clmtqm Asked June 2012

Has anyone had the experience of forcing their borderline mother into assisted living?

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In addition to BPD, my Mother also has Intermittent Explosive Disorder, which falls under the umbrella of OCD. She drags her caregivers out to shop and then returns bags of unwanted items the following day yelling "Bitch" at the store clerk when she questions why Mom didn't sort out all the receipts and items before coming to the store causing long lines. Some of the receipts were from different stores. She can no longer walk very well, losing control of bowels, she's driven up on the sidewalk, memory impaired, paranoid distorted thinking, and calls 911 on a weekly basis and goes to the hospital for breathing issues. Her careprovider who just quit said she was selling her pain medication as well. I have informed her support team, and all agree she needs assisted living, but Mom is hell bent on staying in her apartment. She insists she has all her faculties, and clearly she does not. She is not going to go willingly. How are these situations handled??? She cannot stay home abusing care providers. I am supposed to take her to her doctors appt. today; I've never met him before, but today is supposed to be the big day he tells her it's time. Thanks for any support!

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simon7 Mar 23, 2018
Leave your mom alone. If she wants to live independently - its her right to live that way.
Do not worry about troubles supporting team has with your mom - they are paid for their job to help your mom and not for having tea party with her. Do not worry also about needless (in your opinion) things she buys - she spends her own money and not yours. To me -you look not like loving daughter, but like somebody else. If you don't like the way your mom lives her life - look other way. And last thing - please think about time, when your children (or other interested relatives) will be looking for a way to lock you up. That time is coming.
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Blueandblue Dec 1, 2017
Here's hoping your posts will help tomorrow. Not close to my father, but I still care for him. I know he has lost a lot of weight recently and trouble breathing. My mom who he is divorced from went to check on him as I have been sick and have a disabled husband. She said she thought he was going downhill and didn't think he can drive anymore. She cleaned his apt. but did not ask if he had food or if he had eaten!!! At any rate, upon several peoples advice will try to get him to go to the hospital as he does not have a primary physician and have him evaluated. I am hoping they will recommend a AL. Fingers crossed.
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tvidos Dec 2015
My mom is in an assisted living she has a house not far from the al community she was diagnosed whith dementia/alhzimers she has been through PT & is still using wheelchair most of time walks with walker some PT will be over in 2 more sessions she thinks she is ready & capable of moving back to her house of course with ladies that stay 24/7 with her now Her house would need upgrades to make it handicapped accessible She would still have issues with wheelchair/rollator & balance, doorways, hall, kitchen/dining area, etc trying to get from living area to bedroom & bathroom. Issues reaching van to go out for Dr appts or other activities that she has long dropped from since breaking her leg twice. I could spend lots of $s & never be able to resell the house. Her drivers license expired but she thinks she could get another easy at 88 & I would let her drive. Too risky. I've had to let 2 people go & she made one quit from verbal abuse. She can turn on the mean & the minute she sees me can turn on the nice. She thinks I don't understand & I think shes playing me. She goes off on tangents & all the sitter/companions have seen it & experienced her behavior since they have worked around for other facilities or done private sitting. At AL, she has 3 meals, AL staff, private sitters I pay, hair salon, Homemedic-Nurse Practioner available, medicine dispensed by nurse twice a day I pay, & Pharmacy packaged meds that can be delivered & ordered by NP. She wears a pendent in case of emerg, AL staff comes 1st & they decide who to call-NP or 911. At her house, it would be 911 or wait to see DR when u get an appt. She would rule at the house & I can just imagine how unsafe the situation could be. I dont trust her shes seen how other friends have lived & how it was with her caring for my Dad & now I can go back & see more light on subject than when it was actually happening. I dont feel guilty but dealing with an elder is really hard & she is my Mom but she can be very hurtful & then realize what happened & apologize but continue repeating same behavior. Cant find these geritricain drs talked about in area. Am at a loss & I want to go home (1 1/2 hrs away). Ive worked hard to keep her safe & help her get better & I dont think she will be able to keep any promises she makes to me. She is & always will be defient, hate help, stuff will continue to unexpectedly happen to keep me trapped anyway I go. Hope & wish all Merry Christmas & Happy New Year
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I am very sorry for the above post. Somehow I put it on the wrong thread. My sincere apologies. Cattails.
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Skid: I read your previous posts. You said your husband had three surgeries in April and the beginning of May. You said your were advised on April 12, 2012 that your husband was suffering from dementia.

Would you explain what the surgeries were for and did you have any reason to believe that your husband had dementia prior to April 12 of this year.

You don't explain what his medical issues were and are currently. I think it would be very helpful if you shared more information. Does he actually need more "therapy" or is that just something that is being bantered about as a story to tell him about assisted living?

I think there is more that you should share so people really understand what they are responding to. I will watch for your next answer on this thread. Please respond. Cattails
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judy1 Jun 2012
I think that most people with dementia think that they are perfectly capable of taking care of themselves and don't realize they have any problems so therefore they don't want to move. I was able to get power of attorney with my doctors help but my mom still didn't want to move to an ALF even after the doctor recommended it. She couldn't live alone any longer so I took her over to an ALF under false pretences and ended up just leaving her there. It was the hardest thing that I have ever done. My mom was very very angry with me and made me feel quilty until about after 3 months when she finally accepted the fact that she now lives at the ALF. I know this was pretty extreme but in the long run it was the right thing to do for my mother, she is now so much happier.......and I am relieved that she is in a safe situation.....
Good luck......
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jeannegibbs Jun 2012
What a wonderfully proactive doctor! He is not saying she can't drive -- he's saying she has to pass a driver's test. Awesome.

He is in a much better position to be the authoritarian figure than her children are. Be thankful he is willing to play that role.

It could be that she'll need more supervision than ALF's usually provide, although that could be supplemented by also having a personal care provider. In any case, the first step is getting her to see that she can't continue to live "independently".

Thanks for taking the time to share an update.
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igloo572 Jun 2012
I'd be on the alert that the AL will suggest that she needs a different level of care than what they can provide. It sounds like she is on a lot of meds and has so many different aspects of OCD, etc, that the AL might find she is too complicated.

DEMENTIA TESTS: 3 main tests. Different yet similar….
1. Folstein aka Mini Mental State Exam (MMSE) - 30 point test. Takes about 10 - 20 minutes & looks at math, memory, orientation, basic motor skills. Is copyrighted & needs training to do, so usually done by residents, student MD’s or trained staff @ teaching hospital or nursing home with teaching hospital staff.

2. Mini-Cog: a 3 item recall & a clock drawing test. 2 -3 minutes to do. Should not be used alone as a diagnostic.

3. Memory Orientation Screening Test (MOST): 1. Memory -3 word recall; 2. Orientation - to year, season, time, month etc.; 3. Sequential – memory for a list of 12 items; 4. Time – organization and abstract thinking using a clock face. Takes 5 - 7 minutes. Gives a score from 0 – 29.

Other tests: If Frontotemporal dementia is suspected, can have an Addenbrooke’s Cognitive Exam done. Not all dementias are the same: orientation, attention and memory are worse in ALZ; while language skills, ability to name objects and hallucinations are worse in other dementia’s.

Data analysis found the MOST to be more reliable over time and more accurate in identifying cognitively impaired patients than either the Folstein Mini Mental State Exam or the Mini-Cog. The MOST also measures changes in a patient’s memory over time. This permits the doctor to identify progressive loss or positive responses to treatment.

Having a baseline tests done & repeated is really helpful to be realistic about what careplan to take and see if medication is making a difference over tme. Same with scan on brain shrinkage & what part of the brain. As Jeannie and others have said an MRI cannot diagnose dementia. There is no 1 test that can do that as there are many types of dementia. If there was I'd buy stock in the company and stand back and watch the cash flow in.....lmao!

My mom still has the mini cog done about every 90 days and until last year had a MOST done regularly (her score got to 12 or 13 twice so only once a yr for her now) but she is in a NH and her MD is with a gerontology practice affiliated with a medical school so is a part of a larger study.

Good luck and keep a sense of humor through all this.
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JaneB Jun 2012
I think that doctor is pretty darn bueno! AND so are you. How terrific to set her up to fail, so she takes in the severity of her situation and gets into AL, leaving open the idea that there is some choice here: "Choose to go yourself, or choose to be put there." I wish all doctors were as useful as this one is.
Now you have to let her situation unfold. Maybe you can provide information on AL facilities, or have your brother do it. Maybe you just stand back and watch now. But getting others to help, like this doctor has, is exactly what is needed. She will fight you the same old ways. She will fight, but less effectively, people who are not her kids.
Keep expecting her to behave the way she has, rather than expecting or even wanting her to change stripes. That will make visible whatever the next steps need to be. And it will make more visible the steps you no longer need to take (going into a personal code red, for example, when you hear she has gone to the hospital or called 911).
You're doing great. You really are.
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clmtqm Jun 2012
Just want to say thank you ladies for your support yesterday regarding my Mother. What a crazy day it turned out to be. I called her yesterday morning, and after five rings she picked up. I thought she was speaking to me, lol but it turned out to be a recording she had left a week ago! It said in a desperate like crying voice, "my doctor told me to call 911 and go to the hospital. I don't know who will hear this message, but I will be at the hospital." I called my brother and sister and told them she was going to the hospital, and then called the hospital, and they said, no she isn't here. I was confused. My brother called her Apt. Mgr. and she said, someone saw her leave in her car earlier in the morning. So, now I'm wondering where she is, and whether she will show up at her noon doctors appt., as her doctor planned on telling her she needs Assisted Living. Well, she did show up, as he explained in a phone call to me yesterday afternoon. He told her she could stay home IF she meets three conditions.
1. She must wear a life-alert monitor around her neck. 2. Must have full-time, max hours care provider. 3. Must take and pass a written/drivers test within the next few weeks. If she can't meet any one of these obligations, she goes to Assisted Living. Mom asked the doctor, who's going to put me there??? He said, you can go voluntarily, the easy way, or the State will take you the hard way if you can't control your behavior. (which she can't due to Intermittent Explosive Disorder, and BPD. Without DBT therapy training tools, this will never happen.) The doctor doesn't expect her to pass the driving test, and to be honest, he actually said, "I set her up to fail, because she HAS to have the kind of help AL provides." Seems he was giving her a tiny bit of space to process the reality of the situation? She cannot keep calling 911 2x a week, falling down, abusing and chasing off care providers, and endangering herself and others driving. She said, "I have a beautiful apartment, and no one is touching my canopy bed!" He said, it will be moved to AL. I would think she's in a bit of a panic. She did call last night and apologised for leaving that message on her recorder, and to tell me the doctor visit didn't go well, but wouldn't elaborate. I think the doctor handled the situation well. Any feedback is appreciated.
Hope everyone has a great day.
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