My mother has had significant mental health issues her whole life. She is now begining to have memory loss. She is also going blind due to cataracts and glaucoma. Many of her bizarre behaviors (not wanting to bathe, having auditory and visual hallucinations, etc) she has had her whole life. Her second husband died from Covid about 2 months ago. I am having a very difficult time telling how much of her issue is mental health, how much is not being able to see, and how much is dementia. Because of her mental health issues, she is very hard to help, because she does not believe she needs help, and because she has significant paranoid delusions. Currently, her house is infested with bed bugs. Her caregiver is about to bail on her and I can't get her to let someone clean her house so we can treat for bedbugs. My brother and I are at our wits end. She has some financial resources, but not enough for private nursing home care, and it would have to be an involuntary commitment. We have POA, but not guardianship, which is required in Texas. Just at our wits end and not sure where to go from here. We would appreciate any input as to how to proceed to get her the care she needs when she is so resistant to get an evaluation, doesn't trust doctors, and lies outrageously about everything. Have not found social services in Texas to be particularly helpful.
You say the caregiver is about to bail on her. Say that happens, what happens then? - that day, the next day, the rest of the week, over the course of a month...
The reason I ask is that if it isn't life-threatening (bed bugs are horrible. They are not life-threatening) you may have to let it happen. Then see if social services might like to gee themselves up a bit, assuming your mother herself doesn't change her mind.
Is the current caregiver asking you to do anything specific about the situation?
Her home is infested with bedbugs- a serious hazard.
Her refusal of help when she needs it is causing harm to herself.
Will her doctor allow a temporary medication that will calm her so you can get the house dealt with? With some help and an organised plan I think it could be done.
Once she is safe (offered regular meals & hopefully kept clean) professionals can sort out what's what regarding her symptoms. Then make plans regarding what behaviour strategies or medication may be beneficial. It may be she will require supervised living from now on but usually the least restrictive option is trialled first. Eg home with a caregiver (family or paid). If that fails, facility care may be required.
I'm sorry I do not know the rules for your state. I have researched my own as have 2 relatives lacking insight that self-neglect but are currently stable & accepting home care. I will not be propping things up if/when this changes but calling for professional help. Their needs would drown me in an instant.