How can we make mom move to assist. liv?

patrice607April 9, 2007

Just got back from a long week-end with my MIL who is in the early stages of Alzhiemer's. She is still in her own home and driving. BIL has POA and also lives out of town. Most days she is fine. Her short term memory is totally gone but she compensates by writing everything down. However, we have had some episodes of very abusive, bizarre behavior. I think she's having delusions or hallucinations. BIL says we can't force her to move until something catastrophic happens. I feel this is morally irresponsible. However, I am the in law and without having her sons declare her incompetant, I don't know what to do. Is there any way to avoid disaster???

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Your BIL is being stupid. The idea is to prevent the catastrophe from happening in the first place. That's why people draft POA' substitute the judgment of another for one's own when the time is right. The "time" is typically expected by the giver of the power to be decided by the person to whom the power is given. Read the document. It will tell you.

If your MIL is objecting, then you will, indeed, need to have her declared incompetent before POA can take effect. I would encourage you to confer with one another and decide whether or not the time has come to act. However, your BIL is mistaken about waiting for a "catastrophe" before action can be taken. Would be better if MIL agreed to it voluntarily but if she won't and things have gotten bad enough that you can envision a "catastrophe".....for heaven's sake act.

FWIW, I live in an area that is full of retirees. There isn't a month that goes by where some sort of "castastrophe" or another isn't reported. Everything from kitchen fires to out-of-control driving causing damage or injury. Common as nails. If BIL has the power, he should use it. That is the trust that was bestowed upon him. Its a responsibility and should be taken as such.

    Bookmark   April 9, 2007 at 11:59PM
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Call Alzheimer's Assocation for support and ideas. Also call the local office of the Council on Aging and ask to speak to a staff member. These things are not a do-it-yourself thing, you need help from the pros.

If you are worried about her driving, check the DMV in the state where she lives to find out how to report a possibly impaired driver. When we realized that my dad shouldn't drive, we filled out a form using a fake name/address/phone and had it mailed in his town (no way were we going to risk being outed on that caper) and we begged his doctor to report him. Something worked because at license renewal time, it was denied and he was unable to pass a test to get it renewed. However, we failed to remove the car from his house, so he continued to drive now and then, until he had a minor accident.

As for your BIL, he's being stupid and refusing to face facts. To keep the peace, be careful who you enlist to help you. Some people are incredible blabbermouths. We learned that the hard way.

    Bookmark   April 10, 2007 at 10:41AM
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I don't think anyone can MAKE a person do something against their will, But, you can strongly encourage that person to make the move. Here in Minot, there are alot of really nice assisted living facilities. Each of them are well known, and have lots of activities and a person can call anytime to schedule a tour, with some giving a free meal. One will even do tours for Senior Citizen's groups. As to you MIL, just make it clear to the BIL who holds the POA, that he might be held responsible for certain behavior problems. Like, if the MIL delibertly hurts a friend, child etc who gets called. Or if she accidently sets the house on fire, who gets call, or gets talked into giving her money, signing documents, taking someone into her home--who gets called.
Good luck and like one of the poster's stated, get some legal advice to protect all.

    Bookmark   April 10, 2007 at 5:28PM
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Here's a story that you should send to your BIL. Ask if he and his mother have enough money for such a court case.

Here is a link that might be useful: Elderly driver kills 10

    Bookmark   April 10, 2007 at 5:37PM
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You really are in the worst possible situation here - and the worst is that everyone is at a distance. I agree that you should contact your local Alzheimer's Assn. chapter. Also, there's an Academy Award nominated film by Deborah Hoffmann called Complaints of a Dutiful Daughter which is a beautiful chronicle of a daughter trying to do the right thing at the right time for her Mother who has Alzheimer's. I wouldn't be surprised if it couldn't be downloaded off the internet.

Just some random thoughts that may not apply. Do you know if your MIL sees her doctor regularly? Sometimes something easily curable like a bladder infection really knocks the elderly on their pins - mood changes and acting nutty. Those can lead to dehydration, blood pressure drops, dizziness and falls. At the stage where your MIL is now, being a little delusional is a kind of defense mechanism (which she probably isn't even aware of) for her being confused and forgetful. Making notes, of course, is the same, but that won't last too long. There are so many different kinds of dementia, at least 35, but for those people in my support groups who have a loved one with Alzheimer's type dementia plus hallucinations - Lewy Body dementia is brought into the mix.

Is there someone in the town where she lives who could be trusted to call her on a regular basis? Neighbor, friend, someone from a church group? You or your BIL even though it would be long distance? As long as mail and newspapers, etc. are disappearing, those people who come by the house daily would never be aware someone inside might need assistance. Would she consent to a device like "LifeLine"? It happens sometimes that the local police are asked to check on the welfare of someone elderly and that could result in Social Services being called in.

Even in assisted living, someone might still have to help manage some of her affairs. Your BIL with her POA or a guardian. No matter what, it's going to be gut wrenching, but it makes more sense to consider bringing her to a facility close to you or your BIL rather than leaving her protected in a facility but still at some great distance from either of her sons. And the time to look into facilities is now. You're not obligated, but at least you'd know what's out there when the time comes.

Like asolo said, sometimes it's that catastrophic event that forces your hand. But sometimes despite someone's best efforts, catastrophies occur. I know this is eating you up, but you've got to try and look at things with a "colder eye" so you've got the right frame of mind for the decisions that are going to come down the road.

    Bookmark   April 10, 2007 at 5:45PM
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Thanks to all for the input! I will call the Alz. assoc and the local council on aging. We have also scheduled a dr. appointment with a doc that she really trusts and admires. Maybe she will take his advice.

Every time we mention assisted living or ask about the bills she becomes abusive, screams and yells and throws us out of the house. And we are just starting on this long road...

    Bookmark   April 10, 2007 at 6:09PM
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Have a look at this book: "How to Care for Aging Parents," by Virginia Morris. My sister and I each had a copy. You might want to get a copy for BIL.

Don't forget, the pros (doctor, social worker, etc) can be of great help. There are even professional care managers (I think that is the term, the book has information about them) who can help since you and BIL are out of town. Not to mention that this is new territory for all concerned.

You and BIL will also want to make sure neighbors and trusted friends have contact information for you both. The day our dad had the traffic accident that ended his driving, I got a call about it within an hour.

Good luck.

    Bookmark   April 11, 2007 at 1:57AM
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Hi, I came here to look for some answers to help my dad, saw your post and just had to add a couple things to whats been posted, please look into your mils medicsen and her health, dad was put on a alzhiemers medicsen that caused him to have hallucinations, if there is a bad side affect to a medicsen he will usely have it, and like duluthinbloomz said health problems can cause alot of things that can be treated.
we do have to keep the elderly safe, have you thought about home health care? ( you said she is fine most days) getting angry sounds normal to me, she most likley feels like you all are taken over her life! put yourself in her shoes and thank about it, how would you act if it was you?
A couple of months ago I would have said yes assist liveing would be good, you will be putting your trust to a bunch of caregivers to take care of your mil and if no one is there to over see things she might not be any better off then she is right now, dad went to one and was all for it while he was down with another UTI when he was feeling better he wasnt but went anyway, one week latter I went to vist him and had to take him to the ER was burning up with a fever couldnt stand because he was so weak, had been sick to his stomach and wasnt given medicsen that was orderd prn to help, three weeks later the same thing happened, this time dad was in bad shape and I beleive if i had not went there that day he would have laid there and died! dad was malnutrition , was also O.D.ed on pain medicsen at the ER and ended up in ICU, dad had another UTI and VRE, dont know what came frist, now hes in a rehab center trying to get build back up so he can go home he says, not sure where home will be, I think dad was safer in his little apt with home health, I know he was happier there.
you might be thinking the assisted liveing place was just a bad one, top notch in our area and that scares me! when I told the nurse to get his paper work ready and call a squad her responce was it will cost YOU $ 400 if he goes by squad!
I can not write what I said to her,I have trouble understanding how someone can be smart enought to become a nurse, but not know when someone was that sick. his nurse at the rehab seems just a dizzy, I know there are good nurses and doc out there, I am just saying dont think assisted liveing is the answer to your prayers, you have to over see things anywhere you take your loved one.

    Bookmark   April 11, 2007 at 10:33AM
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Oddie -

thanks for sharing your experience. It really makes me wonder if we should let her stay in Indiana or have her move by us or BIL. As someone pointed out to me, eventually what she wants will be forgotten anyway. So sad...

    Bookmark   April 17, 2007 at 9:46PM
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A move for the elderly can be so hard on them and even cause emotional problems that can lead to physical ones, any changes are so hard, I dont know what the answer is for your family, but if you move her to assisted liveing I would keep her close to someone who cares and can keep a eye on how she is doing daily, after leaveing her home and all that is familiar to her vists from freinds and family is all thats left, I can still hear my dad saying ( this is it, this is the end of the line for me) I beleive he has given up now!

    Bookmark   April 18, 2007 at 10:13AM
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One way is to look around and select a Nursing Home. She's going to end up in one anyway if she has Alzheimers. Find the home you want and put her on the waiting list. An Assisted Living Home is going to work for just a little while unless it is also connected with a nursing home type arrangement for the Alzheimer patient.

The next step is if and when she needs to go to a hospital, see that she is discharged to the Nursing Home instead of home. Don't discuss moving as long as it upsets her. She'll never agree to it until she gets much worse. You may even have to have her declared incompetent. In a way the BIL is correct, you can't force her at this time to move. Be prepared to move her when the time comes.....and it will!!

    Bookmark   April 18, 2007 at 11:22AM
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Tough decisions, no matter how you look at it. Oddie is right, if you move her to any kind of facility, it needs to be very close to someone who can keep an eye on her. My mom is in a wonderful, top-rated assisted living facility, but I still have to keep track of her medications, symptons, etc. They have a large staff and so things get mixed up from time to time.

Agnes' suggestion is a good one. Find a facility NOW before a major crisis and get her on the waiting list. I know I'm prepared to do what she suggests about discharging my mother to a memory care unit if she has another major hospitalization. So much easier than bringing her back to her apartment in the assisted living facility and then moving her a couple of months later.

I guess the bottom line is get your information and resources lined up in advance and be prepared.

    Bookmark   April 18, 2007 at 1:28PM
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Thanks for all the input. Her grandson is near her now but it may be more appropriate for her to be near one of her sons. She is adamant that she wants to stay in her home town now but eventually, that won't matter. I wonder how hard it is to move a patient once they get to that point.

    Bookmark   April 23, 2007 at 8:59PM
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One way the move is often done is that someone will take the person out for a visit...the longer the better....and while they are out, others will pack clothes and other essentials. Then the patient is simply taken to wherever they need to be and never taken back home. That's hard, but sometimes its the only way. NO discussion, just action. And NO turning back. There is no good way. It's going to hurt.

The family is going to be the ones to decide what is best for her. If she has Alzheimers or other dementia, she'll never be talked into moving. As she progresses in the disease, she will forget where she lived. "Home" in her memories may even be the place that she remembers as a little girl.

    Bookmark   April 24, 2007 at 11:33AM
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