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PeterS Asked December 2017

I went from 0 to 100 and I'm in way over my head.

I'll try to make this as short as possible. I appreciate any insight you can provide. My family lives in Michigan, I moved to Canada. I've been estranged from the family for almost a decade due to issues with my father. My father passed away about 6 months ago and I returned to support my family for the funeral. Upon getting home I realized my mom was acting strangely. She was having a hard time getting around, asked about friends I never had, had gotten herself into some legal trouble (civil, not criminal), was months behind on her bills, and so on. Over the last 6 months we’ve been working on putting her life back together. We helped her relocate near a place where her horse is being boarded so she wasn’t driving 3.5 hours a day to check on it for 5 minutes (she has issues with paranoia, people wanting to hurt her horse or her dog, etc). We got her bills up to date, dealt with financing, doctors visits, medication delivery, etc. But in the process she has been almost completely unwilling to help us with anything. She can and does feed herself and her dog, she does have some basic hygiene, but that’s it. She also seems to drive fine. Anything beyond that and it’s a no go. She can’t manage her life. She can’t keep a clean house (to what extent I’m not sure, I’ve been told it’s less than sanitary). She’s not compliant with her meds. She won’t even check her mail so she can pass off pertinent info to me so I can stay on top of her bills. There are issues where we will ask her to do simple things that are obviously in her best interest like simple banking, paying rent, etc, but she simply doesn’t do it. It it’s not part of the basics of survival, it’s up to my brother and I to detect it and act on it. The big question that we had up until recently was that we didn’t know if she “couldn’t” take care of herself, or “wouldn’t”. We get some neurological workup and a cognitive assessment. She has mild cognitive dysfunction, but scores in the normal range. As far as we know there is nothing anatomically wrong with her brain. The next step is to try to get a psychiatric workup done. It should be noted that my mother and father were divorcing at the time of his death and she seemed completely unphased by his death, so we don’t know what if any contribution that adds to the current issue. The place where she’s living in right now is a manufactured home of her choosing that she loved and thought was very convenient until about 2 weeks after she moved in and then started talking about how much she hates it. The good news is that this was supposed to be temporary, we all know that, the lease expires in the Spring. The bad news is that it was her plan to use her savings to buy a house, get land, get a barn, get a pair of horses, some dogs, and live out the rest of her life tending to the animals. This is something we are absolutely convinced that she can’t do. She can’t take care of herself, there’s no way she could take care of animals, nor does she have the financial responsibility to take on something like this on her own. It’s also more than my brother and I can help her manage. We’re trying to figure out what kind of care my mother needs. How we can protect her from herself, etc. Everything up until this point has been reactionary to the “situation of the day”, but a lot of fires are out now and we need to plan for the long term. We really have very little idea of what we can do, or even if we can force her to do anything (or not to do something) given that she has passed a cognitive assessment. Again, any insight you can provide would be greatly appreciated. I doubt I’m the first person to run into a situation like this and I just need some advice on how to proceed from those with experience. Thank you.

moecam Dec 2017
When you check things out, the fact you live in another country [welcome to the greatest place on Earth] could make a difference as to how a P.O.A. works -

I had a friend who lived in Quebec when her mother died - her mom's Ontario will left her & brother as joint executors - because she was out of province she would need to post a bond to be executor - your might have to post a bond or such if you are out of country - at least ask the question

vstefans Dec 2017
Mild cognitive impairment may not really be a mild disability. When empathy and judgment are lost first, the mini mental status scores are not as affected But engaging in wishful thinking, being unable to organize and prioritize, and underestimating the amount of help you will need or the ability of others to realistically provide it may well mean you simply cannot manage your own complex affairs. MRI at this stage may show nothing but a mild degree of atrophy considered normal for age. A little medical workup to look for any reversible factors is indicated.

I'm sorry you are starting down this path, but don't torture yourselves too much over the can't vs won't dilemmas. Assume more "can't" and assume that it is OK to either quietly take over or remind and structure all the things that are not getting done that need to be. Having her participate with your supervision can help her save face and feel more in control - it helped with my mom for us to set up times we'd go through the bills and she would still sign the checks even though she could not manage the register at all.

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Llamalover47 Dec 2017
Something is definitely amiss with her. She has some type of mental decline that makes her either not able to handle basic day-to-day functionality. I wonder since she does not keep up with her incoming mail "has she gotten any tickets when driving that far?" My own late mother  cried about her incoming mail, but she still demanded to live alone until she couldn't  and  it was beyond apparent that I had to move in!

Veronica91 Dec 2017
I absolutely agree that animals are therapeutic BUT nothing the size of a horse. Right now she drives several hours a day to spend five minutes with the horse. Now if she was riding , grooming even just walking it around that MIGHT be different. Horses are very expensive to feed, board, vet and other miscellaneous supplies and totally unpredictible in their behavior. (Even the tamest gentlest under the right circumstances). Right now the horse is being properly cared for so as long as the bills are paid, it can remain her pet. Certainly don't let her fulfill her dream of a farm. It is far too late for that. Small animals preferably no more than two are the limit. I have run a stable are cared for 22 horses so i do know what i am talking about.
The situation you describe certainly does point to cognitive decline and you two sons need to take over. One option which I don't support is taking her to live with one of you. The other is assisted living where there is some supervision with meds meals cleaning and healthcare.
Definitely consult an elder care attorney. Do all the other things suggested about POA financial and health. Maybe she would believe if told you have to have it to continue managing her affairs.
What is her attitude towards the two of you managing her affairs currently.
This is not going to be easy for any of you but do what needs to be done.

Midkid58 Dec 2017
This is a toughie.
She "wants" all these things, but w/o a LOT of help, she isn't going to be able to manage. So, don't help her. Pay her bills, etc,. but don't feed into the fantasy of the farm and such.

She sounds SO MUCH like a neighbor I have. Same lack of initiative to DO anything for herself...not unable, just won't. She's 24. So it may not be an age related issue--it could just her personality. My neighbor gets this wild flights of fancy that NEVER and I mean NEVER pan out. Every single day I see her for a few minutes to over 6 hours. She is on a new "topic" everyday. A new epiphany, a new way of living. I absolutely do NOT encourage her to do any of these crazy things, as she is incapable of even showering unless her hubby leaves her a "to do" list and that's on it.

So--age related? Maybe, but sounds like she didn't get this way overnight. I wouldn't support ANY wild changes of flights of lunacy. I would think she needs a better psych workup than she's gotten. If you have a feeling all is not well, go with your gut.

And of course, she could have some animals. They can be VERY therapeutic. Just not a stableful of horses and a farm's worth of other animals.

Good luck with this!

RayLinStephens Dec 2017
I'm going out on a limb here but "taking care of animals" can be very therapeutic.

As was already mentioned, you can have all bills sent to you or your brother and you can allow your mother a small allowance to spend any way she wants.

If you're concerned, you can even work out something for paying for animal feed and care. But it has been proven that people do better with pets.

I'm sorry if this isn't helpful. Just the flip-side of the coin.

cara77 Dec 2017
In California, APS-adult protective services would be the agency to call. They would go to her and assess the situation, and help if needed. There should be the same agency in your moms state. Check into that.

anonymous238579 Dec 2017
On a practical note. Most of her bills can probably be sent electronically, along with bank statements, so one of you, or in a team can track income and pay bills via the bill pay system at the bank. I recommend setting up a separate email in your mom's name so that it is easier for you to see what belongs to her.

I suspect that your mom will "hate" whatever it is you do regarding her living arrangements, even if she appears to like it at first.

Keep a journal of what she does and how she reacts. This can be a simple spiral notebook, nothing fancy. Note each day what she says and any issues that come up.

Do not let her have very much money, if she is not handling it well. A credit card with a very small limit and do not let the bank or financial institution raise the limit. If she insists on holding a checkbook, only show small amounts in it so she cannot go on a spending spree, while you and your brother hold the majority of funds.

One of you needs a Durable Power of Attorney. Maybe tell Mom that unless she signs strangers will take away her horse and dog and may put her in an institution to live. She doesn't have the ability to reason appropriately and you need to do whatever is necessary to protect her from herself.

And YES, definitely speak with an Eldercare Attorney. It may cost you some up front but will be well worth the money. Your only responsibility is to keep her safe, clean, and protect her assets.

KnittingDtr Dec 2017
Find an attorney specializing in elder law who practices in her state of legal residence. Ask if you and your brother can come in for a free consultation to review your options and the costs, and whether you can be reimbursed from your mom's assets. Find out what your state requires to have a person declared incompetent. Talk to your brother about who should be health care POA and who should be financial POA.

BarbBrooklyn Dec 2017
At the point where my mom was diagnosed with Mild Cognitive Impairment, she could no longer manage day to day decisions about banking or housekeeping without having total panicked meltdowns, daily.

A lot of one's cognitive functioning can be intact, but if your Executive Functioning is shot, there is no longer a " conductor" in the brain, running the show.

Was any imaging done as part of the Neuro workup? My mom's workup included an MR ( which showed a previously undiagnosed stroke) and six hours of paper and pencil testing by both a neurologist and a neuropsychologist.

Did the neurologist give an opinion about what level of assistance your mom needs? Ours was very specific and told us that she should no longer live alone, needed to be around people and needed assistance with medication.

As Rovana points out, she may be competent to make decisions, but you are under no obligation to enable her bad choices. If she talks about buying a property, saying " that's nice" in a noncommittal way could be a plan.

rovana Dec 2017
If she is legally competent there is not much you can do to force her to do anything. BUT for sure you can refuse to enable. If possible she should see a geriatric psychiatrist. Are these ongoing lifelong problems that would indicate mental illness or fairly recent?

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