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My mother has undiagnosed dementia. It is undiagnosed because she refuses to be tested for it but her PCP and a neurologist states that they suspect she does. She gets confused and has lapses in time. I am currently staying with her because I lost my job, have not been able to find another one except for occasional odd jobs online and am a single parent with no support (so it's a rough time).

Today, she became quite violent (hitting and yelling insults) after I talked to her about an evaluation. She has also hidden her documents where she named me POA. I'm calling local shelters to move ASAP and calling around for any job (cashier, stock clerk, whatever is available). Should I file a police report or just move out? This is not the first time this has happened either. To be honest, I'm really scared not for only our safety but being on the streets.

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If the options are being homeless or staying with your mom who has dementia and combative outbursts I would stay at home. Yes, the combativeness is troubling but with the right medication it can be lessened. Call your mom's Dr. and see if they can help. You may need your POA for the Dr. to speak to you about your mom but maybe not. My dad's Dr. knew I was his caregiver and never really made an issue about the POA (however I did have my dad's POA).

If you file a police report Adult Protective Services will likely be called. Then you will be in the 'system'. You may need to get a lawyer if you can't be responsible for your mom yourself. She will need a guardian and a lawyer and court costs can be thousands of dollars. However, if you just take off you can get in trouble for leaving your mom alone.

Take some time and figure out what you're next step needs to be. Don't just take off without thinking things through. I know the combativeness is upsetting and scary but I would think living on the street or in a shelter would be worse.
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Can your doctor prescribe visiting nurse home care? I think Medicare covers it. The doctor should know. The visiting nurses can coordinate with the doctor and get her the medication she needs to control her outbursts. Call her doctor and see what options are available . Another thought... Is she eligible for Medicaid. That is a program thar provides home care and or nursing home care to those financially in need. Call your state Medicaid office as to eligibility requirements.
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Thank you for your answers. I'm still quite upset because other family members also witnessed the attack. I will need to see if I can find a copy of the POA. She is not eligible for Medicaid.
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Look at the county courthouse where you think this POA is filed (it should be).
Hang in there and know that you shouldn't be abused.
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The poa is probably NOT at a courthouse (this is not required); you might call her lawyer (if you know the name or can find out - look in her checkbook to see who she might have written the check to); the attorney might have an original for you. If you don't have a poa - your only alternative is a legal guardianship/conservatorship. This is expensive and time consuming but necessary.
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You definitely needed to call the police, even without the POA in hand. And you call APS before they call you.
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Well, she is now threatening to throw me and the children out. I have drafted a thirty day plan to get myself in a better position to move by then. I've had time to think about it and anonymously contacted both the county and police for guidance . The county stated that if a domestic violence call is made and children are in the house, they would require that I leave immediately or be investigated for neglect. Yet, there is no room in the local shelters right now because they are completely filled up. So like Eyerishlass stated, I would be in the 'system' and not in a good way. I'll have to work hard (and pray) the next thirty days to move out.
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The violence is an absolute indication that she needs an evaluation and probably a guardian. She will end up in the care of the state if she can't care for herself. That's bad news that all the shelters are full!! You sure need one - are you on every possible waiting list?
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First, let me say that I do fear for your safety and am not trying to trivialize it.

With that said, I wouldn't be surprised to find that her outburst was based on fear. Would there be any of us reading this who would not find an evaluation a stressful and fearful thing? Would that not be a likely way to cause an outburst? I think that if I were her that I might not want to take a test that tells me something that I probably not only do not want to know, but would find to be a terrible, terrible burden to bear. Dementia and memory loss are two extremely feared situations and many people do not want to know that they are sliding into them.

Let me ask this: is it important that she get tested for dementia? Is there some benefit or something she would get that's different than if she weren't tested? Another way to look at this is, from her point of view, what's in it for her to comply? If she fears being put away, being labeled with dementia, or something else that she finds distasteful, I wouldn't think she would want to go along with this. If there's no useful outcome, I wouldn't bother with it, for the moment.

If you truly fear for yours and your children's safety, this is truly a problem, but if you think you should/would stay, try thinking of other tactics to work with her.

One more tip: when I got POA for my mother's finances and health, a lawyer friend suggested two notarized copies of each, one for Mom, one for me. If your mom ever gets hers out, see if you can at least get it copied.
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This is extremely sad for you. Without a complete evaluation, including an MRI one does not know for sure what is going on. She does display dementia symptoms. But hard to know for sure. I think you need to get her back to primary doctor. Talk to him ahead of time of what you want him to do. See if he can suggest an evaluation for her in front of you. Coming from him, "the doctor" may have more weight. If she responds to him like she did you, it will get the ball rolling on what needs to be done. If he admits her for mental status change, even better. She has behavioral issues which need to be addressed no matter wherever she is. I know this is hard...... The one thing about getting her into a hospital, so many tests can be done much more quickly than out of hospital.
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Is there anywhere else you can go? Think about other relatives, friends, etc. You may not be that close, but you could ask them if you could crash with them for a specific short term. Especially, if they are aware of what has been going on. You need to get your children out and worry about them first. Mom will have to come second or third.

Then you can call the state to investigate self-neglect of your mom by your mom.

You might 'trick' her by telling her you need therapy because you're depressed about the job loss, etc. and asking her to go with you. You could start out talking about yourself and the kids and work up to talking about her.

And you can try the county courthouse for a copy of the POA, if you don't know the attorney. If you do know him, he should be able to help out.
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The reason for an evaluation is not just to give people news they don't want to hear. The reason is there are treatable things that can cause dementia, and there are treatable things that can make behavior a LOT better. For all we know, Mom has a UTI or other infection and is going off the deep end, and is about to throw the one person out onto the street who actually cares about her, and permanently lose the chance to see her grandchildren, for the want of a medical visit and 10 days worth of a cheap antibiotic.

And if you really lose your ability to manage, as well as the ability to recognize that, do you really want to be left sitting in a pile of excrement, trash, and rotting food, or do you want someone to take over for you? Do you really want all your money to go to the first sweet-talking con artist, related or not, rather than to your care and then your responsible and possibly genuinely needy loved ones?

I can't begin to tell you how much grief and suffering is preventable with timely diagnosis. Not all, it's true, but advice to stick your head in the sand and pretend everything is OK to avoid hurting the feelings of the person invovled is flat out bad advice.
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Confused, is your mother dangerous if she's not being confronted with something upsetting to her? How is she day-to-day? If she's okay normally I'd say keep her calm and work full steam ahead on securing your own situation independent from hers. I'd imagine it is next to impossible to take a strong stand and a parent role with a combative elder when you need them for your very survival. Prayers for good opportunities to open up for you soon.
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Very concerned for you. Great answer from above. You must also, take care of your health and safety before you become sick. God bless
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If you are able to speak with her doctor, you must have provided them with a copy of the Power of Attorney. Do you remember the attorneys name who drew up the papers? My Mom has times she is violent too. But I have a locked filing cabinet, so she can't do that (plus copies of the documents). You can call Adult Protective Services and see if they can do anything to help. And maybe there is a way she can be evaluated in her home. I'm sorry you are going through this. I feel all alone in this with ignorant relatives and a greedy brother who loves calling Adult Protective Services on me. My Mom refuses to see the neurologist because she says "he's crazy" not her. But she has been evaluated. Call Alzheimer's Association and maybe they can give you suggestions. They have a 24-hour line and have helped me a lot.
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The next time she becomes violent with you call the police. When they arrive the situation may escalate and at that point they may bring her to a psych ER. She will be evaluated, and either released, or admitted for observation. Also, as others have suggested, get in touch with Social Services, a social worker will come by for an evaluation, and the social worker will be able to make suggestions to you as far as your living arrangements go. Good luck.
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Not sure what state you are in but if your Mother is getting violent and trying to put her hands on you or the children you should call the police. If she is still violent when they arrive they can put her on a hold and get her evaluated in the hospital for 72 hours. Awful thing to do but necessary at times if she is a danger to herself or to you and the children. Dementia does not get better so educate yourself as much as possible so you know what to expect down the road. Maybe her temper tantrum will pass and you will not have to leave the home. Keep us informed and my thought are with you during this difficult time of your life.
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I think you've received some excellent advice. I've been through this myself twice in the past and geo123's advice was best for my situation. My mother has dementia, but cannot face that idea. This is something I realize and I don't force it on her. The times she became violent was when I tried to take charge of her medications in the past. She was making a mess of things, but did not want to lose control. Losing control of her life was probably her biggest fear, so she tried hitting and insulting. With her, I let her take the control back, then found a gentler way of doing what we needed to do.

I don't talk to my mother about dementia, because it serves no purpose in her case. She talks about my uncle and aunt who had/have dementia, and speaks of them as crazy. Chances are that she knows she has it, but doesn't want other people to know because she doesn't want to be seen as crazy. I can understand that. I don't think any of us want other people to know how crazy we really are. :)
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I do agree you need to call the police because Adult Protective Services is right behind them. However, unless your Mom is violent towards the officer, they will do NOTHING. You are the one who will be investigated. So get Social Services out there, maybe they can put her on a forced hold, but I have found (and been told), it is my MOTHER's welfare they care about, not mine. So they treat her like a China Doll, while I'm the one with the bruise on my chest. Because she's incompetent, they will NEVER arrest her or take her into custody. Call Alzheimer's Association, they will tell you what steps are involved. They are your best option (and Agency on Aging) before Social Services bc once they get involved, it's YOUR ASS on the line. I'm saying this from experience. Adult Protective Services was out here again last week because my brother called them again and told them I wasn't feeding her and leaving her alone for long periods (LIE). Be careful because you and your kids are the ones who matter.
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I agree with vstefans and stand by my first answer...a diagnosis for figuring out a course of treatment is necessary. It is common sense medicine..... What would be helpful for confused is to get her mother in the hospital, so she has a few days to figure out what to do for both of them.
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Thank you everyone for your advice. The doctors will not speak to me in detail because I do not have the POA but they do provide me basic information and that they are concerned she is refusing any further evaluations and possible treatment to slow down the progression. She is very secretive (she has always been this way). I contacted Adult Protective Services and spoke with them for awhile yesterday. They asked many questions and asked if she had ever been seen by a mental health professional. The person I spoke with was quite frank that this was most likely a mental health issue that was not the type that sometimes occurs with dementia . It was difficult to hear because I had to revisit old memories that I must have suppressed over the years.

I've been tiptoeing around the issue with her about talking further with her doctor because she just says I'm crazy and need help when I tell her that it's not time for church, to go to the store, doctor appts, etc. She will then argue until I have to walk out of the room and then on the phone, bad mouth me to other family members or anyone that will listen. This is why I felt it necessary to ask her if she might want to discuss with her doctor why her interpretation of the time is different than mine (hoping that would get the ball rolling for more evaluations and eventually treatment). Unfortunately, the closest family member I have is in another state and I don't know many people in this area. Because she punched me in the face, said that she didn't want my help nor did she care for or love me yesterday, I will be focusing on leaving and not her anymore. I also realized that she is very good at pretending when the situation calls for it, and would pretend like she was "a China Doll" as LEP627 put it - calling the police or even APS for a visit would just anger her more after they left and I don't want APS contacting Child Protective Services. I feel like my hands are tied (not to mention my heart is broken) and I should just lay low while working on moving.
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You have to do what you have to do........ hope all works out......
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I think one way to approach the topic of evaluation is to say that you would like someone to evaluate how you take care of her! The evaluates will really be evaluating her, and telling you how to assist her best, so it is just an another perspective of the same situation. See if her insurance has someone who can come to the home, like a Nurse Practitioner who specializes in elderly and demented folks.

Also, tell her that her behavior scares you and scares your children. Sometimes people have no idea how intense their behavior actually is. "you are scaring me now" can be a helpful tool.

Dad hated when I started doing his meds, at the doctor's request. I use a med box, weekly, and watch him take the meds. He feels he still has control. If your mom is confused, a daily pill box may be the answer, they have some on a timer. If the box is clear, you can look to see what is happening and that the right compartment is empty.
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Since her PCP and neurologist seem to be in agreement, ask one or both of them if they can commit her to the psych unit to have her evaluated (for 72 hrs.). Above all, do not let her hit you, and yes, I would call the police because you want to document the abusive behavior. Don't move until you have a safe place to go (try a women's shelter), and do not antagonize her. She cannot help what her mind is telling her to do. Be safe!
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You can get a geriatric care manager to come to the house. Good idea to get copy of POA from lawyer. We learn that we have to lie and go along with elders with dementia, while taking steps to take care of them at the same time. They reach a point where you cannot and should not try to reason with them and it sounds like you have reached that point. The appointment whether ay home or through a geriatric specialist/psychologist can be described as a visit to review medications and be sure they are the best ones for her. In our case, her regular doctor supported this by saying (truthfully) that she did not have enough expertise with people in my mothers age group to be sure of the best choices for medicines. Switch the doctors report stating dementia with a copy of the request for bloodwork so she does not see the diagnosis to avoid additional tantrum. Discuss this with the care provider ahead of time.
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Another thing you could try is calling her PCP and explaining the situation. Sometimes, if you ask and they can work it out with Medicare, they will assign temporary home visits with a social worker to assess her needs.

You could also make her a doctor's appointment for a check-up, medication refill or whatever, and bring up the subject of an evaluation while you are there. If she has a violent reaction in front of the doctor and they see what you are dealing with sometimes they can help you come up with a way to get her the help she needs - especially if they know there are kids involved, too.

Good luck - my mother isn't physically violent these days but she is verbally and emotionally abusive and has put me (and my husband & kids through h***). You must be feeling quite trapped at this point - have you checked with Social Services regarding temporary assistance for you and your kids?
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This is just my opinion but it may help you to understand her more. Elders are extremely afraid of being diagnosed with dementia or Alz and being in a situation where someone else can take total control of their lives. I don't blame them. I would be too. To add to this is the fact that you are homeless and have nothing. She may be afraid that you are doing this to get her put in a NH and take her home away from her. It may be far from the truth, but not in her mind.
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