My 85 yr old mom lives alone in a small apartment. Over the past several years she does nothing but sit on the sofa watching TV. She refuses to make friends or socialize. I have noticed in the past years her hygiene is not good- not bathing, hair unwashed. She gets weaker by the day because she does not walk much or do anything at all, so it’s even hard for her to use her walker. She is extremely manipulative and stubborn. She fell the other night (we have a Life Alert system for her to wear around her neck, but she won’t wear it) and was on the floor until her grandson found her the next day. She had been there for over 12 hours. She crawled to the door and opened it for him, but did not try to reach the Life Alert because she said she just wanted to lay there and die. She has refused to let us come over for weeks and has cancelled dates with me, my brother and her 3 grandsons for various reasons. When she was found, she had 4 bags of garbage on the kitchen floor crawling with maggots and flies everywhere. She told my som not to tell anyone. I will spare you all the disgusting details, but the apartment was so filthy that the health department or social services would have condemned it as unhealthy and toxic.
She is currently in the hospital for evaluation and seems fine. When she said “you have no idea what I’ve been through”, I confronted her with the condition of her apartment and asked her how she could live like that??? She was always a clean person and kept a tidy house. We have tried for two years to get her to agree to a weekly cleaning service and she refuses, saying her place never gets very dirty. Every dish, every utensil was covered in dried food and piled all over the kitchen. She said that it was a little messy and it wasn’t a big deal.
She has lies to all of the doctors and nurse and because of Covid no one can go into the hospital to speak with her doctors. I have tried calling but each time I get a different nurse and never a doctor.
I don’t think that she can continue to live on her own. For the sake of my sanity and my marriage she cannot live with us.
She has no money and we cannot afford to pay for her care. She is 85 but in the shape of someone 100 and has the mental capacity and judgment of a toddler. She does not seem to have dementia and I do have a medical power of attorney and I am the agent.
She will hate me if I decide she needs to live in an assisted care environment, but she won’t do anything I say or suggest and expects everyone around her to deal with her bad choices. I am 65 and cannot physically or mentally deal with her manipulative ways (lying) and lack of thought to her actions or inactions any longer.
She has not made good life choices her entire life and I refuse to let her drag me down with her.
I honestly don’t know what to do. I am usually a take charge problem-solving, proactive person but I am just at my wits’ end this time.

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I am not understanding these two thoughts: "she has the mental capacity and judgment of a toddler. She does not seem to have dementia..."

She has dementia.

She is in a hospital. You call the discharge planning unit and tell them about the condition of her apartment. You ask them to have her seen by psychiatry and assessed for her ability to live alone.

You make sure to tell them that family will not be providing more than casual support (she may be telling them that someone lives with her or that one of you comes every day).

You tell them that allowing her to go home would be an "unsafe discharge". Use those words.

You do NOT agree to discharge and you sign NO papers.. if they send her home in a cab, call Adult Protective Services.

People who are competent are allowed to make their own bad choices. That does not obligate us to crawl into a hole with them.
Helpful Answer (34)
Riverdale Aug 2021
Perfect concise helpful answer as usual for you.
"I honestly don’t know what to do"... yes, you do. Mother needs a facility. You're just having a hard time admitting it to yourself and then taking the action. And it's okay to have that internal conflict! It's very common. This is just one of those areas where emotions cloud the problem-solving part of you.

"She will hate me if I decide she needs to live in an assisted care environment". Yes, she will. But she will hate you no matter what you do. You can't win. She's better off being hateful in a facility than in her apartment!

There is no decision to be made. You know she cannot keep living in the apartment. She cannot live alone and she cannot live with you. That leaves a facility as the only route. There is no "I don't think" she can live alone.

Sounds like whatever emotional issues she had got amped up x10 with dementia, which is common. Placement will ensure she is safe, not living in filth, and getting the medical care she needs.
Helpful Answer (32)
Harpcat Aug 2021
This is the best no nonsense answer and spot on! Listen to Loopyloo! She is correct.
If your mother has no money, she will not be able to go into an assisted living. Medicaid will not pay for that. She will have to go into a nursing home. Having a live-in caregiver won't be an option for her in the apartment.
While she's in the hospital ask to speak to one of their social workers. Tell them what the apartment was like and that she cannot live independently anymore. Also, make sure to tell that that you will not and cannot have her at your house because you are unable to provide the care she needs. This is important because they will try to talk you into taking her in and will promise all kinds of help. They never deliver on it though. The hospital will find her nursing home placement.
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PLEASE copy all previous steps described here, for HER SAKE and FOR YOURS, FOLLOW THEM.

Her problems, and your difficulty dealing with them, ARE NOT UNIQUE. Many of us have found solutions to problems like yours. The solutions are not often too happy, but you can design a safe life for her and she can be taken care of.

Her brain is broken, and she needs ongoing safety and protection.

Do NOT attempt to discuss this or to reason with her. She can no longer benefit in anyway from explaining.

It is OK if she hates you when she is placed in a safe residential environment. Nothing she “expects” is meaningful, because her brain cannot “expect”, and that cannot be fixed.

Move forward based on the advice you have received here, because those who have offered the advice have LIVED THIS.
Helpful Answer (19)

You need to call (again and again) the hospital and speak to the discharge planner and tell them the condition you found her in and calmly explain she can no longer live alone. You need to be firm that it’s an “unsafe discharge.” List the reasons. The hospital will try and move her out as quickly as possible and say they are putting in visiting nurse and other support services, all of which she will refuse. If you can’t get someone on the phone, then leave long messages, or type something up and fax it to the nursing station, social work office or doctors office - or all three. Just write an objective account of what you have been observing. And include she has no family able to provide the level of care that she needs. Say you can’t support a plan for her to be discharged back to her apartment. They might think you are a pain in the butt - so what. With her weakness and falls, she might be discharged to a rehab which would buy some time and allow you to work with the rehab for options. “Unsafe Discharge” should be your mantra when talking to staff.

Will she hate you if you try and find placement for her? Yes. I am a hated daughter, and there are probably thousands, maybe billions of hated daughters out there! You will not be alone! By making those decisions you are trying to keep your mother safe. Don’t argue with your mother or try and convince her that she will be better off. Just tell her “this isn’t working.” Tell her you can’t support her plan to go back home. She might say she doesn’t “need you anyway” but just don’t respond.

You say she doesn’t have dementia but her bad choices and failure to recognize her need for help is pointing in that direction. She could be great at covering things up. My own mother kept everyone at bay so that no one could see how bad things really were.

Start researching services for her and find out what needs to be done for Medicaid. In some states there are assisted living Medicaid Waivers but they have restrictions.

If she gets sent back home, call Adult Protective Services. Whatever you do, do not agree to take her home with you and do not agree to pay for services. That will be slow suicide and a path to divorce. Get some counseling to help deal with past and present trauma. Good luck! You are being a good daughter for trying to get your mother the help she needs despite her behavior. Remember that.
Helpful Answer (14)

Follow Barb’s advice, which tells you exactly what to do. The ‘system’ then takes over. You aren’t the one who has to organise where she is placed, or is to blame for it. The ‘system’ should then take over her Medicaid application. Don’t do any more cleaning up in her apartment – the ‘system’ also needs to see what’s been going on. The more you try to 'take charge', the more you are at risk yourself of getting stuck in an impossible situation. So is your mother!

If you can go down this track, you won’t be ‘at your wit’s end’. Stop worrying, and good luck!
Helpful Answer (11)

So many of your comments reflect those experiences we had with my mother.

Filthy condo.

It was all dementia.

She “seemed” fine, but her living conditions and personal care told us otherwise.

The “lies”, in my mother’s case, were just words. Sometimes they were to cover herself with an “answer”. But, the answers weren’t logical.

Her life was no longer safe.

It was dementia.

Take Barb’s and Grandma’s advice.

Step by step.

It can feel overwhelming, but you can help your mother to be safe, as well as keeping your own sanity.

Keep coming back here. You’ll see your story, in one way or another, repeated.

Best wishes.
Helpful Answer (11)

She absolutely has dementia. Do what BarbBrooklyn suggests. Unless you pursue guardianship through the courts for the purpose of making decisions for her and managing her affairs, the county will attain guardianship and do that for her. She will go into a care community where she will receive housing, healthcare, meals and the option for social interactions.

One of the most challenging things now will be to look at her with different eyes. She is not intentionally manipulating you, she has dementia. She's not stubborn just to annoy you, she has dementia. Her brain is broken and can't be repaired. To treat her otherwise would be like insisting someone with an amputated leg should be able to walk as if they have 2. The leg is gone and isn't coming back any time soon. In fact, the other leg is slowly disappearing.

I learned a lot about dementia behaviors and how to interact with LOs from watching Teepa Snow videos on YouTube. They were very helpful. Wishing you much clarity, wisdom and peace in your heart as you work through this in your mom's behalf.
Helpful Answer (11)

Since you do have POAs it is time you act on them. Your mom needs help and she needs it now. Since she nor you cannot afford Assisted Living/Nursing Home care, it is time you make an application for Medicaid. This process takes about 3 months, and you will need to procure bank statements, etc. which may make the process longer. Contact your State’s Dept Human Services ( DHS.) Also look for an elder care attorney.
Helpful Answer (9)

Email the social workers at the hospital, discharge planning, her MD and aging and protective services, with copies to yourself. State that it would be an unsafe discharge if she was to be discharged to home. Advise them that you are her medical power of attorney and do not support a discharge to home. Advise them that your mother is an unreliable reporter and may be providing inaccurate statements about her situation.

State that when asked why she didn't try to get help after falling she told family she wanted to lay on the floor and die.

Then briefly list what has happened that supports her inability to appropriately care for herself, starting with being unable mentally to get emergency care when she fell and lay on the floor for 12 hours even when there was a emergency alert device she refuses to use.

If you have photos of her unclean apartment include 1 or 2. List short descriptions of what you found, 4 bags of maggot cover garbage, all dishes and silverware caked with food.

Unable to bathe and maintain her healthy hygiene and refusing assistance.

Ask for her to be assessed for the appropriate level of care. Ask the hospital to begin the application for Medicare and/or Medicare. Ask them to begin the process for placement in that level of care.

At this point your mother is going to hate everyone, but you are doing the right thing.
Helpful Answer (8)

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