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My aunt, 91 is my mother’s twin sister and lives alone in her house with some assistance for shopping and cleaning. She is fiercely independent, walks everywhere, manages her finances and refuses to consider assisted living or downsizing. I am her closest family relative and I live 2 hours away in another state. This year she is struggling with short term memory problems and was diagnosed by a neurologist with MCI. He recommended an aide but she doesn’t want anyone she doesn’t already know. She has long term care insurance but they say she is not eligible to start using it yet (must have a diagnosis of dementia or need assistance with 2 out of 6 ADL’s). The biggest problem she is having (there are others but this is the one I have been dealing with most recently) is that she keeps overflowing her bathtub. She refuses to take showers in spite of all the reasons why it is safer, better, etc. she just refuses to change her habits. It seems so simple to just stay in the bathroom while the water is on, yet she can’t seem to do that. She turns it on and then leaves to feed the cat, make the bed, get the paper, make coffee, Next thing you know the tub is overflowing. We have tried timers. She doesn’t hear them ( hearing aides are not in her ears and that’s another story). A timer worn around her neck? She forgets to put it on. We have even tried a portable bathtub inside the bathtub ( the idea was it could overflow but the tub drain would still be open). This didn’t work because the portable tub is too difficult and unsafe for her to get in and out of without help. Someone suggested a faucet with a sensor the automatically shuts off but that would require opening up the entire bathtub wall to change the plumbing and would be a major bathroom renovation. The obvious solution is shower, aide, supervision. How do I get her to agree to make some changes? I am ready to disable the tub drain so she can’t close it! She has completely ruined the ceiling in her family room and I am now starting to notice a mildew smell. Any ideas would be welcome!

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You state "she has completely ruined the ceiling in her family room and I am now starting to notice a mildew smell."

I think that a even BIGGER problem is developing --MOLD-- in the subfloor of the bathroom and the ceiling of the family room. Mold can be deadly and harmful to a person's health. You need to get someone to inspect the tub and the bathroom floor and family room ceiling for mold ASAP. If there is mold, then you need to do whatever needs to be done to get rid of that mold--even if it means remodeling the bathroom!!!
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Reply to DeeAnna
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With short term memory loss you will just be chasing around trying to solve problems and preventing new ones. Not sure how much time you actually spend with her to know if she is really "managing" her finances, or anything else. We discovered that my MIL and her husband we both in a tailspin of decline even though we saw them often and only lived 6 miles from them. Once we started poking around and looking at their checkbooks (a disaster!) and realizing they were paying their ballooned mortgage but not having enough money to buy food, driving and falling in the grocery store parking lots and having to be driven back home by the kind manager, telling us they were taking their meds (and thinking they were but actually weren't)...and on. Trying to stop your aunt from overflowing her tub may eventually succeed with much effort. Then one day she may start leaving the heat on under a pot.

If you are her durable PoA, I think you are at a juncture where you need to do what she needs, not what she wants. This won't be popular, as you already know. You are not obligated to be her live-in caregiver. A reputable agency can help provide an experienced caregiver who is experienced in getting someone like her to bath or shower. Maybe. You will need to decide how much energy you are willing to expend to keep her in her home where she is less and less "independent" with each passing week.

If you are not her PoA, it will be pretty much impossible to legally make her do anything in her own best interests. You will need to pursue guardianship through the courts to be able to do that. If you don't do it, then you will need to call her county APS and report her as a vulnerable adult. The county will eventually become her guardian and then they will call all the shots of her care and where she resides and manage all her assets. You can still visit her and carry on your relationship, if they place her somewhere close. Please be careful about wearing yourself out in this situation as long-distance caregiving is strenuous and stressful. There are no "wrong" decisions in this, just what works best for the both of you. I wish you all the best. She is blessed to have you helping her!
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Reply to Geaton777
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Do not wait any longer. There are issues of health and danger at hand and there's no reason to wait any longer.

The real truth is that your aunt is no longer safe living by herself. An overflowing bathtub is not maybe going to lead to an accident, it IS going to lead to an accident, and it's just a matter of time until 'something happens'. You and everyone else in your aunt's life can keep pretending that that's not happening, but it is. It is happening.

When our elderly parents' memory starts to go, we realize that all these things we take for granted are actually dangerous. They can start fires on stoves or in microwaves; have accidents when they continue to drive; forget to take medication or forget any of the other many things we just do, automatically. When brains starts to change, these automatic behaviors go awry, and this is only one thing that happens when the brain changes.

If you spend some time on AgingCare.com you'll see that one of the themes is how do we help our elderly family members transition from being autonomous adults to being adults who accept the fact that they need help. Some people are better at accepting this than others and some of our family members are stubborn, angry, proud and do not want to give up their autonomy.

If we don't intercede at these junctions when we see a huge red flag such as overflowing bathtubs, well, that's a huge ticking time bomb. Don't ignore it. Face it, help them face it with dignity.

Your aunt is no longer able to learn new behaviors, most likely, and simple things such as remembering to set a timer or turn off a bathtub are not something you can in any way expect her to do.

As you can see this is going to be really difficult, but it's better to do something now than wait for a tragic accident to occur. Take action now.
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Reply to Rabanette
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Unless someone is with her 24/7, no telling when she will decide to bathe. Hire an aide and my guess is she will work around their arrival. Best thing would be to get inspection of bathroom. If subfloor is going, that could be excuse to shut bathroom for repairs and have her move to independent living. I agree with others that say this is tip
of iceberg and you will find more issues as you prove. I don’t think you said if you are POA but if you are not, hopefully you can get her to sign that too. Managing her is not going to get easier going forward.
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Reply to dogparkmomma
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Sounds like she can't live alone. Today she forgets to turn the bathtub water off, why won't she forget to turn the stove off tomorrow and burn the whole house down? Or leave the gas on and blow it up?
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Rabanette Sep 27, 2020
Exactly. We all have to pay attention to red flags before they turn into....something much worse. Head in the sand doesn't work when it comes to our elderly LOs with memory issues.
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If she is still able to make decisions and is safe otherwise sit her down and give her 3 options.
1. Shower / bath aid
2. you will disable the tub closure so her only option is a shower. Or submit to the renovation for the timer at her expense.
3. Assisted Living.

Doing a timer at this point even if it would mean a renovation might be an option since the ceiling, possibly the floor of the bathroom would need repairs. You have to check for any mold as well and the longer that goes unchecked the worse it can be.
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Reply to Grandma1954
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I fully agree with Geaton. I’d bet the tub overflow is only your biggest issue and there are many more little fires that need attention. Sadly, this only gets worse. I saw this with my grandmother and our family’s valiant attempt to keep her wish to stay in her home and be independent. I hope you have POA and wish you the best in making changes for aunt
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Reply to Daughterof1930
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A shower aide would be the best, if she would agree to it. Will she understand that the overflowing tub is damaging her home? You will have to elder-proof the house as she declines. Talk to a social worker who specializes in elder care to get advice and find out about the things you can do to make the house easier to handle for her. You may have to disable the drain so it won't close. Maybe if you put a shower seat in the shower so she has a place to sit it would be more comfortable for her to take a shower. There are plastic medical style seats that will be OK in the shower.
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Reply to NYCdaughter
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fthome246 Sep 26, 2020
Thank you for your many good suggestions!
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As a home health nurse this was always a difficult situation to witness. Imperative to get POA while Aunt is cognitively intact enough to do so legally. If she declines anymore, family will have to go to court to get a guardian appointed. Next, Adult Protective Services have two parts: Elder Abuse (which is not what I am reading) and Elder at Risk which is the situation here. They will send a social worker to the home to evaluate. They never divulge who made the report to protect family relationships! (nor mine as the nurse so I could continue caring for the fragile senior). A case is then on record, first step. Have you enlisted the assistance of her PCP to get in home care? As I read your note, it is not IF something happens, it is it WILL. These are some of the most difficult times for the person going through these mental status changes and the loved ones watching. My Gran used to say it was like a fog that would roll in and she didn't know what was happening, then the fog would roll out and all was clear again. She filled the tub and left her 5th floor apt to go shopping. The building manager on the 1st floor saw the water all the way down there. That was when the tough decision was made in our family. Gran was 90. She had 9 more years!
Best of luck, hope this helped.
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Reply to Waterspirit
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fthome246 Sep 26, 2020
Thank you for the helpful reminder, and yes that is where this will all go! I do have a DPOA, so the next step is to take the bull by the horns 🤨
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MCI will soon become dementia. Your aunt is already at the point where it is not safe for her to live alone - even if she believes that she "can" do so.

I only see two solutions: (1) do the expense of changing the plumbing to have a shutoff sensor or (2) completely rip out the bathtub and replace it with a non-slip shower base so that she cannot take a bath. (We did #2, BTW, and my husband is 70 and I am 67 - as we are thinking ahead!)

If you are her nearest living relative, you really should consider obtaining a DPOA for her.

Unsupervised baths are unsafe for seniors her age, as if they should feel faint or dizzy, they will slip underneath the water and drown.
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Reply to dragonflower
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Isthisrealyreal Sep 25, 2020
We all have to die of something, what a way to go.
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