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Determining correct placement for elderly mother. Any suggestions?
Any Advice is Welcome.
We have just been thru this with my 83 y/o mom. She was diagnosed with dementia a year ago, is blind in one eye and has debilitating RA. She takes major meds and has experienced several falls. Her DR has recommended no driving but DL is still active and is an ongoing source of angst.


After last fall, and a cryoplasty procedure she was not able to go home. She was sent to rehab that had MC attached. In CPM care plan meeting 24/7 supervision was recommended and MC. At the end of three weeks we were told we would have 4-5 day window to make next decisions.


As a family we were resistant to MC because she’d lived alone (she would have none of it). Within 24 hr from CPM we had a 48 notice discharge notice.


We found AL that had an opening and her paranoia was in high gear. I did not know she was developing an “escape plan” even there. I am her POA and to my face she was in total agreement (dementia with ct scans that look like FTD)


Long story short you see where this is going.


Within 2 weeks she’d called a mover and had her things moved home. She was supposed to have medication management and 24/7 supervision. She fired me as her caregiver and slandered me to everyone that would listen. She hired a lady to come 3-4 hours a day and from what I get she’s driving her around. Prob does some light housekeeping. Her meds are Narcotics and she was very upset when I offered to put them in distribution boxes. I am the enemy now.


I'm at a loss- do I stay away? Without guardianship legally I can’t do anything anyway, but my question is really my moral obligation to her?

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Back away. You tried to care for her. Moral obligation is to be there for her when SHE NEEDS help. All too often an emergency has to happen to be able to get the assistance that they need.
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AT1234 Sep 2018
That’s exactly what I’ve since been told. As horrible as it sounds she’s not far enough along to need me. At this rate she will have spent her savings when she needs it most. This was the emergency, or so I thought.
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“What to do next”? Unfortunately, not much you can do. Mom has already determined her own “placement”. You know she has issues and could possibly be addicted to the narcotics she’s on. She’s made it obvious she is going to take care of herself. You can contact her doctor and have them contact the DMV to suspend her license, but you know any other efforts to help her will not be welcomed.
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AT1234 Sep 2018
Thank you, yes I’ve asked both of her Drs primary care and opthomolgist to sign or fax something that I can take to DMV. Neither would. They’re advice was simply take her keys. I did that until she moved home and she was convinced I’d done something to her car because her remote did not work. She demanded her keys, in Tx you can not take her license.
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Your mother has "diagnosed" dementia and you are her POA. She can't take that away from you now. You will still need to keep an eye on her because she is your responsibility. "Moral obligation" doesn't count here. You agreed to the job (when she had her faculties and asked you to do it), so, unless you wish to resign from being her POA and let the state make choices for her (with NO input from you and possibly never seeing her again) you're stuck with it. You will need to oversee what's going on with her and decide what to do with her when the time comes to place her.

You wrote, "Without guardianship legally I can’t do anything anyway". As I understand it, the POA (your judgement for her wellbeing) is when she can no longer make "rational" decisions. If she was in her right mind, you couldn't do anything. But that's not the case.
If she is confused enough to have the rehab facility tell you that she should be in memory care, she is NOT capable of making good decisions. That doesn't mean that she isn't crafty and tricky and able to figure things out. I had to trick my mother (stage 5 Alzheimer's) into going into the memory facility. I told her we were going to the doctor. Once you're in, it's a locked facility.

Don't take it personally that you are the "enemy". I was too for around a year, until her dementia progressed into more confusion and she no longer recognized me. You will have to grow thick skin to handle all that dementia will throw on you. Remember her brain is broken. That phrase helped me.

Please read up on dementia (or the various types-Alzheimer's, vascular, Parkinson's, frontal lobe, etc.) either on this site or Alz.org-Stages of Alzheimer's. The more you learn, the better prepared to handle what dementia will do .

You can not walk away. You need to see that she is being cared for properly. That doesn't mean you have to see her every day but you must have some system in place with her caregiver for weekly updates and physically see her once in a while. That is what you agreed to in being her POA....even if she doesn't "like" you anymore.
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AT1234 Sep 2018
SueC1957,
I have been very educated on Dementia. Besides numerous Teepa Snow ive attended caregivers seminars as well as living through this horrible disease with my MIL and father.
Neither had these type of behaviors. It is a new world for me. People are completely different but the anger she has towards me is a new reality. I do call each week, but have zero confidence in what she’s telling me. It will take a “catastrophic event” is what I’ve been told.
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If you have POA you may be able to request formal assessment by a geriatric psychologist/psychiatrist and geriatric medical specialist to ascertain whether or not she is capable of performing the cognitive tasks that allow her to continue to manage her own affairs.
Some people with dementia retain the use of social language even after they can no longer actually understand/retain/utilize language to deal competently with life events.
Besides learning whatever you can about types and symptoms of conditions that cause or result in the symptoms of dementia, standardized testing can give you facts that may help you to deal more objectively with your mother’s condition and your reactions to her current difficult interactions with you.
Hope you find some help soon.
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I am going through the same thing with my mother .
I feel for you I only have one doctor signature for guardianship so they told me I had to do a civil commitment to get her into a geriatric psych ward for evaluation . This is what the judge told me I had to do hey to the laws on dementia patients .
So I have done that and there are no beds available and it’s the only facility on this coast that takes dementia patients for evaluation . My mother is very irate at me forgets to pay her phone bill, her cable, etc thank goodness I’m on her checking account but even then she thinks people are taking money out of her account for the wrong reasons . I am at a loss on what to do myself no doctor wants to sign papers like that.I guess the court system Will wait till she gets hurt or hurt somebody else before they allow me to do something to help her. She cannot get into the dementia hall until she has a hospital stay and that’s what geriatric situation is all about . I have shown them all the proof I need. hired a lawyer and still nothing is done . God bless and good luck keep me posted on your situation .
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AT1234 Sep 2018
what the judge said is true I just couldn’t make myself do it. As long as she’s happy and not driving(she tells me her help drives her around) then maybe this gives her more months or even year, I don’t know. My mother is very convincing to people she’s only around a short time so it’s working - for now.
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update to my original post:

my mom fell broke broke her hip required partial hip replacement, then to rehab. Delirium and severe hallucinations for 3 days and back to the hospital for ct scans for blood clots, and uti. I’ve been there for every step. But here we are again, after the 20 day rehab then what? Yes, she will demand to go home.
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Riverdale Oct 2018
Can you get a social worker involved regarding the danger of the situation once she is released?
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Do you have POA? Use it. Breaking a hip is serious. People have passed after breaking one. Have her evaluated at the rehab for LTC. I think she is beyond an AL. Once there, just tell her she needs to be well before they release her. If she has Dementia going under probably didn't help.
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AT1234 Oct 2018
I do. Trying to take this one day at a time doesn’t necessarily work with insurance providers and I’ve done the AL route. She’s not in any shape to do what’s necessary like getting to dining room alone. Thank you for response.
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