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Long story short, both of my parents ended up in the hospital and now rehab together. We finally got my dad (cancer) to agree to assisted living and they are supposed to move in on Monday.


My mom (diabetes and heart disease) has always been extremely vile and abusive, and now has early dementia. She tried to flee from rehab, is screaming at staff, and fighting with my dad. One moment she is okay with moving in with my dad, the next she screams and refuses to.


I have tried to talk my dad into putting my mom in memory care or separate living quarters, but he balks at the cost and refuses. Yet, he will call me in distress saying he can’t live like that anymore. I fear they’ll get kicked out or she’ll escape.


The hospital social worker said she has never seen anything like my mom, and has no alternative plan if she refuses to move in with my dad. What are our options?

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Does Mom have a dementia diagnosis on her medical records? Does anyone have POA for Mom?

I would think if Mom has a dementia diagnosis , that Dad would be able to place her .

What if you just tell Mom it’s temporary for now , just to get her in assisted living ? . Fib . Do not take her in your car or she will never get out of the car . Have an ambulette transport her from rehab to the assisted living . Medicare won’t pay for the ambulette but it’s worth every penny .

Some assisted livings will put a bracelet on wanderers that sounds an alarm if they try to leave the building.

But with your mother’s other behaviors as well , memory care is where she needs to be . You have to get Dad on board with memory care . Tell Dad that assisted living will probably kick her out to memory care anyway . It will be easier to skip all that drama and place Mom in memory care . There will still be drama but at least she will be where she belongs .

Is Mom on any calming meds ? The doctor can prescribe something .

Good Luck .
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Mom needs to be seen by a geriatric psychiatrist, asap.
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There are continuum of care places where she could be in memory care and he could be in AL and they could still see each other frequently if that is desired. Might make it easier for you also. I second the geriatric psychiatrist and calming meds.

Dementia is of course incurable, can be horrific to deal with, and the available options are not great. I get it 100%. But doing nothing and complaining is also hell for you and for him. I have a somewhat similar situation. Would you say your dad is a “help resisting complainer”?
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Mom needs better and further evaluation that will likely lead to a medication to help calm her extreme behaviors
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Here's how to handle your father's cost complaints and when he calls in desperation expecting you to handle every crisis that your demented mother causes.

Tell him:

'Dad, you know I love you but mom needs to be in a memory care facility now. Stop worrying about how much it costs. You're going into assisted living. It's all expensive, and at this point what you going to spend it on?
I want to help to do what's best for you and mom. She can't make decisions for herself anymore. Either you will make the decision where mom is going or the state will because the AL where you're moving to cannot handle her as she is now.
Do not call me again in distress when she gets into trouble or to complain about how abusively she behaves then refuse to make a decision. I don't want to hear it. I will work with you to find her the proper facility to meet her care needs.'

This is what you tell your father, and stick to it.

The AL will be able to put you in touch with a social worker who will work with you and your father. There are such facilities that are assisted living and independent senior living that also offer an area that is memory care or skilled nursing. This is one option married couples have who have different care needs. The AL now may allow your mother to stay with your father if she's properly medicated, not terrorizing him, orthe staff, or trying to take off.

There are options that a social worker can help with. One option that is not available is your father being indecisive and expecting you to put out every fire and handling every crises your mother causes. No to that.
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Your options are entirely dependent on whether Mom has dementia and is incompetent or not.
You have NO options if she is competent and just a mean and trying woman (as you seem to indicate.)
No ALF will put up with this.
She would require MC.
I would start with psychiatric evaluation.
Your mom may end "home alone". It may be her choice. In all honesty I wonder if it might now be the best choice from all you are saying about her current status, her FORMER status, and the social services evaluation.

If you can get "incompetency" I would go with MC. Tell dad this is no longer choice. She needs medications and care. He can visit.
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I agree with BarbBrooklyn that your Mom needs to first get psychiatric help to stabilize her mental state/anxiety. To do this she needs an appropriate evaluation, which may require a stint in the psych ward of a facility or hospital long enough to get her to comply with taking meds since they can't force her to take them. It may take a while so please have tempered expectations about a timeline.

Once this happens, it may be "easier" to know what level of care she actually needs and "easier" to move her. Hopefully someone is her PoA. Even if she never agrees to move, it's in her best interest to do so and there are strategies to transition her, whether she wants to move or not.

I'm so sorry for this distressing situation. Things will feel really hard for a while, but will eventually improve once proper placement is achieved. May you receive peace in your heart as you and your Dad work through this.
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The problem I see here is maybe they don't have the money. Memory care is more expensive than Assisted living. IMO Mom needs to be medicaided. She can no longer make decisions of her own. Dad will be with her in the AL. If you want, her to be able to stay, she must be medicaided. Ask her PCP or Neurologist to give you something to calm her. Writing up an order how its to be given and give that to the facility nurse.
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BurntCaregiver Apr 28, 2024
@JoAnn

If they don't have money to put the mother in memory care then Medicaid will pay after her share of the marital assets have been spent-down.
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I agree with everything said already. I think what is meant by “medicaiding” is “impoverishing.” If Mom doesn’t have enough income, she can qualify for Medicaid.
Definitely needs psychiatric evaluation and medication/care to calm her likely anxiety and depression, in addition to her aggressive and verbally abusive behaviors.
And yes, there are AL facilities that also have a memory care unit. I have worked in them (as a Speech-Language Pathologist).

May your family find peace during this difficult time.
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FML1978: Sadly, mom's "refusing to go to AL with father" is based on a broken brain due to her dementia. She requires residence in a memory care facility.
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Get mom a thorough evaluation by neurologist and psychiatrist - preferably a geriatric psychiatrist. Your mom's behavior may have a neurologic basis - that's why you need a neurologist to evaluate and treat. OR, she might have a psychiatric basis - that would come under a psychiatrist's care. In either case, it appears your mom is anxious and/or agitated. She may benefit from anti-anxiety medications to help her calm down a bit.
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