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What should my expectations be for the behavioral health hospital to make changes? I mean if they are just going to continue to try and coax her into taking her meds, they can do that at the MC. We can't get the doctor to call us, we have left 4 messages on 4 different days. We realize she isn't "going to get better" but we would like to see her anxiety level out and the sadness to go away. Is that even possible? When they moved her she started pacing the halls and knocking on the doors to try and get out. I know any change is hard on alzheimers patients. We are just so frustrated.

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What Social Workers are there?
You need the doctors bombed with messages here. This isn't normal that they will not respond to you. You need to know the plan here or to be part of the plan as to whether the option now is hospice, palliative, forcing medications, to other options.
This is something only you and the medical personnel can deal with, and they MUST. Go to the admins; go wherever you must and don't stop.
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Even in a hospital, a refusal is a refusal. How can a pill be forced? It then becomes assault and battery.
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Moms doc at the memory care AL ordered most of her meds ground up and put into her food when she refused to take them. It's time for you to find a new doctor if 4 messages have not been returned! I don't know if this is the "behavioral health" doc or her PCP at the memory care. In any event, it strikes me absurd that an AD patient would be sent to a "behavioral health hospital" in the first place, as if this is a behavior problem and not Alzheimer's at play! As if this is the very first time the facility has had to deal with a resident refusing pills!

At my mother's private pay MC, there were no social workers on staff. At all. The RN together with moms PCP ought to be able to figure this out themselves. If not, then look into hospice if moms meds are life saving in nature, such as heart meds. Extending the life of an AD sufferer is cruel anyway, imo. My mom's meds were more for pain relief and depression than anything else.

Good luck.
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MaryKathleen Oct 2023
I agree, maybe it is time for hospice;
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When my mother became agitated with increasing symptoms of sundowning and refusing her medications I called her previous geriatric psychiatrist who recommended Seroquel. It initially helped with her anxiety but eventually she did not want to take any more medicine. We were lucky she had a do not resuscitate advance directive and we enrolled her in Hospice. They had more tools at their disposal to help with her anxiety.
I strongly suggest contacting hospice. There are different criteria for dementia patients. It doesn’t mean she is actively dying. As our hospice nurse said she is slowly strolling. Good luck. It’s a really awful thing to watch.
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Most meds can be ground up into her food. Find a new Dr if current one is unresponsive. Yes, hospice care would help.
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Dupedwife Oct 2023
I was thinking the same thing that the medication could be administered in food or drink. Many, many moons ago when my children were little and they had the flu and they refused to take the medication for it, I used to pour the medication in their juice and that’s the way I got them to take it.
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Was she moved because MC could not handle her (meaning her behavior changed after she was in withdrawal from meds)? Otherwise, there is no reason to move someone.
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You have a lot of support in your area: do a search with this sentence."alzheimer's care in Huntsville Tx."

https://www.alz.org/
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Some medications can be administered by a patch, some can be formulated as a liquid. Either of these might be an option.
Be careful crushing or grinding pills, some are coated so they dissolve at the proper time or they are coated so as to mask a bad taste. Capsules usually should not be opened. And time-released should never be ground, crushed.
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My mother has also been refusing her meds. When she was at home, she refused medication until after a meal (so in her mind, there was a reason). When she was in the hospital, she refused because it was in applesauce (she doesn't like applesauce). Now, she's refused because it's ground up, but she can taste it in pudding!
I have suggested that the small pills can be taken by mouth and the larger can be cut in half and swallowed.
I explain what each pill is and what it's for. She takes most pills now and usually from the same nurse.
I know that this is not your entire issue (my Mom doesn't have Alzheimers) but maybe some of my post may help you.
Best wishes
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For whatever it is worth....I'm 84. I live in an independent living facility, have my own apartment and participate in a few activities, but not a lot. Eat in a dining room 2 meals (my choice) a day at a table with 4-5 other women. I did a lot in my life and just want to rest in peace. I, too, have thought about stopping my medications, all of them, from heart, blood pressure, anxiety, memory loss, and all in between. I'm just tired of "hanging around". My family is active so I get very few visits. I can socialize with activities if I want and I do. I don't like most activities, so I am sure to attend a few during the week, and don't miss happy hour with my 1 spritzer and listen or sing along with the entertainer. I am tired, don't want to be bothered with activities, just want to pass my time. Never thought I'd say this, but I wish my time comes soon. I don't want to be "made" to do things, especially if I don't like the activity. I'm not into cardo, mat making, or coloring. There are a lot more activities I could name, but I'm just not interested. I have the daily news paper delivered, and would rather stay in my apartment and read it than go to an activity that I don't like, just because I need to get out.
My socializing is breakfast and dinner in the dining room with 6 other women at the table, and happy hour on Fridays before dinner. I prefer not to socialize too much, led a busy life, going to college at night starting at age 38, and ending when I was in my early 60's. Led a busy life, was assigned all over the world from Europe to Asia, and traveled while working in those continents. Part of my job was traveling around the Pacific teaching classes, so I am well versed on different cultures. I just want to be left alone to do what I want. And I'm ready when God wants to take me, only wish it were soon. I'm not being morbid, I just lived my life and now want to let go. Does this sound crazy?
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olddude Oct 2023
Funny how you mentioned not really wanting to do much at this time in your life.

I will be retiring within the next year or so. I have had several people ask me what I plan to do after retirement. My answer is always the same - I plan on doing nothing after retirement. I am going to sit on my butt and take it easy for the first time in my life.

It is kind of funny how many people assume that after retirement you will just start some other job someplace else (even volunteer work).
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Tresha: It's time to locate a proficient doctor. That is unacceptable for the current, less than subpar doctor to not return four messages. If the medications can be ground, your mother will then be able to ingest them with food. Why on earth was a woman suffering from Alzheimer's sent to a behavioral health hospital? Good grief!
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There are medications that can be given IV and via IM (into muscles) to help with her anxiety and agitation. Those can be given until she is less anxious and more biddable to take oral medications. Once she is less anxious and agitated - and takes oral medication - she can be switched to oral anti-anxiety medications.
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AnnReid Oct 2023
Absolutely my first thought.

It may be possible for her to return her to the MC or may not, but either way, she is obviously in need of relief from whatever now distorted thoughts have caused her behaviors to deteriorate.

I was quite surprised at the quality of the staff physician at the MC in which my most recent LO lived. If there is a staff physician at your mother’s residence, it sounds as though you couldn’t do any worse than transferring her care to that person. If you can, you will have contact with the supervising nursing staff, and the physician will have more frequent updates into her behaviors.

Neither she nor YOU deserve what’s happening now. You ALL are entitled to better.
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You need a new doctor for sure. Ask to speak to their nurse or medical assistant, they can often be tremendous help in getting a message to the doctor and get you an answer.
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My cousin with mid- stage ALZ had to physically be carried into the ER for abad UTI infection , fighting and scratching her own son. After that treatment and recovery, she was non-compliant with meds for her agitated behavior. Her kids needed her to transition into a care facility. The hospital had her in their "psych" ward for a month or more, until they were able to get her to take meds. I'm not sure who provided the aid, but she had one who stayed close to her room all that time.

I agree you should find another doctor if at all possible. I'm so sorry that your family is going through this. May you receive peace in your hearts.
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Sorry your mom is being a challenge. Is she still in behavioral health? Do you have POA? Can you get her moved back to MC? I would get her evaluated for hospice.
Good luck.
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