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Anyone have experience with Baker Act? I am here in Florida with wife that has stage 6 Vascular Dementia. She has Medicare, AARP supplemental and Medicaid. Can no longer provide necessary Care and must do something. Not bedridden so no NH, probably too anxious and violent (sundowners) for Assisted Living Memory Care.

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She does not need to be bed-ridden to go to a nursing home.

What level of care does her doctor recommend? (She needs to be "medically eligible" for NH care.

Have you called your local Area Agency on Aging and asked for a "needs assessment"?
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erwash Jul 2019
Doctor? Agency on Aging? We don't have those here. Perhaps in name only... certainly no-one qualified to deal with this situation.
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My dad is in memory care and you would be surprised at what they handle!! When I moved him I had his family doctor fill out a Form 1823 which declared he was cognitively impaired and that gave me the ability to place him according to his needs. I am in Florida as well. I do have experience with Baker Act - my alcoholic mother - but that requires determining that the person is a harm to themself or others. With my mom it was a suicide threat that got her Baker Acted and into a mental health facility. Did her no good, she was back to the same mess in a week or two.
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For Baker, have to clearly show they are going to harm others &/or do self harm. And where I am that means they have a gun or knife and are brandishing it about on street or sidewalk, not in robbery attempt or carjacking or drug deal gone wrong but more on a serious rant on something odd, or to do self harm

my state -Louisiana- has a twist in that you can call the cops but what’s easier is to call coroners office. Yeah coroners office, as they can issue an “order of protective custody” and send out sheriffs dept or police to pick up the individual for a 72 hr custody hold.

Then usually put then in squad car and off to whatever ER takes uninsured or is a teaching hospital with ER & then they get a PEC order done by ER doc so put on a “physician emergency certificate” which backs up the coroners 72 hr custody hold. & if not better then they get civil commitment orders from a judge. Then back into a locked ward at the hospital till hearing date or transfer to psych hospital or till family is able to set up a psych bed for them in private facility. Their bipolar, schizophrenic or suicidal and weaponized.

erwash - I’m not sure your wife meets the level of crisis that Baker needs. I’m guessing her behavior is aggressive to you & maybe others but not life threatening to herself with a gun or knife. Neither is a picnic but it’s very different in what the police can do.
Has she has 2-4 week medication trials to see if she can find the right meds to quell her aggressiveness and be more even keel? Or if she’s had that, can it be she needs a reset of her drugs as some aren’t working anymore?
Any guidance from her docs? Does she have a geriatric psychiatrist?

As Barb posted, they do not have to be bedfast to be in NH. They need to require “skilled nursing care” for admission & to have it covered by LTC Medicaid. There’s the whole issue of how community assets get broken down for Medicaid for couples when 1 is in a NH & the other staying in the community but I’d leave that for later as getting her on meds that work need to be your time & energy priority imo.

if it comes to it, you do have the nuclear option..... you find a plausible reason to call EMS so she can be taken from your home to the ER; I’d try to have the hospital be the biggest one in your area and that is also a teaching hospital as they should have a geriatric dept.; once at the ER if she’s her aggressive self it’s likely she will be either hospitalized or placed for observation - hospitalized is better as definitely paid my Medicare, observation stays usually aren’t; when the discharge planner (a social worker) from the hospital calls you to ostensibly come to pick her up, you tell them that you cannot provide for safe & secure housing for her, you cannot provide the 24/7 oversight she needs and she - the discharge planner - needs to find placement in a LTC facility for her. There will be blowback. You need to have a list of threatening behavior she’s done to you & in detail, also as to why you cannot provide the oversight needed, like your own medical issues or you do not have the physical ability to restrain her if needed. It’s gonna be hard to do this, you may want to practice all this aloud.

At my moms first NH & for an IL/AL a friend of mine was in, both used “they seem to have had a TIA - transient ischemic Attack- as the reason to call EMS. Google TIA, a lot of the “presentation” is pretty subjective. My mom’s first NH basically used it as a way to shift care to the hospital whenever a resident needed more than cursory oversight, & yeah I moved her out within short order. For the IL/AL, dpoa daughter was mia on dealing with their concerns on her mom’s health, she was wandering & into neighbors biz & homes, inappropriate wardrobe, plus daughter late on rent & refusing to pay for medication management. The place was over her & once EMS took her, they refused to take her back. She did get into a NH locked ward unit.
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erwash Jul 2019
Appreciate your lengthy response. Perhaps I should have mentioned that this lady is 87 and had a stroke 5 years ago, many TIA's since and we have tried a list of drugs longer than your arm. Nothing works, except perhaps Seroquel which puts her out for the day. Been to the gerontologist and neurologist with no success.
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I’m so sorry you’re in this horrible position. One doesn’t need to be bedridden to be in a NH. Many residents are mobile on walkers and wheelchairs. If you have gotten to the point you can no longer care for her safely, call her doctor/neurologist and tell them you can no longer deal with it and she needs to be placed in a NH. Or as igloo pointed out there’s the nuclear option...911 to the ER and then tell them you cannot take her home.
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I agree with many posters that this may come to the "nuclear option" of calling 9ll, having her taken to the ER, and then refusing to take her home. They will then have to deal with it however it is dealt with. You have already really lost her, who she is/who she was, to disease. I am so very very sorry. What an awful thing to have to deal with.
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Erwash - you’ve answered your question, you know..... she’s had TIAs. There’s, ahem, gonna be another one and you let EMS take her to ER. I’d 86 the Seroquel if that enables her to “present” to be more her aggressive, hostile personality.

Its aggression & big time, isn’t it? Honey, I feel for you, your bride is now more bride of Frankenstein. I’m not trying to be mean but who she was was years ago. She’s now what the disease has made her. I think for men, dealing with a wife with dementia & all socialization cannot happen as she goes off, has an extra layer of difficulty. You’ve always been the provider & protector and now helpless to be that; it feels like failure & your bereft. For women, well it’s more a “Tara” moment.... the reach down grab dirt and yell as god is my witness I’ll never be hungry again, women are lots more plucky in dealing with dementia spouse.

But it I digress, you know the answer.... it’s another TIA & EMS run to the hospital & after July 4th holiday as hospital are short staffed on holidays. Again go for bigger hospital or teaching hospital. Good luck.
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https://www.seniorresourceassociation.org/services/publicly-funded-programs/
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ER, I have family near Vero Beach. There ARE psychiatrists and social workers there who are qualified to deal with dementia patients.

You seem to think your wife must be bed bound to qualify for Nursing Home care. Who told you that? Are you getting bad advice from someone or are you making assumptions based on old information?

Please remember that the fact tat you don't agree with a doctor or social worker doesn't make them wrong.

Your wife needs professional care. Please get it for her.
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