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splyt888 Asked June 2015

How to get my severely demented Mom (80) medical care when she's not seen a doctor for 40 yrs?

My mom, almost 80 years old, has been suffering severe dementia for the past 6 months (yesterday she asked when the rigor mortis was going to set in, as she's convinced I'm dead), sits in the liv. room all day, every day talking to/arguing w/ the voices in her head, & refuses to see a Dr. To have tests done/ be treated, as she doesn't think anything is wrong with her. It has been approx. 40 yrs. since her last Dr.'s appt., About 6 months ago, the everyday forgetfulness sharply turned into full-blown dementia as she began holding conversations with herself, insisting the hous & backyard were on fire, & my sister was dead... I called the Dept. for the Aging, & when they sent two women out to do an evaluation, she wasted no time in kicking them out. And since she answered these women correctly when asked the present year & president, the women said that she had rights & there was little they could do. Her condition is worsening daily, & because of her state, I am unable to hold even a part-time job, for fear she will either hurt herself or burn the house down. We are barely getting by on her meager Social Security monthly income, & every instinct I possess tells me she desperately needs medical care & tests done to address this dementia, & I also need to know if this is purely just dementia, or if this is the onset of full blown Alzheimer's Disease. My sister (a nurse, by profession, herself) seems to think that there is little we can do in terms of an intervention, as my mom does possess certain rights, & says she thinks that it's a matter of a waiting game until my mom becomes so physically ill that I am able to call her an ambulance (my sister doesn't see my mom on even a monthly basis, as she lives a few states away from us). I continue to grow more and more concerned, & as she flat out refuses to go to a Dr.'s appointment, or have one come out to our home to complete an assessment, I grow more & more helpless feeling.
I need to know if there are any immediate steps I can take in order for her to receive the care she deserves, rather than having to sit back & wait until her health is compromised to such an extent that I have to call the paramedics for her. My mom has no relatives to speak of, which leaves me in the dark in terms of a genetic predisposition for Dementia, Alzheimer's, or Diabetes.... (My sister says that often people, & in particular seniors, can experience dementia as a complication due to the onset of Diabetes). But again, neither of us knows what to attribute this dementia to, as she refuses to be seen by a doctor. Can anyone help point me in the right direction insofar as resources I can tap or actions I can take instead of feeling trapped into doing nothing at all? I am desperate at this point. I & my sister are also out of luck being able to handle this from a legal standpoint, as my mom has no will, living or otherwise, appointing one of us her Power of Attorney, which would have made it so much simpler to handle things if she had. Can anyone tell me whether I have any type of recourse I may take? I need some answers as soon as is humanly possible! Please,please, please HELP!
Thank you so much, in advance, for your time & trouble! I look forward to hearing from you ASAP!
Very Truly Yours,
C. Mills

sandwich42plus Jun 2015
I love that idea!

With my mom, I was still a stupid, incompetent 12 year old. If I told her the government or doctor had said we had to do something a certain way, she typically didn't argue. She may have not liked it but she wouldn't fight me on it.
If my husband "put his foot down" and told her the way it was going to be, she would completely shut up and go along. It was beautiful while it lasted.

Rosebush Jun 2015
New medicare rule, everyone's needs to see a doctor at least once a year?

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sandwich42plus Jun 2015
If you can get her into the ER, IMMEDIATELY begin the emergency guardianship proceedings.

Every state has their own process and forms, but there is always an emergency option in the absence of other powers like POA or Healthcare Directives. It might help you to look this up in your own state to understand the process, what you can do by yourself vs what you would need an attorney to complete.

Don't wait until the crisis happens to know what to do.

sandwich42plus Jun 2015
Knowing the president and year is not a sign of anything coherent. That was a cop-out by your local agency to avoid getting involved. A real tragedy.
My mom knew the President and year when she had an epic melt down and tried to hurt a bunch of staff at the nursing home.

If you rule out a UTI, then do the following:

Google for the SLUMPS cognitive eval. This is one of many cognitive evaluations that can be done, but this one is simple and pretty fast. Just casually have her do the tasks without saying what it's for, maybe not even all at the same time. You don't want her to get freaked out.

If mom can complete this fairly well without prompts or help, then you're dealing with an early stage and she needs to be seen.
If mom can't complete the tasks, then you need to get her to a neurologist ASAP. It doesn't sound like early stage to me based on your description.

She must be seen by a dementia doctor (neurologist).

"Hog tie her" (not literally!) and get her in the car any way you can. You have our permission to tell her anything necessary. My advice is to not divulge all the facts at one time. "Hey mom, let's go get your brain checked out. We think you're missing a few cards in the deck!" gets very low cooperation.

Maybe just be very vague. "Hey mom, time to get in the car. I think we should go for a ride (or ice cream or whatever)" "Hey mom, we have to stop in here for a minute first (the doctor's). They want to meet you."

Don't say you're going to a doctor. Just arrive there and go inside. If she's never been there, she won't know what it is until it's too late.

Other things you can use:
==Hey mom, I've been told you have to go in for a checkup to keep getting benefits. I have no idea why, but we better follow directions.

==OK, let's go! (No prior explanation before or during. You just go.)

==I need you to help me pick out something at the store. (devious, but who cares at this point if it gets her seen?)

Failing that, if she is having a really bad day or falls, call 911 and say that you have an elder with dementia who is out of control, and refuse to take her home at discharge. Talk to the discharge/transition social worker and explain you are not able to care for her anymore due to the dementia.

Educate yourself on dementia and it's signal behaviors. There are many kinds of dementia, Alzheimer's being only one. There are treatments and activities that can help depending on when your mother gets into the right kind of dementia care.

At some point, you have to step up into the next level of caretaker and understand that there will be some decisions mom doesn't get to refuse anymore. If she is not of sound mind, then she really really needs a good assertive caretaker. Her safety and yours is job #1 right now. Having someone who is a risk to safety in the home is bad, bad news.

JessieBelle Jun 2015
It sounds like your mother could have something as simple as a urinary tract infection (UTIs). Even a small bladder infection can give psychotic symptoms for an elder person. If you have an urgent care facility near you, see if you can talk her into visiting. They can check her urine and see if there is an infection, then prescribe if she does. Does she have her Medicare insurance?

Urgent care facilities are so simple. They are not as scary as the ER. Who knows? Maybe if you can get her to go to urgent care for a urine test, it will open the door to talking her into finding a primary care doctor -- preferably a geriatric specialist.

Eyerishlass Jun 2015
freqflyer is right. Many families do have to wait for an "event" that brings them to the hospital via ambulance especially if their loved one puts their foot down when it comes to seeing a Dr.

Does your mom refuse medical care or is the issue that she just doesn't have a Dr. to go to? If she had a Dr. would she go? If this is the case ask around for a recommendation to a family Dr. Ask your neighbors, people you go to church with, anyone you know. Someone will have the name of a Dr.

If your mom just flat out refuses to go then there's not much you can do about it. You can't force her to go. You can't throw her over your shoulder and physically make her go.

One alternative is to wait until she's having a really bad day with her dementia and call 911. The paramedics will assess her and may decide that they can't take her to the hospital if she doesn't want to go but that's why you wait until her dementia is really bad. Would she be able to pass the assessment? If she's having a really bad day would she know who the president is? Would she know what year it is? If not, then the paramedics are likely to take her in.

freqflyer Jun 2015
Sadly sometimes the only way to get medical help for an elder who refuses to go to the doctor is when they fall or get sick, thus a call to 911 and a trip to the hospital :(

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