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Old 05-09-2016, 02:53 PM   #21
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Interesting. I have heard a theory that dementia just accentuates your trait; if you were a mean person, it turns you into an unbearable person. And that seems to be the case that I have observed in some people.
Dementia is like cancer. We try to characterize it as one thing.

But it isn't. It is a spectrum of disorders. And even within a disorder type, there are dominant and non-dominant types of behaviors.
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Old 05-09-2016, 03:34 PM   #22
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Interesting. I have heard a theory that dementia just accentuates your trait; if you were a mean person, it turns you into an unbearable person. And that seems to be the case that I have observed in some people.
I had thought that too. So there is hope for me after all....

Back to the NH perspective, if they don't have a dementia unit or it is full, what else are they supposed to do with a patient who is a danger to other patients or staff? If they allow that condition to continue it is only a matter of time before someone gets hurt or killed.

Interesting that the article mentioned that eviction happens more often to patients who just went on Medicaid from private pay though.

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Old 05-09-2016, 03:53 PM   #23
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So what would they do to someone like me who is all alone in the world. Nobody to call. Nobody to hassle. Nobody to get "Stuck" with me? Wheel me onto the traffic median in the middle of the 4 lane highway across the street and walk away?
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Old 05-09-2016, 04:03 PM   #24
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So what would they do to someone like me who is all alone in the world. Nobody to call. Nobody to hassle. Nobody to get "Stuck" with me? Wheel me onto the traffic median in the middle of the 4 lane highway across the street and walk away?
I'm guessing they would drop you off in the nearest Walmart parking lot.
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Old 05-09-2016, 04:11 PM   #25
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I'm guessing they would drop you off in the nearest Walmart parking lot.
I might enjoy the view from the traffic median more
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Old 05-09-2016, 04:30 PM   #26
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I'm guessing they would drop you off in the nearest Walmart parking lot.
Maybe that's where some of those "People of Walmart" come from.
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Old 05-09-2016, 04:42 PM   #27
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Interesting. I have heard a theory that dementia just accentuates your trait; if you were a mean person, it turns you into an unbearable person. And that seems to be the case that I have observed in some people.
Since I'm unbearable now, wonder what they'll do with me - while I can still wonder.
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Old 05-09-2016, 04:47 PM   #28
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I seem to recall an article about an LA hospital discharging patients to a cab and having them taken to skid row. Sad.
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Old 05-09-2016, 06:45 PM   #29
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Grandma was sent home from assisted living for hitting and biting the owner. She was getting senile and shouldn't have been home alone over 90 years old. The family was angry with her for getting herself kicked out, only one local daughter who pretty much wasn't speaking to her. They sent the grandson's wife over twice a day to give her medicine and help her dress or undress. Then when she was almost 97 she broke her leg and the hospital sent her the a nursing home in a wheel chair, nobody would give her the cane she had used as a weapon before. They moved her to assisted living at 97 to 98 where she didn't cause trouble at all and didn't care about ever going home again. They were going to evict her at 98 because she was too much trouble but she died before they did it.
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Old 05-09-2016, 07:04 PM   #30
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An over simplification:

There are some differences in some states - but in general - Medicaid only pays for skilled care in a long term care facility. This is not assisted living.

A long term care facility often has a memory care unit (locked unit). There are also circumstances (example: short term rehabilitation) which are covered by Medicare.

Assisted Living is private pay (whatever level of care) unless a state has a Medicaid waiver for assisted living. The number of people in such a state covered by a waiver is typically limited. Some assisted living facilities have memory care / dementia units or can be a facility wholly devoted to dementia care.

If you are in a nursing home and have no family or person who is willing to be your advocate/POA, you would come under the care of the state (often delegated to a case manager in the county health department).

Kindest regards.
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Old 05-09-2016, 08:30 PM   #31
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Demented people don't know what they are doing, but I bet they still feel cold and hungry, and know that living under a bridge sucks.

Darn! I don't know why so many posters desire to live a long life, even if in poor health. Instead of getting dementia, if you have a clear mind and are totally aware of the condition you are in, that your nose itches but you cannot move your arm to scratch it, would it be any better?

Man, I should be blowing my money now on something while I am still conscious and in decent health, but I do not know what. I just do not crave any more material things.

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I seem to recall an article about an LA hospital discharging patients to a cab and having them taken to skid row. Sad.
What if skid rows do not want them?

Taxi driver: "Which bridge should I take you to?"
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Old 05-09-2016, 08:48 PM   #32
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Interesting. I have heard a theory that dementia just accentuates your trait; if you were a mean person, it turns you into an unbearable person. And that seems to be the case that I have observed in some people.
I had a grandma that was very mean, but dementia mellowed her completely. I have noticed with MIL, and possibly others, is that certain behavior traits can amplify. For example, if you don't like to be late, you may start getting to places an hour or a day early. Partly because you are confused with time in general.
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Old 05-10-2016, 12:57 AM   #33
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So, where DO the disruptive/dangerous patients go? There used to be state mental institutions to house people who couldn't live in society but most have been closed down. And I don't know a lot about Alzheimer's, but couldn't the right mix of tranquilizers work?

Special nursing facilities with locked units.

The worst are the violent residents who assault staff and other residents where the families refuse to allow appropriate medication to be given.

So glad I am a retired former nursing home psychiatrist and no longer have to deal with this.

Whether the patient had financial resources or not was not a consideration by the administrations of the nursing homes. In fact it is easier to move someone who has resources than one on Medicaid.


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Old 05-10-2016, 05:57 AM   #34
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"Residents" without families must be quite a relief. They can be restrained and medicated to everyone's (at the facility) satisfaction and no one (as the old folks like to say) "says boo" about it.

Calling these prisoners "residents" reminds me of the term the welfare office uses for recipients: "clients."

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The worst are the violent residents who assault staff and other residents where the families refuse to allow appropriate medication to be given.
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Old 05-10-2016, 07:33 AM   #35
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Maybe the oversight of nursing homes has changed since my father was in them for "rehab" 15 or so years ago, but in the ones he was in, they just drugged the problem patient into catatonia. Same thing with the hospital. So why would behavior be a problem?

My father was somewhat drugged to make him more compliant. He wasn't violent but he liked to argue. Every time he came home, it took a week for him to get out of the fog.
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Old 05-10-2016, 08:31 AM   #36
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... My father was somewhat drugged to make him more compliant. He wasn't violent but he liked to argue. Every time he came home, it took a week for him to get out of the fog.
Oh boy! Many of us here myself included would be drugged into comatose.
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Old 05-10-2016, 03:40 PM   #37
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Oh boy! Many of us here myself included would be drugged into comatose.
It doesn't sound promising for the future of early-retirement.org....
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Old 05-11-2016, 03:13 AM   #38
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Those of you who are so violently opposed to the use of medication for extreme anxiety, depression, psychosis, insomnia that goes on endlessly and violent behavior have obviously spent not one iota of time in the kinds of settings I described. Nor had any medical training.

These patients are truly suffering. I made no one comatose or even sedated, with micro-doses of carefully titrated medication. Nurses would have been relieved if I knocked out the patients - I refused. Everyone's an expert here, right? But this was my specialty. It's so easy to bash doctors, especially psychiatrists as if we are all idiots.

Thanks so much. I am out of here.


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Old 05-11-2016, 04:29 AM   #39
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Those of you who are so violently opposed to the use of medication for extreme anxiety, depression, psychosis, insomnia that goes on endlessly and violent behavior have obviously spent not one iota of time in the kinds of settings I described. Nor had any medical training.
These patients are truly suffering. I made no one comatose or even sedated, with micro-doses of carefully titrated medication. Nurses would have been relieved if I knocked out the patients - I refused. Everyone's an expert here, right? But this was my specialty. It's so easy to bash doctors, especially psychiatrists as if we are all idiots.
Thanks so much. I am out of here.
?Huh?
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Old 05-11-2016, 07:57 AM   #40
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My post was meant to say that some patients are tough to deal with.

When a patient is aggressive or belligerent, what else can we do? Lock him up behind bars, tie him up, or chain him? Do they still use straight jackets and padded rooms like I see on TV?
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