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Sometimes you really do have to let Humpty Dumpty fall off the wall. Our medical and social support systems are setup to be re-active for the most part. It has to get really, really bad for help to come.

There has to be a crisis or an emergency event. An ER visit that can open the door to time in rehab and then a placement in the right kind of care.

KEEP A JOURNAL. These records are your life line to establishing a history of decline and lost ability to live without help. Otherwise, social workers and doctors have to assume all this is "recent and new".

It doesn't have to be a long journal. Just jotted notes from what you see and hear during phone calls and visits. "Mail piling up; mom refused to let me sort it." "Dishes from last week still not washed" "Bathroom smells like urine" "Med bottles in lots of drawers in kitchen and bathroom" "Food in fridge rotten"

The enormity of the situation will creep up on everybody until it's REALLY bad. It's hard to get traction on this stuff with authorities when the parent has a reputation for being difficult, odd, weird, strange, mean, etc. anyway.

Try to track it to the ADLs and IADLs. If you google these, you will get an endless list of different inventories of skills needed to do basic self care and the ones required for independent living. I promise, this will get the attention of the right people.
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One neighbor was falling, fearful, and taking too many laxatives. The paramedics said, after APS had failed to help, that she would literally have to fall outside or call for help herself. She fell outside, went to a board and care.
Family can intervene earlier: 1) by getting a second opinion and, 2) consider what would have happened if you saw her in her chair (more passed out than asleep) and you did not help, but a neighbor saw her or 911 was called.
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Yikes. Addictions are something you do to yourself. Find out what detach with love means, so you can learn to intervene without hurting yourself.
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My first thought was, do the pain management doctor and the addiction doctor know about each other? With the health issues your mother has, she does need medication, but how much? Some kind of supervision might help. Other helps like rehab, physical therapy, more scheduled visits from you might help. When someone is that lost, people move away from them, understandably. But what would happen if you stayed overnight, or until she asked you to leave? You don't have to do that, just start to think outside the box instead of what has not worked before. Do BE THERE and encourage her, or take her when she is ready for rehab. So sorry that you are going through this. There are support groups for you, have you ever been?
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