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Maine127 Asked March 2020

So what’s the next step as we are about at our wits end?

Between mom, MIL and FIL we are about totally burnt out. We have to deal with mom first and then will deal with the other 2. Mom lives with us and as of late has started having explosive bowel movements as least every other week. She doesn’t care to clean up after or herself or clean herself for that matter and we have just about reached our wits end. Both DH and I work out of the area so are gone during the day and we have 2 kids who come home from school to this. She refuses to let anyone go back with her when she goes to visit her Dr so I have a call into the nurse practitioner and waiting to hear back from her. We have tried a home nursing person but when they come she will not let them in the house and just insists she doesn’t have any issues. She constantly says we are picking on her that it wasn’t her and she just refuses to even talk about the situation. She’s 90 will be 91 soon and we have just reached the point where we cannot provide the care she needs but not sure how to proceed next. At this point it’s not fair to anyone and we still have mil and fil issues that are not far behind to deal with. She can’t afford assisted living and doesn’t really have much in the line of assets so not sure what’s the next step. Any advice or guidance would be greatly appreciated

Grandma1954 Mar 2020
If mom is competent...you tell her that in order to continue living with you she needs to follow rules.
She can not be home alone. She needs to have someone monitor her in the bathroom (this is assuming she makes it to the bathroom each time)
You need to be included in her conversations with the doctor. (at least make sure that you are are listed as an approved recipient of medical information ...that HIPAA form. ) And you need to inform her doctor about the explosive diarrhea that is occurring.
If application for Medicaid has not begun start that.
If you truly can not tolerate the situation and she will not agree to your "rules" then the obvious solution is to look for a facility. This will not be easy for a recipient of Medicaid as there are long waiting lists for Medicaid beds. But she at least will know you are serious about your "rules"

If mom is not competent then the "rules" will not work since she will not understand or retain the information.
The Medicaid advice stands.
If you can not tolerate the situation the looking for a facility advice stands.
Discussing the explosive diarrhea with her doctor still stands.

Are you POA?
You might want to consult an Elder Care Attorney is Guardianship a necessity?
You might want to also check with your local Senior Center they may be aware of programs that will help keep her at home with minimal financial cost to her.

Geaton777 Mar 2020
Maine, who is PoA for her? If she has resisted assigning this to you, tell her it is a condition for you to continue to help her. Trying to do anything for her without durable PoA will make a difficult task needlessly more difficult. Do this first.

Has she officially been diagnosed with dementia by any doctor? If not, this is next. You can use a "therapeutic fib" to get her there. Have a pre-written note for her doc ready to discretely hand to them requesting a cognitive exam and test for UTI, just for good measure. They will do this, I've done this with my MIL. They are happy to accommodate you. While there request a Medical INformation Release form and have your mother assign you as her representative. This allows the doc to fully disclose all her medical info to you and for them to intake anything from you about her. This is different than a medical PoA or HIPAA form. Once you know what her cognitive level is you can move further forward.

Stop letting her call the shots. It is no longer about what she wants but what works for everyone. If you hire a reputable in-home care agency you can arrange for them to enter the house on their own with a hidden key or garage door code. The can be instructed not to leave no matter what your mom says -- she's not their employer, you are. This may buy you some time to research facilities for her. Make sure you only consider places that accept Medicaid as it sounds like she will be needing it. Medicaid has a 2.5 to 5 yr 'lookback" period of her finances, so don't co-mingle any funds with hers and don't give or take financial gifts, among other things. It differs from state to state. This is enough for now. Let us know if you make any progress -- we are rooting for you and your hubs for success in managing all of this!

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JoAnn29 Mar 2020
Medicaid and LTC will probably need to be your next choice.

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