If police come: arrest, the ER, APS and care homes

Anyone in danger right now? Step out of reach and call 911, with the words to say. This page is what can happen after someone is hurt, and what you can ask for.

If police come

When you call 911, police usually come. NAMI warns the person may be handcuffed and driven in a police car. It is hard to watch, so expect it. Police may also take them to a hospital for an evaluation, sometimes against their will.

Some states require police to arrest after an assault in the family. Others leave it to the officer. None of the four state laws we read makes an exception for dementia. Whether they meant harm is sorted out later, in court.

Prosecutors can choose not to charge, or drop a case. A 2022 American Bar Association report urges them to handle dementia cases outside the criminal system. A dementia diagnosis should raise the question of whether the person is fit to stand trial.

• Arrested? Get a lawyer right away, and tell them the diagnosis. (The report says lawyers often miss it.)
• Try free legal aid first: LawHelp.org or the Legal Services Corporation finder. (Legal aid has income limits.)
• Look up your state's arrest rule in the Battered Women's Justice Project list. (Updated August 2023. Then read the law it names on your state legislature's site.)

Find out what your area has

Crisis teams are set up county by county, or city by city. On a calm day:

• Call your police department's non-emergency number.Do you have CIT-trained officers or a co-responder team? How do I ask for them?
• Ask your local NAMI group about CIT in your county.
• Call or text 988 and ask if your area has a mobile crisis team. (It is built for mental health crises. Whether it can send help for dementia depends on where you live.)
• Call 211 for local services. (It is confidential, and you can stay anonymous.)
• Tell your police department about Approaching Alzheimer's. (The Alzheimer's Association's free course for first responders.)

The ER, and psychiatric holds

A hospital ER that takes Medicare must give a screening exam to anyone who comes in with an emergency. After that, expect a wait. A 2026 study of older adults in two Massachusetts ERs found more than half waited 24 hours or more. Those admitted for psychiatric care waited a median of 44 hours. Nearly half had dementia.

• Bring a one-page summary. (Diagnosis, medicines, what happened tonight, what calms them, your phone number. The hospital page has an “All About Me” sheet.)
• Lewy body or Parkinson's dementia? Say so before any sedative.
• Ask for a medical work-up. (Pain or an infection can cause sudden aggression.)
• Ask whether a geriatric or behavioral health team, or a video psychiatry visit, is possible. (The 2026 study recommends video psychiatry for older adults who must wait.)

Each state sets its own rules for emergency psychiatric holds. In the two states we checked, Florida and California, a hold lasts up to 72 hours. In some states, dementia alone does not qualify. Florida's law leaves out conditions shown only by dementia.

Geriatric psychiatry units, often called geri-psych, are few. Families report the way in is usually through the ER. Medicare Part A covers inpatient mental health care. In a freestanding psychiatric hospital, it pays for up to 190 days in a lifetime. In 2026 the Part A deductible is $1,736 per benefit period.

Ask to be part of care planning, and bring your notes and the medicine list. (In a small UK study, families felt shut out of decisions.)

Leaving the hospital

Hospitals must plan a discharge with the patient and their caregivers as active partners. The plan must look at what help is available after the hospital.

• Cannot take them home safely? Say so.I need to be part of the discharge plan. I was injured on [date]. I cannot safely care for him at home right now. Please note that in his chart.
• Ask for the social worker or case manager.
• Admitted on Medicare, and discharge feels too soon? Ask for a fast appeal. (The steps are on the hospital page. They do not cover an ER visit or an observation stay.)

Adult Protective Services (APS)

Every state has APS. It looks into abuse, neglect and exploitation of vulnerable adults. It must try the least restrictive help first. Moving someone into a nursing home against their will is “very unlikely,” and takes a judge's order.

• If APS contacts you, cooperate. (If the facts do not show mistreatment, the case is closed.)
• Older or disabled yourself? Ask whether APS can help you too. (Some states serve any older adult. The Alzheimer's Association says no one should live in threat of harm, including from the person with dementia.)
• Find your state's APS on the NAPSA map. (Or call the Eldercare Locator, 1-800-677-1116, weekdays 8 a.m. to 9 p.m. Eastern.)

The Alzheimer's Association helpline can connect you to APS. You do not need to prove abuse is happening. Like many health workers, its consultants must report abuse or neglect they are told about. You can ask them first how they handle a call like yours.

Your injury

• Get care, and tell the clinician how it happened. (Medicare usually covers ER care for an injury.)
• Worried about a police report? Ask first, then get treated either way.Before I give details: are you required to report this to police in this state? Can I say no?
• If they must report, ask them to tell you first. (A national guide tells clinicians to explain where a report goes and what happens next, and to offer to make the call with you there.)
• Older, frail or disabled yourself? The answer can change. (A doctor or nurse may have to tell APS about your injury, even if you say no. Ask how they handle it.)
• Get support for yourself. (Your Area Agency on Aging offers caregiver counseling and support groups. Medicare Part B covers therapy.)

Whether a clinic must call police depends on your state and the injury. Most states require a report of gunshot wounds, and many add stab wounds. Washington's hospital law, for example, covers only gunshot and stab wounds.

Some states go further. In California, health workers must report any injury from an assault, whoever caused it, even if you object. The report names whoever you say hurt you.

A few states let an adult hurt by family say no, with limits. In Oklahoma, if you are an adult and not incapacitated, a clinician reports abuse by family only if you ask. In Pennsylvania, you can say no only if a spouse or partner hurt you, the injury is not serious, and no weapon was used.

If no law requires a report, a clinic usually needs your OK to tell police about abuse. If they report it as abuse or domestic violence, federal privacy rules say they must tell you, unless that could put you in danger.

A report does not decide what happens next. Police do, and in some states they must arrest after a family assault. Prosecutors, not victims, decide on charges. You can still tell police and the prosecutor what you want.

This is general information, not legal advice, and laws change. To check your state, ask the clinic, your state domestic violence coalition, or free legal aid through LawHelp.org. Or read the laws: California, Oklahoma, Pennsylvania, Washington, or the state-by-state list from Futures Without Violence (2019, so check the law it names).

The person's doctor may share what you need to know to help with their care. A doctor may also warn you of a serious and imminent threat to your safety. If you are their health care agent and the power is in effect, you count as the patient for their health information.

If a care home sends them out

A nursing home that takes Medicare or Medicaid can discharge a resident who endangers others. A doctor must document it. The home must give written notice with appeal rights, and copy the state ombudsman. It cannot discharge during an appeal unless staying is unsafe. It must also have a policy for letting residents return after a hospital stay. Assisted living follows state rules instead.

• Call the free Long-Term Care Ombudsman the same day. (Discharge is their most common complaint. Find yours through the Eldercare Locator, 1-800-677-1116.)
• Ask for the written discharge policy. (For assisted living, ask for your state's licensing rules too.)
• Got a discharge notice? Call legal aid too.

Most community care providers refuse to admit, and will discharge, people with dementia and a history of violence, the 2022 ABA report found. That came from surveys and interviews, not national data.

Sources for this page, with the dates we read them: the sources page.