My mother insists on going home. She threatens to call a taxi to take her back. Any advice? - AgingCare.com

My mother insists on going home. She threatens to call a taxi to take her back. Any advice?

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She is in Stage 4 of Alzheimer's. She still has much of her faculties, but her memory test scores have declined since her diagnosis 2 yrs ago from a 24/30 to 18/30. The Dr. says she can't live by herself anymore, which we had already said, so against her wishes, we moved her in with my husband & I in September. She is insisting she is going home & threatens to call a taxi to take her. She is in complete denial (not just with Alz's, but with anything about her health). We do not yet have POA, but do have a letter from the doctor about her cognitive decline. She became more insistent & agitated last night about going home. We have not been able to deflect or distract her, since she still has some mental faculties. What would be best to do? Do we take her home until we get POA? Wouldn't that be neglect? Should we consider a memory facility at this point? We don't know what to do. Any advice would be helpful. TIA.

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That's a tough one, and I'm living much of your story with my mother right now. From my limited, but intense experience, your mother won't stop wanting to go home. I placed my 85 year old mother in assisted living this past June, and she calls me just about every day to tell me if I don't take her home, she's going to call a taxi, call a u-haul, or get a friend back home to come get her. My whole family needs a shrink just to process the daily drama she puts us through. Like you, we have not been able to distract my mother. I tried that, but she's onto my diversion tricks. She doesn't have dementia or Alzheimers, so she's wanting to go back to the home she left a few months ago. But she can barely get out of a chair; she falls often and is a serious fall risk; she can no longer prepare food (but in her mind she can), so going back home is not an option. I would advise you to do what you legally can to get POA. That's important when representing your mother with doctors, agencies, etc. Like you, my mother is in complete denial about her condition. I can't tell you what to do with your mother's living situation, but I will say that in my case I will not be taking my mother back home, as that would in my opinion be tantamount to neglect on my part. It's the hardest thing I've had to deal with so far in life.
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SimplifyLife, is the "home" your Mom is mentioning her recent previous home or does she mean her "childhood home"? Vast majority of times, "home" means where Mom grew up as a child, back when life was simpler and fun. Find out which "home" is her reference so that you can use "therapeutic fibs" to help Mom, such as saying not a good time to travel, the house is being repaired, etc.

It took me a couple of weeks to finally nail down which home my own Mom was talking about. Once she mentioned a key word "cattle" then I knew it was her childhood home from 80 years ago as her parents ran a diary farm.

As for your Mom appointing, reading and signing legal documents, is there a point in the day when Mom appears to be in the here and now? If yes, then set an appointment with an Elder Law attorney for that time frame. If the Attorney feels your Mom just doesn't understand the legal document, he/she will not allow Mom to sign, so don't be surprised if that happens.
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It may be too late to get poa. She’s has to be competent to assign poa, but consult an attorney.

No easy answer for the go home stuff. Maybe her doc could prescribe a calming med.
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Would it be possible to let her go home and have caregivers come in? That would require a good bit of money and would only be possible if your mother would tolerate it. It would make your own life more livable, though. It's not easy living with an unhappy person.

If your mother is in Stage 4 she is probably still competent to sign POAs and advance directives. Do you have a lawyer friend she trusts who will come by the house to get these things done? Our parents can be more cooperative with someone from outside the family than with their children. I doubt my mother would have ever worked with me on the POA, but she would work with her lawyer friend. (Alas, her POA choice made no sense, but I let that go.)
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My mom went through the exact same thing after we found out that some of hers was due to a UTI and got that cleared up we got her into a geriatric psychiatrist who put her on some medications for agitation and anger she has gone downhill since,not due to Medicine,and has calmed down. We did get a DPOA when she was in stage 4. We had a lawyer who was willing to work on the spur of the moment when she had a lucid moment. I try to give her a feeling of control by letting her pay her bills with my help. I assure her many times a day she is loved and safe. Also when my mom progressed to next stage we had to adjust medicine because her agitation and anger got worse again. Prayers for you it’s very difficult.
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Goodness, that's a hard one - so your mother has been in your home for roughly six weeks, and what she's just started saying she wants to go back to her own home? Any idea what triggered her agitation?

If it's available, I think it might be a good idea to get her admitted to a memory care facility for assessment. Also, check there isn't a u.t.i. if you haven't already done so, and speak to her or your doctor to see if they can make any practical suggestions.

You *could* think about taking her back to her house and staying with her for a very short while, if absolutely necessary. But you can't leave her there alone, and even if it does calm her it isn't going to be the solution for long.

Did she agree to move in with you? Was she clear at the time about the plan being long-term?
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If this is a sudden change, it's a change in mental status and needs to be reported to her MD. Could be a UTI or it could be sun downing. In any event, she needs to be seen by her doctor.
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Being in a care center with a doctor's order saying she can't live alone due to her terminal illness and danger, the care center won't release her no matter what she does. She would have to sneak out to do it. My dad was incontinent and not walking anymore in stage 5. If she still walks, and is not incontinent or is incontinent, you can get CNA's to come in 4+ hours a day to care for her, and an RN comes in too twice a week to take vitals, and a person that bathes them twice a week for free through hospice only because she has a terminal illness and of course if she is in your home. You just go to Hospice and sign them up. She doesn't realize it, but she is better off in the nursing home for her own safety. She can't leave. My dad was in a care center in the Dementia unit which was a large unit, and they lock the main doors so the patients can't run off out of the building. Even the visitors have to be let in to visit. The RNs have a code they punched on this number pad that let people come and go. She needs that type of unit.
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I'd get legal advice from an Elder Law attorney about the options. Also, if she doesn't know the phone numbers or have money or card, she can't use a cab. Still, she may try to walk.

Is her doctor one who regularly treats dementia patients? My LO's doctor wrote an order that she enter a Secure Memory Care, due to her significant dementia and wandering. But, I also had DPOA and HCPOA. Not sure how it works if you don't. It may be that court options are more appropriate. The attorney would be able to provide you with that info.
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Complete denial is very definitely a stage that most Alzheimer's patients go through, and it is very tiresome while it lasts. You will just have to tough it out. The patient seems alert and capable, so seems normal, but what is often totally lacking is a logical thread of argument, and people at this stage may often have short or long periods of being totally lost in time and space. Even if she managed to get into a taxi, she might be unable to give the driver the adress to take her to. Or may be wondering why she is sitting in a strange car with someone she doesn't know.

So the fury and denial are signs of a person still battling to be "normal", but the doctor may be experienced enough to see that the possibility for her to live at home alone 24/7 is past.
Try distraction if she really gets moody. Also, you can put up a notice of a false taxi number for her to call, or warn any local taxi company to refuse to send any taxi to your address unless the booking is made from your mobile or your husband's mobile number.

My own Alzheimer's friend took a long time to accept that she no longer needed money for a taxi fare home in her wallet. (In fact her old home is literally around the corner from her current nursing home, but exit from this building is prohibited for residents in mental care.)
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