My sister and I both have Power of Attorney for our mom. My sister wants to put our mom in a nursing home because she sometimes forgets what day it is and when recent events occured. My sister thinks Mom is incapable of making decisions. I live with Mom and nothing can be further from the truth. She's 87 and she still drives. She balances her own checkbook. She gardens. She does housework. You get the picture. My mom's doctor thinks she has dementia based on the limited information my sister has told him. While my mom has had bouts with confusion, especially time, they aren't continuous. Whenever they do occur, it's always when she's woken from a nap.

They actually started after she was put on medication for high blood pressure. I read where certain blood pressure medications can deplete your melatonin levels which controls your sleep cycle. So I bought a melatonin supplement. I started with 3 mg and noticed a slight change. I noticed an even bigger improvement when we upped it to 5 mg. Four months went by and everything was normal. Then, she fell and broke her hip. She didn't lose her balance or anything. It was simply an accident. After spending one week in the hospital and four weeks in a nursing home for physical therapy, she is back home. My sister calls three days after mom gets home and mom is confused about what day it is. Well, she was asleep at the time. Need I remind you that mom hasn't had any problems for the last several months. I also just found out that mom forgot to take her melatonin the night before. She's also in intense pain. From what I've read, dementia doesn't come and go. It's continuous and gets worse over time. It's also incurable. I think my mom has been misdiagnosed for dementia. I think her symptoms are more indicative of delirium, which can be cured if the cause is found. I've read articles about how often people are diagnosed for dementia when they really don't have it. I think my mom's doctor diagnosed her for dementia based on the limited information my sister gave him. Anyway, if my sister wants to have my mom committed and the doctor agrees with her, can my mom and I prevent them from doing so? My sister's name is listed first on the Power of Attorney but only because she's older. The POA says we have equal but separate decision making powers.

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Take your mom to a specialist that works with diagnosing dementia in the elderly. That’s what we did with our mom. The Dr. listened to our “stories” about mom, he went through every single medicine she was taking to see what possible side effects could be going on, he ordered blood work, MRI’s of her brain, and a psychiatrist at the center also did a work up on her. She was diagnosed with vascular dementia, (Dr. said she had had “numerous” mini-strokes (we were never aware of them) & also diagnosed with Lewey Body Dementia.

What the Dr. said when we sat down with him was, “Just tell me what’s been going on & I’ll be the referee.” I think it will be clear to the Dr. if your sister is lying, or if you’re looking at the situation through rose colored glasses.

One can not just be placed in a nursing home, certain criteria has to exist.
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The doctor has not given a diagnosis, in fact, has he. I know of no doctor on God's green earth who would offer a formal diagnosis without examining the patient. Wouldn't happen. Isn't this much more likely..? [wavy lines]

Sister: mother often forgets the day of the week, she's disoriented and falling, is this dementia?

Doctor: could be.

Sister then trots happily back to you and announces that the doctor agrees with her that the diagnosis is dementia.

Are you in regular communication with your mother's doctor yourself? If not, why not?
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I understand what you’re trying to do. Does Mom live alone or with you? The only way to be certain if Mom has dementia is to have her tested and evaluated. It doesn’t really matter what the doctor ”thinks”or what your sister tells or doesn't tell him. Test results don’t lie. That way, if the diagnoses comes back that she does have dementia, you will need to accept it as well. Dementia is not caused by pills or lack of melatonin or waking up from a nap and it only gets worse. Do you think your sister might just be looking toward the future? Does she have health care POA and you have financial? Durable POA covers both and is a lot easier.

Why do you think Mom is delirious? Isn’t that a pretty serious condition? How do you think the doctor should go about diagnosing her for this?

Have Mom tested and evaluated by a geriatric psychiatrist for dementia. Then, you and your sister need to calmly sit down and discuss what to do and when. If you do take care of Mom, there are medications that can keep dementia at bay for a while so she can continue to live with you until it’s no longer in her best interest to do so. It is not an easy diagnoses to accept. But a lot of us here have had to do it and we are always here to help.
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Whether your mom has dementia or not, there is no reason she can’t continue to live with you, as long as she has appropriate supervision from you or someone else.

The doctor may voice an opinion, but has no ability to waive a wand and have your mom sent to a nursing home, unless there is some major elder abuse going on that we
dont know about.

Talk to your sister about her worries of having your mom home with you. Once you can define the worries then you can discuss how to overcome those worries while keeping mom at home.

good luck to you. And by the way, this is a really good argument for why not to assign two people with equal decision making power on your POA!
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againx100 Jan 2019
Two people with POA sounds like a VERY difficult situation!
Just wanted to add that
1. a person can absolutely seem ok when they have dementia. Especially if they are in their familiar surroundings but they may still have dementia. Some progress very slowly.
2. There are many people who have dementia who live at home....even alone. My aunts dr suggested she live at home as long as possible.
3. Your mother can change her POA to just you while she is still competent to do so. Your sister can’t keep her from doing that. If one of you files for guardianship that will over ride the POA but that is expensive and no guarantees you would be awarded. It’s best to work together if possible.
4. Many people become confused after being in the hospital, while in pain, on medications that need adjusting or even with a UTI.
5. See if you can find a geriatric primary. I find them to be very supportive of elders and their rights. Also she should not be in a lot of pain. Get that taken care of. Did she get s bone density test? Is she using a walker? Still doing therapy? Try to keep the therapy going.

Get mom tested as has been suggested. It’s good to know where you stand.
Also if you haven’t already, read the book “Being Mortal, Medication and what matters in the end” by Atul Gawande.
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Ds99302, I have several reactions to your posts in addition to the comments others have made about a doctor making a diagnosis. Here ere is some food for thought...
1. You say you live with your mom. Where would you live if your mom went to assisted living or memory care? Is it possible that is influencing your concern about where your mom lives?
2. Your use of the word committed concerns me. Moving a LO to a senior living facility is not a commitment. It is a choice for providing a safe and supportive living solution. Right now, you are providing that support to your mom. What would happen if you could not?
3. How rich is your life? Do you work? Have a family? Or is taking care of your mom your main focus?
4. Dementia symptoms can come and go, especially if is vascular. It is even possible that your mom fell because of a mini stroke. Would you want that to happen when she is driving? She needs a full evaluation to determine her mental status for her well being and that of others.
5. When we see someone every day, we are able to see some things clearly. But sometimes we miss the forest for the trees. Your sister may be seeing things you are not because she is not there as much. My brother and I use each other as a check and balance to validate our parents' status. At some point, you and your sister need to work as a team to ensure your mom's well being.
Taking care of aging parents is a challenging journey. I wish safe travels for you and your sister.
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Ahmijoy Jan 2019
Wonderful answer! When reading the original post, I really got the impression that the OP was “making excuses” for her mom’s behaviors and not wanting to face what may be facts. We all do that. But at some point I feel Mom really needs testing and evaluation. I hope the sisters can find some middle ground.
I can see where you think mom was miss dx. Some medications can cause confusion. Having a deep sleep when napping can cause confusion for a brief few minutes.
However, you really need to take mom to a neurologist to have her tested. Reading articles give you just enough information to help you fill in the blanks of what you want to hear. Not meaning to be harsh. A Dr can not legally dx on what someone states about another person. As Ahmijoy said, "test results don't lie."

I think you think someone with dementia just goes completely mad. But it is my experience with my own mother it started out slow. Just forgeting things time to time, even now she has times when she is all there; however, those days are get further apart. Nonetheless, the disease does not start out continuously showing it's ugly head here and there in the early stages.
If nothing else get her tested just for a peace of mind!

Your sister can not just put your mom in a NH and throw away the keys.
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ds99302 Jan 2019
My mom doesn't forget things. She remembers what she has to do and where she has to go. She's still drives but she won't be able to again until her hip gets better. She's never had an accident and she's never gotten lost or confused about where she is. She has several friends who will ride in a car with her and they don't seem to have a problem with it. If she does forget something, it's because either she didn't hear it or she didn't think it was important. When she was at the nursing home for therapy for her broken hip, the speech therapist asked her one day if she remembered what she had for lunch the day before. My mom said no. The therapist asked why not. My mom said because it wasn't important. The therapist said my mom was forgetful and needed help making decisions because she couldn't remember what she had for lunch yesterday. I was in the room and I asked the therapist well who remembers what the had at every meal? I told the staff I didn't want her working with my mom anymore. I wasn't the only family member who felt that way. Also, whenever she wakes up from a nap and thinks it's the next day, she's always disappointed when it's not. "You mean it's still Tuesday?" It's like she wants the day to be over with. This is especially true if she had something planned the next day or in this last case, she was sore from hip surgery and can barely walk even with a walker. Keep in mind that it's been four months since this last happened. That's really her only symptom. I've been living with her ever since my dad passed away 10 years ago. She still makes her own decisions. I'm there to do household repairs and for protection. My mom has taken the test where they ask you to do things like spell world backwards or copy two overlapping polygons and she did well on that test. Even my other sister said she was surprised at how well she did. When asked to spell world backwards, my sister said she herself had to stop and think about it. Mom did it right away. The problem, and this may be part of the reason for the diagnosis, is my mom doesn't remember things that are unimportant to her. Who does? The one problem she does have is she constantly interupts people while they're in the middle of a sentence. That's not a sign of mental decline though. Her whole family is like that. You get them all in a room and there will be 3 or 4 conversations going on simultaneously. They all try to talk over each other and if you're talking to one of them, it's not uncommon for someone else to suddenly start talking to you.
Did mom fall and break her hip or did she fall because her hip broke? That is more common than people realize, my doctor said that osteoporosis is killing our seniors in epidemic rates and no one is even looking at because of the fallout of a senior being immobile due to the injury, so pneumonia and blood clots are blamed, when in reality it started because of osteoporosis.

Broken bones are traumatic on our systems, it takes a long time for elders to heal from them. 4 months is not overly long, imo. However, many dementia journeys start with a broken bone.

If not knowing what day it is, is cause to go into NH, I better pack my bags. When we don't have something everyday that keeps us informed of the day, it is easy to not know. I think I would be finding a doctor that is actually treating mom based on mom and not hearsay. That is a red flag.

You live with your mom, you would be able to see if she is slipping, but i think that she has just been through a major injury and now is not the optimal time for testing and diagnosing, she could be displaying symptoms from the trauma that will go away.

I would keep an eye on her for signs and I would look for a doctor that treats elders as human beings with rights.

Do research on symptoms of Alzheimer's and dementia, get educated and you will be able to advocate for mom from a position of knowledge.

It does seem like it can come and go, good days and bad days. It is a rollercoaster and there are no hard and fast rules how it effects everyone, it is a personal disease that treats each person differently.

I pray that your mom doesn't have dementia and that you are able to accept whatever it is.
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jacobsonbob Jan 2019
The point about a bone breaking and resulting in a fall is an excellent one. My mother broke both her femurs (about a year apart). The first one broke (due to osteoporosis) while sitting on the toilet, and she had to fall to floor deliberately to crawl to a telephone in the bedroom to call for help (my father was in the hospital at the time due to a mild stroke). A year later the other leg went while going downstairs, but she was able to sit down. Fortunately, both my father and a family friend were there to get her the necessary help. Both falls required the insertion of a titanium rod and considerable physical therapy. She then was able to enjoy a few years of normal living until dementia became obvious.
You care for mom? When is the last time you took her to the doctor?
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I agree with countrymouse. No doctor diagnoses over the phone. They do a formal assessment. It might be dementia and it might not be. Who knows. Dementia does come and go. They can seem fine one minute, then not a few mins later. Or be somewhere back in time in their mind.
Was mom diagnosed with dementia in the hospital when she broke her hip? Was she able to walk, follow directions for PT,OT, nursing staff?
Can your mom get around now, or is she bedridden? If she broke her hip from a fall, she will 100% fall again. That is a fact. Does sis think you cant manage her care? Can mom get up out of bed?

I dont understand why your sis is trying to get her into a home if your mom has you. Nursing homes are 10k a month easy. Thats not including meds, or doc, dentist, podiatrist visits. They want all pertinant info about your mom's finances too.

Im sure the monthly cost of living, is much less with you taking care of her. What is her hurry to get her in a home? Does she think your mom's care is too much for you alone? Would the house be sold if mom goes in a home? Or is it your house? Would sis be able to visit more at a nursing home?

I dont think she can force the issue if you are POA too. Is she ready to take you to court over this? You dont have to open the door if an ambulance shows up to take her to a home if one is called. It would be a company that shuttles residents to nursing homes/doc appts. It probably wouldnt be the ambulance to take her to the ER unless your sis says its an emergency.

I would think you are the best option for your mom. Being at home in familiar souroundings. Why cant you both compromise and have an aid or 2 come in? It would give you some help with mom's care. It might be a better, and much cheaper option than a home. Sis might be happy mom has more help.
How does your mom get to the bathroom and bathe? Are their steps in the home your mom has to navigate? Mom isnt driving now is she? If she has slight forgetfulness, that is not a good thing behind the wheel. You should be driving, not her. Her driving days should be over. Id be worried for her safety and others. Its not just her on the road. She could hit the gas instead of the brake and hurt someone else. An innocent person. Its just not a good idea.
Perhaps you can give us an update. Is it your home? Does sis think your level of care is not enough? Is your mom able to walk? Does sis think she can control more if mom is moved to a home?
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