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My Mom lives alone and started losing her words, and ability to communicate about 3 years ago. They diagnosed her with Alzheimer's. When she could, she explained, everything was haywired in her head. She is aware who everyone is and her surroundings and does not want to leave her house. She sleeps through the whole night. I feel when she no longer does, it will be time to put her in a home. I have a camera in place. We managed her pills via Alexa until this year. Now we are there 3 times a day, to assure pills, meals, showers, etc. In between visits, she walks to the back and fourth and puts things away in strange places. She can no longer work the TV remote, coffee pot, microwave. She is understandably bored. She can't read, talk, focus on TV, etc.


I tried to bring her to my house and she definitely let me know, she wanted to go home. She still has pride and does not want to seem helpless in front of people. It is very frustrating for her and us.

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It’s always a struggle to decide where they would be better off. I think it depends on the person’s personality. If your mother is fairly docile, then getting her into MC could happen by telling her that her doctor wants her to get some tests and she will need to stay overnight. Then take her to the MC unit and one night becomes forever. Once she settles in she may do really well because she won’t be isolated anymore.

I struggle with the “safety” issue. Yes, we want to keep them safe. But is it any worse to die in your own home from an accident than die slowly while lingering in a MC unit for potentially years? Who are we keeping them around for, them or us? I hear people say all the time that you wouldn’t let a 2 year old make decisions about where they will live or decisions around physical safety. Well of course not. You raise a child in the belief that they will live to adulthood and you make decisions to ensure they do. Our loved ones have a terminally progressive disease that is only going to end one way. How long do we want them to suffer the indignity of this disease? Personally, I have decided to let my father stay in his home, as imperfect as the situation is, until there is an event that triggers placement. If that happens I will have no choice, but until then I’ll risk his safety in favor of his happiness. This is a choice I have made based on my dad’s personality. You may choose something different for your mother based on her personality.
Maybe it will be a fall, or a neighbor calling APS, or something worse. But I know my dad. He is a very difficult person and I fully believe that if he knew he was headed for a facility he would kill himself. So he will stay in his home until there is an event that forces him out. That is the decision I have made and I am at peace with it. I wish you luck with your mother.
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AnnReid Feb 2023
As to “….die in your own home…”, if my mom had died from her fall it might actually have been better than falling at home, shattering her hip, and finally winding up in the excellent residential center where she lived another 5 1/2 very good years.

Each family situation warrants the best decision making the caregiver(s) can make. But often, no “best” decision emerges, and the anxiety of making the decision(s) can be overwhelming.

My mother was the “very difficult person”. And we left her in her home until her fall, from which she never really recovered. I’ve wondered since she died whether I should have done anything differently, and I still don’t know, but I DO know that she suffered terribly from the effects of the broken hip.

No “best” answers.
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When my mother's dementia progressed to the point where everyday items like cleaning detergents and ovens became a danger to her, I had her moved into the Memory Care bldg of the Assisted Living residence she was living in for 4 years prior. I didn't want to wait for a crisis to happen before making sure she was properly cared for 24/7 and kept as safe as humanly possible from things that would harm her, including wandering off one day or night and getting lost. I had both POAs for her, she had a medical diagnosis of dementia, and that's all that was required to move her to safety.

Sometimes it's a POAs job to put aside what a parent "wants" in favor of what they need. Socialization is something all elders require, along with an activity program designed to keep them from getting bored. My mom greatly benefited from the social programs she had going on at her MC, and the mini bus rides they'd go on for scenic drives.

If I had it to do all over again, I'd place mom in the Memory Care ALF in a heartbeat. You've all taken on a huge burden in order to keep mom at home when there will likely come a time where it's impossible to continue doing so.

Whatever you decide to do, just keep mom's safety the number 1 priority instead of her "desire" to stay home. The cast of characters it takes to enable that desire is enormous and takes a big toll after a while.

Wishing you the best of luck with a difficult situation.
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CynthiaLO Feb 2023
TY
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Deep inside, I think we know when it’s time, but there are so many factors that cloud the process. The issue of money and what it will cost. The upheaval of moving, finding a facility. Going head to head with family members, or even mom herself. And the one I think is greatest to overcome, the realization that this is no longer the person who took care of everyone else. This is now a person who needs total care herself. We don’t let two year olds make big decisions for themselves. This is where you are now. I think once you flip into that mindset, you will know what to do. You said your mom was or is becoming less verbal and cannot communicate well. She can’t operate basic devices in the home. You’ve done a great job keeping it all together, but her life is very empty and I’m sure yours is quite stressful as well. No one wants to leave their home. It’s probably instinctual, it’s so deeply embedded in our psyche. But you need to think for her now. Is living alone in a place where she cannot turn on a tv or get herself a glass of water a good life for her? What happens if she falls, or decides to use the stove one day, or simply walks outside and doesn’t come back in? And nothing is worse than isolation, especially when one is scared or anxious. Have you looked into getting caregivers to stay with her? Adult daycare? Have you explored local memory care facilities? Once you research your options and see what is available, you will also understand better where your mom stands on the spectrum of autonomy. I know it’s hard, and there is a tremendous amount of emotional turmoil that goes with it, but I know you want what’s best for her, and you will feel more at peace when you get her into a safer and healthier situation.
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CareSurvivor Feb 2023
This is such a thorough, thoughtful, and kind response. I would add only, Cynthia, that you need to take care of you too. It will get harder on you, and you need the opportunity to be just her daughter again, knowing that your mom is safe. Please don't wait for a crisis and have to make a quick decision. Sending love.
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As much as your mom doesn't want to leave her home(no one ever does)it definitely sounds like it's past time to place her in a memory care facility, as she is no longer safe in her own home.
You know that she will only continue to get worse and you certainly don't want something really bad to happen to her before she then will have no choice but to be placed.
It's always recommended to place someone with any of the dementias in a memory care facility before they get to far gone, so they can still interact with the staff and other folks, and get used to their new surroundings.
You may just be surprised how well your mom may do in a place like that being around other folks her age and having different activities to keep her busy.
And the best part is you get to get back to just being her daughter and advocate and not her caregiver. That my dear is priceless.
Wishing you and your mom the very best on this heart wrenching journey.
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Mom can no longer 'drive'.
So technically you have the 'wheel'. But I pick up that Mom is still the one 'steering' her life.

Does that sound right?

Are you looking to define when to take over the 'steering' - for safety or legal reasons?

Or are you wanting to explore the moral dilemma? When to stop asking Mom's permission? To act for her best interest, even if this is against her wishes?

I pick up that you want to keep Mom in her familiar surrounds as long as possible. Is that right?

A very thoughtful & loving thing to do. It sounds like with family + non-family caregivers this has been extended well past what many can do. As independence fades, having supervision, then assistance is required. Calls & cameras, then pop in visits, then part then full day assistance. You've drawn a line for when nighttime assistance is required.

Did you want to examine what *possible* looks like?

I'd say a lot depends on how much assistance Mom needs & how much assistance she has over the day.
Eg when alone, can she press a falls alarm? Call 911? My Mother can't & therefore cannot be left alone at all.
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I agree with funkygrandma59 I am afraid. I think that it is no longer safe for your mother to be alone. You don't mention how close you are in terms of distance to get to her, and it does sound like you have done EVERYTHING to make it safe, including a camera system. I think that you are close because you mention going over to do pills now three times a day.
I am curious who has suggested to you you are legally responsible and for what????? Are you your Mom's POA?
I would discuss current arrangements with her MD first of all. I believe I might call APS and discuss with them the distance, your expectations, how often you are monitoring the camera (I am aware this can be nearly constant with our phones today).
Again, how close to where she is are you? And what if you are 60 miles away when you see something that requires checking on her, a fall, say.
I am uncertain, given ALL you have done for safety why I am so uncomfortable still. Perhaps a fear of a fire? I just think that she is no longer competent in any way to care for herself, and should therefore no longer be alone.
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CynthiaLO Feb 2023
We do have a village going to her house daily. Sister, brother, caregivers within 2 blocks. I am the furthest away. I do feel, once she starts getting up at night, it will not be her choice. I will make an appointment and discuss with her MD, who she currently sees annually. That sounds like a good start. Thanks
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The TV remote got me right away. Mom couldn't tell the difference between that and the phone. Then she called me to fix her computer again and I missed her by 5 minutes, she called a driver to take her to an appointment that we went to the day before. Out there somewhere without her cell phone! Too scary. Took her to assisted living and that lasted a couple of months and moved her to memory care which makes sure all her medication is taken. She had a medicine machine that did really well for years, she liked when it flashed and said "time for your medication". Then she started missing them because she was tired all the time.
One thing I'd like to mention is that she started getting strange in the one bedroom assisted living, she thought her furniture was in other peoples apartments. It finally dawned on me and the facility that she should go to a studio in MC. My belief was that she would go into one room and lose her furniture because she couldn't see it. I tried situating her between both rooms and showing her it was all there. She is better in a studio where she could see everything she owns. I wish I would have put her in MC first hand and saved her the confusion.
The wandering was the final one, thankfully the police was able to track her cell phone that was left behind. I would definitely go with being safe and worry about proving that I did anything unlawfully. I'm sure you have enough evidence to prove your intentions are of good nature.
What does your heart tell you? Sometimes our heads get just as muddled as theirs. Be well!
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My friend had to move his mother to a home this is what he did... He had his wife take her on a day trip to make her tired. While they were gone he had movers take her furniture to the new place set it up to the best they could so it looked like her home, hanging pictures, setting up the bedroom, living room, etc. Then when the day was over his wife brought her back to the facility and she never knew the difference. Also, just keep telling her "this is your home" "yes you are home" maybe even spread some of her perfume or a familiar aroma around that would say "home" to her.
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momkennedy1 Feb 2023
My cousin just did this for my aunt last fall. When she realized she wasn’t home, they told her she was on vacation. She accepts that. Much smoother than when my mother had to go to nursing home.
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Memory cares are private pay. But if she has the money its good to place her. She could try to cook and leave oil or boiling water on the stove. Dementia has no rhyme or reason, is very unpredictable. With MC even Long-term care with Medicaid paying is better than sitting in a house all day alone and not being able to do anything.

Do you have POA? If Immediate thats good, if Springing you need a doctor or two to say that she is incompetent to make informed decisions. Its no longer what Mom wants, its what she needs. She needs to be somewhere where she is safe, gets 3 meals a day, meds given to her on time and care. MC will give her socialization, activities, and entertainment. My Mom was in LTC and got all this. Also, freedom to walk around.
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CynthiaLO Feb 2023
Thank you, yes I have POA. We are in a small town and could afford MC for a year.
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No one on this help site has directly witnessed evidence to validly recommend what is best for your Mother. It’s scary people say your mother should be moved without knowing anything first hand.

There are only Five LEGAL ways for your mother to be removed from her home and one work around way. Remember, law says, everyone has the right to make their own bad decisions even if you disagree with them, except if a doctor, or Court says decisions are wrong.

Dimentia, Alzheimer’s, and other medical issues are no longer are automatiche trips out of one’s home even for their own good. Remember assistant and memory care living, as well as long term living,may not be any safer. Patients fall and get worse mentally outside of home. Change is worst for dimentia and senior mind. My Mum’s doctor says life expectancy reduces by living in those places, bc patients are in unfamiliar places without comforts of own home.

Here are the ONLY legal ways to remove anyone:

1. Full consent of senior. Try it.
2.POA to you effective immediately or effective by date you wish to move mother.
3. POA requiring regular doctor and one other doctor (in CA) to certify in writing they conducted hour long assessment founding she is not longer able to care for herself safety in her home/incompetence.

Then she has option to pay for help to come on at first four hours a day threetimes a week which helps. Sometimes this prevents the final move out. It gets enough down and provides socializing. But socializing isn’t a legal nor medical requirment to move or stay. It’s only a quality of life. Multi millions of Competent seniors prefer not to have socialization and remain at home for their disabilities.

4. Two doctors certifying in writing she is not able to safely reside by herself. (This is law in CA.) One doctor must be her primary doctor for at least seven years.

5. Court issued temporary Conservatorship to begin process of full Conservatorship. Remember a POA only as a “Nominee” for a Conservatorship. Only Court can make you actual legal conservator after it’s long, expensive, full investigation. So the work around is have her sign w notary a Durable POA giving POA the right to choose residences once POA is effective.

6. Work around-Either you obtain consent of the Senior, written certification from two doctors (in CA), POA becomes effective, you get conservatorship or, hope the assisted, memory, or long term care facility, accepts your Mother with the POA as you deciding for her and with the certification from doctor. Most facilities do accept this. So that helps your situation. But know this. These facilities, ALL of them require you get doctor to sign form mentioning all mother’s medical info, get a Tb, Precussis blood test, and a sign off by regular doctor for to the facility. Facilities MUST get the doctor to sign off. It’s standard so facility knows medical history and current state of their future occupant.

BEST OPTION if you have no POA, the best options is to combine your mother’s consent and have the doctor sign off on the State’s form that your mother is okay to reside in the facility.

Next best option is have Doctor sign statement mother still has understanding of herself, who her family is, her assets, the consequence of her actions as related to estate planning wills, POA. Then have her sign a State Durable POA giving you immediate POA over her and write/add to generic form that she assigns you legal right to make all residential assignments with a notary. Then you have legal right to decide for her. Make effective date immediate.

Just bc one has dimentia/Alzheimer’s doesn’t mean they loose their legal rights. Too many people are in rush to have doctor sign off patients is incompetent. That only prevents patient from consenting and from giving you valid POA to help her which you need. Don’t need all your wits to sign POA. Look up Probate Code req for patients’ legal rt to give POA. That will help you. Then get off internet
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lealonnie1 Feb 2023
Each one of us on this site "has the expertise to recommend what is best for your Mother." And why the op is here in the first place, to ASK for our opinions, which she is getting. The vast majority of us have lived thru the "caring for a parent with AD/dementia" nightmare first hand and have plenty of advice to impart based on experience. Since you have NO profile set up but a whole TON of advice to hand out, what qualifies YOU to do so??
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