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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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I'm so glad that there was a good outcome in court!
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That's really great that you were able to get guardianship over your mother and get her into a safe place with the help she needs. Let your mom moan and groan all she wants, sometimes what a person needs is not going to be what they want. You are doing what is best for her. She is clean, safe, fed and has medical professinals to take care of her. Happiness is a choice. Only she can make that choice.
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Update: I got the guardianship in June, and immediately put my mother into a lovely two-bedroom/2 bath assisted living apartment. She is not ready for memory care as she is not a wanderer. Although she still complains about being forced to move, she has adjusted well. The facility is expensive ($7,000+ a month), and the legal costs were approximately $18,000 but I am so relieved she is in a safe place. In the process now of selling her condo. Thanks for the advice here and support!
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What a dreadful position you are being put in.

I would not accept guardianship from a judge that would not "get" that mom needs to be in a facility, since she is consistently refusing in-home care.

Check with YOUR lawyer, but if that is what is proposed, I suggest that your lawyer counter that you will allow your mother to become a ward of the state if that is her/his decision. Let someone professional get paid to force care on your mother at home.

Make sure that HER lawyer informs her that you are "walking" because she's uncooperative.
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Beware - we were in a similar situation. Mom refused to move, considered herself independent, yadda yadda, and after a few months of daily one-hour visits (not really tasked yet to do anything) from nursing aides, refused to let them in.
What got me to this site was to find out how we were supposed to move her. In her case, she had dementia, beyond early stages but still somewhat functional. Refusal to go meant we started to explore the guardianship, but the assisted living memory care place we selected WOULD NOT DO committals!! Not only that, but insisted that SHE had to agree to move in... GReat! She refuses and cannot be ordered in....
So, be sure to check with any place that you have selected for her to be sure they will accept a 'committal'. Someone suggested that perhaps they consider a committal as a difficult person... We got around this in a different way.
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I am the original poster, Middledaughter, with an update: Although I have a durable POA, it's not enough apparently to force someone to move out of their home if they resist. I hired an attorney and I am seeking conservatorship (over financial) and guardianship (over her person.) The court appointed a guardian ad litem to recommend what is best for her, and because she is contesting the guardianship, the court has appointed independent counsel for her. So with three lawyers involved, it ain't gonna be cheap! Fortunately, in her state, it comes out of her assets (which are considerable) and not mine. Now that the hearing date has been set, I feel relieved. My one concern now is that given her strong objection, the judge may give me guardianship but order me to let her stay in her own home (with 24 hour care.) Given my experience with home aides, who do what she says and not what needs to be done, I don't see this as a great option.
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Middledaughter, so glad you are making progress. I know its hard and you might feel like a "bad guy" to your mom. As her dementia progresses, she will probably forget a lot of this and not harbor ill feelings. My mother was angry for several years about us selling her car and moving her when she was in the "in-between" stage of dementia. The last few years of her life, she still complained but she didn't connect it with anything we did.
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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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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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You start the petition for Guardian, it is long overdue. The court can decide whether she can stay at home. Your sister can have her say in court.
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Your mother needs a 24/7 in home person as it looks like you can afford this. A nursing home will not be able to cope with her at this stage. Do you have a POA?
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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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There are worse things than having your mother not speak to you.

Please take care of her instead of worrying about a relationship now.

Sorry for your loss.
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I think you may just have to involve APS but start with the people at Eldercare to see if they have any ideas. you said she has long term care insurance which is good. Do you know how long this will last?
As far as meds are concerned discuss with her Dr what is really necessary for her to continue to take or what can be added to make her more compliant. the fewer the better is usually the best choice. Time to act before things happen by themselves.
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I thought of an idea for those who refuse to take dementia meds. The caregivers can actually see if there's a liquid version they can just mix with the persons drink, or a type of pill that will allow for crushing and mixing with the person's food so they'll never know they're actually taking their meds. The caregiver can actually pick up the meds for the patient and just don't let the patient know they have it so that way there are no fights over meds. The person will never know they're actually taking their meds if it's blended well enough with food or even smoothies. Your blender is your friend, perhaps consider using it to make healthy smoothies and just slip the medicine in there with the ingredients. Approaching it this way sure beats fighting the person to swallow a pill when they don't want to because that way they'll never know the meds are actually in what they're consuming
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I'm nearly at that stage in my mom's case. She's one step behind in that she won't even accept the doctor's diagnosis of dementia or take Aricept because she is convinced she doesn't need it. I'm grappling with the same issue, i.e. home care or moving her into an assisted living place that has a memory wing that she can be moved into. I appreciate the information on this string.
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Well, 'middledaughter', you will just have to shut your ears to all the outcry and arrange to do what is best for your mother, and get her into assisted living, or memory care, for her own good. So WHAT if she objects and laughs in your face? What's she going to do? Call the police and have you arrested? Sue you? Let her vent and throw a fit. Her time for living on her own is OVER, she can't maintain a safe, healthy life on her own if she won't let the hired help give her medication or whatever. Your mother is not who she used to be, her brain is deteriorating..... If my 5 year old ran out in the yard and poooped in the kiddy pool, slept under a bush, and wouldn't eat anything but cheese doodles, would I just stand there wringing my hands and asking for advice? No! Measures must be taken for that kid's own good, medical attention or a special program if needed, in spite of the certain battle of wills that is sure to come. So must you 'man up' and do the right thing. So, you have everyone's permission and encouragement her to do it.
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I found that with my Mother I had to become the adult as she became the child. With the dementia they do not think things through clearly. They do not remember doing some things. They do not understand timeline dimensions. If you have POA, I would check further in the document to see what further powers you have in order to make sure she is taken care of. Work with her doctor. We had her move in with us after she broke a hip but it was a mentally impossible environment and she wanted to go home. My brother and his family moved in to take care of my Mother but it was physically and mentally an impossible environment. My brother dumped her into a terrible nursing home and left. After visiting a few times, (45min drive 1 way), I knew we had to get her out. We found a nice Assisted Living place that gave her an apartment, meals, laundry, etc. and was affordable. Got her VA benefits applied for, set up and sold her home and put that into an account to pay for her care. As she slowly declined from Parkingson and LBD and then a broken back from a fall, I was so happy that we pushed to get her into a nice care place.
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Boy does this sound familiar. Do you have POA? Do you have her on the waiting list for AL or memory care? If you have the dementia diagnosis, and have POA - you should be able to place her in memory care. The facilities where you have a deposit - have they assessed her yet? That is key and that needs to be done.

I took my mom "out to lunch" at the ALF where she now lives and staff assessed her then. I just said we going out to lunch and meeting a friend of mine. She was mad when we got there, but then forgot all about it because she had a wonderful time.

I would not place your mom in a ALF that does not have a memory care unit. Also, if she has not been assessed - the facility that has your deposit may not accept her. My mom can be very argumentative and a risk for wandering - so when assessed - they said she needed to be in a locked memory care unit.

I could not take her kicking and screaming - to emotional for me. So I hired a geriatric care manager to move my mom into the ALF. Once again, she was taken "out to lunch" and then told she would be staying there for awhile. That way, she did not associate me with the move.

Its never going to be easy, but there are people who are not emotionally involved and can help you with the move. To this day, my mom doesn't think she needs any help and she thinks her mind is fine. There is no rationalizing here. If you have to trick her, you have to trick her.
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The only thing I can add, besides agreeing with most of what was already said (are you my long lost sibling?) is this:
Our elder care attorney told us we cannot "drag her out of the house" if she refuses to go. We were ready to take that next step and get guardianship to get her into a memory care place, but THEY will not accept committals (I posted a question on this forum about this).
That said, I can also relate to the sibling issue. My younger brother refuses to listen to the information I looked up and provided, but doesn't research on his own (he is VERY computer saavy, so that is not the reason). He is ADAMANT that she would want assisted living, not memory care. Despite the facilities (the first he found and we went to, and the place we decided on) telling him this, he still is being a pain in the butt, and will likely continue. He doesn't/won't accept that assisted living is mainly for people with physical limitations. Memory Care assisted living provides the physical help, when needed, but is more secure and safe - the better choice for our mother.
It was finally worked out (hopefully, she was just taken there at about noon today) by seeing a new doctor local to the place (her other long-time doctor office has been ignoring me and all my requests) - between durable power and doctor saying she should be moved, we got over that hump.
We also tried the aides, but after a few months, only an hour/day to "check" on her, she refused to let them in.
At 93, with limited hearing, macular degeneration (legally blind in one eye) and dementia, the woman needed to move months ago, but without the doctor helping, we could not do it. She has been living alone, and refused to go to brother's, I cannot physically take care of her. She was supposed to move in Tuesday, but developed cellulitis (dangerous for anyone, even more so for someone her age and mental status!) and the move was delayed.
If YOU have durable power and doctor says needs to be done, then it comes down to little white lies to mom. Take her "to lunch" at the place and let them take over. If sibling also has power, I would just not discuss it with him/her and move forward. My next step if brothers, doctor and facility wouldn't work with us was to call social services and let them take her out. She'd go to a nursing home, which I believe is covered for 60 or 90 days by medicare, but we didn't want her there. IF we had to go that route, then we could maybe get her to agree to another place nicer as she still has some mental function - mainly short term memory and being adamant that she is independent, can get out, people come in and can take care of herself (none of it true except in her mind).
I hope the best for you. The stress getting to this point has been tremendous for me (younger brother fights everything we try to say or do, older brother lives in NC so he can only help when he comes up. Everything falls on me, all the calls, paperwork, etc, fighting to get what she NEEDS! BTW, if your dad was in the service, you might be able to get veteran's benefits to help pay. We did the whole trust thing for all her money and condo to protect her assets last year. VA requires minimal funds or they won't help. Despite all the physical help needed for moms and dads who are suffering from this, there is a ton of paperwork to do....
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Hang in there! I was in a similar situation with my mom not wanting any help. She left lights on continuously, left the water running, and she left the stove on almost burning the house down. There was also strange behavior which almost tore my family apart. I tried to hire aides but she wouldn't let them in the house unless I was home (I work all day). She was diagnosed with dementia a couple of months ago explaining the mental issues. Now she is in a assisted living facility with memory care with the help of many people( Doctors, Assisted living workers, and my wife), due to her refusing to go. She is doing good now and I'm able to take care of my family knowing my mom has the care she needs. Make sure you have the POA documents since you will have to make all of the decision on her behalf. Do what is best for You and your mom. Take care!
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It's good to hear stories about elderly people who are careful who comes into their homes, it seems like someone was smarter than others may have given her credit for. Kudos to her! I'm glad she was smart enough not to let anyone in except close family she trusted. Only let those who trust in your home because you're sitting duck if you're too trusting and let the wrong person in. I'm not up there yet, but definitely smart enough to not even answer the door unless I'm expecting someone and not answer the phone unless it's someone I know or I'm expecting a call from. These days that's the way to be for safety and prevention of scammers. Always protect yourself and your home. Again, kudos to that woman who was smart enough to protect herself in her own home by not letting anyone in except trusted people, good for her! If she's still living, tell her congratulations, I'm very proud of people that smart especially when they're most vulnerable, I'm just amazed and I think that story just made my day! 👏😃👍
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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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Sometimes people are just not in a position to be able to do anything like others are. At very least they would ask around if they don't know the ropes like I had to with my foster dad until I finally found out there was such a place as the APS and where it was. If you're not able to intervene, they can't hold you reliable for that if you just don't have the knowledge or resources. However, as mentioned here, they can hold you accountable if you flat out refuse when you know someone's in danger, but I tend to think that only if you've voluntarily taken responsibility for them as a or guardian or medical POA. I know when my foster dad was declining and had no guardian, I was definitely not held responsible since I was not in a position to be able to help him. At very least I could do is start calling around and asking to see where I may turn after telling about the situation. Most of the time no one could help, which made it much harder for me because I lacked the help needed to get him out of a house that could've fallen down on top of him anytime, and I definitely didn't have the help needed to get other stuff done for him that clearly needed done. This was one of those situations where a friend finally told me that I've done all I can do at that point and all I can do is let whatever happens happen because there's nothing more I personally could've done in my situation. I was by no means held responsible for him, I was already doing everything I possibly could with what little knowledge and resources I already had. I was glad the APS finally stepped in but I was definitely not happy with the guardian who had to end up taking over everything. Sometimes when guardians take over, things don't always turn out desirable or favorable to the family or other loved ones, but I guess that's just how the cookie crumbles sometimes and there's really nothing much you can do about it when I big shot lawyer happens to be your loved one's guardian. I hope I never get that bad and need a guardian, because I could at very least sense when somethings wrong and throw a fit about it and become very combative and uncooperative like my foster dad currently is. I think something is definitely going on in that nursing home that shouldn't be going on because I can see it in dad's reactions
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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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I agree with others that you need to move ahead with whatever will get your mother into a safer situation. It is unlikely that AL is the best choice so consider memory care. I understand how it feels when your mother says she will not speak to you. That might happen, but likely once she is getting the care and medicine she needs, she will come around. With my mother i had to wait for a crisis. After a hospital stay, she was transferred to a nursing home for rehab. I refused to take her home and eventually i moved her to another facility. I did have POA.She accused me of every nasty thing such as stealing, lying, etc. It was deeply painful. Now 8 months later, she has settled in, and has forgotten how much she hated me. Of course you have the complication of a sister who wont back you up. One thing I did was restrict my visits with her for while. I did not see her alone and came only twice a week. One visit was a treat going out. The other was a bit more social and taking care of practical matters. You are not alone going through this. I got terrific support and practical advice here. Good luck to you.
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I've said this before relative to my own situation with my mom, but there is a point, as other posters have said, that the parent-child roles reverse. I'm getting there with my husband too. You should also realize that if someone comes into her home and sees the state in which she is living, they could very well file a report with Adult Protective Services. It's time to use whatever means you need to in order to get Mom the care she needs.
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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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To me, it's pretty easy. What's more important? Her well being or the threat of never speaking to you? How involved is your sister in all of this? Maybe she needs help as well.
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