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I am new to the forum. My mother is about to come out of rehab following a fall, which has left her paraplegic, health issues with her lungs and a diagnosis of onset dementia/Alzheimer. She lives alone and wants to stay there. She has money for a few months but then would have to go onto a state program. We would like her to go to a home as her choices of homes are much better if she enters as paying for 6 months then switch to the state program.


She has decided that she wants a friend, who is 81, to stay with her at night and his daughter, who we do not know, to do her care during the day. This friend has been known in the past to try to get and sometimes get my mother to give him money and also invest in schemes such as investing in Iraqi Dinars and against her family advice. Let's just say we do not trust the friend and we have no details of the daughter, who supposedly is a carer.


What information do we need from them. They want to charge her $12 an hour. My mother has not been declared incompetent. Do we have to set up insurance? Any advice for a contract? Get their Social Security number? What happens if the 80 year old is injured etc.
The problem is made worse as I live out of country and my two sisters have differing opinions. One thinks we should just let her do whatever she wants and she'll have to live with the consequences. The other thinks we need to take control and it appears I may have to be the final decision maker. Thanks for any help you can give.

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I am new to the forum and pushed enter too soon. My mother is about to come out of rehab following a fall, which has left her paraplegic, health issues with her lungs and a diagnosis of onset dementia/Alzheimer. She lives alone and wants to stay there. She has money for a few months but then would have to go onto a state program. We would like her to go to a home as her choices of homes are much better if she enters as paying for 6 months then switch to the state program.

She has decided that she wants a friend, who is 81, to stay with her at night and his daughter, who we do not know, to do her care during the day. This friend has been known in the past to try to get and sometimes get my mother to give him money and also invest in schemes such as investing in Iraqi Dinars and against her family advice. Let's just say we do not trust the friend and we have no details of the daughter, who supposedly is a carer.

What information do we need from them. They want to charge her $12 an hour. My mother has not been declared incompetent. Do we have to set up insurance? Any advice for a contract? Get their Social Security number? What happens if the 80 year old is injured etc.
The problem is made worse as I live out of country and my two sisters have differing opinions. One thinks we should just let her do whatever she wants and she'll have to live with the consequences. The other thinks we need to take control and it appears I may have to be the final decision maker. Thanks for any help you can give.
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I don't know how you can take control until/unless your mother is declared incompetent. How does the sister who wants to take control propose to do this?

Is your mother in the US?

What does your mother plan to do when she runs out of money to pay these people? From what you say that will be fairly soon. In the US Medicaid will not pay for around-the-clock home care. And her dementia is only going to get worse. So, presumably, she will wind up in a facility at that point. You are correct (again, in the US) that she may have a better range of options if she is self-pay for a period before Medicaid is necessary.

All of Mom's money is going to be used up on her care, one way or another. And she is going to wind up in a facility fairly soon, one way or another. This is true regardless of what you do or don't do. Right?

If she goes ahead with hiring these "friends" try to encourage her to set it up with a contract, and to do the correct things as an employer (regarding withholding taxes, etc.) If there is no contract it COULD appear to Medicaid that she has been giving money away, and that will interfere with their coverage. (Again, the assumes she is in the US.)

You (or a sister who lives nearer her) may need to guide her. "Let's go see an attorney to make sure we treat your friends fairly and legally." Once she sees what is involved in being an employer she may re-think it.
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As your mother is still in rehab, you can work with their discharge planner. The discharge planner will quite correctly respect your mother's autonomy, but at the same time he or she can equally correctly propose a number of alternatives for your mother to consider. So this is where you and sisters and anyone else who cares come up with a mini-presentation of the various options and "nudge" mother towards selecting the right one. I.e. one that does not leave her vulnerable to abuse or unintentional neglect and is not COMPLETELY NUTS.

As an example of presenting the right positives: a good facility will welcome visitors, and she will be able to continue to enjoy her friends' company. Without burdening them with her personal care.

Supposing friend and daughter (and daughter's spouse, and his brother, and their children..?) move in. I'm just saying what if. Is mother going to sling them out on their ear? How?

If I were you, I'd make some calls - do a full fact-finding exercise. Speak to your mother, the discharge planner, and ideally the gentleman friend (whose intentions may still be honourable even if his advice is disastrous, don't forget - be nice). Certainly if there's any suggestion of her becoming primary caregiver, then *somebody* needs to interview the daughter formally.

I'd also want to speak to mother's doctor direct. Did the fall cause the paraplegia, or did a stroke cause the fall?

At the moment your mother is in charge but the discharge planner is responsible for ensuring that an adequate care plan is in place. That gives you the opportunity to request that *all* of the factors are taken into account - including, if need be or the diagnosis warrants it, your mother's competence.
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Thank you for your responses. My mother is in the US. She actually has been cared for by medicaid and vetrans. They will give some basic support such as physio and home care but not a lot and not long term. The fall was caused by an accident. She has had strokes in the past and epilepsy and really should not have been pruning a tree. So we are where we are.

She will end up in a home sooner or later. We wanted it sooner as we think she will be better cared for and she is very social. She thrives on the attention. She just wants to go home now. We have seen a lawyer regarding other issues as she will have to go under state care at some point and that will involve going into a home as they would, at best, provide 40 hours of care if she stayed at home. Thank you for your responses.
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Oh my word.

Is it a small mercy to be grateful for that she wasn't using a chainsaw?

I sympathise with the cold sweats induced by such an adventurous elder. But it's impossible not to admire her spirit. May she find her feet in a good facility where there is plenty to keep her busy and content, and may she long have friends visiting her there.
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Churchmouse, she had called my sister that morning and asked if she could borrow her chainsaw. My sister said 'no' but that she would come by that afternoon to help her. Alas, she could not wait. the first thing my mother said was 'aren't you glad you didn't give me the chainsaw?'. In the same vein, my sister mentioned Darwin's theory of natural selection. My mother's spirit will bring her through with more grey hairs for her daughters!
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Aaaarrrgghhh!!! And there I was thinking I was joking!
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$12 an hour is not an unreasonable charge but that comes to $8,640 a month. Don't know where in the US mother is located but that sounds like a a good sum to cover the costs of a good nursing home which it sounds as though she needs with all her current health issues.
Is the friend and his daughter trained to deal with seizures for example and the mundane tasks of getting her to the bathroom in the middle of the night?
Agree there is a danger that neither is trustworthy so a back ground check is vital. The fact the friend makes what you consider unrealistic investments is beside the point as long as he does not do it with her money. Pretty important to get control of the finances at the very least. one of your sisters in the US should try and get Mom to agree to POA both medical and financial. A DNR may or may not be appropriate at this time. Wanting to climb a ladder with a chainsaw while a laudible ambition at her age certainly does not demonstrate good judgement. 
I can see you have a fight on your hands and would predict Mom won't agree to any suggestions but maybe the $8,000+ a month might sway her somewhat. She will be into over $100K a year how long can that go on? Good luck you are certainly going to need it.
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