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My 87-year-old mom lives alone and his suffering from early stages of dementia. Prior to this she also suffered from schizophrenia as well. She has lost most of her mobility and refuses any help. She currently urinates and defecates in a bucket near her bed. Her apartment is over-ran with vermin. My brother is more than willing to take her in, but she refuses. What can we do?

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Speak to your town's social worker. News flash here=a lot of elders refuse help!
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While other comments here are helpful with respect to longer term options, I think I have a recommendation that will yield more immediate action.

Call 911 for an ambulance. Tell the dispatcher that you came into your mother's home and she cannot move, that she has to be taken to the emergency room. An ambulance will take her to an emergency room, they will do some tests and probably place her on an "observation" status and discharge her to a rehab facility. The rehab facility cannot discharge her home if she lives alone & cannot take care of herself, so she will most likely be admitted to the long term care part of the facility---which is what she needs, apparently. OR, she can agree to go live with your brother, which would have to be documented in the rehab/LTC notes. Also, if the apartment is that bad, it will be noted on the ambulance documents which is further support for her not to return to that place alone.

Furthermore, during the time she is in the hospital/rehab/LTC facility, get in touch with her landlord & let him/her know the situation & what's been going on. I am sure the landlord wouldn't be very happy with one of the apartments being over run with vermin. He might tell your mother that she cannot come back, forcing her to go live with your brother. Aside from the health issues, it is not safe for her to be living by herself, eliminating in a bucket surrounded by vermin.
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If your mom gets social security and has dementia, be prepared for an investigation to determine who will pay her bills as a fiduciary. The fiduciary can only pay for your mom's bills. You or she will get a letter informing you of this action. I'm pretty sure if you go to the doctor, they will refer the case to social security.
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Your mother should not be in your brothers care...it would not be fair to him, or to her! I went through this EXACT thing with my Mother, and am still recovering from it. Your Mother belongs in a Nursing Home where she will have 24 hr. a day care. I finally had to do this through the intervention of a crisis worker, who I requested come to the house to assess my mother. They got the ball rolling very quickly.
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This is bad, very bad, like you hear about happening down south somewhere. She's incontinent, has dementia and schizophrenia, SHE BELONGS IN A FACILITY. Tell brother his heart is in the right place, but MeeMaw is way beyond the point of 'moving in' with him! She is way way beyond the care of an interested offspring. She will fall down and crack her head. (in which case you can get the social worker at the hospital to find a placement for her. DO NOT OFFER TO TAKE HER HOME WITH OFFSPRING. She will set the place on fire from the stove. She will wander naked through the neighborhood. Mommy's days of living alone are over.)....Now, let's do it proper here: has she been diagnosed with dementia? Is there anyone in charge there? Are the papers (living will, durable power of attorney, transfer of the house 5 years prior) filled out by an intelligent elder care lawyer? Does her doctor have anything of interest to suggest? Please. Read the postings here. Your brother can 'take her in' but it will be a whole lot more than he ever imagined.
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I have no answers but I do want to tell you that you must be a good person. We really never know in life what we have to deal with. With ourselves as well as other people. A good person has a conscience and a sense of responsibility and yes, a heart. I feel sure that no matter how difficult this could become that you will make the right decision. There are no easy answers but have hope that you will find the best solution for you and your Mom. So, take a deep breath, and get ready to go thru all the hoops to find the best solution. I will be thinking about you and praying for you and your family. "HUGS"!!
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My heart hurts for you. I agree with above where you need to get her medical help, be it a psych evaluation or temporary admittance, so that she can get on the right meds and get her behavior under control as best they can. I also agree that your brother needs to go in with both eyes open. He needs to talk with those who evaluate her so he understands completely what she is going to need. I applaud your brother for offering to take your mom in, but it could be an absolutely horrible experience for everyone involved is he doesn't have a clear understanding of what he is required to do in taking care of mom. Best of luck, but act swiftly, time is of the essence.
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Early dementia does not necessarily mean that one can no longer live on their own - perhaps with a little home aid. I'm 85 and use a walker during the day due to my decreased mobility. I keep and use a urinal by my bed at night as I am afraid of falling when my legs and I are not wide enough awake to maneuver to the bathroom safely. Also I get back to sleep better and that leads to clearer thinking in the morning. The urinal is a real help that gets emptied in the morning. Is the bucket an adaptation she has wisely made, and does she get it emptied and cleaned regularly? If so, she may be adjusting to her problems and will be able to cope quite well for the next year or so.

As for the vermin - what is the apartment manager/owner doing? Has it been reported to them? Pest control should show up within hours after a report. In one building I lived in a guy did not report his mice as it eased his loneliness! We all ended up with a battle on our hands as the mice spread well beyond his unit.

She may be right that it is still too early to give in and go live with her son. An expert who does an in home evaluation could be a great help. I often see families forcing mothers to move to our senior living before they want or have to be. I do encourage seniors to move while they can still make their own choices.
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As a daughter of an aging mother with Schizophrenia, I can't fault most of the answers here, with the exception that they assume that such a person has a doctor, and will consent to see a doctor and/or to stay on medication. My mother refuses to see the doctor in the first place, and when she has been forced to (during and after those 72-hour commitments) she does not stay on meds or keep future appointments, even though I'm the one bringing her to them. Therefore, she has no doctor to consult with. For those of you who have never dealt with this additional factor (beyond aging and dementia) you may not realize that what you suggest does not have the impact that logic tells you it will. To get the 72-hour hold, at least in TX, you have to start with a 911 call or take evidence to a court. The first-responders have to deem your mother a danger to herself or others. Most rational and caring people would say the conditions shared in this example are dangerous. I have not found first-responders or courts to work "rationally" - they have to work based on legal definitions of danger. What they say is that clearly the woman needs help to live, but that's not a reason for commitment. And so the cycle continues. I agree with calling the resources available locally on aging and even Adult Protective Services. Join NAMI. But getting a Schizophrenic woman evicted is cruel. She will then not have a home and may continue to refuse to live with anyone. Now you've got one more elderly mentally-ill person on the streets. Heartless. At least this woman has a roof over her head right now. She can be located and food can be brought to here. If she's homeless, it becomes much harder to find her. (I know this from years of experience.) Please, if you have no first-hand experience with parents who have long-term mental illness in addition to aging and dementia, understand that those of us who do have years of experience of being unable to do much legally, and that logical answers are not always practical answers.
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Please also know that if your mom isn't listening to your brother now, there is not much chance that will change. He may be taking on WAY more than he understands, or can be made to understand. (Experience talking...) If he is married it will put quite a stress on that relationship, as well. I'm not saying this to discourage him, just to try to make him aware of things to consider before relocating your mom. Perhaps there is a better, safer, medical placement near your brother. I'm so sorry you're going through this. Stay strong! Best wishes and kudos to your brother!!!! You are not alone!!!
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Call the health department and notify the apartment manager to have her evicted. This is an unhealthy situation! You mentioned she "showed" signs of schizophrenia. One does not get rid of this mental illness on its own, and requires medication to manage it. Have her put under a 72 hour hold in a psych hospital to have her evaluated and once she is, medications prescribed and she is stabilized, then your brother may take her home. Know that schizophrenia is a really difficult mental illness to deal with, and your brother would be taking on a great deal. With a dual diagnosis (mental illness and dementia) she could qualify for financial aid. Check out those resources as well. Best wishes!
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so heartbreaking for you mom! good luck...hope she gets the care she needs!
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Agree with all of the above and send a big hug!
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Does anyone have DPOA over her medical and living decisions? If so, that will be a big help. Secondly, you will like need her physician(s) to do a full medical exam including mental capacity and document to the effect of her dementia and ability to take care of herself; if physician won't assess mental capacity -- then ask for referrral to geriatric psychiatrist.

Additionally you can call APS to investigate, evaluate, document her living conditions and ability to manage. They can help you take mom from her home and move in with brother or other residential care.

You will need all above to force her to move if she refuses.

All above answers are helpful. But I've been thru above and it stopped when APS felt my mother should have help but her living conditions weren't deplorable enough and mom refused psych eval -- which I couldn't force her to go.
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In my case, with my mom, who has dementia, parent became child and (only) child became parent. My mom was determined to move in with me, but for too many reasons to list, including a disabled husband I take care of, that would have been disasterous for all concerned. Although your brother is very willing to take her in, make sure he and his family know what they're getting into. You need help getting your mom out of her home and into a safe place, wherever that may be. When I taught preschool, the parents used to laugh that their children listened to me but not to them, so perhaps her doctor, who is not a stranger but a person of authority may be the one to speak with her. When my mother called 911 for the third time in a month simply because she had messed herself, I knew it was time to take action. I love and respect my mother and I knew what needed to be done for her. Good luck!
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In most cases the elder should make the decision to move but this is obviously not one of those cases.

I'd contact the doctor first to see if he or she can expedite some type of action. If that isn't possible, call protective services. As you and your brother so wisely see, this can't be allowed to go on.

Best wishes to you. I hope that you'll keep in contact for support.
Carol
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In addition to calling protective services I would also recommend an involuntary commitment to a geriatric psychiatric unit to get her medically stable and to determine the level of care she needs. The mental health diagnosis with dementia is a lot to manage. She needs to be medically assessed and supported.
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Speak to her physician. They can get help right away if they are aware of this. She is unsafe and unable to care for herself. The doctor can expedite things, her own doctor or an emergency doctor. Make certain they know she is unsafe
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You may have to obtain Guardianship of her. Or someone will. Another family member or she will have a court appointed Guardian.
Senior Services may help, There is also a Senior Ombudsman that may step in. If you have none of these resources a call to the Health Department or Police Department might get some help or at least get the ball rolling for some help.
If she has a Doctor that she goes to that might be your first call they might be able to help a bit faster by getting a Social Worker involved sooner.
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You call your county office of the aging and ask for help. They will send a Social Worker to help her. If she needs placement, they will seek "protective custody" in court. Let them do it.
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