Dr. Suggesting calling 911 and sending mom for geri-pysch Eval???

NatA77

I am nervous to go down this road.  We've done everything by the book including getting Guardianship of our mother.   I've read some of the forum topics that mention geri-pysch and looking for more information.  Mom has dementia which is getting worse. She is refusing to ever leave her home, she has been prescribed meds to help and refuses to take even a vitamin.  We have home health care coming in 7 days a week about 10 hours a day.  There was an opening last week at a MC facility and we tricked mom getting there for an assessment.  She refused to get out of the car and got so combative and verbally abusive with us that we ended up calling 911 to get a police officer to de-escalate the situation (per facilities recommendation).  We got mom in and they did assessment (she was mad but was so starved for attention you couldn't keep her from talking).  Just as we suspected,  Monday morning I got the call they wouldn't take her due to her behavioral issues.  Spoke to many in the field and found out that this is going to be our roadblock for getting mom into a facility and those people you can hire to help can not help us due to her behavior.  Which leads us to the option of what the doctor had suggested.  911 and geri-psych at hospital.  Has anyone had to do this?  What does it entail?  The stories sound awful...lack of care, heavily medicated patients, etc.  How is this going to help us?  Mom is just dead set on never leaving her home.  That is all she cares about.  We know this can not go on much longer.  Staying at home has only increased her anxiety, everybody is stealing from her, she is refusing meals from the "Babysitter" and not letting them help with much of anything in the home.  That is her way of protesting to us about having the in home health care.  We are at the tipping point of paying out more money in home health care then in an actually facility.  So something has to give and we can't get her into a facility on our own with her behavior.  Anybody else have to go this route to get their LO into a care facility?  What will this entail and how do we make sure we are doing our do dilegence for mom's sake.  I also asked the doctor for more information just wondering if anyone has gone thru and can talk about their experience.

ElCy

My experience with 911: I was terrified to call 911 on my DH but had no other options after he locked me out of the house for 3 days.  It was the best thing for us. He was in geripsych for 4 weeks. They found the right medication for him. He was admitted to MC (he wouldn’t have been before hand). He’s bee in MC for 1 month. The meds have helped him to be sweet, kind and happy. It’s a God send.

Ed1937

Geripsych is what you want. They're the experts when it comes to medications.

M1

IIt's the route i had to go too. More common than you might think. Getting stabilized on medication does not need to mean zombied out. But once admitted there are discharge planners who can help arrange further assessments, the MC staff will go see her at the hospital.

Good that you have guardianship because you will definitely need it.

BothDementia

My Dad has ALZ and is currently living in an ALF with Mom who has vascular dementia. We've been monitoring his behavior knowing that as ALZ progresses, his behavior will change. And it did. He became very combative, belligerent, and sometimes would hit the furniture when yelling at Mom. At one point, Mom got so scare and worry that he might choke her to death in the middle of the night that she locked herself in the bathroom and called us for help. We connected with Dad's gero-psych right away who in turn prescribed medication, at the lowest dosage, for Dad to take twice a day. It took a while (several weeks) for the medication to take effect; but, it did calm Dad down a lot and he is no longer combative, belligerent, nor physically threatening. He does seem more sleepy through out the day though so we are considering lowering his dosage further and continue monitoring. I highly recommend talking to a gero-psych; s/he can provide valuable services to help both us(caregivers) and our LO with dementia navigate through various behavior issues associated with dementia.

ninalu

Likewise for us, a 911 hospitalization and in-patient stay with geri-psych eval was incredibly helpful and beneficial. Prior to that, we'd done pretty well with the support of my LO's primary care physician using PRN anxiety medication on an outpatient basis (mom was living at home with my help), but as certain symptoms became more prominent, e.g.  

- confusion re: time of day (is it day or night?)
- confusion re: place (where am i?)
- inability to sleep / rest
- feelings of distrust and suspicion for others and their motives
- fear of what is happening to her, knowing something is not right
- inability to self-soothe 
- difficulty staying engaged in an activity
- outbursts of anger or crying 

we needed more help than mom's PCP could give. The geri-psych eval helped mom get settled on low doses of a couple different medications and it was truly amazing how much improvement we saw. The meds did not sedate her - she became highly functional socially - and they seemed to lift the bulk of her agitation and suspicion. She self-reported feeling well and she smiled a LOT more. And she slept. Not perfectly, but a lot better. 

As mom has progressed through mid-stage Alz into later stage, I credit the geri-psych consult and continued follow-up as being an essential part of helping us through this difficult journey.

pdavenport

I live in Los Angeles and my oldest sister is going through a very simuliar situation in NYC. Her son and her significant other are at wits end. She won't let anyone into the house other than them.She thinks that people come into the home and steal and now my sister is claiming one of our siblings, who she use to be very close with is writing on her documents. This sibling has not been to her house in years. One of our brother told us to call 911 and let them take her to give us time to get her to a facility. Home healthcare will not help as she may kick them out when the family leaves for a minute. I am so sad and this is so hard. I went to NY to see her and I watched her eat and she swore she had not eaten in days. She is still okay with me in LA but my days are numbered before she forgets me. It's not about the $$ to care for her but she is so unstable. It seems she has Dementia/Alzehimer's and has an evaluation with her Nero soon. Praying for an outcome.

toolbeltexpert

We had to go this route as well it took 3 calls to 911 on three different days, because she had to voluntarily go in the ambulance. It was 12 hrs at the er, then 6 weeks in the geripsych which after a few different medicines that didn't have bad side effects she then went to a snf till I got her in a mcf. I don't understand guardianship so I can't speak to what that does. But I do know that without the geripsych my dw would be pretty hard to handle. 

Stewart 

NatA77

Okay last question for all that replied.  I got a call back from the Social Worker (mom's medical clinic) and she referred me to a specific geriatric psych unit.  I called and the number didn't work.  So the other number that was associated with it got me back to my mom's clinic but more specific to mental health.  Of course the lady that I got at themedical clinic was mad that the social worker gave out a number direct to a specific clinic.  She wasn't supposed to do that.  You need to bring your mom into the ER.  I tried to ask more specific questions so I could be prepared for what to expect but the mental health lady couldn't elaborate any more on it other than bring her in.  Geez.....why is everyone so tight lipped about a process.  Okay....so I guess my brother and I will pick a day to visit the ER with mom.   What I am wanting to know since most of you have done this how did you do it and what did you say to ER desk when you get there?  We will obviously have to trick mom to get her into the car.  We drive her to ER entrance.  We know Mom is then going to see where we are and refuse to get out of the car because that is what she does best.  And I will be going into the ER desk and telling them what?Hi.....We are here because my mom's primary geriatric doctor says to bring our mom who has dementia to the ER because she is refusing to go into a care facility when we find her an opening, and she is not doing well at home with in home health care coming in 7 days a week and nobody wants to take her because she has behavior issues so doctor said to come here?  Is this what we are supposed to say and do???  Nobody is giving me a straight answer.  Is this really how it works?