My mother is 78 years old - which doesn't seem so old, but she is. She's been in bad health for several years. My dad died a little more than 2 years ago and I've watched her go downhill. She has COPD, has had 6 bypass surgery seven years ago. Recently she was diagnosed with stage 2 lung cancer. After chemo and radiation, she seems to have won that battle...no signs in the lymph nodes, etc. Her short term memory began getting bad and I wrote it off as "chemo-brain", but it's been 5 months and the memory is getting worse. She seems easily confused and agitated. She recently was back in the hospital with pneumonia and due to her overall health, she was sent to rehab. She signed herself in and said she'd do what she was told. She's been there 2 weeks and she won't cooperate. She'll do arm exercises, but refuses to walk or do any kind of leg exercises. If she won't participate or improve, Medicare will stop paying and they will release her. She lives in Assisted Living, but she doesn't take care of herself. Her apartment is always littered with papers and Kleenex on the floor, the cat box full (and she always says she cleaned it the day before). I try to get over 2 - 3 times per week and spend the time cleaning (often she refuses to allow housekeeping to come in). I was thinking she was lazy and taking advantage of me. Now I think she can't take care of even the little things anymore. Although I have medical POA, until I can have her declared incompetent, I'm limited on what I can do. I'm torn between leaving her in AL with some additional care for quality of life, but I feel she'd be safer in a long term facility for her safety. I have an appointment for an geriatric evaluation in April, but won't have the results until May - and that's IF I can get her in the car and to these appointments. How do I choose the right course, how do I qualify her for Medicaid to help pay the costs of long term care (she private pays for AL) and how do I declare her incompetent without humiliating her? I'm her only caregiver. My sibling is estranged from the family - and in my opinion, just waiting for my mother to die to see if there's any money left. She stole from my mother's house the day after my dad died. She is not someone I can turn to for help. Feeling really stuck. Thanks for suggestions and advice.
If she won't sign the DPOA papers, you can still attempt to get incompetency declared, but be sure to document (like, videotape or audio tape what you are saying, and describe what you are doing as in her best interests) and that way you can go before a court and show the judge, you are trying to do the best for your mom and not just trying to twist her arm.
You could also have the AL facility schedule a family meeting with your mom, you, and the staff, and perhaps they have a social worker who could describe the need for her to have a DPOA.
For your estranged sibling, you do need to be extra careful that your mom's will is as your mom would like it, too, because with no will, your sister will receive 50% of anything that is left.
You may need an attorney to help organize all this, but it is not necessary and it definitely is expensive. Lots of information is out there, check your state's attorney general website--they'll have all the DPOA forms right there for you to download, plus loads of information to help guide you.
I would see what the evaluation uncovers about her abilities or future health needs. She is a bit young for a nursing home, nursing homes were usually for the last 18 months to 3 yrs of life. She isn't 80 yet.
I suspect she may be a bit depressed with the loss of husband, mounting health issues which could be reflective of the memory/confusion. Some of her meds may be part of the problem also.
Good luck.
For the most part, they are all more affordable than SNFs, so depending upon your Mom's finances, she may be able to live comfortably in an AL without exhausting her funds.
I can't stress enough how important it is to establish that relationship with her medical team. As far as medicaid, spend the money for a good elder law attorney and cover all your bases. Step back and look at this as what can I do today. As long as the big picture is blocking your view you'll drive your self crazy and it will paralyze you from even making the first move. It doesn't all have to be done right now. You'll make mistakes and that's OK just share them with the rest of us along with your triumphs. I find it no different from raising kids "tough love" I'm doing this cause I love you and want what is best for you! (cause their not able to do it for their-self). As far as Chemo brain I'm convinced it messes with your memory and thought process and not sure you can put a time limit on it. They are so busy trying to cure what is trying to kill you that they have no idea what the long term affects are. It's been almost 3 years and I still struggle wondering if there is permeant damage done with my ability to multi task and recall even the smallest stuff. As far as your sibling, You may be right but it's out of your control. You have to live with your decisions and actions. My first step if asked..... Give Hospice a call and ask if they would evaluate your Mom. Their not just end of life and an amazing resource. Second step call her insurance and say this is the problem what can you do to help us, what is available to us?