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For the past 5+ years, I've been caring for my 84 year old mother who has dementia in my home. In the past month she has had a precipitous decline cognitively...knows my name but doesn't realize I'm her daughter, wandering, agitation that's starting to border on aggression, thinks her parents are alive & doesn't recognize my home as her home any longer. Fearing a UTI, I took her to the doctor. Urine was clean & we're awaiting a CT appt to compare to her previous one 2 yrs ago & to rule out strokes or tumors or whatever. He did a mini-mental...the first one that she's ever had to my knowledge...and she scored only 13/30. He stated that, in his opinion, she is incompetent to refuse nursing home placement but did add 3x/day Risperdal, & Trazodone at bedtime with the Seroquel she was already on to see if we could eek out a few more mon the at home. The first few days, she was markedly better...much more relaxed, less argumentative & less agitated. Last PM, she had about an hour to an hour and a half period where she was agitated that she needed to "go home" & there was no changing her mind. She is 100% completely self-ambulatory & I wasn't certain what I was going to do if she went outside & refused to come back in. Eventually she calmed & slept through the night. Tonight, starting around 5pm, she was extremely agitated, adamant that she was left in charge of my horses, that they were no longer in their fenced pasture & that she had to go get them back in. No amount of talking or showing her that they were safely contained appeased her. In desperation, I gave her the 1mg Xanax I can give in "emergencies". It didn't faze her one bit. It was as though I'd given her a Tic-tac! I'm pretty certain at one point that she was on the verge of striking me physically, but never did. Thought I had her convinced that all was ok because she could see them through the window next to her chair while she sat & watched TV & I prepped a very quick dinner of cold ham & cheese sandwiches (didn't want to be away from her long). I no more than got the first one made & looked out the kitchen window to see that she had slipped out the back door, down the lane to the barn, over the bridge & through the gate into the horse pasture. By the time I could bolt from the kitchen , she was attempting to get one of the horses to go towards the barn. The horse dutifully did as asked but then took a sharp turn to the left to avoid going into the barn & would have inadvertantly knocked mom down if it hadn't been for a nearby wall. As I'm running to intervene, she tried again with one of the other horses....one that's been known to kick first & ask questions later! Thankfully, he was in a good mood & simply walked away from her...but the whole incident *could* have been very ugly! (Tomorrow, I'm buying a padlock for the pasture gate...but, the mood she was in tonight, I wouldn't put it past her to try scaling the fence!) Despite all of the meds & the additional Xanax, it took her 3.5 very loooong hours to calm down again. This "near miss" has me deeply concerned that I can no longer keep her safe here at home. She has a long history of refusing placement...and even said she would refuse it the day I took her to the doc. I know her elder lawyer will be the one to petition for involuntary admission due to incompetence but what are the steps that I should be expecting & how long does it take?

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Mom's elder lawyer told me the last time we talked that he could help me admit her to a home against her will by petitioning a judge to deem her incompetent as long as her doctors assessed her to be. It is her lawyer's own statement that made me think he would assist in filing & arguing that petition. I do have a few problems touring facilities & speaking with staff to get more info because I'm completely alone in caring for Mom. She would have to come with me & it's entirely possible that she'll pitch a fit & refuse to go in...in which case, *I* won't be able to go in. I'm gonna look into taking her to elder daycare so that i have the freedom to start touring nursing homes & pulling info together. Again, though, she has a long history of refusing to go there, either, and I'm concerned that she'll walk out & they won't be able to legally prevent her. As for documenting her behaviors, I've been texting a play-by-play of sorts to my bro & I've used the video cam on my smartphone to record some of it. Unfortunately, I was WAY to consumed with trying to appease her & keep her safe last night to have the time to record that.
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See an attorney who regularly does it. The process and rules vary by state. I'm curious why you think your mom's attorney will file the petition. Normally, attorneys don't sue their own clients. You might get your own attorney.

There are normally provisions for emergency situations when a person needs a guardian and their safety and welfare is in immediate danger and at risk.

Inquire from a Secure Memory Care facility in your area what they require to admit someone like your mom. Will they accept your DPOA, HCPOA and a doctor's recommendation of Secure care? I think it depends on the laws in your state.
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It sounds like she may be a candidate for a memory care facility. If bro disagree about getting her into care remind him that you're the one who has done all the heavy lifting and ask if he would like to take over.

Joint poas seem to lead to these disputes quite often. Start keeping a daily log of Moms needs and behaviors. If I have any meddling relatives when my folks go into care I have logs dating back over the last year with every crisis, fall, ER trip, meds, doc visits etc. Start laying some track.........
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Olly, you're wise to prefer that your brother visit while she's still at home so he can see for himself what the situation is. If he can't though, do you have any means to video some of the incidents, and/or document them secretly and send them to him so he can at least get a better idea what you're facing?
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Yes, I have financial & medical co-POA's along with my brother. He has claimed that he's in agreement with whatever I decide to do. He lives over 900 miles from me & hasn't seen her level of confusion or behaviors for 6 months but says that he's planning to visit the end of October. I'd prefer for him to be able to visit with her here at home for several reasons...I know he will be *extremely* uncomfortable visiting a nursing home, especially a dementia unit. Secondly, I want him to *see* for himself what I'm dealing with so that there is no chance of "You put her in a home before she needed it" kind of stuff later. Just praying I can safely hold out that long. She microwaved dry coffee grounds on a paper plate this morning while I had the dogs out to potty. The whole kitchen smelled burnt & then she tried to do it again in a coffee mug about 30 min later but, thankfully, I was right there & realized what she was about to do.
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If you have POA you can take care of her affairs. If not you need legal guardianship. The process varies from state to state but usually requires two docs to declare mental incompetence and a hearing before a court. In some cases the person in question may have to appear.
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Do you already have a POA that gives you authority over her housing if she is declared incompetent?

The lawyer will be able to explain the entire process in MO and what to expect. I know it is the weekend and you'd like to have some information NOW (I would) so I hope someone with this experience will pop in and answer you.

I can say that dementia often (usually?) reaches a point where the loved one cannot safely be cared for at home. It was reasonable to try to get a few more months at home, but it doesn't look like that is successful.

Have you researched memory care facilities in your area? Do you have financial arrangements made? A few months could help you deal with these practical matters, but you have to do what the disease requires you to do. I sure hope you can get an appointment with the lawyer very promptly, and get the ball rolling.

I am so sorry for what you are facing. I hope that between her doctor and her lawyer you will get the kind of help you both need.
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