My mother is 101, and has Borderline Personality Disorder and narcissism, both for her life time, and, in recent years, increasing paranoia. She is well situated in an ALF. This summer, after some troublesome events, her lawyer activated the EPA (enduring Power of Attorney) and PD (Personal Directive) on which I am named as mother's agent. Mother's paranoia has focussed on the ALF staff thinking that they steal things from her, over charge her etc. and now it apparently has extended to her bank. Everything that mother has said was stolen has been found by the ALF staff in her unit. I live 5 hrs. drive away and am 76 myself. My sister, who is a year older than me has never been helpful. I have always been the one asked to do things - right from our 20s.I moved mother from her apartment 4 years ago to the ALF of her choice. That lasted 6 months, when there was in incident with a staff member. They did not handle it well, neither did mother (no surprise) so mother was moved to another ALF of her choice - the one she is in now. The staff in this ALF have been nothing but professional, kind, concerned for mother's best interests, and although she has caused them some problems, they are willing to work with the situation. She has been there for over 3 years now. I am very impressed with them. Her case manager recommends that mother stay where she is, as the alternatives are not as good. It is reasonably expensive, but mother's financial manager has assured me that mother has enough money to last another 8 years clearly, and more. Due to her paranoia, mother wants to move to another ALF, which, incidentally is cheaper, though that is not mother's reason for wanting to move. She calls the staff where she is "thieves". My sis has similar mental problems to my mother and always has. A psychiatrist who saw all of us years ago pronounced me normal. my mother mentally ill, and then said he was more concerned about my sister. He had gone to see them after seeing me and they threw him out after 10 minutes,
After the fiasco of last summer, mother had settled down and was content to stay where she was. As long as she takes the antipsychotic drugs, her life is manageable. Then her behaviour started changing for the worse after my sis, (who lives in Scotland) planned a trip over. I went down to visit mother end of October and she refused to see me or to answer my phone calls. The purpose of my trip was to obtain info regarding her insurances, pension people etc and get her business mail redirected to me. She is still very bright, according to the drs. borderline competent. I work to get her agreement in these things before I do them and I had her agreement to take over her business mail. My sis planned a trip over here for the end of November without consulting me regarding dates then she and mother were mad at me for not being available. At the last minute, one of my plans fell through so I called mother that I was available and she refused to see me again. That was followed by an abusive phone call from my sister who claims that I have not been doing my job as EPA etc. I should mention that when I first moved mother my sister was visiting and literally did not lift a finger to help with the move, but sat and watched us work, and went home with the most expensive piece of mother's collectibles. The next day I had 9 phone calls, which I did not answer - each voice mail crazier than the next and begging me to come down and move furniture??? I contacted the ALF staff and mother's case manager who told me that my sister has been judgemental, demanding, and critical with them. She is trying to get mother into a cheaper ALF for which mother does not qualify, as it is for people with more disabilities than mother has, and has demanded that the case manager make an assessment that will get mother in there. It is not going to happen. All this after I told my sister that my decision as mother's agent was to keep her where she is. Where ever mother is she will bring her problems with her. In my mind keeping her where she is where the staff are good and working to get her back on meds is the only answer. Sis recognises that mother will be unhappy where ever she is. Mother’s case manager has called the mental health nurse to evaluate mother and possibly admit her to a psych ward for stabilization and treatment. The staff all see that mother has regressed since my sister’s visit. Sis has returned home and will be back probably within the month to move mother. Although she cannot move her to the place she is trying to, there are other places she could move mother. I have told the ALF not to accept any termination of lease there without my approval. That will not stop my sis from moving mother if she can. I suspect that I need to ask mother’s lawyer to send my sister notice that she does not have the authority to move mother. I am Canadian and we do not resort to using lawyers quickly, and am looking for any ideas of how to deal wi
What is it specifically that your mother hopes will improve with this move anyway? Is it some vague desire for change, a new crop of people who don't have her number yet, or is their something concrete that she wants that could possibly be negotiated where she is?
may be worth posting as a separate post for people who are moving family members
quote:
Over the past two decades, increasing attention has been paid to relocation stress syndrome (RSS), which is also known as transfer trauma. RSS is a formal nursing diagnosis characterized by a combination of physiologic and psychologic disturbances that occur as a result of transferring a person from one environment to another. Symptoms of relocation stress syndrome include exhaustion, sleep disturbances, anxiety, grief and loss, depression and disorientation. In seniors, these symptoms are exacerbated by dementia, mild cognitive impairment, poor physical health, frailty, lack of a support system, and sensory impairment. For these seniors in particular, the resulting confusion, depression and agitation have led to increased falls, undesirable weight loss and self-care deficits.
Although initial studies on RSS focused on outcomes of individuals moved to nursing homes and assisted living facilities without their involvement or consent, it is now generally understood that RSS can affect those who have chosen to move, been involuntarily relocated, or been placed in a care facility for mental or medical needs."
It can be alleviated by:
Involving the senior in the decision and planning process.
Providing the senior with an opportunity to ask questions and discuss his or her concerns.
Honoring the individual’s preferences and allowing him or her to maintain control.
Paying attention to details and maintain the senior’s daily routine as much as possible.
Safeguarding the senior’s personal possessions.
Involving the senior in setting up the new room or apartment.
Making the new home resemble (as much as possible) the old home.
Helping the resident become acclimated
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Unfortunately I think mother is moving because she is fleeing the old place and has a conviction that the new pace is "better". She hasn't voiced any concerns except to move, I don't know anything about the new home care providers she would have or the new case manager nor does she. She would undoubtedly be involved in setting a new place up. I doubt she would feel any grief or loss and she is not particularly frail.
Mother used to assess herself very well. When I showed her her new computer with Windows 8 she said she would just have to learn it. I offered to take it to the shop and have them install Windows 7 so it would be more like her old one, but she refused, thinking she could learn it. She has hardly used the new computer. 6-7 years ago she taught herself the basics of computer use, with a little help from a few people, I think she is not capable anymore. This summer I set up the new one so she could access her new email program with about 3 clicks and showed her how to "reply", She practiced it while I was there and sent a few emails over the next few weeks and then nothing since. Amazing really that she did it in the first place, but that she cannot now is one outward sign of inward decline.
Just thinking on paper here...
He also said that moving a senior is very hard on them.
He said re sis and mother they seem to have some confusion. I guess! They have not researched what the facility offers and what mother qualifies for. I know mother is probably not capable, but my sister is, at least, I think she is
I found out the apartment units, have meals supplied in a dining room,and security, and they do have kitchens which mother needs as she does not eat in the dining room, but has all her meals made by home care, Any home care is contracted out. But there is no nurse on the floor. That makes me comfortable for a 101 yr. old. Where she is there are nursing aids available 24/7.
I have more messages on f/b probably from my niece, but am not even looking at them so don't even know who they are from. I have no intention of being sucked into a question/answer session with her.
I told the manager that mother has BPD and narcissism as well as paranoia and then he started sounding nervous.
Emjo, have you come across these people? It's a Canadian organisation, quite high-end academics/professionals, but maybe if you chucked a question at them they might have specific answers? Looks like they have a searchable website, though I have dug around it properly (yet).
Besides getting back-up on how detrimental another move would make, don't forget you can point to your mother's "form" in this respect. How many moves in how short a time has it been? Not only potentially detrimental to her welfare, but also utterly futile in terms of hoping to achieve a better environment for her. Try not to worry. Everybody rational is on your side, and the world's not THAT crazy. (I hope…)
Gosh you must get weary.
When you say the EPA was activated, is that the same as "registered" in the UK? Because here, once it is, the donor strictly speaking can no longer control the funds and must do it through his/her attorney. In the age of debit cards, internet shopping etc. obviously this doesn't immediately get followed to the letter, but that is the law. You can if you like ask the ALF Director to remove debit cards, credit cards, cheque books etc. "for safe keeping", leaving your mother with pocket money - that's not only fine but also what you are actually meant to do. Then, for as long as she has capacity, you must use her money as she directs within the restraints of responsible financial management; but it is you who's meant to be doing the using, as her agent, not she herself. Gives you a fair old bit of leverage.
Ah, her mistress's voice I hear… Back later.
Can you or anyone reading point me to some literature about the effects of moving on someone in mother's condition. She does not have Alz and no doctor has mentioned dementia, but she has pretty severe short term memory loss, and paranoia along with her BPD and narcissism.
sis has found out I called the ALF (Vanguard) and told them not to admit mother - not that I really have a say as she has to be qualified by our health system and she doesn't fit the criteria, AND the PD is not activated at present.
Her daughter (my niece) has contacted me and said she needs to know if I did this. I guess sis realises that she may not get a response from me. I will respond to her if we can discuss things civilly and without accusations. At the moment, I am gathering information to help them understand the health system here, the environment mother would be in if by some stretch of chance she did get into the place she wants to, and also what the effect of the move would be on her according to the mental health nurse and literature in general regarding the effect of another move on some one in her mental state. I got back to niece saying it is not that simple and I will be in touch her and the family - being everyone I cced this summer when we were going through the flight to Ontario crisis.. As others have said it takes, I can't remember the phrase, but the parallel for a senior of it takes a village to raise a child. I do believe that family should be informed at least and at best, included of they wish.
Another chat with the ALF director let me know he would be happy to speak with mother's doctor about their concerns for her, so I will call her doctor this morning. Also, he said that if mother was applying to another place at the proper level of care - which for her is supported living in our health care system terms - that it would be correct and even advisable for me to have a chat with the director of that place about the problems mother has e.g. the BPD and narcissism which makes the paranoia more difficult to deal with, to see if he feels they are equipped to deal with her. He also said that he thinks I am doing the right things, which was good to hear.
Deep breaths - There is no doubt some of these interactions and the anticipated reactions trigger off the PTSD I have due to my family dysfunction. I had a lot of anxiety growing up. Home was definitely not a safe place. In fact, it was a dangerous place. I know many of you understand that. One hour at a time, one day at a time...
One does need enough cooperation to get the person in for the assessment. A few years ago one young doctor in another medicenter started to assess mother and she faced him down and shamed him for trying to do it, and left that center. Poor guy was just doing his job.
Yes, mother is amazing and a mixture of good and bad. On retiring she went to Haiti for about 6 months each year until she was over 80. She is a physiotherapist and volunteered with handicapped children. She would come back to Canada and give slide shows to groups to raise money for the school. I got mail from her once saying “It is me and 200 men again” This time it was the Kiwanis I think. She stayed in Haiti through the revolution although Canadians were advised to return home. She said the soldiers were not concerned about an old person like herself, and that she was more afraid of the cockroaches as they did not care how old you were. She would write and say that she could not use her balcony that night as the canons were going off. My sister’s comment was that mother was enjoying the revolution. There are more stories and mother has written them down. I think my sister has them. Unfortunately all that ability now is being sucked into the vortex of paranoia. Mother was awarded an honorary PhD from the University of Windsor for her work in Haiti and also some advocacy she did for of seniors in Ontario when she was there. It adds to her elitism.
How would mother flit? She and my sister would hire someone to pack and move her. She has a decent amount of furniture some of which would need to be sold/disposed of. I think she is still quite capable of packing personal items. Certainly my sister is if she wants to. Mother orders cabs for herself all the time. She has a favourite one who looks after her very well. I think she has an account with them,
Hope your mum is OK – no disaster, I trust. Let us know.
Thanks brandy - yeah, it is a mess. I think I would be in the same position as you are if I gave up POA. One of the things that keeps me going now is believing that mother is incompetent and that she needs someone to make decisions in her best interests, as opposed to making decisions that will save the inheritance. for the next generation.
(((((((((((((hugs to all))))))))))))
Times like this, I wish I was a drinker. but it just doesn't do it for me. Sigh…
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You know, I have to say, I know it doesn't help you, but your mother is pretty amazing. Just wish it was in a good way, instead of devoted to being a universal thorn in the flesh. I can see why you feel you can't just wash your hands and walk away. I think.
… but with consistent back up from the care home staff's records, she's not going to get away with just staging a command performance.
If your mother attempts another midnight flit, how is she going to move her stuff? It may be a mean trick to pull, but if you order a firm "nolle prosequi" to those around her she's going to have a job packing her things, ordering the cab and getting herself shifted, isn't she?
Another Friday night spent waiting for mother to finish her supper - I think she's going for a record - instead of down the pub. Guy did offer to watch her, I'm not complaining, but she's very wobbly and I'm afraid there might be something brewing (no pun intended), not the best time for me to be downing the real ale. Oh my word what is she up to? - got to go… x
Maybe some progress is being made. If mother moves, this process starts all over again, which I think is part of her agenda. Maintaining control is extremely important to her, and that is usual for many people in her situation, and more so to her because of her personality disorder. She has moved from one doctor to another in the 16 years she has been west. I can recall 6 doctors off hand that she has been to in that time...
So, until she is assessed as being incompetent/incapable, my hands are tied and, although I am concerned for her, there is really nothing I can do. I suspect she is aware of the consequences of being assessed incompetent as she cancelled an appointment her case manager set up with her at a geriatric clinic, and has not shared with the case manager what doctor she is using.
This brings me back to square one and whether or not it is wise for me to continue as EPA/ PD (potential) because of the stress it causes me. I suspect that mother will dodge another assessment to the greatest of her ability. Due to mother's personality disorder she turns everything into a battle and my sister is the same.
Any more suggestions?
Lifespan - thank you. My mother is indeed still quite bright, but totally non compliant as regards taking the medication that has been prescribed her for paranoia. As far as I am aware, there is no way to ensure that she does. It would make her life and that of others, including me, much easier of she would comply. Since being part of this forum. I am not surprised that the problem that I am facing is more common than many think. You are correct, I am not in the US, but in Alberta, Canada. The lawyer, who I have informed about the situation, is mother's lawyer, who drew up the documents, and who is pledged to act in mother's best interests. She has been helpful previously. I feel she needs to be kept informed. If I require another lawyer, I will obtain one. I have found the names of 2 lawyers in my mother's city who include elder law as part of their areas of expertise. I am not aware of anything that states that I will be compensated and reimbursed, and that is not my main concern. Whatever it has cost me to carry out my duties, I have paid for so far and am fine with that. I thank you again for pointing out to me that it is my duty to "step forward," Only days ago, I was considering dropping the role of agent, but after seeing, amongst other things, how my sister alienated the people who deal with my mother, I feel that I must continue in this role. Knowing the two of us very well, mother chose me. Will she be furious at me for stopping the move? Yes, but it is in her best interests. I appreciate your feedback.
I emailed mother's lawyer this morning asking her advice as to how to ensure that my sister does not carry out her plans to move mother. Any prayers from those of you who do pray, are welcome. I know that this lies in greater hands than mine, but I need to do my part.
I have some understanding of your problems. I practice Elder Law and also set up special needs trusts for individuals with disabilities like those facing some of your family members. I also have clients with the same "disabilities" and with the help of medication, and a good doctor, do quite well in life, and more accomplished than most others.
Seeing a lawyer is not "pulling out the big guns." It is your fiduciary duty under the documents making you agent. While the problem you are facing is unfamiliar to you, it is more common than you would think. The agent under the documents must step forward.
I assume that you are not in the U.S. and I am not familiar with your laws. But in our state (Pennsylvania) the agent is compensated and reimbursed for enforcing the documents that were drafted earlier.
Capt what happened to hitting people over the head with a 2x4. Us old ladies have a hard job lifting a log of firewood. we don't spend our day breaking rock. Changing diapers is more our speed !
Jeanne, you mentioned specifying to the bank that mother's funds are not to be used for any other facility. That might work. I will need to contact the bank for that, I have a lady there who has been very helpful. It would not make me popular, but then this is not a popularity contest.
glad - yes, just one sis in Scotland, a letter to sis and copy or similar to the ALF would probably be the best step at present. It would be very difficult for me to take steps to keep sis and mother apart. I don't think there is anything I can do about the monies, but I can discuss it with her financial advisor. Yes, we are in similar situations. We want our mothers to be where they are best taken care of even if it uses up much of her financial resources.
Bermuda - as I wrote to Jeanne, I don't see an end to this. I know there is one - one of us will die, but neither event seems imminent. You would do well to deal with the things that are most troubling to you, as these situations can go on for a long time. Never did I expect to be dealing with this at my age.
Mother's funds are not in a trust. Her will, of which I am the executor, is very simple as far as I know. What she has is to be divided equally between my sis and me, with a few small bequests. I think what needs to be accomplished can be done via the lawyer.
cap - no, it shouldn't be necessary, sigh, but that has nothing to do with the realities. It is what it is and I have to deal with it. The support here is invaluable.
The mental health nurse gave me her phone numbers, and I will share any more info I gain with her and will find out her assessment. She is trying to gather results of the tests mother had in the summer to get a baseline, especially of mother's memory, which is the one thing mother admits has deteriorated. Mother might agree to go for more testing in future, on the basis of that, though it would be more extensive than memory tests. The nurse said that what she has to deal with is mother's non compliance i.e. not taking her meds. Mother could be hospitalized and stabilized, but then, when released, she will revert to not taking her meds.There are no easy answers to that. The nurse was very strong about not moving mother due to the effects of a move on her mental state. That helps me. I mentioned the concern I had about my sis charging me with not doing my job and she laughed and said seeing that mother was so well looked after she didn't think it would sell. However, she also said she will be gathering as much info as she can, so that if it came to anything legal, the evidence of my involvement is available. It was recommended to me by the ex actually, who has a good mind for legalities, that I document everything I have done for mother since she moved west (about 15 years) and also what it has cost me, It may be helpful at some point.
I want to thank you all for your suggestions and support. I am considering them all seriously - except the firewood one lol. My next step is to write the lawyer,bring her up to date and ask her what can be done to prevent my sister from moving mother.
Once that has been accomplished I think I will take a holiday, whether G is free or not!
Anymore suggestions/comments most welcome. You have opened my eyes to some possibilities I had not thought of.
(((((((((((((((hugs))))))))))))) and thanks to all..
I had a long, long chat with the mental health nurse today which stirred up a lot of feelings, but was good and we are mutually supportive, She agrees that mother should be left where she is and moving her would likely increase her memory loss and paranoia.
Thanks for all your suggestions. - even you cap, It gave me a good visual. I will answer what each of you has written but need a break now. More later!
I hope it is obvious that I am doing my best, and I will continue to do that. Thanks for the wisdom and support.
Bermuda has a good idea. If I remember there is a trust for your mom. Is there language in there that will remove a beneficiary of the trust if they unsuccessfully challenge it?
Glad you decided to keep the EPA! You have done a great job for years making sure you moms need are met. I too, am hoping for a volcanic eruption. Is there just the one sister in Scotland?
I also understand about not wanting to keep sister from your mother. Hopefully it will not come to that. Yes have the attorney write your sister and use his legal mumbo jumbo to keep mom where she is. It may also be wise to have him copy the facility where mom is to also let them know that they are permitted to take whatever action is necessary to prevent sis from moving mom, including calling the police to arrest sister.
So similar, to my situation, but shoe on other foot so to speak.
See what the lawyer suggests. I suppose it could be made clear that EPA will not be paying for any care center other than the one she is in. Whatever it takes, I hope you can do your best under very trying circumstances. Good luck!
I just looked up Guardianship and EPA/PD in Alberta. Guardianship can be applied for if there is no EPA/PD/
quote from a government site
"The AGTA (Alberta Guardianship and Trustee Act) applies in situations where an adult has lost capacity and does not have a personal directive or enduring power of attorney. In these circumstances, a relative or friend would have to apply to court to become the adult's co-decision maker/guardian (for personal decisions) or trustee (for financial/property decisions). When an adult has no family member or friend who can take on these roles, the Public Guardian or Public Trustee may act as the adult's decision maker(s)."
So it appears they have similar purposes and probably similar powers.