Elderly Parent Problems

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El_PAso

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Hi,

I have a 94 year old mother who has been living on her own. I live out of state and have limited finances and options. She was doing ok till the past year or so. I took a leave of absence on her promise to find a retirement community and am currently living with her.

A more well off sister is willing to pay $4000/month until her home sells so she can get in a very nice place in Southern California where she lives.

Unfortunately now that I am here she is refusing to cooperate and my sister has had it and threatening to pull support. I am about to lose my professional position.

A concerned party has threatened to call Adult Protective Services and basically turn her over to the state if I leave.

She has definite mental issues with memory and a bit worse and can no longer live alone. She has alienated ALL her neighbors and most friends. Oh yea…she is mean and stubborn.

I am the one on the spot. If I continue with my life she will surely end up in a bad place. We have been working on this for 3-5 years and pretty much everyone out of pateince.

I have no clue where to turn…. I know we should not warehouse our parents but if they refuse to cooperate what can be done? As I said I am here now and have spent every minute of every vacation for the past 5 yeasr caring for her.

When is enough enough??!!

Thanks for your support and guiding me with Catholic principles.

El Paso
 
In retrospect, it may have been a mistake for you to move in with her, although you had the best of intentions. Make a plan to move on with your life. You may have to move out to force her to see that she needs a new living situation.
 
It seems like you should continue with your originally planned course of action.

Sadly, your mother is very very likely suffering from dementia or she has had a stroke, and that has caused the dramatic change in her behavior. It is remotely possible that meds could help her with that.

It seems like you should carry out the original plan.

God Bless.
 
El_PAso said:
Hi,

I have a 94 year old mother who has been living on her own. I live out of state and have limited finances and options. She was doing ok till the past year or so. I took a leave of absence on her promise to find a retirement community and am currently living with her.

A more well off sister is willing to pay $4000/month until her home sells so she can get in a very nice place in Southern California where she lives.

Unfortunately now that I am here she is refusing to cooperate and my sister has had it and threatening to pull support. I am about to lose my professional position.

A concerned party has threatened to call Adult Protective Services and basically turn her over to the state if I leave.

She has definite mental issues with memory and a bit worse and can no longer live alone. She has alienated ALL her neighbors and most friends. Oh yea…she is mean and stubborn.

I am the one on the spot. If I continue with my life she will surely end up in a bad place. We have been working on this for 3-5 years and pretty much everyone out of pateince.

I have no clue where to turn…. I know we should not warehouse our parents but if they refuse to cooperate what can be done? As I said I am here now and have spent every minute of every vacation for the past 5 yeasr caring for her.

When is enough enough??!!

Thanks for your support and guiding me with Catholic principles.

El Paso
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In your shoes, I would turn to that “concerned party” and the well-off sister for help. Go to the people at your local county health department who handle these things. They may have advice about what your options are.

My guess is that either you will have legal grounds to force her into a different situation for her own safety, or you won’t. You may be able to get these parties to explain that to her for you. If you have no grounds to force her out of her house, then the “concerned party” won’t, either. You’ll all be forced to let your mother make her own decisions and take the consequences for herself. If she is as sane and capable as her jurisdiction says she has to be, that is her choice. She wants to exercise it, so once you’ve made your case for a wiser course, let her have her way. There is good reason to believe that the concerned party can be given directions by the Health Department on how to recognize it when your mother can no longer be given that much autonomy.
 
For her own safety, if the doctor has diagnosed her with Dementia, she may need to go into a skilled nursing facility, especially if she is combative. A facility would give her the proper medications, therapy, nutrition, recreation, etc. Her life is changed, she is no longer the same. Yes, we are to take care of parents in their senior years. Admitting her into a facility is taking care of her. Unless someone can stay in the home with her, keep her from wandering out in the streets, bathe her, provide her meals, give her 24 hour care, accompany her to doctor’s appointments and possibly emergency room visits, she may have to be in a nursing home. I would make sure it is a good one. Sometimes we have to face decisions we don’t want to. It is a heartbreaking decision. I am not saying you have to do this, it is a personal decision. Just passing on the experience I have had with various cases. Praying for you and your mother and family.
 
Thank you all,

To make clear I have not moved in per se. I was “tricked” into coming out to see her through a transition that she is balking at now that I am here. I make it clear daily that I need to move on within 2 weeks if she does not chose a course of action. I have only a few boxes of books and clothes and my belongings are in storage.

She has not been diagnosed with anything. When alone she is very much confused and almost delusional. When interacting she is more on track but still has trouble with dates and appointments etc… She will clearly benefit from a community atmosphere that we are attempting to get her into.

She can afford a $4000 a month “resort” and this would be ideal. She can even afford more advanced care as needed. But she has to chose otherwise it is APS and that is so heartbreaking as she stands to lose all her assets and end up in a state facility.

I have more patience than my sister unfortunately she holds the financial cards and I am stuck between their bickering ways…

It was wonderful to be reading Galatians this week in the LOTH! Lent is upon us as well and I will be “suffering” along.

I am so blessed to have my Catholic faith and know it is all going to work out! No clue how but it will!

El paso
 
I might give her doctor a call. Say that she’s confused and often delusional when she’s by herself, and you’re concerned that she’s unable to take care of herself.
 
Places that deal specifically with dementia and Alzheimers patients may well be the best place for her to go where her needs can best be met.

We have a place here called Memory Care. I don’t know much about it, though.
 
Please consider giving your local Alzheimer’s association a call too. Even though your mom has not been diagnosed, these people deal with these kinds of situations regularly and can likely give you good advice and direction.

What is the state of your mother’s financial affairs. It seems pretty obvious that she cannot handle them on her own…You may need the advice a good elder-care attorney.

God Bless you for trying to care for your mother.
You and your sister will need to make some difficutl choices and your mother may rebel, but you must remember that - when you were small children - she had to make choices for you that you did not like…

Peace
James
 
I agree with DarkLight, you need to talk to her doctor and explain how she is when she is alone. They will know what to say, what to ask, and will be able to determine what course of action is needed, and make an appointment to see her.

If you need to leave, you need to leave. Let your sister know that you are not the only one responsible for your mom, and that you have a job you need to get back to.

I don’t know who the concerned party is that is threatening you with calling APS, but unless you are legally in charge of your mom and neglecting her, I don’t see how you would get in trouble. If your sister lives near your mom, she needs to step up and help. If not, maybe APS would be able to get help for your mom if she is refusing. However, depending on where you live, you may be able to get a social,worker involved to help manage if you are not living near your mom. Does any one have power of attorney?
 
El_PAso said:
Thank you all,

To make clear I have not moved in per se. I was “tricked” into coming out to see her through a transition that she is balking at now that I am here. I make it clear daily that I need to move on within 2 weeks if she does not chose a course of action. I have only a few boxes of books and clothes and my belongings are in storage.

She has not been diagnosed with anything. When alone she is very much confused and almost delusional. When interacting she is more on track but still has trouble with dates and appointments etc… She will clearly benefit from a community atmosphere that we are attempting to get her into.

She can afford a $4000 a month “resort” and this would be ideal. She can even afford more advanced care as needed. But she has to chose otherwise it is APS and that is so heartbreaking as she stands to lose all her assets and end up in a state facility.

I have more patience than my sister unfortunately she holds the financial cards and I am stuck between their bickering ways…

It was wonderful to be reading Galatians this week in the LOTH! Lent is upon us as well and I will be “suffering” along.

I am so blessed to have my Catholic faith and know it is all going to work out! No clue how but it will!

El paso
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Given her age, is it really such a bad idea to plan to spend everything she has on good care?

She doesn’t need anything right now except for good care.

Come to think of it, I wonder if there are any specialists on elder care issues that you can talk to locally. Beware of anybody who encourages you to move money around–there are nasty clawback provisions where when an elderly person enters Medicaid nursing home care, the government looks back five years to see if the elderly person gave away any assets that should have gone toward their nursing home care.

kiplinger.com/article/insurance/T037-C000-S002-the-crackdown-on-medicaid-planning.html

I have heard good things about memory care facilities.

Don’t feel guilty about this, because there really isn’t a realistic way for a single adult to care for a difficult 90-something-lady 24/7. Even if money were not an issue at all, you could not provide all the care she needs by yourself.

Ideally, she’d be in a nursing home near where you plan to live.

Good luck!
 
acadiANNA said:
For her own safety, if the doctor has diagnosed her with Dementia, she may need to go into a skilled nursing facility, especially if she is combative. A facility would give her the proper medications, therapy, nutrition, recreation, etc. Her life is changed, she is no longer the same. Yes, we are to take care of parents in their senior years. Admitting her into a facility is taking care of her. Unless someone can stay in the home with her, keep her from wandering out in the streets, bathe her, provide her meals, give her 24 hour care, accompany her to doctor’s appointments and possibly emergency room visits, she may have to be in a nursing home. I would make sure it is a good one. Sometimes we have to face decisions we don’t want to. It is a heartbreaking decision. I am not saying you have to do this, it is a personal decision. Just passing on the experience I have had with various cases. Praying for you and your mother and family.
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As a former long-term care nurse, I can tell you that it’s often very, very difficult to provide 24-hour care to an older parent, especially if that person has dementia and/or other mental health issues. Putting your mother in some sort of facility IS taking care of her, as the PPs have stated - as long as you carefully vet the facility and ensure that it is appropriate to her needs. There are nurses and health care aides there who are trained to deal with her behaviours appropriately, and they themselves have days off and shifts off to rest - which you will not get if you’re providing her care 24 hours a day.

I also suggest that you contact a lawyer. Depending on your mother’s cognitive abilities, you may be able to apply for the legal ability to make decisions for her. You might also check to see if she has created a document that specifies who can make decisions for her should she lose the ability to do so. A lawyer can help you determine the process by which someone can take over decision-making responsibilities as the laws may differ depending on your area.
 
I don’t know if your mother has made any provisions for her care should she become incapacitated, including a medical power of attorney, a will / trust, etc.

If so, then those documents may clarify her wishes since it sounds like she may not be able to take care of herself.

If not, then you and your sister may want to meet with an elder law attorney and discuss your options.

As her children, you may be able to petition for guardianship / conservatorship of your mother if these arrangements have not been made.

The conservator manages the finances the guardian manages her care. They can be the same person, or not. The roles can also be shared.

Ideally, you and your sister would come to some agreement on who does what – so you both work together to manage your mother’s affairs when she is not able to take care of herself.

The elder law attorney would also know who in your state makes the determination of whether your mother is incapacitated, such as the family doctor / social worker etc.

Also, whoever gets the “conservator” position if that comes up is going want to keep good records. There are reporting requirements for conservators, and reports are reviewed by local government. So be careful.

Good luck.
 
His_helpmeet said:
As a former long-term care nurse, I can tell you that it’s often very, very difficult to provide 24-hour care to an older parent, especially if that person has dementia and/or other mental health issues. Putting your mother in some sort of facility IS taking care of her, as the PPs have stated - as long as you carefully vet the facility and ensure that it is appropriate to her needs. There are nurses and health care aides there who are trained to deal with her behaviours appropriately, and they themselves have days off and shifts off to rest - which you will not get if you’re providing her care 24 hours a day.

I also suggest that you contact a lawyer. Depending on your mother’s cognitive abilities, you may be able to apply for the legal ability to make decisions for her. You might also check to see if she has created a document that specifies who can make decisions for her should she lose the ability to do so. A lawyer can help you determine the process by which someone can take over decision-making responsibilities as the laws may differ depending on your area.
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The other problem is that at her age mental status changes are not necessarily an indication of a permanent loss of mental capacity. A urinary tract infection or some other relatively minor problem can have huge effects on a very old person’s central nervous system and, really, all of her organ systems.

As for contacting a lawyer, the sister who has the purse strings is highly likely to also be the sister with the power of attorney set up, naming her. It may be that the “concerned” party ought to be given her phone number, if the OP’s hands are being tied. If she makes it clear that she’s going to call the authorities if the OP leaves without the mother being moved to an assisted care facility, the sister with the cards may be forced to realize that she needs to play them. Sometimes an outside party can accomplish what a family member cannot.
 
Chances are very good there aren’t any health care directive or power of attorney documents, that she never completed one, let alone signed it. There probably isn’t a will either. In which case, the court will have to be petitioned to allow the OP and/or her sister to have power of attorney and conservatorship. Start that by finding her doctor and going from there. I can say if the elder person is stubborn, mean and combative with just enough lucidity to fight it tooth and nail, it will be an extremely difficult and heartbreaking process. One has no idea how much such a person can guilt trip the family into knots unless one has been there.

One other bit of advice that has already been offered in this thread and with which I strongly concur: if a single adult is going to try to take care of an aging spouse or parent on their own, that isn’t going to go well in the long term. At some point, the care giver has to get help, just no two ways about that.
 
An attorney should be contacted to get Power of Attorney for your mother. She will need to sign the papers in the presence of the attorney. One would get POA, the second person if the first should become incapacitated. A nursing home will require this to be done before being admitted. As well as do not resuscitate orders if you plan that. If no DNR form is signed, she will be given all possible treatment to recover.
 
acadiANNA said:
An attorney should be contacted to get Power of Attorney for your mother. She will need to sign the papers in the presence of the attorney. One would get POA, the second person if the first should become incapacitated. A nursing home will require this to be done before being admitted. As well as do not resuscitate orders if you plan that. If no DNR form is signed, she will be given all possible treatment to recover.
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Otherwise, the alternative is to have her declared incompetent, which in some states will result in a court-selected party making her decisions. The court is not bound to select a family member who will do the job for free, either. More to the point, in many jurisdictions your mother will be entitled to her day in court, if she wants this. These things rarely happen quickly when the patient in question set up nothing for the event.

I would want to know from someone familiar with elder law in your mother’s area what scenarios are possible. Forcing her to sell her home and move to assisted living with no legal finding of incompetence probably isn’t one of them. There may not be anything you can do right now, but you won’t know until you get the answers from someone who truly has the expertise to tell you. These are all matters to talk over with your sister, especially the options that can’t be accomplished without some cash.
 
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