What to Do if LO is suddenly angry and wants no help from you now, the POA?

Good Intentions

HELP! My aunt has no children  and asked me, a nurse, her niece to be her medical and general POA years ago. She fell in 2018 broke her spine and pelvis and me and  my husband flew to her state to help her at her request. We helped her find a SNF/rehab after the hospital discharged her after three days, then an assisted living community with private caregivers now increased to  around the clock. She has a diagnosis of dementia. I coordinate her care, her bills, taxes, insurance etc. It is a full time job even long-distance, especially through the pandemic, as everyone knows. The AL community insists on the 24 hr caregivers. There is no room in their Memory Care wing.  I feel so sorry for the pandemic isolation and flew out to see her several times, but it is very hard on my own family's finances and my health, I am a 63 year old with diabetes, and I can only get off work so often.

We have always tried to relocate her to our state so she could see her sister, my mom, who she loves dearly and other family. She really needs that now as her cognitive problems have increased and she is very vulnerable financially and personally.  Her present AL + 24 hr caregivers is too expensive, her finances will soon be depleted unless I find something else.

I found a very nice memory care community in the town we live in a block away from our house. She would pay 1/2 the cost she is paying now, and have loving family and sister to assure that she is getting good care and nutrition, even when her finances are depleted and she becomes more disabled.

My husband and I are not retired, I work 12 hr shifts, my 97 year old mom lives with us, and I have a baby grandson that I help out with.

I just took off work, traveled here to see her and discuss what she wants now.  She told me to "leave, it's been 6 months of hell and you didn't help me".  She won't see me. This has been an abrupt change of events and I am very sad. Even though I am trying to be objective about this I am hurting. I told her I would check with her tomorrow. I am the only one who has ever been there for her. 

 What do I do if she doesn't want to see me? I am still her POA and handle all her finances and medical providers call me. I don't know who would safely take over all this for her.  I guess I am too late to move her near family. I am crying and I am having trouble keeping my diabetes stable today.  My husband wants me to reimburse our credit card for my travel expenses

  immediately from her account. What to do? 

LicketyGlitz

Hey Good, depression, anger, rage are all part of this disease, and I suspect even if she was a little bent out of shape at you this would not be happening if it weren't for her dementia. I recommend two things:

1. You are the legal guardian. What you say goes. She is most likely not cognitive enough to choose a new one and have a lawyer draw up papers. You may need to work behind the scenes, but I wouldn't give up on your plan just yet, it sounds like a really good solution. She may be ungrateful one day and just fine the next, so try and take it in stride as you do what is best on her behalf.

2. Ask for her to evaluated for depression and theses angry behaviors. Preferably by a geriatric psych doctor. There are medications that can help manage the worst of dementia's manifestations, and while they won't make her shiny happy, they will make life more manageable for her and you. My mom's geri psych doctor was the most important person on her med team, making our journey less horrid for her and my sister and I.

And just one last thing, if money is already getting low is the place you are considering also Medicaid eligible? Once the money runs out she can move to Medicaid, but it's a hassle to do it on your own, and a Medicaid eligible facility will help you with that process (plus she doesn't have to move again!)

Chin up! She's gonna be rascally, try and not take it personally when you can. And good luck to you all!

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Good Intentions

Thank you. I feel like this is really good advice.

Good Intentions

Thank you,  she did set she and I up with a DPOA when she first fell. I will call her eldercare attorney and ask about the issues you wisely and helpfully brought up. My long-suffering husband is over it all.  And yes, it's amazing  what the jackals and con men can pull off even when you think you are so careful from a distance.   I love my aunt, her elderly brother and my mom love her.  I will never abandon her. If she fires me I will find help for her as best I can. I try to think what her previous self wanted, when she set all this up with me before she became this sick. I knew this was going to be rough, just the shock of a sudden complete rejection I didn't see coming.  I can't kidnap her and drag her kicking and screaming through a relocation, no matter how I see the advantage to her, the whole family has tried for years, but she had a right to stay put.

  Pandemic didn't help. My daughter found me a good therapist, sounds like a great idea. Moral of the story: 1). I would tell someone" I would love to be your caregiver, but not long-distance". 2). Plan and protect against the scavengers and cons early. They are very good at what they do, and choosing the vulnerable who don't have family locally. A few got through before I realized her judgement was gone.  3.) A good Elder Care lawyer is worth every penny. 4) Thank you for all your helpful replies, you probably saved me, someone you don't even know. Blessings and all things good to your caring  hearts.

Rescue mom

If you can’t do it—and I don’t know how anybody could, long distance plus your own family and health needs—you simply can’t do it. Many people cannot, and have been in the same boat 

Seems like getting the attorney is very important for you to do now to explore how others can step in. You have your own family to consider. The disease has already taken her, it should not take you, too.  That’s why dementia is called the cruelest, it so often claims two people—the patient, and the caregiver’s life.

As was already said elsewhere here today, you are not doing anything “to” her, you are doing things “for” her, to help her, even though she does not understand that now. Her likes and wants may well be very dangerous for her, but she can not see that now. Her likes and wants are no longer the automatic operative path. 

Few PWDs enter a facility (or move elsewhere, or accept much in-home care) willingly, most need some kind of subterfuge to get them there. And yes, some caregivers have moved them long distances, unwillingly. It was necessary for the PWD well-being.

 Toddlers don’t like rules for their safety, but they still must stay out of the road, away from the stove, etc., to be safe—even if they’re kicking and screaming opposition. This is somewhat like dealing with a toddler, you are the responsible adult now. The PWD  brain is broken, someone else must be in charge now, for sheer safety, even if she doesn’t like it. There are many threads here about  using “fiblets” to help a PWD accept help. You just cannot expect them to be rational or logical about much of anything now.

There are also heart-breaking stories here now from spouses whose partners don’t know them, or say “I hate you” or “get out” because of dementia. It’s a horrible part of what the disease can and often does bring. But she still needs care, whether she likes it or not, it’s now a matter of who does it. The lawyer can surely  help you find ways to transfer or change the DPOA.

Facilities have trained staff who work in shifts. It may not be the answer she likes, but this disease often is a matter of choosing between bad and less bad. A “good” solution/answer does not exist. Safety is paramount now. Many soon like a different facility elsewhere.

You have nothing to feel bad about. She was very fortunate to have you for so long. Now it’s time for the Next Step, moving her, or finding a new DPOA (who, it sounds like, will have to move her regardless). This horrible disease never gets better, it only gets worse.

jfkoc

I don't think I would discuss "what she wants" anymore and if she is needs 24/7 extra care then she probably can no longer fire you.

How about getting her to accept a visit to see herr relatives? Why? They want to see her...the unit is going to be closed for painting or some kind of major repair....the list goes on. Again I would not discuss this...just pick her up and you are on your way. She may be angry confused etc so make it as short sweet and positive an adventure as possible.

Iris L.

Good Intentions wrote:

If she fires me I will find help for her as best I can. 

You have to keep in mind that what she may say may not be beneficial for her or in keeping with reality.  Are you familiar with anosognosia?  PWDs with anosognosia believe they are fine, and become upset when others try to help them, because they see it as interference.  If you understand the reasoning behind what they say, it can help to not become so upset yourself.

 

I try to think what her previous self wanted, when she set all this up with me before she became this sick. I knew this was going to be rough, just the shock of a sudden complete rejection I didn't see coming.  

I can't kidnap her and drag her kicking and screaming through a relocation, no matter how I see the advantage to her, the whole family has tried for years, but she had a right to stay put.

Your aunt wanted to be taken care of, when she was rationaland made legal arrangements.  She herself didn't know how dementia would proceed, because most people don't unless they have already had close experience.  Use therapeutic fibs.  Other members have moved their reluctant LOs over long distances.  Yes, it was hard but they did it. There are several detailed threads on this topic.

  Pandemic didn't help. My daughter found me a good therapist, sounds like a great idea. 

Reading threads of other members in your situation will be beneficial.  Often professionals don't understand the nuances of caregiving for a PWD and the need for a new way of communicating and how to compensate for anosognosia and family dynamics.  The Alzheimer's Association offers a Care Consultant via the Helpline to provide personalized support.

Iris L.

Rescue mom

I wonder how this has worked out, or developed….I had the impression an attorney meeting was happening soon.

Iris is right about finding good therapists, though. Not all understand the communication “techniques” and issues involved when the patient deals with an Alzheimer’s caregiver.