I'm an only child living out of town and having to work with an elderly parent refusing all assistance. Any advice? - AgingCare.com

I'm an only child living out of town and having to work with an elderly parent refusing all assistance. Any advice?

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She can no longer walk. First of all I'm grateful for this site in that I realize I'm not alone and this is apparent a life process. Mom has repeated falls and lives alone out of state from me. I've asked for help from the appropriate professionals but they still believe she is competent (she refuses to release POA and no guardianship) today I got ANOTHER call...she's in rehab and refusing to stay (again) but I can't take care of her alone with no financial resources or a plan of action from anyone. Also, she just spent at least a week in the hospital before transfer to the rehab and not a soul updated me. I'm not sure if she told them not to talk to me. I get bits of info on this from and bits of info on that from others. Any advice? I know I need a physician to comply for guardianship but none so far. And with her BEHAVIOR issues, I really don't know how to manage. It's one thing to have a physical problem--thats more clear cut--when you have an undiagnosed psych problem that has been present for years--that's another. And yes, there has been a psych geriatric consult during hospitalizations with her refusing to comply to even get that correct.

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The other interesting factor here is abuse you may have received as a child due to the personality disorder. As a child abuse survivor, it's important that I **not** be involved in mthr's day to day care as it could easily lead to retaliation. When she slapped me in the waiting room at the hospital for no good reason during the time we were getting her recovery in order, I was glad I was in a public place. How dare she? She smiled her evil grin. Ugh, old times.

Do not sign anything agreeing to pay one dime of your money. You can refuse to sign everything until you have temporary emergency guardianship. You can sign her up for Medicaid so she can enter somewhere Medicaid pending. But don't use your money.
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Reply to surprise
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The adult protective services people in mthr's town were very supportive. They suggested that with the personality issues, I might not want to get as involved as she needed- because of the "baggage" she'd handed off to me. They said it would be perfectly understandable if I declined to be guardian and chose to allow the state to take over.

A serious advantage of state guardianship is the fact that you would be powerless to change her living situation, her finances, her doc... You could speak to the state appointed guardian if you wanted, but when your mthr *demands* release/change, your hands are "tied." I chose to take mthr on because there were financial abuse issues and I wanted to try to go after the abusers.
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Reply to surprise
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thank you all for your response. things are moving quickly. the nurse pratitioner at the facility indicated that mom could not leave along and that we are dealing with a possible personality disorder/dementia. (the personality thing is and has been a problem since i was a kid just undiagnosed) im heading down there monday to try to meet and talk with the social worker and discharge planner, however, the financial hardship this could put me in is VERY questionable and legal issues are NEVER cut and dry. with the personality issue i sit here now wondering if i can even handle this. (i understand this condition and know theres no cure for that) ive GOT to do something and make a choice. you all have wonderful advice and answers but i keep going back to the response of surprise. this is so frustrating...and scary.
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Reply to Looking4hope
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Looking4Hope, I feel your pain. After my father passed away my mom was alone in NJ and I had moved to Canada years ago after I was married. It is a scary road to travel when living far away and the worry & anxiety can be overwhelming. My mom didn't want to sign over POA either, and I didn't have the money or time to go after guardianship and trust me time was of the essence. After my mom had a really bad fall that ended with a brain bleed where she ended up in the hospital, then short term care and she was a candidate for long term care...I really had a heart to heart with her. She didn't comply at first, but eventually on a whim she gave in...best thing that happened, so please try to talk to her, it will save you in the end! I struggled with helping her before I had that POA. I knew she wasn't capable to being alone, her health was deteriorating, and all I wanted was for her to be safe and cared for. I felt horrible taking her independence away, but I knew it was best. Eventually my mom was declared unable to make health and financial decisions on her own due to dementia that progressed so fast after her fall. In the end, no matter the right decisions I made, my mom passed away less than 3 months after her fall. I knew for awhile she needed help but she refused. She wouldn't hire anyone to come in, she wouldn't move to assisted living, and there was nothing I could do! In the end it took a horrible fall and some convincing to be in charge of her health care. It all honestly came too late. I'm sorry to say it really will take something drastic to happen before you can step in and even then you may have road blocks. I wish you luck.
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Reply to EricaMagoo83
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I agree with Windyridge. Long-distance caregiving is difficult at best. Sometimes the person who is helping make the decisions is notified of options as an afterthought because they’re not there.

If it were me, I’d take a week off from work. I would notify all parties involved with your mom, including the facility’s administration, social services department, her nurse, as many therapists as can be there, a psychiatrist if there’s one on staff,and especially her physician. Let them know a good while in advance so that everyone can adjust their schedule and be there. Do NOT allow Mom to attend. This is an important meeting. Mom can be told what’s happening after the decisions are made. Bring any and all papers you can find on Mom. Have what’s called a “Care Conference”. Don’t let yourself be intimidated. Let them know you are taking time off from your job and traveled quite a distance to get this squared away so when you leave, it has to be a done deal. Mom needs to be evaluated and diagnosed. I would even mention having someone from the local Adult Protective Services attend since Mom lives alone. Unfortunately, you are on a tightrope right now. Mom is “too bad” to live alone, but not “bad enough” for a snap diagnoses and treatment plan. But something has to be done because right now you are spinning your wheels and not getting anywhere. Good luck and keep us posted.
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Reply to Ahmijoy
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It's funny- during the years mthr needed help, when people asked me how she was doing, I'd respond, "dealing with untreated/ undiagnosed mental illness is really hard to cope with." You took the words right out of my mouth!

Let her be, don't get involved. Tell the rehab if they call that you appreciate being kept informed, but you can't control her behavior as long as she's competent and you won't be rescuing her now just to turn her back to her dangerous habits.

If rehab can get you to sign her out, they don't face liability. If you sign her out and let her go, courts could find you guilty of elder neglect. It's best if you stay out until she has the accident that details her.

Mthr ended up wandering her town and not knowing where she lived. Had a big bleeding cancer, we rescued her, she recovered, and she's now warm, dry, and fed at a memory care. She's the happiest she's been in her life.
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Reply to surprise
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I know it must be very hard to try to deal with this from a distance but are you able to make a trip to visit her now? I don’t want to alarm you but these rehab and discharge issues are very tricky and can have lasting consequences. They can be helped with boots on the ground, and face to face meetings with the social worker/doctors and you may even be able to facilitate your Moms cooperation with them. I think now would be an appropriate time for a trip, if possible. You don’t have guardianship (yet) but you can help influence the direction this path is going. (My Mom also told her doctors she was doing all the ADL...not! God knows where she would have ended up if I hadn’t been there.). It’s important for you and the experts to be on the same page, and you will get a better sense of her condition in person than getting it from reports. Then you will have a better vision for your Moms ongoing care.
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Reply to rocketjcat
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I’m also a solo, long distance caregiver. The last son. My folks refused any in home help for years. It was finally a series of events that forced the issue. Mom had a bad fall, went into hospital and dads dementia had escalated suddenly. I had mom transferred to assisted living and eased Dad in with her a few days later.

Mom was considered competent at the time but anyone could see she could not be at home. The AL staff deal with this all the time. They did not require a letter from doctors.

I think you need to make the trip, get involved with having her placed. Her facility must have a social worker or placement person. Or contact the local commision on aging for help.

I’m going through the guardianship/conservator process now. It will take about 90 days and cost about $3000. This will enable me to sell the house and continue to pay for their care.
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Reply to Windyridge
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thank you guys for your response. last night i got a call at the rehab center and she was "sundowning" the staff member there talked about getting the facility physician to follow through with ANOTHER attempted to evaluate further. because of the limit in rehab days im anxious. im praying that the staff at this facility will REALLY step in and help in the positive direction. im going to push for that.
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Reply to Looking4hope
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So sorry to hear about this. I know it is so stressful. It sounds like you have been putting in a lot of time on this, already. First of all ,since you are long distance, how are these professionals formulating their opinion that she is competent? I ask, because if early on my LO was asked questions about her abilities, she would have sounded fine, but, she was not accurately reporting things. She really believed that she was able to prepare meals, pay bills, handle hygiene, take medications, etc. Her answers would have been glowing with positives, but, it was not true. Only having a family member there to speak the truth truly shows the situation and thus the reality of the situation.
Is there some way this can happen?

I might consult with an Elder Law attorney in her jurisdiction to get advice and options. if you feel these professionals are not properly assessing her, perhaps a CYA letter is appropriate.

And, it may be that if the rehab can't confirm an at home aftercare plan, they won't release her. Others here may know about that.
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