ToniTired Asked October 2021
In a nursing home, what happens when a person is disruptive?
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When my mom was in a nursing home, a lady was admitted who was very loud and angry and verbal. One day she was there and then she wasn't. Do they kick these people out? If they kick them out, where do they go?
My husband is loud and sometimes combative and I'm worried that if he goes in, they would kick him out.
I like to look at all the options and be prepared before I take action on anything to see if there are alternatives if need be.
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A disruptive resident may be sent for a psychiatric evaluation to see if meds can be prescribed to calm the behaviors before being sent back to the community. Again, each facility has it's own protocol for such matters. Your best bet would be to involve your husband's doctor to get his behavior controlled before placing him so you don't have to stress out about the what if's.
Good luck!
person before you decide …
ask neurologist/geriatric about meds
Chances are these could be somewhat mitigated , but don’t expect a complete turnaround … mostly it’s raw personality combined with anger and fear !!!
and tell them you don’t want him drugged and sleepy all day.
lots variations in homes … make sure you’re upfront before deciding.
actually who wouldn’t be angry anxious and fearful in their situation!!
If he can be better managed at home on meds that ease his agitation and possible delusion that he's under attack, that might make it easier for you to care for him at home.
We don't live where there are anything but primary care doctors who rotate like clock hands and contract doctors at the closest hospital. Full Alzheimer's testing is about a 4 hour drive from here. When we get moved, it will be much closer.
I guess different facilities may have different rules. Call a few and ask?
She was on hospice at the time; they recommended a smaller care home. It worked better for mom, but yes, she was pretty heavily medicated. Everything else was tried, that was the only option. They had tried everything to try to get her compliant..
If hubs were kicked out of a nursing home I don't think a care home would be able to provide the level of care he needs. My mom was pretty healthy with the exception being her dementia.
Get him evaluated for hospice that may give you some additional ideas. There are geriatric psych facilities. You have more options than home and nursing home. There IS AN ANSWER.
From what you are telling us he should never be left alone. You need to find a place for him. Start by contacting the Area Agency on Aging of Human Services in your county.
I totally believe you when you say that sometimes there's no option other than heavily medicating someone. I've seen the behaviors and as a caregiver have often been on the receiving end of hitting, punching, spitting, biting, shoving and I'm not even going to mention the verbal assault and obscenity someone with dementia is capable of. Medicating is often the only option even when the person is in a care facility and there's a full staff. This is for the safety of the other residents, the staff, and themselves.
There's always a choice though. No one has to keep someone at home who cannot be cared for at home. A care facility will take assets. All are all greedy. Medicaid itself is reasonable to deal with though. They will not put a spouse out on the street or force them into penury and hardship.
They will not however preserve an estate so heirs may inherit it at some point. It breaks my heart to hear so many burned out and desperate people who are family caregivers saying there's no choice but to keep the person at home. There is always a choice. It might not be what everyone wants or likes, but it's available.
He uses a walker and wants to use his crutches which I won't give him. When he told his doctor months ago he wanted the crutches the doctor said he needed a PT evaluation first. That was many months ago. Our small town has been hurt badly by COVID and there isn't an appointment to be had at the PT. Plus I don't know if the doctor ever followed through with the PT as my husband is at risk of falling backward. Our rural hospital and medical offices seem to be in turmoil.
He yells at me that he wants his crutches everyday, somedays more than others. He is very angry because I won't let him have them. He would be a danger to himself on the crutches. My first impulse is too yell back at him but I just walk away.
When he was in the nursing home after a horrific accident when he fell from lack of O2, they were going to kick him out because he wouldn't follow their instructions in the PT department when he was learning to walk again. He was just being an a**. When he finally understood, he straightened up and minded.
I had not considered drugs. I'll send the doctor a letter so he will have what I'm seeing since my husband gets mad when I try to talk at the doctors visits. There are also things I'd like to tell the doctor that I wouldn't want to say in front of DH.
Maybe I'll also remind DH about the last fall he had which did so much damage.
Even if your husband is used to getting his own way most of his life and wants what he wants when he wants it, does not mean that one person (you) can give it to him.
What happens if (God forbid) something happens to you? Your husband goes straight to the nursing home. If he's disruptive and combative in there they will be the one who deals with it if you're not available to. So don't worry about that.
There's another option for the two of you if you want to live together. Moving somewhere else. There are assisted living facilities where spouses live together even if only one of them needs care. I worked in an AL like this and it was nice. The residents each had like a small apartment where they lived. Meals were served in a lovely dining room and there was staff around 24-hours a day. Some of the residents were married couples where one was ill or had dementia and the other didn't. In our facility when a person's dementia advanced or their other conditions worsened to the point were they needed a nursing home, they were moved to one. Their spouses stayed with us.
Why hold onto a house and have to keep up a property at your age with no one helping you? It's not worth it.
If you have to put your husband in a memory care facility, you could move to an independent senior community. These places are nice and you wouldn't be alone. Please look into some different options. You don't have to be 100% of the care plan. Good luck.
That's how they do it now in nursing homes/memory care. When a resident is getting aggressive they have to send them to the hospital. There's every intention of taking them back though. This is the way it has to be because care facilities aren't allowed to use restraints anymore. Not just literal physical restraints to immediately stop a resident who's being violent, but chemical restraints aren't allowed either. A nurse in an emergency can't just give a person like this an injection anymore and they calm right down. The use of restraints was very abused in nursing homes for a long time. So of course the answer to this abuse of restraints is "zero tolerance" in care facilities. All that means is zero thinking. There's no such thing as discretion and professional judgment allowed anymore in care facilities. Sometimes a person with dementia has to be restrained either physically or chemically for their own safety and everyone else's. Care facilities aren't allowed to so they send them out to the hospital where they tinker with meds and send them back.
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