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Dear Lucy-- what a sad progression--or rather regression--for your father. It is very hard to understand why the neuro and psychiatrist won't communicate--have you been really assertive and insisted? As for the "skilled care" need and acute med. emergency, I wonder if this is in relation only to his insurance coverage, and especially to Medicare, which will only pay in a NH if skilled care is needed. It would seem the psychotic episodes would indicate this. Would it make a difference if he were "private pay"? You saiud they took him off all those meds, but not whether they tried either clozapine or olanzapine (sp?) which can help with such problems.They are used by many neuros for PWPs with hallucinations, etc. Hooe this may be some help--stay connected. Camilla Flintermann, CG for Peter, 78/7, Oxford,Ohio [log in to unmask] * * * * * * * * * * * * * * "Ask me about the CARE list for PD caregivers!" * * * * * * * * * * * * * *