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I work in the Mental Health field as a case manager. I drive about 4000 miles a month and provide services in home and at school. I share a home with my aging mom (80) and special needs brother who is 62. Mom fell and broke 2 ribs this year. Later she broke a hip.


I have been trying to juggle caring for both my mom and brother and work. However, my mom has a long history of abusing her children. She is also very manipulative. She has chronic UTI's and full spectrum hallucinations. Even though she has severe memory issues, gets confused and can't manager hers or my brother's money without over extending them each month (she is my brother's payee) the doctors at the hospital refuse to give her any kind of diagnosis other than depression. She is a master at masking her behaviors and maintaining when dealing with outsiders.


The last is frustrating because my brother is terrifed of mom. Last weekend she had him in the living room with a rifle and she was armed with a spray bottle of antiseptic. She threatened to spray me in the face twice. She was convinced there were intruders in the house. I took the rifle from my brother and relocated it off the property. I took her to the ER the following day after taking two falls. She had been refusing to use her walker and had crawled over the railing of her bed.


She is largely incontinent and I discovered she has been defacting in her underwear and making my brother wash them while I'm at work. She has also been doubling up on her meds or insisting she has taken them when she hasn't. She keeps trying to take out loans and I am already having to pay for their groceries and scripts.


On top of all this she is verbally abusive to both my brother and I. She won't try to do anything for herself (except shower which she'll do when I'm at work-this is a disaster waiting to happen). My brother and I wait on her hand and foot in an effort to maintain some kind of peace. Then she tells people we won't let her do anything. I have two sisters who live far away and haven't seen mom in 14 and 18 years because the sound of her voice sends them into anxiety attacks. I have no support and continually use up all my sick leave and vacation time because of various crises that arise from my mom.


I can't take it anymore and neither can my brother. She is in senior care at the hospital right now (the psych ward). We need her to go into the nursing home, but like I said, the doctor says she is just depressed. How can I get her into a nursing home without having guardianship or a POA?

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Your mother is mentally ill. Her behavior goes far beyond dementia or the mental incapacities of aging. She has been mentally ill for decades and decades and it sounds like it was always accepted and never treated. The idea that there are or ever were firearms in the house, and probably other weapons as well, is terrifying.

No matter how clever your mother is, she would not be able to fool a well-trained mental health professional, or a team of them. She needs to be institutionalized and evaluated and placed in the appropriate facility. What she has done to your brother is at the least abuse on a horrific level and quite possibly assault. It is unconscionable that it was ever tolerated, more so that it was tolerated all his life.

Your mother needs constant supervision by trained professionals; I mean 24/7. With her history, she should not be left alone with your brother. In my city a mentally challenged man who was his mother’s only caregiver recently stabbed his mother to death. He was convicted and is serving 8-10 years. The family reacted by saying they were unaware of “how bad it was” for their brother.

The next time she acts out, call 911 and tell them you fear for your and your brother’s safety. She needs to be Baker Acted. This is not something you can handle on your own.
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katydid1 Nov 2018
Excellent advice as usual Ahmijoy!!
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Ask her Dr at the hospital or you might have to see lawyer and do what is called a 51/50, this is for extreme messure for putting someone in a mental hospital, which I know that is were your mom is now. If I recall a 51/50 is that you fear that mom is danger to herself and others, which sounds like she is.
Next, you need to find out what you can do, if anything to get your brother another payee. You need to protect him in everyway you can.

If you can not get your mother the help she needs than you need to find away to help your brother and yourself. But the 2 of you "cannot or should not" live this way.

You might have to come up with a plan B that finding some where eles to live. You both deserve better. We can't always help family members (mom) who don't want help, so you save the ones you can & yourself.
I agree with Ahmijoy this goes way past dementia.

May God keep both of you safe and help you find the help you both deserve.
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Doormat2018
Simple solution!! Let the hospital know that you refuse to take her home, and why, upon discharge. They will then have to find placement for her. Stick to your guns (no pun intended)before she ends up hurting your brother or you. You can also report what she did to your brother to APS for further ammo to get her placed.  Good luck!!!
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Your mother is on a psychiatric ward, now this minute.

I should print off what you have just posted here, take it to her attending psychiatric team, and ask them for their constructive advice.

You could also contact your brother's team (through whichever office handles his SS payments, perhaps) and warn them that his mother will soon no longer be able to act for him. If you consider her treatment of him abusive, you can report that too. How has he been coping during her repeated absences?

And then, you can leave. You may feel responsible for your mother and your brother, but legally you're not - are you? - and practically you cannot solve this situation on your own. If you leave, the household will fall apart very rapidly. Try to get support in place for your brother beforehand.
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Yes, tell them you refuse to take her home and care for her any longer. You must work to make a home for brother. Tell them u fear for your life and yours too. Then you need to take brother to SS office and find out how u can have payee changed because Mom is not capable.
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Your a Mental health case manager, so what would you do or say IF you walked into a home with the exact situation that your brother and mother are in?

If you are a case manager, you well know the mandated reporter requirements, really you’ve got to deal with this cause if police or APS goes out to the house to do a wellness check and see the situation, it could cascade into problems for your job.

You know the answer......... your mom needs be get a proper geriatric psych evaluation, a medication management figured out and live in a controlled environment for her own safety and security. You have got to tell them clearly about the gun & bottle incident, the fecal stuff (& I bet she’s doing other stuff with sh** that you don’t even want to start thinking about.....), her chronic UTIs, the series of falls, etc. there’s a pattern that’s beyond being depressed. Really you know what needs to happen & this means she DOES NOT RETURN HOME. The hospital discharge planner will have to find a place for her and you have got to have this happen for your brothers sake.

And really while mom is hospitalized, get brother & yourself to the bank and open up a new checking account for him that you are signatory on and POD to you and then you two go to Social Security office to get his representative payee changed to you with direct deposit going to the new account AND then go and have a nice meal just the two of you!
The bank may even have a form that you can take to SSA, that SSa scans and it populates the banking codes.

Your 2 siblings that won’t have anything to do with her, if you can gird up and ask them about her abusing them or any incidents with her that led to their estrangement. Also when you chat with them ask 1 to be a backup signatory on brothers new bank account.
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anonymous806474 Nov 2018
Call APS as soon as possible, as she is a danger to herself and you and brother...…….they will listen and do the inevitable...your story on here says it all and yes do print it out...there is shame and you are the responsible one
here...its time to save yourself and brother as a relative of an aunt whos
children adult ones, wanted me to care for someone who was mentally off I simply refused
to help be caretaker,even though I would be paid,cook and friendly bottle washer to aunt who needed psy. meds,calling rescue four times in a week
for fear and wanting to be with someone,she did not like caretaker strangers..…..I was insulted and accused of being lazy…...u see I do not want the responsibility of a manipulative aunt crying out for attention nor should I.....…..I knew her pattern as her boyfriend left town to be with his family as she was declining...…...no wants this type of elder abuse at the
stretched moment...…...she needs to be medicated,sorry, and in a facilty
is there money?...…...Medicaid takes time to get down to the 2000 in her account..spenddown..then call an elder attorney..or the ambudsman at your local senior center...………………...o not feel guilty...……..no one can take care of your Mom now other than a professional..then they will put her on
some meds because she is abusive and out of control......
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I am a former psychiatric nurse. Your mother's problems go way beyond "depression." She is seriously mentally ill and needs to be in a place where she is no longer a danger to herself or others. (She might even have schizophrenia or schizoaffective, based on her symptoms.) It is unsafe to keep her at home in her current condition. Keep a list of all her weird behaviors and type them up in a formal document so you have ammunition to use both with a physician and a care facility.
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I just wanted to contribute in regards to a comment I see that mentions a 5150 (fifty one fifty). You don't need a lawyer to do this. A 5150 is an involuntary hold in a psych ward for 72 hours. Google "Baker Act".
I had to do this to my mother when I was growing up.
For what it's worth, there are really affordable cameras that record sound and video for $30 (plus the SD card!) on Amazon. I bought 2 from a company called Wyze. Anyway, you can put the cameras up and let her get comfy. Eventually she'll forget what you'll have footage that the doctors can use. Check your local law, your might not even have to tell her they're up, but if you do, make SURE you keep the recording of your explaining the cameras for everyone's safety. The ones I have I used their app to view and listen on my phone. Huge help if I need to collect the mail or grab something small at the store at the end of the road.

She needs help, ASAP. By her getting help, you'd be getting help. I'm pretty sure you may be able to get a doctor to declare her incompetent so you can admit her to an ALF/nursing home.

My mother was abusive. Right now I'm caring for my in-laws who are great people, well, were great people. :( I still feel it is an honor to be able to help them. I'm absolutely dreading when my mother requires help. I have no siblings so yes, I'm stuck. I already decided that if she got abusive while I was caring for her, she gets only one second chance.

I wish I could offer more info. Wishing for the best for you and your brother. 💜

Typed on a phone at 4:11 am. Please forgive any typos!
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If you have a Smart phone or video recorder, use it the next time mom is having a violent episode... and then show it to the doctor who will only say she's depressed. Holding a shotgun on someone while also verbally threatening them is a bit more than having a bad day. The safety of you and your brother is paramount; without treatment, your mother can't- and shouldn't- be trusted.
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Before reading any of others' answers, if she is still in the hospital today, REFUSE to take her home. Do NOT let the hospital discharge planner, social worker, or case manager discharge her to home. Say NO, and mean it. You need to do this for yourself and your brother.
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