I am caregiver to my Mother. She has the on-site of dementia. Can I legally move her to a community?

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Her PCP has just diagnosed her with 'bipolar' disorder. Currently, she is residing in an Independent Retirement Community, but I am having additional caregivers help me, (and they require payment). I have DPOA. Mom's PCP has stated that she should be in a more assisted type environment. Mom will not go for that. What can I do? The additional caregivers will break her financially, so it can't continue. Any suggestions? Can I legally move her to a rehabilitation, assisted type retirement community? And if so, what are the absolute best in and around the Austin/Cedar Park area? I've seen one and was not pleased with their staff, or their attitudes. I want someone who will actually 'care' for my Mother, in my absence. I am one of the children who does visit very frequently, but with her medication and her dosing herself, I cannot be there 24/7.

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Babalou, GardenArtist and JessieBelle, thank you for your responses and your support. It helps to know I'm not alone. Have a great day.
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SueAnn, I'm sure it is going to be okay, but you really need an eldercare attorney. On mom's dime.
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You know, I had an incredible dream a couple nights ago....I was running from something terrifying and almost ran off a cliff, and was trying to catch my balance, wailing my arms and stuff, when I turned around and my Father was behind my, extending his hand to reach for me. I shouted out "Daddy?"......I had just turned 6 and he left for Vietnam within 2 weeks, and he had already been gone on a previous tour, so I never really remembered his face, except in pictures. But, in my dream I saw his face like he was right there - so real. I don't know why I'm telling you all this.......it just felt like he was somehow trying to tell me, it's going to be OK.
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After Mom moved to Texas, she sold the main home we lived in. This home was in the name of #1 son and herself. It would have sold for more than $100K more than she received, but he never would get off of his lazy, drunk butt to help the realtor. The MO realtor was calling me, to try to get him to do something. Anyways, he has cancer now, is basically white trash, his kitchen floor has caved in and I've tried to convince him that he needs to do radiation like his DR has told him to do, however he says he doesn't want to drive 'that' far. WOW! I swear, my older twin brothers must share a brain.

So, Mom received 1/2 of the profits, which wasn't a ton of money; then, she and I had a 'join tenants in common' piece of property, that was sold just this year, but all of those proceeds went directly into HER account. The VA has deemed her 'incompetent' and named me as her VA fiduciary. So, I have a scanner and keep all of her receipts. What a job that is, with all of her I want this, and then waits til I get there and decides, oh I forgot to tell you, so go back out and get me something else!

Yes, she receives SS and VA benefits, and she has one remaining piece of property left. It's up in Missouri, so this and the one that sold earlier this year aren't very high in price. They were just rental properties.

There's no way I'd send her back to Missouri. Mike (#1) would try to get his hands on what's left of her money and spend it on himself; and Mark (his twin) even though he lives in Dallas has not seen our Mom in (9) nine years!!! They disgust me to no end, but I still keep them in my prayers. I can't worry about them right now.
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SueAnn, it worries me that your mother has no money. There are many AL facilities in Austin and the surrounding areas, but they are fairly expensive. I knew one lady who stayed at Barton Hills off IH-35. She gave it good reviews. It is full service as long as residents can walk and don't have serious behavior problems. There is also a good one in Bastrop, but it is even more expensive. There are also AL facilities in San Marcos and New Braunfels, but the ones I know about are not as nice or have the level of service your mother may need.

Does your mother receive VA benefits? She may qualify for help with AL or nursing facilities through the VA. That would help a lot if she did.
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SueAnn, my understanding of Asian culture is that the wife of the oldest son in the family is expected to care for the son's parents in their old age. So it may be that that philosophy is why she's so demanding - even though she's been in America presumably for several decades, and you're her daughter, not the wife of her son, that cultural upbringing may be so inculcated in her that she's seguing back to it now with the variation that she expects her daughter, not her son's wife to take care of her.

However, that doesn't mean that you need to be a doormat for her.

I also would not be comfortable accepting a PCP's diagnosis of bi-polar, especially if he/she is someone who's not familiar with the Asian culture. I agree with Babalou; I think that diagnosis is better left to qualified psychiatrists.

As to your questions:

1. What you can do is be firm, stand up to her and make it clear you won't tolerate her abusive treatment.

2. Alternately you can check the DPOA to see if you have authority to delegate it to someone else, such as your brothers. Then find out if they'll accept the responsibility, which I doubt they will. At that point, you'll know for sure that they're not going to help.

3. At that point, make your own decision, and find a good AL facility.

You asked about facilities in the Austin/Cedar Park area. Unless one of us here is familiar with that area, we couldn't really recommend any facility with any guaranteed knowledge that it was superior.

You can check the Medicare.gov site, search for AL facilities in the Austin area, make comparisons as that site allows, then tour those on your short list. Make a checklist of what you think your mother should have, and get answers to your questions, including what the patient:staff ratio is.

Tour the facility at different times, find out what activities exist, and get as much information as you can.

You could also ask the psychiatrist, or a geriatrician if you have one, to recommend good facilities.
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I'm going to assume that she was on lots of meds to keep her from acting out. With a better diagnosis, she will get appropriate medication and function better.

But the dementia is what's driving the train here, and that will only get worse. How much have you read, on this site and elsewhere about dementia?

I used to think that dementia meant that a person was losing their memory skills. What I've found with my mom is that she's lost her reasoning skills, her ability to see the big picture, and to make safe choices. So, read up on dementia and especially , watch the YouTube videos of Teepa Snow. She's got some great, simple techniques that often work with dementia patients.

About your brothers. They've stolen your mom's money. If you ever need to apply for Medicaid on her behalf, she won't be able to get it right away, because there will be a waiting period before she qualifies. Medicaid currently looks back at 5 years of banking records. So YOU should keep all receipts for any monies you spend on mom's behalf. And I would notify your brother's that when mom can no longer be cared for with just her VA and SS income, you'll be sending her back to them to be cared for at their homes. Unless they'd like to start paying her back, as you're sure that money was just a loan.

You are probably going to need to find an eldercare attorney who understands Medicaid to advise you about this. You use Mom's money for this, not yours.

If you can't convince mom that she needs to move to Assisted Living (AL), you may have to seek guardianship. There is always the option of walking away and letting the state take over guardianship.

It sounds as though your mom has a long standing mental illness, not her fault, but not yours, either. Being raised by a bipolar parent is damaging. Seeking therapy for support during this very trying period is not a mark of weakness, but one of strength. And don't let ANY ONE tell you otherwise.
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Oh my goodness, what a tale! AL is Assisted Living.

I assume with dementia, that PCPs is referring her to a psychiatrist from evaluation of medication. That will be a good referral to get. More in a bit!
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Hi Babalou, what's "AL"? Her PCP office called me 3 times today, and they are referring her out to a psychotherapist, so I should be expecting a call from her sometime soon.

A little about her background: She's been a VN war widow and has never remarried, raised 3 kids (I'm the youngest), however she is asian : / I make that face, because anyone who is familiar with the asian culture, knows that the males are #1....I heard this my entire life growing up. Well #1 son lived in the same town and couldn't even drive 3 miles or less to visit her when she was at an assisted living home, but they did have a joint checking account, which he managed to consistently pay his bills with, write checks to his twin brother (Dallas), and do whatever he wanted with MOM's money. When I flew up to get her in May of 2013, he didn't even have the decency to see his own mother before we got on a train back to Austin. I was pissed and she was crushed, so I drove her over there. On the way back to Austin, on the train, #1 son texts me to say Mom's broke! So I had to ask my Husband if we had enough money to pay Mom's 1st months rent where she currently lives, until her VA and SS rolled in at the beginning of the following month. I was a bit peeved again at him. Anyways, enough of those 2.

She was on 17 pills up in Missouri, and I asked her PCP when she arrived if we could get her off the ones she absolutely did not need, which we did. I thought it was nonsense, how doped up they had her.

She was happy as could be, I was there from practically sun up to sun down, to be sure she was comfortable enough there. This lasted for 6-9 months, which didn't help my marriage probably.

I catered to her every need, and now it has turned and bitten me in the butt. If I don't do what she asks, she's hateful, curses at me, tells me she wants to go back to Missouri (to what?), calls 911 (4 times this year until I just disconnected her phone, which was in my name) if she wants me to give her more pills than she's suppose to take. The police knows she's incompetent and understand what I'm dealing with, but say they have to come and I completely understand.

I pray and try my hardest, but she is making it extremely hard. Of all of her children, her lowly (you're nothing but dirt in my country) daughter is the one catering to you, cleaning your butt and everything else she has demanded that I do.

I do have DPOA, which is the way she wanted it when she first arrived in Austin. God help me.
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Sue Ann, I'm not sure I'd take an internist ' s diagnosis of Bipolar disorder without getting confirmation from a psychiatrist, preferably a geriatric psychiatrist. Now, that's easy for me to say, I live in an area where there are lots of geriatric psychiatrists. But you might want another opinion.

In terms of getting your mom moved, I would look for an AL that also has a specialized dementia unit. The only sure thing in life is that dementia progresses. So sooner or later, she'll need a higher level of care.

Have you heard of "therapeutic fibbing"? Sometimes, we find ourselves having to tell out parents whoppers to gain cooperation. The place is being renovated, or her room was found to have a leak and you need to move her for a month while they fix it. Or, they no longer take her insurance. Something like that. I know, it doesn't fell good to lie to one's mother. But the highest purpose, I think, is to keep her safe.
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