Not really sure if I am looking for advice or just to vent. My mom, 82, is undiagnosed but certainly has Alzheimer's. I had a geriatric appointment for her later this week, but of course that is canceled so who knows when that will happen.
Mom lives alone in the house she bought in 1975 when our dad died. It's just me and my brother. I live about 75 miles away, he lives 7 hours away. Mom has gotten increasingly paranoid, thinks people are moving her things and stealing from her. Her house needs some work, like painting and windows, but she refuses to spend the money. I have encouraged a home equity loan, even though she has the cash. She said she's never had a loan, and won't get one now.
She is not on any medications. She has been clinically depressed for years, but won't believe that depression is more than just sitting around all day crying, so she denies it. She would never agree to any mental health treatments. She's of the generation where mental health issues are shameful, not talked about and certainly you don't go to a doctor for that. The whole town will know!!
Part of the issue is the small town she lives in. There are few specialists, and certainly no geriatricians. I have to bring her to my town for anything but the most basic treatment.
She has a trust that was set up over ten years ago when my stepfather was still alive. I do not have a copy of it. I contacted the attorney and he said she never signed the will. And that the POA is so old (old forms) that she needs a new one. Again, the attorney is in my town and currently closed.
Last week a very heavy piece of furniture fell over, almost on top of her. She says she was just looking at it, and it fell over. That is just not physically possible. She must have been trying to move it.
Then there are the burned potholders and food left cooking. Last year she allowed two strangers into her home and signed up for some scam energy provider. Of course I had to fix that. She wants to switch banks because she is convinced that the manager of the local branch of a national bank "hates her" and is "messing with her" because she keeps getting locked out of her online account. She is, of course, entering incorrect information and locking up the account. She cannot fix it herself so I have to do it for her.
Moving out of the home she can no longer manage is not an option. She is not ready for a nursing home and I would never put her in one. There is one very nice independent living place in town, but it's not an option because they don't allow pets. She has two cats and I would never consider taking them from her. There is no assisted living near her. AND she is adamant that she will NOT leave her home.
I would like to get her a paid companion/caretaker. I can't go more than once a week, and right now I can't go at all, because of the lockdown. The problem with that is she does NOT want strangers in the house. It would just cause her more anxiety and she would feel like they were a guest she'd have to talk to and entertain.
My brother will go along with whatever I suggest. She won't listen to me, but she will listen to him. Unfortunately she will only go along with him if he's physically there, which of course he can't be all the time. He's an essential employee so who knows how long until it's safe for him to see her.
Any thoughts or ideas welcome.
She refuses to go to any doctor for anything, she has arthritis and it's causing a rash all over her body has for years they have medicine for it but she won't go to the doc for it, she's in pain from her arthritis but refuses to take any pain meds a doc gives we barely get her to take ibuprofen
My husband has 3 other siblings but they do not help it's just us
She won't let strangers in her home either so a help at home person is out of the question, she insists someone is moving her stuff too and it's her she moves stuff on a daily basis and then gets so mad that she can't find it
She is undiagnosed but from my research she has alzheimers, dementia and sundowners and she's lonely her husband passed away almost a year ago
She is to the stage to where she is very inappropriate she cusses, she starts talking about her rash and lifts her shirt and one day she even took it off right before my husband was to be at her house, I am there at least 3 days a week just so she doesn't have to be by herself, I clean for her because she has stopped she's was messier than she use to be
As I said it's not an answer but it's to let you know you are not alone in this
Is your mom at risk of harm?
Burned meals, scorched potholders, heavy furniture "falling" on her... all suggest that she can not live alone since she is not safe alone. I would like to add that it appears she is at great risk of being scammed in all forms: mail, online, and strangers that come to the door.
Can your mom meet all her needs herself - daily, weekly...?
It appears she needs somebody to manage her finances - preferably with a POA.
It also appears she needs somebody to mange her health care - also POA.
She needs somebody there to help her daily and that can be family, friend, or home health care aide. Unless she is a night time wanderer, she may be OK to sleep in her own home by herself.
I advise you to get her a geriatric appointment as soon as possible. The doctor can test for mental competency. If ruled incompetent, then she can be "made" to abide with home health care or residential facility. Please get new POAs written up before that happens; since you can not get a POA written once somebody is declared mentally incompetent.
(1st thing I would do is test for a urinary tract infection, that could be causing some of these behaviors.)
Ask around, via telephone, about all of the services available in her community. Meals on Wheels, friendly visits/calls, companion sitting, etc.
These can be a start to getting someone in that can keep an eye on her and help her with household tasks that are becoming dangerous.
Another thing to do would be to get her doctor to write an order for occupational therapy, they can come in and help you remove potential dangers from the home. They can point out where grab bars should go, what is needed for a safe shower, and that sort of thing.
One thing that I discovered on my caregiving journey is that you just have to wait for the senior to be willing. Because you can't take away their quality of life for quantity. Why make them miserable? Stuff happens to people of all ages, so we need to help them be as safe as possible and wait for the time when there are no more choices. Hospitalization and then fulltime care is what most of us face with stubborn parents. It's not optimal but it is the best we can hope for.
Catholic charities, Jewish family services, interfaith community services and many more can help you find services to help her stay a bit safer and maybe even start feeling okay with people helping. They can help her have some companionship, even if it is just daily calls right now.
Best of luck with all this. It is difficult at its best and right now is the worst time possible for anything.
She still lives alone, won't move in with us, I take care of her, her house and bills and then our house, I am so overwhelmed with everything.
You go ahead and vent Hun
I am here
Whats the worse thing that can happen at home that can’t happen at a nursing home? At home she’s less likely to get the virus. She won’t have underpaid and overworked aides as caregivers. She won’t be abused like happens at adult homes. She’s getting older. We all are. We will all be in her shoes soon enough! How do we want to be thought of and treated?
They can be life savers or life wreckers.
This lady doesn't want to place her mom, she wants help bringing in help.
I understand that you have a facility and you want clients, it is big money after all, but this is the wrong place to solicit facility placement.
I agree with those who have said to move her closer. A companion will be difficult to manage long term. AL’s do take pets although I don’t know about 2 cats. And I don’t know how humane it is to have cats used to a house kept instead in one room. She has dementia and she cannot take care of herself. That takes a lot of “I will never do that” decisions off the table. You have a lot of things that you say “can’t hsppen”. Must move with cats, does not want to move at all, and does not want strangers in house. You can of course just let her do what she wants until she ends up in ER or worse. If you are hoping to avoid that, she has to move closer. Maybe with one cat and maybe with none. Hopefully someone in the family will take them? Maybe get her to move and keep cats yourself “temporarily”? Something clearly has to change. While you are waiting, start reaching out to facilities near you to see what they offer. And get county statistics for Covid infection at the facilities just so you are aware.
Given a choice, sure, a whole house is better, they can pick spots they like. However, if they are sent to a shelter, they WILL be in one room, if that, and likely with other cats. Since not all of mine get along, I have "zones". Several have the Master BR with a very long hallway. Others are in a large kitchen with access to the partially finished basement (my mouser likes this!) Two never got along with the others, bad fights, pee, etc, so they were given their own room. One BR. We lost the male to a dental cleaning, so in order to have a roomie for his sister, I took in an 11yo one-eyed tux who is semi-feral, spent TEN years in the shelter, a room about the same size with 11-13 cats in the room!!! He must think he's been given an upgrade to move to a similar room, but only has to share it with a little 6.5 pound kitty!
Cats, even 2, can be okay in a single room. They still have spots to nap, hopefully a window for Bird TV, and a perch/scratching post. The bigger concern is their actual care - feeding, litter, vet, etc. I've read threads where a woman was feeding inappropriate foods, cat litter wasn't maintained, cat(s) were overfed and obese, etc. THIS is a bigger concern. Since no one is on the ground full time, this can't be monitored, so who knows how well she can care for them. It may seem ok during those short random visits, but ....
A dx would be the start. To know what you are dealing with - dementia symptoms can be caused by other reasons that need to be ruled out.
But the more immediate issue is safety. My top red flags for needing supervision are *falls*fires*fear*fraud*.
Moving heavy furniture or other risky decisions lead to falls. Burn marks escalate to kitchen fires. Problems handling finances can become fraud target. Paranoid thinking can lead to fear, even leaving the home or wandering at night. You've mentioned all of this (except wandering).
You've mentioned a lot of things you know you don't want: leaving her home, leaving pets, NH. I do understand. But add house fire, falls & fraud to that list.
Is there an Area of Aging to discuss what immediate measures can be added to increase her safety?
In time, once you get a dx, you can re-do that priority list. Decide what's really important.
If you decide that you need to move her into Assisted living, do a little research on "Therapeutic Fibbing ".
I know it sounds awful, however it's a very useful tool. And sometimes the most humane way to convince a loved one to move.
Hang in there!
That said, EVERYTHING you mention about her thoughts and behaviors clearly spells dementia. Although POAs are helpful in allowing you to manage her finances, etc, getting a HEL is probably not going to work. I would table that. IF she has funds, work on getting her where she needs to be, then use the money to do the needed work and sell the place. That's what we did.
Why limit looking for a facility to where SHE lives? One or both of you need to interface with the facility and visit/check on things, so it would make more sense to look for a place closer to where you live. IL is out of the question. She already IS, on some level, in an IL situation and can't handle it. NH is also something that shouldn't be on the table. NH is primarily for those who need specialized nursing care. She doesn't, at least not yet. Even AL isn't going to work. She sounds beyond that level. MC is what should be the goal. Agreed that not all will allow animals, but my mother's place DOES allow them. Pet(s) have to stay in their room (one even had a large dog!), but otherwise it was working. If it were me, my kids would have to reserve several rooms... :-P Search around where you or your brother lives. There has to be some out there.
Our mother was also ADAMANT she would not move anywhere, not even in with my brothers (not that this would be even remotely viable!) This is despite her many times saying she needs to clean up/clear out stuff, in case she ever has to "get out of here." When asked where she was going, she said AL!!! Enter dementia - nope. Not.Going.To.Happen. EC atty told us we couldn't force her to move and suggested guardianship. Facility we chose said NO committals. This is how I ended up here. Facility said just get her here, we'll manage it from there. The trick was getting her there. In her case, just before the planned move she injured her leg and developed cellulitis, serious infection. Not enough sense to get it checked or even tell one of us! OB arrived a few days prior to the move and had to be threatened to take her to ER PRONTO! YB drafted a fake letter from 'Elder Services' for the hospital and told her she either moves where we choose or they will place her. Fibs... They can be your friends... She was mad as all hell, but reluctantly went with the bros.
So, have this atty send you a copy of the ORIGINAL POA, regardless of what he says about date. Look for MC places closer to you, find one that might take her cats. Get this ball rolling, because she is a huge accident waiting to happen! If possible, can you or bro talk her into at least coming to visit (live) with one of you, SHORT TERM, with her cats, esp once you find a place nearby? Tell her whatever you need to - place needs major work, govt is quarantining area, ANY lie that will work, just to get her at least under a roof with oversight! Then make plans for the next move. Right now, regardless of MC, Atty, doc availability, she needs to be under some kind of supervision. NOW.
ME? I'd rather run away with my cats than be separated. I know that neither of my kids would take the cats in, so it's me or the shelter. I've made my decision for no more kittens (they can live long time, don't want any to outlive me! My oldest is now 21+, has CKD, lung tumors and dementia, so no one's going to take her in!) Stick with those I have and if/when the time comes, look for older cats that need a home!
An option to consider, for when she can no longer provide the care they need - look up robot cat Joy. Again, my mother was never a pet person, barely tolerated us having a dog, but OB sent one to her and she was fascinated by what it could do! It purrs, opens/closes eyes, meows, wiggles ears, licks paw, will roll over to allow belly rubs, etc. Obviously it isn't real, but at some point it will be to those with dementia or other cognitive issues. It is a little pricey, but if it works, it's worth it! OB later got a really cheap little dog at WM - it walks, barks, waggles tail, pants, etc. Not as "realistic", but mom was still fascinated by it.
You make a lot of good suggestions in your question and immediately shoot them down. Whatever arrangements you end up making for your mom, it is going to mean some hard choices and changes. It's rough. Don't box yourself in with so many "I'd never" statements. Your goal will be your mother's health and safety. That might mean re-homing her pets or putting her in a memory care at some point. Don't make your job harder by listing all the things you'll never do before you've even started on this journey.
This is a hard journey you've started. This forum will be a good place for help and support.
You mentioned that there is an existing POA. Who is her POA?
The POA, essentially has the power to act on her behalf.
Her primary care doctor should at the very least be able to give a diagnosis of moderate mental impairment. This gives the POA a leg to stand on.
If she is truly unsafe to live alone, your options are limited and very heartwrenching.
When someone has dementia, they no longer live in the same reality as you.
As much as you don't want to separate her from her beloved pets, is it worth her wellbeing?
You have a tough road ahead.
Maybe try to consider her physical wellbeing first. Unfortunately, her mental wellbeing seems to be out of your hands.
God bless!!
Your Mom cannot sign an updated POA because she probably has no idea what its all about.
Your Mom should not be alone. Independent living is not an option. These communities don't give any care and if they do, its not 24/7. It maybe help with meds. She needs to be able to do for herself. An AL would be my choice. And soon. A scorched potholder could end up being one on fire. If you can't bring her into ur home you r going to have to make a decision on her care soon.
If u have a neurologist nearby, that would be my choice to evaluate Mom.
I agree that assisted living would be a great idea at this point. My only problem is finding one that would allow her cats. Taking them from her is NOT an option. It would be terribly cruel and I will not do that to my mom.
We really need a geriatrician. No, there are no neurologists nearby. The only specialist locally is an orthopedic surgeon.
Do you have POA? Would she sign papers to do so? And the unsigned will? Can your attorney draw up the papers that need to be updated and signed? Then as soon as you can go see her, try to get her to sign them?
The burned potholders are a huge red flag. She should not be cooking! She really should not be living alone. She is a bit unsafe.
There are lots of things that you say can not happen. I ask you to consider looking at what's right and safe for her. She will not WANT to leave her home, quite understandably. BUT she's going to burn the house down. She is not in a position to make good decisions anymore. Her brain is not working right and you are going to have to think about stepping up and ensuring her safety, regardless of what she wants. With dementia, people really aren't in a position to understand what they need, what is appropriate, what is safe.
She doesn't want strangers in the house. Well, something is going to have to give her. She is probably in need of in home care or moving to a nursing home.
I'm sorry if you think my suggestions are impossible. But I do think you need to consider reframing the situation and looking at it from a different angle.
Best of luck.
I really need my brother and his family to help me in person. They would be here if they could, We all get along and would work together. But everyone is quarantined.
I do appreciate your suggestions. It's all compounded by how few services are available in her area. I will take her anywhere at any time, when it's safe again.
Something does have to change, and in a big way. Thanks for your input.