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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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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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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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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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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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Only a court order can give guardianship once the person is no longer cognizant for POA choice, and they will need psychiatric evaluation for competency; a visiting Justice in the psych ward will appoint someone. As for hidden cameras in nursing homes that may turn around and bite with legal liabilities due to privacy laws and nursing homes are private property. Hidden cameras are legal in your OWN home but nursing home is NOT your property--your MUST get written permission from the facility. Check out your own state laws. The only way to legally monitor your loved one is to VISIT EVERY SINGLE DAY and very frequently, and do a skin assessment every single time.
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jacobsonbob Nov 2018
Is this response actually intended as a comment for "Delusions of extreme physical abuse. Who do you believe?"?
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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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This may have been suggested already, but seems to not be as I scan what’s been written. Ask to speak to a social worker at the facility your mother is in. If she has been discharged already, contact Adult Protective Services or your local council on aging, or find a local geriatric medicine service, or senior services agency and ask to speak to a social worker. An MSW can help you with how to accomplish what you are trying to do. The other thing you can do is petition the court. For that you need to see a Probate attorney. The attorney will help you with the steps you need to take to get Guardianship, Conservatorship, etc. I’ve had to seek Guardianship for a loved one before. It can happen fairly quickly. A Social worker and a Probate attorney are the 2 professionals you need.
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I don't have much experience with this but my first thought is to get your brother out of this situation. Even if you have to move into a hotel for a week, he should not have to endure this.
As someone else said, get his SS payee changed and then change his environment.
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Question: why do you have a rifle in your home? Your mother should not have access to firearms. You need to refuse to take her home from the hospital. Site that she’s a danger to herself and your brother and cannot remain in the home. No one can make you take her home. The social worker at the hospital will assist you with placement in a facility equipped to manage her mental illness. You should also contact Adult Protective Services to report the abuse of your brother.
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All excellent responses, and I hope you carefully consider each one.

You don’t need guardianship or DPOA in place at the time of admission to a home from the hospital, though you will eventually have to do that or an outside guardian will be appointed. Evaluation from the psych admission, along with your account of what happens at home, is the beginning of the beginning, for you and your brother.

Start this process BEFORE your mom’s intended discharge from her 72-hold. Refuse to take her home.

My mom is 89 years old and has memory loss and balance problems, just recently transferred from hospital to NH. She had no POA or guardian at the time of admission. I was told (after she had been there for a month) that unless the family establishes guardianship, an outside guardian would be appointed by the Court. I am currently in the process of obtaining guardianship so the NH administrators MUST share her medical/treatment plan with me for decision making.

Go to the website of the your county probate court. Print out all forms in the “Guardianship” section. You can file the petition without a lawyer, but speak to an elder lawyer with any questions you may have after reading the information you obtain from the website.

You can usually get a free consultation for your questions. If you decide to retain that elder lawyer, you also have that option, of course. But it is possible to do this on your own at the cost of filing fees only.

i wish you luck and success at this difficult time.

(Posting from Michigan.)
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I agree with all the others in that she should not be able to set foot in the house ever again. Is the house in her name? You will not be able to get POA I believe giving all you have mentioned. Can you hire an elder care attorney regarding the house? Her behavior is not one of a true parent regarding a nurturing nature nor does it sound as though it may ever have been. Thus I hope you can avoid feeling guilty. Perhaps she may be able to be more stabilized with medication. Even if that is the case she still should never be in your home environment. Her history indicates that. I am so sorry for all you have been through. I hope you find information provided here and are able to follow through. Most importantly you need to refuse to take her home by indicating to all those necessary in the process all the dangerous behavior she exhibits. I wish you strength.
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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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Go to a family lawyer. It will cost you a lot of money but they will get the proper evaluations for you and go to court. Being a guardian has it drawbacks you have to account to the court for everything.. you can be just a financial guardian with less reporting to the court but you have less control over her but if she is declared incompetent you control the finances. Also if she is out of the home now send her directly to the nursing home from where she is at, don't let her come back. Just keep in mind if she is that difficult some homes will not keep them. I feel for your situation. It's really tough.
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If your brother has always lived with your mother, I believe they can not put him out of the house. Please check with elder attorney about this. Until you get that answer DO NOT MOVE. No one should have a gun under your roof given your circumstances. Laws are there to protect you and your brother regarding the house. Laws are also there to protect your mother from hurting anyone, including herself. Right now you need to protect brother from not having roof over his head. Talk to elder attorney ASAP! Best wishes to you all.
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igloo572 Nov 2018
If your thinking about Medicaid Estate Recovery (MERP), yes the brother if he is handicapped, that’s an exemption to Recovery.
But the sticky will be that if mom has all 4 kids as equal heirs as per her valid will, then the other 3 might not have an exemption to MERP. Mom would need to leave home only to handicapped son to get property exempt from Recovery and home would need to be fully paid off with no mortgage to transfer title to him.
Going to need an attorney to deal with this one way or another ....
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I would try to find a reputable nursing facility and ask for advise.
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Start taping her abuse so that you have proof of it & just use your cell phone - don't worry about pix just do voice record - don't let her know it is on either -

Now she is on the phych ward she won't be able to hide what she is doing - best thing is if she lost it while you were visiting & staff see it - these people are trained & know about the manipulations that can occur - while she can hold it together for short times at dr's office she won't be able to do so 24/7 on the ward

For your brother's sake refuse to let her come back without more assistance - if they declare her incompetant, then would bro be able to manage & you know the answer is NO - so because you are on the road a lot then she needs to go straight to a NH -

Talk to the social worker at the hospital & ask that someone have an interview with bro about what he thinks about mom - that should be enough to convince them where mom should be
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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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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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There are many things entangled with each other here. By the sounds of it Mom has had mental issues for a long time and I can tell you from experience UTI's are making that much worse! It may not be as noticeable to you because it isn't new behavior for her and you are used to flux in "crazy" and mean behavior. It may not be a simple or easy thing separating your mom and brother either because it sounds like they have been mutually dependent on each other for a very long time and even though it's a very unhealthy interdependence it's what your brother knows. Abusive relationships are so complicated. My guess is the best way to accomplish what you want (mom in a facility of some sort) and what sure sounds best for everyone including mom, is to get her admitted to the hospital and then use them to accomplish the rest. Her UTI's, falls and extra erratic behavior is just the ticket. Once she is in the hospital whether it be for a fall or a psyc eval (UTI...) make sure she get's a psyc eval and that you fill the right people in on all of the events, plus, that you have told us about here. Even though she is so expert at pulling it together and putting on a good front when need be if the right people know about this they should also know how to evaluate it. If you can insist some elderly psyc experts are also involved that would be good too and if the hospital has a good system and people in these areas they will have a team that includes a social worker or someone to work with you and your brother too. Not only does all of this hopefully accomplish getting your mom any help and medication that might help, it should accomplish finding and sending her to another living situation where she can be cared for without posing a danger to you and your brother. The key here is making sure they know she can'r be released home so they have the responsibility of keeping her until a suitable place is found and it takes the responsibility or focus of being the "bad guy" out of your hands. Your mom can an should blame the hospital, officials, doctors for not letting her go home and placing her in a facility or NH, your hands are tied. However this doesn't necessarily mean you can'r be involved and have some control over where she goes if you want to. Think about the medical staff as being your "cover".

If she has a primary provider that she trusts or knows her well and you feel comfortable with you might be able to get them to initiate and facilitate all of this too. Either way you will need to be open honest and upfront with the medical personnel, on the side and not confronting Mom but on your mom's, your brothers and your behalf you need to lay it all out for everyone you can to make sure the right people finally get the picture and message. This may be the hardest part but it will be better than it could be if you allow things to be minimized or overlooked when you have the window of opportunity. UTI's may be playing a big part in current behavior but it isn't the underlying problem by the sounds of it so you may have to remind yourself of the past and make sure they know the problems go deeper than the UTI fueled gun indecent and even if once cured she isn't as violently dangerous she is unpredictable and UTI's are going to keep happening making her dangerous to your brother as well as you again if she goes home... Remind yourself too, this is not being cruel or selfish, non-caring in any way in fact just the opposite. You are doing what is right and best for your mom as well as your brother even if you take yourself out of the equation. Watching out for and taking over the care of your brother is no small thing either, you are a wonderful, responsible and loving sister (and daughter) who has gone and is going above and beyond.
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Levans2008 Nov 2018
So sorry you are going through this. The anger management is hard in itself. But you have alot of other issues you are dealing with.
Yes your mom should be removed from being around your brother. She needs to be where she is getting medical help. Advocate for her even though its hard since you may think she has made her own bed. The instability could be UTI but could be from her background growing up or a not so good marriage...you just do not know. There is a root cause somewhere. Especially if others have not seen her have difficulties it is perceived by others she has no reason to be angry. Hang in there you are a key person in trying to get your family on a good path. Find a good psyche dr that will listen to you. And get Mom the help she needs.
My mom has had anger issues in the past and it took alot of explaining and talking to get her to understand that her life circumstances have changed and that she now has to relinquist some decisions to you or family members. And she needs a third party (psyche dr) to help her. Testing can be done for AL also test for bipolar. See a urologist if having accidents to see what the issues are there 1st. Check blood pressures. Does she have headaches? Is she in pain?This can also cause anger but some of our parents were taught not to say they are in pain because this is a sign of weakness or taught you never complain. Best wishes....
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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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Mom must not be allowed to return home. Protect your brother.
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Protect your brother. Does he have a social worker? Try to work with them and get his payee changed to you.  Be honest about all her threats, hallucinations.  Your brother is in danger and should be able to receive protection as a vulnerable adult.  Basically get all financial affairs into your hands - mom is incompetent in reality.
Now, who owns the house? Pays the rent? If it is not mom then refuse to take her to live with you and brother. Explain that it is a dangerous discharge and you and brother cannot take responsibility. The psych ward of the hospital will have to place her - you are done.  You may not be able to get her into a nursing home yourself, but can you work with social workers, perhaps your brother's, to get yourselves separated from her?  Emphasize the continuing abuse and danger to your brother  and demand enforcement of laws protecting vulnerable adults.  I'm afraid that if you do nothing, continue to try to placate mom, someone is going to be killed by her. Don't hesitate to report any threats by her to the police.  This is a situation where the squeaking wheel gets taken care of - if you keep trying to cope as you have, the authorities will leave you to it.   The danger is real here. And mom is not going to get help outside of institutional treatment.
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THE PROBLEM SOUNDS TOO LONG TO BELIEVE ALL OF THIS UNDER ONE ROOF! I KNOW I WOULD BE DEPRESSED SENSING UNDERLYING HATRED AND ILL WILL FROM FAMILY MEMBERS.

PRACTICE LOVE...ASKING OTHERS OUTSIDE THE HOME FOR HELP AND SUPPORT AND MOST OF ALL...REMEMBERING WHO SHE IS AND THE OPPORTUNITY FOR LIFE SHE GAVE MAY SOBER YOU UP TO SHOW LOVE AND MERCY RIGHT THERE WHERE YOU ARE.
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rovana Nov 2018
Coppertino, you make some good points, but if mom is in fact mentally ill, abusing vulnerable brother, there is nothing wrong in taking situation seriously and acting to protect brother.  Mom gave birth, but this is not some kind of limitless entitlement and no one is "entitled" to abuse another. The kind thing to do here is to protect brother and to get mom into professional treatment.
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1 - Call Protective Services and let them know that she is not only abusing your brother but she is not safe to be left alone.

2 - Attend any discharge planning meetings for Mom and stand firm that you can no longer care for her so she cannot be discharged home.
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