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Eight weeks ago, I was living a normal life living with my 78 year old mom and checking in weekly with her 76 year old sister who lived on her own in an apartment. I had been working at home for the past 15 months because of COVID closures, and had gone on vacation and was due to return to the office the following week. My mom just suddenly had a complete unexplained physical and mental meltdown and I had to return early from my vacation. Suddenly needed specialist visits (some kind of speech impediment that turned out not to be stroke) and anxiety meds which she will not take regularly. In the meantime she lost her beloved cat, which she had been dreading (the cat was 15 yrs old) and this only made her state worse. (My mom had many stresses leading up to this moment: close aunt of hers died in winter, longtime neighbor died in spring, good Internet-friend died in spring, then she was turned down for knee surgery she really wanted, and then the cat died.)


During all this while my sister and I were dealing with my mom's collapse, my aunt (the 76 year-old sister) had a disaster - her basement apartment flooded, leading to extreme chaos. Unfortunately my aunt is an alcoholic and hoarder who we had been trying to get help for but she was very resistant. We had concluded earlier that she was unable to care for herself and live on her own but she still drove and could feed herself so APS wasn't interested even though her apartment was an extreme mess. Landlord gave her a ridiculous deadline of 48 hours to remove all her things so that her carpets could be replaced. The deadline was later extended, but the stress overcame her and my mother and the whole family as various scrambles to secure movers and help with her massive amounts of stuff came to nothing. We were able to secure a new apartment for her but unable to get help with the stuff (even though we urged her to only take her most important things). In this day and age it is impossible to schedule movers or find any help with moving (we are a small family, just my sister and I the only able bodied).


On top of it, my mom's mental condition continued to deteriorate - ranting, anger, she doesn't really like her sister (my aunt) so they got on each others nerves because we had to take my aunt in and she was sleeping on the couch - not good for her.


Last week, the worst happened... my aunt had a stroke.


My aunt is now in the hospital being assessed for rehab. We have told a social worker that she was unable to live on her own safely even before the stroke happened. We hope at best that she can live in an apartment with daily help. She does not seem to have really bad aphasia or paralysis and could benefit from rehab, but she has episodes of "time slips" and confused speech that have led her doctors to believe she can't make her own medical decisions. Of course, I defer to their judgment. She communicates very well and has less time-slips when she has family around, so I visit her twice daily as I work right next door to the hospital. I try to talk to her nurses as much as possible but rarely see them.


The problem is that my aunt gave my mother's name as her medical contact under HIPAA and now my mom is making medical decisions for her. I am most concerned about the fact that my mom is mentally unbalanced and does not understand the true situation with my aunt since she is unable to visit and see how she is. My mom is also saying very inappropriate and unhelpful things (personality grudges) about my aunt's mental state to the nurses who call, which I fear are giving them a wrong picture of her baseline cognition. When we have important questions to ask the nurses, my mom tends to go off script and pursue her own emotional agenda.


(Part 1)

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No, your Mom should not be making decisions for her sister. She does not need the stress. I would tell the SW this. I would also ask that Aunt be evaluated to see if she needs 24/7 care. If its found she does, then she will need to go to an AL, if she can afford it or Longterm care with Medicaid paying. If you are not already Aunts POA, I probably would not take on that responsibility. The State could take over ur Aunts care but then you nor Mom could make any decisions for her. A State Guardian would be assigned to her care.

You can't take care of both of them. Mom is # priority.
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The first few months of the disaster are the most difficult. Getting your aunt into rehab and then maybe assisted living will be a Godsend. As for your mom, getting a psychiatric appointment can be like pulling teeth. In short, too many patients, not enough doctors. But sounds like your mom needs a complete physical. I hate to say this, but if your mom takes a fall, it may be the only way to get her into the hospital for a complete physical and mental evaluation. It's awful even to have to think like that, but desperate times call for desperate measure. (Of course, then you'll likely have to deal with hospital psychosis---a whole other can of worms.)
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I'm so sorry for this dismaying circumstance. Please forgive my bluntness to you but your situation needs urgent clarity: "... episodes of 'time slips' and confused speech" = dementia and memory impairment. Using euphemisms to describe reality looks like you are in deep denial. I realize you are overwhelmed by the double poop-show going on, but if you can't bring yourself to call it what it is, you won't be able to improve anything in their lives. I think you would benefit from counseling for co-dependency and enabling. You need to save yourself first before you can adequately help your mom without everyone going down in flames.

Has your mom or aunt been assessed for this by a doctor? If not, this needs to happen. The way you get it to happen is at her next appointment you go with a pre-written note that you discretely hand to the nurse outlining your concerns and requesting a cognitive/memory test. Hopefully you will also get your mom to assign you as her Medical Rep (the HIPAA form). This is NOT the same as a MPoA... this does not allow one to make medical decisions for another person, it merely allows that person's medical team to disclose private information to the Rep without the person having to be present during that discussion. If your mom is making medical decisions for your aunt without being her MPoA, this is most likely not legal.

Your aunt is an alcoholic hoarder. Hoarding is a mental disorder that requires therapy to overcome. Do not clean out her home ever again -- she will just be angry that you did (not grateful) and then fill it back up. Keep your distance and allow APS to eventually deal with her. It will need to get "bad enough" before this happens and will be difficult to stand on the sidelines and watch it but she will eventually become a ward of the county and then she'll get the help she needs, whether she wants it or not. There's no other way to deal with someone like her (please read other posts on this forum regarding similar issues). You are under no obligation to help her and honestly, you can't. If she's not willing/able to do it herself you and your sister will burn out trying to drag her *and your mom* into a "better state", which they will never achieve.

Do not move in with your mom or have her move in with you. It sounds like your mom needs more care than you and your sister can provide, even with your aunt out of the picture, because she's not cooperative in any way. I recommend talking to a counselor so that you can self-care and get objective clarity on your situation. I agree it is gut-wrenching to watch LOs deteriorate and not knowing where to begin to address things. Here's where you begin: you take care of you. On an airplane that is nose-diving and the oxygen mask drops down, you put on yours first then your mom's. Please read the many many many posts about caregiver burnout on this forum. It's real and the only remedy is for you to care for yourself first. May you and your sister gain clarity, wisdom and peace in your heart as you work through this challenge together.
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SistyUglers Sep 2021
Please read my post again. Thanks!

My mom already lives with me and she has for 10 years. We co-own our home. This problem with her is new. I described her resistance to doctors.

My aunt had a stroke and is under the care of doctors. She is the one with the time slips and confused speech, because she had a stroke. She is probably going to assisted living, if not an actual nursing home.

(Was I not clear about the above?)
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(Part 2)

In the meantime I still live with mom and am terrified she will have a serious fall. Sometimes she uses her proper walker and takes care of herself, other times she does too much and she has had minor falls. The last time she had a fall, she was taken to ER and absolutely had a mental meltdown (she is very bad in hospitals).
At best, she is nearly manic and abusive to me when I am home, which is exhausting as my sister and I try to deal with both of them. She is supposed to be on Lexapro, which does help, but she is paranoid about side effects. She got her doctor to give her Effexor instead, which she didn't take either at all, and now she wants back on the Lexapro, except her doctor cancelled the prescription...

Yes, we've contacted a psychiatrist and no, she refuses to go. We've even encouraged her to dial a pet bereavement counselor. My mom has obsessive tendencies which we always knew about but which have come to the fore and are making her very, very difficult to work with... especially now. She keeps making and cancelling doctor and specalist appointments. Exasperating because we keep getting time off work to take her (she can no longer drive). She has become extremely self-centered (more than usual) and does not seem to know how much difficulty she is causing. She thinks she is in control of everything and that my sister and I are meddling. She and my aunt do not have any friends or social contacts other than me and my sister.

I have lost 15 lbs since this started and am worried about my own physical health. I am run ragged dawn to dusk, mainly by my mom.

So this is where I am now. Thanks for listening
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bundleofjoy Sep 2021
hugs sisty!!

let’s try to take care of ourselves first. if possible, somehow hire people who can help your mom + aunt.

we must not drown.
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