How do we put Mom in a home? Can Dad have the state or agency do it instead?

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We finally decided that Mom needs advanced care. However, my dad is feeling too guilty to sign the papers himself and is considering having the state or some agency check her into the home. Is that possible? If so, who do we contact? Mom is still aware enough of her surroundings that she gets suspicious of what is going on, knows her surroundings, what people are doing but her self care is so bad and she refuses to cooperate with us despite us pleading and telling her that her lack of self-care will land her in a home. So how do we go about this now? Is there a way to get her into a home without her pinning the blame on any one of the family members?

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StChaos You are very Welcome!!! My main reason for coming here to this site is to try help people in yours or a similar situation. I have been through the "I can't do it anymore, but nobody is capable but me" thing ....and it is all a mind game with yourself or other family members dealing with it all. Now, I can tell you, after Mom's almost three years in the NH, I kind of got my Mother back! She may not exactly know who I am but she is herself. Her personality is in check, so to speak. The scary thing LOL I now know why she gave me such a hard time as her 24/7 caregiver, I am just like her. As I write this I am thinking about how I reacted to a social situation just yesterday at my Christmas Party for work. I decided not to sit with the people who I usually sit with because lately they just make me mad. they all complain get stressed, over stupid stuff and just are not comfortable to be around lately. I was at a party and wanted fun not to be uncomfortable. My Mom refuses to sit around people who have unhappy energy. I guess the apple didn't fall far from the tree. In the same sense that is exactly how I can read her emotions and feelings without words. She talks, but what I mean is she doesn't have to. I can come off the elevator and take a glance at her, way down the hall, and know exactly what mood she's in, the staff actually has said to me your just like your Mom. So I do not think personality is hidden by dementia, as loved ones we have to make sure they remain who they are and "not try to change" their behaviors only control the surroundings so that their souls shine, not take their souls away from them.
Back to my earlier post when Mom was admitted to NH stable..... they switched her medication and I noticed (because I know her) I tried to explain to them , I know your just doing your job, I know you think I'm telling you this because she does not want me around and that's not why I am concerned, I am not telling you I want you to drug her, I'm simply telling you I know her and you'll be sorry!!!! Well Mom went from being the easiest resident to being the most difficult.... then I get a call "what do we do your Mom's out of control!" I warned them!!! I explained to them that I know she has dementia that's why she's here and you can't fix that but the meds she was prescribed were for stabilization, Not for creating another person. I want her stable for her benefit not yours not mine. I am telling you all this because, you know your Mom you know when she's happy and just because she's need 24/7 NH care does not mean you don't have to care anymore. You can communicate with the staff, Dr's etc.
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My mom was very similar and we had the same fears. We signed her up for an ALF, moved her furniture in while she was with another relative, then delivered her to the ALF after everything was set up including having all her family pictures on the wall. She was resistant and threatened to burn the place down. Because of this we had to have 24 care for her for the first 30 days. We worked it out using family members and paid sitters.

The 30 day transition period helped A LOT. We got her used to the routine and at the end of the 30 days she was content. There are some family members that did not want to be involved and still do not visit. That is the hardest part for her. She does get lonely and if I had known they would flake out, I would have moved her closer to me, so I could visit more.
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Thanks a million, wuvsicecream! It's good to know what to expect from doctors and NH staff as we prepare to have her admitted. I've become more comfortable with the idea of her being in a NH from reading up in these forums and getting some solid advice. Tomorrow, I visit my folks and will be taking some contact information for my dad so he can get the answers he needs so he can take the next step in helping my mom get the care she needs and deserves.
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StChaos I am glad you cleared up my question about her condition and her Dr's response to it. Not anyone can know really how her behaviors are unless they spend a decent amount of time with her. So obviously that would be in your case yourself and your Dad. My Mom spent months in a mental hospital, was unarguably in need of NH care, directly released to NH from the mental hospital and under 3 Dr's agreement. I got a call the next day from the NH social worker asking me why she was there. I was her contact so that's why she called me, then she asked me what my relationship was to her. I said her daughter, she said "she told me she didn't have children", I said "now you know why she's there?"
My point is at the mental hospital they diagnosed and treated her with meds to stability, to the point that she was to anyone not knowing her unable to see her dementia. without the meds and the routine and the assistance in daily needs she appeared to be quite alright. Prior to the mental hospital she was, as it looks from your post just like your Mother. Three years later not much has changed with her behaviors, a few times I had to meet with staff about her personality change, it was due to meds being adjusted not the illness alone. The NH decision was truthfully the best thing for her. There was no way I could have done it alone. She is happy for the most part and she gets a lot of stimulation, entertainment, and is well cared for. I know everyone is different and I also see many types of dementia and behaviors at the NH. What I see is people who complain about not wanting whats good for them. I see people smile because there is entertainment, I see crying screaming, I see the staff giving people who are not in reality, moments of joy and much needed care. With dementia you can do what's best for a person as much as possible you can't reverse the condition. You can only adjust to the situation given and do what's best for the quality of life. If you are doing what's best for a person blame and guilt should not be your concern. These emotions are normal but not helpful. You really should get a diagnosis from a neurologist and try to stabilize her condition by routine and care needs that will be stable. Trying to reason with a person who has dementia is useless. You can try to focus on what the solution is and not the problem. I learned this the hard way myself.
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Thank you for your support, jeannegibbs. Every little bit of support means a lot these day!!! Thank you!!! :)
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You are so right! Having Mother get the kind of care she needs in a professional setting is going to be rough. Keeping where she is now is rough. Any way you slice it, dementia is a very, very rough disease! I am so sorry that your family has to deal with this.
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To answer you, wuvsicecream, she has dementia. Most sites I've read list seven stages and she's in the fifth heading into the sixth. So it's fairly advanced. She refuses to allow "outsiders" into her home to help with chores---this even includes her grandkids or even her children. She threw a tantrum over the idea of bringing in **gasp** strangers from the elderly assistance groups to clean her house. However, I personally know her current doctor (he's also my primary care doctor) and they guy is a big marshmallow and I can't see him pushing to have her put in a home so I don't know if she needs to be evaluated by a different doctor---is there someone who specializes in evaluating the elderly for this sort of thing?

Thanks for the advice, jeannegibbs. I try not to use it as a threat...but sometimes it comes out that way...we tried it in the earlier stages to get her to cooperate and it sometimes worked but now that it's advanced, it's not working. I have a mental disorder myself so I understand that her actions aren't directly her fault but the fault of her brain's chemistry and malfunctions. This gave me more patience with her attitude problems than my dad's patience. However, the level of care she needs has increased, along with her combativeness recently and I don't think we're providing her with the help she really needs. Also the rest of the family is starting to come around that she needs additional help that my father and I alone cannot handle.

I will pass on the idea to my father of the idea that it "doesn't have to be true--it just has to be kind" and see if he can agree to that. To be honest, since her dementia got worse, she turned on my dad and accuses him of just about everything. He's become the target of her aggressions and when I ask her why, she says "I don't know". So even if it was the state (in reality), she's probably going to blame him anyways...

Unfortunately, she was considerably more sane when she went to visit my aunt in a care facility in her dwindling days, which may have also fed her negative view of such places. She's always been antisocial...so I don't see her changing her mind about an elder care facility. No matter how this goes down, it's going to be rough.
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I suppose if Mom were a ward of the state they would do what was necessary, but short of that I'm not sure how that would work.

BUT ... I don't guess you are going to show Mom any signatures. You can tell her any one you want signed her in. Make something up -- The Agency for Elder Healthcare -- or anything that would take the blame off of Dad.

Mom has dementia. She cannot help her behavior. She cannot be reasoned with -- she just does not have the capacity. Telling her that not taking care of herself will land her in a home makes the home sound like a punishment, and probably doesn't help her attitude about going to one. (I know you didn't mean it as a punishment, but she probably isn't capable of very sophisticated reasoning at this point.) Her lack of self-care is not deliberate and she can't simply be talked into behaving better. There is something wrong with her brain -- plaques or tangles or clumps or something that doesn't belong there -- and no amount of promises or threats or convincing is going to change that.

It is not Mother's fault that she has dementia. And it is not Father's fault. I am sorry he is feeling so guilty. He did not cause the dementia, he did not make it get worse, and he cannot help it that she is beyond being cared for at home.

I hope you can all do what needs to be done for Mother. Then tell her any explanation that will minimize her grief and interfere least with her relationships with all of you. It doesn't have to be "true" -- it just has to be kind.
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StChoas What is your Mothers condition? Has she been to a Dr. about her care needs? If she needs 24/7 nursing home care this needs to be agreed to by a doctor.
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