I'll try to make this as short as possible. I appreciate any insight you can provide. My family lives in Michigan, I moved to Canada. I've been estranged from the family for almost a decade due to issues with my father. My father passed away about 6 months ago and I returned to support my family for the funeral. Upon getting home I realized my mom was acting strangely. She was having a hard time getting around, asked about friends I never had, had gotten herself into some legal trouble (civil, not criminal), was months behind on her bills, and so on. Over the last 6 months we’ve been working on putting her life back together. We helped her relocate near a place where her horse is being boarded so she wasn’t driving 3.5 hours a day to check on it for 5 minutes (she has issues with paranoia, people wanting to hurt her horse or her dog, etc). We got her bills up to date, dealt with financing, doctors visits, medication delivery, etc. But in the process she has been almost completely unwilling to help us with anything. She can and does feed herself and her dog, she does have some basic hygiene, but that’s it. She also seems to drive fine. Anything beyond that and it’s a no go. She can’t manage her life. She can’t keep a clean house (to what extent I’m not sure, I’ve been told it’s less than sanitary). She’s not compliant with her meds. She won’t even check her mail so she can pass off pertinent info to me so I can stay on top of her bills. There are issues where we will ask her to do simple things that are obviously in her best interest like simple banking, paying rent, etc, but she simply doesn’t do it. It it’s not part of the basics of survival, it’s up to my brother and I to detect it and act on it. The big question that we had up until recently was that we didn’t know if she “couldn’t” take care of herself, or “wouldn’t”. We get some neurological workup and a cognitive assessment. She has mild cognitive dysfunction, but scores in the normal range. As far as we know there is nothing anatomically wrong with her brain. The next step is to try to get a psychiatric workup done. It should be noted that my mother and father were divorcing at the time of his death and she seemed completely unphased by his death, so we don’t know what if any contribution that adds to the current issue. The place where she’s living in right now is a manufactured home of her choosing that she loved and thought was very convenient until about 2 weeks after she moved in and then started talking about how much she hates it. The good news is that this was supposed to be temporary, we all know that, the lease expires in the Spring. The bad news is that it was her plan to use her savings to buy a house, get land, get a barn, get a pair of horses, some dogs, and live out the rest of her life tending to the animals. This is something we are absolutely convinced that she can’t do. She can’t take care of herself, there’s no way she could take care of animals, nor does she have the financial responsibility to take on something like this on her own. It’s also more than my brother and I can help her manage. We’re trying to figure out what kind of care my mother needs. How we can protect her from herself, etc. Everything up until this point has been reactionary to the “situation of the day”, but a lot of fires are out now and we need to plan for the long term. We really have very little idea of what we can do, or even if we can force her to do anything (or not to do something) given that she has passed a cognitive assessment. Again, any insight you can provide would be greatly appreciated. I doubt I’m the first person to run into a situation like this and I just need some advice on how to proceed from those with experience. Thank you.
A lot of one's cognitive functioning can be intact, but if your Executive Functioning is shot, there is no longer a " conductor" in the brain, running the show.
Was any imaging done as part of the Neuro workup? My mom's workup included an MR ( which showed a previously undiagnosed stroke) and six hours of paper and pencil testing by both a neurologist and a neuropsychologist.
Did the neurologist give an opinion about what level of assistance your mom needs? Ours was very specific and told us that she should no longer live alone, needed to be around people and needed assistance with medication.
As Rovana points out, she may be competent to make decisions, but you are under no obligation to enable her bad choices. If she talks about buying a property, saying " that's nice" in a noncommittal way could be a plan.
I suspect that your mom will "hate" whatever it is you do regarding her living arrangements, even if she appears to like it at first.
Keep a journal of what she does and how she reacts. This can be a simple spiral notebook, nothing fancy. Note each day what she says and any issues that come up.
Do not let her have very much money, if she is not handling it well. A credit card with a very small limit and do not let the bank or financial institution raise the limit. If she insists on holding a checkbook, only show small amounts in it so she cannot go on a spending spree, while you and your brother hold the majority of funds.
One of you needs a Durable Power of Attorney. Maybe tell Mom that unless she signs strangers will take away her horse and dog and may put her in an institution to live. She doesn't have the ability to reason appropriately and you need to do whatever is necessary to protect her from herself.
And YES, definitely speak with an Eldercare Attorney. It may cost you some up front but will be well worth the money. Your only responsibility is to keep her safe, clean, and protect her assets.
I'm sorry you are starting down this path, but don't torture yourselves too much over the can't vs won't dilemmas. Assume more "can't" and assume that it is OK to either quietly take over or remind and structure all the things that are not getting done that need to be. Having her participate with your supervision can help her save face and feel more in control - it helped with my mom for us to set up times we'd go through the bills and she would still sign the checks even though she could not manage the register at all.
As was already mentioned, you can have all bills sent to you or your brother and you can allow your mother a small allowance to spend any way she wants.
If you're concerned, you can even work out something for paying for animal feed and care. But it has been proven that people do better with pets.
I'm sorry if this isn't helpful. Just the flip-side of the coin.
She "wants" all these things, but w/o a LOT of help, she isn't going to be able to manage. So, don't help her. Pay her bills, etc,. but don't feed into the fantasy of the farm and such.
She sounds SO MUCH like a neighbor I have. Same lack of initiative to DO anything for herself...not unable, just won't. She's 24. So it may not be an age related issue--it could just her personality. My neighbor gets this wild flights of fancy that NEVER and I mean NEVER pan out. Every single day I see her for a few minutes to over 6 hours. She is on a new "topic" everyday. A new epiphany, a new way of living. I absolutely do NOT encourage her to do any of these crazy things, as she is incapable of even showering unless her hubby leaves her a "to do" list and that's on it.
So--age related? Maybe, but sounds like she didn't get this way overnight. I wouldn't support ANY wild changes of flights of lunacy. I would think she needs a better psych workup than she's gotten. If you have a feeling all is not well, go with your gut.
And of course, she could have some animals. They can be VERY therapeutic. Just not a stableful of horses and a farm's worth of other animals.
Good luck with this!
The situation you describe certainly does point to cognitive decline and you two sons need to take over. One option which I don't support is taking her to live with one of you. The other is assisted living where there is some supervision with meds meals cleaning and healthcare.
Definitely consult an elder care attorney. Do all the other things suggested about POA financial and health. Maybe she would believe if told you have to have it to continue managing her affairs.
What is her attitude towards the two of you managing her affairs currently.
This is not going to be easy for any of you but do what needs to be done.
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