Advanced dementia plus volatile and aggressive. We are in the midst of a full psychiatric and neurological evaluation, but both MDs have said that medications may not work or may even worsen the erratic mood swings and violent behavior. Are there even long-term geriatric psychiatric facilities in this country any more? Very limited resources so it would have to be a facility that will ultimately accept medicaid. In terms of ADLs, she probably would qualify for SNF. She CAN do more ADLs but is at the point where she refuses to cooperate or help. She is ambulatory. She feeds herself and brushes her own teeth. Everything else requires assistance or cueing. She frequently fights (bites, kicks, scratches, pulls hair, and spits) with showers, dressing, and many other ADLs and transitions. Mid-Atlantic region (Maryland, Virginia, Pennsylvania, Washington DC). New England (Massachusetts / New Hampshire) is also an option with another son.
First of all, if she is in home care and MDs will not medicate her sufficiently then she needs to be delivered to the ER and you need to tell them she is a danger to others and you cannot accept her back in the home.
I am hopeful that no one in family has accepted POA. If not, see to it that you do not. You may need to allow her to become a ward of the state so that she is safely placed, as no facility will want to accept her without adequate medication.
So step one, wherever she is now she needs social services to place her. I have zero idea where, how or in what facility.
If she is at home now you need to call EMS, make the story a GOOD ONE in which she is a danger to self and others, and NOT ACCEPT her home.
If anyone here is POA for this person with dementia, then this likely becomes a case where that needs to be given up with an attorney and she needs to be ward of the state.
Be certain to tell these doctors that she cannot be placed, nor go home until adequately medicated. And that you are leaning toward making her a ward of the state due to (and use these exact words):
A) She is a danger to herself
B) She is a danger to yourself
C) You cannot handle nor control her nor be responsible for her
Tell them she cannot return to (nor remain in) your home.
Masonicare Behavioral Health Hospital in Wallingford, CT says it treats "dementia accompanied by behavioral disturbances". And they take Medicaid! 860-996-2396
McLean Geriatric Psychiatry Inpatient Services at Mass General Brigham. 617-855-3141