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My mother has early stage dementia and my sister lives with her and she is a hoarder. There are plastice bags and clutter everywhere. The house is filthy. There is no food, no clean clothes, and my mother is alone 12 hours a day while my sister is at work. My sister is using my mother's money to pay bills and then keeping what is left over. My sister refuses to pay for things my mother needs. APS told my sister my mother needs socialization and the health department says there are no blocked exits and working smoke detector so they closed the case. I do not have the money to seek guardianship. I am taking my mother to see a gerontologist and I will report what is going on. I am hoping the doctor will report this situation to APS again and maybe they will do something. Is there anything else I can do? Has anyone else had this situation?

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There's one other avenue to explore: if you have tangible evidence that sis is mentally ill, she is "unable" to perform her duties as POA. Present that tangible evidence to APS and keep on them, calling and following up on the report as often as you can. Remember, keeping a messy or cluttered house is not mental illness, and you haven't really described any of your sister's behaviours that fit that description. She is entitled to some form of compensation for the role she plays, isn't she? Are the amounts she is "taking" reasonable when compared to the amount of time, effort and inconvenience taking care of mom costs your sister? Sometimes siblings that aren't doing the caregiving need to consider these things when judging the caregiver. She does seem to need help, though.
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Just wondering how the sister can hold down a job for 12 hours a day, and be so mentally ill and have such a messy house? And if she has a job why does she also need mom's money? Maybe there are some other bits of info missing here. Maybe sister's job pays very little? Sounds like very precarious situation.....how did mom come to live with that sister in first place?
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Interestingly enough, I had a similar situation. I wasn't the one who called APS. A neighbor called the city about the conditions of my mother's home and they called APS. Just like your situation, they evaluated for a few months, camels by and checked on her, but ultimately dropped their case. Why? Primarily because of what my mother was telling them. She told them she was scared of what her husband would do, so they backed off and didn't put any pressure on him. The city was looking at code enforcement issues due to the hoarding environment and APS told them to back off on that as well as long as my mother was there. They listened. But my mother refused to leave. The only option they gave her was to leave and go yo a shelter where she would have nothing but what she could bring with her, sans her pets which she is extremely attached to. Things came to ahead when she had a heart attack. I called the social worker the day after their normal visit. She said my mother didn't look well but she refused to be taken to urgent care. I checked on her and she didn't sound right. Her husband refused, despite asking him to, to take her to the hospital. I took her in where she got worse and they determined she had a heart attack.

APS dropped the case when she once again refused their help. Even though your mother may be in early stages of dementia, she may come off in a short visit with a social worker as having enough capacity to declare what she wants. If your mother told them she doesn't want to leave, they will consider it a case of her not be willing to help herself. They take the victims choice into consideration. They will not force her against her will out of her home unless she is at immediate risk of danger and it has to be almost a life and death danger. You can call the city's code enforcement to deal with the hoarding issue, but again it will be slow or maybe not at all. It took two years to get my mom out of the home and into a senior independent low rent apartment. It took a lot of visits and a tremendous amount of patience and persistence. I had to show my mother that she could depend on me to help her out and that she had choices that could make her happier. It's not easy at all, but getting her out was the best I could fo for her.
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I so agree with rfhendricks. I cared for my in laws for 8 years had a 5 year reprieve and then it was my parents turn although my mom was functional for a long time with her dementia/alzheimers until my dad had a massive heart attack and then all Hell broke loose. These last 5 years have been constant drs. appts., visits to my mom, or hospital stays. If I hadn't had my husband and my faith to hold onto I don't know what I would have done. My sister passed away a couple of years ago but I didn't have much help there due to her own health and caring for grandson. Please try to find a support group or friend that is going through the same so you have someone to lean on and bounce things off of. Wish this site had been around or I had found it years ago. God bless you and I will keep all of you in my prayers.
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If your sister is mentally ill then why does she have DPOA? My mom had dementia and I was both her DPOA and payee. Payee is a big pain but was worth it in order to take care of my moms finances. Once she was admitted to a nursing home, they became responsible. First and foremost take care of yourself. You will be of no help to your mother if you were to get down with your health. God be with you.
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My sister refuses help. I have contacted a hoarding task force to clean up the house and my sister refuses because she will have to go for therapy and pay for it. She refuses a caregiver agency to come in and assist with light housekeeping , laundry, prepare meals, as well care for my mother because she would have to pay and they would use water, detergent, she would have to buy food. The house is such a mess you would have to climb over junk to get to the laundry room. I live 3 hours away and I have offered to take my mom to her doctor appointments. My sister agrees because she has told me it is an inconvenience for her to take my mom to the doctors and she does not want to spend the gas to take her or take off work. I am dealing with a very mentally ill person. This is not a dispute between two sisters about how to care for our mother, it is a case of neglect boarding on abuse.
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Note that you cannot sign the consent for treatment for mom at the new doctor, and she is not competent to sign. Only her POA can sign. You can try an emergency room for immediate care, if you believe and have evidence that her health is in immediate jeopardy, but other than that, you're not legally able to bring on a new doctor without the POA's consent and signature. Mom appointed her to handle that, and you need to be able to prove that sister is unwilling and unable.
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Social services can be so difficult to navigate. Most APS and other social workers try to do their best but they are bound by certain rules and regs. My parents have a complex situation at home (similar to yours) and I took this approach.

Because my Dad is mentally ill, my parents are only living on social security, I contact the Department of Heath and Human Services to see if my Dad would qualify for "services" whether that be in home care and in the future an adult living situation. My Mom was his caregiver for years but she herself now has some bit issues.

It has taken about six months now, and still not everything is set, but we are on our way. Once I filed a grievance about my Dad's situation (so hard to do because I thought my Mom would get in trouble) a social worker came out to evaluate the situation. I made sure NOT to do anything at their house so the social worker could see just how they lived.

The social worker was very clear that my Dad did need help and it looked like my Mom could not really do it anymore. He qualifies for 31 hours per month of in home assistance which we will be using for house cleaning, laundry, and maybe food prep. Too we can use part of those hours for adult day care if I can get him comfortable with that.

My Mom throughout all of this had a heart attack and has her own problems. She is still resistant to the whole thing. I have had to become the bad guy sometimes and remind them a thousand times it is for their safety.

APS was called on my Dad during this processes because he was falling and in the hospital. Because I had started the other route the APS worker did come out and interview my Dad, acknowledge the issues, and put the case on hold to watch what the other social worker was doing. At least in the State of Washington if the issue is not resolved then they come out multiple times and do something at some point, but it does take forever.

Good luck and know that we are thinking about you and know how tough this is.
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I just lived through a similar situation, and things do not sound good to me. If mom hasn't already prepared her POA, etc, it's too late to do so now and your only recourse is going to probate court to get a guardian appointed. She already is exhibiting signs of dementia, so nothing she signs is binding and it all can be easily challenged. Your only viable option is to go to probate court and get a guardian appointed, but most likely that won't be you or your sister, unless you are both completely "squeeky clean" and can demonstrate you possess the ability, skills, availability and a safe place to caregive. It will cost you a lot of time, money and aggravation. APS will probably do nothing anyway, even if there's evidence of some neglect. It takes an absolute diaster for them to act and remove someone from authority or to remove the patient from the situation. And your sister will never, ever cooperate. If she has POA, you and mom are in for a very bumpy ride. Hire a lawyer for advise, or just learn to live with the situation as it is, as it is highly unlikely to change. Have you offered to help sister by going to their home, doing laundry, throwing out the clutter, taking on some of the errands, etc? You'd be surprised how overwhelmed she may be by it all, and very few of us have the courage or wisdom to reach out for help. And none of us caregivers think our siblings are willing to help us, it's just that rare. We hear the kind of complaints you've made all the time from people who want to criticize the way we're handling things, but get very little help from the complainers. My sister sounds just like yours. Be careful about taking mom to another doctor without her consent -- if sis has POA, you can get in a lot of trouble, since you do not have to right to do that without her permission.
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Thank you to everyone for your responses. I am not able to work with my sister because she is mentally ill and has severe depression issues and refuses to seek help for herself. There is neglect of mother's needs and my mother is not competent to realize the neglect due her dementia. There are no clean clothes, dishes or food.. I finally convinced my sister to get meals on wheels so my mom would have something to eat. My sister has POA and I think DPOA too. My sister refuses a caregiver or sending my mom to senior center because it costs money and she is taking whatever money is leftover from bills. I am taking my mother to a gerantologist in 2 months and hopefully they will intervene.
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I'm more concerned about your sister keeping your mom's money. That's the big problem right this minute (although I know it's disturbing seeing how your mom is living). You said you don't have the money to seek guardianship. If there is a local college near by there are usually law school students that will help for free to try to figure this out with you. If not here is a website that can maybe help. Good Luck. rocketlawyer
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APS were called and visited my parents several times, but they are just not staffed to be able to assist. If they do take action, it is usually not a pleasant consequence and will only require reporting on top of the help your mom needs.

You will need for a doctor to validate that your mom is capable of being able to sign a DPOA. If you don't, your sister could report that mom has dementia and this will turn into a larger mess for you and your family. Seek the advice of an elder law attorney.

If you can, work to find a bridge with your sister. If you can, would she let you get mom to local senior centers for socialization? If you are members of a church, the pastor might be able to help arbitrate. There are also professional arbitrators that may be able to help you and your sister find common ground. She may think she's entitled to compensation because she is caring for your mom. As one of four siblings, we had many disagreements about care, but always worked to find a common ground.

This is tough, but I do think you should look beyond APS to find a solution. Best of luck.
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Change that to DaveIFM makes a good point. Sorry.
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What is your mother's position on all of this? If she's not distressed you may need to back off despite how disturbing you find her circumstances. Presumably your sister has POA or is at least a signer on a joint account.

Public services are reluctant (for good reason) to intercede when households are messy, cluttered and even dirty. Lifestyle choices that aren't dangerous fall into the "none of the government's business" category. Their role is to ascertain safety rather than judging housekeeping skills.

This is not to minimize your distress at your mother's circumstances, but rather to point out that you may not have sufficient grounds to intervene. Jwinters59 makes a good point about consulting an attorney before further inserting yourself into the mix.

It sounds as if there is already difficulty in your relationship with your sister. Adding APS and the Department of Health to the mix will likely further polarize the two of you, probably causing your mother to choose between you. This could get very ugly in a hurry.

My advice: find a way to work WITH your sister rather than against her.
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Pray, and wait for the recommendation of the physician. No one can help one except the person needing the help.
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I wish I knew how to help you. I am just starting down this road and trying to get my mom in with a geriatrician. There are only six around here, even though the population is probably 40% over the age of 65.

Maybe the doctor can evaluate your mom and say what level of care she needs. Here, by state law, they determine if it is a 1, 2 or 3. If it is more than your sister is qualified to provide, maybe that is how to get her out of that situation. I hope someone else has a good answer.
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Jwinters59
Your profile says: I am caring for my mother, living at home

Is your mother in her own house or your house?

How does your sister sister access your mother's money? Is it deposited to a bank account? Are you on the account?

As DPOA you could write checks on mother's account, sign them as DPOA and put the money in safe place

Talk to an elder affairs attorney before doing anything. No way would I become a guardian or become her payee.
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The only thing I can suggest is you get Durable Power of Attorney, this will over ride the POA. Also, you can take your mother to the Social Security office and become her payee. Then you would be responsible for paying her bills and getting her medical attention. Money will have to be used for her care only, you have to keep all receipts and records of where the money went. SS does a yearly audit. Its time consuming and a big pain but your sister has no rights to keep your moms money. Extra money needs to go into a savings account for when something major happens. Good luck.
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