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My 89 yr.old MIL was last diagnosed at "medium-stage dementia." She has no sense of her own personal safety anymore. The dementia started 2.5-3 years ago.


Recently, a family member needed to stop by my MIL's without the visit being scheduled. Usually, things are written on a wall calendar with a phone call the day before the visit (though, unfortunately this doesn't work now). During the unplanned arrival, the family member arrived at a keypad that is used to activate and ring a phone in my MIL's apt. to let her know someone has arrived. Here's the problem. Rather than asking who was at the door ringing her apt., she simply opened the door. After the family member knocked at my MIL's apt., my MIL simply opened the door. She doesn't ask who is at the door anymore. She also arrived at the front door in an open bathrobe, t-shirt, an undergarment, and sandals. This certainly compromises her safety plus it would give her nosey neighbors nothing they need to see.


Continuing the safety line, family members had moved her patio furniture outside for her. A few days later, all of the furniture was in her small living area. She said the birds were making a mess of the furniture so she brought it back in. There's no way she could move that furniture safely, though she says she did (she also insists she got the furniture out of storage and set it up herself). She ambulates with a wheelie walker.


Unsafe choices are being made and my MIL has worsening physical issues that are troubling her. She was hospitalized once for a fall and, as she has shared with me, "I fall, but I'm fine." The bruising I see sometimes makes me think otherwise.


We aren't in the position to use an Assisted Living facility (if it would even be appropriate).


I'm not a doctor, but I feel she is unsafe and something needs to be done, but what? Who do I talk to? Her PCP? My MIL has an appointment scheduled with doctors who deal with memory challenges. Can they do anything, depending on what they find?


Any input is appreciated. Her family — which includes me, of course — wants her safe.


Thanks so much.

Tip off the doctors who deal with memory care before the appointment. Write them a note and mail it to the doctor or submit it through mom's patient portal. You go (or someone else that you trust) to her appointment with her. Take a copy of that note and make sure the doctor sees it there. Sit behind mom, and if she lies to the doctor, shake your head "no." Yes, the doctor can recommend memory care. She is clearly beyond Assisted Living. Doctors see this all the time. They catch on fast because that's what they're trained to do.

Home care for someone at this stage is VERY difficult. You may think you can handle it; family members will offer to help; don't count on it. Professional care is necessary. She needs 24/7 care with a whole team to look after her in a facility. Don't even think of someone moving in with her or of her moving in with family. It's not sustainable as the disease progresses. My husband is in memory care, and the care surpasses what family can do at home.

I don't know why you think you're not in a position to use a facility. Investigate what is offered in mom's area. The doctor may help, or he may recommend someone else to help. This is serious business. Mom should not be alone now.
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Reply to Fawnby
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JJDFLT Apr 23, 2025
Thank you so much. I agree with everything you said. Those folks closest by blood to my MIL will be harder to convince but I agree. My MIL needs care that her family isn't able or trained to do. Now the nitty-gritty work begins. Again, thanks so much.
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"We aren't in the position to use an Active Living facility"

Why not? Is it that she can't afford it?

You can't really do much unless someone is her PoA. If she has a PoA this person needs to take her in for an exam and request a cognitive and memory test. This test and subsequent diagnosis of impairment will activate the PoA authority to make decisions and take actions on her behalf.

You're correct: she no long can safely live without supervision. She either needs a 24/7 in-home aid or a facility.

The "they" in "Can they do anything, depending on what they find?" would be APS if she doesn't have a PoA. Then they will put her on track for a 3rd party legal guardian assigned by a court. This person will transition her into a facility and use Medicaid and her SS income to pay for it. There aren't many options if she doesn't have a PoA and doesn't have enough income.

More information would be helpful.
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Reply to Geaton777
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Not sure why it wouldn't be appropriate for your MIL to live is assisted living?
Ask yourself, can she escape in a house fire if she was stuck after she fell down inside her bathroom? Or anywhere in the house? My mom and dad both fell often and hit their heads. My dad broke his hip. I was always running over to their house to call 911. I realized I was in denial and got them out of the house to sell it and pay for their care in personal care homes where there is 24 hour care.
Your mother in law is not going to turn around from medication. If anything, she may deteriorate rapidly. Either move her in with a caretaker in the family or shop around for care homes in your area. Please don't hesitate with your decisions.
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Reply to Onlychild2024
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JJ, you start the process of getting MIL the help she needs by:

1. Get her to the doctor to rule out other causes of her behavior OR verify this is cognition. Can someone go with her to the appointment already scheduled?

2. Contact the local to her, county counsel on aging. Google it, I have found it is easy to find.

3. Someone should go to the Department of Health and Human Services website and get the long term care Medicaid (this could be called something else in her state) application. This is for facility placement and it will help you know what types of facilities that her states Medicaid will cover.

This will guide you through the process. There is paperwork that will need to be gathered and provided. There are tight time frames for submitting paperwork once the process is started, so whomever can handle it; is it, because they kick the application back if they don't get paperwork within the stated time frame, no exceptions. Then you get to start over, with a prior denial in her file.

I recommend getting the application and gathering all the paperwork before submitting the application, that stops a scramble when it matters.

She will need to be Medically and Financially in need to qualify for assistance, so the more doctors documenting the better for the cause.

One thing that people don't understand, if her doctor(s) do not deem her incapacitated and she refuses help, there is no forcing her to do anything she doesn't want to.

You can also check for community services in her area. This would be a good question for the County counsel on aging. They have already compiled all the resources and are happy to send it.

Prayers that you find the appropriate help and she is compliant with filling her needs.

I found out how very much I didn't know I didn't know when I was faced with this type of situation.

Best of luck.

Edit: KEEP A FULL COPY OF EVERYTHING SUBMITTED. You may have to resubmit items.
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Reply to Isthisrealyreal
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In Minnesota a county social worker came out and did an assessment on my mom. She became my mom's social worker until my parents had met the spend down. The social worker told us when it was time to apply for Medicaid. My mom's long term care is now covered by her social security check and Medicaid. My dad still lives in their house, so once he isn't living there, we will sell it and then repay Medicaid back.
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Reply to Renee64
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Yes, you talk to her doctor, in advance of the appointment through dropping off a letter or using the patient portal, and relating the behaviors and concerns you’ve seen. She can no longer live alone, she now requires memory care or a caregiver in her home around the clock. Her finances pay for her care, and when that runs out, Medicaid will help. She may resist changes to her living arrangements but this is truly the time she needs family to look out for her and act to keep her safe
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JJDFLT Apr 23, 2025
Thank you for your reply. I couldn't agree more with what you have said. I must say, since this isn't something our family has had to navigate before, your information about my MIL's finances paying for her care and then Medicaid will help. This is the info we don't know. MIL's finances are very modest, so if Medicaid will 'help' where do the extra finances needed come from? I don't want to be a burden to you, so if there is someone or an organization you could point me to regarding paying for all of this, I'd be grateful. I know as a family we talked this all out but it was some time ago.
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I've got a few questions:

1. Is she aware of her impaired thinking skills?
2. The condo that she is living in, is it a safe community behind the gate or is it in a "rough" neighborhood?
3. Does the condo complex have a resident manager? Does the person know who might be helping your MIL with her "moving"?
4. What is she doing about food? Does she use a stove for cooking or do something that could be a fire hazard?
5. Who is taking care of her finances? or does she have some "helper" that you are not aware of? or is she still capable of doing her own finances including bills?)

It will be difficult to move her if she thinks she has an adequate support system in place.

If she doesn't have a good support system, it may be easier to convince her to move into managed care.

P.S. She might be at the point of her life where she is happy to have nosey neighbors. As long as she is not in danger, nosey neighbors might be the way she is managing to take care of herself while living alone.
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Reply to ChoppedLiver
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If her PCP doesn’t provide all the info you need, try searching for your local county resources on aging. They should be able to provide a list of local facilities and helpful places to call. They may be able to suggest a social worker or geriatric care manager who can assess her level of care needs. From what you describe, she no longer sounds safe living in her own. If you can get a professional assessment and advice, that may help convince whoever else needs to be convinced.

You dont mention how she gets groceries, prepares meals, bathes, pays bills, computer/phone issues…..problems with all these seem likely given her being mid stage dementia.

good luck!
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Reply to Suzy23
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Just a question, where is your husband in all of this? It is his mother. I was so lucky my MIL moved 900 mi away because I am sure we would have been her Caregivers. Not that I would not have helped, but my DH would have been her main caregiver. She was not an easy person to get along with.
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Reply to JoAnn29
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JJDFLT,
to apply for medicaid, you call the county health and human services office.
If you look it up online, there may be a link directly to Medicaid services.
If she is income eligible, then she will be approved.

And, yes, her PCP can make the referral to a skilled nursing facility or memory care facility. As her medicaid application is being reviewed, you will want to tour several different facilities, meet with the admissions director, ask questions, and pick your favorite option. You should ask the doctor for guidance on what type of care facility would best meet her needs.

And, as someone else has pointed out, if she is unwilling to move, then someone with POA will have to invoke their authority and make the decision for her.
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