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My mom has been living in squalor and is at risk for falls due to the condition of her apartment. My sisters and I called the state of WA for assistance and at that time, they said there was nothing they could do because my mom seemed to know the condition of her surroundings and was ok with the decision to live that way. Recently my mom has been diagnosed with stage 4 Alzheimer’s and we are trying to get her into an assisted living with memory care. My mom visits places with us but refuses to move or make us (one of her children) her power of attorney. Any advice on getting her to move in to assisted living? If she continues to refuse, what is our responsibility as her adult children?

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APS is adult protective services and you can remain anonymous when you make a report. She is a vulnerable senior living in squalor, that should be enough to get them to go out.

Be very clear that you must remain anonymous so you can help her.

My heart goes out to you. What a dreadful situation for all of you.

I would try to find a certified elder law attorney through www.nelf.org, you should not be charged for an initial consultation. That other attorney should have referred you to an elder law attorney. So much lack of integrity in that industry, you need to be careful. But using one that is certified will guarantee that they know the situation and won't be changing you for their education.

At this stage of things you can call APS and the odds they will intervene are pretty high. I feel sorry for that poor dog. I don't think they enjoy living like that but they are adaptable for sure.

You say your mom doesn't want to be a burden, so you have to operate from what you know she wanted when she was in her right mind. Anything said now that contradicts what she said with a sound mind needs to be treated as the disease babbling and not moms real desires. That is hard when they are so certain and convincing but you know what she really wanted. Follow that and you'll do fine.

Hugs!
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Reply to Isthisrealyreal
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If mom is still driving, please, please get her off the road. If dementia has been diagnosed then it should be possible - if doc is not cooperative, you might remind her/him that liability issues for doc might arise.  As for apartment, have you called your local health department?
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Reply to rovana
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Who has POA? Mom can no longer make informed decisions so you make them for her. No, she isn't going to like it but its now what she needs not what she wants.
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seattlecare Mar 12, 2019
I replied to your question but don’t see it here...sorry if I am repeating myself.

My step dad had POA but he passed four years ago. On the advice of my mom’s doctors, we are trying to get POA now. My twin will be POA because she is also executor and I be the alternate. Despite painstakingly explaining to my mom what a POA is, why we need one, the fact she had one before (my step dad) but he’s gone, and my mom needs a new one, my mom refuses to sign the form.

Originally we (my twin sister and I) contacted an estate attorney and that attorney wanted to set up an hour consultation with us at $350/hr. Then a week later, that attorney wanted us to go back in and the attorney would explain to us the law, my mom’s rights etc, our options and so forth. Another hour at $350. Then finally on a third appointment, another $350 now totaling $1050, the attorney would give us the form and help us fill it out, notarize etc. OR, we could download the form ourselves, bring to a notary, sign form with picture IDs, and get two witnesses not related to my mom to sign all for $15. All of that could be done at my mom’s bank. But my mom refused to sign the form. She texted and said “her feelings for her seem worthless,” and “what [I] assumed for my thoughts are apparently not appropriate for me,” and “How can this be created if it’s about me and I don’t know about it?” I know this doesn’t make sense but my mom has Alzheimer’s and likely had been drinking when she sent this to me via text so...

Tomorrow we are accompanying my mom to her primary care doctor to go over the neurocognitive test that has the Alzheimer’s 3/4 diagnosis and what that means. I have already contacted the doctor to give them the head’s up that my mom is refusing assisted living and refusing to give my sister POA. Hopefully that insight will direct the conversation down this path.

Thank you for replying!
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2 ways to go here.
1. And worst case...Wait for a catastrophic event that will land her in the hospital then in rehab. You can then stress that she is unable to live alone and care for herself. In all likely hood she would not be released to home. You could then get her into Assisted but better would be Memory Care.
2. Gain Guardianship of your Mother. This would require a court case and does involve paperwork. If you do not think you could be a Guardian the court will appoint one. At that point you could get her into Memory Care.

Neither a great option but if she resists moving there is not much you can do until she has been declared incompetent. Once she has been declared incompetent she can no longer make decisions as to where she should live.

It might be wise to consult an Elder Care Attorney for advice before you go any route.
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seattlecare Mar 12, 2019
Thank you for replying! Yes we are waiting for option #1, unfortunately, the catastrophic event. She has fallen so many times and has had so many head injuries that the doctor thinks that is contributing to her memory loss. My mom says she doesn’t want to be a burden but the burden lies in knowing she’s not safe where she is living.

I will contact an elder care attorney - I did not know there was such an attorney. We have consulted with an estate attorney.
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I'm curious as to why you say she has Stage 4 Alzheimers. Is this what her doctor has said? Just wondering, because, her doctor may be able to assist if he believes that it's harmful to her to live alone. Do you know of anything other than her house of squalor that is a problem with her now? Like, does she take her medication properly? Is she able to shop for food, prepare and eat proper meals? Does she handle her hygiene properly? Pay her own bills on time? I'd try to figure this out and then consult with an Elder Law attorney in her jurisdiction to see what evidence you need to gain authority to act on her behalf by the court. The attorneys should be able to explain what you'll need from the doctor and other evidence, costs, process, etc. They can also provide you with information on what, if any, responsibility, you have to her as a family member who resists your help.
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seattlecare Mar 12, 2019
I had a long reply answering your questions but I lost the reply. If you got it, sorry to repeat myself!

A year ago my mom had a baseline neurocognitive study done with a psychologist. She was diagnosed with age related cognitive decline and given some suggestions that would improve her memory: better sleep hygiene and using her CPAP, better nutrition (she has steady diet of fast food), mental and physical exercise (she leads a sedentary lifestyle), and use of a walker to prevent falls. My mom has not followed any of the advice her doctors. So a year later, now, she has been diagnosed with stage 3/4 Alzheimer’s from same phsychologist. He attributes the fast decline to not following any of the things he asked her to do a year ago and she’s fallen at least three times and so that’s three more head injuries we know about. Also, she is a massive alcoholic and claims she’s no longer drinking but we have evidence to the contrary.

My mom lives like a hoarder. Stuff piled everywhere. My sister and I cleaned out her house a year ago and it’s worse now than ever before. My mom has a dog she can’t walk so she lets the dog use pee pads in the second bedroom however the dog misses and so now she had mushrooms and other stuff growing out of the carpet and so no houselceaner will clean her house. One literally needs to enter the apartment with a mask until you become accustomed to the smell. She says she is showering but she has boxes piled up in both showers so we know she is not. She uses dry shampoo and wet wipes and so we estimate it’s been two years since a proper shower. Bills are being paid through automatic deductions and I am monitoring her account. She has a pill organizer for meds. We contacted the state of WA to do a welfare check 2 years ago and they interviewed her for 4 hours in her home. They said that even though she was living like that, she knew the consequences so there wasn’t anything else they could do. I can call them again but it took about a year for my mom to forgive us for calling her them the first time. Tomorrow my sister and I are gaining access to her apartment to snap photos for evidence in the event we need it and to look for evidence of alcohol consumption. I will contact an attorney. Thank you for your reply!
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I am sorry that your family has to travel this journey.

Stage 4 and getting worse. She probably won't willing give you POA, you have already made it clear that you want to move her. Such a nasty disease, she won't see it is for her safety, she will see you as the people that want to take her from her home. Now she will be defensive and distrustful , watching for the take over. This is the insanity that happens in their broken brain.

Our system is not much better, but when you look at the abuse perpetrated against elderly, you can understand that the line has to be drawn somewhere.

You can't make her do anything she has been deemed competent to choose her own path on, unfortunately or fortunately that won't last forever, she will get to a point that she cannot take care of her basic needs, maybe become non-verbal or immobile, at this stage APS will have to intervene or you and sibs can apply for guardianship and move forward from there. It really depends on how much you and sibs want to do for her, guardian means you are the responsible adult for her, i don't believe that includes financially but I would check out your states laws, rules and requirements for guardianship so you know what you will be facing. If family doesn't do this the state will appoint someone to do it.

If your mom has no money, it might be a good idea to look into Medicaid now, that way it is in progress or not such a surprise when you need, if you need, to apply.

As hard as it is to stand there and watch the train wreck approach that is how it is, people have rights and those rights include bad, dangerous, unhealthy, crazy choices that we all know will make a hard situation harder but you have no choice. She will get to a point that she will no longer have the mental capacity to be in charge, that is when you can intervene.

Stay strong, keep an eye on her and when you see decline call APS, they will eventually see she is no longer safe to live alone.

Hugs to you and your sister, you will need each other before this is finished, don't let anything create a separation.
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Reply to Isthisrealyreal
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seattlecare Mar 12, 2019
Thank you for your reply!

You are so right...we are literally watching the train wreck as it unfolds in slow motion. And I am so lucky I have a twin to ride the storm out with.

You mentioned APS-is that the government agency that does the well fair checks on the elderly? We called the state of WA two years ago and two investigators (counselors, agents-not sure what they are called?) dropped in on my mom and deemed her competent “enough.” They told us (my sister and I) to call again in the future and they would do another surprise visit but my mom was so upset we called the “State of WA on her” the first time, it took her a long time to get over that. And she is so suspicious and paranoid, thinking we are all taking about her being her back (which we do).

Thank you for your advice and kindness!
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Can you find out what your Mother does want?

Can someone help her in her home to clean up, improve the living conditions?
Start there.
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Reply to Sendhelp
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seattlecare Mar 12, 2019
Yes, thank you for your reply, my mom wants to remain in her own apartment and continue driving her car. Her apartment is actually laid out very well-it’s on the ground floor and is two bedroom/two bath. A year ago my twin sister and I went into her apartment and cleaned it out. We removed all the stacks of paper, all the boxes. We discovered the power outlet behind the couch was smoldering and had burned the back of the couch so we got that taken care of. Thank God nothing burnt down! My mom has a dog but she can’t walk the dog so she allows the dog to use the second bedroom as a bathroom. The dog misses the pee pads so feces and urine left on the carpet FOR YEARS is now growing mushrooms and God knows what else. It is a hazmat issue so the housekeeper we tried to hire would not enter the apartment. Yes, it smells that bad. So we offered my mom hazmat cleaning and new carpet after the dog dies, which sadly could be anytime now, and she could stay in her apartment.

Fastforward to now: My mom’s apartment is now worse off than it was a year ago when my sister and I spent a week cleaning it out. Dog hasn’t died yet so we don’t want to change out the carpet until that happens. I pray she won’t get another dog when this one does though I know she will be so lonely.

She took a nasty fall 1/9/19 and tried to conceal that from us (she was likely drunk) and now I’m not sure she should stay in her apartment by herself. My mom went to a 5 physical therapy sessions to determine her walk/gait and get a custom walker because she’s such a fall risk (neuropathy, balance issues and probably still drinking despite being an alcoholic) but she refuses to use a walker. Also honestly the walker would not fit in her apartment with all the junk she has EVERYWHERE.

So at the end of the day, I believe my mom wants to continue living like she does because she can hide her alcohol in her current living situation. She can go out and buy it and drink herself to oblivion every night and no one knows...or so she thinks. My mom is becoming more isolated - she has 6 local grandchildren (3 that can drive) but her living conditions prevent visits from friends and family. She does come to visit us in our homes (my twin and I), she does attend grandkids concerts and sporting events, and we do accompany her to her appointments. She says she doesn’t want to become a burden but the burden lies in us never knowing if she’s safe or has fallen. She constantly trips over boxes and junk lining the hallways and all over the floor in her apartment.

I’m rambling on now...I’m at a loss as to what to do about convincing my mom to move to assisted living and allowing us to be her Power of Attorney. Like I said, we can’t even get her to use her walker.

So tomorrow my sister and I will gain access to her apartment and take pics in case we need evidence. We will also look for evidence of alcohol consumption as she insists she’s been sober for 2 years. We are accompanying my mom to a doctor’s appt tomorrow and these concerns will all be discussed as well as the cognitive report from the psychologist that diagnosed her with stage 3/4 Alzheimer’s. My mom’s dog is old and ill so once he passes, which could be anytime now, then we will hire a hazmat team to clean out the apartment and replace carpet. Not much more we can do. Oh...and people are recommending we contact and elder care attorney so I will do that this week too!

Thank you for your time!
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