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My mother, who has dementia, has in home aides a couple of hours a day. They are supposed to help her bathe, take medication, do light housekeeping, and drive her to her many social activities. (She has a LTC policy that pays for this.) Unfortunately, the home care aides do what she tells them to do , and not what I have told them to do, which means my mother seldom gets a bath, and that she forgets to take her pills without a reminder. I want her to move to assisted living, and I put deposits on two different facilities. Her doctor says she MUST move to assisted living or get 24 hour a day in home care (based on recent cognitive testing). She laughs in his face! I am thinking of starting the legal process to get a guardianship, but I have no support from my sister who says our mother is happy (living in squalor -- did I say she refuses to have her house cleaned?). Her friends are calling us with concerns. She is showing up to bridge in soiled clothes with holes and serving moldy food to guests. She put back in the refrigerator old food an aide had thrown in the garbage. My mother says if we go the legal route she will never speak to us. Advice please!

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It sounds as if your mother needs to be in a memory unit unless you can hire 24-hour aids through an agency who, as was suggested, "actually do their jobs."

If you have a Durable Power of Attorney you can do this. If not you may need guardianship. Your doctor can back you up. If she never speaks to you - well, that will last about a day - but just roll with it.

Most elders have no idea how nice most modern assisted living facilities are. Yes, there are bad ones, but, in most states, they have improved immensely.Many are lovely and offer compassionate care. The same is true for many nursing homes. Both types of facilities often offer memory care.

I feel that this is a case where you have to override your mother's wishes because her brain will not allow her to think clearly. She needs your help. It's very hard, I know. We hate having our parents so upset with us. You'll need to be prepared for her to be nasty to you even after you move her. Just let it go. Eventually, she will likely get so that she enjoys herself, especially since you indicate that she is social. This could be the best thing that every happened to her, yet she may not admit it to you. Bite the bullet anyway and do what must be done.

Good luck to you with this. It's tough. Many of us know this.
Carol
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Well if her doctor deems her mental state is such she cannot be left alone, then just take her to the facility (with the doctor signing all necessary papers) and let professionals care for her. What difference does it make what she says? She has dementia! Pretty soon she will lose the ability to speak and you won't have to listen to her. What makes you think people with dementia are rational? You don't say if you have Medical Power of Attorney. If your sister says she thinks your mother is "happy", then she is in denial. Dementia is NOT a "happy" disease. It only gets worse and your mother is in a terminal illness, so put your adult, rational thinking in gear and help her because she cannot help herself!
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As mentioned here, it also sounds to me like she just needs to be in a different facility like memory care. If she needs round-the-clock care then assisted living won't cut it, not by a long shot. I wouldn't worry about her feelings when going for guardianship, you must do what you must do, you don't really have much of a choice in this matter if she needs a guardian. If you can't do it, someone else will believe it or not, like it or not someone will take guardianship of her even if it happens to be the state it's going to happen one way or the other whether she likes it or not. Not taking guardianship of someone in mental decline will result in serious consequences later when something happens like her wandering out into the street and maybe even getting hit by a car by someone who can't stop in time because she just ran right out there without looking. She could end up in some other very dangerous situation and maybe with someone out there with a criminal history. Another scenario is if someone doesn't have guardianship of her, she could very well end up getting scammed out of all of her money or maybe even forgetting to pay the bills and she gets evicted. Assisted-living is for people who can still take care of themselves and are ambulatory, not for someone needing nursing home care. You would hate to walk in one day and find her on the floor because if she falls and maybe breaks a hip, there may not be anyone around to help her back up. Another thing to consider is if she has a medical emergency, she may or may not be able to get to the help box to get help. There are so many things to consider before enabling potentially dangerous situations to happen by someone somewhere not getting guardianship. Not getting guardianship of someone who obviously needs it is very shady business, no guardian means bad things can happen anytime to that person obviously needing guardianship. It's the same thing with letting a child running loose and something happening to that child sooner or later, you just don't let children run loose no more than you would let a demented person run loose. My foster dad was a perfect example of why they guardian was needed because dad badly neglected himself and he didn't realize when the dump he was renting was actually falling down around him due to severe deterioration all because the slumlord let it get that bad. The multi apartment house clearly could've fallen down on him and I would've walked in one day to find him in the rubble. What actually happened though is wild animals were getting into the building. Yes, we had raccoons and stray cats even getting inside the walls. On multiple occasions though, raccoons would actually show up in dad's apartment, so this was a dangerous scenario and he had no guardian at the time and I was far from able to do that kind of thing. He had no blood relatives left and when you have a demented person in a dangerous situation with no one able to take guardianship and definitely no family, this is a very dangerous mix because dad could've easily gotten bit by what could've turned out to be a rabid coon. The wildlife authorities didn't want to seem to do nothing and neither did the city cops, or even the fire department. When the cops finally came, all they did was just take the raccoon out in the front lawn and turn it loose, only for it to find its way back in days later. I personally think we had a bunch of incompetent people working for our town and whoever was working in a position where a lot of wildlife was concerned and refusing to help was also in competent! Not one of those people should've ever been in those job positions just because they either don't want to do it or they don't handle these matters. If they don't help in the situations then what the heck are they even doing in those jobs? Public servants are just that, they're supposed to help even in situations like this where you have an elderly person who is declining and they happen to get a wild raccoon in their apartment and can't get it out. Yes, at the time I suspect my dad had dementia even at time, but I was at the point where I didn't recognize it until it further developed later. Dad should have had a guardian much sooner but hindsight is a very good teacher. Someone out there can hopefully learn from my experience because someone out there is most likely a first timer who doesn't even recognize warning signs of mental decline, and this can go on for years until one day you wake up and it's unmistakable and very obvious that you're loved one desperately needs the help you're not able to give them. Guardianship arrangements should actually be made very early as soon as the person is diagnosed with mental decline. Don't wait for something to happen before someone goes for guardianship whether it be you or someone else, even the state. Don't wait until the person is badly sick, hurt or broke due to scams before guardianship is in place.
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My husband and his siblings had a simular situation. At some point you become responsible for her safety. If you are aware she is in danger and don't do something you could be held liable. They had the doctor make the order and they took her to the home. You have to get your siblings on board. If they refuse speak to an elder care lawyer and let them know you have told your siblings your concerns and they refuse to help. This way you have documented proof.
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Update on my mother. I have filed for a guardianship. I felt such a sense of relief after doing it. While my sister decided not to be a co-petitioner, she is not fighting me on this. She will not testify on my behalf, but neither will she testify for my mother. I appreciate all the advice from everyone. (By the way, I do have a durable POA, but lawyer decided to go the guardianship route.)
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As has been said, this is very hard but...

What choice is there?

You have to bit the bullet and do what is necessary.

I was in a similar situation. I did force my mother into the AL, it was awful, and then she began to receive the correct medications in the correct dosages. And life was good. That was 2.5 years ago.

Today it is all just a bad memory. I visit my mom and she knows who I am and we play cards.

Even if your mom won't speak to you, is that worse than what is happening now??? Are you having great conversations with your mom?

Do what is the best for her and let the chips fall where they may.
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You have to think of her more like your child now than your mother. As with our kids who puff up scream holler and cry say I hate you & all that. Well they get over it. She will to. It may seem harsh for a bit but you have to do what is best for your mother bottom line.
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If your mother needs 24/7 care, AL might not take her unless they have a memory care unit. Unfortunately, neither home care aides or AL aides can force a patient to do anything. You need to get a doctor's documentation that she needs guardianship. I would guess a memory care unit aide has much more authority to get a patient to do things? (not sure, if a legal guardianship, changes things and you could give caregivers more authority, like with caring for a child too young to make decisons?) I just know in AL, my mother still refused to bathe and they could not, by law, force her. They only succeeded twice in a 9 month period to convince her to take a shower with help. AL doesn't watch residents 24/7, just assists physically, monitors to make sure they are safe, healthy and go to meals, keep their apt clean, etc.

Yes, you feel guilty, but the truth is, your mother is not your mom any more - you need to be her mom now - as hard as that is, it is for her own safety. She is incompetent and doesn't know it. Wouldn't a memory care unit be a lot less expensive than 24/7 aides? - and the upkeep and expense of her home, bills, etc (the stress of which is on you, not her) would be eliminated. Eventually you will end up cleaning out the house and selling it anyway. And you can use the money from the home sale to pay for her progressive needs for more and more care.
Our mother had many of the same behaviors, rotten food, filthy clothes, not bathing, forgetting to eat, stubborn, mean etc. Physically she was healthy, but unable to function in independent living. She couldn't be trusted to take medication, she wrote little notes all over the apt, then wrote notes directly on the refrigerator. My sister fought me on moving her for three years from IL (for 5 years previous to IL, getting her out of her house - where she refused to let anyone in except us - so we had it all). as she went further and further downhill mentally. Finally, the doctor agreed to document she couldn't live in IL with her level of dementia. IL then said we had to move her (which removed some of our guilt as it was a "higher authority" decision). The good thing is - you already have that from your mother's doctor, you just need to make it legal with the courts.

Of course Mom didn't want to move so we never told her the plans. Sis took her home for 3 days while the rest of us moved her to her new home. We gave her a tranquilizer, sat her down and informed her she no longer lived in IL. Then took her to AL and left her with the people who have dealt with these situations many times. Yes, we felt guilty, but at this point Mom could not make rational decisions and we knew she would be safer there. A plus over caregivers (some are good, others just babysitters) is AL has company of others her age, people to eat with and entertainment and professional staff there 24/7.

Even in AL, Mom struggled and 9 months later ended up in NH where she lived 5 months before passing in March. When the downhill mental slide begins, it is pretty fast but at least she had good care by people better able to deal with her problems than me (70 & sis 78)
Its been 9 months since Mom passed and I am still sad but know she is in a better place, and we did the best we could for her, as long as we could. Sad of the way things went for her because we waited too long to move her. We were so often frustrated and angry with her for not cooperating when we should have known it was not her fault, it was ours for trying to reason with a person who was no longer rational and not able to be there all the time.

I wish you luck. Try not to feel guilty, just tell yourself that you are doing what is best for her, and the situation is just like a child who resents a parent telling them what to do, realize this is the point in life when roles switch.
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If she does stay at home, you need someone that is going to do what should be done not just listen to what she says. They need to do the cloths washing while they are there (all the clothes). They need to police the refrigerator and not just put bad stuff in the garbage but in the outside tub so it is unassessable. Some pills can be acquired in liquid form so it is easy to add to the food or drink. Also bathing doesn't have to be every day, but a warm towel in the morning can be refreshing. As for your sister: Ask her to be there 24/7 for one week and she will realize her mother needs help. Each kid wants to think their parent is ok, so there is some denial that sets in. If she doesn't notice food on her clothes then her eyesight might be going bad. My mother washed the dishes. I dryed so I could spot unwashed dishes and put them aside to wash again. Your mother mostly needs more asertive home health care people.
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Oskigirl -- I recommend your concept of moving her into an assisted living place that has a memory wing that she can be moved into. In retrospect, I realize how much damage I did to my health and peace of mind by delaying placing my husband in a nursing home.
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