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My elderly mother clearly has a form of dementia. She's paranoid, delusional, trusts no one, and has become verbally vicious. She refuses to see a neurologist because we all want to 'lock her up and steal her home from her.' Her personality has changed drastically over the last few years--she distrusts the entire medical community, believes that people are coming into the house and stealing her things, and is convinced my 80 year old dad is having an affair (when he goes out grocery shopping for the both of them). My elderly father lives with her and is giving the best care possible, but he cannot cope any longer. She has gotten to the point that she often doesn't recognise family members, has very little short term memory, and has become unrelentingly verbally abusive to dad. I really worry for him, but my sister and I don't know what to do and we don't know what our options are for getting my mother care.


My mother refuses to allow any outside help into the house, refuses supported living, refuses to speak to a doctor, is on narcotics to treat pain for a separate condition, and is 100% dependent on my father for care. He has been doing the best he can, but is suffering from exhaustion and the mental abuse she hurls at him constantly. I think he's finally at the point where he realises something has to change.


Does anyone have any recommendations of how to approach this? Attempting to get her declared mentally unfit to FORCE her into care? What advice and resources can we access where we live (Wisconsin) to help us figure out our options? I literally don't know where to start. Any advice or shared experience would be so very helpful. Thank you so much.

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How is her prescription for narcotics being renewed if she will not see a doctor?

I would use that as a starting point. Call the pharmacist or prescribing doctor and see what you can do to stop the drug supply. Force her to have to see the doctor to get a new RX.

Hopefully once you get her in the door with the doctor they can address your concerns.

Make sure you create a document outlining your concerns for the doctor and hopefully you can deliver to the office ahead of time.
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If this behavior and mental status is of a recent onset, not a life long condition. Then, the suspicion that she is having some brain disease like a type of dementia, is correct. The only way to force her to have a mental evaluation, is if she becomes dangerous to herself or to others. Otherwise, she has the right to refuse treatment, regardless of how psychotic she is. The three conditions required to force a psychiatric evaluation, are:
1- The patient is a suicidal risk
2- The patient is a homicidal risk
3- The patient is in such mental condition, that he/she can not take care of his/her basic physical needs, that will risk his/her life ( eating, dressing adequately according to the weather, exhibiting reckless behavior, etc.).
More specifically this is the procedure:
A police officer or paramedic does not have the authority to take her to a psychiatric facility if she refuses, unless accompanied by the appropriate paper work. This paper work consists of two specially printed forms, "Petition for an emergency psychiatric evaluation". One is filled and signed by a relative or friend and the other by a social worker, psychologist or psychiatrist. Those forms can be found in any Mental Health clinic, psychiatric facility or private office of a mental health professional. The patient has to be examined by a mental health provider who will fill up and sign one of the forms. There is no other way, unless the patient commits a crime and is arrested. This procedure is complicated in order to protect the rights of the patient.
After the patient is taken to a psychiatric facility, she will be evaluated within 24 hours. If the evaluation confirms that the patient is dangerous, she will be taken before a judge who may commit her to the facility for treatment until she is no longer dangerous. If the initial psychiatric evaluation finds her to be non-dangerous, she will be released. Remember, only if the patient is dangerous he or she can be committed. Being psychotic is not enough.
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I'm really worried for Mom's behavior when it comes to Dad. She thinks he's cheating on her by going to the grocery store, how soon will she be showing up with a knife at the door?

IMO he has to call 911 on her. You might be able to help by springing for the hotel room for him and you, with you meeting the authorities/paramedics saying that you removed the 80-yo-dad because the mom is a danger to him and gravely disabled to herself. That should get her a psych admit (5150/Baker Act) at least. From there, you probably know how to get the ball rolling.
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This is a terrible situation for all concerned, but especially for your poor dad who's probably ready to have a breakdown himself from all the stress. I hate dementia with every ounce of my being, and we read stories like yours ALL the time around here; where one spouse is wreaking havoc and refusing help, yet killing their spouse in the process of such behavior. Does your dad have medical POA for her? I think he needs to sit down with a certified Elder Care Attorney to see what his options are and for guidance in how to go about getting her into Memory Care Assisted Living now. It's his best bet for GOOD advice on the matter and for financial guidance as well, including how to qualify for Medicaid down the road should money run out, should the family home be sold to finance her stay in Memory Care, etc. There's a lot to go over, much more than anyone can tell you on an internet forum.

I worked as a receptionist in a Memory Care community before the plague broke out. I met many husbands who had no other choice but to place their wives in our care due to circumstances like your father is in. Dementia reaches a point, often, where placement is the only answer, and that's okay. Your dad can go visit her (once she settles in) frequently and become her husband again instead of her exhausted/burned out 24/7 caregiver which is TOO MUCH for a man his age. It often works out well for both parties as each can rest well at night and the dementia patient can get 24/7 care that's very much needed, including showers and brief changes.

Wishing you and dad the best of luck and sending you a hug and prayer for peace with whatever you decide to do.
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