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Here's the situation:


There are three of us:
- Grandma (91, widowed, dementia with moments of lucidity, lives by herself)
- Her daughter in law (my Mother, also widowed, caregives for her own 88 yo father)
- Myself (lives completely across the country)


Grandma refuses any help. We ask her to go to nursing home but she refuses. We ask her to get outside help to come in and she refuses since it's too expensive.


She has been wandering outside quite frequently (approx. once a week around 3am-5am). She also falls often and has no one to help her get up. My mother will check on her (~5 times a day) and if she has fallen, she'll call a building security guard to help her get her back up onto the bed. Mother has to work and can't always be around to watch Grandma and she has her own father to care for.


Recently, Grandma took a fall and hurt her hip and couldn't get out of bed. We sent her to the hospital and the x-rays show no fractures just muscle strain or hip strain or something like that. Anyway, we want to send her to nursing home but after speaking with her, the doctor said that unless she makes the decision to, we cannot take away her right to make decisions for herself.


I looked at some articles on this site and they same the same thing. Unless we have guardianship (which we don't have) and the doctor is unwilling to declare her incapacitated since she can answer questions for herself, we cannot legally move her.


My question is: what do we do? Grandma is making my mother's life miserable since she regularly gets woken up in the wee hours to go get Grandma, she requires multiple visits and needs to be fed medication, food, cooking, cleaning, etc. Do we have to live a miserable life until Grandma passes away?


And if she does pass away in her own apartment, will we be responsible?

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Agree wholeheartedly - when the person begins to wander, it is time for placement to a memory care floor. Game changer.
Wandering is dangerous and must be halted.
I would call APS if her family doesn't see the light or the person can't agree due to dementia.
Wandering was our cue that MIL was going into a facility somewhere. Fortunately she has the resources to afford it as she is private pay.
She was found by a neighbor walking down the street in the middle of the night in her pajamas and someone called my husband's brother (my BIL) who lived very near instead of 911 as they knew each other.  He went to collect her. Her house went on the market and sold quickly which is what is paying her monthly fee at AL.
From then on it was 24/7 supervision for her. She is on a locked memory unit now after the staff allowed her to live on the downstairs regular AL independent clients. She gave up that privilege when she was moved to memory care due to 2 more episodes of "elopement" - she did it two more times from AL. Found walking down the street a few blocks x2. 
Yes APS if she doesn't go willingly but she needs 24/7 supervision ASAP. 
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Let's examine the facts;
"91, dementia with "MOMENTS" of lucidity, wandering outside quite frequently at 3am-5 am, falling frequently, can't take medication, cook, clean on her own or function without the assistance of your mother."
Sounds like she needs an assisted living /memory care/nursing facility to me.
Is her doctor blind, deaf and dumb? Does he know all this?
Call him or set up an appointment with him to discuss her behavior. Demented patients can have " show-timers", literally faking their sanity and hiding their dementia, for a short time, to fool others. Write down as many examples of her confusion, weird behavior and incapacitates as you can. Have your mom take videos on your phone of her abnormal behavior. If he won't budge after that, make an appointment with a geriatric neurologist who can administer the appropriate tests to declare her incompetent.
Her behavior is NOT normal for a sane person.

Also, as said above, alert Adult Protective Services that she is a danger to herself. Call the county or hospital and ask to speak to a social worker. They have lots of referrals and suggestions.

Do not let this go. You may find her dead in the street from being run over in the wee hours of the morning.
She needs to be placed for her own protection. Your mother can only handle so much or she will collapse. I agree, turn her phone off. Tell her to tell your grandma to call the police if she needs something. After a few home visits, THEY will refer her to APS and possibly have her evaluated mentally.

I still can't believe that she's got her doctor so fooled!
Good luck.
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You're not liable. You have the opinion of a medical practitioner that your grandmother is a consenting adult in full possession of her mental faculties. However ironic you may find that opinion, it absolves you of all responsibility.

Your mother must learn to turn her phone off at night. Sign grandma up to an alarm call system instead - if she won't, she won't, and on her head be it. I agree too about alerting APS to the situation. Your mother can't force your grandmother to accept help or supervision, but she can report her concerns to anyone she likes who'll listen.

And if your grandmother should be found passed away in her own bed... while still sad, of course, can you think of a better final outcome for her?
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I'd call adult protective services with all information about her history, situation, high risk for exposure, getting lost, etc. Wandering is very dangerous and I would think a doctor would be concerned about it. And as far as liability goes, I'd consult with an attorney for legal advice about that.
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I would call Adult Protective Services in grandma's community and report her as a vulnerable elder.
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Does Grandma have a regular doctor? Would he/she prescribe hospice? I'd bring in hospice so that you have someone else looking at Grandma on a regular basis to both cover yourselves and to get help with Grandma's care so that you don't feel like you're alone in all of this.

My mom died at home in May in her bed (in an independent living facility) with hospice care for the last week of her life. When she passed, I called hospice and they sent out a nurse to declare her gone and their hospice doctor signed her death certificate since she hadn't seen her regular doctor in some time. They'll give you all kinds of support and good advice. See if you can get them in to help.
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