's back at MC because he had to be.

I'm going to call the Gerontologist in the morning to ask her again if I can hire her to look at his meds and guide me.  I did scan within 50-75 miles for a behavioral unit, but was also told he'd have to be first evaluated by a psychologist, then placed, maybe.  He's sick, not mentally ill, there is surely a difference though behaviors might overlap.  He's also on meds for schizophrenia and seizures, both of which are NOT recommended for dementia. 

He was put on Trazodone to help him sleep and also large notes everywhere to not wake him to pee during the night as they were each hour on the hour.  He was in a stupor and crying when I arrived today, taking a long time to console him.  Hurt, hurt like crazy to see him like that.  He was also so sleepy and it was 1:30.  So, I think he's totally over medicated.  From never taking an aspirin to the list I've attached.  This is nuts!

jfkoc

I ran a drug interaction on drugs.com for you;

https://www.drugs.com/interaction/list/?drug_list=1979-0,1551-0,2057-0,1146-0,2228-0

riajean

Wow!!! Thank you so much for this, most appreciated!  I intend to share this tomorrow.  Again, thank you!

jfkoc

Our pharmacist, when faced with a new prescription for my husband, called my attention to the fact that it was a duplication and flatly stated that  is was customary to increase the first rather than add a second. She also told me about drugs.com.

Since that time I have never picked up a perscription until I had checked it out. 

Pearzee

My dad was aggressive as well and was sent to geri-psych four different times.  Nursing home refused to take him back after 4th admission.  I tried to have him transferred to another hospital's geri-psych to get a second opinion to no avail.  Dad's psychiatrist in the Geri-psych wanted to do electric shock treatments but could not provide us with any research that said it was effective for people with AD and told us to do our own research.  We asked for time to research ourselves but dad was sent through our county's court system without our knowledge and permission to a psychiatric hospital an hour away.  Even the doctor's there could not control his aggression.  Oh, and the social worker at the hospital who was supposed to be "helping" us was the one who went behind our backs to have dad transferred to the mental hospital.  Don't trust anyone.

ImMaggieMae

Pearzee, it sounds like a nightmare. How awful for you to have to go through all of that. What was the final outcome with his care?

jmlarue

I don't understand why you felt compelled to stop consulting with the VA doctors. Does your DH not have a service connected disability rating? Even if VA health care requires some sort of co-pay for service, it was my understanding that he would be entitled to access to the VA health care system for life. If you do have an appt. with the VA doctor on the 19th, I would recommend that you call to ask for that appointment to be moved up to an urgent status due to psychosis.

riajean

jmlarue, if your question is for me, it's due to trying to cover the cost of home health and at the time the VA didn't think my husband qualified for their "home care" which only consisted of coming to the house to bathe and dress him which, at the time, he and sometimes with my help, was doing this.  So, they refused saying we didn't need their help as that was all they could offer.  The other issue with the VA was the home health company said they didn't allow us to use the VA AND medicaid, so I felt pushed to use only their doctors in their program.  So many ins/outs/twists/turns over the past 7 plus years with home health aides, rules and options with the VA and Medicaid.

NO, my husband's illness is not service related, though he does qualify for benefits like aid and attendance and pension due to his being in the Army near the end of the Vietnam war.  So, there are restrictions, limitations and rules.  I was at the mercy of the help I could find with the companies and their rules.  My appointment on the 19th is a call and it was the ONLY available time for his doctor.  I'll discuss everything then and hopefully find something better for my husband. 

I did connect with Palliative care this week and there is a geri-psych ward in his area, but right now, due to removing some double-duty meds that caused him to be crying (darn* it!) and now that they're leaving him alone at night - not waking him on the hour to pee, he's sleeping at night.  He needs CARE, not instructions he doesn't understand, so I'm looking for someone to spend some time with him 2-3 times a week just holding him, listening to music because they don't have staff to do the "person centered care" they brag about.  Working on it.  Working on it.

Joydean

Reaching out , I hope and pray your dh is getting the help he needs! I also hope you are taking care of yourself! 

Please let us know how you both are doing. Wishing the best for both of you. 

Pearzee

ImMaggieMae wrote:

Pearzee, it sounds like a nightmare. How awful for you to have to go through all of that. What was the final outcome with his care?

Hi, InMaggieMae.  He stayed at the psychiatric hospital for about four months before he died.  We drove down to see him a couple of times a week.  He received good care at that hospital - certainly better than he received at the original one - but to have him transferred against our will was awful as we had no idea what was going to happen.  I'll never get over it.