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Mom is currently visiting me in my city and agreed to look at assisted living communities. That agreement changes every 20 minutes because she is determined to live independently 400 miles away. I'm the only child/relative left. Mom is 90 with vascular dementia that is progressing...and neighbor caregiver who checked in on her says he can no longer provide assistance. "It's time." I have an appointment with an elder law attorney in three days. Am I the client because I need advice on my POA for Mom....or is she? I'm thinking I am. She has trust and wills and POA all set. I'm the one who needs legal advice. We have visited 2 lovely and new assisted living facilities...tours, lunch...great places and we had fun joining some other residents for lunch. Of course I have tried to include Mom (for over a year and a half) in ideas/plans to move to my city and be part of a senior community. Her cognitive ability, of course, has deteriorated to the point where agrees one minute and then insists she will never live her home a few minutes later. This is an excellent example of how impossible it is to reason with an elder who is living with dementia. What I get from her is...I can take care of myself...go live your life...forget about me...I'll be dead soon anyway....you don't want to come to Chicago to live...well, I don't want to live here....leave me alone and forget about me. .... etc., etc., etc. I do have POA that includes the recommendation of only one physician for me to take over decisions...and I have a copy of her neuropsych evaluation with the diagnosis and recommendation that she cannot make her own decisions with care. So...am I the client for the elder law attorney.....and if anyone has suggestions for how to proceed from here, I'm all ears....and believe me, I've even thought of getting her committed while I get her furniture and things relocated...the abduction scenario. She is grieving and full of fear and anger. My heart breaks for her.

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Amy, I have to agree with others you did the right thing! Its hard when our parents get into their 80s and 90s. We as the adult children sometimes have to take control and make the final decision. I know its not easy and there is always guilt, but we have to. 99 years old and there is really no other choice. (((hugs)))
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Amy, i remember your terribly conflicted feelings at the time; you did EXACTLY the right thing! Anyone who says you didn't is wrong.
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amy -you did fine in a very difficult situation ((((((hugs)))))
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Maybe some of you think my sister and I were cruel in how we moved Mom to AL so I feel I need to explain why we had no choice. Mom was 99 and living in IL. IL told us they could not renew her lease based on the doctor's evaluation of her level of dementia. She hadn't bathed in a year, she was not eating, depressed, negative, accusing people of stealing and she had fallen several times. She refused to use the elevator or walker and was going up and down a long flight of stairs which scared everyone half to death every time. She wore the same clothes for a month unless we took them away. She was deaf, even with a hearing aid, so mostly did not know or understand what was going on or what was said, and her memory and dementia were really bad. She refused to let anyone in the apartment to help her, except us - which she gave us a bad time - so home care was impossible. She desperately needed medication for her anxiety and depression and because she refused help and couldn't be trusted with drugs, being somewhere with 24/7 care was the only way. The IL was not equipped for what she needed. My sister was caring in her home for her dying husband, I couldn't monitor her 8 hours a day.  My home is not senior friendly and Mom did not like coming to my house. We tried talking to her, but because of her advanced dementia it was impossible to reason or convince her or even explain why she had to move.  I felt like a rat doing it, but it was the only way to get her medical help and keep her safe.  In the end, she at least got the medication and oversight she needed and did have some friends. 
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Congratulations on successfully navigating the AL dilemma. We had to fool Mom by having her visit my sister while hubby and I moved her things from IL. Then sis gave her a tranquilizer which just about knocked her out so we could get her in the door. The staff took it over from there. We felt really mean, but knew it was the only way to get her help. They always seem to take out their anger on the daughters! But they told us Mom was actually pretty content there when we weren't around. She even used to sit on the couch with an older man and they would hold hands. Dementia is an awful thing but know you did your very best for your mother and that she is actually happier than she wants you to know.
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Thanks, Shane....Oh, she is a firecracker and is naturally obsessing about her home and wanting to be home. She is saying nice things about the facility, the other residents and staff. Long journey ahead, but as you say, the battle is half over and we each have our personal space and I know she is somewhere I would definitely choose for myself: Mill Creek Village in Columbia, MO if anyone wants to google it.

Another point I want to make to any new folks reading/learning from our experiences is this: I've always visited Mom at home but this last visit, when we agreed to go visit where I live (Columbia, MO)...it was only then that I truly saw how impaired her thinking/confusion had become. She was in her element in her familiar home...but outside familiar territory it a whole other story...and terrifying. I'm the only child...so I am so grateful circumstances happened as they did. Also very grateful for all the folks who post questions/dilemmas on this site and the many responses of wisdom offered. I'm a daily reader.
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Congratulations! I was always hoping to have my mom move near me but could never pull it off. You did it!
So pleased for you!
On the other hand, now your mom has to adjust. If she plays the bad guy with you, who knows? She may be an angel at the AL. Time will tell.
Good luck. Half the battle is over. She may love being there getting waited on for her 3 meals a day, housekeeping services, activities, etc. I hope it progresses smoothly.
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Thank you, everyone. Mom has had her first night in an assisted living 1 BR apartment. It happened by circumstance and she is furious.

Yesterday, we drove to the assisted living community "to do paperwork." I reminded Mom of her agreement to do a 6 month trial. When paperwork, shared with Mom who angrily said, "It looks like I'll be staying her a while," was almost completed, it came to the question of starting date. I just turned to Mom and asked what she thought. "Today. Just put me away today." We gave it some pause, I asked again, and she said today.

So on a day I thought I might get some paperwork done, Mom was actually admitted. She insisted on going back to my house to pack the few clothes she had brought down for the visit with me, so we went. On the ride back to the assisted living facility she said, "Well, it was really nice for you to have me. I really enjoyed my visit." She thought we were driving back to Illinois. I kept quiet and just nodded my head. When we arrived she asked what we were doing there and I reminded her of the paperwork we did. She said, "Shit!" got out of the car and insisted on lugging her suitcase in. The rest of the time I was there, administrators were with us while she bad mouthed me and insisted she didn't want to be there. She wanted to go home. In our situation, it seems that my presence is and clearly will be a trigger for anger. I am the enemy, the wicked witch, the one always telling her what to do. Truth be told, I am the adult woman and little girl who has always been afraid of my mother. She will be on her best behavior when I am not around.

When I left I asked for a hug, and she allowed it. I went home for counseling with two friends. Mom called twice. Last night I slept only 2 hours. Today I will bring her some supplies. Later this week, a friend and I will go to Mom's place and arrange the move of her clothes, favorite things, and furniture.

She is safe. She is living in my city. I am relieved this happened rather unexpectedly...and will move forward with getting her a visit with my primary care physician and turning her apartment into her new home...even though she shouted at me not to bring anything from Grayslake, IL because she's going back tomorrow.

This community has various levels of care...there are funds to provide whatever she needs..and we'll move forward with the next phase. I have an appointment with my psychologist and the new lawyer in two days...and I have the support of close gal pals who are like sisters.
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You are doing the right thing seeing the attorney to find out what your rights are. I would say in this case you are the client as you are the one seeking advice but that could change later.
If Mom's current home could be maintained while she has a trial stay in AL that would be ideal because the ultimate decision could be 24 hour care at home or an AL in her current location if she has a good group of supportive friends, church etc there. 400 miles is a long way to go for a short visit but with proper local support could be done and then if necessary as she progresses move her closer to you.
i think the right first thing to do is wait and see what the lawyer has to say then proceed from there. Mom is never going to make a decision with the dementia.
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I agree about discussing anxiety meds with doctor. A geriatric psychiatrist would be best. You already have a doctor saying that she's not competent to make decisions, so that frees you up to make the decisions, according to the legal authority you have by DPOA and Healthcare POA. The paperwork should state what you have and your attorney can confirm. 

I'd consider that while your mom may seem to be changing her mind about things.  She likely has forgotten what she told you 20 minutes earlier and that's why she's telling you something different.  It's more of memory loss of what she just said than mind changing. That would be my suspicion. 

It's not likely that people with dementia are going to suddenly or gradually see the light, get on board, agree, be reasonable, etc. They can't continue to drive the train. It's nice to placate as suggested above, but, I'd get a reason that she's moving to the facility and reiterate as she is placed. With my LO her Primary told her she needed AL. Period. She would not let it go. So, my LO adjusted to the idea of going to rehab to get her physical therapy, medications, help with her memory, etc. temporarily. The professionals at the facility are skilled and are good at administering medications.

Do you know what level of care your mom needs? I'd explore that, so you know what type of facility you need to find. The neuropsychological evaluation may provide some information, but, I'm not sure if it will help with what daily activities she needs assistance with, like, bathing, food preparation, laundry, toileting, etc.  I'd keep in mind that with an AL community, as she progresses with dementia, she may need a higher level of care.  I'd consider if they have that available on site, like a Memory Care unit, so she doesn't have to move to a new facility later on.  Also, I'd explore just how much the AL will provide in hands on care.  It varies by state as to what they are allowed to do.  
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Let's say your mother is the client, and you are her agent. You want the legal advice to make it possible and practical for her POA (you, as it happens, but it could have been anyone) to fulfil the responsibilities that go with that.

Apart from anything else - not to be grabby, just to be fair - that also means she's the one who gets the invoice! After all, the entire exercise is for her benefit, not yours.

I don't mean this to sound like a con either, but could you perhaps get her firm(er) agreement to give her choice of facility a "fair trial" of, say three months? For one thing, she might be more likely to agree if it doesn't mean making a final, irrevocable decision; and for another if, as seems likely, she's unable to make any kind of decision before long, it'll be a heck of a lot easier to make the move permanent if she's already placed.
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What is her "reasoning"for refusing meds?
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Not seen by a geriatric psychiatrist...just a neuropsychologist for the evaluation which was done a year ago. She refuses all meds now...but (a little humor here...) I've been tempted to lace her morning tea with my Prozac. (!!)
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A couple of things..


Has she been seen by a geriatric psychiatrist? It sounds as though she might benefit from meds for depression and agitation. Vascular dementia often causes and exacerbates these conditions.

I think you are the lawyer's client. You want to know if you have the authority to determine where mom lives. But even if the answer is no, you are going to mske a good faith effort to move her to the AL, because that's what she needs.

Therapeutic fictions are helpful. "Oh mom, the foctor wants you to stay here for a while until you get stronger/until I get back from my trip/until your house is fitted with a new roof." With my mom, it was until the winter was over.
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