Mom has stage 4 liver and lung cancer, diabetes and MS and insists she is perfectly fine living alone. My sister and I have been helping her for the past 3 years. We both work full time and live about an hour away. She has been slowly declining, but in the past 2-3 months she has really gone down hill. The local police and EMT are getting regular calls from her -sometimes just to bring in her groceries. She has recently become verbally abusive and believes everyone including my sister and I are lying to her and trying to cheat her. Her memory is going-she mixes different events together, but insists she is perfectly fine and still capable of living alone. She has always had hoarder instincts, but these have gotten out of control recently.

Her doctors have referred her to 3 different hospice services, but after meeting with them, she has rejected services. She has hired and fired multiple support agencies-usually in the same week. Her doctors aren’t willing to stick their necks out to declare her incompetent so we can take on healthcare POA. Finally APS has taken notice-both the latest hospice and the EMT service reported her, but APS has done nothing so far. Mom is on Medicaid, and we’ve been reluctant to pursue guardianship because of the time it would take-figuring because of the cancer it didn’t make sense and we didn’t want to put her through it. She refuses to consider moving and insists she is going to die in her house. Feeling incredibly stuck by this whole situation. There doesn’t seem to be anything we can do to help her or that she even wants any help! We are both fed up with the verbal abuse and her inability to recognize the situation. It would be nice if she were at least comfortable and safe. And of course there is still some feeling that maybe we should do something with her for Thanksgiving-but no way it could happen at her house. Way too much mess, urine, dogs, etc. COVID makes it even more challenging. I hate to say this but neither of us have any love for her. Should we just walk away and leave her to her fate?

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Your Mom has so much wrong with her and everyone of them could be causing her confusion and other problems.

First liver cancer. If the liver is not working correctly toxins are probably being released into her system which causes a delirium. If she is not taking her diabetes meds correctly, another reason she is showing signs of a dementia. And then the MS and lung cancer. MS effects the respiratory system too. Meaning, she may not be getting enough oxygen to her brain. Again, Dementia type symptoms.

APS, what do you think they can do. Their first responsibility is to try and keep a person in their home. They really can't force someone to leave their home without good cause like they are a danger to themselves and others. Adults have a right to live and die the way they want.

The only time I have heard APS doing anything was when after a number of calls from neighbors calling APS one neighbor was able to get hold of an out of state son. He called APS asking for a "well visit". When APS finally went in, they found the woman had Dementia and gangrene in her foot. They removed her but left her 400lb challenged son behind. It took a call to a friend of mine who had worked in the County and knew this family to call her friends at the Health Dept to get him out of that apt. He has been living for two years in the same NH as his Mom.

Maybe you should try the Health Dept.
Helpful Answer (1)
Reply to JoAnn29

You mention two sources that have reported your mother to APS. Have you also done this yourself? Sometimes the squeaky wheel gets the grease. Perhaps they could use your perspective on what’s going on to add to their case
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Reply to Daughterof1930

I am sorry to say it but it does sound as though your mother will get her wish before very long.

So that you and your sister don't get emotionally ambushed (by guilt or regret, which tend to strike even people who are in no way to blame. Or maybe even more so) it might be best to keep in as close contact as you can with APS and any hospice provider APS might involve, and work in step with them.

Mother wants to die in her house. So: that then becomes the goal, and the partnership of professionals and family aims to accomplish it with as little collateral damage as possible.

For example: she doesn't want any help, she feels dreadful and she can't bear any intrusion. Those things are true, she's not being a drama queen. But she also doesn't actually want to end her days covered in blood and faeces. A way has to be found to assist her that keeps intrusion to the absolute minimum - she may take that more easily from friendly outsiders in uniform than she can from you, and then if you and your sister are kept completely separate from issues like personal care, it might give you a chance just to be with your mother without trying to make her do anything. APS and any other social care organisations they work with ought to know all this and welcome your participation in your mother's support (because it's in her best interests).

The verbal abuse may come from a combination of feeling incredibly ill and possible brain metastases or other effects of the advancing cancers. I know it doesn't make it any easier for you daughters to hear from your mother, but it would mean your mother genuinely has no idea what she's saying. These are not your real mother's real words.

I'm so sorry it's happening.
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Reply to Countrymouse

The only thing you can do is offer her help. If she continues to refuse, unfortunately there's nothing you can really do.
People have the right to make their own decisions, even the bad ones.
As hard as it might be- because of other people's expectations- if she is bound and determined to die at home with no assistance, let her be.
Peace to you during this time, I'm sure it's been terrible to deal with.
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Reply to notgoodenough

Quick answer to your question.
Now more.
Nothing you can do will change your mom.
So pretty much all you can do is wait.
Something will happen and rather than the EMS dropping off a bag of groceries will take her to the hospital.
NOW you can do something. If they want to discharge her home you can say it is an unsafe discharge, that she can not live alone. And she can not live with you.
Most likely they would send her to rehab. when they try to discharge her from there you say the same thing. Hopefully at some point here some doctor would have made the determination that she is not competent.
You do not have to seek Guardianship A court can appoint a Guardian. She would then become a Ward of the State and they would make all decisions regarding her care and where she goes.

But without a doctor stating that she is not competent all you can do is WAIT.
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Reply to Grandma1954

You don’t mention how you and sister help Mom or how often. If you’re going frequently, she’s probably under the false impression that she indeed IS living on her own just fine! Just can’t see that she is doing so only because of the generosity of you two.
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Reply to LoopyLoo

APS is probably in overdrive right now due to the pandemic and the wave of seniors having all sorts of issues (especially if she lives in a county with high population). You state that "doctors aren’t willing to stick their necks out to declare her incompetent" but being a hoarder doesn't automatically mean she is cognitively incapacitated. They can't make a diagnosis without her being physically present for an exam. If you can't trick her into going in for a physical exam (where a doctor would also administer a cognitive exam) then there's nothing more you can do. Also, please realize that pursuing guardianship is not just time consuming -- it's incredibly expensive (thousands of dollars). I think you two have done yeoman's work of trying to protect her from herself. Now you are out of options and I think you can distance yourself from her with clear consciouses and let APS move in and take over.
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Reply to Geaton777

It sounds like you have done everything in your power.

APS is involved, it may take time for them to act, but I hope you can have a safe healthy Thanksgiving without her. You know that if she is included she will create a situation to ruin it for everyone else.
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Reply to Tothill

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