In a nursing home, what happens when a person is disruptive?

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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.

Care Decisions Skilled Nursing Facility

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It's best to speak directly with the administration of the facility you are considering about such matters. There is no across the board answer that would apply to all nursing homes as to what they'd do about disruptive behavior. Private pay Assisted Living and Memory Care communities can ask any resident to leave for a wide variety of reasons. Medicaid paid nursing homes have different rules.

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!

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For sure … speak to director in
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!!

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Have you ever consulted a Geriatris Psychiatrist about your husband's combativeness?

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.

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Not yet. It would require a very long drive and my husband is not very mobile and even a drive to his doctors appointment just about does him in. I'll speak to his primary doctor about this option. Perhaps an online consult.
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.

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This is disturbing. I would talk to his doc to see what can be done now for your own well being. Probably could benefit from some meds to calm him down, Both of you will be happier.

I guess different facilities may have different rules. Call a few and ask?

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This might not be very encouraginging, but when my neighbor was placed in a nursing home, he was very disruptive, to the point of turning over chairs and throwing things! The nursing home folks called the police and he was taken back to the hospital that put him there. From there the hospital called the family to come get him. And he was on several pain drugs, I believe Xanax was one of them. I think one thing that made him so agitated was he was a smoker and, of course, he wasn't allowed to smoke in the nursing home.

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Your neighbor could have refused to bring him home based solely on the safety factor for everyone, alone. The only answer may have been the psychiatric hospital.

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There really aren't any alternatives.

Home or a Facility. that's your two choices.

You can hire a Live In or Cargiver help at your home or go to a facility.

Faciliries are way understaffed and one could wait up to 20 minutes just to get an answer or help from an aide.

Most people are medicated and the more of a problem you are, the more medicated you get which I think can lead to being made zombie like, also can cause more falls and being depressed and suicidal.

Best if you can figure out a way to keep your lived one at home.

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My mom was kicked out of a memory care facility because of her behaviors, hitting, kicking, biting....

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.

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gladimhere,
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.

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Thank you all for your replies. He's somewhat of a spoiled person. He wants what he wants when he wants it and mostly in the past he was able to get what he wanted.
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.

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ToniTired,

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.

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Since your husband has disruptive behaviors, please talk to a geriatric psychiatrist to help evaluate and treat him for these behaviors. Many times this behavior is due to high levels of anxiety, agitation, and frustration. Consistent routines, consistent environment, and anti-anxiety medication should quell most of this. Unfortunately, sometimes facilities must ask families to remove their loved ones since others' safety is being threatened.

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Hi Taarna, I have been working with a geriatric psychiatrist for several years because I kept him home for 8 years. The memory care facility has used 11 different meds in the last 15 days, I just wish they would let it get in his system before he starts a whole new cycle. Has of today he is back in the hospital with a elevated heart rate and lethargy and not eating I am at my wits end because now I feel like I should have kept him home even though he was aggressive toward me.

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My husband is in a memory care facility and he got aggressive with staff he ended up being removed and taken to the hospital from there he was put in a behavioral hospital which they monitored him and changed his meds, from there he was sent back to the same memory care facility I was so afraid he was going to get kicked out but they took him back , I just hope and pray he behaves now.

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JSunny,

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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Memory care units and nursing homes should be equipped to handle agitated and disruptive people. These are common symptoms of dementia and it might be worse if a person is hard of hearing. Talk to the staff about how they handle this. There are gentle ways to redirect people to get them on a different topic or train of thought. Talk to his doctor about this and see if there are calming medications that might help. My mother's doctor prescribed melatonin, it's natural and has to be taken every day to build up in the body. It can be calming and help sleep.

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You may wish to consider the use of medical marijuana to see if this can mitigate the behavior prior to the use of heavy sedation type medications. The indica strains usually present with a calming relaxing effect. The availability in tincture and edibles make for easy consumption and control of the dosage. I give husband and a ThC/CBN tincture at night. He usually will sleep about 8 hours before getting up to go to the bathroom He is usually docile but has started to become agitated when he sees certain people, pictures on tv or in person. He gets a real angry face and calls them jack***. Praying this will stop and I’m seeking dispensary help and marijuana doctor input on ways that may curb this. My experience has been that many behaviors are transient. It will pass and a new surprise will await us.

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I had never thought of that. He's only awake for maybe 8 hours in a 24hr day. I've never really taken not of how long he sleeps but it's a lot. I'll talk this over with his primary doctor also.
His outburst are short lived, it's just irritating that he starts each day this way. Good idea to look into.

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Because of where we live, I have been in the process of getting ready to move. We should be out of here in under 2 years. If he lives that long, we will move to a house in a town 3 hours drive from here that has services. I posted the question because I've been going through all our financial papers and getting ready to see an attorney. I realize that I won't be able to keep him at home forever although I would prefer it. My hope is that he is able to die at home. The thought of AL crossed my mind but unlike most people neither of us are social creatures. I get exhausted around people so that idea didn't last long. But it's a good one. So if it gets to a point where I can't do it anymore, and we are where there is help to hire, I will either hire full time help or depending on finances, put him in a NH and hope he behaves himself.

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I met someone I hired when I was wrongfully put on hospice in 2013. Lived in OREGON at the time. This woman & I became so close & when I moved to AL in 2015 to take care of dad, I got sick, called my friend & she left her home, sisters, grown children & the only life she'd ever known & flew 3000 miles to help both me and my dad. She promised she would never leave me & she hasn't almost 8 yrs after that promise .I have no friends really. Homebodies. If you can find a livein, DO IT. The kittens are recent I wrote about ealier. With her and them, life isn't that bad dealing with an abusive man. Pray about it. Ask if roles reversed, would you want him to toss you out when things got tough? My parents married for life, 64 yrs. He NEVER put her anywhere, even when he was diagnosed with prostate cancer. Remember the good times and why you married him. Seems that some who respond with the "get rid of them" attitude don't know that kind of commitment.

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I don't know all the answers but I am assuming they will try certain medications to calm them down; or they may isolate them in a particular area where there is more supervision. In some cases they might be placed into another more suitable facility. However, I think they are trained to deal with situations like this and will take appropriate action. Whatever happens, NEVER LET THEM COME HOME WITH YOU

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ToniTired: Imho, perhaps your husband needs to see a geriatric psychiatrist and I did see your other post of eleven hours ago.

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Different homes can deal with different residential problems, if someone is admitted they cannot cope with then they will require the person be moved, so look for somewhere that takes people with a range of problems, and who can cope with a range of residents so that he would not have to move if needs become greater.

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When my dad became angry, verbally abusive, telling all the nurses they were going to hell because they wouldn't listen to him & do what HE SAYS or they can't be saved, they called me. I went & when I got there, they said, "Thank God you're here.!! We don't know what to do with him". Same abuse he dishes out to me at home 24/7. The suggestion was a psychiatric hospital. I worked in nursing homes for years. My dad was in a regular hospital. He was very ill, too
I brought him home because my personal experience with nursing homes is that I will take anything he dishes out before I would put him in one. The lack of care and the abuse these places serve up would HORRIFY YOU if you knew what really goes on. If you have ANY OPTION, KEEP HIM HOME. They can't help what they're doing. It's not their fault. Best advice I ever got was to take it, understand their sick and go in your room and cry it out. I got myself 2 kittens who give me such joy & change my mood INSTANTLY when they look at me with those adorable faces. Dad doesn't like them so I g9an Emotional Support Animal letter from a Psychotherapist online called Pettable so I tell him they are a Dr's order, like insulin & he wouldn't take that away, would he? He really likes them mow and LAUGHS watching them run and wrestle. Maybe something like this could help you with his agression??? Like I said, I will do whatever is humanly possible to keep him away from a place where no one there loves or cares like family.

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In a nursing home, what happens when a person is disruptive?

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