Dad and Mom are both 85. After a long period of divorce they remarried and had a brief period of happiness. My father was responsible for the bills and although he was showing signs of dementia, my mother didn’t make herself aware of their finances until it was too late and they filed for bankruptcy. This was 5 years ago and the marriage deteriorated steadily after that. My dad’s dementia continued to manifest itself and my mother couldn’t cope with him, was frequently mean and complained to anyone who would listen. My dad’s memory is severely diminished with each new day so he Often doesn’t remember the terrible treatment he faces every day by my mother.
Recently my dad , after an argument, left their home to walk to my home (about 3 miles) in the dark, in the pouring rain, fell in street and was helped to my house by a Good Samaritan. He fractured his clavicle. I decided he would stay with me. Two days later my mom fell in her bathroom and is currently hospitalized with a Cervical fracture C2.
Dad then developed pneumonia and is now hospitalized.
Prior to Dad’s current hospitalization and during the period leading to pneumonia diagnosis, dad began slurring his words, was unsteady and was very out of it, much more than usual and had accidents at night.
When we start to try and decide what to do going forward, we know dad will go along with whatever my sister, brother and I say. My mother will be in rehab after discharge from hospital for several weeks. She is adamant that she will not move out of her apartment which is not affordable, two floors, she has vision limitations, etc.
I realize this may sound very convoluted and I’ve tried to be concise because I’m hoping it will resonate with someone who may have dealt with this situation or a version of same.
Any feedback or thoughts are appreciated.
Your father may be biddable at the moment, but what if mother emerges from rehab all guns blazing and claims him back? They're a married couple. The default position, the assumption, is that they stay together.
So at the moment he's in hospital - any estimate of when he might hope to be discharged? - and she's in rehab; and the last time anyone looked they'd had a huge dust-up and weren't speaking to one another. But you know better than I do that this is a volatile couple whose lifelong relationship has been one of conflict and reconciliation. It must have been harrowing and exhausting for you children, but the point is it's not over. You have to approach whatever plan(s) you want to make treating them as a unit until they are officially not one.
Has your father's mental capacity been assessed? What is his legal status when it comes to these decisions?
Your mother, mentally, is fine? She is also, officially, your father's next of kin and his primary caregiver. You can't just set her to one side. If it becomes an issue of safeguarding your vulnerable father you're looking at a guardianship application. With his fracture and the pneumonia it should be comparatively easy to hurry it through, perhaps, but that will be the end of friendly relations with your mother. I think you really need professional advice, the sooner the better.
We needed to move mom and she wouldn't even consider any kind of move (AL, despite being in her plans prior to dementia, was NOT going to happen and she refused offers from brothers to move in with them.) Our EC attorney, who had set up everything, including all POAs, years before said we could NOT force her to move with just POA, despite her having dementia, and recommended guardianship. The facility we had chosen said NO to committals. In the end we had to "trick" her into going there - staff had said just get her there and they would take over.
Your mother, if competent, is going to be difficult to move. IF the doctors can write up orders that she is not safe to live alone, it might help when it comes time to discharge from rehab, but I wouldn't hold my breath! You could try setting her up in a place and moving her straight to there from the rehab, and say it is doctor's orders until she improves even more, kind of like a half-way house. If you can do that, you just keep deferring the move back home, blaming the doctors.
The only other option is to set up home care and let her go home. That also could be an issue, dementia or not. Some people refuse the help and order them out or fire them. We wanted to keep mom in her condo as long as possible, so we started with a 1 hour (minimum) check and med check (using a timed dispenser, they would check it and guide her to take it if she hadn't, which was often! They can't dispense it, but they can check/guide.) Anyway, that lasted only about 1.5 months, 5 days/week (none of us was close enough to do even semi-weekly checks.) She then refused to let them in and we had to resort to plan B, the move.
Depending on their finances (given the bankruptcy issues, sounds like they don't have much!) and to help get options for mom, it might be good to consult with an EC attorney, as your dad will likely need to apply for Medicaid. Draw up all your questions on paper and check for EC attorneys - often you can get a free initial consult, where you can ask all these questions and take notes to see who can provide the best help (and compare prices.)
Using https://www.naela.org you can enter your zip code and find local EC attorneys.
I don't see anyone else mentioning it, so here goes: Have him checked for a UTI. I was skeptical when first reading this on the forum, but having had several episodes, I am a convert! It is an easy test (preferable to go with a full culture, if possible, not just the dip stick test, although that could be done first) and will quickly rule that out.
It is bizarre what UTIs can do. Mom used to get UTIs all the time, but she knew and would seek treatment. About a year+ after moving her to MC, she began having some serious late afternoon/early evening sun-downing, ranting that she had to get out, go home, had guests arriving and setting off all the door alarms. When the finally calmed her down, she was okay overnight and in the morning/early afternoon, then it would start. Sure enough. UTI. We had to use Lorazepam along with the antibiotics to keep her calm until it was cleared.
This year (just finished year 3 at MC) her two UTIs manifested as bed-wetting at night. She is fine during the day, can't be roused to go during the night, but sometimes they find her on the floor because she tries to go and hasn't had the stamina/desire to stand/walk on her own at any time recently, so she ends up on the floor. After treatment, the bed-wetting stops.
So do consider having a check for UTI on dad.
Because he had fallen while in her care a few times (we practically knew the ER staff by then), we simply asked to talk to Case Management at the hospital and explained their living situation. Case Manager got FIL’s doctor involved, and they flat-out told both my in-laws that Dad wasn’t safe to go back to their house, and that Mom could no longer care for him. We found an excellent Assisted Living facility close to us. Rather than let him go there alone, Mom agreed to move in with him. It’s been two years, and she is still quite bitter and angry, and is very mean to him. But at least they are safe! Probably one or both of them would be dead if we hadn’t gotten them placed.
My mother passed in 2004 and I stepped in to assist my father. I promised him that he could remain in his home, for as long as he was able to function. BUT, I told him that if the day came, I would make the decisions about where he resided.
The day came that I went to see him and he was sitting in the dark, watching the television which was off. I asked him what he ate and his reply was that he couldn't decide what to eat, so he didn't. I asked what he ate the night before and it was pretty much the same. I told him the time had come for me to relocate him and that I would place a Mobile Home on my property for him to continue to have privacy and independence. Yes, he cried, but also thanked me for taking charge. I said to him, give me 3 months to get your health back and you can then return to your home. BUT, when it happens again, you will not be returning to your home.
Thankfully Pop had a small pension and it paid the notes on the trailer and I had peace of mind knowing that he was safe in my front yard. 24 hours after moving him to the trailer, he told me he was never going back to his home - this was his home now.
The day always comes that we must become as the parent, advising our parents what is best for them. Not Telling, Advising them. Pop lived in my front yard for 5 years and was very contented.
I only hope you will be as blessed as I was.
Do not take them home. This is your opportunity to get both placed somewhere. Dad, I would place in LTC with Medicaid if needed. His Dementia will only worsen and be beyond an AL. Mom, same thing, if she can't afford an AL then its LTC. If you bring her home, it will be harder to place her later. Also remember, Mom will become a Community Spouse meaning she will be left enough to live on. If she can't afford where she is living, there are nice Senior apts either u pay on scale or there is a flat rate.
Look for respite care and/or home health care for both when they leave where they are. Ask their doctors re: these, and get those lined up. They have to have somewhere to go as they can't go home and be alone.
Find AL with memory care, select the best choice/s to show, and take them to each one if they're able. Otherwise, show them pictures, and get an agreement. If mom won't agree, tell her she can't live alone any longer due to safety and fall risks, so she'll have to move & live in AL even if it's separate from dad's living memory care. They can be at the same place, but not necessarily in the same apartment.
You'd be neglecting her care if you leave her in apt. at her age, so maybe tell her that. She may make necessary changes to help herself for you and so you don't worry. And, of course, dad can't go back home to her or any home without 24/7 care.
If they do not have enough money to self pay for AL, then apply for Medicaid.
Your mother's doesn't wants no longer matter, it is about what she can afford and what is in her best interest...for her well-being, same applies to your father.
- does anyone have durable PoA for either parent? Sounds like your dad would be willing and if so, download the docs from Legalzoom.com or Rocketlawyer.com and get that into the works. Your mom doesn't sound like she'd be willing...
- if you have durable PoA for your mom and since she is currently in rehab, I would make sure she goes straight into AL or LTC. She won't like it, she'll be extremely angry, but she is irrationally unrealistic and now you must operate in her own best interest.
- if you don't have PoA for your mom, I would contact the social worker at her rehab and let them know in no way should she go back to her apartment or check herself out of rehab, if at all possible.
A lot hinges on the PoA question so please provide this info if you can. Blessings!