How do I help my husband who is the caretaker of his mother (92) who lives alone 300 miles away?

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She has increasing dementia.

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She should not be living alone. She should be in a Nursing Home or an Assisted Living facility.
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tgreene, there comes a time when someone who is in their 90's and has dementia cannot be by themselves. Along with dementia some times comes fall risks. Plus dementia can remain the same then out of the blue the next day become worse. I've seen that with my Dad.

Agency caregivers are so very important but only if your Mom-in-law would allow the caregivers to come into the house..... my late Mom [97] refused caregivers after the third day, and had also refused cleaning help. There was nothing I could do as it was her and my Dad's decision, thus both had to take the consequence of that decision. It took a serious medical issue for me to get caregivers into my parents home.

As others have recommended, if there is a financial Power of Attorney, then take over all of Mom-in-law's bills and other financial issues. That helps in keeping away scams when Mom says "you have to talk to my son".
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I sympathize my mother is 600 miles away. In addition to a POA. He needs a directive for healthcare and give that to each dr so they will discuss health issues with him.. Also if he has bank accounts they may want there own POA instead of a generic one. That has been my experience . My father put my name on there checking account years ago and that helps. I can write a check for my mothers caregiver from her checking account.
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Most importantly, have your husband obtain Durable Power of Attorney on behalf of your Mother-In-Law and then get engaged with her doctors office as soon as possible. My husband's 91 year old mother who lived 200 miles from us, experienced a lot of anger and paranoia issues in the beginning as her dementia took hold. (My first post on this site, in fact, was focused on her paranoia and anger issues...you may find it helpful to read some of the great suggestions I was offered in reply to my questions in that post). Mom wanted to die in her own home and we did everything in our power to support that decision. (She is still living, however has abandoned the concept that she can remain independent as her executive functionality is caput and she is absolutely unsafe living alone now...she is safely nested in a Memory Care facility 20 minutes from our home and for the most part, couldn't be happier). While she was still trying to live out her days in her home, though, we communicated regularly with Mom and with her doctors office, most especially the medical social worker employed there who helped us orchestrate a support network for mom from 200 miles away. Because Moms behavior was replete with a lot of accusation (you have stolen my corn cob holders... you stole my bermuda shorts... people are stealing my bushes in the middle of the night) and denial (I don't need a damned doctor...there's nothing wrong with me...etc) and she also needed treatment for hypertension, we were able to secure a psychiatric nurse (through the doctor's office referral) to visit her once weekly for BP and wellness checks which Medicare covered. This lasted for a few months until Mom became suspicious and angry with having a nurse visit weekly. It was a good run, though. We also engaged Meals on Wheels to come to her home M - F with nutritious food as she was no longer reliable (or safe) in the kitchen. We found a food store and pharmacy that offered delivery and had snacks, fruits, juices, etc as well as her meds delivered for her. (She stopped driving in 2012). Eventually we brought home health aides into the mix with hope their presence would help her with taking her medication, keep her clean with baths (she had stopped bathing) and counter her isolation and loneliness just by being there. This worked for about one month, but as fate would have it, her need to be relocated into assisted living came to play before the aides completely wore out their welcome). We had taken over Mom's finances this early spring and had her mail forwarded to our home. Unfortunately, we left her with her checkbook and credit card, as we didn't realize at the time that she could no longer be responsible with them. She made several very expensive purchases and was rooked into signing a very large check to a contractor for work she did not need done on her house. Because the home health aides were present at the time of the transaction, we were made aware of its occurrence, unfortunately were too late to stop payment on the check and are currently in court with charges against the contractor for elder abuse - financial exploitation. (She still lost the money, but we are trying to keep this guy off the streets). We took the checkbooks and credit card, a day late and more than a few dollars short. Her doctors office advised us that Mom was at great risk for this sort of stuff as she lost her executive function. By early summer, when we spoke with Mom about her financial situation and her living conditions (deplorable, this once fastidious person had stopped doing Anything domestic or in support of her quality of life), she had no recollection of having spent money, or that she was running out of it. We were fortunate. She (Thank God) finally came to agree that she could not continue living alone this way. She said, "I'm ripe to move, I can't go on this way...something is wrong with my head and I am scared". We immediately started searching for facilities that were near us and would work with her dementia. We luckily found one that had an available bed. It's terribly expensive, but we were able to get her started there and cover the first three months of her rent. We have finished emptying her house out and it is now for sale to pay her way in assisted living, memory care. I apologize if I have rambled, it's been a long trek and the journey is not over. I thought perhaps someone else's experiences with a situation similar to yours could be useful to you as you find yourself caught up in wanting and needing to help a loved one as they progress down the awful road of dementia. It's so difficult, watching someone go downhill like this. It's worse though, when they are far away as it makes you feel powerless to help them and ignorant of what might be going on without you being around to help or stop things from happening. Ultimately, reducing the distance between mom and us has, so far anyway, had a positive effect on both Mom and Us.
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I am caregiving for my dad who is 250 miles away. It is not easy. I have engaged a local caregiving agency that sends caregivers to him for 8-10 hours a day. He can manage the remainder of the time right now. I highly recommend using an agency rather than trying to self manage caregivers. It has taken a while to get the "right" caregivers that he gets along with. Plus, if someone calls in sick or has to leave early, they agency has the resources to make sure there is still coverage. Dad is fortunate to have long term care insurance that helps cover these expenses. The other thing that has proven invaluable is that I have set up Nest Cam security camera's throughout the house. Bedroom, living area, basement. This allows me to check in and see where he is and to make sure everything is OK. How many times have you called and gotten no answer and worried about what was going on ? This camera system is priceless for peace of mind and extended care giving. Also, a Life Line device for her to wear is also a huge help/support. There are Life Line devices with automatic fall detection. If it detects a fall it auto calls for help. Again..priceless. Good luck!
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Is she living alone?
If so you have a few options.
Have someone come in to care for her. But at some point someone will have to be with her 24/7.
You can hire live in caregivers or come and go. Advantages to both and real drawback to both.
You can place her in Assisted Living until she needs full Memory Care.
If you choose to do that you have 2 options.
Place her where she currently lives and has friends that may visit..once in a while until they no longer have time or get busy doing other things.
Place her close to you so you can visit and have more direct contact and more contact with her medical team.

Whatever the choice you should see an Elder Care Lawyer to make sure all the papers that are necessary are i order POA for Health Care and POA for Financial. Will and any Trusts are set up, if there are any assets.
If there are no assets will you be needing to apply for Medicare? If so that process should start as soon as possible.
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Have all her legal documents reviewed. Who will be made POA if she is declared incompetent? It has to be your husband for him to be the legal caretaker. The job is difficult so make sure everything is set up correctly.
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I doubt seriously if she is safe alone. He could ask her MD to send a visiting nurse to check her weekly. Not sure if her insurance will cover that.
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