Need advice: How do I vet Memory Care facilities when I am home all day with DH

LanaJoy

I think I am close to having to place DH in MC. He has become aggressive to the point where it is more than 50% if the time. He screams at me, grabs me by the arms and pushes me up against the wall. A few times he has thrown me to the floor. His anger flares up without warning over nothing. Like when he said he was hot and I very gently suggested he change out of the sweatshirt he was wearing and into a T-shirt. We live in Arizona and had our first 100 degree day over the weekend. He is still dressing as if it were winter. He totally blew up, as if I was criticizing him about what he was wearing. He wakes me up at 3AM to tell me that the cars are leaving the garage on their own power. I am sleep deprived. He sometimes does not know who I am even though we have been together for 35 years. He even forgot who he was the other day and asked me what his name was. I do not have family nearby who can help. I asked the neurologist for meds to even out his moods. The doctor said there was nothing she would prescribe for him because of his age, he's 87.

So my question is this: how do I go about finding and vetting MC when I am home with him all day? Do I take him with me? And what kinds of questions should I be asking? We occasionally venture out when he is calm and in a good mood. But I hesitate to go out for long outings because his angry outbursts are so unpredictable. He recently jumped out of the car when I was stopped in traffic and he would not get back in. This was a busy street with no sidewalks. People were calling 911 because an old man was shuffling along the road while cars whizzed by at 45 mph. Eventually a policeman arrived and got him back in my car.

This is my first post on this discussion board. Though I have been reading the discussions regularly for weeks now and it helps to know that I am not alone and the only one dealing with these issues. Sorry to ramble on so much. Once I started writing it just sort of all poured out

Ed1937

Nothing wrong with putting your concerns out there for others to read. That's how you get help. Welcome to the forums, but sorry you need them.

If you could get someone to stay with him for a while, maybe you could go to a local support group meeting. That's where you will get the best information for local questions. Or if you know someone else locally, ask if they have any information on the subject. Lastly, check on yelp or another site for information. Of course if you could get someone to stay with him for a while, that would give you more options.

If you visit a facility, try to talk to a few of the aides, and ask them if it's a good place to work. If the aides are not happy working there, that's one strike against that place. Also do your best to talk to some of the visitors to see what they think about the facility.

Ask under what circumstances would a person be asked to find another facility. Just realize that they might not tell you the full story. We've had people here who had loved ones asked to leave, after they were told they would not have to. It's all about the money. Ask if cameras are allowed in the rooms. Ask if they feed people when they get to the point where they need the help. Ask how many residents there are to aides and other staff members. There are many other questions to ask, and I'm sure you will get other answers. If you don't get any tonight, check back tomorrow.

Here are 3 links for you. https://www.thememorycenter.com/checklist-questions-to-ask-when-visiting-memory-care-communities/

https://www.alzheimers.net/2014-04-24-questions-to-ask-about-memory-care

https://www.whereyoulivematters.org/questions-for-memory-care/

loveskitties

Hi, sorry you need to be here and hope that you find the information shared to be of help.

Your DH's aggression would most likely keep him from being accepted to a MC facility.

I am most concerned about the physical aggression he is exhibiting...your personal safety is important.

I don't know what type of doctor he currently sees, but regardless of his age, there must be some medications which could help control his aggression.

One option which others have used, is that when a physically aggressive episode occurs is to call 911 and have them take him to a geri-psyc hospital for evaluation and to find medications which will control things. This option does 2 things for you, it will help keep you safe at home with him, and also help to get him qualified at a MC facility...they don't mind meds but they can't deal with the physical aggression out of care for their other patients and the staff.

Others will be along to offer their suggestions. I hope something provided on this site is a help for you.

[Deleted User]

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M1

Welcome to the forum. Agree strongly that you will likely have to hospitalize him to get the aggression under control before he can be placed. But the social workers at the hospital can help you vet places and have him assessed-your best chance to physically visit memory care units will be while he is hospitalized. It likely will take 2-3 weeks to get him stabilized. But maybe you can do some online research ahead of time.

I had to this a year ago and I know it's not easy, but it's the only way forward. You cannot care for him at home any more.

MN Chickadee

It's likely no MC will accept him with the current aggression. Given that you have no other respite, a stay at a senior behavioral health unit (geriatric psych) inpatient may be the best option. There doctors and nurses who specialize in dementia aggression would find meds to get him stable while you would be able to look at facilities and work with the unit's social worker on placement. You could discuss a direct admit with his doctors.

Keep your phone always on you, have a room you can go in and lock the door in the event you are in danger. People with dementia have harmed their loved ones before, do not take your safety lightly. Remove any fire arms or items that could be used as weapons like clubs, bats, or knives. If you feel in danger dial 911 and the EMTs would take him for a psych hold at the emergency room, from there you could have him transferred to a geriatric psych unit and start that process. Please be vigilant about your safety.

toolbeltexpert

Lanajoy welcome to the forum and sorry for the reason you had to find us. I had to go thru much of what has been suggested, my dw went to a geripsych 7wks then a short stay at a rehab,nursing home then to mcf. The most important thing I did was to get a dpoa, durable power of attorney, I got it by telling my dw it's was in case something happened to me that she would be taken care of that made it about me not her. Without that I would still be trying to get the help she needed.

Document what is going on video it, write it down it is very helpful especially for you in case you think you made the wrong decision. I have to keep reminding myself of this.

When and if you get him in a geripsych, make it clear you cannot keep him home, your safety and his is at stake don't back down ever. I know this isn't going to be easy but it is necessary. There will be lots more to offer their experiences.

Don't worry about rambling on, venting we all do it, and it is helpful to get it out.

Stewart

Ed1937

The "Lessons I learned" posted by Veronica leaves only one thing out, IMHO. Number 12 should also state that the room you identify as a safe room should have a window that you can crawl out of if necessary. If he breaks the door down, and there is no way out of there, you are in trouble. But LT gave us a really good post with that one.

jfkoc

W/O reading all of the above I suggest using the telephone first.

1. Ask what specific training program us used for new staff and ongoing.
2. Request a copy of their contract.
3. Request a copy of their license,

If any of these raise a red flag cross them off your list.

I agree that a local support group is one of the best places to get the "clear dope" on everything from facilities to Drs to agencies.

Nowhere

Is he aggressive with others? If not, I’d tell him up front that if he has any control of himself he’s to stop the bullying because next time you will call the police. Get a plan. Find a safe place for you to get away from him and call 911 the next time he pushes, touches, or threatens you in anger. Tell the police he threatened you and you do not feel safe and they will have to take him to the ER. Once there, you’ll have to refuse to bring him home by asking for a psych hold.

Be strong. Be proactive. You matter, too. One cannot live like this. I’ve been similarly through this with my husband although he was not physically threatening but more paranoid where he would accuse me of poisoning him and he’d call the police on me. He’d make doctor appts for himself and not tell me and he couldn’t drive there! He was fearful of me not being able to understand or see his own cognitive loss. He’d jump out of my car, too, with bouts of anger/depression/rage. His doctors would not prescribe anything for him as he might feel loopy and be a fall risk. It took a trip to the hospital for the doctor to diagnose somatic delusions and prescribed Seroquel which helped change his behavior within two days! Sadly though, he continued to be troubled that extended family was stealing and he started hitchhiking, and trespassing. I needed to eventually place him and was able to visit facilities with him under the guise I was looking for my elderly parent, but pre explained by text or phone call to them that it would really be for my husband and he’d be with me at the appt. By taking him they had a good idea if he’d be a fit. Sometimes he would say during the conversation that he liked the place so much and we’d laugh that maybe we should both sign up. You can approach it as retirement living for the pair of you? 😉Make it fun trips. Include lunch. Fiblets necessary!

Good luck!

Marta

I strongly endorse the advice about admission to a psychiatric unit. I had to go that route also: aggression>ER>behavioral health two weeks>MC.

You can do this!

LanaJoy

Thank you all for your advice. You have opened my eyes and made me see my situation for what it really is. For the record, he is 77, not 87. That was a typo. Not that that makes much difference.

MNChicadee, your advice about having a safe room that I can lock myself in worked until he broke the doorknob and the lock no longer works. I now flee to my car and lock myself in for safety. I also recently learned how to make emergency calls on my Apple Watch which I always wear.

I didn't know about geri-psych hospitals which several of you mentioned. Recently, during one of his rages against me he stormed out of the house. I did not follow him out because I was relieved to not be in the same room with him. Apparently he was out on the driveway yelling at passing cars. A neighbor called 911. When the sheriff brought him back to the house the officer was obviously concerned for my safety because even then DH was trying to pull me away and shutting the door on the officer. The officer kept asking me if I would be ok. Rather than being honest with the officer I reassured him that I would be fine. I think partly out of denial and partly out of embarrassment. That would have been the perfect opportunity to have my DH transferred to a geri-psych hospital.

He is only aggressive with me. When he is around other people, even around police officers, he is turns on the charm. I am hopeful that would his aggressive behavior would not keep him from being accepted into MC. When he is not agitated he is kind and affectionate. He's all "I love you" and kissy kissy. But now you have opened my eyes to what can happen if I am not proactive about protecting myself because his bad behavior is escalating at a rapid pace.

Victoria2020, I took your advice and contacted the neurologist today and explained my situation. She called in a prescription for seroquel. I am crossing my fingers that it will help.

ED1937, your practical advice for vetting MC was exactly what I needed. This is all so new to me and everything seems to be happening so fast. It's hard for me to wrap my head around what my life has become.

M1

The Seroquel is a good start, but still. If you don't proactively hospitalize him, he will likely be sent there from memory care the first time he blows up. The memory care facilities will be more receptive to assessing him if the referral comes from a hospital than from you directly, i guarantee you.