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She has dementia, the house is empty and mom wants to move back. Mom has dementia,she moved into a lovely assisted living facility 5 months ago. The family home is empty, no-one can move in there, and it must be sold. A brother living in another city tells mom that it is her decision to sell, even though he knows she is not cognitively capable of making that decision based on reason.When he visits, he brings her back to the home for up to a weeks visit. She constantly talks about moving back home and his refusal to get on board with us is causing a lot of anxiety, unhappiness and confusion in mom. We have no other option, we must sell the house. How do we impress on him that we cannot give in to mom's feelings about moving back home because it is not possible, and his attitude is making it more difficult for her?

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Nasmir: When you wrote "That's why it can be important, while the person is still cognizant, they write down how they want to be cared for if a memory impairment befalls them," you had to have been talking about the OP. So whom didn't have the DNR; I don't know who "she" is?
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Nasmir, Yes, I understand your frustrations regarding the NH bills, but these thing can and sometimes do take time to has them out! Im hope full that you will come to some sort of resolution to them.
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Nasmir: I believe that you're referring to a DNR order, right?
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Nasmir, I'm sorry, but "going to these places " probably did not cause your Mom to further deteriorate and pass away, her frail condition, ilness, and the continuous downhill spiral, was probably the issue, and for that, I am sincerely saddened by. It was through No fault of your own, nor probably the facilities fault, just an unfortunate symptom of getting old and the disease processes thay are declining from. It doesn't matter if the facility was 5 star or less, I'm sure that they did see that she was always fed and clean, and beyond this, it is often the case that they begin into the Failure to Thrive category. It really is Sad, but we All do Eventually Die, and having witnessed 3 of our parents pass away, the end of each was never easy for them, nor us! Our last remaining parent, who lives with us, is declining rapidly, and despite every effort on our part, there is truly nothing we can do but be supportive, and help him in any way, and to make him as comfortable as possible. Whether he is with us or in a facility, I don't think it will matter, he is 86, and his body is deteriorating, it is what happens in life. I hope that someday, there is an outstanding way to make this transition to the end of living better for you and for me, history shows this is not to be true! We decline, and then we die, nobody lives forever. I do hope that you are not beating yourself up over this, I'm sure that you did the best that you could, with what you had to work with, whether it was financial or lack of options to keep her in your home, but please know, she is at peace, and in a better place.
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Nasmir Depression IS a mental issue and a very serious one at that

It can be incredibly debilitating
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Well I am going to ignore the stupid answers on here because a diagnosis of dementia is a solid indication that a person may not have the ability to make cognitive decisions. I only say MAY because dementia is sometimes diagnosed very early on. My mother can make choices for sure but she isn't able to rationalise why or the consequences of her choices so they are NOT decisions.

She also can't make decisions that exist in todays world. When I told her that I had given her grandson a toy she asked how much it was...money being a real issue for her. She went ballistic when I said it cost (in US money) about 17$ said I was wasteful.

This is the same woman who then went to church and gave them all the money as in her purse (at this time I didn't know the problem) some 200$ in your money and then complained someone had stolen it from her!

My son was in denial about Mums condition until he spent some time (a few days) in her company and realised that she wasn't 'quite all there' Mum has perfectly lucid days but not perfect as in normal. Perfectly lucid as in she knows she has to wash and to get dressed.

I think what you need to do Nelsonjosie is to sit your brother down and explain dementia to him and get some print offs from this site to help him understand the path dementia takes and that now you have to act to a) cover the costs of care and b) get the most money you can for the property unless you could rent it out which might be another option

Then once you are talking explain that taking your mum back to the house is not helping and that he needs to take Mum to visit places she used to go to rather than the place she lived in instead. She will forget and unlike other ridiculous comments she cannot make these decisions now as she doesn't understand the associative implications of that decision
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Nasmir, I am sorry for your loss of your wonderful Mom, I really do understand, as I've lost both of my wonderful parents too!
But you keep going back to it being your "Mother's choice", but just who was going to be there, to care for your Mom, 24 hours a day, you? For our Loved Ones with Dementia and other debilitating diseases and decline, its not always possible for a Son or Daughter to take on this exhausting task! My parents had other horrible illnesses that took their lives, but I have been caring for my FIL, in our home for the past 13 years, and quite frankly, we are completely beyond burned out, caring for him, as he has battled through Lymphoma, and general age related decline. He is a Narcissistic, and is extremely difficult to care for, and my husband, his Son has dealt with a lifetime of FOG, FEAR, OBLIGATION, and GUILT, which is a horrible situation to be in, causing you to be resentful of them robbing you of your life, when they themselves have mentally abused you for your whole life, and he never spent, not even One Day ever, caring for one of his own parents!

I wish you would try to put yourself in others shoes, who have exhausted all other options for caring for their folks, and NEED the family to be on the same page, in further seeing that their parents get appropriate care. And you are right, no Nursing home is like living in a loving family environment, but sometimes, there is no other way!
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Nasmir, I have to ask this, and I am not being smart or nasty. Did your mom want to go into a home? You are so pro keeping the parents in the family home that I am led to believe she wanted to go to home,, May I ask why? you are very lucky if this was her sole desire.
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Nasmir - do you understand what dementia really is? I ask because before I understood that my mother was suffering from it, I more or less thought it was a generic term for basic age related mental decline - like poor memory. I did not know the clinical definition - that dementia is a disease that kills the brain - literally causing the brain to shrink and for brain cells to die. In the beggining a person can loose the ability to do simple math - basic addition and subtraction. Once this horrible disease reaches a certain point a person can no longer make rational choices - they become incapable of reasoning. In extreme cases the person can actually looses the ability to swallow food. Just how are they going to make decisions regarding their lifestyle?
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Nasmir: I will repeat it. A person with dementia does not make decisions as to where they will live!
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Do u have POA? If so, its ur decision in the end. Your brothers needs to realize that Moms dementia will only get worse. Selling her house will allow you to keep her in a nice place a little longer. I keep my brother in the loop but in the end, I sign the papers.
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I'm trying to fill out paper work to apply for VA death benefit to help pay for my mom's assisted living . But it is so complicated ! Is there anyone out there who can help with this ?
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Nasmir: I send you condolences on the loss of your mom. So sorry for your loss.
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Nasmir: You've got to be kidding, right= "it's mom decision and how and where she wants to live?" No, the individual with dementia does not get to make that choice.
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Nelsonjosie7: The house itself is a target for thieves. Let's say a newspaper has given out samples and throw them at the curb; so guess what's not being picked up-yes, the newspapers and thieves LOOK FOR THIS KIND OF ACTIVITY and then pick the lock! Sure, I understand that there's nothing to be stolen as you said the "home is vacant," but vandalism happens all too frequently and a person who has crime on his resume is going to do a lot of damage. Let's say the thief is on drugs and the home has copper pipe. It gets stolen. Also, as someone else implied, tall grass is another "welcome mat" for thieves. I hope that you have someone watching the house. We had to leave my late mother's home in Massachusetts vacant and finally return to our home in Maryland, but we had a realtor with a key and also a policeman friend who routinely checked on the home.
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nelsonjosie7: Your mom needs to stay in the Assisted Living for a reason. She has dementia. No, the brother is absolutely INCORRECT about telling her that it's her decision to sell. Medical professionals and financial advisors tell you that a person who is ill IS NOT QUALIFIED TO AND SHOULD NOT make these major decisions! I've heard it so often that it's become a part of my mindset. With the brother dictating this or that, it's no wonder that mom is confused! He, himself, may need a mental assessment. He is causing too much strife in the family unit! Tell him to get on board the right train or zip it!
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Rainmom is right about having everything on schedule.

My Dad's memory gets more confused for the rest of the day and the day after if there is a wrench thrown into his schedule, such as him going outside the facility to a doctor's appointment.
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Just a note on schedules. As I've mentioned before, I have noticed many similarities between autism and dementia. On of these similarities is being on a schedule. The majority of individuals with autism both do better when on a schedule and they prefer to be on a schedule. Being on a schedule reduces anxiety for people who feel a loss of control in their world and their daily living - they know what comes next and how things work when it is a repetitive routine. It is reassuring.
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It might be helpful for the siblings of this family to sit down together with an Elder Mediator who is skilled and trained to help families with these kinds of dilemmas. An Elder Mediator can help families develop a shared plan that they can all agree with around a number of issues related to the direction of an elder parent when the parent is no longer able to make these good determinations on their own. The family members can share how they feel the parent would want things to be managed along with what they feel is the best manageable plan for the parent. The Elder Mediator facilitates the discussion and the development of a plan as directed by the family.
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Your brother is in denial and wants to hold on to the past. This is very common and can go very easy or cause a real battle. A sit down with a Elder Law Attorney is an excellent idea. Make sure you have all the facts, Dr.'s diagnosis, financial records, etc., before hand. Unless he is willing and able to take responsibility of his mother with all that comes with that, changes need to be made for her own good. When dementia shows it's ugly head, parental roles reverse. He must come to terms with that and do the right thing for your mother's well being and care like we did. Fortunately, my brother never bulked or fought us on anything after knowing the facts. After 10 yrs, she still lives with us, is happy and well taken care of. Financially, a ALF was out of the question and she would have been broke years ago and probably gone. If she had the vison to have NH insurance and kept up the payments, that is wonderful. Our mother let hers lapse. Good luck everyone.
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The decision to sell a home can bring out many emotions, some of them very painful.

If your Mom has an elder law attorney, consider talking with her attorney about how planning for the changing care needs in the memory loss journey.

What is the prognosis from your Mom's physicians? How long will Assisted Living continue to be suitable?

With this information, and knowledge of your Mom's finances and resources, the attorney can give you some insights on how the house (a valuable asset) fits in with long term care planning.

If your Mom might need Medicaid to pay for nursing home care in the future, there are several different approaches to the real estate ownership that can be considered now.

Once you talk with an experienced elder law attorney about the Medicaid regulations in your state, in the context of your Mom's financial situation and her potential eligibility for other benefits, you'll have more facts and information to offer your brother on the decision to sell or hold on to the property.

That could help you and him manage the very real emotions that go with this time of transition.
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Nasmir, you wrote, "No AL is lovely, sad to say. Just about everything is on a schedule, when to eat, etc, and many are understaffed, so much so, to keep an eye on residents they all sit around the nurses station watching tv."
I have been a nurse for 37 years and working as a visiting (home health) nurse for the last 4 years. Many of our patients are in board and care homes, assisted living facilities, nursing homes and memory care facilities. I have been in them all. MOST range from nice to luxurious. Gone are the dark institutional dumps of the 1960's, 70's and 80's. Today's "old folks homes" are a far cry from what they used to be. They are now competitive, wanting the high dollar payment but having to give something of value in return. There are millions of us baby boomers who are not putting up with the dismal conditions of years past for our parents or ourselves. We would all like perfect living conditions for our loved ones but we're bound by financial factors and health concerns. I had to put my mom in a great memory care facility in Rosarito, Mexico because neither she nor I could afford the $3,500.-$5,000./month cost in California. I'm very happy with the building, caregivers and ancillary staff and the cost is affordable. You do the best you can for what you've got to work with.

I'm sorry that your mother resided in a facility that didn't meet your standards. I'm curious as to why you didn't move her if you were dissatisfied with the "conditions".

As someone else said, life is on a schedule. Don't you get up in the morning and have breakfast or eat dinner at night? Even restaurants have hours when they're open for business. Trying to manage large amounts of people pretty much demands scheduling. Think... camp for kids, corporate business meetings, a normal school day, all of these have to have structure and organization to get things done and so everyone eats in a timely manner.
Now throw dementia into the mix and sometimes it's all you (and the staff) can do to make it through the day. People with dementia can be uncooperative, combative, obsessive/compulsive, have disrupted sleep schedules, be demanding, loud, sad, withdrawn or any other emotion that, for those of us without dementia, normally keep in check. Fortunately, your dear departed mom didn't suffer from dementia. It's a world of its own for the sufferer and their family, an existence that no one enjoys.

The seniors sitting around the TV at the nurses station may have 'wanted' to congregate there. They can see the nurses at work (and may be friends with some of them), watch a program on TV or just socialize with the other "inmates" (as my dad used to call his fellow residents at the b & c.) [I miss you and your humor, Dad.]

So what you perceive to be a sad situation, may be a time of fellowship. People so easily point a finger or make assumptions who have never been on the other side and truly have no clue as to what's really going on. Walk a mile in my (nursing) shoes then post again.
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I knew a young man whose parents died when he was 18. He stayed in the house, never changing a thing. 36 years later: He no longer lives there, but he will NOT sell the house. Nothing has been changed. The dining room set is exactly in the same spot as it was in 1980. Call it a shrine, a mausoleum or whatever you want. He's 54 now and will NEVER sell that house. It's his own personal reassurance that his parents are still with him.
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Jeanne I agree, I was not dissing NHs.. sorry if it sounded that way. and Dads MC was awesome!
Nasmir, sorry as well for the loss of your mother.
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Nasmir, I'm so sorry for the loss of your mom.
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pamzimmrrt, except for not having her own apartment, my mom's nursing home provides many of the same benefits of an AL. (She needs more care than an AL could provide.) The NH is "lovely" given my mother's needs.

I think we all need to be careful not to characterize all facilities as if none have them have improved over the last generation. I'll bet some ALs are less than lovely and some NHs are more than lovely and Memory Care facilities are all over the map.

All we can do is select from what is available to best meet our loved ones needs.
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rainmom,,, you go girl! I have worked in AL's and other facilities, and had my father in a great MC... if my time comes to that I would also go.. rather than have my daughter give up her life. Hubs and I have Mom now, and I know that 2 week break we had was a blessing! If the time comes, She also liked the place dad was...
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While I hope to never have the need to ever have to live anywhere but in my own home this experience with my parents has taught me we don't always get what we want in the end but rather - what we need. Hubby and I are in our early 50's and again, due to this experience we are already having discussions on how to stay in our own home as long as we can. That said, we agree that if the need arises we would be fine living in any one of the places my mom has lived based on what's appropriate for our related stage of mental and/or physical health. Yes, my moms IL, AL and NH have all been "lovely" places. Especially the NH - in comparison to industry standards it is by far the nicest nursing home I have ever seen. It's a shame some people seem to want to make already guilt ridden adult children feel even worse for doing what's best for their parents safety and wellness.
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Es Pamz, and I bet that the OP, has already lived through many years of caring for their Mom, and probably all on her own, as so many of us caregivers do, and having Mom move into a nice AL facility was a last resort, perhaps maybe from absolute caregivers burnout! I know, as I've had my FIL in our home for the past 13 years, and we are reaching that threshold, where we are planning on selling our Own home as it is becoming too much for my husband (62) to manage, and we want to start living and vacationing, and being free birds! We've given up not only 13 years to my FIL, but many more years before that, taking care of our other 3 parents until they passed away! Caregivers burnout is a real thing, and before you know it, you've missed out on your own retirement! My FIL can sit and watch TV in a nice Assisted living place, just as well a here at my home! It certainly doesn't mean that we are going to abandon him, just that we are going to start thinking about our lives too, before it's too late, and something happens to one of us! Dad will be well cared for, we'll see to it!
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Wow, brother has some real emotional issues, he can't let go and he brings her home to assure HIMSELF she'll never die. So assign him to totally care for the house, get the mail, mow the lawn, make repairs. Pile it on until he can't keep up the pace. Your mom is playing on his fear, obligation and guilt and he is succumbing. Dementia knows who to whittle down.
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