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.

Rick4407

Though many here have faced similar situations, our suggestions are of little use.  You need a geri-psych to prescribe what's needed and then try various combinations to find the right mix.  That is usually done in a hospital setting.  Rick

M1

Nyla, seroquel should actually kick in pretty quickly and can be rapidly increased as needed.  At dementia doses i doubt it will affect his weight.  Sounds to me like a more immediate and persistent problem may be his inability to cooperate with rehab or follow instructions. Sorry you are struggling with this.

May flowers

We had good luck with Risperidone

NylaBlue

Thanks so much for your responses. The nearest geri-psych unit nearly 100 miles away. The hospitalists here are stuck on treating the flu and now pneumonia (as of this morning) so someone has to press for treating the anxiety and delusions and that’s me. I’m glad Seroquel is faster acting than I thought. It’s a place to start.

M1

Sorry to hear about the pneumonia, it's been such a bad winter and it's only getting started. He won't be going anywhere for a few days, maybe that'll buy you some breathing room, so to speak.