What can we do? She thinks I'm out to get her and that I have everyone on my side, so we can all confuse her and drive her insane. I do not want her to go home; she is currently in a rehabilitation center. We can not afford 24-hour care at home and have applied to the state, but we aren't sure of the outcome. She was sent home previously and wouldn't answer the door for the at-home services they sent.
She does not take her meds, eat or keep any type of schedule alone, even at the rehabilitation center she sometimes grabs her meds and doesn't take them.
I've read that POA does no good because if the person is lucid, they can not be kept anywhere against their will, and to get guardianship is costly. She looks lucid but isn't underneath. She's confused and agitated and, last night, threatened to break her fingers while we were talking (I recorded this on my phone). Regardless, I will get the documents from the law library today to see if we can obtain an emergency guardianship for her.
What else can we do? We live in AZ.
I would tell the rehab social workers that you cannot act for your mother legally, that you haven't the knowledge nor the time and cannot control her, and that you are requesting that APS examine her for competency and diagnosis. I would tell them that you want state guardianship and that sending her home is an "unsafe discharge". It is important that you use that exact wording--unsafe discharge--and repeat it to nursing, discharge planning, social workers, doctors.
I would allow the state to take guardianship. You do not tell us here that your mother even has a diagnosis. It isn't clear whether she is suffering from dementia or from mental illness. She doesn't seem to have a diagnosis. She needs help you really aren't qualified to give her.
If she does go home call APS for wellness checks. Do not enable her staying in an unsafe environment on her own.
I am so sorry you and your mom are going through all this.
In my personal experience with getting PoA activated, the doctors are very sympathetic and willing to get this done. I'm PoA for my 105-yr old Aunt in FL (I'm in MN). She has been amazingly cogent up until these past few months. She is barely mobile, living in her home with a paid family caregiver. Because I had accompanied her to past medical exams and met with her primary doc, I was able (over the phone) to get her this doctor to do a house call (yesterday) because I made the case that I can't do anything for her until she has a diagnosis in her records, signed by her doctor. I told the doc she is running out of money and without active PoA I had no way to pay for her future care.
I've also done similar with my MIL and my own Mom.
If you are her PoA then see what you can get done by carefully and diplomatically explaining to a primary doctor that you can't help her until she has a diagnosis of cogntive impairment that requires help by her PoA. At 83, it is highly likely that her prior undiagnosed mental illness is now blended with age-related decline that she would have had anyway, mental illness or not.
I wish you success in getting this done instead of guardianship.
She needs to take her meds and the nursing staff has ways of getting that done.
I managed to get my mom out of her house when she fell. I had her hospitalized and the social worker petitioned the court for me to have guardianship.
It isn't a matter if 'she looks lucid.' Dementia is a medically diagnosed condition. Some MDs will say that a person is not capable of caring for themselves (their own welfare). However it is documented, it is necessary for you to acquire this medical determination. You do not 'talk' logic as it doesn't register. You are talking to 'fear, confusion and perhaps anger - at the unknowns. The best you can do is talk to her in a way that will keep her as calm as possible. "I am doing my best ... (if she says she wants to go home). You do not argue; it just causes more emotional upset / turmoil.
She 'should' be watched to ensure she is taking her medication. How do you know she isn't taking them?
If you cannot afford an attorney, which you need, see if you can find a pro bono attorney. Research low income attorney services. Contact your city hall, Senior Service Dept.
Gena / Touch Matters
That way she can say whatever she wants but, she will be considered an unsafe discharge, use that term frequently in your conversations with the facility. She can not legally obligate you to take her back into your home if she has care needs that you can not meet.
You must stay firm in your lack of ability to safely care for her, no matter how emotional or abusive she becomes.
Best of luck, these situations just stink.
Also, “memory care” is a misnomer. I have not seen a facility that actually provides any memory care. They just dump everyone with memory problems, in a specific unit.
I have a friend that deals with a lot of these issues in Arizona, if you would like to give me your email address, I’m happy to pass your info along and see what kind of suggestion she has. I’m in Pennsylvania so all I can say is that the facilities here are horrible horrible horrible. Nursing Home neglect is a long-term problem and “guardianship” adds another layer of issues, with more uninvolved uncaring people to be paid.
You can email me if you’d like:
I created that email when we were trying to get our mother out of the clutches of strangers. Do not buy into the myth that “guardianship” is a helpful thing.
What, in your opinion, should memory care be?
This is something you could work on having her sign now. If she will.
You have applied to the state - for what? Medicaid assistance? In AZ, that would be AHCCCS LTC. I live in AZ too. That might give you some options to get home health care. But I've got to be honest, caregivers are in short supply. I am my husband's caregiver, for which I am paid through his AHCCCS benefits. That is what works for us.
The very harsh reality is, unless you move her in with you and become her caregiver, if she can't be placed in a nursing home - Everyone says they don't want that - then, she may live on her own, not take her meds properly, not eat properly, and not take care of herself to the standards you would like to see.
And, her improper care could be life threatening. That is the reality of growing old with disease. You can accept that she will die on her terms or intervene and get her into a nursing home or care for her at home.
Sit down with her in one of her lucid moments, and see if she will assign POA to you. And discuss with her what her options are and what you plan to do. Be open and honest.
You can download the POA forms online, and she would have to sign with a notary.
she was considered safe for discharge - recovered, basically - and moved out into a care home temporarily whilst we waited for the purchase of her new apartment very near me to complete (for the purchase) - I had had to sell her house as she felt neighbours were evil and could see through the walls at her and accused her of murdering her husband etc etc etc (she didn’t btw!!). She then refused to take her antipsychotic in the temporary care home and regressed completely into another psychotic episode. It was a nightmare but I moved her into her flat anyway. Then she miraculously seemed to recover, still refusing to take the antipsychotics. This was three months’ ago. She is now back in a general hospital after taking an overdose of paracetamol and relapsing with another psychotic episode.
They have called me today about discharge - I am finding it a struggle to go in as she is desperate to come home but the hospital staff said they will slap on a DOL order if she tries to leave (deprivation of liberty).
it gets a little complicated in the UK as healthcare is free of charge here. HOWEVER they do try and get you out of the system as soon as they can unless they are found to be responsible for ongoing healthcare. They were taking about a residential care facility (like your mother, mine will not entertain the idea of going in one) but in fact, many care homes will take seniors with dementia, but not a schizophrenia type illness like psychosis…. I am literally becoming ill with this actually.
Next time, do not move your mum back into her own home when she is refusing to take her meds and is either in danger of entering a psychotic state, or has actually done so. Tell the hospital that your mum is an unsafe discharge and is "at risk", as there is no care set up for her at home and that she refuses carers at home.
Your mum really does need to be cared for in a psychiatric ward. Speak with the social worker and ask them to help you push for that. If your mum doesn't have an assigned SW, then phone the department for the elderly at your local social services and tell them you cannot cope with your mum's ongoing care and you need help. Or speak with the SW at the hospital.
I think that the SWs who deal with the elderly also work with adults who need extra care, such as those with mental health issues and learning difficulties. They can push for appropriate care in a way that you cannot.
Although I had issues with my mum's first SW (wet behind the ears and idealistic) the social worker got things done that I had been struggling to do on my own.
I actually had to fight the first SW who tried to have Mum sectioned, however that's exactly what you do need.
I'm sorry if I'm "teaching my grandmother to suck eggs" - you've been through this for so long and you've probably tried everything already. However, you did move your mum into the flat even though she wasn't in a fit state. You've probably been put in the position of enabling your mum for many years. If your mum is now 95 years old, I expect you need a rest!
Wishing you all the best.
My mom was very similar. I lived across the country and my only sibling lived in another state as well. My mom was convinced that my sister and I were stealing from her. She hid everything and was constantly angry. She refused anyone coming into their home (my dad was blind and they lived in a two story house alone). We did hire in house help but my mom was pretty horrible to both of the aides. My sister and I had POA. It does not help in terms of making her do anything she did not want to do.
I set up an appointment with a neurologist and flew to NY to take my mom to be diagnosed. When I arrived at their house, I found a note on their front door stating that my dad was in the hospital and this neighbor (who did not know either of my parents) had taken my mom down to the emergency room to see my dad. My mom was wandering the streets of their neighborhood looking for help.
In the end, the hospital knew my dad needed rehab and that my mom could not be responsible for him. He went into a nursing home, and she followed because she could not live alone and did not want to be away from my dad.
She hated it but he was fine. She passed in June and he knows this but still pretends that she is still here but in a different ward from him and that she does not really know who he is. I let him believe that. No sense making him sad.
My point is that decisions had to be made to make sure they were safe. My mom was wandering, sad, scared, seeing people in their house, believing that cars were following her. She was suffering. Did she like the nursing home? No. Would I do the same thing again? Yes.
Was it easy? No, but they were safe. I could not take them across the country to my home, my sister could not take them in either.
Look at your options:
Hiring help in is great but expensive and they have to agree to the help. It is also hard to find help, especially if you want full time help and if your mom wanders, you need night time help.
Set up an appointment with an elder attorney. One hour can give you what you need - knowledge. I disagree that guardianship is awful, but it is REALLY expensive and you have to pay ($10,000 - $15,000) and it requires court dates so you have to be local.
Call the Alzheimer's Association and request an in home visit so they can assess your mom.
Call A Place for Mom or another business that helps you find nearby senior facilities that fit your mom's needs. These companies are free to you and they break down all the costs and then go and visit the ones that fit your mom's needs.
Call Adult Protective Services and have them come and assess her. This did not help me but it was another question asked and more knowledge learned.
Basically do what you are doing here, ask questions and learn what your options are. My mom was miserable in her home and she was miserable in the nursing home. But she was safe and medicated in the nursing home.
I so hope you find some answers. It is a hard road but there are lots of people who care. Ask all the questions you can. What I did worked for me but it was hard. I wish you luck and send positive vibes.