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She lives in FL in the winter and Ct in the summer. She does not want to go back to CT this year where all of our family is. Dr has told her she either has to get daily care check in or he will turn it over to social services. She is refusing everything and thinks she is fine. My sister and I have POA attorney, which mom does not recall drafting up. In the meantime my sister is verbally abusive toward her and is starting to get physical. What can I do? Any advice would help.

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Oh, sheesh. My Mom thinks she is fine too. And so adamant about it! But, in actuality, she can't remember what she does during the day. Literally, sometimes, moment to moment. But, your sister being verbally abusive? And physical?! That is COMPLETELY UNACCEPTABLE and changes the whole situation. Maybe get legal help. Does the sister live in FL? And, where are you?
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I'd see attorney to confirm your rights under POA. Is it Durable POA? Will doctor say that she is not competent? If so, ask about proceeding with decisions, even if mother not on board. Or you could report sister to APS and ask to contribute info about mother's need for care per her doctor AND you let doctor know that mom is ignoring his order about care. I've seen that happen before and the county may step in, investigate and perhaps file to have her declared incompetent and a Guardian appointed. An attorney could advise you about all of that. It's difficult to do long distance though.
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Let the Dr handle it. Let him turn it over to social services and she can then make the decision whether to move back or not once she sees he is serious - usually white coat syndrome has far more effect that anything we can say to our relatives. Clearly your sister is not coping which is going to put extra responsibility on you, although you both have POA perhaps a quiet conversation on the situation, just the two of you around and if she wishes to relinquish because she cannot cope then do necessary legal paperwork - not sure what that is in the US, here in the UK she would simply have to write a letter and have a public notary witness her signing it and you would have sole POA. (Had this with my brother when it came to father's funeral and he refused to have anything to do with it or with estate - it must arise a lot) If you are happy to go this route and to take any "you did this to mother" flak then I am sure it would enable you to do the best for your mum with the least stress most the time.
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If sister is physically abusive call 911.
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Tell her you don't care what the Dr says. You miss her and would appreciate it if she would spend more time with you. Make it her idea to help you. Try not to threaten her that will just make things worse and she might go to your abusive sisters out of spite.
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You have a very difficult situation to tend to. Can you speak directly to her doctor and come up with a plan together? You need to know what options are available, then make a choice of which works best for your family. Best of luck to you and your mom.
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wendyalf Apr 2019
yes we did come up with a plan but mom is not agreeing to any of them . Options were to come home where family is, have an aide check on her daily, or get senior services involved . Now she said she wishes gonna find a new doctor ;(
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My mum is the same. She has no idea how much she is forgetting and if she calls me one more time about her medications, which have become an obsession...... Yet in her mind she’s perfectly capable of living alone. It’s a hard situation and often they will delay until the inevitable fall or disaster happens and then all decisions will be taken away from them. Surely better to organise things while they can have some control over their future.
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Tell your sister to NOT get physical with your mom or else she will be arrested. You could possibly take your mom to another physician for a second opinion and that would make your mom feel better. Also, a test such as Katz ADL can be ran on your mom to see if she passes or not. Tests were ran on my mom while she was hospitalized and then the determination was made that she couldn't live on her own anymore. This testing helped me make a good decision for the safety and well being of my mom. It also made my mom realize that a change had to be made, no matter how hard it was. Mind you, it's not easy right now but I believe it has been a step in the right direction. I wish you the best and please keep your sister under control and possibly away from your mom.
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Aging Life Care Managers are a huge help in dealing with issues such as these. You can find them by visiting the national associations website. There is a button that will allow you to find a care manager by zip code/proximity to you.
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My mother felt the same. When she was told no driving and she needed 24/7 supervision. I was her caregiver and she was abusive toward me. 3 weeks ago, we had to put her in a nursing home, because I could not do it all. She still thinks that she can take care of herself and she does not need to be cared for. She is in a wheelchair, incontinent, wearing diapers, cannot bathe or cook for herself. Your mother may never admit that she needs care.
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Your sister is showing burnout signs, so I'm guessing she lives in the area of FL or is with your mom? Maybe you might want to call protective/social services proactively and explain your legal position, and then let things play out. Often the MD's are looking to cya (cover their asses) so make broad, godlike statements with no clue as to the impact on the family. Sometimes they genuinely do care. If your mom is not rational enough to accept the tradeoff..i.e. ok you get to stay in FL BUT you have to have someone in to check on you (maybe someone to fix a meal, do some tidying up) then you may have to exert your powers. Is she fine? Has she been tested/assessed for her cognitive abilities? Or is it a physical risk of falling the MD is concerned about?
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Verbal abuse is not good...but one of the blessings of dementia is the person is not likely to remember moments later. Even the best of caregivers lose it once in a while. Personally, I am grateful for the deafness so my elders cannot hear what I say under my breath at times:-)
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TouchMatters Apr 2019
Not remembering/disability of inflicted and being abusive are are different as a lamp and a shoe. They are very separate and different areas. Verbal abuse is not merely 'not good,' it is a potentially criminal offense.
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I agree. Your sister needs to step aside before she does something she can be arrested for. My mom recently moved in after the doctor stated she couldn't live alone anymore. We had mentioned it before, but now she has to live with us because, Frankly, she burnt her house down. She passed out while cooking. Even now she doesn't understand why we won't let her use the stove. But she is agreeable and doesn't want to be a bother. we also have someone come in for 3 hrs a day while a work to make her lunch and just help out. It is an adjustment to say the least, but well worth the peace of mind.

I wish you well and hope she turns around. I would hate to have anyone go through what i did before their parent decided to move in. It was an eye opener.
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With advanced dementia, you will need to do whatever is necessary to make this as smooth a transition as possible. As your mom lives in the moment (and feeling a multitude of feelings: loss of independence, fear, powerlessness, confusion), she will act out and express herself.

Best way (or one way to handle this) is to tell her whatever may appease her in the moment, i.e., we are going to vist so-in-so who has a beautiful garden, who is an artist . . . or visit my old friend from college who is a . . . designer and has beautiful . . . to show us.

When for her own welfare, I believe it is NOT lying to 'try' to get her to go along with whatever you need her to do.

Your sister is a serious red flag and as someone said, could be arrested. Her behavior is likely a combination of burnout, lack of experience in how to deal with people w/dementia (as many people thrown in this role are totally unfamiliar with how to interact-relate to a person w/dementia), and how she feels about herself (low self-esteem, stress, resentment-past relationship issues with your mom). Whatever her issues are, she needs some education and timeouts IF she is going to be actively involved with your mom's care and decision making.

* Many/most people with brain cell deterioration will not know what they do not know/remember, etc. They will make definite statements of 'their truth.'

This is the disease. I encounter this all the time (with my clients). It can be tricky on how to respond - for all of us.

Do remember: MOST IMPORTANT FOR CARE PROVIDER:

DO NOT ARGUE WITH PERSON INFLICTED W DEMENTIA. Agree, redirect, give timeouts, hold their hand, look them in the eye and smile.

Think of how you'd want someone to respond/interact with you if this was you. Compassion, understanding. We all 'get caught in this net' no matter how educated or skillful, and experienced we may be.

This is not an easy road. It is PH.d. training in dementia. It is one of the most challenging areas of my life-work. And, I've lost over 70 lbs and kept it off for 35 years---that wasn't easy and often still isn't. But this 'dementia' is something else. Key for me was giving myself time outs and leaving - somehow shifting the current feelings / situation. Be it leaving for a minute, an hour, a day.

For one's own sanity, a person must learn how to set boundaries and be aware when their own "I can't take this anymore" moments pop up. Once that is reached, it is time to shift - somehow. Was I able to do this all the time. NO. It is a moment to moment or episode to episode decision. The more one is able to shift somehow, the more they will do that and not engage in this 'fight'.

I encourage you and your sister to sign up for Teepa Snow's webinars. Look at her website. She teaches people how to interact and work w/people with dementia. Teepa is brilliant and likely the country's - if not the world's expert - on dementia.

Remember and tell your sister, your mom DOESN'T react like this 'ON PURPOSE.' It is how her brain works.

* * *
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Sounds like sister is burned out and needs a break. You never know until you are the actual person dealing with another that has dementia how you will react.
Check with her hospital there to see if they can connect you with a social worker to help guide you. They should have all the resources you need.
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Is the doctor who has now told her she can't be on her own in FL or CT? Is it a doctor she has had for a while and knows or her part time FL doctor and her long time doctor is in CT? Why doesn't she want to go to CT for the summer as she always has? I ask because it may be fearing moving to CT for the summer as usual because she is worried her doc there will agree and it might be someone she is less able to write off and ignore (in her mind) or because her family lives there year round and she is afraid she wont be able to go back to FL once she moves in with you in CT but getting some of these fears or concerns out on the table ahead of time might help you navigate how to move forward. For instance if she isn't afraid of what the doctor in CT will say maybe use that as a carrot to get her to CT, if she's afraid she wont go back to FL and that's something that's really important to her, she has a lot of friends there for instance, reassure her you will find a way to make that happen and the time in CT gives you a chance to figure it out. That is of course if CT is a better situation supervision wise.

Where does your sister live? Is she in FL and your in CT or has she been the one who made the last trip to FL to be with mom? Aside from her short fuse with mom at the moment, how is your relationship with Sis. do you work well together, see eye to eye and share the care giving of Mom? My brother and I share most of the duties for mom, we monitor her via web cams, Echo Shows and her phone but it's at best a 3-4 times a day thing and more and more often entails an hourly call so when she becomes more obstinate and difficult we each can find ourselves burnt out and getting frustrated and we have gotten pretty good at recognizing the signs in each other but we trade off. So when Mom and I just aren't getting along he can step in and give me a break for a few days and vice versa. It helps a lot and works pretty well. We have divided many of the "chores" too but it's nice to be able to talk things out with each other as well as just vent to one another, are you able to do this with your sister? Maybe you and other siblings if you have them could give her a break for a bit so she can recharge? On the other hand not everyone is cut out for the personal one on one care giving and maybe it would be a better set up for your sister to not do so much hands on and take on the scheduling and phone/email contact with doctors, ordering medications the things that can be done from a distance and you do more of the face to face stuff. Still if what you are seeing is part of a bigger problem like you and sister don't see eye to eye and you fear her goals are very different from yours or what is best for mom, this is something that should probably be nipped in the bud so to speak. I don't mean be confrontational right off but perhaps having a conversation about what you are each thinking and then with mom about her wishes if you and sister aren't seeing eye to eye. It's probably better to figure out if problems exist and where they are, what can and can't be overcome, sooner rather than later when it comes to shared POA Sis. Hopefully it's just burn out and she needs a break and or a different division of mom chores.
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I’ m curious how you know your sister is abusing her. Did she tell you, you saw it or could your Mom be confused. If she is delusional or having hallucinations, she could see a bruise she got herself and assume your sister did it. According to my mother I stole her furniture ( it’s in her apartment just where we moved it from her house) and my sister is stealing all her money( paying her bills lol) . Im just saying make sure you know the real situation
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I am a RN my mom can't be alone. I was fortunate enough to find a lady who NEEDED a place to live who was willing to stay with mom, and I hire another person a few days a week to do more skilled things. My mom has dementia. So does yours. That's hard to hear. You need to step up with your POA and just make the decisions. Explain to mom that you could be cited by social services for Neglect charges if you don't take certain steps to care for her. She won't want you to be fined, jailed or get in trouble, so she will try to comply. Try to find a domestic, if she doesn't actually need nursing care, but see if you can get some training in care of dementia for whoever you choose as the arguments will get worse as her memory gets worse. My mom's dementia is from Arteriosclerosis (hardening of the arteries) also diabetes. It won't kill her and won't get too much worse. But if it were Alzheimer's then it will get a lot wors. Testing is imperative with a mental health facility. Go to your local hospital to find out where to go for this. May God give you courage, strength and wisdom in your decisions.
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Please make sure these are not false accusation against your sister. It is the worst to be accused if your mother was just looking for some attention. It will tear your family apart. It's so sad they seek attention this way.My mother would say we didn't allow her to do something, when in fact SHE did not want to. Of course when it is true , don't wait, call the authorities.
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Agree with maggiepie. Check it out first. The things my Mom says to people? Wow. If they believed her we may be in jail! And the things we've given up to take good care of her?! She hasn't accused anyone of abuse, thankfully. But the things she says? So not how it really is. Her perspective is just so distorted. Says she sits home alone all day. Um, no. My niece takes great care of her. Takes her anywhere she wants to go. And, I saw you today, went to dinner, etc. But few minutes later, she doesn't even remember.
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Wendyalf; Sorry to say but maggiepie is correct about false accusations with Alzheimer's & dementia patients ....let me assure you 90% of the time the caregiver is the one being verbally and or physically abused Alzheimer's patient can get MEAN.....not that necessarily the physical part even really hurts the care giver ,,but it makes careing for the elder person so difficult ...SO if the Dr. Said mom can not be alone then HE IS CORRECT she has to have round the clock people watching her ....mom could get out and get lost or there are even cases where Alzheimer's patients have wandered off and froze to death...if Dr. Says social services then he means it!! That could cause all of you alot of greif like elderly neglect or abuse ....beware once the dr says social worker could be trouble for you tell mom shes gonna get her daughters in trouble maybe i just dont know SORRY ABOUT YOUR SITUATION I was in the ssme place with my aunt but fortunately she had a couple of friends she really trusted that helped to convince her she can not be alone anymore hugs to you.....
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When sister gets physically abusive, 9-1-1 MUST be called! Good grief!!
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I went through the same thing. My mother was going through Drs because she didn't like what they were telling her. Furthermore, my mother was telling people that I was poising her and I wasn't letting her do anything in her house and that my BF and I was costing her money because we were not paying for anything. These were all false, when in fact my mother was verbally abusing me. But unfortunately there are people that still believe the lies she told even though she has stop lying about me she never went back and cleared my name.

Drs are mandate reporters this means if someone is being abuse in anyway or nelgected whether they are a child or adult they have to report it. It is the law. So, your mom's Dr will report to the Social Worker.

As far as for your sister you really need to find out if it is true if your sister really is being physically abusive before you start accusing her of wrong doing. Believe me it cuts like a knife when people think you are hurting your mother when in fact your mother is the one hurtting you. I carry those wounds everyday!
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Davenport Apr 2019
Love and compassion.
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I think perhaps I would consider checking with another doctor. Second of all, you could inquire for general information at your local Office on Aging. Something is definitely happening as no doctor will threaten Social Services unless there is solid backing to do so. And the fact that your sister is getting abusive worries me. She may be justified in getting extremely angry with your mother's behavior which, I suspect, is going down hill. I have a feeling you may have to force the issue and get her to CT or possibly look into placing her into a facility. If you don't see what your sister is doing and why, you are going to be in the dark. But I don't like the sound of things. Are you able to go and visit for a week or two and observe so you know what is going on? The trouble is that many older people, especially with dementia, have horrible behavior and become abusive and that simply cannot and must not be tolerated. Maybe your sister is justified. But you need to see for yourself. Good luck.
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