Is a memory care unit or nursing home better?
Is a memory care unit or nursing home better for my mother who's in stage 6 of Alzheimer's? I am her caregiver 24/7 with Thursday off for respite care to come in. I'm trying to decide if she should be in a memory care unit or nursing home.
She's combative - at least once a week. She hallucinates and get angry every day sometimes as long as five hours or more. Angry to the point I'm afraid she will have a heart attack. The only activity she can do is fold clothes.
She sometimes doesn't know how to use utensils while eating. She refuses her medications, so I crush them up and hide them in food. Every morning there is feces on the floor in the hallway, smeared on the counter top in her bathroom or she wets herself. She gets mad when asked if we can go change clothes. She swears when she's mad and she NEVER use to swear
She's currently taking: Namenda (5 mg @ bedtime), Aricept (10mg @ bedtime), Seroquel (2 - 25 mg breakfast, lunch, dinner), Trandolapril (4 mg @ bedtime), Sertraline (50 mg @ bedtime) and Singular (10 mg @ bedtime)
I honestly thought I would be able to care for her until she passed, however, I am realizing I can't. I just want one move for her. If a memory facility is the best then, i have a place ready for her. I have learned so much from being able to take care of her. I have been blessed. She doesn't know who I am or who she is. She has a lovely home on the bay and can watch the fishing boats come in and out all day long. I hate to take that from her, but sometimes, she doesn't see them either.
what is a memory unit? i need to know
At this point, no memory care facility will take her.
She is ready for a nursing home, or may end up in a geriatric psych unit. Your mother is a danger to herself and others. You have done all you can do.
If you are unsure as to how to proceed, next time she "gets angry," call 911 and report a geri-psych emergency. Paramedics will come and hospitalize her, where she will be evaluated for placement.
My heart goes out to you, but you have done all you can...
My first thought was to recommend namenda which proved to be a life-saver for us. We gave Mom her meds in her morning Ensure - smashing all but bp meds so she didn't see them. Maybe the dosage could be increased. Like your mom, Mom would have never said a dirty word but b-4 namenda, could rip Daddy & I apart like a drunkin sailor. lol She was physically fine & could get around. She never forgot Daddy & me. She called all the children Precious if/when she couldn't remember their names. Mom passed in March & Daddy right behind her. It was very difficult & other people had all kinds of solutions to "the problem" but never any time. We chose to care for Mom in her home of over 50 yrs. We had a couple grandchildren & 1 daughter who helped me & gave Daddy a break once in a while. Maybe someone could come into your mom's home to help you? She could continue to watch the beach? After your mother's passing, the memories & what YOU have done caring for your own mother is what matters! It doesn't matter what others think or what they thought. You will know in your heart that you did what was right for the woman who raised you. I can only speak for myself. I was an only child & my parents were older when I was born. We survived but it was very very difficult. I have peace of mind & self-satisfaction that my mother & father passed from their own beds in their own home. I have been blessed. I know in my heart I did what was right for us. Only you can make that decision. Take care of yourself ~
A memory care home is an assisted living type of facility that specializes in caring for those with dementia or Alzheimer's disease. There are homes that will care for those suffering with behavioral issues like those written above.
Harbor House Memory Care, which is a small family owned company based in Wisconsin has been quite successful in working with behavioral issues and has developed a nationally recognized training program called "Safe Harbor" that helps team members safely and lovingly provide care through all stages and issues related to Alzheimer's disease and dementia. There website is www.myharborhouse.com if you want to learn more.
Please contact your local Alzheimer's Association and ask for help with this process. It's a free call and you will be very thankful that you did!
I'm somewhat new to this process of caregiving to a family member, my Mother-In-Law. My hats off to any person that does provide the caregiving, it is hard and does test one's patience for sure. Question: What is stage 6? I have seen others list different stages on this site before and I asked our Neurologist and he had never heard of 'stages with #'s" only mild-moderate-advanced levels as a way of discription. My MIL was just put on Nameda and is on the Exlelon patch. My heart goes out to you.
Maybe the meds themselves are part of your mother's issues. Some people become more disturbed on psych meds and sometimes maybe it's the mix of the meds. You need to have someone competent to assess your mother's meds and it would be worth getting her to a psychiatrist for this.
I only say this from having seem families whose loved one had some of these behavior issues being helped once a really good medication review was done.
Nursing homes really are very inappropriate places for people whose main issue is dementia. But for your poor Mom, and for you, i wonder if she really has dementia or whether she actually has a previously undiagnosed mental illness. it's really very important to have answers to these questions. for you, for her and for her future appropriate care.
in my 20 years as a professional caregiver of people with dementia, those with as wide a range of continuing and intensive emotional issues as your mother seems to have, the center of those either was either medication or correct diagnosis.
i do urge you to push to have both thoroughly checked out. it might be the saving of this situation.
the saddest thing that goes on in the whole dementia world is that outsiders, even medical ones, too readily throw every old person into the dementia or Alzheimer's basket, when sometimes quite different issues are really going on.
i'm not trying to diagnose here, just to help you get to someone who really might be able to help more accurately to relieve your mother's suffering and the great burden of pain on your family.
with the right diagnosis and the appropriate medication, your mother might do very well in a small kind care home.
Galowa, I cant believe from one letter you are telling this woman she has done all that she can! You cant know th complete situation, and to say that no memory care facility will take her, is wrong! Call 911 on your own mother that is suffering from sth, but that sth is not alcohol, or drug abuse! I think Frena might have hit th nail on th head with her suspicions that th underlying reason maybe th medications. just because certain meds, taken in certain doses, at specfic times of th day, work for ten patients, doesnt mean thy will automatically work for th 11th! CJL doesnt gv any info on whether her meds are th same shes been taking or if shes tried many. I hope tho, that if her meds have been questioned for compatability, and/or to combat th behavior problem, that smbdy will try this before moving th woman from a home im sure she would hope to pass from. then again i do not know th situation either. maybe she'd feel safer in a hospital. this is why im going to make a living will ASAP. So my loved ones know my wishes. Th only thing I think Im able to say with certainty about this woman Iv never met, but am told never cursed, is she wldnt care to have th police called on her!!!
Have you ever heard of Validation Techniques for Dementia Care? It is a method of communicating with the old old (age 80 and older) with dementia, for a large percentage the Validation method also helps in reducing and sometimes stopping problem behaviors. The founder of the program is Naomi Feil, you can find her books at Amazon.com, in many Area Agencies on Agencies resource rooms, and possibly at your local library.
My advice to you is to first seek out medical assistance. There are medications that will help your mother's moods. This doctor has to be a geriatric specialist - a regular MD will probably not be of any assistance. Get those behavioral issues under control. There are facilities that will take your mother that are memory care or dementia units and those are the appropriate place for her. Nursing homes have two issues - they are not as highly trained as speciality units to deal with the special needs of a person with Alzheimer's or Dementia. Second - the bells, alarms, activities, noise etc, will drive your mother crazy in a nursing home. She needs the low stimulation that a memory care/dementia unit will provide. I have been through all of this with my own mother and have learned everything the hard way. Any facility you put her in needs to be watched closely that they are providing the care your mother needs and deserves. You must be your mother' advocate to insure the proper care is given. If she is mobile and able to do some things for herself, she is certainly placeable in a memory care/dementia unit. Find that Doctor - even if you have to travel a ways - it will be well worth it to help your mother find some peace with this terrible disease. Good luck and my thoughts and prays are with you.
and i do want to, again, also urge you to have your Mom assessed by a psychiatrist who will be better able to work out what exactly is going on with your Mom. then her medication can also be reviewed usefully at the same time. please make an appointment with a psychiatrist. before that, make a full and careful (non-accusing) list of her behaviors to take with you. my friend eventually got her wildly-out-of-control 80-year-old Mom psychiatrically assessed (with my encouragement). she turned out to be a never-diagnosed bipolar person and had previously often self-medicated with legally prescribed hydrocodone to which, the psychiatrist said, she was actually allergic (which added to her wild behaviors). she is now appropriately medicated, not drugged out of her skull, and is peaceful, emotionally available,friendly and as smart as ever and my friend says, "I never had this Mom before." They talk, laugh, joke about and relate in ways never before possible. So, with the right help from the right person, peace and communication can become possible. At that point, you can decide how to go further in your plans. Good luck to you.
To ALL Contributors:
Galowa here, standing by my initial response.
THE POSTER HAS CLEARLY DONE ALL SHE CAN DO...
And yes, I can tell from ONE LETTER.
Let's read with care people... and let's control ourselves when responding...
This poster's mother is CLEARLY already under the care of either a psychiatrist, neurologist or competent geriatrician, and this can be discerned by anyone who reads carefully... You can tell by the INTRICATELY SCHEDULED medication regimen her mom was on at the time of the initial post. When physicians begin administering meds, they usually start with a low strength, once or twice daily dosage. Gradually they increase the strength of medication for effect, and tinker with the SCHEDULE of administration in an effort to accommodate the needs of the patient and caregiver. The poster has a physician, and together they have DONE ALL THE RIGHT THINGS.
When I post here I try to TELL THE TRUTH. That is what I did in my first post on this thread, based on everything the poster said in her letter, and based on my own considerable personal experience. However, CAN ANYONE know EVERYTHING? Absolutely NOT.
So - LET THE FACTS SPEAK.
My mother's neurologist very recently informed me that there is no Alzheimer's "Stage 6" - or any other stage, for that matter. All there are, really, are amalgamations of symptoms. THE SYMPTOMS determine "how deeply into the disease" an Alzheimer's patient is. The "Stage Approach" is the medical community's attempt at helping families understand what even physicians still do not really know, which is - "how far gone" a patient is...
The original poster WANTED ONE MOVE FOR HER MOTHER.
That could not be assisted living, because they are not designed to keep you there "until the end." AND, even Assisted Living Facilities with "dedicated memory care units" CANNOT AND WILL NOT ACCOMMODATE A RESIDENT WHO IS "ANTI-SOCIAL." That INCLUDES combativeness, sexual impropriety, etc. This initial poster has a combative mother.
Based on HER OWN ORIGINAL STATEMENTS, the poster sought placement for a person whose symptoms she described as:
COMBATIVE regularly (at least once weekly),
HALLUCINATING DAILY for extensive periods of time, and
Responding to hallucinating with DANGEROUSLY AGGRESSIVE BEHAVIOUR,
NON-COMPLIANT with respect to taking medications,
NON-COMPLIANT with respect to personal hygiene
INCAPABLE OF MANAGING HER ACTIVITIES OF DAILY LIVING
Sometimes UNABLE TO UTILIZE EATING UTENSILS
INCOMPETENT around basic hygiene - spreading feces, etc.
INCONTINENT of both bowel and bladder,
NO LONGER AWARE OF HER DAUGHTER'S IDENTITY, and
NO LONGER AWARE OF HER OWN IDENTITY...
This woman's mother NEEDS CARE SHE CAN ONLY RECEIVE in a NURSING HOME.
Her daughter can no longer do it.
And Memory Care IS NOT DESIGNED TO DO IT.
IF one is unsure how to proceed, and/or a loved one becomes dangerously unmanageable, CALLING 911 is a reasonable and CARING thing to do...
PARAMEDICS come prepared to help with what is a clearly MEDICAL EMERGENCY.
POLICE may be in the background, but where I come from, we are taught that the POLICE are there to PROTECT AND SERVE. No fear there.
Only a source of HELP WHEN NEEDED.
I DO wonder what the original poster ended up doing?
I hope she and her mom are OK.
My heart goes out to her, one way or another.
And I STILL have no doubt she HAS done all she can...
I think you should get a second opinion on your Mom's meds. My Dad is on ano antidepressant and his aggressive behaviour is much better. Good luck with the decisions you have to make.
I believe, from personal experience, that 4 basic steps can help you in making a decision for future care: go to your mother's GP and request an MRI on the brain which will show the extent of any physical damaged areas, and some fo the causes; take those results to an appointment with a Geriatric MD; the Geriatric MD will most likely suggest an exam with a Neuro Psychologist, who after an extensive exam with your mother, and a short interview with you will then document her findings together with her recommendation as to the extent of care needed. I hope that if you choose this course of action that it helps you, in that you will have answers to her exact medical condition, a prognosis, and the avenues for possible care. At the very least, both of your needs and well being have to be part of your decision. I hope you find inner peace in your decision.
My heart goes out to this woman. I'm sure she has moved on, and I hope she has found peace. If she were to come back somehow and read this post I would tell her: I strongly urge you to at least tour a couple of memory care homes, either AFH's or nursing facilities, that specialize in Alzheimer's and other forms of dementia. From what you've told us, this situation has grown far beyond your abilities to cope and adequately care for your mother. (I say this as someone who has been through the same challenges of caring for an aging, much loved mother with dementia. ) My dear, if you won't consider this for your own health and safety, do it for your mom. Do you think your mother, blessed with her full faculties, would want you to suffer as you do? Yes, the transition is difficult, but your mother will very likely thrive in her new home eventually. She may feel much safer in a structured environment with trained staff to help her. In response to Cindy, who kept her parents in her own home, remarks such as "You will know in your heart that you did what was right for the woman who raised you" are unhelpful. What worked for your parents, may not necessarily be the same course of action for others.
To CJL, When I read a comment or message like yours I think I am blessed with my situation. One thing I do know though is the difference between having to be a caregiver for one's Mother and for one's spouse. My Mother died of Alzheimer's and I had her for her last year when my Father died. Now, twenty years later I have my wife with Alzheimer's.
I am not at all sure I know what Memory Care Unit is. My wife spends her days while I work for 8am to 5pm in a Day Care Facility for Alzheimer's. She is very well attended to and I would refer to the facility as a kind of therapy Unit for Alzheimer's people.
Personally, even if you promised your Mother she would die at home, I would if it were me, put her in a good Nursing Home. My wife is in her seven year and in the late severe stage of the disease and I don't have to contend with all the things you do.
You are to be commended for your effort in caregiving.......
God Bless you,
for everyone's info, a Memory Care unit is care dedicated specifically for the care, activity level and needs of people who have dementia. i believe, cynic that i am, that they call it Memory Care because that sounds softer that Alzheimer's unit. however, that is also more accurate since all Alzheimer's is dementia but by no means is all dementia Alzheimer's. so care constructed especially for the limits, needs and entertainment of those with dementia can be wonderful (and much more than most people could ever do at home). to know whether they are actually wonderful, always check the reports on every licensed place you are even considering. these days, they are always available on line. that way, you can see a) how the yearly inspection goes and b) what they were reported for and what the outcome was. that's usually where the down-and-dirty truth is, if there is any.
For "MountainToSea" and "jpreaves"
!!!! "HEAR, HEAR" !!!
Thanks to you both, for telling it like it is...
WE must make the most OF life - as it unfolds before us.
We don't have to like it, but ultimately we MUST accept ilife and deal with life on "life's terms."
Peace and Love to All,
CJL, please do what your heart tells you to do. It is too much for one person and one day of respite is not enough. You will be able to breathe once again. Memory Care Units have ratings; also ask on Facebook in your area and people will tell you what Memory Care Unit is best. That is what I have done. You are not alone!
It is time for you to rest. I know I don't want my children to have to deal with me if I ever get to that point.
This comment is for "GALOWA" whoever you are.
Your remarks are explicit and right to the point. I don't pretend to be one who knows everything....that's why I read these blogs! But I sense your experience and knowledge of this misterious disease called Alzheimer's. I think we need to be very careful how we judge any situation in regard to this disease. If I wanted medical advice I would go to a Neurologist who specializes in Memory Loss. I do think we can help each other here by expressing how we deal with a certain characteristic. And just because it works for one person doesn't mean it will work for another.
I have a very compassionate feeling for all those assisting anyone suffering with Alzheimer's disease.
God Bless you all,
CJL - Bless your heart. I can tell you really love your mom!
I am new to the caregiver role and my mom is in early stages. This website has been invaluable so far with all the advice I've read from "veterans" of our situation.
After reading everyone's comments so far, what sounds reasonable to me is to go to the Geriatric MD to evaluate the situation including the meds. I'd encourage you to check out Memory Care units in your area. They are specially trained to deal with all types of memory issues. Unfortunately combative, extreme behavior is common, the right facility would be able handle it but it is something that has to be addressed during the tour because some aren't equipped for it.
Also, there are places that have varying levels of care where she could be placed in memory care now then if needed transferred to skilled nursing if/when it is needed all on the same property.
You need a break and your mom needs more specialized care. My thoughts and prayers are with you.
As suggested above I would take a good look at the medications your mother is on. And rather than adding one...try sorting through what she is currently taking.
We have had personal experience with Aricept, Exelon and Axona.
We tried my mother in law who is in great physical shape but in the moderate stage of Alzheimers on Aricept and she became very nasty. Took her off it and she returned to her normal lovely self. We then tried her on the Exelon patch and once again she became very nasty. We discontinued the patch and once again she returned to her lovely self. We then tried Axona and even that made her nasty. Discontinued it and have our sweet mother in law back. Best of luck. I hope it is something as simple as her medications. You are a wonderful daughter.
I agree with Galowa. I am a licensed mental health professional and I evaluate people for 5150 hospitalizations. When a patient's behavior is that far gone they need urgent help. Where I live, the community can call us directly. I work for County Mental Health. We also work closely with law enforcement, so when families call the police due to an out of control family member the police know to call us for assistance in getting someone hospitalized. It sounds to me like the writer has done all that she could reasonably do. Calling the police is not a bad thing. The police are there to protect and to serve. They get calls like this all the time. The police know that the person isn't a criminal and that they need hospitalization. Granted, there are a few cops out there, usually the younger ones, that aren't familiar with the process or with what is available, but most law enforcement agencies receive training in how to deal with patients that are suffering from mental or behavioral issues. Also, most patients in that condition are not willing to seek help on a voluntary basis and a 5150 hold is sometimes the only way to force them into a hospital to be evaluated. I know this is difficult, but if you really love your family member and you have tried everything else you need to love them enough to make the call. It may help more than you know.
I recommend getting your mother a referral to a Psychiatrist; one who treats the elderly and is familiar with dementia issues. My mother is very calm and easy to care for now. That has not always been the case. The right medication for her is what has made all the difference in the world. But, this takes time for the psychiatrist to discover what works for your mother. Everyone is different. Right now, all my mother is on is 300mg. Seroquel XR at bedtime. (this is not a high dose by the way) She is calm, no more anxieties, no more "drive you crazy" obcessive issues. (Now, she does get on little issues but they are not unmanageable like they used to be). She is not "doped up". She actually seems a little more alert. Her "sundowning" used to be maddening. That has all but disappeared. When I heard you mention that you mother was on Singular, I couldn't help but remember when a couple of my family members took Singular for sinus/breathing problems. My brother and his wife almost divorced while he was on it. He was impossible to live with. Same thing happened with his grandson (3 yrs old)_He got so hyper and terrible to handle. Both of them were taken off Singular and no more symptoms. So, maybe this is some of the problem. But, back to doctors. Most likely, the psychiatrist will admit your mom into a geriatric psych unit in a hospital for about 10 days where they can administer meds and where she can be observed to see which ones help her the best. She will also be evaluated by trained social workers, etc. and they have group meetings during the day. The right medication is the answer to these issues in dementia/altz. It's a balancing act for the doctor. They want to control the issues that are making the patient (and caregive) so miserable, but they don't want to keep them "doped up. Psychiatrists are trained in giving antipsychotic medications. Other doctors not as much. Bless you as you continue to care for your mom.
CJL, While this is a difficult decision that I have been through with my mother, I found that she was much better after she entered a specialized, warm and loving Alzheimer's/Dementia only assisted living facility. Her behavior and agitation calmed immediately as they are able to provide the structure and safe surroundings that she needed and are able to monitor her medications and work with a specialized geriatic/pallative care physician to increase her quality of like. As difficult as it was for me to take her out of her home, I realized within 3 weeks that she was much better and I am so thankful that her neurologist gently told me that it was "time" for the assisted living.
Yes, do your homework and check out the facilities extremely well and monitor her general well-being. Yes, I recommend a specialized Alzheimer's place versus regular assisted living --I found that in regular AL, other residents without Alzheimer's or dementia can be very unkind to those with the disease and the Alzheimer's patients are usually segregated in another area of the facility. Yes, do not beat yourself up--our role as daughters, sons, etc. is to make those decisions in a loving way, but to indeed make them for our loved one as well as for our own well-being. It breaks my heart every day that my mother has this disease, but I know I have done what is best for her. Because of the wonderful place she lives now, she has been able to have dignity and wonderful care as she slips away from us. I can enjoy her on a one-to-one basis and not let the heartbreaking daily physical care required erode whatever time we have left together. My mother would want it that way, too, and that gives me unbelievable peace in light of the daily grief this disease brings.
I read all the wonderful insights....but to tell you the truth, to get the help you need is like finding a needle in a haystack. While my mother exists in La La land of Dementia...finding a doctor to go beyond Aricept is literally a job in this area. Woodbine, NJ
I too read all the answers and the recomendations of memory care facilities are great,but try to find one that will take someone with Medicare/Medicaid- the waiting list is a MILE LONG. I applied 2 months ago for my Mom and it will probably be 6-9 months at least..No one takes medicare/medicaid at the good homes. Now, if I want to put her in a LOUSY nursing home, that I can do, but the average stay there is 6 months....My Mom does not need a nursing home, but she is at a point where I am losing sleep and I am becoming more and more depressed and I am suffering migraines 2-3 days a week. She will not bathe for me and doesn't want to eat her meals. We make too much money for home health, but not enough to afford to put her in a home and pay for it... What do you suggest???
I agree with Sunny Wonders.. read Validation Techniques for Dementia Care by Naomi Feil. My mother is now in what I think is the beginning of late-stage dementia/alzheimers. My family has found that Mom is less depressed, less accusatory, less verbally combative when we use this technique, rather than the "Reality Therapy" that is broadly used. Check out Naomi in action...http://www.youtube.com/watch?v=CrZXz10FcVM
I was aghast when the neurologist said that if the behavior becomes dangerous to call the police. She said the police will be able to take the patient to the correct facility. I did end up doing this every time when he would 'run away' from home. Fortunately the patrol policemen knew what to do and knew about dementia. It was the detective who had to search the house to make sure I didn't kill him. ha! ha!
Also, my husband has FTLD. He can take the Namenda but not the Aricept. because it causes behavior problems in FTLD patients.
Do as others suggest. Take her to her neurologist / or to a psychiatrist to have the medications re-assessed. They need to be of therapeutic levels in order to work. Your mom is on low dosages of the medications. And there is no shame in saying you need her in a nursing home. In Ohio, we have the Dept of Aging that offers services according to income. It is administered by each county dept of Aging. They also can assess what you need plus be your case manager on all the resources available financed by grants, private and public funds.
It has been exactly four months since the passing of my loving wife who suffered with Alzheimer's disease for six years and four months.
I always tried to honor my wife's wishes. She lost several members of her family to Alzheimer's and they all died at home. One of those who passed on (a grandmother) was very combative toward the end of her journey through the debilitating disease.
So my wife gave me notice that she too wanted to die at home. What she didn't have any way of knowing was how bad she would get and the toll it took on me. Six weeks before she died I had to make that awful choice and put her in a home for 24/7 care....it was either that or I might not make it myself........so the decision was diffucult but I knew it had to be done. Oddly enough she knew who I was (couldn't remember my name but knew I was her husband). She spent two weeks or her stay in the home and two weeks in the Hospital before the doctor said to send her to Hospice. She lasted 20 more days in Hospice and when she died I had to deal mostly with my guilt. I kept thinking I should have not put her away. She was mad at me and decided to go ahead and die. Thinking that she was holding back of dying for so long I finally after two weeks told he it was alright to "let go" that I would be alright and that I was sorry I had to put her into a home. She died on the 20th day in Hospice.
The last six months she was alive she took on a companion disease to Alzheimer's called Lewy Body Dementia....and all of it's terrible symptoms. I simply could not handle her any longer and was getting no rest at all. I did what I though was best for her and best for me.
By the way, I was naive I know now but I called the place I put my wife a home...........it was Emeritus and it had a wing for Memory Care.......this was not a Nursing Home. When she got too combative they would send her to the Hospital. Thank God we had Medicaid becasue the bill I saw was for over $15K plus bunches for thransporting her from the hospital back to the home.
My mother has been to the point that you are describing when she was taking the plethora of medications you described as part of geriatric psychiatric evaluation. Once she was taken off 5 or 6 drugs and got down to 3 milder meds. she settled into a calmer state of "agitation". Have you tried to get her off some of these meds?????
This message is for CJL. My heart goes out to you. Sounds like your mother requires an evaluation from a skilled doctor. I recommend lab work to see if there is a major imbalance causing outbursts. Diabetes or low blood sugar can create irritability and mood change. Most likely medication needs to be adjusted. Great caution should be used when treating the elderly. Many doctors will side on benefits of drugs vs side effects. It is up to the family or advocate to research and monitor changes. This is reality. Many times doctors will provide medication as a convenience to staff instead of looking at patient holistically to determine best treatment based on age, needs and quality of life. Basically our system is broken and doctors are consumed by mounds of paperwork. Which is why within first 5 minutes prescription pad comes out and you are provided with just another medication. In regard to behavior. Nursing homes SNF will not take a pt if they are exhibit any form of violence within a (30) probation period (State of Ca). If they do, your mother will be subjected to psychiatric medications, leaving her in a vegetable state. This is for thier convenience. Her behavior is probably due to an illness that she is unable to communicate to you. This is very sad. Locate a qualified doctor to assist you. Further medication will only compound issues, masking what is really the problem. Don't give up. Get some help for yourself. This is what your mother would want for you. Also pick up a copy of the 36 hour day. This will help you to under the disease. Please find someone who is qualified to care for your mother so you can care for yourself. Best of luck to you and God bless you
Just a quick note as all are good ideas but the one thing with my own mother is when she hallucinates and is combative is she usually has a unrinary tract infection and it really exaberates the dementia symptoms she already has.
We had more or less the same problem with a loved one. Namenda turned out to be very wrong for her. Changed her personality for the worse. Ask her doctor.