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I completely understand, I would not call in a guardian, only as a last , last resort. Hire a Geriatric Case Manager, they can do evaluations, and can do it very un-assumming, and unbiased opinions. Dementia patients can do better in their own homes, and Alzheimer's .com has good resources, for financial options, and talking with mom if she needs to move, for her safety reasons. Mostly, do what makes mom happy, and explain you have two options: Get help in for her, or she will have to go elsewhere for help, but she no longer can stay alone, for her peace of mind, as well as yours. Again, Alzheimers has some wonderful resources about handling your situation. Good Luck
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Thanks for all the guidance. We have been working with in-home elder care in her area, but mom refuses the help. Currently her housekeeper checks on her and takes her to doctor's appts when we're not there. This wonderful person is telling us it's too hard on her, as she has other obligations. No, our mom isn't able to tend to all her own needs, and she has frequent fainting spells as well as early dementia with memory loss and depression. She is a very stubborn and has always been independent, more so after becoming a widow 20 yrs ago. We are trying to work with her doctors, but she presents well, as if nothing has changed, when she has her office visits, including the psychiatrist. She denies everything. Our chief concern is her safety. She has a medic alert pendant that she also refuses to use. All this came to light when she stayed in bed all day, unable to get up, and waited for the housekeeper to come in. She was in the hospital for a week. We've been trying to address this for a year. We're afraid the next step may have to be legal, but that's the last thing we want to have to do.
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If she can manage the four basic life activities then she could stay in her own apt., even if it is 1000 miles from your home. The four activities of life are : Feeding oneself, Bathing oneself, Managing one's continence, and some form of mobility by yourself. If she is TERMINAL, then by all means, move her closer to you so you can keep an eye on her and visit with her frequently.
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If she resists your every effort, see if there is a geriatric care manager in her area to assess her needs & coordinate care

As a last resort, you could ask her doctor to evaluate her, provide a written assessment of his findings, have her declared incompetent and/or call Adult Protective Services in your state to see that she is moved to a care facility..
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We have a similar situation, only my mother lived two blocks away until she had her stroke. I am an only child. We tried to have my mother's renter and a few caregivers help my mother, but she only wanted me to help her. She did not want to live with us, and her doctor said she needed supervision 24/7. We discovered the Emeritus Assisted Living Home in Vacaville, CA just 10 min. away. There are several scattered throughout the states. We have been so pleased w/their concept of family. Mom's long-term CalPERS pays about 1/2 of the cost; we changed her Dr. and she visits my mother every two weeks. My mother longs for home and asks often, but at the Emeritus A.L. Dementia support group they taught the relatives how to "disengage and redirect the conversation". I thought the advice you received above was so good. Esp. about "extending the season", and relate to the loved one as you would a small child--being the protector, nurturer and supporter. We cannot reason with my mother, but we can channel her energies elsewhere (we take each situation as it comes and do the RIGHT THING and not go with our emotions) then we are blessed. Our family seeks God in prayer and the scriptures each day as well. May God bless you and may you have wisdom and discernment during this difficult time. We are thankful for this site!
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We have a similiar situation with my in-laws. Only child living 12 hours away - they have moved in with us and long for home. We approached it as just for this season - not so overwhelming to accept as forever - then the "season" gets extended. You would not leave a small child alone - it is the same thing - you are responsible for your family and are doing the right thing. She has gotten to do it her way for 88 years. We don't always get what we want and I know how hard it is to reason with someone in that state - my in-laws are both early Alzheimer's - but again we don't always reason with a child - this is just the way it has to be now and try to find a favorite thing to entice her. Good luck!
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She has early dementia and will not accept in-home help either. My husband is her only child and is traveling at least once a month to check on her. We're looking into retirement communities in our area. Thanks for commenting, Lilli.
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Is she a danger to herself? Is she unable to care for her basic needs? Would she be okay with a little in-home help? If she can maintain her home with a little help, let her stay in place. If she is truly in danger, she needs to come live near you, or a family member needs to go to her.
My Mom moved across country to be near us and has received excellent care. But, she still longs for "home."
There is never a perfect situation...just shoot for the best one.
Good luck....Lilli
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