Have been trying to get psychiatric help for 15 years for mother who just turned 89, since a private detective telephoned in 2005 to tell me my mother had hired him to spy on a man she had had a crush on for 40 years. In her mind, the man wants to marry her (he died in 2012, she refuses to believe so).

Her delusions are compartmentalized, so she can appear superficially functional, while behind closed doors she is a recluse, a hoarder, she gives away money to scammers, her finances are disordered, her hygiene is poor, and she has paranoia, believing neighbors enter her apartment and steal worthless items. Occasionally, she has accused me, her only child (daughter) of thefts.

I need to hear from anyone who has experience getting psychiatric intervention for a senior with a longstanding mental health problem (hostility, delusions, some paranoid) who is also losing capacity to manage her affairs, from hygiene to money. No, I don't have any POA. The thought of her granting me that is laughable.

In New York, we have Article 81 of the Mental Hygiene Law to get guardianship/ conservatorship. I've heard it's a difficult process; if you are familiar with getting an Article 81 guardianship, do share your experience!

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What diagnostic workups has your Mom had?
What is she diagnosed with?
Is she on Medication.
You will need excellent documentation of diagnosis for any of this. There is likely to be a court battle. You may be looking at 10,000 in costs at the minimum and without facilities she may remain where she currently is on medication.
For myself, given I did not live with this woman, nor she with me, I would allow the laws of the State to intervene when intervention is deemed needed by the State or the Laws thereof.
At the least, if you are moving forward with this, now is the time to see an Elder Law Attorney in New York.
You can't get blood out of a turnip. It may be impossible to do anything about this realistically.
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ToBeHelpful Jan 2021
She is not on medication, she thinks she is flawless and everyone else is the problem, a typical attitude of the mentally ill. She refuses help. Her diagnosis is self-evident if you are familiar with the field of psychiatry (I studied psychobiology in college but ended up in investment banking LOL): Delusional Personality Disorder (DSM IV). She is a nuisance to the people in her co-op, the management wants her out. I have years of documentation. I know to see an Elder Lawyer, I was just hoping someone who'd had to 'hoe this row' before me could give me the benefit of their experience.
Are you living with her or she with you?

Is she a danger to herself or others? (That is the basis on which you can call 911 and have her get an involuntary psychiatric evaluation).

Have you called APS and reported her deplorable living conditions? If she is competent (and it sound like she is) she can live any d@mn way she wants).

Finally, what would you like for her?

Have you called the Area Agency on Aging (call 311 to find out what contract agency covers her neighborhood) and talked to them about her situation?

Getting guardianship is extremely expensive and you might not win, given that she would probably contest it. If yoi won, she would not be anymore ammenabke to yoir help, AND you would be legally responsible for her.
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ToBeHelpful Jan 2021
We do not live together, I live 125 miles away.

Her building management called APS and the verdict was that her apartment is cluttered, but not that bad.

I called APS a few years later but she would not let them in.

She has tantrums, physically attacks me, and throw things at me, but absent bloodshed, police are disinterested.

I would like to have a health aide of some sort checking in on her regularly. Her mental illness is much worse because of her isolation.

Ultimately, I think she would be much better off in a retirement home. The two times she spent a month at a nursing home/rehab when she had each of her knees replaced, she was so happy to have people around and things to do, she brightened up immensely. It was so remarkable to see.

But when she is at home, alone, she looks down her nose at "old people" who live in "nursing homes." It's an irony, because I feel right at home with older folks living in community, probably because my grandparents (her parents) were so dear to me growing up.

I am not terrifically concerned about the cost of getting guardianship, I think the cost of not getting guardianship is much higher. Obviously, she is consistently self-defeating. I would like to see her house(s) and her finances put in order so she can be comfortable until she is 99 or older, and I can thereafter inherit an orderly estate, rather than spending years after she is dead continuing to tidy up after her.
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