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My Mom’s primary provider won’t refer her to a long-term nursing home. Mom is 80, her behavior with Alzheimers is very aggressive. She can’t stay in a memory care facility because she can’t get along with people. I think she’ll hurt them since she’s threatened caregivers already. Can I go around the her primary doctor some how?

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Consider:

The next time she threatens, or hallucinates, call 911 and have her transported to the hospital.

Get a psychiatric evaluation while she is there.

Tell discharge planning she can no longer be managed at home and needs placement.
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Can you switch to a different doctor? One who specializes in elder care and understand Alzheimer's.
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What a piece of work this doctor is. Too bad you cant drop your mother off at his door step so he can take care of her. Definitely get another doctor. One that specializes in dementia.
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Has she had a behaviorally based evaluation? If she can be prescribed carefully chosen medication to curb her (fairly typical) conduct you’ll have more flexibility in finding suitable placements for her.

Ask her current physician to recommend a geriatric psychologist/psychiatrist who can administer testing and develop a behavioral management plan for you to use in finding a residential site that can handle aggressive clients.

If her current physician can’t/won’t help, by all means seek out a 2nd opinion.

USE her current doctor if you can, but doesn’t lose sight of the fact that she AND YOU need solutions. If Current Doctor Isn’t helping you to solve her problems, look for someone who will. Good Luck, and take GOOD CARE of YOURSELF, too.
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PCPs know a little about everything but are not specialists. She should be going to at least a neurologist. Medicare does not need referrals but her suppliment may require one. Especially Medicare advantages.

A neurologist can prescribe meds that will help, run tests and an MRI. This will tell him what Dementia she has. He can refer her to a NH.

I would wonder why your PCP refuses to refer her to a NH. Sounds to me she is 24/7 care.
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Where is she going to go then? The only places to go from memory care would be a psychiatric facility or a nursing home. Geriatric psych evaluation and a stay in the facility may be the first step, but the next place would be a nursing home. Get a social worker involved.
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You & dr have to get her calmer before she referred to nursing home or else either they won’t take her in or the undesirable nursing home facility will . My mother takes Seroquel..& was initially prescribed by neurologist. It’s no picnic..this disease…& only gets worse. With the incontinence, make sure she wears diapers & has bed chucks underneath..& even if she’s sitting in wheelchair, put chucks underneath. Make sure her privates cleaned good & put A&D ointment &/or Desitin cream on backside. HUGS 🤗
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Dementia patients with psychosis should be treated by a psychiatrist, not a neurologist until the condition is stabilized.
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CaregiverL May 2022
TChamp, Neurologist is experienced in treating dementia patients & all of the psychotic symptoms. Psychiatrist, IMHO, not recommended since there is no treatment to “get well & function better?!” Maybe someone who has mood swings & suffers depression can benefit from psychiatric help, but dementia patients don’t get “better…” only worse.
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You can see another gerontologist that's in her Medicare providers. I would do that asap and go from there. Doc can refer you to a specialist like a geri psych, or others.
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