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Kate4620 Asked January 2022

I need advice. I feel like I’m navigating blind.

Hi! First post and will be a doozy. (TLDR at bottom).


My 78 yo mom is currently living in a hotel because she accidentally set fire to her house. While she was still at home, over the past 3 years, my husband (and our 2 adult kids) would cook meals and deliver every day; pay her bills and manage her finances; clean her yard; and until 3 years ago, clean her home.


Three years ago, my father died. After he passed, my mom stopped allowing us entry in to her home. Things got bad. Really bad. We could see (and smell) from the doorway she was no longer picking up trash. She had her two dogs (which we confiscated a year ago) go to the bathroom inside her home and would not clean it up.


Worse still, she developed incontinence issues (both types) and would either not wear the diapers we purchased or would wear them until they leaked. She would not wash her clothes. Would not shower. Her clothes would be stained with all manner of waste and she would not even change her clothing.


After the fire, I managed to obtain Power Of Attorney for her as I’m handling her insurance and home rebuild solely. She is unable to help—so she gave me the ability to manage that for her.


Now, while in hotel that insurance pays for, her lack of hygiene and squalor persists. She will chose to lay in her own waste rather than let me assist her. I don’t understand that.


I have no idea how to proceed. I’ve broached the subject of in-home aids, assisted living, etc., and she is adamant that she doesn’t need or want help.


My POA does enable me to make some decisions for her. But, it’s tricky…she is so stubborn about not wanting the help she clearly needs that whenever I suggest help she becomes angry, cruel, etc.


Yesterday, I went to her hotel room and cleaned as she won’t allow housekeeping to enter. Her bathroom was a diarrhea “crime scene” if you can imagine that and she had soiled her bed down to mattress. She was laying in the waste instead of using other side of bed.


“It’s not that bad,” she said. “It’s not that dirty!” Yet it took me (no exaggeration) 5 1/2 hours to remove the smell from her clothing.


TLDR: 1) she needs help 2) she refuses help 3) she lives in squalor and sees no problem with it 4) she is clearly mentally ill and refuses medical help 5) I have POA and no clue how to proceed. And a big btw—I’m disabled.


help!

lealonnie1 Jan 2022
Sorry but, APS 'looking in on her' for 5 minutes and deeming her 'competent' does not MAKE her competent or even MEAN she's competent. What it means is that APS washed their hands of her and decided not to do anything about the fact that your mother is living the way she is. Your brother the physician, has he given your mother a MoCA cognizance exam to KNOW for a fact that she is indeed in possession of her faculties and 'chooses' to live like this? I'd bet my savings account that she is NOT in possession of her faculties and that she does NOT 'choose' to live like this b/c nobody w/o dementia/ALZ or a very serious mental illness would 'choose' to live like this, lying in their own waste every day.

Your mother is exhibiting classic signs & GIANT RED FLAGS of dementia that others are ignoring and/or in denial about, mainly your Brother the Physician. Men in particular are very hesitant to admit their mothers have dementia; we see it here on the forum all the time.

So your mother accidentally burned her house down, no doubt by leaving a pan on a red hot burner (classic dementia). Before that, you were bringing her meals, paying her bills and taking care of all the chores she could no longer take care of herself; managing her entire LIFE, in other words: also a sign of classic dementia: no longer able to manage one's own life. Her being 'verbally abusive' to you when you try to help also fits under the classic dementia umbrella behavior, btw.

Now she's living in squalor in a hotel and not allowing housekeeping in to clean, also classic dementia: Hiding out & stubbornly refusing help. Meaning YOU or SHE will be responsible for paying a HUGE bill upon move-out of said hotel. The mattress is ruined, at the very least, all the bedding, and the carpeting, bathroom fixtures may need replacing, etc. HUGE bill forthcoming. I'm actually surprised the hotel is allowing her to insist on no housekeeping!

So while everyone sits around pretending mother is fine, not riddled with dementia or mental illness at the very least, havoc has been & is being, wreaked at every turn. Follow MJs advice & contact a certified Elder Care atty immediately to get the guardianship paperwork going.

Actions MUST be taken right away to stop the bleeding before everyone is bankrupt! The EC attorney can hopefully guide you about what to do NOW.

Good luck and Godspeed, my friend, you are going to need it. My heart hurts for what you're going through.

PS: I also wanted to add that it's common for an elder to decline dramatically after the loss of a spouse (my condolences on the loss of your father.) If mom was going down the dementia highway prior, she likely started RACING down that highway afterward.
sp19690 Jan 2022
Great response for this poster. But can't 911 have the mother committed for a psych evaluation?
Taarna Jan 2022
Call the authorities. Your mother needs to be admitted for evaluation and treatment against her will since she is a danger to herself. Once she is in treatment, allow case management and social services to place her into a memory care facility where her needs can be met. This is my advice as a nurse.
cherokeegrrl54 Jan 2022
Thank you, Taarna. Excellent advice. Liz

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graygrammie Jan 2022
I don't understand how the hotel staff has any interaction with her if she doesn't allow anyone in the room and you always find her in a mess. There is no way that she would be welcomed to the lobby if she wreaks of urine and feces, worse yet if it is visible. What would happen if you stayed away a few days and asked the hotel staff to check on her? They might be the ones that can get the ball rolling if they see her in the state you've described.

It is awful what you are going through. I could never do it.
Kate4620 Jan 2022
I think they interact with other her when she leaves the room.
Caregiverstress Jan 2022
I had a friend in a similar situation. Her mother would not accept help and was a danger to herself. After trying everything unsuccessfully to get her mom to agree to be admitted to a care facility, (including tricking her into a “one night stay” hoping her mom would be comfortable enough there to want to stay but she up and left in the middle of the night) she finally had to call APS and they admitted her to a psych ward. Eventually from there she was admitted to a care facility. It sucks but sometimes you have to take the most extreme measures to get them into a care facility.

sp19690 Jan 2022
I really think next time you visit her if she is covered in feces again you should step out of the room and call 911 for help with her. I don't understand how APS can say she's allowed to live covered in feces and a caregiver who let's that happen xan be charged with neglect.
Kate4620 Jan 2022
Yes! I agree! Someone would be fired for allowing this.

I have calls in to attorneys. 🤞🏻
Rick10 Jan 2022
Adult Social Services. Your state has something under this heading or Department of Human Services. Contact them yesterday. She needs to be in a care facility obviously. She of course won't like it but she can't live the way she is. Even the hotel will eventually have her removed. I don't know if your POA is just financial or also medical but the social workers will see the problem and act on it.
DrLokvig Jan 2022
We call that agency APS Adult Protective Services (under the Aging and Longterm Care division of the health dept)
MJ1929 Jan 2022
You need an elder care attorney to get you going on guardianship. Mom isn't competent, you'll (as in she) be paying a ton of money to replace everything in that hotel room, and the time to get control is about three years ago.

Call an attorney today.
Kate4620 Jan 2022
I think this may be the next thing I do. However 2.5 years ago I called APS and they visited her twice. They found her “able to make decisions. Even bad ones” and closed the case. (My mom is a former RN and knows the lingo. All the right things to say).


edited to add I’ve got calls in to attorneys 🤞🏻
I’m learning that there may not be a darn thing I can do.
sp19690 Jan 2022
Too bad the hotel couldn't call the police regatding her staying there with all the fecal filth they may be able to get her comitted to the hospital on a psych evil and you can go from there. No one mentally competent is going to lay in their feces. You also need to stop cleaning up her messes.
Kate4620 Jan 2022
Trust me: being physically disabled and having put up with her sh*t (literally) for over three years the LAST thing I want to do is clean up after her.

she’s not grateful (often verbally abusive) when I do/try.

I just can’t stomach the idea of my mom living that way. Makes me mad. Makes me sad. Frustrates me to no end.
babziellia Jan 2022
My 2 cents.

You say this started after your father died. How long were they married? How was their marriage and companionship? Has Mom ever verbalized wanting to die?

Other question: Is your brother, the physician. her PCP? I think it would be bettet if he were not since it's easier to motivate an elder to do what's necessary with the medical advice of non-family member.

Do you go with Mom to all her dr appts? Does/will Mom go to drs other than brother at all?

About POA. You only have so much power. Is it durable? What's in the language regarding powers and limitations? Did an attorney draft it, did you write it yourself, or did you use an online template? Does Mom have advanced directive and living will, etc.?

While she may have UTI or early dementia, my money is on DEPRESSION. It's been 3 years, and if untreated that long, it's become severe. Compare Mom's behavior in the last three years to before her husband passed. Was it a slow decline or an abrupt change?

IMO, your first action is to get her to a doctor for a complete physical and mental health consult for depression, not incompetence. Depression is awful and takes over your life to the point that you don't care about ANYTHING.

Have you had a candid conversation with your Mom about her feelings and will to live? You may be able to have her admitted to the hospital for suicide watch and evaluation. Sounds like she needs meds for depression and anxiety (that's underlying all of this - suddenly alone, without her life partner, lost and in despair). If this is the route, then Mom will need ongoing professional pysch visits with a psychiatrist, not a psychologist. You should insist on attending with her at first until the psych dr can see her alone (although I rec you take her and be available).

Make multiple copies of your POA and any other end of life documents; carry them with you to distribute to all her drs. etc. Designate one copy for you to track to whom you give them (I made a 1-line signature record on the back of mine with date, facility name/Dr name, name of person who actually took it, and made them initial it.

You actually need. at minimum:
Financial POA
POAHC (health care)
Advanced Directive/Living Will.
You can PM me if you want, and I'll email you copies of what I had for my Mom (Mom passed last Thanksgiving).

Bottom line, sounds like Mom is competent, but SUFFERING with severe depression. Please have her diagnosed asap. Mom needs help, even if you must strong arm her to get to the drs using your POA. Hopefully, you have a POAHC, not just a standard POA, and your POA needs to be DURABLE.
babziellia Jan 2022
And another thing I forgot to mention:
I think it's imperative that YOU go with Mom to all her dr visits to 1) listen and take notes and 2) speak to the drs yourself and rat Mom out if she plays down or lies about herself. It's helpful to sit behind Mom so she can't see you making eye contact and shaking your head to the dr. Try to speak with all the drs personally first before Mom sees the dr. Be creative. Wisper to the register that you need to speak privately with the dr - not just the nurse/PA - tell Mom you need to use the restroom there, whatever. If any dr won't allow you time, dump them and find another one. You need drs that will work with you for the benefit of Mom.
AlvaDeer Jan 2022
She must be diagnosed as incompetent in order for you to make decisions for her. You will need to get that diagnosis even if it involves calling APS to open a case, or calling ambulance for delivery to ER.
If she is not diagnosed as incompetent the short and sweet answer here is that there is little that can be done. When the Hotels/motels find out the conditions of their property she will be evicted.
If you are disabled in a way that precludes your being able to act for your Mother it may be time to let the state take on guardianship, because once APS calls them and arranges that you will have no input, but it will all be out of your hand.
The unfortunate thing is that mental illness doesn't usually qualify for guardianship by either you or the state. This is but one of the reason there are so many homeless on our streets, clearly mentally ill, who have no access to care and nowhere to live.
I am so sorry. I cannot begin to imagine what you are going through.
Kate4620 Jan 2022
thank you!

as I stated above to others, I had APS look in on her and they found her competent.

My brother is a physician and he says she has her faculties but is living this way by choice.

Without her agreeing to see a doctor (who isn’t her son) I fear I won’t be able to push for guardianship.

maybe hiring someone for home health, another for housecleaning???

This is so frustrating and hard!
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