Caring for my Mom. I'd appreciate perspective from others who have had issues with navigating what is best for a parent.

I think you should wait and see what the outcome of her cognitive/memory exam is, even though you suspect she may have decline BUT at 76, which is "relatively" young, it may be caused by other issues, such as thyroid, diabetes, high blood pressure, tumor, etc., so make sure all other causes are also discounted -- because there is no real test for dementia, only eliminating other causes. Also they should be able to see if she indeed did have a stroke if they do imaging.

Definitely do not co-sign for a house, or have her live with you. And, I don't think you should spend a lot of energy "explaining" things to her (if she does have dementia) because they can't really work within reason and logic anymore.

If she doesn't have dementia...read your PoA carefully to see when it is activated. Once the ex-con brother gets out of prison, it can become very interesting so I think the best course of action would be to make sure all her bills are paid online and password protected, she only has a cc with a low balance allowance (or a debit card connected to an account that has very limited funds in it), put most of her cash in a savings account that you can manage. Make sure all her sensitive ID, info and small valuables are in a locked fireproof file kept in either your house or hers. And if she takes any prescription meds, especially for pain, this needs to be closely monitored (count the pills!).

It's definitely NOT 'too soon' for Assisted Living when your mother is soiling herself and sitting on the sofa w/o pants on, not remembering the incident, having you manage all of her bills, meds, etc. That sounds like dementia to me and there IS a definitive test she can be given to find out: it's called the MoCA exam and based on a score of 1-30. Based on what she scores, the doctor will be able to determine if dementia is present and if her executive brain function has been impaired. If she gets a 28 on the test, then he can move on to other sources of her issues such as a brain tumor or other health issues.

Dementia has been known to be diagnosed in people as young as 55, as it was in a woman named Linda who lived in the Memory Care AL I worked at in 2019. She just passed away recently at the age of 60. Anymore, 76 is definitely not 'too young' to be diagnosed with one of the dementias, unfortunately.


Loving your mother means that you want the best care for her; Assisted Living, in reality, is not some house of horrors but like a hotel for seniors where they have their own apartment, meals served in a dining room with a menu, activities, social interaction, day trips and transportation by mini bus to appointments and shopping. She'd have caregivers available at the push of a button or the pull of a string as well. It offers her something you cannot: autonomy and a life of her own.

Nowhere is it written that YOU have to be mom's caregiver, especially if it's wearing you out. By no means should you co-sign ANYTHING under ANY circumstances, either! Mom is in no shape to own a home or pay bills or do upkeep/maintenance! And who knows what the situation will be when her son is released from prison. The reality of coming out and facing civilian life again can be very hard for someone on parole. Taking care of an elder, or anyone else for that matter, is probably the last thing he'd be up for. The vision your mother has of getting a home with your brother is a fantasy, probably heightened by her cognitive impairment, honestly.

If mom is diagnosed with dementia, THEN you can use your POA to have her placed in AL or Memory Care AL, depending on the evaluation that's given to her upon admittance (beforehand, actually). She'd probably qualify for regular AL until the dementia got bad enough to where Memory Care was required; I'd look into AL with an attached Memory Care if I were you.

One step at a time, right? But the first thing to do is to squash your attitude that AL is a bad thing or that you should feel guilty about not wanting mom to live with you. I made that decision decades ago; that my folks would not be living with me b/c I am not the caregiver type nor do I have a great friendship with my mother to begin with. My folks have been in AL since 2014 and it was THE best decision for all of us, truthfully. Dad passed in 2015 and mom is now 95 and in Memory Care at the same place with advanced dementia and with more issues than Newsweek. There is no way on earth I'd be equipped to handle them here at home; she gets great care in the MC and I visit her often.

Wishing you the best of luck coming up with a plan of action for all of this. I know it's not easy & you have my condolences for all the stress you're under.

I would get her placed before brother gets released. He will definitely move into her apt and then u will not be able to get rid of him.

So glad you seem to have set boundries. Do not get yourself in debt for Mom. Especially if brother gets involved. If you can get a formal diagnosis of Dementia, take ur POA and tell the bank that no one but you should be able to access Moms accts.

It’s not too soon. Sounds like it’s overdue.

the #1 abuser of the elderly is a non-working son who is addicted, unemployed, or recently released from jail, living off of their elderly parents.

I think you have the outline of a good plan for Mom's care.

Start with that Dr appointment for follow-up on that fall (therapeutic fib to get her there if required). Book a long visit if possible. Mention the fall. Mention the wider picture - fairly recent bereavement, adjusting to widowhood, transition required to more suitable housing. That a full medical would be beneficial to ensuring you all have the facts & can plan for the right level of care. See what's recommended, where that takes you.

Once you have the facts on her health, you can proceed.

My gut feeling already is Assisted Living will be a good fit.

Company, activities, staff available to assist motivate/emotional support to adjust to being a widow. There will be MANY other ladies, a new circle of gal pals. (Note: many older folk picture AL like the dim dark old nursing homes of yesteryear.. all apple sauce & gruel. Many are more like hotels these days - with cafes, gardens & sitting rooms).

Regarding your brother. I very much like your firm boundaries.

"wants him to have a house to go to".

Ok, that's a Mother's love speaking. Love is nice, but can be blind.

Maybe your brother will be helped to reconnect into the community, with social services, social worker, shared home accommodation? I have no knowledge of the system. What I do know is giving him a free house will rob him of the opportunity to work towards his own housing goals, gain pride in saving & taking steps towards his own future.

Get the legal ducks on a row too. A kind hearted Mom can be a soft touch for financial 'loans' & more. An elder I met years ago was nearly a victim of elder abuse. While in hospital, his just released from jail son broke into his home & changed the locks. Took his Father to court, claiming he was demented & asked/needed him to stay. Attempted to move the old man into NH & take the house. Old man (90s) was able to prove his competency, order eviction & get a restraining order. But could have gone the other way.

Trust your gut regarding your brother.

It’s a good idea to write a list of ‘NO’s, for you and everyone else involved. NO: I am not going to support my brother in any way - I don't trust him to change. NO: mother is not moving in with me. NO: I love her and enjoy her company when all is going well (my dreadful father was like that), but I cannot be with her when she is ‘hateful and terrible’. NO: I will not assist her to put her things into storage – it’s up to her to organise things that won't help in the long run. NO: I won’t clean up and pretend that ‘accidents’ didn’t happen. NO: I won’t move to her town. NO: I cannot help her if she won’t listen to sensible advice.

Most importantly, NO: I have no responsibility to do what she wants - particularly if I can see that it's stupid.

This list of ‘NO’s, written down, stops a lot of circular arguments. You can do some ‘YES’s as well: YES: I love you. YES: I will help if you are willing to make some choices that I can see are sensible.

Making all this very clear to yourself, your mother, the family, and any agencies who get involved, will almost certainly help. Go for it!

It sounds as if your whole family is having a very rough time, and I'm sorry to hear it.

I think your reaching out to seek perspective is an excellent first step.

Let's start with you. You're living and working in a one-bedroomed apartment. Now it would be very wrong to jump to any conclusions and I'm not about to do that, but are you really in a position to be anybody's full-time caregiver? You say your personal life is all but gone; how about your own employment and financial security and future prospects, the real basics? You know what they say - always put your own oxygen mask on first before you try to help anyone else.

You have DPOA, you're helping your mother get medical advice to check out what's going on with her balance and memory issues, but you're a long way off being able to make decisions for her without her agreement. So at this stage I'm not sure it's a good idea even to try. It could wreck the relationship that you'll need to have with her to support her when she needs it more.

Then your mother. She's 75. It is very unusual for a lady of her comparatively young age *never* to have worked. Were there just the two children, you and your brother? Were there other important reasons or issues that made her so fully dependent on your Dad?

The niece - whose child is she? How close is her relationship with her grandmother? What role does she have in her work at the ALF?

Then your brother. You're not close to him and you don't want anything to do with him when he is released from prison. It's tempting for us to make a lot of assumptions about him, but for one thing we know nothing and for another it isn't reasonable to expect your mother to be equally indifferent to his future wellbeing. What happened? - what impact did his conviction and imprisonment have on your mother, and on your father if it all goes back that far?

All in all, it's such a complex and turbulent situation that it might be best to get professional counsel. That way everybody's needs and ability to contribute could be taken into account, and help the whole family find a way forward. Where is your mother staying now, is she back in her apartment and living alone?

All of these answers have been very helpful and reassuring. Thank you!
Mom's doctor gave her a quick test for dementia at her appointment this and she did "pretty good" on it, as he said. His diagnosis for now was ADHD which surprised me a bit but made some sense too. He also said that she has compacted wax in her ears that was contributing to her falls, so we're going to an ENT to get her ears cleaned and he suggested physical therapy for her to gain better control of her balance. Strangely enough, he didn't suggest any imaging for the recent fall at my niece's house that involved her sitting with no pants for some time - and not remembering it. Although he does contribute a lot of her behavior deep depression and stress.
My Mom is back at her apartment, by herself, until Wednesday when I will pick her up again. I have scheduled some counseling for her on Tuesday and my niece will be taking her to that appointment. I want try to get her someone to talk to at least once a month.
For the individual that asked about my niece's relationship....she is the daughter of my brother. But my parent's got legal guardianship when she was 13. She is like my (much younger) little sister. She is currently a nurses assistant at an ALF. They love her there - she is very sweet and very caring. She also wants nothing to do with her Dad and talks to him only because it pleases my Mom. He has been locked up for 16 years and will be released in July of this year. Because of the nature of his crime there are many places that he is not permitted to live. But I am not going to mix my life up with his by getting Mom a house so that she can live with him.
To say my Mom never worked was probably not 100% accurate. She did babysit for a couple of years after my brother and I grew up and moved out, for a young couple. That is the extent of any work that she has ever done outside of being a homemaker. It was just my brother and I - there were no other children. She was a full-time Mom. And after we moved out she was lost. She also babysat my brother's child from his 3rd marriage, before he got locked up (which was before this child turned 1 - we haven't seen her since).
After my brother went away, she and Dad raised my niece and Mom's behavior started getting strange. Most of her outbursts would happen in the middle of the night with my Dad where she thought she would hear him having conversations on the phone with another woman, but he was actually fast asleep. Once she threatened him with a knife. A couple of times she thought she heard my niece having conversations too-and my niece would wake up to my Mom standing over her. Several years down the road (after my niece had moved out) Mom ended up spending a weekend at a facility where she was diagnosed with sleep deprived psychosis. The doctors at that facility severely overmedicated her with anti-psychotics. Eventually we tried several therapists, none of which she liked until that fizzled out. Her middle of the night behavior then picked back up and has continued off and on. Even while Dad was in physical decline she would have episodes where she would hear him saying things or hear a neighbor saying things - and she hit him once. She still gets agitated but hasn't hit anyone again, except for about a year ago when she hit my niece from behind...pulled her hair and slapped her glasses off her face. At that time though she had a terrible UTI that really affected her mentally. She keeps those as well, the UTIs, because of her incontinence.
I'm going to try the low dose Adderall that the doctor has prescribed to see if that yields any positive results. But I still think I should consider the ALF for her. She is absolutely against it though.
Thank you to everyone that has responded. If you have any further advice, I'm open to it!! :)

So, actually, there is quite a long history of paranoia and auditory hallucinations. I'm glad there's a referral to ENT - if they decide to throw in some neurological investigations that might be quite revealing too. Was the doctor aware of her night time behaviours, though?

And no, I'd agree then - your mother never worked. Babysitting is what teens do for pocket money. It is not actual, regular, hold-down-a-job work.

Your dad must have been a total hero and legend. The only problem with rare individuals like him, people who hold everyone else together, is that when they go... things fall apart. You must have started having your suspicions when his dementia began to get the better of him, and I'm afraid there might be quite a lot of other sad revelations yet to come about how many mountains he moved to keep your mother out of institutions. I'm not surprised she isn't keen on the idea of one now.

Are you confident that you have access to *all* of the information you need to help her make good choices?

A lot on the plate…
Truth, your mom is declining… your mom needs some changes in her lifestyle now.
Multiple changes as your mom ages are difficult. I was told , every physical environment move causes more dementia decline. I saw it with my MIL , and my mom .

I would look down that road and find the AL that your mom can thrive in.she will probably be mad … that’s OK … The violent episodes frightens me about your situation. My moms outburst and then starting to hit were the dementia signals that I didn’t realize was happening. She would have passed the test at that time…

Take care of yourself, I wish you good wisdom for looking further than just your immediate situation…

Hugs, Peppermint.

Bear in mind/take fully to heart that your mother may not be capable of formulating a plan and weighing up major decisions. It was all done for her, no?

That doesn't mean you have to carry her forever, but it could mean you'll have to make the difficult choices - because she can't. No good asking her what she wants if she simply doesn't know the answer.

Thank you so much, DaughterfromCA! Having a place like this to seek the perspective/advice of others is very helpful as I can sometimes get paralyzed with the fear of making a wrong choice that negatively effects my Mom.
I cannot thank you and everyone on here that has responded, enough. :)

With a history of falls, she should not be on her own. If she can afford it, an ALF would be a good idea. Even at a discount, monthly rent can run between $3900 - $7,000 a month. More depending on services.

Another option is in home care with a fall program. The caregivers can take them to appointments, grocery shopping, schedule activities and much more. Most are private pay and range from 20 hours a week to 24/7 care. Average cost for 20 hours a week can be under 1,000.

Peppermintloz, please do not pay for your mom's care. Even if she allowed it.

If she is deemed competent then you can step back and let her make decisions. Even if they are bad and you don't agree.

As far as your brother, his choices are what make him homeless. Don't buy in to his prison hustle of everyone is responsible for him except him.

You are doing so much good care for your mother, and she is incapable of recognizing it. A parent has a very very very hard time cutting off an adult child who has not been able to function as a responsible adult. He knows just what to say and do to try to get her/you to rescue him, now that dad has passed.
Her vehemence about the assisted living is likely based in the usual resistance of 'not going to old people place" and also her knowledge that if she does agree to move to AL, she gives up the ability to help him with housing. And when she is not physically present with you 24/7, her ability to wear you down on your boundaries will weaken.
She may show some decline in function by moving to AL...but she will decline as well when your brother is around her or calling her all the time. And that will wear you down, too.
Low hanging fruit - ear wax, PT, mild stimulant medication- may give her short term improvement, but not a dramatic improvement.
Given the incontinence and violent outbursts in the present, and her history in the past, her brain is showing serious signs of decay. She may not have a diagnosis of dementia yet - but that is because dementia is a symptom of several diseases and the medical team tries to manage/rule out all treatable physical issues first, to see if her condition improves. At her age, this seems sensible...and these can all be addressed in AL as well.
Safety for her, and you are the most important.

Is brother going to be on parole? If so, many prisons will prioritize those who are going back to "family" for release. Call the warden's office at your brother's institution. Advise them of your mother's condition and that her housing is itself in flux. If your mother is on any controlled medication, definitely advise them of it.

This might delay his parole for some months, giving you more time to find a solution without his being there.

Peppermint,

I concur that for now it's safest to leave her where she is since brother can't live there.

Meanwhile, talk up the AL as if it's you and Niece's private vacation destination. The chef-prepared lunches are fantastic. Their gardens are so beautiful it's like a members-only park. You get so much for so little with niece's help that you only wish she were there.

See if she'll go with you to at least check it out.

Hello, I'm back with a little more information and feedback if you have any. I had my Mom stop taking the Adderall (and relayed that message to her doctor who also agreed), because it was making her dizzy and nauseous.
In my heart I knew Adderall likely wasn't the answer but I wanted to try. This week she went to my niece's with her pants on backwards - they were pull-on jeans but the pockets indicated that they were clearly on backwards - and she said they ere uncomfortable. She went to change them and came back out with them backwards again. Took 3 tries to get it right. She admitted that she felt very off that day. I don't know if this could be attributed to the Adderall, as she was taking it at the time....
She also spent one night with my niece because my her husband was working late. After he came home very late, within the hour Mom was coming up the stairs (which she isn't' supposed to do, due to being a fall risk) because she thought she heard him hitting my niece. They heard her coming up the stairs and waited. She got there with her phone in hand ready to call 911, something she has also done to her neighbors at her apartment building a few times in the past year. My niece then eased her mind and walked her back down the stairs to bed. Her husband has never and would never lay a hand on her - this is a perfect example of the things that Mom hears and acts upon at night (primarily). I've asked her doctor, again, for an MRI. He responds to all other inquiries but not that one. I don't understand why. Should I press him harder? Should look at going to another doctor? I mean, he didn't knock it out of the park with the ADHD diagnosis and I've told him about her being aggressive and a (sometimes) hitter and about her falling a few weeks ago and not remembering.
Today I'll be heading out to stay with her for a few days and then likely bring her back to stay with me for a bit. She's been back and forth to my niece's for a few days, mainly to visit with her son, who is 7 (he LOVES seeing my Mom). I'm sure she could use a break.
Thank you for any advice!

Very tough situation. Your priority is first YOURSELF. Mom is second. Soon-to-be paroled brother you are not close to you is not your problem. IF your mom can facilitate moving into a house on her own, there is nothing you can do about that. If she can't, she can stay right where she is, and your brother can't move in with her.

As others have said, DO NOT Co-Sign a mortgage. Not your responsibility.

Good luck to you!