My mom (92, 5 years at ALF, semi-private room for 7 weeks now, out of money, dementia, bad behavior) has started cursing at the administration and is rude to her hospice nurse. All reasoning skills are gone. She is negative to everyone, refuses any kind of anxiety meds, and is simply miserable. The recent move from private to semi-private has definitely added stress for everyone. Nurse says she is "transitioning". I am still enemy #1, so once again I will stay away & check in with her Hospice nurse. We're all tired of her disrespect but with dementia, I do not see a change. I'm worried that she'll physically strike back at others there like she has me. Then, we'll have to move her. Any suggestions or words of wisdom? I just wish the medical experts could convince her to take an anti-anxiety med that would bring calmness. I realize she has rights, & she knows she does! If a new med is brought up, she generally refuses ALL her meds for several days thereafter. She's had a horrible experience years ago & is fearful it will happen again.

If she is deemed unable to remain at the ALF, they have to give you notice of termination of right to reside there. Usually if hospice is seeing the patient they are willing to keep the patient. Sustained angry irritability is a behavior that can be due to dememtia alone, realizing that she is dying and expressing it in this manner (lots of people are angry at dying, and being nasty to everyone is a way of expressing fear and anger without using direct statements, and brain irritability occurs as part of dying process even in people who are not old and do not have dementia or brain disease.)In other words, it's just about trying to find ways to ease the distress. Transdermal patch may help. Adding plain old Tylenol can ease the general aches and pains of being very old. (Nothing works well anymore, less body fat means more pressure on your body no matter how you sit or lie, etc). Hospice SW can help dealing with ALF and try to head off problems.
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Reply to Clairesmum

Well let's see, your mother needs medication to HELP her FEEL better and to stop cussing everyone out which is a sign of agitation. Those here who tell you nonsensical things like "why does she need medication, her condition is terminal?" apparently do not understand WHAT purpose medicine SERVES. It serves the purpose of keeping your mom calm AND in place where she's at so they don't ask her to leave! When my mother with advanced dementia got to the point where she was cussing & acting out, I called her doctor who agreed it was time to give her .25 mgs of Ativan every 8 hours. Mom didn't want to take meds, so they were crushed up and put into applesauce, so she agreed to take them that way. She wasn't told what they were, though, just that she needed a new medication, period. Yes, your mom DOES have to agree to take her meds, but you can call the shots about getting those meds ordered and how they should be delivered to her.

So, when her nurse says she is 'transitioning', does that mean she's in the dying process 'transitioning' or that she's 'adjusting' to the new roommate situation 'transitioning'? When hospice is involved, that word can mean two different things. See if hospice has a way of getting anxiety meds into her w/o her knowledge. I don't know that it's a possibility, but I do know that hospice nurses have a way of working miracles with difficult people; they did with my own mother. They can also deliver Ativan in liquid form thru an eyedropper on the side of her cheek, if necessary. Just a thought.

The other thing to do is check with her ALF; will they keep her there until death since she's on hospice care, no matter what? Or will they ask her to leave if she gets difficult to handle? That will make a difference as to what treatment hospice and her doctor can attempt to prescribe for her. If the ALF will ask her to leave, under what circumstances will they do so?

The other idea is that mom is told the anti anxiety meds are for something else, like a vitamin or a tummy med. What road you take depends on what the ALF tells you as far as if they'll ask her to leave if she gets rowdy enough.

Dementia is such a horrible disease and I watched my mother suffer with it for years until she died at 95 years old last month. All the fight went OUT of her in the last 6 months, though, and what was left was just a shell of who she once was. She used to be a spitfire and that fire just went out one day, like a light switch had been flipped. I thank God He took her when He did, honestly, b/c it was all too much to bear for her AND for me.

I wish you good luck & Godspeed as you deal with all of this.
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Reply to lealonnie1
Marylin Apr 9, 2022
My prayers are for you during grieving times. You have always provided good responses for my inquiries. I know it's in God's timing but I will be relieved for my mom's sake when she no longer has to exist like this. Right now, she's refusing meds and we're looking at a weekly Klonopin patch that can calm her anxious soul. Thank you!
Why does she need medication, her condition is terminal. Mentally incompetent, patients have the right to refuse medicines. They can be locked up in an institution, but can't be forced to swallow medicines. All patients competent or not, are required to consent to take medicines. It's against the law to force medications on them, unless it's an emergency in which, the patient and the people around the patient are in immediate danger of physical harm.
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Reply to TChamp

Since has dementia, is she still competent? Do you have POA? If she's not competent, how can she say no to a med because how would she understand it? If you have POA, can't you tell them YES to the med?

Is she still in AL?? Is it memory care because that sounds like what she might need?
Helpful Answer (1)
Reply to againx100

Any hope of hiding a med in food? Or some therapeutic lie about wha the new med is for? She definitely needs calming and meds are great for that
Helpful Answer (2)
Reply to Daughterof1930
TChamp Mar 23, 2022
Medications won't make her younger and mentally sound. She has the right to refuse them.
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