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Unless she can be stabilized on meds, it sounds to me as though you are looking at long term placement. ACS can and will remove a child from an environment that is deemed unsafe in this circumstance.
It really does not sound like a safe situation in your home right now. And if she refuses to take her medications, it might not improve even if they find the right combination for her. I suggest that you try the psychiatric ward, but also start looking for long term care for her, in case that does not provide sufficient improvement.
I am in this boat with my own mother and have lived it up close & in color.
Mom has had a dementia diagnosis for about 15 years and untreated bi-polar & personality disorders most of her life. These past two years of psychotic episodes, breakdowns, suicidal attempts, violence, wildness, meanness has been h3ll on earth for her and us.
This is not something I can recommend dealing with in your own home, especially when others live there who do not deserve to live in a dementia & psychiatric ward. It's their home too and they deserve a nice, calm, serene place to come at the end of their day in the world. When this person is in your home, it will not be the restful haven it should be. Especially as things escalate with her. Dementia doesn't turn off or down psychiatric problems until much, much later.
My mother had the 4 of us all about ready to jump off the bridge when she lived with us only a few weeks. My teenagers were and are still afraid of her. Mom tried to plant seeds of suspicion and paranoia in my marriage. My family comes first. The minute I could get mom placed, I did. She could not be left alone for even a minute. Not even for me to use the bathroom. She would scream and yell that we had abandoned her. She would not let any of us assist with her meds, and she was taking all kinds of pills whenever it suited her. I know one of them was Ativan, which can't be taken "whenever". Missing it made her hallucinate and become wild.
This was not healthy for me, my husband, or my kids to remain around.
Mom needed specialized care above & beyond your typical dementia patient. She ended up being in independent living for a few months, and then moved into the skilled nursing unit after a bad fall. Eventually Mom ended up in a geriatric psych ward for 5 days after a big violent episode, and it was the best thing that ever happened to her. They changed a lot of her meds and got her on something that really turned down her anger, her paranoia, and her hallucinations (Risperidone). At discharge, she was moved into a special unit of the memory care unit where the people with deeper psychiatric issues need to be. It's very quiet in that unit, and very routine-based. I am best buddies with the psych nurse in that unit these days.
Some places don't have these units in a nursing home, so you will need to work with a social worker to understand what the options are in your community. Some memory care-only facilities can't handle advanced psychiatric behaviors, so the facility needs to be the right one. Other communities have the facilities in the hospital, which is the opposite of the way it is where I am.
It's not perfect and she will never be "normal", but she can't be hurt by the world or herself. Her ability to hurt staff and others is minimized as much as it can be without restraints. The people who work in this unit are saints.
Do NOT feel guilty for taking the necessary actions to keep your mom safe, well, and to protect your own private home space for your sanity and your family's.
I mean this kindly and in a supportive way, but just who do you think you are? Why should you be able to care for such a sick person single-handedly, without breaks, without backup, and while performing all the normal tasks of running a household and raising a family?
This is NOT about "your mother is an evil woman, abandon her" -- it IS about "your mother is a sick person and needs care one person cannot provide in a home settting."
I wish they'd formulate some of these meds in a patch that could be applied to the person's back or butt, so they can't take it off.