No SNF will accept my combative husband

NylaBlue

Last week my husband was coughing, sneezing, weak and unable to get out of bed so I called 911. After 12 hours in the Emergency Department he was admitted with a diagnosis of influenza A. After a week in the hospital his flu symptoms are improved, but on his third day of PT he can only stand for less than a minute and walk a few steps. 

I’ve been working with the hospital care manager on getting him released to a SNF for rehab, but so far none will take him because of his behavior in the hospital. On being admitted he cursed, was physically combative and uncooperative. He thinks anyone who touches him is trying to kill him. Three days ago a hospitalist put him on Seroquel 12.5 mg once every evening. I understand this doesn’t take full effect for weeks and I’m concerned about weight gain as he is already obese.  In the meantime the care manager is looking for a bed in facilities up to two hours away!

Can anyone suggest a faster acting medication to keep him calm without knocking him out? He needs to be released to rehab and hopefully one closer to our home so I can help with his therapy.

Ed1937

Is he aggressive with you? If so, tell the hospital that you cannot take him home because it is unsafe for you. It's up to them to find a suitable place for him. They can't force you to take him home, but you might not have a choice where they send him. A geropsychiatrist is really probably the best to handle the medication.

dayn2nite2

His weight is the least of your worries at this time.  If there is no geri-psych unit at the hospital he is admitted to, can they transfer him to one?  Stabilization with medication and a documented period of non-combativeness must be shown before you'll get anyone to take him.

If they can't do that, then the hospital will have to look further and further out for a place.

Gig Harbor

Can they increase his seroquel? That seems like a pretty low dose. Definitely don’t take him home. Now that he has had more than a three day stay Medicare will cover the cost of his rehab. Good luck.

ImMaggieMae

Risperidone worked for my DH when Seroquel didn’t. The Risperidone worked within a couple of days of hospitalization. He was not combative, just highly agitated, pulling out an IV twice. It didn’t knock him out during the day but kept him asleep at night. That was over a year ago and he’s still taking it and it’s still working well for him. But everyone is different.

NylaBlue

Thanks so much for your responses. The hospitalists here are stuck on treating the flu and now pneumonia (as of this morning) so I have to press for treatment of the anxiety and delusions. I have told them I can’t safely bring Paul home as he is now.