Sending someone in memory care to inpatient behavioral health

Merla · February 5

So my parent increasingly has been having delusions and consequently was aggressively exit seeking this morning. The memory care is on the ground floor and the hallway doors to the outside actually do open if one presses on them for 30 seconds. She refused to come back inside. As I understand it she went outside to both the courtyard as well as the parking lot and also it's freezing out. There were some episodes of her being highly agitated and yelling at people. This is a dramatic change in behaviors that has happened in the past several weeks.

So they are sending her to a behavioral health hospital via ambulance. I was very caught off guard. I thought that memory care could deal with anything in house. I just don't see this going well but it seemed like I didn't have a choice in the matter. What am I supposed to do?

April23 · February 5

Can someone get there to be with her? I’ve never heard of this but my concern would be anti-psychotics or other medication being given. Hopefully someone here can tell you more. I would think as POA you could refuse it but maybe I’m mistaken.

At my dad’s current MC RCF, a code is required to unlock the doors and is not even given to families or visitors. A code was also used at his previous MC AL but families were allowed to have it since we took an elevator (which I would not choose if I could do it over).

Please keep us posted!

Merla · February 5

I think the issue is that the memory care is all one floor. So the main entrance has a code but I think she was going out the emergency exits in the hallways.

I was shocked that they took her to a hospital because I thought memory could deal with pretty much anything.

jen ht · February 6

Could she have a UTI? Do you know if they checked that already?

Thinking of you both

H1235 · February 6

My concern would not be that they might put her on antipsychotics, but why her doctor ( I assume she sees one at the mc) hasn’t put her on something for the delusions and agitation before things got to this point. You said it has been a few weeks. I don’t know how you deal with this from so far away.

terei · February 6

Best to find out if the hospital she is going to can help with geriatric psych issues. She should be assessed and medicated appropriately tp control her behaviors. MC does not have the capability of ‘handling’ physical aggression and out of control behavior unless they have a dr available that can prescribe meds and closely monitor the results, which would be unusual. I would be happy they are being proactive about getting her to a place that can help her.

Merla · February 6

her behavior to me sounded like within the realm of normal dementia behavior but escalating.

They did put her on seroquel but then took her off of it bc it seemed to be making things worse and were going to Try another med next week once the seroquel was completely out of her system. The memory care administratle positioned this hospitalization as efficient medication. Management and safety. However it's like what choice did I have in that they decided she needed to leave for "safety" reasons so my choices would have been to discharge her from memory care or what?!!! I asked for her to stay in the memory care and they didn't give me this option.

it also seems ridiculous that thr facility has emergency doors at the end of the e hallways that aren't locked or can't be locked but supposedly this is per state fire code law. So she cracked the code of getting out of the place simply by pushing on the door for 30 seconds.

So now she is disoriented on a geriatric behavioral health unit where they allow very little contact from anyone.

Merla · February 6

Also she is at a high end highly rated well regarded memory care so part of me thinks they were more concerned about her behavior being disruptive to others and people and family would complain about the door alarms going off and scenes at the reception.

SDianeL · February 6

emergency exit doors in a memory care facility must unlock to allow evacuation during an emergency despite being secured against wandering. These doors typically feature delayed egress (opening after 15-30 seconds), magnetic locks that fail-safe (unlock) upon power loss, or release automatically when the fire alarm/sprinkler system is triggered. The facility doesn’t have the staff to watch her every minute. It’s not they can’t handle it, they just aren’t staffed to. Once her meds are regulated she should be able to return to the facility. If she still tries to escape you may need to hire help to keep her safe.

Merla · February 6

So this is what the memory care administrator told me. And the same thing about the emergency doors except that it's unfortunate those doors lead directly outside to the courtyard or parking lot or street so it's a bigger issue to be exiting seeking than if she wasn't on the ground floor. I am just shocked bc she is at memory care to receive specialized care for dementia yet her situation is spiraling out of control and and her symptoms are not being managed well in this setting. However I'm concerned about her being scared and disoriented by herself I the geriatric behavioral health unit and would have rather her stay there in the memory care where she is in a familiar setting and around familiar faces.

Merla · February 8

I've been calling my parent at each of the three phone times just to let her know I'm working on getting her out of her and so she doesn't feel totally abandoned. Does this sound helpful?

H1235 · February 8

https://alzconnected.org/discussion/comment/265537#Comment_265537

I think it sounds like you don’t think she should be there and that you don’t trust them. Giving her this impression may make her fight her care there by refusing to comply with necessary treatment. It may make their job more difficult and in turn her stay even longer. Just my opinion.

Merla · February 8

so she ended up having a terrible uti so what a joke. The memory care was suppose to test for this but then didn't because that day they couldn't get a urine sample.

So I don't think she be there bc the uti was likely driving a lot of the behavior. So I do want her released asap and the memory care Dr can figure out her medication there. This behavior unit is off the charts terrible. Like injecting people left and right and the environment causes much worse behavior than ever happened at memory care due to confusion and disorientation. A total nightmare.

Merla · February 8

She is super drugged out.

im really mad at myself for not figuring out how to prevent this and this is a totally traumatic experience and even more so when the major cause was uti

April23 · February 8

https://alzconnected.org/discussion/comment/265586#Comment_265586

I'm so sorry! Can you get her released back to the MC? Just focus on getting your mom better, out of this unit and then you can plan what is best for her going forward.

Merla · February 8

yeah this is what I'm trying to do but this hospital situation is terrible and it's somewhat out of my control to take immediate action in that no one is calling me back who has the power to release her. Such a total nightmare. I feel like the memory care escalated this situation unnecessarily so and gave me no warning ie they just called me to inform me they were calling an ambulance so what choice did I really have or time to ask questions or plan or think up alternatives or complains to corporate. I'm seriously irate about this and even more so because I can't get her out of there. There literally are so many better ways to have dealt with bad behavior caused by uti.

when she gets out of there I am going to make a seething call to corporate and we have a care meeting coming up but it's like the traumatic experience has and is already happened so it's not something they can fix

tboard · February 14

https://alzconnected.org/discussion/75294/sending-someone-in-memory-care-to-inpatient-behavioral-health

She was in the wrong facility if she was able to get outside into the cold. As someone who has dealt with parents with dementia and now a spouse with dementia I can tell you that their behaviors can change quickly and suddenly. Sometimes the changes are permanent other times they happen occasionally and then more and more often. You say the changes happened over several weeks. That sounds pretty normal for someone with dementia. Blame the disease.

Sending someone in memory care to inpatient behavioral health

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