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My 97-yr-old parent, on Medicaid, recently entered memory care and she, her belongings, and room were treated for bed bugs (that apparently followed from her last place). She refuses to shower or get her hair washed. The staff calls me often because of this and they are unable to get rid of the bed bugs. She hangs her clothes she wore back in the closet. She won't listen to me about showering and they told me she may be asked to leave the facility. She would then be homeless. My health has suffered trying to help her and I stay awake nights not knowing where to turn. She gets beligererent with me and always has been quite mean with me (I'm an only child and have POA). Can I go through the process of making her an adult ward of the state, give up POA, or what other options do I have? The nurses are almost in tears when they phone me because this parent is so belligerent and they don't know what to do either.

The rule of thumb is "lead, follow, or get out of the way."

So let's take those options one by one.

Lead. You have POA (do you know what sort?). Your mother has been admitted to memory care, she therefore must have been eligible, it should therefore not be too difficult to establish that she lacks capacity to make her own decisions. But POA makes you responsible for the key *decisions*, not for hands-on provision of services. The staff should not be ringing you for directions on your mother's hour-by-hour care. They are the trained, skilled workforce, not you. If they need additional support, they should be asking their line managers for instructions and escalating issues as appropriate. Have you had a formal care planning meeting with the memory care unit's managers? What is the plan?

Follow. What professionals have been leading your mother's mental health care? What has been their advice? Has the schizophrenia been formally diagnosed, is it a longstanding issue? Again, all this should feed in to the care plan.

Get out of the way. You can speak to a lawyer about how to make a formal surrender of your POA and transfer responsibility for your mother's care to the state. Or, you can go online to your state's own government portal and look for guidance there - https://www2.illinois.gov/sites/gac/OSG/Pages/Guardianship-Fact-sheet.aspx

I'm hoping that your mother hasn't been in the unit for very long, and it's mainly a question of getting to grips with an effective care plan. But no one on this forum, absolutely nobody, would blame you for wanting to give up a responsibility you just can't fulfil. Good luck, please let us know how you're getting on.
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woohoopepper Apr 12, 2019
Twenty-plus years ago she was only diagnosed with delusional paranoia (when placed in a mental ward of a hospital for a few days). She didn't let on that she was hearing voices but sounded almost completely competent to the psychiatric staff. Her independent living facility way back then felt she was a risk to other residents, wanting to save them from (non existent) abusive situations. People living there were becoming afraid of her, so she was taken to the hospital. The psychiatrist at the hospital told me, upon discharging her, that he felt she was going to be fine, seemed to understand exactly what was happening to her and agreed she would not act on what she felt was happening around her because it wasn't true. Ten days later, she scared the same lady, wanting to rescue her, and I was called (4.5 hours away then) and told she had 30 days to evacuate. (This all happened in Cincinnati, OH at the time).
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I agree, this is a memory care facility. The staff should be trained to care for Dementia patients. There is a way to get residents to shower. Tell them to only call you when there is an emergency. They r the professionals. Also tell them to have Mom evaluated and medicated. If they feel she is too much, send her to a psychic facility to see what meds will help her. At that point, tell the Psychic facility that you can no longer have the responsibility for Mom because of your own health issues. You will sign off to allow the state to intervene.
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I am surprised that the nurses are calling you upset. They should be experienced in dealing with non compliant residents. The bed bugs are a serious issue but again, this leaves me questioning the staff and their competence. Can they not move her to another room temporarily while they completely disinfect her room and personal belongings? I’m not a fan of medicating people but since Mom has dementia, maybe she needs to be on something to help with her behavior? And if she’s already on meds, maybe they need to be tweaked. This isn’t new behavior is it?
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Reply to worriedinCali
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I agree that the facility needs to manage her care properly. That is their job, not yours. They are trained professionals and should be able to attend to her needs and work with her to get her into compliance with health and safety. Maybe, they need your permission to destroy her contaminated clothes and belongings. I'd give it.

If you just don't want to be involved any longer, then you might consult with an attorney about the process of filing with the court to have a Guardian appointed and that it be the county or some other proper person the court can appoint. To me, there is nothing wrong with doing this, when you are no longer able to be responsible or involved. It's a huge job and family members usually get no compensation though the work may entail many hours of time and energy for years on end.
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Update: I forgot to mention she was coming to the facility from a hospital where she had fallen and had a brain bleed. She was (with my signing) admitted to Hospice care because it appeared this was it. When we got to the memory care unit, she immediately began walking around saying she did not have time to talk to people because she was getting ready for bed (the brain bleed made her nearly completely deaf), and the Hospice person who went in to assess her, called me and said "Nope, not today!" Apparently she is just fine.

About the bed bugs, she did not appear to understand what was going on, they switched her overnight to another room, followed all proper procedures for extermination and her clothes were bagged several days and washed/dried hot water. In the intervening time, she was given new clothes to wear but refused to take off the clothes she had been wearing (for those several days) and would not wear any clothes that were not hers. They did not catch that when my completely mobile mom finally got her clothes returned, hung up, and left the room, she changed out of the ones she wore for about five days and hung them up too! OY! I have mentioned this to the staff.

Yesterday, when I arrived after no sleep the night before. I was greeted at the front desk with "We got her to shower this morning!" When I got to the unit, the most wonderful staff member said that yes she got her to take a shower somehow and she (the staff member) also washed her hair the best she could gently due to the head wound. It seems the day staff is much more confident and at least reassuring to me then the night staff. At least for now. They now have also often witnessed my mom's belligerence and appear to handle it better than the night staff.

I have no way else to describe my mom's always odd personality except to say if anyone has watched the Ted Bundy documentary (I think Netflix), that is her personality exactly (without the serial murders). She seems sweet and competent one minute, greeting and complimenting the staff, uses her big educated sounding words, agrees in a "yes, of course" compliant way, and then BAM, she instantly turns on people like a caged animal. Sedation, perhaps, but she doesn't like being sedated and is definitely at risk of falling (hence the brain bleed). She has her walker, but she hobbles around without it in her room.

Anyway, thanks for the responses, I read them all, and I appreciate you taking the time to reply.
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Seneca Apr 15, 2019
Is she able to take, or has the facility's prescriber, rx d Lithium for the outbursts?
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I am Not sure What Facility you have that cannot HANDLE this poor soul. Only Incompetence would tell me they are Not Fit for her own "FITS. Yes, You can become, hun, a Guardian by Going to Court but my suggestion is Put her in a facility who is More professional FIRST.
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IsntEasy Apr 15, 2019
I can tell you, as someone who's interacted with literally hundreds of seniors in assisted living, that you really need more information than you have to determine that the community is at fault here.

There are many residents who, due to dementia, depression, or just plain old grumpiness, exhibit behaviors that make it nearly impossibly to properly care for them. They deserve our compassion and patience and so does the staff.
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Before you do that you may want to take her finances into consideration. Florida is just one of many states where an elder parent has been made a ward of the state and its been a disaster. The person assigned to her case will have all power over her as well as her finances. In Florida care givers of elderly have sold items for way less than the actual value, they sell homes for less than the value, they do anything they please and spend what they want. I had a friend whos wife was a ward and they tried to also make him incompetent and is isnt. He left Florida and has been on the run for a couple years now. He worked 60 years+ they even took his Social Security. He was once wealthy now his wife is a ward of the state and he is a fugitive on the run. Simply because they said he was crazy and he isn't. He is a very smart man who never graduated high school but became a millionaire by working hard. Now all that belongs to the state of Florida. I believe they even have the right to pull the plug or deny medical care if they deem necessary. They have total control over the person and any assets. Its scary as hell. Google Florida Elder Abuse Caregivers Wards of State add the governor's name in there too. There was a call to have the Judge who oversees most of the cases removed from the bench brcause of questionable tactics. Be careful and good luck. Its very hard caring for someone who really doesn't realize your only trying to do whats best for them.
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Lymie61 Apr 17, 2019
I remember reading a similar horror story about one particular attorney or maybe judge in another state (I think) who was targeting older people with money (I forget how they were being found but maybe through property records) and gaining guardianship, placing them in facilities maybe also connected somehow and selling off all the assets. It was very scary and I think part of the reason I don't remember all of the details is that I blocked it out, it was so awful. I seem to remember family members coming along but too late to stop the process or maybe gaining back control after much of the damage had been done and that's how the ring (all I can think of to call it) got exposed finally. The elderly that this was happening to were too embarrassed and or proud to admit they didn't know what was happening or had been duped and they were from various counties so it was spread out a bit I think. Anyway it's hard to believe and very frightening that something like this can happen and only goes to show just how blind we are to our elderly and assumptive about them we are as a society. In other societies seniors are revered and treated very differently, here they are part of the disposable society we live in to a large degree. Yes I know it's far more complicated...but there is a definite difference
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It would seem like the facility could do a little more re: "making" her cooperate somehow with getting rid of the bed bugs. With her clothing - could they take it all and wash it and change her into something clean and get those things in the laundry, for example?

I don't think they can make her shower but I hope they are pushing her, nicely, to get clean, with assistance.
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Reply to againx100
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Hire an elder law attorney to help you with the paperwork as soon as you can.

Based on your interactions with the facility, you will be asked to remove her soon.

Give yourself permission to take a complete break, however long you need.
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Countrymouse nailed it! Nothing further to add.
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