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I'm my mother's only child and the only family member who lives anywhere near her. Without getting into the backstory, we haven't exactly had a great relationship. Suffice to say that my childhood was abusive and I left home when I was 17. I still tried to include her in my and my children's lives to no avail. She only reached out to me, her siblings or friends when she needed something and eventually alienated everyone despite our attempts to contact or visit her. It's been a couple of years since we were in regular contact but I made sure the management company of the senior building where she lives had my phone number in case of an emergency.

A few months ago, the office contacted me because she was being a nuisance... knocking on neighbor's doors in the middle of the night, screaming and yelling and calling the police a few times a week, convinced that the super was stealing from her or moving things around in her apartment. She also burned a plastic container on her stove and had been taken in for an overnight psych evaluation. At the time, she was found competent and allowed to return home. Despite our past, she's still my mother and needed help so I started visiting and calling frequently. Eventually I learned that not only was she not eating well or taking her meds even though I'd bring/buy her food and remind her to take her meds but her behavior had become even more erratic than the management company led me to believe. She would cover the sprinklers in her apartment with plastic bags because she swore that they were cameras that the super was using to spy on her. No matter how many times I'd remove the bags and explain that the sprinklers were for her safety, she'd have them back up the next time I visited. She was also leaving the building at all hours of the night (in not the safest of neighborhoods) and would sometimes be brought home by the police because she'd become confused. A couple of weeks ago, she was threatened with eviction if her behavior continued because it violated terms of her lease.

I was looking into assisted living (there's no room for her in my apartment) and had set up an appointment to take her to mental health clinic for an evaluation when she had an extremely bad episode of paranoia and was admitted to the hospital. She was diagnosed with dementia and it was decided by everyone who's evaluated her (even the bioethics department) that it's no longer safe for her to return to her apartment alone. There are no resources to hire help for 24 hours so she'll be going to a nursing home.

She's been in the hospital almost 2 weeks now and feels there's nothing wrong with her so she should go home. Her extreme paranoia is being controlled somewhat with medication but she gets very agitated and verbal. My visits with her start off nicely then she lashes out and calls me all sorts of nasty names, accusing me of wanting to get rid of her so I can have her money (she has some savings but not enough to pay for more than a month of home care). She'll be discharged to a nursing home soon. I researched and visited several places and let the social worker know my top choices which are all very nice, well rated and reviewed and have specialized care and activities for patients with dementia. They're also close enough for me to visit weekly if not a couple of times a week.

So how do I explain it to her when she's convinced there's nothing wrong with her? Can I even explain it to her in a way that she'll comprehend? Or should I expect to be nothing more than "the bitch" as she's now referring to me regardless of what I say?

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I don't even think you yourself would have to explain anything to her. Just defer to the hospital social worker, the doctor's recommendation, etc. It's easier if you don't make it something that you did, let the other people be the ones who decided for her. In her mental state, and with all the reams of documentation from various places & people, what is the worst that could happen? She is not able to counteract what all the evidence says, so don't worry about it. Just help her transition, to a reasonable degree, but don't spend too much time on it. Your own life is more important, take care of yourself first.
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Just an fyi too just because you are named the POA or anything else doesn't mean you must take on that role.
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Your mom needs to be in a nursing home for her own good and that is at this point you know is the best place for her regardless of her objections. The hospital social worker will find a bed that is available that will meet her needs and the financial issues she will face. When my FIL was hospitalized it was hard for us to make that decision as we knew he never wanted to go to a nursing home but we also knew he had to go as we couldn't keep him safe or provide the type of care he needed. He didn't get discharged with the help of the social worker until a bed was found for him. Now we have since moved him from the first place as the first place did meet his needs but we thought there was better facilities out there. If nothing else the first placement will give you time to find a place that meets all the financial, physical and mental needs.
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With the help of the social worker and the discharge planner, she should be able to be in a safe place. She will need medications to help her settle in and it would be best not to visit for two weeks until she is acclimated. So sorry you have to go through this, but with proper meds she will be calmer.
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I think I would stress to mom that professionals have evaluated her and determined that it's not safe or healthy for her to go back home. I'm sure with her dementia that she won't understand or agree with that assessment. But that's the devil of dementia. She'll never get it, whatever you do.

You're acting on her behalf in her best interest, whether she gets it or not. Please, please, please follow the advice/direction of the professionals who say she needs to be in a nursing home. Then maybe don't visit too frequently so that she can get acclimated. Every time you visit, she's going to argue that she should be allowed to go back home and probably get agitated about it (like your visits now). So minimize that stress on her (and you) until she can adjust to her new surroundings. I'm sure the staff can give you an idea of what might work for your mom. You can be in touch with them as much as you like, just don't visit your mom for a while. Those would be my suggestions. It's not easy for either of you, but you're doing the right thing.
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Hi cher062 and thanks. I realize it's not really her talking but it's not easy to get used to and I want to make the transition as easy as possible for her. Not sure, though, how getting the hospital social worker involved means that I can't take responsibility. I have POA and am her health care proxy and take those roles seriously. I've spoken with pretty much all the hospital staff who are caring for her or have evaluated her and met with the psychiatrists and some staff from the bioethics department who became involved when my mother said she'd rather die than go to a nursing home. They had to make 100% sure everyone was in agreement that my mother's not competent to make her own decisions. It's my understanding that the social worker helps with nursing home placement and whatever other services are needed like applying for Medicaid. Is there something about her involvement that I'm not being told?
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Unfortunately you have to realize that this disease changes our loved ones dramatically. Yes we become the bitch or bastard for making the hard decisions that need to be made. You can't reason with someone in this mental state and 'normal' will never be what it was before. This is a thankless job that requires a saints patience. Just make the decisions you know need to be made, try not to feel guilty when your mom calls you every rotten name she can think of and know you still love her and will always do the best you can for her.
The good thing is that she is in a hospital. Get the hospital social worker involved. This will be the hard part but you have to let the hospital know you wont be taking responsibility for her (very hard to do) it will also mean you wont get a say in future decisions but if she is as bad as you say the hospital can't just let her out the front door either. The social worker at the hospital can help get the evals necessary so she can be transported and placed in an appropriate care facility. Your description of her behavior would rule out assisted living as well because there is violence there. She is going to need a nursing facility that can provide for that behavior. Keep strong and let the state help get things done.
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I guess it should be mentioned that she was found not competent to make safe and sound decisions for herself. I also have POA and am her health care proxy.
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