My mom and I need help finding a care solution for my grandma. Grandma is 82 and lives at home (NY State, rural). Her health has been declining (weight loss, leg edema, dental/ vision/ hearing complaints, ingrown infected toenails, mobility problems, incontinence, frequent falls, etc). She probably has high blood pressure and may be pre-diabetic. She was diagnosed with borderline personality disorder many years ago; a therapist also said she had strong Munchausen tendencies (this is complicating everything). She has extreme mood swings. According to mom, she's always displayed a lot of attention-seeking irrational behavior. Lately she seems disoriented and confused periodically. She refuses to allow a housekeeper or day aide to come to her home (she says they will rob her).

My mom bought her a new washer / dryer so she could do laundry, and I bought her a new mattress, bedding set, pillows. I'm an Occupational therapist (for kids, but I know a bit about home modifications), so I added some safety mods to her bathroom (a shower bench, grab bars, grip mat, long cord for shower head, etc.). After these changes, she still refuses to do laundry, sleep in her bed, or shower/ bathe. She will only do laundry if my mom does it with her, will only sleep in her lift chair, and will only bathe if I'm there (she removed the bench).

She also has some very strange and unsafe personal hygiene- she often refuses to use the bodywash I brought, and bathes sitting in Palmolive (urinary tract infections). Recently when I gave her a gentle, conservative pedicure, she said she didn't like it and after I left she recut her toenails very short with a rusty straight blade kitchen scissor (badly infected ingrown toenails). She has gone months and months without bathing or doing laundry. Grandma recently sabotaged her lift chair (ripped out/ cut the wiring) so I would come over and have to electrical tape it back together. She recently fell, again, standing on a chair to change a lightbulb, although we told her many times not to. She won't wear the new shoes I got her (same brand, color, and style as the old ones) and insists on wearing the old ones (15+ years old with some type of fungus in them). She dresses in literal rags instead of the new sweatsuits, pajamas, and robes I got her. She will only eat high-salt TV dinners and cannot cook for herself, and her legs are extremely swollen. She takes a taxi to the grocery store, but only when she's been out of food for at least 24 hours.

She misses all her doctor appointments, and will only go if my mom accompanies her, but refuses to schedule the appointments on days my mom doesn't work. My mom had a doctor do a house call, and grandma wouldn't open the door and the doctor left. My mom has called out of work to bring her to appointments, and then sometimes grandma will not answer the door. She turns her phone off for days at a time. We've called the police for welfare checks. She only turned on her phone recently when I sent her a letter asking her to. I mail letters and photos every few weeks.

Years ago, she agreed to sell her home and mom did renevations, then grandma refused to sign the paper to begin the sale. My mom began proceedings for a retirement community, then grandma called it off. She said she wanted an aide, then changed her mind and won't discuss it now. Grandma said she couldnt move because of her 3 cats, but mom and I told her many times that we will care for them and she can always visit them. Grandma agreed to several senior housing renovation programs that may have put a lien on the home. No one knows her finances. Mom & I are basically broke.

Mom & grandma have a VERY strained relationship, mom won't talk about it much, but I know grandma was neglectful, maybe abusive, grandma kicked mom out when she was 15. Mom has no siblings. My mom lives an hour away, works very long hours at a demanding job, and can't drop everything to "play games". I live 4 hours away, no car. Help!

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Circling, you or your mom should contact the patient advocate department at the hospital and raise holy he[[ about what happened.

Call the social work department and find out from them EXACTLY what needs to be done to get gma into care.

If they say there is nothing to be done, I think your mom needs to seriously consider letting gma be. Call the police once a week for a "wellness check".

She's getting what she wants; your mom shouldn't have to give up her mental and physical health to foist care upon someone who is determined not to have it.

Mental illness is hard to live with. Your mom should seriously consider walking away. Can she do that?
Helpful Answer (1)

"The hospital physician said he couldn't do anything about any of the chronic conditions or mental health concerns, didn't look at the letter, said the social worker was unavailable, and told my mother she would need to spend the next week taking Grandma to the dentist, gastroenterologist, podiatrist, ophthalmologist, urologist, and dermatologist."

I feel so badly for your mother. That was the point where your mother should have refused to take her back to her house. Medical professionals order other people to do things (as this MD did to your mother) whenever they can get away with it.

Please keep us updated. Your grandmother belongs in a facility, and you and your mother are NOT responsible for her welfare (unless one of you takes guardianship of her).

IS she still considered to be mentally competent?
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Update- Recently, mom took grandma to the emergency room. mom is at her breaking point with grandma's self neglect. Grandma recently claimed a variety of ailments, some of which are real (infected tooth, infected toenail), some are unclear (vision loss in one eye, periodic incontinence) and finally agreed to seek medical care, she said she'd go to the ER and we felt like it was finally at turning point to get some help. When Mom got to the ER, she had a prepared letter detailing Grandma's self neglect, history of allllll the police welfare checks (to answer a previous poster, when the police show up, Grandma is filthy, but a charmer). Mom asked to speak to the hospital social worker. The hospital physician said he couldn't do anything about any of the chronic conditions or mental health concerns, didn't look at the letter, said the social worker was unavailable, and told my mother she would need to spend the next week taking Grandma to the dentist, gastroenterologist, podiatrist, ophthalmologist, urologist, and dermatologist. Mom left the hospital in tears. Grandma flushed her antibiotics when she got home and said it was a good day. Now what?
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You've called the police for welfare checkS plural? - and what happened?
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CirclingSkies May 2019
Thanks for your reply, I posted an update in answers. When the police show up, grandma is filthy, but a charmer. She will laugh and pat their arms and say she is perfectly fine, and that she just doesn't know what that daughter of hers is so worried about
Reporting grandma to APS as a venerable senior is always an option. If APS visits and determines grandma is incompetent, they can help you gain guardianship. Just be aware that once APS is involved, they may make decisions about grandma's care you wouldn't like. They may place grandma in the first available bed even if the facility is hours away from either you or your mother.
Helpful Answer (3)
cwillie Apr 2019
I know you meant to type vulnerable, but it tickled my funny bone that venerable should be appropriate too!
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If you and your mom paid for those things to help grandma out, you have done enough. More than enough, financially and don't do it anymore. The both of you need to take a step back and leave her to her own devices. If she falls, has a stroke and needs long term care, so be it. When that happens, you can just say to the social worker that she has to find a facility for grandma, she won't be living with family and stick to your guns.
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If and this is a big if...your Grandma is of sound mind you can not force her to do anything. If you spoke to a lawyer (strongly advise Elder Care Attorney) he or she may find that in their opinion she does not have the capacity to understand documents and at that point you may be able to gain Guardianship (or the court can appoint a Guardian)
It is then that you can force some changes.
Failing the above it often takes a catastrophic event like a fall that would hospitalize her, send her into rehab but at least prior to hospital discharge you can say that she is not safe at home, and she can not live alone. Then this brings in..does she live with Mom, with you (both probably a very strong NO. So the result is Assisted Living or Memory Care.
The the question becomes,,does she have the funds for private pay or will she go on Medicaid?
More questions to answer...
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