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So here goes, my 88 yo MIL broke her hip in November 17, we moved in with her as she had been told several times before break she could not live alone. She has been in mental decline now for about 6 years, she stopped going to church, stopped all outside activities, stopped crafting etc, insurance stopped insuring due to multiple accidents. Has not been able to drive for a very long time, last time I rode with her was about 7 years ago and she wouldn’t recognize stop lights etc. but just has stopped driving when insurance refused to insure. Now she is letting her homeowners laps, she can not distinguish bills from ads thinks she has 7 different insurance companies, and it’s all just ads and didn’t and refuses to pay the one she has. She does not understand her bank statements, she thinks she’s broke, and she is trying to cause some serious financial harm to herself due to fees and taxes.


Her geriatric put her on aricept, but says she does not have Dementia or Alzheimer’s???? But ordered hospice??? Sadly she has always been Narcissistic and she is absolutely mean and horrible to my husband and I, constantly lies says we neglect her we don’t feed her we are stealing from and the list goes on and on. Any excuse she can come with to try to have us removed. She has so many signs of mixed Dementia but no diagnosis, my husband does have a DPOA but it’s useless on stopping her from financial harm in AL (Alabama), we have learned it’s a very expensive useless piece of paper. What makes this situation worse is doctor basically refuses to diagnose her and we are not getting much help from hospice either with it, because she passes the minis and is fine in front of health care.


The financial harm I’m talking about is not going to cost her a few bucks it’s going to cost her 100s of thousands, she doesn’t need the money but if she makes this mistake because she does not understand her money it is going to put her in a bad financial situation, is there anyway we can get help or advice on how to stop her? Or what can we do to prove she is no longer competent in handling her affairs? She refuses all doctors but the one she has. He will not listen to our concerns or even send her for further evaluation. Between all of this it is seriously taking a toll on my husband and I mentally, physically and emotionally... any advice is greatly appreciated...

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First of all, find another doctor. Find a Geriatric Psychiatrist and have her evaluated. By AL do you mean Alabama or Assisted !iving? I’m assuming she is still living with you at her home? If she is formally diagnosed with dementia/Alzheimer’s your husband’s POA will absolutely be effective. She needs to be in a facility. She doesn’t sound competent to make her own decisions. As for the financial issues, you may have to contact an attorney.
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Hopeless75 Sep 2018
Yes by AL I mean Alabama yes she lives with us, even though her doctor put her on aricept he refuses to diagnosis her.. Unfortunately our attorney says nothing we can do unless she is declared incompetent, and we have set up appointments on top of appointments to go to another doctor and she refuses to go half the time we can’t even get her to go to the one who won’t help, we’ve even tried taking her and she refuse to get out of car . We in a dang if you do and dang if you don’t situation
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Is your husband's POA active or is it the kind that needs a diagnosis of incompetence? Hospice is end of life care so they aren't going to be concerned about anything but the terminal diagnosis that made her eligible - from your post I'm not sure what that is? If your hubs can act I would proactively move her money into accounts she can't easily access and/or term specific savings that are locked in and difficult to move. If he can't invoke his power as POA now then try to find a trusted family member, financial planner or whoever can convince her to do it herself. Lie to her if that's what it takes.
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Hopeless75 Sep 2018
we don’t understand why he sent in hospice because she is still active she can dress herself and small things she just don’t remember how to cook or laundry or clean house, it’s so confusing even to us there are certain things she can still do but there are things she can not do. And the financial thing is before we moved in some big banker talked her into moving her money from cds and savings and putting them into a god awful annuity and if she tries to cash them out now she is going to loose tons, and his DPOA iit’s for if she becomes incapacitated or unable to make descisions. We live in Alabama and when it comes to stuff like this the laws are tough because there has been so many people in the past abused the DPOA so there for a few years back Alabama changed laws and made it damn near impossible for the honest ones.
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It sounds as though she is locked into the Annuity so that is all water under the bridge, some people must feel they are good investments or they wouldn't still be available - perhaps it will work for her.🤞 What concerns me more is her being accepted in hospice - this forum is full of posts from people whose loved ones death in hospice has left them confused, angry and accusatory. Hospice is for people who have a terminal diagnosis and are dying, perhaps not imminently but within the next 6 months to a year. Is it possible your mil has not been upfront with you about her medical condition? I think it is imperative that you find a way to get her seen by another doctor, preferably a gerontologist, use trickery if you have to. Gee mil, your doc is on vacation and we need to renew your prescription, or we got a notice from your insurance that everyone over 85 needs to have a check up with a gerontologist or ???
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Hello,

Some of the responses to your questions are accurate, but not all of them. It is not true that hospice is not concerned with your loved one and will not write a letter of incompetency. I am a Social Worker for hospice and I have had several letters written for incompetency. I am writing one tomorrow, wrote one last week. Our medical director signs the letter. The letter is written based on the RN Case Manager’s assessment of the patient and the patient’s decline.

It is a myth that all people who come on service for hospice...die. I have had several patients discharged for what is called extended prognosis..they get better. However, the criteria for hospice is that, if the disease is to run its normal course, the patient will pass within six months. This does not always happen. Often times I have seen patients that needed the care hospice provides, regular meals and medical treatment and they get better. Not always. When i speak of regular meals, I mean when they are moved to a skilled nursing facility and they are fed regularly. Sometimes they improve. I have one such patient now who may be coming off service for that reason.

Hope this is helpful.
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Oops, I forgot to answer the main question regarding incapacity. If hospice doctor writes the letter for incapacity, you should be okay to pursue the living trust or other power of attorney responsibilities.

Although she is on hospice, some hospice will not cover certain curative medications. The fact that she is taking aricept is good. But, it has been my experience that she needs to take namenda along with aricept to get results.

Hope this was hopeful. Write me directly if you need further assistance.
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She is passing the mini mental examination...For her that is a good sign. Poor sign for you. Not sure how she is doing that when she is diminished in other areas. Often times dementia patients cannot pass the mini mental examination. You, however, as stated earlier can get conservatorship by showing her spending sprees and poor judgement. If she is on hospice, ask the hospice social worker if they can write a letter of incompetency.
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Hopeless75 Sep 2018
We have spoken to the hospice worker several times about this, even though she is on hospice she can still use her doctor, which makes no sense. Hospice also told us only their doctor could step in is if her doctor is on leave and can only fill prescriptions that have ran out, and says even though they make notes of these things happening that her doctor only gets their notes at his request.. hospice has told us that their hands are pretty much tied and nothing they can do.
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Hopeless75, if you moved in with MIL, why can't you move out? You say she is "mean and horrible" to you and your DH. Is he an only child? If not, then how did it end up that he's saddled with her?

Sounds like MIL has a large estate? What does the will look like? What I'm getting at is if there are other heirs (or does your H inherit all?), then they should also be involved. Or are they waiting around to just pounce once she's died?

MIL ought to be paying the both of you for your caregiving, also.

Is she by herself during the day? Do you both work?
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Hopeless75 Sep 2018
My husband is a only child, her nastiest doesn’t bother him as it does me, he says he’s immune to it she’s been like that all his life, however it does bother him the way she treats me for the simple fact of what all I do for her and never even so much as a thank you from her,me however I wear my heart on my sleeve and the name calling and let me tell she’s called me everything but a human, however I just walk away and go cry somewhere, as far as the will We have no clue and don’t really care, he’s saddled in due to a promise to his dad on his death bed cause His dad was his hero till this day and there for he is going to honor his dads last wish to him. The only reason we worry about her making financial mistakes is for the simple fact it will be us that have to pay for NH when it comes to that point and it wouldn’t be fair for us to have to wipe out our retirement and savings due to her mismanagement. I’m sorry I feel that way as I’m sure we are not the only ones to feel that when it comes to their personal assets..and as far as her every being alone no she is not other than when I’m outside gardening or cleaning up the yard and such as I am a stay at home wife. As far as her paying us we could care less a thank you goes a long way,
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You should be able to get her tested for dementia, can be a long test. Call www.Alz.org (Alzheimer's Association)

They should be able to help you out with a lot of these questions

Dementia does not affect all abilities all at once, and is different for every person.

And most doctors do not know how to deal with dementia!
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Hubby is wearing virtual earplugs and blinders. It doesn’t bother him because it sounds like most of it is aimed at you. Sure, he “feels bad” that she’s abusing you as well as him now, but ultimately it’s up to him to pull the plug on her behavior.

Why would you even consider spending your retirement money for her care? Whose idea was that? File for Medicaid. I don’t remember if Hubby has POA, but if he does, find yourselves a nice apartment, move out and sell her house. She can be Self-pay/Medicaid pending until then. She is paying you. You have the privilege of living with her and of taking her abuse. You collect your wages in misery.
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Hopeless: It seems that others can take advantage of our old people, while family is supposed to sit back and take it. There is no "system" for dealing with all this in America. It's insane, IMO.

Why have you both not insisted on being told why she is in hospice? Why has your husband not stepped up and demonstrated who (should be) in charge here? Why is he more loyal to a dead man than to his living wife? Why does it look as if you are willingly taking on the management of this situation with someone else's mother and then tolerate being insulted? Are you an eldest child who always has been the one to look out for others in the family? Why do you feel the need/obligation to cater to a mean narcissist?

Why have you both not just found another doctor for MIL? I would choose a female doctor, one who is taller than mil, very self-assured, and who really understands dementia. ( Or a good looking large gentle male--but he needs plenty of diplomas on his wall) Take mil to see this new doc. You don't have to tell her where you are taking her and since she doesnt have her own wheels she will just have to deal with it all. When she shows her condition by her behaviour, you should get the evals you want.

(You might also tell mommy dearest that you are keeping notes and plan to write a book about her--- and see what changes that brings about).

(I'd like to know how the dishonest people manage to scam old folks and walk away, while the responsible family members are stopped from doing the right thing by legislators who are either ignorant -- or complicit in the frauds-- and by the various parts of the medical/human services community not communicating with each other. {You see what I did with words there! } But I'm too tired myself to really investigate these issues).

At some point, your husband has to take control, IMO. What can she do, disown him? As it's going he will be the same as disowned, anyway. And your own relationship will suffer, as well as your financials. You need to care yourselves or both of you will break.

I have a situation of my own to deal with and every friend tells me to take care of myself first. I finally decided that they are right, that the pain I'm going through is just hurting me and not helping solve the issues with my loved one. So the first step has been making up my mind to save my own life. Think about that, will you. (Of course this person I love is not a member of my or my late husband's family).

My wish for you is that you put your own sanity and health above the need to care for someone who doesn't like you and thinks she doesn't want your help. Demented or not, that should tell you how she feels about the woman who married her husband. This is a bag of wiggling worms and a short vacation at a nice spa (with hubby taking over all your chores for a few days) should give you a chance to put it all in perspective and come up with a plan to deal with the chaos.

Wishing you a new saner life with a husband who appreciates all you've done to keep HIS promise.
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Some really good questions have been asked here.

You don't care about the will, don't care about being paid, yet you are concerned with eventually having to pay for a nursing home?

What's going to happen is that as MIL needs more and more help, you will be expected to provide more and more help. Are you up to that? Do you realize that up to 40% of caregivers die before their charges?

Does your husband care? Or is he going to step up and wipe MIL's butt, get up with her throughout the night, tolerate the UTTER CHAOS that could easily become your life with an elder with dementia? All because of a promise made to an old man on his deathbed?

Hmmm...
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Get another doctor. He is useless, Have a neurological exam done. If Mom can't understand how her spending or not spending her money effects her finances and bill paying then she is no longer reasoning or processing what is being said to her. These were my Moms first signs of Dementia.

You cannot be held responsible for payment of Moms care in a NH.
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Johnny13 Sep 2018
shop for another hospice agency too
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My my recommendation is if the doctor is not cooperating then you need to find a better doctor
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I have not read all of the replies because I have to get to the nursing home to see my mom, no time to read now. But, I will tell you what finally worked for us.

My mom’s also narcissist, controlling, 97-years-old, very similar to yours. Could not do banking, understand her mail, saved every piece because it might be important (ads, etc.), wanted to donate to all these money-grabbing organizations, etc. All these people who say “find another doc” don’t know how hard that can be when your mother has been seeing the same two docs for 30 years and are the only docs in her little town. I finally made an appointment w/ her doc to see if she had a UTI. In her office, she went to pee in the cup and missed so there wasn’t enough for them to test. Doc then sent her to ER to have urinalysis done. THERE, I got to talk to different docs and tell them she needs a dementia workup, and gave them examples of her most frightening behaviors. She’s one of those who always pulls it together in front of “new” people, so she was sitting in the bed chatting away, asking why they weren’t sending her home yet, etc., and I told the docs in front of her that she has gone outside in the dark 3 or 4 times looking for me because she’s convinced that I’m laying in the street, and I don’t even live in that town. She got angry, called me a liar, told the docs I’ve been lying for years, etc. She was all jazzed up about it in defense of herself, so I threw in another one that I had not mentioned before: “what about the secret door in your closet that other tenants can use to get into your apartment?” She got madder and said, “You have not seen my closet or that door!” I looked at the doc and said, “I’ve been hanging up her clothes in that closet for 10 years, there is no door.” That’s when they ordered the workup. Eventual diagnosis, Moderate Neurocognitive Disorder (dementia).
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Mfreemam Sep 2018
I’m having the same issues with my mom, only difference, she REFUSES to see a doctor. Had a call from her this morning she was upset, bus didn’t come to take her and the “guards” home. She still lives at home, refuses to move. I wish I could get her into the hospital for an evaluation.
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Where we are, to get hospice services based on dementia, hospice does an evaluation. That should help get ball rolling for you. If not, get the eval elsewhere...and a new md.
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Could the doctor order a brain MRI? It might show brain atrophy or fluid build up. Couldn’t hurt to ask. A neurologist could certainly help, but I totally understand that finding another specialist is time consuming and it feels like “starting over.”
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My mother had the same problem with her general family doctor. She put her on Fluoxentine (Prosac) and Aricept and continued to treat her as a general patient. Any questions I asked about her condition or behavior, the doctor said Mother was depressed and these meds would help. After two years of this I found a certified geriatric specialist and it has made all the difference. She sent her to a neurologist who did numerous tests and diagnosed vascular dementia with possible underlying Alzheimers. Scar tissue in the brain accounts for some of the physical problems she has had for a long time that a regular doctor just discounts as a change in thyroid medication or just old age. It seems that your mother needs to see another doctor. If she is already seeing a geriatric doctor, insist that she be referred to a neurologist for testing. Call the Alzheimers organization for information on doctors or how to proceed with your mother's care and support. They handle all dementias, not just Alzheimers. There is no reason the DPOA should not be used when you need to keep track of her finances or assist in making decisions for her. Perhaps you should also see an elder law attorney to make sure the DPOA is properly done or if changes need to be made (why does your husband have the DPOA for your mother?).
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Catneal Sep 2018
Sorry, after rereading your post, I realize Mom is actually your MIL and not your mother, so disregard my last comment above.
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Same case scenario. Decide if it’s going to be you or her. I decided it wasn’t going to be me and I took steps to protect myself and get her the help she needs. Call in resources to help point you in the right direction. You will be happy you did. You can’t live another person’s life for them and keep things the way they were used to living. Her life has changed and it’s bigger than you and her. See an elder care attorney pronto!
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Find a family law lawyer. Your doctor is a loser for not plugging you into the system to get the decision making turned over to you or a third party. You should report him or her to the state medical board.

There are multiple levels of financial control and powers if decision making beyond declaring "this person is a vegetable." In most states you just petition a local judge who takes one look at MIL and shakes their head then grants you what you need. Doctors are typically scared of everythong because they live their whole lives in the shadow of malpractice, even putting their houses in a spouse's name to avoid losing their home in a suit so they will hem and haw about big decisions.

Lawyers just do their thing. Find a family law lawyer right away.
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She needs to be seen by a neurologist. We tried her primary care for 3 yrs and dr would not do anything. You also need an elder care attorney and set up a trust for her financial affairs. I dont understand why doctors are so reluctant to help families. It is always a struggle.
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You have your hands full and my question is - do you want it to continue or stop? If you want to get it to stop, FIND ANOTHER DOCTOR WHO IS AN EXPERT IN ELDER CARE and find a way to get him to step in and evaluate her. Also start looking for facilities that will accept people like this and consider putting her into one at once. Also check for help from an ELDERCARE ATTORNEY. The fact this harming you and your family is the straw that broke the camel's back. Get tough and look after yourself. Since she is mean and refuses to cooperate, that makes it time to get her out of your hair. Sorry if this is harsh but it is true. When the day comes that the people you care for are making life hell for you, it is time to do something about it.
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If MIL spends all day of her money, her house will have to be sold to pay for some of her care at a nursing home. Once that money is gone, she will qualify for Medicaid. You Will Never Have To Pay For Her Care Out Of Your Funds.
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rovana Sep 2018
I see a problem here - what you say is true....but from a legal standpoint of filial responsibility.  But we have to take conscience, family feeling, etc. into the mix.  Mom spends her money, Medicaid steps in, but there will still be needs/demands for a nicer choice of facility, extras, items not covered by Medicaid. Now legally you could, I suppose, just say "no", but to most people guilt would "force" you to step up, to some extent.
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It's Alot like a storm. Your story described my mom. I would say first step which is key. Is put all bills on automatic payment. That will help a ton. Far as feeling broke not much you can do about that. With a shredder you can shred junk mail. But the auto payments help.
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Get another doctor. A geriatric doctor if possible.
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Long story short

Rresearch State Law!
Go to Court. You can represent yourself, but a Fiduciary will be appointed for Mom.
Get all of your ducks in a row and GO FOR IT
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Narcissistic personality disorder can mimic alzheimers and dementia.

The word salad, the obstinance, the meanness, etc.

Narcissistic personality disorder does not render someone incapable of making competent well informed decisions in the eyes of the law.

If she does not show true signs of dementia or Alzheimers, the doctor will be risking his license by claiming she does have those disorders, if she does not.

He/she also is open to being sued.

Many doctors have witnessed family members who attempt to deem a parent incompetent as a way to get control of their finances and engage in financial fraud.

Often these people want POA so they can put bank accounts and other funds in joint name as a way to shut out siblings.

If their is later a will contest the doctor will be liable if he claims your mother is incompetent without proof positive.

You will need to get several other opinions.

Still, judge may not declare her incompetent, if only some doctors claim she is incompetent and others do not.

So unless you can get all the doctors to agree she is incompetent, you may have an uphill battle.
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If her doctor put her on aricept and she doesn't not have dementia, I would want to know why. My husband also had the side effects of diarrhea and he couldn't sleep at night. We took him off of it after 3 weeks.
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1. Why is DPOA useless in AL?
2. Have an advocate come to the house to assess her condition(s). If you don't do it and someone in the family or friend sees what is going on....they can report you to APS
3. CHANGE HER DOCTOR! Take her to a specialist. My Mom's former doctor specialized in Diabete Alzheimer's 3. I never heard about this form of Alzheimer's until this past April!
4. "TALK" with an attorney who also specializes with issues like this so you can go to Court and your husband can become her guardian/conservator.
MAKE SURE THAT THE ATTORNEY'S PRACTICE DOES AT LEAST 75% OF ELDER LAW...NOT FAMILY....ELDER!
5. Once the appointment is made, your husband will have the power to do what needs to be done
6. CAUTION...YOU WILL RESPONSIBLE TO THE COURT FOR EVERY DECISION MADE AND THAT INCLUDES ANY ADVICE THE ATTORNEY GIVES. YES, THEY CAN BE SHADY TOO
7. IF the DPOA STATES your husband has the ability to act in her stead, he has been given permission from his Mother to do so and it should be recognized as such.
8. Get to the bank, get the DPOA on file, have the account changed over to a POA which will have her name as owner, but husband as POA. That gives him the right to do everything necessary regarding her finances.
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