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Janine2020 Asked September 2022

A business card from APS was placed on my door with a message to call the SW at my convenience. Any advice?

My 80 year old mother with dementia/Alzheimer's lives alone next door to us (my father used to live with her but was placed in a residential care home almost 2 years ago). We have cameras in her house to keep an eye on her per her primary care Dr's request. We bring meals and check on her throughout the day yet she continues to ring our camera doorbell and try opening our door multiple times a day (she has forgotten how to use a phone) with recent outbursts that she no longer wants to live alone and will take her life if we don't meet her demands immediately (like coming over to look for her cat that likes to hide who we also help take care of). She will also demand to stay on our porch until we can come out (not always possible to do working from home with meetings, etc). She sleeps through the night and is on Memantine for her Memory & Sertaline due to her history of depression. She only mentions this suicidal ideation in front of me when she is trying to get her way with what she wants. If we are around others she won't mention it and does not have a plan to carry it out when asked. My father has been through psychiatric hospital stays for suicidal ideations and we have been told that they will not treat patients who have Alzheimer's/Dementia so that doesn't appear to be a treatment option for her. She needs help bathing (I hurt my arm trying to get her out of the bath tub before so we have to do sponge baths) but her Dr will not sign off for in-home health care since her Dr says she is not considered to be home bound per Medicare criteria. She is a hoarder and her house is full of stuff which is another issue since she has always refused getting rid of things. We own her house and are paying out of pocket for my dad's assisted living and also her high credit card debt so we aren't able to afford to pay out of pocket for her care too (especially given the high cost of memory care). I take her to appointments, out to eat and to visit my dad at his care home so she gets out of the house often. We have tried taking her out to socialize with friends but they get frustrated with her repetitiveness. I am an only child with no other family to help and am trying the best I can.

AlvaDeer Jan 2023
Janine, thanks for updating us. So few do. We appreciate it.

MargaretMcKen Jan 2023
Regarding APS and the September comments from Burnt, my experience is that social workers vary a lot, partly depending on the training they received. When I started in welfare management, I actually sat in a couple of social work lectures at the Uni where I was teaching, and I thought the training was worse than useless. Considerably worse than useless, encouraging behaviors that my own experience with groups (and me) suggested would do damage.

So tread warily, but don’t assume the worst, seems like good advice about an APS visit. No wonder people have very different views!

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Janine2020 Jan 2023
Thank you all for your helpful advice and feedback, so sorry for the delay in responding as we since had an unexpected death in the family due to Covid. I truly appreciate all your responses.

I was able to return APS's phone call with strength and bravery thanks to all of you! Turns out they referred us to other resources such as applying for Medicaid for long term placement which we did and are still waiting for a final 'decision' upon submitting some additional documentation that they recently requested, whew!

JoAnn29 Sep 2022
Just a note, the OP has not responded to any of the replies.

I have to say that our APS does nothing. Calls to them daily about the smell coming from an apt went uninvestigated. They had removed the mother because of Dementia and a black toe but left her 400# son who has challenges.

A friend had guardianship over a much younger cousin. Her husband had ALZ and her mother was in NH care. She asked the State to take over his care because at almost 80 with a ALZ husband and ill mother she just could not do it anymore. Well they took over, took him out if the group home he had been in for years. Told the Caregivers they were not to call my friend, and threatened their license would be taken away if they did. Took him out of the ARC (a workshop for the challenged) and placed him. They will not tell her where he is. The poor man (in his 50s) has been taken away from everything he knows and does not have the ability to understand why. My nephew works with a state coordinator in the next County. She just took over his case. He talked about things that happened 10 yrs ago and she took them as now. She mentioned APS to me and I laughed. I said they won't do a thing and I told her what I just wrote. She was surprised at what I told her and gave me a number for my friend to call. I so hope they can help.

So sorry Clairesmum, where I live APS is the last people you want involved in certain circumstances. If I had a neighbor I felt was a danger to themselves and had no family, yes would call them.
gladimhere Sep 2022
No responses? So why spend so much time and use so many words to again respond to something that OP is not responding to?

Sorry, Joanne, just one of my pet peeves. So many long responses to posters that never come back. If they want more info they will ask.

Again, sorry, it has been a very, VERY, long day!
GardenArtist Sep 2022
I have to agree with BurntCaregiver. Initially I avoided conversations and used e-mail so I'd have documentation, including for questions and info I requested (which to this date hasn't been provided). I realized that they have their own agenda, with their own set of "facts", and don't necessarily have the elder's best welfare in mind.

That may be true only for my experience, but I would never voluntarily involve APS after my experience.
BurntCaregiver Sep 2022
It's not just your experience, GardenArtist. This is many peoples' experience with APS social workers.
I have been involved with APS many times over the years with different elderly care clients. I even called them myself a few times.
You are right that they have their own agendas and their own set of "facts". I had a client who was removed from her home and "placed" because APS deemed the home unsafe. It was not unsafe. She was elderly but had a decent life with her family and was happy. They forced her out. I should also add that she did have almost over half a million dollars in LTC insurance that wasn't getting used.
I called APS for an elderly client that I had years ago because she was living in a hoard like you'd see on tv. I quit that position because it was so disgusting and unsafe. APS came. She did have a path (which I had to make for her) from her filthy, hoarded bedroom to the filthy hoarded kitchen and bathroom. Her son and DIL also lived there. APS deemed the situation just fine in spite of the home being as the SW described 'a little messy'. It was infested with bugs, roaches, and vermin. This was 'a little messy' to the APS social worker who came out. Also this client was poor and didn't have a half million in LTC coverage.
I don't trust them much and will tell anybody to always let them do the talking. Don't volunteer information.
Clairesmum Sep 2022
I'm a former APS worker. You are doing so much to care for your mom, and support your dad. From what you say, you are the 'overwhelmed caregiver" who benefits from APS assistance in accessing some information and resources that can help you. If you have nothing to hide, then it is not an adversarial process.
APS knows 'the system', and can be effective at advocating for your mom. They can also refer you to those who can help with Medicaid planning, chore services, care at home if she is appropriate to be at home, etc. APS can help cut through some of the 'red tape' and confusing information that is so hard to figure out.

APS can help arrange for a psychiatric admission for your mother - even patients with dementia benefit from psychiatric care. A specialized geriatric psychiatry unit is even better, but often those are not locked units. As your mom seems fully ambulatory and also unable to remember instructions, a locked unit would be the safest place for her to start. Assessment of competency can start here as well. Community MDs mean well but are not well versed in geriatric medical care and community resources.
Good luck to you, and your family.
mstrbill Sep 2022
Thank you Clairesmum for chiming in. Hopefully you can add your insight to other future posts here. I have a question after reading some of the other responses here. Were you hindered at all or did your course of action change based on the finances of the person you were checking on? What if there was a situation where family (perhaps son or daughter) was taking care of parent, or trying to, but couldn't keep up with the demands anymore, perhaps because they had to work, and there was no money to pay for in home help. Let's suppose the only income parent had was a modest SS check and maybe a small pension, and had no LTC insurance.
igloo572 Sep 2022
It’s probably either neighbor (as they keep on seeing mom on your porch knocking at all hours) or when you & mom went to visit dad, one of the staff at his facility noticed something or dad said something to them after y’all left that was of concern for her safety. Professional licensed staff at a facility are mandated reporters so if they noticed something they have to contact APS. Like if mom mentioned suicide to him & they overheard, or he said afterwards she said was going to harm herself, they are supposed to report to APS.

Whichever it was, APS came by to see living conditions on mom & in the process to speak with you as you are family AND next door caregiver. Breathe deeply, return the call.

What will help for APS phone call is for you to do a list of all the things you & hubs have done to provide for safety & security for mom: camera system, providing meals, taking to doctors visits, etc. If you easily have the dates of last visits, write dates down on the list. Mention to APS that you did all this for when your dad was still living next door until 2 years ago. Mention why he had to move out…… that it was for his safety and security as he had suicidal ideation. It shows you understand when care gets beyond what can be ok at home and that your mom seems to still be ok at home as she sleeps nights, eats, goes shopping, gets herself dressed, has a pet etc.

That you own the home next door where she lives, pay her CC bills and do for her shows your concern. APS will look into property ownership and how her SS mo income is deposited. It standard procedure for APS to make sure no financial shenanigans. Don’t take this part personally.

BUT I think there’s 3 way bigger issue than your speaking w/APS:
1. she cannot live on her own anymore…. her coming over to your home is going to become she wanders down the street and for blocks. She needs 2&/7 oversight which means in a facility or moves in w you & she pays to have caregivers hired.
Also, moms MD does NOT determine if she goes into a facility. No need to wait for him to write orders. If there is an AL & $ to have her pay for it, she could move into one manana. Your dad is in an AL, what about her moving into same AL?
and
2. You have hurt yourself so cannot bathe and assist her as you have in the past. She needs to have some sort of in-home healthcare provided. APS can likely help have this happen as they can do a referral for community based Medicaid program for inhome assistance. If your moms MD knows you have hurt yourself & can no longer do things like bathing & won’t do a script for inhome care, well, I’d get a new MD.
And
3. So you & hubs are paying for your dads AL & paying moms CC, right? Why? If she is not paying minimal rent + utilities bills for the house she lives at, why? They both should have some sort of income, like Social Security $. At a minimum they need to use that $ to pay for AL (dad) & rent (mom).

Please pls realize, once ea become “at need” medically & financially for a Medicaid program, like a NH, they can apply. But on you as their POA to get this started. Neither moms MD or the staff at dads AL is going to do this, it’s on you as POA to do this. APS might be able to actually be helpful in this to get mom moved into a facility as emergency placement as you physically right now cannot caregive. Sticky part is that things like this tend to have a temporary guardianship named. But sometimes we need to have someone outside step in and take over as we emotionally &/or physically cannot flat make the decisions needed for our elders safety and security.

House she lives in next door, was bought & owned by you & hubs, right? Wasn’t mom & dads then gifted to you between now & back to 2017, right? If so, it’s your asset; not required to sell it & use the $ to pay for their care.

Fawnby Sep 2022
APS is a source of help for your mom and for you. Find out what they offer. Your mom isn’t really okay now even though you might think things are under control. She can change in a nanosecond because her brain no longer functions normally. I had a neighbor whose daughter thought things were going smoothly until one night she got a call saying that her mom was walking down the street stark naked in October as the leaves were turning. The mom said that she had to go for a walk because it was too hot in her house. Needless to say, she went to memory care after that. But she could have been hit by a car or wandered off into someone’s back yard and died of exposure, or attacked by a dog or starved to death in the woods. Please consider placement for your mom. She needs more help now.

mstrbill Sep 2022
Why isn't she in a nursing home? It sounds like she's progressed to the point of not being able to live alone anymore. You don't have to be her full time caregiver either if you are unable to. So what's left? She needs to be placed. APS will likely try to get you to take on a more active role. You can tell them you can't do more than you are already doing and you need them to help with the situation. They can intervene and do what they see fit and find placement for her.

freqflyer Sep 2022
Janine2020, I would be very concerned about a love one who has Alzheimer's/Dementia being able to just walk out of her house at any time. It is not uncommon for a person with such memory issues to just walk away from her house. That happened to a friend's wife, she always stayed around the house, but out of the blue she took off walking. The whole neighborhood was out looking for her and finally found her.

Take a clue from the cat, if the cat is hiding inside the house, there must be a serious issue going on that makes the cat scared.

And I agree with the other writers, it is not your responsibility to pay for your parents care. Unless it won't hurt financially when it is your time for care.

AlvaDeer Sep 2022
You don't say if you have "taken on responsibility in some way" legally, such as allowing yourself you be appointed POA. If you have taken on this duty then you are responsible for helping to place your mother safely. At this point that likely is not "living alone" albeit next to you.
Never consider using your own money for either of your parents. You will need that for your own care in future. Your parent's assets serve to care for them. When they are destitute the State and Federal Government will pay for placement through medicaid.
If she requires placement, and you are not, do not wish to be POA, let APS know that, and allow your Mom to be put in the guardianship of the state. Explain your circumstances as they have to you. Do know you will then have nothing to say about dispersal of their assets and her placement, or where it is. Someone at this point will have to be responsible for these folks who are not responsible for themselves anymore, but that doesn't mean bankrupting yourself on their care nor depleting your own assets. You have apparently already allowed them to stay rent free in a home you own which has as a result of that been likely ruined.
So sorry this is happening. But sounds like Mom is no longer safe alone. You will have to act or request that the state act for your parent in your stead as you are unable to care for her due to her condition--she needs placement.
If you are not POA or guardian and do not wish to be, I would use words describing yourself as "physically" and "mentally" incapable of her care.
I hope you will update us. And yes, call the number on the card and be honest with them in all your dealings.

BurntCaregiver Sep 2022
First of all, you do not have to pay for anything for either of your parents. Their income pays for their care and what isn't covered they must go on Medicaid. Why is she not living with your father in residential care?
I think you should call that APS social worker and ask why a business card was left in your mother's door.
The most important thing to remember when dealing with these people (APS or anyone associated with elders) is to let them do the talking. Do not allow them to get any information out of you because they will try and are trained on how to get unsuspecting family members to say what they want to hear.
Right off the bat, let them know that your mother has no money or assets. This will reduce whatever "interest" they have in her.
If they know she lives in a hoard, they will get her placed. I have seen this happen many times to seniors I've worked for. That's why I always say nothing gets an elder a one-way ticket to a nursing home faster then being stubborn.
APS will trespass. They pull all kinds of things. I had a live-in private position years ago. The client had two caregivers myself and another who split the week. One evening I saw someone walking around the outside of the property and trying to look in the windows. It wasn't quite dark yet so I hadn't pulled the shades for the night. I called 911 and told the police someone was trying to get in and to come quietly. Cops got there in less than five minutes and had this person on the ground in handcuffs instantly. It was an APS social worker making a "visit". The cops asked why she did knock ring one of the doorbells (front or back) or knock, because normally when people visit they don't lurk a person's house looking in windows. They do. They knew an elderly person was living at that address alone and they couldn't find what homecare agency they had. That's because they had private care.
We had no choice but to let them in, but only when an appointment was made for a home visit. We did not tolerate any 'just popping in' nonsense. Be careful withe them.
Lay down some boundaries with your mother and learn how to ignore her sometimes. Do not give her any attention whatsoever and walk away when she starts with the suicide ideation and tantrums. If she has dementia, take the credit cards away, Or better still, just stop paying them and they will get shut off. Enough is enough.

AnnReid Sep 2022
So someone who has a connection with her or you appears to have concerns about how your mother is currently living.

Based solely on your comments here, are you willing to consider the possibility that her safety and YOUR welfare may necessitate a reorganization of your father’s care AND the care she needs?

Sometimes as “onlies” we are reluctant to realize it when an impossible situation comes along to confront us. Are you at this point? Are you financing your father’s residential care, but not yet able to consider the fact that many signals are pointing to the fact that your mother may need residential care too?

In your situation, I’d find an accountant who was very familiar with complex family finance, and work with that expert to develop a financial arrangement that would allow her to be placed sooner than later.

I ridiculously kept my mother’s house for AT LEAST 2 years after I should have admitted that I’d never have any reasonable use for it. If I’d been working with an account tang (I am now), I’m sure I would have thought and acted differently at the time.

If I’m totally off the track, please feel free to ignore my comments. Call the APS worker and find out what they have to say.

gladimhere Sep 2022
Call them immediately. Be open, honest and forthcoming. If mom cannot use a phone she should not be living alone.

Somebody has filed a request for an investigation. Sounds like mom should be in a facility. The state will take guardianship if you do not address this, including clearing out her house.I

Sell the house use proceeds to pay for her and dad's care. You should not be paying anything towards dad's care.
BurntCaregiver Sep 2022
No. Never do that with APS. Let them do the talking and if you have a question, then ask it. Never volunteer any information to these people.
They will get on a crusade to "place" some elderly person who is living well enough with their family, but will completely neglect other in truly dangerous situations.

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