A good Geri psych is hard to find and even harder to get into

clarinetist · June 12

The quest for psychiatric help for my DH continues. My husband came home from 2 weeks in an acute care Geri psych unit not much better than when he went in. I’ve been trying to get him into one of the two non-acute Geri psychs in our state so that all his psychiatric meds can be adjusted. Apparently the acute facilities just focus on getting him calm enough to get back into his memory care.

I found out (too late) that in order to get him into a non-acute facility, he has to be seen in an ER that is affiliated with the hospital that has the non-acute geri psych, as they only take patients from their own network of hospitals. Unfortunately there’s no guarantee that the ambulance that takes him from the memory care will go to one of those hospitals.

So when, 4 days after being discharged, my DH experienced severe agitation I had to take him in my car to the ER affiliated with one of the non-acute Geri psych units. He spent the night in the ER, and this morning the hospital social worker told me there were no beds in the Geri psych unit, and he could not stay in the ER to wait for a bed. There was an opening in an acute Geri psych unit in another hospital, and he had to go there. So this evening an ambulance took him to another acute Geri psych facility.

To add insult to injury, this hospital is an hour’s drive (one way) from my home, and you’re only allowed to visit for half an hour each day. 2 hours of driving for a half hour of visiting.

It now feels as if getting good Geri psych care is a roll of the dice. If you take your LO to the right ER and if there happens to be a bed open when you do, your LO can get the more comprehensive treatment.

I can’t keep subjecting my DH to hospitalizations, however, in hopes that I can find a magic drug combo that keeps him calm, but not too sedated. It may be that the best outcome I can expect for him is to be fairly heavily sedated in exchange for not feeling anxious. At this point, I think he and I would accept that.

trottingalong · June 12

I’m so sorry. I live in a remote area where we are approximately 6 hours away from any Geri Psyche facility. We have a small hospital here with few doctors. No one specializes in anything close to dementia awareness. Driving two hours round trip for a 30 minute visit almost seems not worth it. I believe this is a dilemma throughout the US. If you don’t live near a large medical facility within a heavily populated area, you are out of luck. I hope you have an outcome better than some solutions of heavily medicating a person. Keep us posted.

M1 · June 12

I too am so sorry. Our system is soooo broken. I wish the public will were there to make changes.

housefinch · June 12

How stressful! I’m very sorry you’re facing this situation. Agree with @M1. Hopefully someday things will improve.

Dio · June 12

I know exactly what you're going through. When ambulance took my DH to the local ER, of course, they wanted to release him the moment he calmed down. I didn't know that I could refuse to take him home when I feared for my safety. So I took him home only to have this repeated 2 days later. This time, the ER person who called me to tell me DH is being released was nicer. He told me this hospital didn't have geri-psych and that he had called all the places within a 50 mile radius. No one had a bed. DH could not be admitted to the hospital because he wasn't physically ill that required hospitalization. I realized then that our healthcare system is so f*cked up. He said he'll let DH stay in the ER since it was already wee hours of the night and that he's doing me a favor by letting me sleep…good grief!! When I asked the ER attending nurses what should I do if DH got violent again, they shrugged and said call 911. I said they'll just send him here again. They nodded. I was so angry I didn't know what to do with myself. Thankfully, DH's psychiatrist prescribed the right med after 3rd visit to ER, so we didn't have any more returns. But ultimately, I had to place DH in memory care.

I hope you can find a good neurologist who will be able to prescribe your husband the right meds. It was the only thing that saved us.

michiganpat · June 12

These stories make me so sad and angry! Our healthcare system is so messed up. It's taken me quite awhile to actually believe "the cavalry is not coming". I have seen it with my own family members and read it in these posts. Something has to change but until then all we can do is the best we can for our loved ones. Clarinetist, know that I and many others are thinking of you and hoping for a good outcome for you and your DH.

clarinetist · June 12

Thanks, everyone, for your support-it is so appreciated! I’m in the process of finding a new Geri psych for my DH. He has one, but I haven’t been able to get in touch with him for over a month, so it’s time to get him a new one. I know my DH will have to wait months to get an appointment, if I can find a geriatric psychiatrist accepting new patients, so I need to get the ball rolling.

In the meantime, knowing the acute unit will only do so much, I’m going to see today if they’ll try tapering him off the Seroquel and switching him over to risperidone. The first order of business, I think, is getting the aggression under control. He’s on a large dose of antidepressant, but it doesn’t seem to be helping. I would like to see if the antidepressant can be removed, but I know the psychiatrist can only change one thing at a time, so that will probably have to wait until I find a new geriatric psychiatrist.

I was pretty frustrated last night, but with a plan of action, feel calmer today. We’ll see how it goes at the new unit.

harshedbuzz · June 12

@clarinetist It's so hard. I'm sorry. I live in a very well medically serviced area and even here, it is a considerable drive and wait to get to see a geriatric psychiatrist.

When dad was acting out and I thought we'd have to go this route, the local Area Agency on Aging gave me the direct line phone numbers to the 3 area geri psych in-patient units. This would have allowed me to call ahead to see if beds were available to avoid this scenario.

HB

easy23 · June 12

My husband's geri-psych only does telehealth appointments. He does a thorough job in prescribing meds and has been a lifeline for me. I can text him whenever I need help. In addition to his own practice, he also works in a local hospital and at a few AL/Memory Care facilities. He was my mother's psychiatrist at a subacute rehab place. I looked him up on the internet and found his website. He was taking new patients.

Maybe you can find someone like this!

mrahope · June 12

I just want to add my experience to this thread, also. We moved from a suburb of a large city to a small university town so I could get support from my DS and DDIL. Since moving here, it took us 4 months to see a neurologist (DH has severe RLS in addition to dementia) and over 6 months to see a geriatric specialist. That specialist is not a psychiatrist but there is one in the practice. And did I mention these docs are a 45 minute trip away from where we live? If we had access to some better management of medications to control aggressive and agitated behavior maybe we could have held off placement a little longer. G-d bless the docs who do consent to deal with our LOs. I know it's tough to see patients who only get worse, but think of the families around them.