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Norajune: It is your mother who has rights. Is she still legally competent to make her own decisions? (Dementia covers a large range of cognitive changes and not every one with that diagnosis would automatically be considered incompetent.) If she can legally make her own decisions, she can decide where she wants to live. She can also change her mind about who has POA. So, assuming she is still capable of deciding, what does Mother want?

You live too far away to take care of your mother where she is, but obviously you wouldn't be too far away if she lives with you! I don't understand your sisters' point. You live too far away from them?

It sounds like you also want to do this without causing divisions within the familly. Good for you! I wonder if a family meeting, perhaps conducted by an impartial outsider, would be a good idea. Including the brothers, and your mother, as well as you girls, in a discussion about what is the best long-term solution for Mother. This is not about which child is right, of what the children's rights are, it is about what is right for Mother.

One question -- the critical one right now -- is Where should Mother live? Close behind it is How will this be paid for? If she goes into AL, that comes out of her assets/income. If she goes to live with one of her children, there are also expenses that need to come out of her funds. For example, the primary caregiver absolutely needs some respite. Don't get into a position where you are the primary caregiver but you have to beg a POA sister to spend money for Mother's care while you take occasional time off.

My best wishes to you are you work this out. Please keep us informed.
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My mother has 8 adult children and has been recently diagnosed with dementia.My two younger sisters have power of attorney, and as far as they will tell me no guardianship. My mother 5 years ago mentioned to my younger sister she did not want to move from the city she lives now. But, now she has told me she wants to change her mind since she has visited a assisted living home, and does not want to live in them. I live furtherest away (3 hours away) from my Mom. My sisters who have the POA, want her in the home. I am willing to take care of my Mother, they will not let me. Do I have any
rights or what can I do? I don't want to fight with any of my siblings, or go to court.
But, my Mother is so dear to me it is breaking my heart. My mother can remember a lot still, her short term memory is really bad, and the doctor says she needs 24/7 care. I have had experience in the nursing homes, and a strong back.
She doesn't require much care now, but I want to take care of her till the end of her life. The sisters just tell me and give me excuses that I live too far away.:(
AF
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My Mom is 91, I work full time but my husband is home with her during the day. We have no lives of our own, She hardly eats and has trouble walking. I bathe her and do her laundry. There is no "day off". She is terrified of a nursing home, so am I frankly.
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Perhaps I was fortunate on this one---I had my Mom's physician strongly suggest this to her.....however, I had toured a nearby facility, and thought it was a good & safe place for her to be, and thus the transition went quite smooth---I hope this is of help!
Hap
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Sherri, you gave a very good answer, based on your own experience. You didn't ask for advice, but I feel compelled to offer some anyway: Lose the guilt. Guilt serves a very useful purpose and it should kick in when someone intentionally does something bad. People who cheat on their taxes should feel guilty. People who cheat on their spouses should feel guilty. People who push little old ladies down and steal their purses should feel guilty. People who make the best decisions they can out of love are not entitled to feel guilty. They didn't earn it and they don't deserve it. Please give yours up! :)
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Do you have power of attorney and is your mother officially incompetent to make her own decisions?

Even without the legal means to make decisions for her, you can make decisions for yourself. You can decide not to have your mother live with you. Then where will she go? I would get Social Services involved at this point, if they are not already. Here is an elderly woman whose doctor says she cannot live alone. What are her options? Make it clear that you will do everything you can for her, but not in your own home/place of business.

That is kind of the easy part. Now, how do you make that palatable to Mom? Boy, I hope other caregiver can help with that. I'm sure it isn't going to be easy. How far into the 3 month trial period are you? Is it time for a discussion about what isn't working for you so far? Is there some third party your mother would perceive as neutral who could help conduct a meeting about this?

You apparently don't want Mom to smoke or drink. (Who could blame you?) Was that part of the explicit agreement in the beginning? Or did you just assume she would continue without them as she had in the hospital, and she just assumed that once she was out of the hospital she could resume? What does her doctor say about this? For example, my husband's doctor says up to 2 alcoholic drinks a way are OK for him, unless I notice that they impair his walking or his cognitive abilities. Maybe getting her one scotch before dinner wouldn't be disasterous -- or maybe it would be a very bad idea. The point is that lots and lots of details like this have to be worked out in order to live peacefully together. And maybe there really is no way for this to continue successfully and you could have a much better relationship with your mother if you visited her frequently elsewhere and didn't feel like you had to take responsibility for her behavior.

Try to get an outside profession involved if at all possible.
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There are all kinds of assisted living places available. She could have her own room or share a room or there are even apartments available.
Our mother was diagnosed and then about six years into the disease I really had problems getting her to take her meds, bathe and she was dangerous. She would leave things on and walk around town whenever she had the chance. We wouldn't know where she was. Other people then saw that she was at a disadvantage and started taking advantage of her. She would walk to her bank and she withdrew over $6,000 in cash that she never knew what she did with the money.
Your loved one will never "want" to go to a facility. And it takes them a while to get accustomed to somewhere other than home. I started about a year before Mom got really bad and we would go and look at "Open Houses" and would attend activities that the different homes would open to the public.
She never, ever wanted to go. It was very difficult for a year. She accused me of stealing from her (but she accused everyone else also). She told me she hated me and when she looked at me, she really did hate me.
But the truth is, now she thinks as the nursing home as her home. She is not alone or isolated. The nurses know how to handle her when she doesn't want to take her meds or take a bath.
She rolled out of bed last year and fractured her back. This year she went into a comatose state because her heart was over worked because her thyroid was out of whack.
I always feel guilty that she is in the home and she has a way of even making me feel worse. But I know I can live with that guilt...I couldn't live with the guilt if she would die in my care because I didn't handle a situation correctly.
God Bless and write again soon....Sherri
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My mom is 81 and her doctor says she can no longer live alone. She falls frequently and the paramedics are usually called. Her blood alcohol level is very high. Hense, probably why she falls. She is in denial On top of that she cannot take care of her home, shower or drive. She is full-time in a walker. She is also a heavy smoker. In February after the last trip to the ER the Doctor said no more living alone. Assisted living or go home with a family member. That would be me. Her only daughter. I have 3 brothers but that is not an option. I live alone and work my accounting business from my home. 3 days after getting her in my home she was back at the hospital. This time for 2 months. She had kidney cancer. She came back home with me April 23rd, minus a kidney and as healthy as can be expected. She was alcohol and tobacco free for 2 months. 1st night - get me my scotch and a cigarette! It is not going well...for me anyway. I did say this was a 3 month trial. This is not working for me. Now how do I move her into assisted living withhout hurting her or making me feel like a bad person and doing this to my mom? I could give details of the strife but most of you probably already know the pitfalls of being a family care giver. Any suggestions?
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A POA does not give you the authority to place her anywhere against her will unless she has been deemed incompetent (typically the POA language stipulates that at least two physicians document that the patient is incompetent) OR indicated on the POA that she wanted it to be effective immediately. You can pursue guardianship (which would essentially deem her incompetent) or appeal to your local adult protective services department if she is a danger to herself and/or others. (Does she have the ability to respond appropriately if there were an emergency - fire, medical, intruder, etc? This is often a deciding factor for some authorities/doctors.) Would it be more acceptable to her, cheaper and as effective to have a non-medical home caregiver come in a few hours a day to check on her, assist with activities of daily living and other aspects of her care? Sometimes a few hours of non-medical home care can make the senior FAR safer and the senior can see that this is the best way to maintain their independence.
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My mother-in-law is suffering from dementia and currently has a family friend that cares for her several states away from her children. The children are wanting her to move closer to them and live in an assisted living facility. She absolutely refuses. She cannot cook for herself, her eyesight is poor (I think moreso from the dementia), her hearing is poor and she does not shower until after getting prodded by her caregiver to do so over several days. She gets very mad when asked to bath. Her memory is getting worse also especially for the short term. Her two sons and daughter are wondering if they can get her doctor to demand that she go into an assisted living facility or nursing home. Her caregiver that lives with her is going to retire. There are no other caregivers that would tolerate the hoarding conditions of my mother-in-laws house and because of her failing mental condition as well as the other issues we feel it's time to move her. Her response is that when her care giver leaves she will curl up in bed and stay there. She is NOT leaving. My question is a simple one. What steps do we have to take to make her leave even when she doesn't want to? She lives in Texas. We live in Missouri. Do we have to go to court?
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Thank you LakeForest.
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I am the Direstor of Admissions for a Retirement/Assisted Living/Memory Care community called Lake Forest Park in Ft. Pierce Florida. I have to work with this issue every day. For those of you wrestling with this serious issue, a few thoughts that may help: When our parents were young, there was no such thing as assisted living. Our elders stayed at home until the situation was a panic then were sent to a nursing home (SNF) where people were degraded, treated poorly and often abused. Is it any wonder they have this immage about assisted living? Also consider the shrinking world of our elders. First they lose a spouse, then the dog dies, then they are told that the home they have lived in for 20 years is no longer safe for them, then you take the car away, then the checkbook. Is it any wonder they fight so hard to maintain what they feel is their independance? You and I know this is wrong but it does not change what they believe. Please understand that they are quite literely afraid.

Make sure they visit the community and dine with and talk to the residents there; it will go a long way for their comfort level and you will learn quite a lot about the real story on the community you are considering.
The doctor idea is a GREAT one and can be very successful. Use it whenever possible.

When you speak to your parents about the concept of the move, try not to present it to them as something they must do for themselves. Telling Mom she has to move because she is incapable of self care will only get you a ton of push back. Instead, present it more like: "Mom, you and Dad have been making sacrafices and doing things for us kids your whole lives, and we love you and admire you for it. But, WE need to ask you to do one more thing for US, please make this move so we can stop worring.

I hope this is some small help to some of you.
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Yes!! have the doctor tell her that she needs the medical assistance she'll get in assisted living. My Mom began to suffer severe arthritis complications and one knee would give out. She fell a few years ago and broke a hip. He told her "move now or you'll fall and end up in a nursing home. Move while you can have input on the decision and can still get around well enough to make friends." it worked. She still asks if she can go home but we repeat the same thing to her: Your house is not safe and remodeling is too expensive. You can't cook food, can't shower alone and need wider halls and doors for your wheel chair. You are safer here. She can't argue with that. Some days she becomes beligerent about it but we change the subject. The Mom we know and love is slowing leaving us and that beligerent lady is not her but we're kind to her just the same. It takes some getting used to but after six months we're okay with it now and Mom's in a safe place.
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If your mother competent, as defined by your state's law, then you don't have the ability to make her do anything against her will. The best way that I have seen work over is to slowly introduce the facility to an elderly person. If they have adult day care, use it occasionally. If they have a large social event that they would allow non-residents to attend, take your mom.

Much of the resistance of elders to ASL's or NH's is fear of the unknown. If you can knock down a lot of the unknowns, your will eventually succeed.

David Fitch
http://elderlawminnnesota.com
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I love the idea of having the doctor tell your mother and her learning that AL are far different that a nursing home. It's not the "Poor House" that so many are afraid of.

My overall approach in trying to influence people in a good direction is to find someone whom they respect greatly and discuss the concern with them. If they agree with me, I encourage them to discuss this with ___ in generalities or ask them if I have their permission to quote them to ___. For example, my mother greatly respects the opinion of the family lawyer. Her trust level of me is high enough that often I would share what ___ thought of ____ and she'd go alone because the lawyer thought it was a good idea. My mom's neurologist was so tactful that she never really grasped what he was saying to her about assisted living. So, quoting him never got us anywhere.
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Hi - I totally agree with Crowmagnum...the fact that she is compitent right now, one does not know what will happen down the line, also inasmuch as the doctors think AL would be good for her, I am in agreement. Also you DO NOT want to wait for a crisis and then you will have not much choice, if any, in finding a facility for Mom....
I would check the different facilities, and get her on a waiting list...you can tell her that this is what the doctor has ordered, and ultimately it will be a sound move for everyone involved.

My own Mom was told by her doctor to make such a move, and coming from a person with a medical background-I was fortunate she went along with it.

AL is not the end of the world-and she will still be able to maintain some/ or most of her independance. She may even thrive with all the activities many of the AL facilities have to offer.

Good luck!
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Has her doctor told her what he told you about not needing to live alone? In my state, NC, I have heard of a doctor writing an order for a person to go to such a home and they went.

My mother was able to write checks for several years before her stroke which along with a broken hip forced her into a nursing home. However, the ability to write checks does not mean competency to handle one's business which she did not do for since all of this exploded I've been working with a CPA to file 6 years of past due taxes.

It will be much better for you and your relationship with your mother if someone else can help her see her need to go to assisted living. Otherwise, you will have to wait until she is willing or some crisis takes place like with my own mother.
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I'm going through a similar thing w/ my Mom right now. She is in an independent retirement community, and has a 1 bdrm apt. with full kitchen, washer/dryer etc. Her memory is VERY bad (short term, and some long term) but I feel she's handling herself fine at this point. She showers every morning, and dresses nicely, she fixes her own breakfast, takes good care of her cat and litter box, she goes down to dinner every evening with other residents and chats and laughs, (she can't find her own way to the dining room as she hasn't been at this place too long, and it's quite a distance) but if the others couldn't take her down one evening, she'd be fine with staying in her apt. and fixing soup or scrambled eggs, etc. One very active and fully functioning neighbor lady keeps telling me she thinks Mom should go to the assisted living section of this place. Mom is adamant about NOT wanting to go to assisted living. I live 5 minutes away from Mom and see her at least twice a day, take her places, have her over to my place, etc. so I see how she's doing. Some days are better than others, and when she gets extra tired she becomes a bit more confused. I think parents should be allowed to live independently as long as they possibly can, if that is their desire. I've heard that forcing them into assisted living against their will can often result in fast deterioration.
If the parent is able to do MOST things for themselves, and not endangering their own lives, why can't they continue to live in their own homes? Your Mom is paying her own bills and communicating by writing. (My Mom could no way be paying her own bills....I do all of that) Your Mom must have her wits about her, I would think. Maybe your sister could have another chance at caring for her, and you could install a Nanny-cam to make sure that there is not verbal abuse going on. Another idea would be to get somebody to give your sis a break on a somewhat regular basis, so that she can get some stress relief. She might not have the degree of patience it takes to care for an elderly parent on a constant duty. A break each day might help immensely. I would encourage you to try to let your Mom have her wishes met as long as possible. If it doesn't work out, at least you'll know you gave it a shot.
Best of luck to you. I can totally relate.
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Like you said you are power of attorney and you probably could make her move, but do you want that? You can see in my profile I not only have my own home care business but I write articles for The examiner under the section of Elder care. I get my articles from my clients or former clients and their families.
I know from personal experience that trying to force your elderly mom to do something is not good for your relationship.
I slightly understand dementia but know that it's different for every person. I don't know what aphasia is at all.
I've known people with dementia that their minds lived more in the past than they did the now. The retained good memories and would refer to them often.
I guess before you even approach your mother about moving I'd research the assisted living facilities in your neighborhood. In our area they are much higher than living at home and hiring a part time home care provider. The benefit usually is they make the meals for them and provide maybe 20 minutes of personal time a day. But you can hire someone to make the meals, do laundry, talk to your mom and help with the bills.
I am not an expert, I've just seen struggles that occur with a family when not united on an idea.
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