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Not really sure if I am looking for advice or just to vent. My mom, 82, is undiagnosed but certainly has Alzheimer's. I had a geriatric appointment for her later this week, but of course that is canceled so who knows when that will happen.


Mom lives alone in the house she bought in 1975 when our dad died. It's just me and my brother. I live about 75 miles away, he lives 7 hours away. Mom has gotten increasingly paranoid, thinks people are moving her things and stealing from her. Her house needs some work, like painting and windows, but she refuses to spend the money. I have encouraged a home equity loan, even though she has the cash. She said she's never had a loan, and won't get one now.


She is not on any medications. She has been clinically depressed for years, but won't believe that depression is more than just sitting around all day crying, so she denies it. She would never agree to any mental health treatments. She's of the generation where mental health issues are shameful, not talked about and certainly you don't go to a doctor for that. The whole town will know!!


Part of the issue is the small town she lives in. There are few specialists, and certainly no geriatricians. I have to bring her to my town for anything but the most basic treatment.


She has a trust that was set up over ten years ago when my stepfather was still alive. I do not have a copy of it. I contacted the attorney and he said she never signed the will. And that the POA is so old (old forms) that she needs a new one. Again, the attorney is in my town and currently closed.


Last week a very heavy piece of furniture fell over, almost on top of her. She says she was just looking at it, and it fell over. That is just not physically possible. She must have been trying to move it.


Then there are the burned potholders and food left cooking. Last year she allowed two strangers into her home and signed up for some scam energy provider. Of course I had to fix that. She wants to switch banks because she is convinced that the manager of the local branch of a national bank "hates her" and is "messing with her" because she keeps getting locked out of her online account. She is, of course, entering incorrect information and locking up the account. She cannot fix it herself so I have to do it for her.


Moving out of the home she can no longer manage is not an option. She is not ready for a nursing home and I would never put her in one. There is one very nice independent living place in town, but it's not an option because they don't allow pets. She has two cats and I would never consider taking them from her. There is no assisted living near her. AND she is adamant that she will NOT leave her home.


I would like to get her a paid companion/caretaker. I can't go more than once a week, and right now I can't go at all, because of the lockdown. The problem with that is she does NOT want strangers in the house. It would just cause her more anxiety and she would feel like they were a guest she'd have to talk to and entertain.


My brother will go along with whatever I suggest. She won't listen to me, but she will listen to him. Unfortunately she will only go along with him if he's physically there, which of course he can't be all the time. He's an essential employee so who knows how long until it's safe for him to see her.


Any thoughts or ideas welcome.

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Lots of states have written new statutes allowing for important paperwork to be processed remotely. The lawyers near me are open for business- just not for office visits. We also had someone virtually examined by a geriatric physician- so you might call your mom's doctor and ask if Telemedicine is available to her. (Someone may have to visit her to accomplish this though.)

You make a lot of good suggestions in your question and immediately shoot them down. Whatever arrangements you end up making for your mom, it is going to mean some hard choices and changes. It's rough. Don't box yourself in with so many "I'd never" statements. Your goal will be your mother's health and safety. That might mean re-homing her pets or putting her in a memory care at some point. Don't make your job harder by listing all the things you'll never do before you've even started on this journey.

This is a hard journey you've started. This forum will be a good place for help and support.
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jacobsonbob Apr 2020
Excellent suggestion! Some situations simply can't be fixed without making some unpleasant choices and decisions, so all options need to be on the table.
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Wow, lots of issues going on here! I don't think a diagnosis is all that important at this point, so whenever the appointment get rescheduled, that should be fine. Yes, a diagnosis is not a bad thing to have and can help with a better understanding of what's going on.

Do you have POA? Would she sign papers to do so? And the unsigned will? Can your attorney draw up the papers that need to be updated and signed? Then as soon as you can go see her, try to get her to sign them?

The burned potholders are a huge red flag. She should not be cooking! She really should not be living alone. She is a bit unsafe.

There are lots of things that you say can not happen. I ask you to consider looking at what's right and safe for her. She will not WANT to leave her home, quite understandably. BUT she's going to burn the house down. She is not in a position to make good decisions anymore. Her brain is not working right and you are going to have to think about stepping up and ensuring her safety, regardless of what she wants. With dementia, people really aren't in a position to understand what they need, what is appropriate, what is safe.

She doesn't want strangers in the house. Well, something is going to have to give her. She is probably in need of in home care or moving to a nursing home.

I'm sorry if you think my suggestions are impossible. But I do think you need to consider reframing the situation and looking at it from a different angle.

Best of luck.
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bolliveb Apr 2020
Thank you. Yes I have POA but I do not have a copy. The attorney said it needs to be updated with new forms as he said I'd have a hard time with a document signed in 2008. No problem getting her to sign a new one, but that requires the lawyer re-opening the office, and it being safe for me to get her and travel to sign it at his office. She never signed her will either, so we need to do that. I will not have a problem getting her to cooperate with this, but who knows when it can be done? In a perfect situation it would have been done months ago, along with the geriatrician visit. I held off, as wintertime travel here is always iffy. And mom will not leave the house to travel in winter. She's terrified of being in a car if it's snowing. Always has been, nothing new.

I really need my brother and his family to help me in person. They would be here if they could, We all get along and would work together. But everyone is quarantined.

I do appreciate your suggestions. It's all compounded by how few services are available in her area. I will take her anywhere at any time, when it's safe again.

Something does have to change, and in a big way. Thanks for your input.
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Who did your mother appoint as POA? I've never heard of a POA being "too old" unless those appointed are not viable to do so. It doesn't sound like Alzheimer's, though, but dementia. The caretaker/companion is a good idea, if she will allow it. Your mother is the exact same age as mine when she began having dementia and then paranoia. My mother began calling the police in the middle of the night with paranoid delusions. Then the police would call me. It wasn't too long before Adult Protective Services got involved and she was removed from the house. I also live 75 miles from her. The whole experience was very painful/stressful. After three facility moves in 5 years, she's in a nursing home with severe dementia, but is on the right balance of meds. If I could advise you, I would say to start looking for possible residence facilities NOW for your mother, so you have a plan and you are not caught off guard. Dementia can spiral quickly out of control, you want to be prepared. Good luck.
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So you visited your Mother & found she may have moved to Dementiaville... She looks the same, her house looks the same but everything is different. A new place where skills once had are lost, accidents get more frequent, rational decisions are missing & replaced by ridgid thinking. It can be a scary place but once you get advice, you can start to plan & find your way.

A dx would be the start. To know what you are dealing with - dementia symptoms can be caused by other reasons that need to be ruled out.

But the more immediate issue is safety. My top red flags for needing supervision are *falls*fires*fear*fraud*.

Moving heavy furniture or other risky decisions lead to falls. Burn marks escalate to kitchen fires. Problems handling finances can become fraud target. Paranoid thinking can lead to fear, even leaving the home or wandering at night. You've mentioned all of this (except wandering).

You've mentioned a lot of things you know you don't want: leaving her home, leaving pets, NH. I do understand. But add house fire, falls & fraud to that list.

Is there an Area of Aging to discuss what immediate measures can be added to increase her safety?

In time, once you get a dx, you can re-do that priority list. Decide what's really important.
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jacobsonbob Apr 2020
This gives the old military draft term "4-F" a new meaning! In this case, it means a disaster just waiting for the most inopportune time to happen.
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I think the lawyer wants more money. My Mom did her POA in 2006. I had no problem in 2014 using it. The only "update" I see is declaring her incompetent by a doctor and the lawyer writing a letter to that fact. I had one company that requested that to be able to do business as Moms rep.
Your Mom cannot sign an updated POA because she probably has no idea what its all about.

Your Mom should not be alone. Independent living is not an option. These communities don't give any care and if they do, its not 24/7. It maybe help with meds. She needs to be able to do for herself. An AL would be my choice. And soon. A scorched potholder could end up being one on fire. If you can't bring her into ur home you r going to have to make a decision on her care soon.

If u have a neurologist nearby, that would be my choice to evaluate Mom.
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bolliveb Apr 2020
Thanks. The attorney is not charging more. The work was done years ago.

I agree that assisted living would be a great idea at this point. My only problem is finding one that would allow her cats. Taking them from her is NOT an option. It would be terribly cruel and I will not do that to my mom.

We really need a geriatrician. No, there are no neurologists nearby. The only specialist locally is an orthopedic surgeon.
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Bolliveb,
You mentioned that there is an existing POA. Who is her POA?
The POA, essentially has the power to act on her behalf.
Her primary care doctor should at the very least be able to give a diagnosis of moderate mental impairment. This gives the POA a leg to stand on.
If she is truly unsafe to live alone, your options are limited and very heartwrenching.
When someone has dementia, they no longer live in the same reality as you.
As much as you don't want to separate her from her beloved pets, is it worth her wellbeing?
You have a tough road ahead.
Maybe try to consider her physical wellbeing first. Unfortunately, her mental wellbeing seems to be out of your hands.
God bless!!
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Bolliveb,
If you decide that you need to move her into Assisted living, do a little research on "Therapeutic Fibbing ".
I know it sounds awful, however it's a very useful tool. And sometimes the most humane way to convince a loved one to move.
Hang in there!
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If you agree with getting an updated POA, get that signed before you get a confirmed diagnosis. Once she is diagnosed with dementia, she can no longer sign a new POA. The POA we have for FIL is more than 20 years old. It has been fine for healthcare and most financial although we did have to get a letter says he is incompetent. If the current POA is correctly written, is should be fine.

I agree with those who have said to move her closer. A companion will be difficult to manage long term. AL’s do take pets although I don’t know about 2 cats. And I don’t know how humane it is to have cats used to a house kept instead in one room. She has dementia and she cannot take care of herself. That takes a lot of “I will never do that” decisions off the table. You have a lot of things that you say “can’t hsppen”. Must move with cats, does not want to move at all, and does not want strangers in house. You can of course just let her do what she wants until she ends up in ER or worse. If you are hoping to avoid that, she has to move closer. Maybe with one cat and maybe with none. Hopefully someone in the family will take them? Maybe get her to move and keep cats yourself “temporarily”? Something clearly has to change. While you are waiting, start reaching out to facilities near you to see what they offer. And get county statistics for Covid infection at the facilities just so you are aware.
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disgustedtoo Apr 2020
"And I don’t know how humane it is to have cats used to a house kept instead in one room."

Given a choice, sure, a whole house is better, they can pick spots they like. However, if they are sent to a shelter, they WILL be in one room, if that, and likely with other cats. Since not all of mine get along, I have "zones". Several have the Master BR with a very long hallway. Others are in a large kitchen with access to the partially finished basement (my mouser likes this!) Two never got along with the others, bad fights, pee, etc, so they were given their own room. One BR. We lost the male to a dental cleaning, so in order to have a roomie for his sister, I took in an 11yo one-eyed tux who is semi-feral, spent TEN years in the shelter, a room about the same size with 11-13 cats in the room!!! He must think he's been given an upgrade to move to a similar room, but only has to share it with a little 6.5 pound kitty!

Cats, even 2, can be okay in a single room. They still have spots to nap, hopefully a window for Bird TV, and a perch/scratching post. The bigger concern is their actual care - feeding, litter, vet, etc. I've read threads where a woman was feeding inappropriate foods, cat litter wasn't maintained, cat(s) were overfed and obese, etc. THIS is a bigger concern. Since no one is on the ground full time, this can't be monitored, so who knows how well she can care for them. It may seem ok during those short random visits, but ....
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That sounds exactly like my mother in law, she is paranoid and says she sees people outside taking stuff they aren't. Sh also refuses to go to any doctors for anything she won't even go for a check up, we (my husband and I) are the only ones who care for her she has 3 other children that does not and will not help
She still lives alone, won't move in with us, I take care of her, her house and bills and then our house, I am so overwhelmed with everything.
You go ahead and vent Hun
I am here
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Here's what happened with our family (and it worked!) for my oldest sister; we invited her for a 'little visit' that turned into 6 months (but for my AD sister it seemed only like a 'few weeks'). While your mom is visiting you, you could tell her that you arranged to have her house 'repainted inside and out' and that YOU are paying for it, not her. Then there were termites found in several places, so that has to be repaired, etc. You get my idea: drag out her 'visit' as long as possible. Our sister REALLY enjoyed being with family (she, too, had been living alone) and eventually she decided to sell her house (I have DPOA, so I arranged for the sale, the furniture move, etc.). Then our sister put herself on a waiting list at a really nice local ALF; plus she had bought LongTerm care insurance years ago, and with her AD diagnosis the LTC insurance started paying the bill after the 1st 90 days. Our sister REALLY enjoys her apartment there, with activities, outings, movies down the hall shown twice each day. And she is NOT in MC, but basically has no short-term memory left, but is on 25mgs of Zoloft and 25mgs of Seroquel that work wonders! We do have a professional caregiver (a long-time friend of the family) coming to visit her 1-2 times a week, plus she's with family on the weekends (at least before the COVID lockdown started). Best of luck with your mom!!
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