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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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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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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 2020
A million dollars when you are that person.
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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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Give her a "debit card" that is actually a reloadable gift card. When she spends her "limit", she's done.
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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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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 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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@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 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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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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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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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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