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My 82 yo mom lives alone in a big apartment building with high security--a good thing, except that the only way to get into her apartment is for her to tell the front desk to let you up. She is not demented, but is in massive denial about getting older and numerous health problems. She is definitely depressed. The last time I was there was a few months ago. She fell and finally agreed to let an ambulance take her to the hospital, where she was for several weeks. I cleaned her apt during that time and was appalled. She had been ordering takeout daily and not throwing anything out. Newspapers everywhere. Roaches. And the worst is that I discovered she has been dealing with fecal incontinence, the poor thing. So I had to throw out most of her sheets and towels.


Anyway, she returned to a clean apartment and allowed her cleaning lady to come for the first few weeks, but now she's back to canceling everything--cleaning lady, dates with me, doctors appts (she was supposed to see a GI specialist for the fecal problem). Anytime I try to reason with her, she gets furious with me. She insists she needs no care, no help, is perfectly fine and it's her business if she goes to the doctor or not. I know this is true, but it's killing me. I am so afraid of having to go back to that apt whenever the next crisis hits. I actually called APS anonymously and they showed up in her lobby but she would not let the person upstairs! I am terrified my mom will find out I called them (but APS will keep it anonymous/confidential, right??)

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Xin, are we talking about NYC? Maybe Penn South or someplace like that? Ask to speak to the folks supervising the social workers. Talk to management.

But also, if you can, get her to a neuropsychologist who works with a neurologist. Her reasoning skills need assessment. Talk to her doctor for a referral to a rehab center that specializes in this testing. Again, I don't know where you are, but Burke Institute in White Plains does good work in this area, and I suspect that Rusk at NYU does also.
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xinabess, one suggestion, do NOT clean up your Mom's apartment before APS comes to visit.... that is just stalling the situation.
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Well, the good (ish) news is that my mom has spoken with the social worker from APS, who will be making a home visit next week —assuming my mom will let her in. I suspect (hope!!) that my mom will have me come over to clean before the visit. I don't know. So much of the advice out there (and here) presumes that actually getting into the home of the elderly person in question is not the problem. I guess most people live in houses. Because my mom has to authorize people who show up in her building, via front-desk security, it adds a whole extra layer of difficulty that most people don't have to deal with. Ugh.
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The building should be doing regular extermination already. See if the building superintendent can speak with your mother about letting an exterminator into her apartment. Can you bring her cleaning lady with you so she can clean? Old people don't need to be demented to make shockingly bad decisions! In my experience with my inlaws, they made terrible decisions to maintain their independence and prevent us "kids" from knowing the truth. I wish you lots of luck.
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Thanks so much, everyone. It's so complicated. The building complex is huge and has a large elderly population plus a social work center onsite, yet they have all been USELESS, despite my pleas. I did talk to the discharge coordinator honestly during my mom's recent hospital stay and she, too, was no help. Her entire goal was to ship my mom to a rehab facility for her back injury. At the facility, my mom passed all the physical and mental tests with flying colors, so they sent her home. It's been a really rough year, as she had a mastectomy last Nov followed by the back fracture, and then the recent fecal incontinence. I think her self-neglect is more about depression and feeling overwhelmed. Thanks for being here. I'm glad I found this site. It's good to know I am not alone.
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I guess I am both surprised and not surprised that your mom was able to pass the cognitive tests. For quite a while my mom could hold it together and pass the tests. She still can seems okay for very short periods - she did that just this past Monday at a dr. visit. But I'll i needed to do was introduce a specific subject and she was off on a demented rant - you should have seen the dr.'s face! I fear you may be started on the path I've been on for a while - steady line of living - crisis - adjustments to fit new state of living - steady line - crisis - adjustment...and so on until the crisis' became so frequent that there was no steady time and major adjustment had to be made. In the words of the wonderful Betty Davis " fasten your seat belts, were in for a bumpy ride."
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The main reason I mentioned the roaches/vermin is that this may be the best way to intervene since she obviously won't allow intervention voluntarily. Getting the building manager and eventually the police involved with either ensure that she cleans up, or ensure that she gets proper care somewhere else.
Angel
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Living in filth is an indication that her decision making part of the brain is not working. Refusing to allow a cleaning lady is another sign she not thinking clearly. I'm willing to bet she is not bathing either. Be prepared to expect another visit to the hospital, but this time have a long chat with the discharge coordinator about her living conditions.
Next time, don't clean up, take pictures and show them to the discharge coordinator, ask for help getting her to a safe place.
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xinabess, I agree with Angel, the roaches will encroach into the other apartments via the duct work and any tiny openings like the plumbing and electrical outlets..... property management needs to be informed now, otherwise it could be very expensive to control, and who knows maybe property management could find your mother responsible for any damage.

Is this something current with your Mom or has she always been haphazard when it comes to keeping a place clean? If this is something new, then it means either she's no longer has the energy to clean for herself or that her memory is slipping. Maybe this is the "crisis" that is needed to get your Mom into a more controlled environment, if she can afford Assisted Living.
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Thanks, Rainmom. She passed all the cognitive tests with flying colors when she was in the hospital and rehab. They were amazed at how on the ball she was in terms of her memory, math skills, recollection of phone numbers, etc. She really isn't demented, per se. The denial is extreme, however, to the point of being delusional I think.
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Towards the top of my post it should be I guess I couldNT tell the difference. We need an edit button here, lol!
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In your post you said she didn't have dementia. I would suggest rethinking that. When my mom ended up in a rehab after a fall 10 weeks ago they did two dementia test which she scored high on both. I was somewhat surprised - my mom has always been eccentric so I guess I could tell the difference. Since then I've done a lot of reading about the disease and see in good ole' 20/20 hindsite that I was missing a ton of signs. If it comes down to waiting for the next crisis and she winds up in the hospital insist she is tested for dementia. If she tests positive you will find new avenues to pursue in getting her and you help. Alas - along with new avenues will be many new difficult challenges and tough decisions. Best of luck to you!
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She doesn't have rodents, but definitely roaches. I spoke with someone at APS today and they said they will try to gain entry three times and after that, the case is closed. They are not going to try to get past the guy at the desk. If they ring up and she says don't come up, they will go away. So I am trying to simply accept the situation (ha) because I don't know what else to do except wait for the other shoe to drop. My mom is furious about being "infantilized," which of course I understand. She cannot let go of her image of herself as independent and glamorous (both of which she was). Crazily enough, after the apt was cleaned last time, she ordered WHITE carpet for her bedroom. Talk about denial.
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If I'm not mistaken, having rodents and insects in the apartment affects all the other apartments too. I think you should have a private conversation with the building manager and have him step in...if he doesn't then their entire property could become infested. Also, APS really should have insisted on entry...or if they did not have the authority, the police certainly would. If she's living like that then she is in danger and the police can step in and remove her /condemn the apartment.

Angel
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And in answer to your query, APS is supposed to keep information from someone reporting a situation as confidential.

Your mother figure out it was you though; how would you handle that? You're within your rights and responsibilities to be concerned, but she might resent that. Still, you do have an obligation to report the condition, and you obviously have a great deal of concern about the situation in which she's living.

There's also the issue that the living conditions are going to affect her health, one way or another, sooner or later. So you're acting in her best interests, even though she may not believe that.
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I'm surprised APS didn't ask management to let them in. I think that would have been within reason and within legal boundaries.

I honestly don't have any good suggestions, but if there were roaches once, and the lack of cleanliness is continuing, there may well be roaches again. And they don't necessarily confine themselves to one apartment.

I'd hate to recommend bringing building management in on the situation as they might decide eviction is appropriate, but they would have master keys to allow APS into the apartment.

And I don't disagree that it's a very serious concern but am wondering what the next step would be if the lack of cleanliness is repeated and the cycle starts all over again, especially if your mother dismissed the cleaning staff.
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