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My mother lives in a major city about 6 hours drive away, where my brother takes on the main burden of caring for her. She is in her nineties, and has dementia. That is, I will repeatedly say the same things in the same conversation, each time as if it was the first time.


Her main social outlet outside the home is mahjong (though my brother and his wife visit and shop for her regularly). Due to her declining cognition, she can only go when her Mahjong partners come to pick her up. I guess it is about once a week, on average. However, her losses are about $1,000/month, give or take 50%. We know that funds will be needed when we can no longer provide the care needed to live outside of an institution, so this loss is worrisome. My brother has visibility into the bank withdrawals, but my mother doesn't remember making them, and is unable to keep track of them. If we are too resistant to bringing her to the bank, she will just go on her own, which is very hazardous.


What strategies are there to address the uncontrolled loss? There is value in Mahjong's socialization, but we suspect that she is being exploited for her dementia. Neither she nor we have control of the situation.

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@cwillie: Agreed, confronting the other players and having mom behave lgoically are the two obvious fronts. And no progress on either fronts means no solution. I am mulling over how to progress on either front.

@NeedHelpWithMom: Yes, I've read about the severity to which people can be addicted to casinos. In some ways, I guess we're lucky.

@Taarna: In order for a debit card to work, she would have to agree. I will seek opportunities to broach the subject when we next talk. But she will likely forget where she keeps debit cards, or think that it has been stolen. We'll see.

@Robin1234: It would be nice if Mom could jsut play, not for money. But this is a non-starter. She has had a lifetime of monetary stakes gambling via mahjong.

@RedVanAnnie: I will find an opportunity to speak to the PoA about options. So far, my understanding is that he has visibility of the withdrawals, but not control. Mom can simply visit a bank to avoid ATM machine limits, and that trip is hazardous.

@gdaughter: You can call her current arrangement as assisted living. There is a nurse in the building, and my bro's adjacent condo is connected via small skywalk. He's not very mobile, though he does far more than what would be considered reasonable to meet their needs.

I don't think the players can be considered criminals, as Mom seeks to play with them. For all they know, she is incredibly wealthy. They are unknown to the siblings, due to generational, cultural, and linguistic gaps. We don't drive her, they come and pick her up. It is in a private home, and we are not invited. Even if we somehow got ourselves invited, I don't think it would be well received for us to scold them. It's Mom's decision to go.

Mom might accept a different game with others, but it's hard at her age to find players.

I'm not aware of any local office on aging. This forum is the closest thing I can think of to try to benefit from other people's experience.

@Tothill: Yes, she is socially distancing and isolating right now. Canada *might* be better than elsehwere, but institutionalized living is still not great. People go into there and simply exist, waiting to die. I try to take her to visit a family friend in one such establishment. Not these days, however, due to COVID-19. I don't think the main caregiving bro can sleuth down the players because of the dynamics above. Also, he is stretched way thin because of the even greater care that a step father needs. I'm not sure if I can connect with children of the players, even if I was in with the current mahjong crowd (which would be a miracle to accomplish). Limiting the amount per day of mahjong would be hard...they play at their stakes, and it is up to Mom whether to join. She doesn't have other options. Thanks for your idea of talk to Gamblers Anonymous to see if they have any wisdom that might apply. 

@TorieJ: Finding other players is hard. There is a cultural divide. It's like asking a western stranger on the streets to find alternative players. For us, it's almost as foreign a culture. The burbs is not a small close-knit communities. It's cars and condos. Your personal network is only loosely based on geography. Even if we magically find such players, that is just one aspect....it really matters what the social dynamic is like. Mom doesn't event want to get involved with the actitivites offered within the residential complex, including mahjong. I'm imagining that it's like the highschool clique dynamics in the movies. The activity is only half the story, if even.

@Peanuts56: I'm mulling over how a complete outsiders like myself might somehow insinuate myself into clique. The barriers are considerable.

@my2cents: I can't call the co-players to restrict Mom's involvement. No one can. She calls them herself. At least, she *talks* to them herself -- I'm not sure who initiates contact most. It might be nice if the play sessions took place in her condo unit, and this has happened in the past. I don't think it's feasible anym
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This may be difficult for her amend/cease/change, but as well as NOT entering into outside social circles during this pandemic, do you think that she could switch over to a free game site?
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Reply to Llamalover47
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I would talk to her Mahjong partners, express your appreciation that they include her and manage her transportation there. I would share with them that you are concerned about her spending and need to help her budget her money. Decide how much you think she can afford to spend ($50 a week? $100?) and let the friends in on that. Ask them if there are other considerations you don't know about.

I agree this is important socialization. I also agree with other posters that the help her friends are providing has a $ value that shouldn't be ignored.

As long as you keep a concerned and appreciative tone to the conversation, her friends may help shed light on the situation or, if they are taking advantage, realize that it can't continue.

I can imagine a situation, though, where your mom insists on picking up the tab for lunch every week or slipping her friend $50 for each trip. Your mom's friends may have no idea that she can't afford to be that loose with her money. Some people can and do behave that way.
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Reply to IsntEasy
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To those who think this 90 y.o. dementia lady is being taken advantage of, how many of you would volunteer to pick her up every week, spend a whole day with her, entertain her, playing games with her, socialize with her, provide her with food and drink, then take her back home FOR FREE or POKER CHIPS or a few quarters? Be real.

Even though she is 90 and has dementia, the OP said the lady insists on using her money as she wants, and she wants to use it for her entertainment. At 90, there aren't too many things that she can do for fun. Unless, her children get conservatorship over her, they can't make her do anything she doesn't agree to. And if she can no longer have a little weekly fun and pays with her own money, she just might as well die soon from boredom and loneliness.

For the son who lives with and takes care of his mom, how much is a full day break from his dementia mother worth to him? He can go out and do things without having to worry about his mother. How much is that freedom worth?
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Isthisrealyreal Mar 26, 2020
A million dollars when you are that person.
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Call the friends that provide transport and tell them she cannot go weekly anymore - maybe even tell them why.
There may be more than Mahjong going on because that seems like some pretty high stakes for a group of old ladies.

The other option is to have the Mahjong group come to her house so brother can see how they are betting. It might be people 'borrowing' from her and not the game at all
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I recently learned how to play American mah jongg and our instructor informed us that if we play for money that the group agree to play for a set amount. She told us that her group comes with $3.00 total. When the $3.00 is gone, you're out of the game. If you review the game card, each hand has a value: 25 cents, 50 cents, etc. There are instructions on betting. There are chips with the game set that can be used in place of money. I'm wondering if she is giving money to participants outside of the actual game. I thought maybe they are all playing for high stakes but I'm not sure. In any event, something clearly is nor right. I would contact another player to discuss the betting strategy. If possible, I would limit the money that she has. I was told to bring quarters and small change to play if the group wants to play for money. However, our group just plays for fun, no money involved.
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Reply to Peanuts56
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I'm taking a different approach, as someone who plays Mah Jongg on a regular basis. Find someone in mom's area who is a Mah Jongg player and find a way for that person to observe them playing. That person will understand whether they are playing the American version or Chinese version of Mah Jongg. If it is the version that this observer is familiar with they will not need to observe long to figure out whether mom is a victim.

If, by chance, they are playing the American version, using the cards sent annually to show which tiles create a winning hand and how many "points" that hand is worth, it will be an advantage. My group uses the points as pennies. Most hands you win or lose 25 or 50 cents, and we limit losses in a week to $4. If you lose $4, you get to keep playing without paying until you have a winning hand. Perhaps they are playing for dollars?
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Tothill,

Exactly, limit the money. Years ago, I played Pokeno and Bunko with my friends. We had a group of 12 women. We took turns hosting the games in our homes. We did serve booze or wine but no one was drunk. We served appetizers, dinner and dessert! We each brought a wrapped gift worth no more than $25. During the month of December, we didn’t play. We had a holiday party out with gifts, cocktails and dinner out at a restaurant. It was fun!
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For the time being, she should not be going to Mahjong as all clubs and social activities have been shut down do to Covid-19. If the group continues to meet, then perhaps a call to the authorities about them flouting the isolation rules may be in order?

It is a sad consequence of this terrible disease that at least here in BC spaces will be freed up in nursing homes and care facilities. The other good thing is that you are in Canada and do not have to worry about Medicaid look back rules.

Your description of your mother reminds me of a late neighbour. She had had a massive stroke and had vascular dementia, she could not differentiate between girls and boys, yet continued to play bridge every day at the seniors centre. It was an important outlet for her.

I realize you are dealing with cultural dynamics that I cannot fully understand. I will probably overstep in these suggestions, but here goes:

Contact Gamblers Anon in Richmond Hill, or whatever community she lives in. They likely will have members who understand the cultural implications of Mahjong and also if there are games in the community that play for points, not money.

See if your brother can discover who is winning. As I recall there are 4 players, if Mum is consistently losing, are other players in the same boat and one winning.

Mum may need an allowance. I know this would be a huge challenge for me, if I attempted to put my Mum on an allowance and impossible with my Dad.

Could you connect with the children of the other players? They may have similar concerns.

I know it will be very difficult in these troubling times, but it sounds like Mum needs a full cognitive work up. Once that happens, you and your brother will know what you are dealing with medically.

My granny was a gambler, but her group played poker and only played for small coins. It was years ago, but she never took more than $20 to her weekly game. This was long before casinos.
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OMG. My first reaction was to say GAME OVER! But this is so much more than being that simple!
And some questions...like how does she get to the bank? Has she been officially diagnosed? Does your bros have POA for finances. Is it time now for the move to assisted living? Who ARE these people she plays with? Is this a criminal activity/exploitation?
Can you or the bros speak to the game players? What's their take? Is this really where the funds go missing? These ladies are playing for big $$$. Would mom accept an alternate game with different people? What about stopping them from picking mom up? Where are they playing? In a private home? WHAT if mom shows up with NO money? How she is able to keep track of her funds with the cognitive/memory issues? She needs to show up with less funds for them to access.

It's really hard for you not being there and I'm guessing with the burden of it all on your bros, it's really hard to take this on also. Devil's advocate: Your brother isn't creating a cover to siphon off funds for himself is he? Sorry...but it's happened. I'd call the bank and ask for ideas, in general, even if they can't reveal details if you have no access. I'm afraid they won't be able to share details if you are not listed on the account.

Also might want to touch base with your local office on aging who may know of ways to locate other games where they play for lower stakes!

Right now I'd almost hope that the social distancing has put a stop to the insanity. In fact...if the losses continue during this time, it might indicate something really is up that you should be further concerned about!
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Can you or someone else be made to be your mother's POA for financial metters?

She should not be allowed to spend so much money for non-technical enertainment.
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Are there non-gambling mahjong groups? Maybe join one of them? She is clearly being taken advantage of and the people taking advantage of her should be ashamed.
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Give her a "debit card" that is actually a reloadable gift card. When she spends her "limit", she's done.
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Here’s an interesting tidbit. If someone gave you a million dollars and you spent $1000 a day, you will run out of money in three years.

So, a million dollars is a substantial amount of cash but if a person spends $1000 on a regular basis, such as everyday, the money won’t last very long!

Is your mom going to stick to playing only once a month? Well, I suppose she isn’t playing at all now with social distancing.

How do you get her to spend less? That’s tough. There are elderly people who love gambling.

I personally know someone (my friend’s mom) that got a million dollars after her husband died.

She was a lonely widow and went to the casino for entertainment and to make friends. Bad decision on her part! She barely has any of that million dollars left. She was cashing checks at the casino right and left!

She became severely addicted and thinks she has made friends. Her daughter has told me that she is terrified for her mom. She accepts rides from strangers to and from the casino. She gives these people money all the time. It’s sad.

She refuses to go to a senior center for activities. She says that is for ‘old’ people. She is 80 years old!

Her daughter is beside herself. Her mother is incontinent and started wearing diapers to the casino. Sometimes her diaper gets so heavy that she takes it off in the ladies room and throws it away.

She told her daughter she figured out if she wore black pants that no one can see if she pees on herself without her diaper on. That is gross!

She’s an addict. Gambling is addictive for some people. They no longer play for entertainment. This woman has put just about the entire million into the slot machines!

No one can gamble now in our area. We are on lockdown. Even before the lockdown, our casinos voluntarily closed to participate in social distancing.
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@97yroldmom: You're right, she won't change her mind, and the ethics gets complicated. Interesting how you (rightly) described this as financing those who are taking advantage of her, but we can't even assume ill will on their part. As far as they know, she is flush with cash. In the end, she decides whether to play and whether she cares about tracking her expenditures. COVID-19 puts a pause on this, temporarily.

@gladimhere: Her condo complex does have mahjong and taichi (except for these days of social distancing). She is avoided these local activities for decades because she doesn't like the cliques and gossiping. For all I know, she might have a point.

@NeedHelpWithMom: Mahjong is part of cantonese culture, more among women. I'm guessing it's like bridge, with similar social dynamics.

@Judy79: Yes, it is online, but it doesn't replicate the social context of playing in "meat space".

@againx100: We don't know the people she plays with. We live in separate worlds, the siblings having grown up here. It's possible that the participant merely think that Mom is flush with cash. Which she is, I guess, since she withdraws the cash. There is no way that we can think of to control her withdrawals. Even a daily limit doesn't work as it is circumvented with a personal visit to the bank. And we don't want to push it in that direction too much because it is hazardous for her to make that trip. You mentioned the casino, an yes that has also been a source of significant loss. Recently, however, she seems to have switched to mahjong.

@cwillie: Crashing their party is a severely drastic move. We (the siblings) don't know them, are not guests, and linguistically, are very limited in our abilities to communicate with them. I'm sure we can make the point, but we would be the boors. For all we know, they may believe their winnings are fair, that Mom is just rich, and that she can decide not to partake. The fact is, she willingly seeks to partake due to the social stimulation. Scolding them would just get Mom ostracized. In the end, we rely on Mom to care.
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cwillie Mar 26, 2020
If you won't confront the other players and feel there are social benefits that make you reluctant to put a stop to it then you have no solution - you can't convince your mom to stop by using logic because with dementia there is no logic, and besides this sounds like a long term problem and if she didn't care before she most certainly can't now. I guess it is her money to waste - be thankful she won't face the kind of penalties our American cousins in similar circumstances do.
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“There are ethical issues to broach, and our mother would have to agree to it, I think. Frankly, she doesn't care about tomorrow.”

This concept of ethics when dealing with the very compromised is a tricky aspect of caregiving.
I have an old uncle who is breathing horribly. He doesn’t go for medical care. He is competent “enough” to call the shots for his life. Similar to your mom.

Because his wife is on hospice (Parkinson’s and dementia)and is being cared for by their live-in daughter, he is being looked after to a degree. Daughter fully expects her dad to go before her mom.

Cousins life is on hold. Her choice. Of course when we make our choice no one realizes what they are signing up for.

IMO, Your mom won’t change her mind. She will live her life as she chooses and it’s just too bad if you and brother are concerned. You will have to make the hard decisions sooner or later. Now would perhaps allow her to live a freer lifestyle longer with more savings to hire caregivers when she becomes disabled.

Later could mean more involvement from the two of you in providing her care.

All of this is relative to the standards you aspire to hold and the lengths you are willing to go to. Ethically it is about your lives as well as your mom’s. It just depends on how much you want to contribute.

No two cases are alike except that we all do die and the space immediately prior to dying can be eased by having funds to finance it. I don’t necessarily disagree with what she is doing but I would resent financing anyone taking advantage of her. That’s what you will be doing if your funds have to be used to take care of her when hers have been frittered away.

Perhaps the Covid19 virus will persuade her to stay home and that will help to break the cycle. I hope so.
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Suggest to the building where she lives that they start a MahJong group. Or are these games already in her building? Are there any groups or volunteers that would start a group there? And start using poker chips or toothpicks for gambling.

If mom is not declared incapacitated she can do as she pleases with her money. Unfortunately.
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gdaughter Mar 26, 2020
Poker chips. Easier to handle and better for the environment though they should be sanitized now in the age of Corona...
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I must be out of the loop. I don’t know this game. It is is an expensive hobby. At those prices a person could go through a lot of money pretty quickly.
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Judy79 Mar 24, 2020
That game can be played free online. I think MSN games.
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Do you know the people she plays with? If so, you can alert them to the FACT that she is not in her right mind and that taking money from her is like taking candy from a baby. They may not be aware?

OTOH, is there a way to only give her access to X amount of cash so that her losses are, say, half of what they have been?

My mom likes the casino, so she losses a boatload of money every time she goes. But she is only MCI, not dementia and not that bad and has money. I do not like it, but have not felt the need to say much about it yet. She knows I'm not into it but she can still pay all her bills, etc.
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She needs cash for this gambling, so for the time being she isn't going to have any access to it - she and the others in her group shouldn't be going out AT ALL, especially not when living anywhere in the GTA.
I think I would tackle this at the source, either the other ladies she plays with or their families, she can't be the only one burning through money. Now would be a good time to change the rules of this little club to make a switch to much lower stakes or even something like poker chips instead of real money lest any of them are tempted to go out to the bank for more cash. IMO if she is a continual loser because of her dementia and they keep taking her money they should all be ashamed of themselves, and no doubt their families would be horrified.
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I do agree that there is value in mahjong's socialization. Just how much value is the question.

How many hours is it from the time your mother gets picked up until she gets dropped off? Does she get food and drink while she's at the partners' home?

Where I live, there are adult day care centers. If she were to go to one of those centers, she'd be picked up early morning and dropped off around 1 pm or 2 pm. She would get breakfast, lunch, entertaining, exercise, and socialization. The cost for each day runs between $80-$100 a day.

So, how much do you think her mahjong partners' time and effort are worth for keeping and entertaining your mother once a week for x amount of hours?

Once you decide in your mind how much she can spend/lose at mahjong, you may feel better about her going there. But now, the other question is how to limit the amount of money she takes with her to play.

Does your brother have Power of Attorney for your mother? Can your brother access her account? Does she have a savings account that some of her money can be transferred to? Can your brother tell her that she can only take $ xx to play each time?
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ElderlyCarer Mar 23, 2020
Thank you for those ideas, Polarbear.

Assuming that we can find an adult care centre in our city (Toronto suburb), it would be great if my mother would go to them. She lives in a condo complex for the elderly, so activities on-site (except for these COVID-19 days), e.g., mahjong, taichi. However, she has never partaken, despite suggestions to do so over many years. Her reasons are the cliques and gossip that takes place in her own home (meaning the condo complex). I don't consider it my place to say whether her concerns are well founded, as I would have to be in her shoes to do that. I think I have to respect that those are her concerns.

She may be more open to a program that takes place outside of a seniors residence, such as at a community centre. These seem to go by the term "adult day centre/programs", whereas "adult care centre" seems to generate Google hits pertaining to long term care facilities.

With regard to details of enjoyment during mahjong, from what I've observed in past decades, it's like visiting your card playing buddies (perhaps bridge? I don't play cards either) for afternoon tea. Except that it takes the majority of the day, with snacks and meals. Over the decades, mahjong has become recognized as a very socially and cognitivel active activity. I'm sure that buddy-type bonds develop, so it goes beyond merely going outside for activity to break the boredom. It may be difficult to replace the former with the latter. At this point, however, I consider it a possibility.

I will ask my bro about the Power of Attorney. I believe that he can access the account, but being able to restrict access is the challenge. There are ethical issues to broach, and our mother would have to agree to it, I think. Frankly, she doesn't care about tomorrow. Her attitude is why bother, you can't take it with you. I suspect that she doesn't care for living in an institute when she can no longer live in her current complex. She may not wish to live long when at that point. She likely would not be open to the idea of having an "allowance" account.

Taking "x" amount to a mahjong visit would be difficult to implement because of the cavalier financial attitude. I would be shocked if this hasn't been tried, but I will give it a try.

Thanks again.
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