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Just an update - my mother fell again, remembered nothing, woke up on the floor of her bathroom, scooted herself to the phone to call sister-in-law who came over and helped her get up then left. Caregiver arrived shortly thereafter and began cleaning mom’s wound with peroxide and a washcloth. No one called me, no one called EMT’s. I went to her this morning and found her arm a God awful mess, her thin skin bleeding and sloughing, her face bruised. I wish I could post the photo but it would make you sick. Took her straight to Urgent Care who sent her to ER for work-up. Medical team was astounded. Of course brother is out of town. His negligence has to stop.

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Social worker was going to help me get her in short term rehab with goal of going to nursing home (would need POA for that). The other brother (1,000 miles away who hasn’t seen her in 10 years) is running his mouth and told her we’re just trying to get out of taking care of her so getting her willingly in rehab is not going to happen. They are all angry cause I said I need to get a part time job and can’t cart her around if she goes back home to the other side of town. I’m exhausted doing 24/7 care because of her insulin and suicidal comments. So I pushed the doctor appointment up cause POA (brother) isn’t going to show up anyway (still out of town) and let doctor guide me.

I’ve been serving this woman her meals on a tray and checking blood sugar, giving insulin, diapering her, caring for her wound, have home health in my home every day, shopping for food, preparing diabetic meals and she doesn’t appreciate a darn thing. It’s never enough. She wants me to do it on her terms, in her house. I’m done. I’m taking her home.

February 16 will be the anniversary of my husband’s suicide and I have to deal with the triggers my mom dishes out. Pure emotional abuse and manipulation.
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I’ve contacted the social worker - reviewing her chart and getting back to me tomorrow.
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TW, please read what CWillie has written!

It really seems like you are being played by your mom and brother.

You can't afford not to work and to be at her beck and call, without the authority to direct her medical care or spend HER funds on her care.

If your mom is suicidal, she needs to be in a psychiatric unit that will address those issues.

If your mother needs medical supervision of her glucose levels and insulin administration, she needs to be in a NH situation.
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Twillie I've been following along and not posting but I've got to jump in - she can't be competent enough to direct her own care and to appoint you as medical POA and also be so incompetent that your brother's financial POA keeps her from accessing her own money, so which is it? Brother is using his position to bully and manipulate, if she is truly competent what she says trumps what he says.
And are the doctors aware of her suicidal threats? Surely this is a clear demonstration that she is a danger to herself and could be used to force a 72 hour psych evaluation.
As for the endocrinologist, IMO he isn't the person to appeal to about her ability to remain at home and planning long term solutions, that isn't his role or area of expertise.
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P.S. mom did ask for my help when she called me after her fall and injury. She is competent enough to hire a caregiver to drive her to her appointment with the endocrinologist where I could meet her there. She is also stubborn enough not to. She told me the other night when I was making her do finger stick BS check that she’s “getting tired of this sh&t and threatened taking large dose of insulin.”
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The endocrinologist practices at the hospital less than 2 miles from my house. If my brother comes to get her (they live on the other side of town). Mom lives alone about ten minutes frm him. Brother hates to be inconvenienced to drive outside his own county. But the fact remains doctor wants the POA at Feb 20 appointment.

I have been driving two counties over for 3 years checking on her and taking her out for a good meal weekly and taking her to specialists when needed. I did this on advice of a elder care lawyer after she left IL. I journal everything.

So last night I started a talk with my mom about getting legal advice if I’m going to remain involved. And I’m going to ask her to give me medical POA and let me place her in assisted living. And then hope and pray brother will pay the bills if he is in fact Financial power of Attorney.
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TW; Is your mother ASKING for your care? If so, you need to tell her in no uncertain terms that it can only happen if she assigns you as her health care proxy and arranges to pay you for care. (If she's still competent enough to do this).

If she is unwilling to do this, you need to find out what your responsibilities are legally, now that the doc has told you that she can't be left alone. (This is why we all told you NOT to take this on; now you may be legally obligated NOT to leave).

I'm hoping others will chime in here with good advice.

One more thing; "mom won't go back to the endo doc unless I take her". Didn't you say that mom can't go anywhere without assistance? Do you mean she won't initiate an appointment? That's the dementia. It sounds as though you are expecting your mom to act like a person with a brain that works. Hers is broken beyond repair.
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Barb, I know you are right. I am unable to say No. And I’m torn about going no-contact. I do better when I have minimal contact. Can I just go ahead and take her home?

Btw, the doctor isn’t working on LTC solutions. I would bet money my mom won’t even go back to this doctor unless I take her.
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TWillie; Reading all of your posts, it seems to me that you are volunteering to be taken advantage of. I'm sorry if that sounds mean, but look at what you've told us.

Your mom prefers your brother and SIL's care to yours. She is leaving him all of her money. She accedes to your brother's demands to leave the IL you found for her and lives as a shut in.

She refuses to take her doctor's advice to live in a supervised situation. She wants to return home. She hasn't been declared incompetent.

You voluntarily brought her into your home. You can only be a doormat if you lie down for others.
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I sent a message to the doctor that I can’t do this indefinitely and have a part-time job lined up. That my brother and SIL handle her money and while they give mom crappy care they live closest to her and it’s them she defers to. And I am beginning to feel taken advantage of.
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Call the endocrinologist this morning and have a serious talk about the fact that you are going bankrupt.

Your mother needs to be moved to a supervised environment immediately, Like to your brother's home, where his wife can care for her.
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"Endocrinologist told me to tell her “we’re working on it” and keep her here with me because she can’t go home with the insulin new endo prescribed."

She has med administration supervision, so that's all the dr. cares about. Just what is he "working on"? He's trying to find placement for her? Or is he working on something else (home health care)?

So her stinginess means YOU become the LTC solution. That isn't right. Are you going to give in?
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Did I ever mention that she threatens killing herself by insulin OD? That’s why endo won’t let her take Humalog unsupervised because I told the doc what’s been going on.
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Barb, SW said to get her back to her home (that’s what mom wants anyway). Endocrinologist told me to tell her “we’re working on it” and keep her here with me because she can’t go home with the insulin new endo prescribed. That’s why I thought with doctor involved and APS involved maybe she would get placed in a nursing home. I’m dreaming right???

She would probably function well in AL if a caregiver gives the insulin correctly. But she doesn’t want to pay for AL. Trying to get money from her to buy some food and her necessities while she is here has been hard enough. Stingy!!!
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So, TWillie; Did you talk to the APS and SW folks about taking your mom home to her place? Are they advising you to do that?

Since your mother is not cooperative and clearly does not want your care, and has NOT been judged incompetent, it seems as though you should deliver her to her home and notify your brother and SIL in writing, via certified letter that she is back in their ballpark.

I know this sounds hard-hearted. But if your mother doesn't want your care, you really shouldn't be ruining yourself financially to provide it.
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Twillie, I wonder how much anyone is going to be working on LTC for your mother, because she's in your home now, and YOU are acting (for now) as the LTC. And I'm sure it makes everyone satisfied but YOU. Be careful...this is how we see so many temporary caregivers become the permanent caregivers.

The only impetus the medical folks have to find LTC options is when the elder needs to be discharged and there is nowhere for them to go because family refuses to be the caregiver. The temporary solution all too often becomes the permanent solution.
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Perhaps she is at the point of needing nursing home care? It must be such a challenge for you to care for her when she is not so willing to care for herself. And now you must be so tired, having her at your home.
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P. S. I don’t actually want her to go home - where she will suffer another crisis. I want her to go to assisted living for LTC. The uncontrolled diabetes is the catalyst. Not sure if we are going to find assisted living that can administer insulin - could end up being sliding scale. For now I am charged with the duty - 4 x day.
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So my mom has been in my home for nearly two weeks - is on Home health care and has had visits from social workers. She still either can’t or won’t answer the question who is her medical power of attorney. I honestly don’t want the job because she is uncooperative in her care. A social worker for Sixty Plus came to visit her and determined that the only person mom is going to listen to is SIL. But SIL is the one who found her on the floor injured and never got her any help and didn’t call me. I was at the end of my rope and reported this to APS. Don’t know if anyone was negligent but my mom is certainly self-neglecting. She wants to go home and ohhh how I would love that but we have to hang on till she sees endocrinologist again. I believe that doctor is working to get her in LTC. I’m not sure what to expect from APS investigation if anything. They did come to my home to evaluate her - wound is healing and I’m giving her excellent care but it’s wearing me out and can’t go on indefinitely.
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Well, your mom hasn't been found incompetent to make her own medical decions by two MDs. The social worker can't make a determination of competence, she can only go by what has been doctor verified and court-ordered.

It sounds as though endo doc sees that mom can't care for herself and she's prepared to tell POA that. This is a good thing.
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I’m confused. Social Worker told me mom is competent to make her own decisions about living arrangements. So why did Endocrinologist say she wants POA at next appointment to discuss mom needing insulin injections in a supervised setting? Can’t the financial power of attorney make decisions where the agent is going to live?

Mom’s condition is getting worse. She almost fell even using the walker trying to get to the bathroom. She is peeing all night long (kidneys trying to excrete sugar) and I could hardly manage to get her on the toilet she was so limp. I put her in a diaper and forbid her to get up. I’m on constant alert, it’s very hard to sleep.
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TWillie, I'm so glad you got mom to the endocrinologist.

Will your brother be able to go to the next appoinrment?
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Update: I’ve taken mom to the endocrinologist this AM. Definitely Lantus is to be taken at bedtime. I took her monitor and my blood sugar recordings and it didn't take doctor long to figure things out. She took blood to see if mom is producing any insulin. She counseled mom that she cannot re-use her lancets and needles like she’s been doing among other things. In a brief private conversation she told me mom needs insulin injections at mealtimes but she won’t allow her to self-manage it. Thus she wants the POA (my brother) at the next appointment in 4 weeks. I then had to take her back to the ER because her wound bled during the night and nightgown was stuck to her skin and urgent care wouldn’t touch it.

We did speak to a social worker and wow it was like a counseling session - my mom got to express her thoughts and emotions. While we didn’t get any long term care plans in place at least I’ve got her to accept my help for a little while to get through this.

I’ve come to realize that her sugar spikes at meals are making her practically psychotic. Last night was real bad so talking to social worker and doctor today was a start to getting some help I hope.
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Twillie, good luck today and let us know how the endo appointment goes!.
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Twillie
Please do let us know what your mom’s endo says about the Lantus. My husband takes it in the morning. I’m sure each dr has their reason for the time they suggest. The explanation I gave was what we were told he should do and why. I hope your mom isn’t very sore from her fall.
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97yearoldmom, research shows that Lantus is FDA approved for taking at bedtime. But there is evidence to support that it should be taken in the AM. Seeing endocrinologist in the AM. Thanks.
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I was told that Lantus should be given in the morning so it is working when food is being eaten. Taking it at night has her sugar drop when no food is coming in. It is a long acting drug but not a 24 hr drug. But everyone’s system is not the same. Let us know what the endocrinologist says.
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I’m doing a lot of research. What is happening to my mom is she is on Lantus long acting insulin injected at bedtime. If she has not eaten properly she is hypoglycemic during the night. Sugar is spiking after meals during the day to 340-400 range. She is small 124 lbs. GP is the prescriber and only prescribes 1 test strip per day. That is not enough. She’s using an old Accucheck monitor. Yeah I know she’s gone hypoglycemic on me many times and I have to call EMT’s. And yes I know she needs round the clock care. That’s why I fight with my brother because he’s been letting her live alone under the guise that he’s taking care of her when he’s actually delegating it to his wife and while she might be a decent person she’s not taking care of my mother like I do.
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You post says she has sudden drop in blood pressure. Some people get that on a regular basis. I have had it a few times, as has my brother. I'd explore Postprandial hypotension. Some people get these drops in blood pressure after a meal. Other times, it just happens. It's hard to predict. I'd have her doctor discuss things to do to stop the fainting. Like, if you start to feel faint, you immediately lay down, head level with body and wait for it to pass. If you try to keep standing, it will force a fainting. If you mother isn't able to manage, she may need around the clock supervision, but, still, even someone else being in the house, she could still faint.
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Is your mother insulin dependent? Who administers her medications? Does someone check her blood sugar regularly?
An elderly person with questionable judgement on insulin should be in a supervised setting. I think to pursue AL or some type of supervision is appropriate at this time.
When you take her to her endocrinologist bring her glucometer with you so he/she can check blood sugar history. Every meter has that capability these days.
Someone should be checking your mother’s blood sugar 3-4 x per day, and certainly before giving her an injectible insulin. Her aide should be able to do this if she’s a CNA.
As for the wound, those take so long to heal. Try a vaseline type dressing in the beginning so when changed it doesn’t slough off new skin.
Good luck to you!
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