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My brother is obstructing the care I give to my mother. I take her to specialists and spend time with her at least one a week and many times have her in my home when she is sick. She is 82, diabetic, copd, hiatal hernia, dementi and now impaired kidney function. Although he lives closer he is a pilot and never home. He seems to want complete control over mother and he is co-owner of all her bank accounts and is POA. But he’s not taking care of mother. I’ve had to call EMS twice in one week - once she was found unresponsive with blood sugar of 27 (on a day when he had been with her). He won’t comply with mediation, I don’t want to file for guardianship as he would fight me to the death over her money, she won’t go in a home where she can get medication management. I’m ready to call APS.

Similar happened to me. Mom had low blood sugar, I called EMS. They showed up and were all friendly and concerned. They took her to the hospital,she did start feeling better. I found out later, through, hospital records I requested and were sent to me, that EMT's reported possibility of elder abuse. Mind you in same report it was also noted she was well feed and attentive.

EMS probably reported it to the hospital same as your mom.

Some may not know, but when EMS and/or Fire respond to these calls, many take a note of living conditions as well as the health and well being of the person the call is for, and they'll report what they find to the hospital, and let the hospital take it from there.
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Reply to shad250
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My suggestion. It seems as though his main concern would be HER money. Petition the court for Emergency Temp Guardianship, put all brothers, sisters. Down as interested parties, request money be put in trust, (why do either of you feel the necessity to handle her finances, all the background checks, credit checks. And if behind on student loan or filed for bankruptcy, need to validate, and have to pay to be bonded, oh, not to mention, be responsible for keeping receipts for 3 years after guardianship ends, keeping records, etc, and if you get audited and things do not add up, then there is paying
Money back, why hassle with it? Explain to court the responsibilities you have assumed, and the fact that your brother isnt there a lot. Let him answer o. His own behalf and try to justify why you have had to assume all the responsibility for her care thus far and how he plans on changing that in the near future. If she wants him. Then, you need to decide, is his level of care sufficient? Neglectful? Etc. All and all, this is your choice to make. Would it bring about WWIII? Or...there is a hotline you can call. Do it anonymously, and put this all on someone elses plate, decision to make, it wont fall back on you ad far as upsetting them
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Reply to mpieffer01
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So upon advice I reached out to county Aging division. They counseled me to ask the police officer to report to APS and to file a report myself. She said she would call my mom and talk to her about hospice but I know even the mention of that Mom will go nuts. She did tell me that I would have to stay on them (APS) which tells me as y’all have that such is all for naught. I’m just going to step back as y’all have suggested. I did report all of Mom’s current problems to her PCP. They are going to order home health care and contact my brother. Let him give up his job to take care of her if he doesn’t want me involved. Thanks everyone!
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Reply to Twillie
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If your mother is competent she could revoke the HCPOA and POA. If she refuses to revoke these documents you are out of luck. As far as competency this would most likely end up in very expensive court battle. I am not sure what state you live in but you can file a protective order with APS. This is what they do in my state. The petition can result in an emergency or temporary order. After a hearing the court can issue a protective order or approve a consent agreement. The protective order or consent agreement cannot exceed one year. The order can be extended after another hearing.

Protections and remedies under the order are somewhat similar to protections available under Iowa’s Domestic Abuse Law. This includes protections for personal safety, safe housing, and also protections and remedies concerning financial exploitation. Examples are:

Restricting defendant’s contact with the vulnerable elder to stop abuse, harassment, intimidation, etc.
Moving the defendant from the elder person’s home or requiring the defendant to find housing for the vulnerable elder, and
Requiring the defendant to return property or funds as well as prohibiting transfer of funds and property.  Just a word of caution if your mother refuses to cooperate with APS their is very little they can do. Sure they will file the paperwork and make a recommendation but that is about it. This is why I always considered APS kind of a bad joke.
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Reply to bryort
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This sounds like a situation of legal and financial control by your brother, but literally "dumping" the problem on you when it suits them.

If you do step back as others recommend, I suggest you do so with a notification in writing, documenting instances and emphasizing that you are stuck with the responsibility w/o cooperation from those who have legal authority.

You never know when your brother and his wife will create some unpleasant event or unfounded charges if you stand up to them.
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Reply to GardenArtist
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I would just step back. If they want you to take care of anything, say no, they have all the control, they have to deal with it and never ask you again. If she ends up in the hospital, that's on them.
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Reply to Evermore99
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Your mom is being taken care of, poorly, it seems, by your brother. She chose HIM for this job. Step back and let her be.

Take care of yourself, my dear. You have a lot to heal from.
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Reply to BarbBrooklyn
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Yes Barb. And I have been counseled to step back for my own wellbeing. But I get drug back in when she is sick - out of a sense of compassion and I guess duty. I will try to step back even if it hurts.
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Reply to Twillie
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If that is mom's choice, then mismanagement is what mom seems to want.

This is the mom who caused your marriage to have issues, and who was unsympathetic when your poor son died, right? Yes, there is a mental health issue. She isn't going to change. Neither is your brother.

I'm so sorry for your troubles. Take care of yourself.
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Reply to BarbBrooklyn
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Addendum: yes brother has HCPOA and DPOA. Sister in law handles the checking account. Mom defers to them for everything.
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Reply to Twillie
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I will try to answer some of the questions so as to clarify.

Yes my mom is insulin dependent. Yes she lives alone by her own choice. Yes she has a caregiver 2 days/week 4 hrs/day. No they do not help her with medication. Mom fired her previous doctor who recommended nursing home OR hospice care for medication management. So brother takes her to his personal doctor. Sister in law handles the caregiving agency. Both refuse to communicate with me - tell me I’m crazy and start BS. Yes I know all the doctors orders will be in the records, that is what I rely on and comply with at all times. My mother gives her own insulin but when she is sick she does not eat yet still gives the same dose. I have her in my home frequently for days at a time - this time she admitted she was “upset” the night she took too much insulin. She has used this a manipulative tactic before. There is a psyche issue here too. Thank you for all your responses. I will re-read and study them on my laptop. And then comment and ask questions tomorrow. It’s been a long exhausting week. Thank you.
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Reply to Twillie
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Twillie, I think getting a needs assessment would be a good next step. When the assessment is scheduled, Be There! People being assessed sometimes exaggerate their abilities and skills. It is good to have a knowledgeable person there to make gentle corrections. The person doing the assessment needs a realistic picture, not a fantasy.

Is your mother on insulin? That can make managing medicines much more complex. You say you see Mom at least once a week and that brother is seldom around. Is she supposed to be managing her medications on her own? And she has dementia? Yikes! A blood sugar level of 27 -- OMG -- do you suppose she took more insulin than she needed? Did she take her usual insulin dose and then not eat anything? I imagine that your Mom takes meds more than once a day. Not being able to take her pills correctly is what finally determined than even with all the support we arranged for her, our mother could no longer live alone.

Good luck!
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Reply to jeannegibbs
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Barb, you are SOOOOO right about the choice between happy vs. safe parents who are challenging.
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Reply to GardenArtist
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So, Tw, I went back and read some of your other posts, and it seems that you have considered calling APS in the past.

In all likelihood, they would find that mom is no longer able to live alone, and might get a temporary emergency guardian appointed so that she can be removed to someplace safe.

The choice, in caring for stubborn, noncooperative parents, is between keeping them safe and keeping them happy. Read Atul Gawande's On Being Mortal for a full discussion of that topic.
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Reply to BarbBrooklyn
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Twillie;

Who is her Medical, not financial, POA?

What does MOM want?

If mom is "competent" in the legal sense, what SHE wants is what happens. If she is resisting care, then there is little that brother or you can do about it. Until she ends up in the hospital with some crisis; then you call in the professionals to help with determining what level of care she needs.

Is she "just" diabetic?  I seem to recall that she has pretty significant dementia, such that Hospice was recommended when she fell and broke her hip.

I would use her next hospitalization to get the discharge planning department involved; you need to point out to them that she lives alone; people with dementia cannot and should not live alone past the early stages:  she desperately needs medication management, and how can that best be accomplished.

I could be completely off-base here; maybe your brother is a penny-pinching jerk, but the fact that you state that MOM "will not" accept the idea of AL tells me that there is more than just brother being stubborn here, maybe.

Rather than APS, have you considered calling the local Area Agency on Aging for a needs assessment, or asked her doctor to order one?
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Reply to BarbBrooklyn
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Document the episodes when he's there and doesn't provide proper care. EMS and ER will also have records to support the diabetic emergencies.

You can call APS, but I would be concerned that they might see friction in the family and file in the local court to have a so-called professional guardian or conservator appointed, taking control away from both of you.

You might itemize the issues and present them to your brother, and try a conciliatory approach to get him to recognize the danger he's creating. I suggest this b/c it would be better if he could be made to realize the treacherous path he's navigating and work with you instead of against you.

Since he's a professional, try a business type approach, i.e., a situation exists, we need to discuss and resolve it, amicably, and both of you need to find a solution Before someone outside the family does. Let him know that EMS and hospitals are mandated reporters and must, or may already have, reported the diabetic episodes to APS.

APS may have to be involved if his behavior continues to be neglectful of your mother's needs. And if this happens, he could be out of the picture, even for visitation. (I've seen that when I worked for an attorney involved in guardianship and conservatorship.)

I know this sounds naïve, especially since he's the one who's out in the world earning presumably big bucks. But given the danger of another diabetic emergency, and the possibility of both of you losing control, trying to reach an accommodation stance is better. If you can't, then you can share that information with APS if you call them, but do be prepared for them to conclude that the situation between you and brother is not a workable one.

You might also share the information with the doctor managing her diabetes, and ask for a written guideline or instructions that you can show your brother.

You also might try to explain that to him, i.e., that HE's caused these emergencies b/c of failure to comply with medication, that the medical records will document the details, and that he could be considered negligent if he fails to follow proper medication and care procedure. I wouldn't think he'd want to deal with legal charges against him; it would affect his employment record.

And remember, if he's proxy under a legal or financial POA, that doesn't give him authority to ignore medications or make medical decisions on your mother's behalf. And that might be a "step-down" alternative for involving APS; instead of removing control by either of you, they could "counsel" him and advise that his "care" needs to be compliant with your mother's needs.

Another option might be for him to "help" with financial contributions to pay for care in a facility where he can't meddle or ignore her care needs. That might put some fear into him and shake him up a bit.

That's also a concern regardless of your brother; is she living alone? Is she able to manage her meds if you or brother aren't there? Is there any consideration of in-home help for her, since she refuses an outside placement?
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