We finally got mother-in-law into Independent Living, but it's apparent she needs more care. How do we approach her?

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My mother-in-law moved into an Independent Care building about 3 months ago. It is obvious to her son and I that she is suffering from dementia and it seems to be rapidly progressing. She just thinks she's "forgetful" but I'm seeing signs of middle-stage Alzheimer's. She's become mean and paranoid at times. Nastier and more confused at night. All this is totally out-of-character for her. She's forgetting to pay bills and I fear isn't eating well. We live 7 hours away, so there's only so much we can do on a daily basis. She has 2 other children that have nothing to do with her, so it's really up to us. I've talked to her financial advisor and my husband talked to the lawyer who drew up her Living Trust. I know my husband can get on her accounts and pay her few bills online, but I still think she needs to know that she should probably be in assisted living. How do you tell a loved one that she's got dementia far worse than she realizes? I think all her church lady friends see it, but won't say anything. I'm worried that one of these days she's going to leave her apartment and get totally lost.We're not on her HIPA form so there's no point in contacting her physician. Thanks in advance for any advice

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Edit: Oh, sorry, I see your husband has her POA. (But not her healthcare POA.) Get the healthcare one. She sure doesn't want to leave her healthcare decisions in the hands of doctors and hospitals should she get into trouble. I think it's more important to have THAT one than the durable.

Instead of rushing ahead with having someone CHECK on her every day, get her a Lifeline pendant (or whatever they call them in the UK). This gives her the ability to request assistance 24/7. More useful than having someone check in on her once a day, in my opinion. You can use a little guilty trip on her with that one: "Mom, we'd feel soooo much better if we knew you had a way to ask for help should you need it." Have all the information available and use the old, "How does that sound to you," close. ;)
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I think I'd start with getting extra services for her.

"Mum, if you want to stay in independent living, I think it's time to add on some services."

Have an idea of what you think those services should be and suggest a few. If you can get her to accept one of them, you've got the camel's nose in the tent. Sounds like helping her pay bills will be a shoo-in. Next would be healthcare power of attorney and durable power of attorney. If she doesn't have these documents, she should. These three things are just good "life management" and, except for paying her bills, have nothing to do with her competence to live independently. But her DECISION to do these things probably does. ;)
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Thanks, I'll let my husband know that. We could hire someone at the facility to check on her daily, and have suggested that, but she doesn't see the need for it.Or want to pay the extra money. But her finances are very healthy so it's really not an issue. Husband has POA and I guess he could probably institute some things without her knowledge, but attorney says it's better to keep her in the loop.
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H IPAA means that doc can talk to YOU. You don't need permission to tell, write or fax the doctor your observations. I suspect that the UK management will be contacting POA if they think she needs a higher level of care.
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