My mother’s doctor has declared that she can’t be alone. Mom thinks she is fine and is furious with the Dr. What can I do?

Oh, sheesh. My Mom thinks she is fine too. And so adamant about it! But, in actuality, she can't remember what she does during the day. Literally, sometimes, moment to moment. But, your sister being verbally abusive? And physical?! That is COMPLETELY UNACCEPTABLE and changes the whole situation. Maybe get legal help. Does the sister live in FL? And, where are you?

Tell her you don't care what the Dr says. You miss her and would appreciate it if she would spend more time with you. Make it her idea to help you. Try not to threaten her that will just make things worse and she might go to your abusive sisters out of spite.

If sister is physically abusive call 911.

Tell your sister to NOT get physical with your mom or else she will be arrested. You could possibly take your mom to another physician for a second opinion and that would make your mom feel better. Also, a test such as Katz ADL can be ran on your mom to see if she passes or not. Tests were ran on my mom while she was hospitalized and then the determination was made that she couldn't live on her own anymore. This testing helped me make a good decision for the safety and well being of my mom. It also made my mom realize that a change had to be made, no matter how hard it was. Mind you, it's not easy right now but I believe it has been a step in the right direction. I wish you the best and please keep your sister under control and possibly away from your mom.

My mother felt the same. When she was told no driving and she needed 24/7 supervision. I was her caregiver and she was abusive toward me. 3 weeks ago, we had to put her in a nursing home, because I could not do it all. She still thinks that she can take care of herself and she does not need to be cared for. She is in a wheelchair, incontinent, wearing diapers, cannot bathe or cook for herself. Your mother may never admit that she needs care.

I'd see attorney to confirm your rights under POA. Is it Durable POA? Will doctor say that she is not competent? If so, ask about proceeding with decisions, even if mother not on board. Or you could report sister to APS and ask to contribute info about mother's need for care per her doctor AND you let doctor know that mom is ignoring his order about care. I've seen that happen before and the county may step in, investigate and perhaps file to have her declared incompetent and a Guardian appointed. An attorney could advise you about all of that. It's difficult to do long distance though.

Let the Dr handle it. Let him turn it over to social services and she can then make the decision whether to move back or not once she sees he is serious - usually white coat syndrome has far more effect that anything we can say to our relatives. Clearly your sister is not coping which is going to put extra responsibility on you, although you both have POA perhaps a quiet conversation on the situation, just the two of you around and if she wishes to relinquish because she cannot cope then do necessary legal paperwork - not sure what that is in the US, here in the UK she would simply have to write a letter and have a public notary witness her signing it and you would have sole POA. (Had this with my brother when it came to father's funeral and he refused to have anything to do with it or with estate - it must arise a lot) If you are happy to go this route and to take any "you did this to mother" flak then I am sure it would enable you to do the best for your mum with the least stress most the time.

Aging Life Care Managers are a huge help in dealing with issues such as these. You can find them by visiting the national associations website. There is a button that will allow you to find a care manager by zip code/proximity to you.

I’ m curious how you know your sister is abusing her. Did she tell you, you saw it or could your Mom be confused. If she is delusional or having hallucinations, she could see a bruise she got herself and assume your sister did it. According to my mother I stole her furniture ( it’s in her apartment just where we moved it from her house) and my sister is stealing all her money( paying her bills lol) . Im just saying make sure you know the real situation

With advanced dementia, you will need to do whatever is necessary to make this as smooth a transition as possible. As your mom lives in the moment (and feeling a multitude of feelings: loss of independence, fear, powerlessness, confusion), she will act out and express herself.

Best way (or one way to handle this) is to tell her whatever may appease her in the moment, i.e., we are going to vist so-in-so who has a beautiful garden, who is an artist . . . or visit my old friend from college who is a . . . designer and has beautiful . . . to show us.

When for her own welfare, I believe it is NOT lying to 'try' to get her to go along with whatever you need her to do.

Your sister is a serious red flag and as someone said, could be arrested. Her behavior is likely a combination of burnout, lack of experience in how to deal with people w/dementia (as many people thrown in this role are totally unfamiliar with how to interact-relate to a person w/dementia), and how she feels about herself (low self-esteem, stress, resentment-past relationship issues with your mom). Whatever her issues are, she needs some education and timeouts IF she is going to be actively involved with your mom's care and decision making.

* Many/most people with brain cell deterioration will not know what they do not know/remember, etc. They will make definite statements of 'their truth.'

This is the disease. I encounter this all the time (with my clients). It can be tricky on how to respond - for all of us.

Do remember: MOST IMPORTANT FOR CARE PROVIDER:

DO NOT ARGUE WITH PERSON INFLICTED W DEMENTIA. Agree, redirect, give timeouts, hold their hand, look them in the eye and smile.

Think of how you'd want someone to respond/interact with you if this was you. Compassion, understanding. We all 'get caught in this net' no matter how educated or skillful, and experienced we may be.

This is not an easy road. It is PH.d. training in dementia. It is one of the most challenging areas of my life-work. And, I've lost over 70 lbs and kept it off for 35 years---that wasn't easy and often still isn't. But this 'dementia' is something else. Key for me was giving myself time outs and leaving - somehow shifting the current feelings / situation. Be it leaving for a minute, an hour, a day.

For one's own sanity, a person must learn how to set boundaries and be aware when their own "I can't take this anymore" moments pop up. Once that is reached, it is time to shift - somehow. Was I able to do this all the time. NO. It is a moment to moment or episode to episode decision. The more one is able to shift somehow, the more they will do that and not engage in this 'fight'.

I encourage you and your sister to sign up for Teepa Snow's webinars. Look at her website. She teaches people how to interact and work w/people with dementia. Teepa is brilliant and likely the country's - if not the world's expert - on dementia.

Remember and tell your sister, your mom DOESN'T react like this 'ON PURPOSE.' It is how her brain works.

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