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Aging Happens: We lack resources for people with behavior problems

I did not want to write this column. I was hoping that instead I could write one with my usual approach: present the problem and offer options and solutions. Instead, I’m going to tell you about a problem that does not have a handy solution, no matter how hard I and many others have tried to find one.

The situation is this. If your aging loved one has a long-term behavioral health issue, or dementia with behavior issues, or both, finding a local placement is all but impossible. I say this with great caution. Impossible sounds too overwhelming to even tackle. But I think it’s really important to share with you what I have learned with two clients in the past few months.

They both live in a local facility: one in assisted living, and one in memory care. The one in assisted living most likely has both behavioral health and dementia issues. The one in memory care clearly has later stage dementia, but he’s one of these unfortunate folks whose behavior was deemed a risk to themselves or others where he lives. And the main point is that both of them received eviction notices to vacate these facilities due to their behavioral problems.

The answers to both seemed obvious. Find each one a better fit for their needs. And therein lies the real problem. They now have a “bad reputation,” backed up with chart notes showing behaviors that no one wants to bring into their facility — they have to keep their current residents safe and don’t want to admit a known disturbance.

The first person was rejected by seven other local placement options, including assisted living, dementia care and adult foster care. The other person was turned down by that same number here locally, as well as 3 or 4 places in the Portland area. What’s a family to do?

We used to have a geriatric psychiatric facility near Portland called Tuality, and they were a godsend for people who needed to get their person on the right meds and into a more workable frame of mind. They have since closed their doors. There is a Providence hospital inpatient section in Portland that addresses this, but the requirements are steep to get admitted, and they rarely have room for anyone from out of their area.

What can you do, then? The family of the person in memory care has gone all out to help. They have brought in extra private-pay caregivers to be with him when he seems to have a harder time of day. They had the primary doctor change the meds to help him manage better.

But then it came out that the facility itself had some real gaps in their ability to assist him and address his problems. So much so that the family is now in court over this whole thing. First, over the eviction itself, and now, the possible negligence on the part of the facility.

The long list of people involved now includes Adult Protective Services in Medford; an administrative law judge; the care-giving agency; the Community-Based Care Licensing Complaint Unit; the deputy long-term care ombudsman in Salem; Southern Oregon long-term care ombudsman; as well as the administrator and regional director of the facility. Not to mention all the family members, lawyers and other experts who have gotten involved.

If this sounds unbelievable, now you know why I did not want to write this column. Here’s the reason I wrote it anyway. It’s important to be aware of the gap in services for people with these impairments here and throughout the state. Plan for this. If someone needs medication, please find a physician who’s willing to work with them. Not every physician is, so be clear with them if you’re dealing with this problem. Be sure that your person gets placed correctly, the first time.

In both cases, it’s possible none of this might have happened if they had been in a different setting. Rely on a real professional to help you find that correct placement the first time. And if this person has been noted to have “a bad reputation” and needs to be moved out, it might be a story not dissimilar to this one. My heart goes out to all those who face this untenable and very exhausting search for the right place to live. For these two individuals, it’s yet to be resolved. I will let you know the outcomes down the line.

Ellen Waldman is a certified aging life care professional. Submit questions about aging and Ashland-area aging resources and column suggestions to her through her website, www.SeniorOptionsAshland.com.

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