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Parents moved to be closer to me for my help, however they chose a town an hour from where I had a support system and good medical care. Now the three of us are isolated in a small town with no support system and good medical care is distances away. Dad is 89, mom is 77. Dad recently began to have delusions, memory loss and becomes more aggressive (can be physical). Mom refuses to bring in help (cost is a factor as is dads rejection of help). He often doesn’t know who she is and my being there makes things worse, as he thinks we are plotting against him.


My only brother is not in the area, but is trying to speak to them about this over the phone, but mom only tells us about things when she is scared. We have called the police once and she says she will again if she feels in danger, but recently locked herself in the car trying to leave and he stood behind the car to prevent it and would not call the police. Even so, the police have said unless she presses charges, they can’t do anything if he seems to be lucid (which he fakes well with strangers). The doctors, when he will go, have not been helpful because he hides the behavior. They think he had a stroke, but it’s been 4 weeks and they still don’t have the results of brain scan. They put him on anti depressants and anxiety, but to no help. They fired home health, because it agitated him. Mom is isolated and I am concerned for her safety, but she refuses to leave (he literally can’t care for himself alone), refuses to put him in a care facility and refuses for someone to come in to help. What are our options? How do we handle this? I am isolated in this small town, 5 miles from my isolated parents, unable to physically help in any way. I am at my wits end and don’t want the result to be finding my mom hurt or dead.

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Write the doctor a letter expressing your concerns; the doctor may not be able to respond to you without violating HIPPA but he can listen.

Find an elder law attorney and start preparing for the upcoming "event' when your Dad is going to be hospitalized so you can work with the hospital social worker to get your father placed. Keep a log of every time your mother has needed to call the police or when your father kept her from leaving or fired home care, etc. Get copies of any police reports or invoices from care givers you can access. I used my phone camera to take pictures of documents in my parents' home. I also recorded my Dad on one of his incoherent rants - you don't need video necessarily so just setup a recorder app on your phone where you can start recording with one touch (check to make sure your state has one party consent if you want to use this in court, you can play for a doctor even if you cannot use in court). Even a little objective backup to your log makes it more creditable. Tour some MC and have in mind a facility where you would like to place your father. Work with your brother, he may have things to add to the log too.

Most attorneys will discuss your situation or give you one session for free. They will tell you what you need to gain guardianship and what the up front and total fees will be. If you gain guardianship, all the expenses are reimbursed from the ward's funds if you want them to be. You might want to consider joint guardianship with your brother.

When your father lands in the hospital you may be able to get the hospital social worker to help you get a full evaluation by a geriatric psychiatrist. The results of that evaluation can be used to gain guardianship even if you don't have access to it. When you file for guardianship, the court will appoint a guardian ad litum who will be able to access your father's medical records and will investigate whether your father needs a guardianship. If the hospital social worker won't help, you may need to contact APS.

Seeking guardianship may alienate your mother for a time or your mother may be relieved. My mother also resisted challenging my father's competency or placing him in a facility for many years. When I told her things had just gotten too unsafe for her and Dad and too unworkable for me so I was petitioning for guardianship even against her wishes, she decided to support me.

It's a hard and stressful time when you worry Dad may hurt Mom or himself and there's not much you can do about it. I prayed a lot. I told my mother I was worrying a lot about her and Dad while leaving out the "we need help" part of the conversation. About once a month I brought the "we need help" conversation back around trying to use a new opener. What are we going to do when Dad puts you into the hospital? Dad's taking a dozen medications now, do you think he can possibly keep up with all of them? Your PCP says taking care of Dad is destroying your health, what are we going to do when you can't take care of him anymore?

Best wishes that your situation works out well for your family.
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Sandwichedinsc Oct 5, 2018
Thank you for this detailed and concerned response. We are doing most of this now, finally after much strife and searching for answers. I was able to make an appointment with an attorney. Hopefully it will be in everyone’s bests interests, including both parents. He continues to go to neighbors to get a cab to the bank, as he is leaving with half the money. I pray whatever happens that they both get to a comfortable and safe place. Bless you.
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Opposite here. Mom is verbally abusive and delusional. She always had a way to dig into dad, but now that she has advanced Alzheimer it is so much worse. Dad is 87, in good shape and wants to enjoy the rest of his life. I think he feels obligated to nurse her to the end. I am in in the process of obtaining guardianship for mom so I can have the authority to place mom, to not only keep her safe and clean but to save the rest of my dad's life. I am not sure if this is what to do, but my gut says yes.
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Sandwichedinsc Oct 5, 2018
I find that it’s a generational issue. I’ve already set up a living will for my kids and told them what to do in this situation. I would prefer to have medical care st my fingertips and to be around others, no matter how sad, than to be isolated in my home waiting for my kids to visit.
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Try calling Adult Protective Services. Your mom needs to be safe. Has dad been checked for a UTI?
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Sandwichedinsc Oct 5, 2018
Thank you. Yes, no UTI. But great call out. I had no idea about how that could impact him until recently. Knowing some medical causes is helpful. I am learning way more than I ever thought possible or wanted to. Additionally, he has sleep apnea and at one point his masks were leaking air, which resulted in sleep deprivation. That was a contributing factor as well. So much.
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It would be good to get the HIPPA forms signed, so that you can take part in the doctor’s discussions. In the meantime, you could write to the doctor, or ask for a meeting on your own. If you let the doctor know more about the problems, even if he or she can't discuss it with you, it may lead to different questions to check the situation more thoroughly. That’s important if your father is a good faker.

The key to dealing with the whole problem is probably your mother. She may need counselling, or you may need to take her to see AL places. She may have a worse impression of them than is justified. She could also be encouraged to look ahead – at what point does she think that she and your father cannot manage as at present? What would be her triggers for looking for different care? What intervention would help her besides the police? How can your brother help? While your mother is competent and won’t take steps, there is little you can do. If she focusses on things getting worse, it may help her to stop ‘coping’.
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Sandwichedinsc Oct 5, 2018
Thank you. Yes, we have HIPPA, but he won’t let her go anywhere without him, so all that is discussed at the doctors is in his presence. I intervened and now he won’t allow me access, so no conversations with doctors for me. Mom is the key. In situations like this, knowing options to share with her is the solution that helps move things to the next level.
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When...notice I did not say If...your dad is hospitalized discuss that you can not bring him home that your Mom is not safe in her home with him there. This same discussion can be had with any Paramedic or Police officer. As soon as you indicate that you are not safe in your home more steps will be taken to help resolve the safety issue. Not saying the system is 100% effective but at least the documentation will be in place. By the way the Police and or Paramedics should have the safety discussion not in the presence of your father. Most people are afraid to say they are fearful while standing in front of the person they fear.

Now..another question for you. Is your Dad or your Mom a Veteran? If so there may be more help available through the VA. In home help that would be free for the Veteran. (so your Mom or Dad would not have to worry about the cost)

Can you get security cameras where you can view what is going on at any time? This way if you see something that is concerning YOU can call the police or paramedics. If your dad begins to become physically violent your mom may never be able to get that call completed. If cameras are not an option a Medical Alert for your mom might be faster than the phone
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Sandwichedinsc Oct 9, 2018
Dad is a vet, but we are in a unique situation. The nearest hospital is pretty far away, so dad sees civilian docs and vet docs. It has created a nightmare for this situation with sharing information. Each agency wants to start from scratch.
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Sandwich, You can call 911 & ambulance comes instead of police squad & say he has UTI ...and a danger to himself & others in house...tell them he’s incontinent (even if not true ) & needs medical care...they take him to hospital & 3 day stay will qualify for nursing home placement...he most likely has the dementia that becomes combative like my 91yo mother...she’s on Seroquel 25mg ...Neurologist prescribes now she is on 2 pills 4X a day.She started 1 a day. I took her out of nursing home 1 1/2 yrs ago against advice of staff there as it was told to me it would get worse. It does get worse & the Neurologist just keeps telling me to increase Seroquel....
your mother is in danger so PLEASE act before she is injured & can’t care for herself no less your father.

Yesterday my mother pulled my hair & try twisting my hand & fingers ...I have to be quick to pull away. Now a new thing, she keeps unbuckling her wheelchair belt & think she can walk...last weekend fell out of her wheelchair. I called EMS to put her back in wheelchair. I then gave her extra pill Seroquel & she calmed down. I also have lift machine & hospital bed. She can’t walk for 2yrs.

I have private paid caregiver that I share hours with. ..& I change diaper overnight. Private caregiver does about 43 hrs.

Im my mother’s primary caregiver & 59 yo so I can imagine how burnt out & exhausted your mother must be.

Hugs 🤗 to you.
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igloo572 Oct 8, 2018
Spot on!!
Sandwich, remember he has to be “admitted” to the hospital and there for 3 days to get into a NH via the hospitalization discharge to a NH for rehab. Often hospitals will place them into “observation” status....... you cannot have that as observation cannot segueway into a NH placement. Also observation is not 100% Medicare coverage as a hospitalization would be.

The SW or discharge staff at the hospital will likely press heavily upon your mom or you to come and pick him up and take him home. You must state it’s a totally unsafe situation for him at home and nobody’s coming to get him, You & mom will have to hold steadfast to absolutely NOT doing this. No matter how much he cries or cajoles or promises. Discharge planner will find a spot for him somewhere. Then it’s onto you all dealing with just how your paying for his continuing stay at the NH, whether it’s private pay or applying for Medicaid.
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You can call Adult Protective Services or have their doctors office do it on your behalf. Our Dr was reluctant so I called the manager of nursing because they have a responsibility to report it. APS will come visit them multiple times, they will call and get your statement about what is going on.
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Thank you. I will try this.
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