New here: Brother, Sister-in-Law, and I are at a loss

LaurieBr

My mother is undiagnosed but is showing all the signs of some sort of dementia.  She has forgotten most of our cousins who she would visit with and send cards every year.  She asks the same questions over and over requiring that we give the same explanation which she forgets.  She has what we call her "bat sh-- crazy" times which come out of nowhere and then she doesn't understand why the person she told to get out of her life doesn't answer her calls (most recently, my cousin and my sister-in-law who both helped her tremendously).

She lives alone, does not leave her condo (except the occasional ambulance ride...last one for a UTI that she thought was stroke), and fortunately no longer has a car.  My brother and sister-in-law have been bringing her groceries weekly, responding to her technology calls, bringing dinner once a week, and doing just about everything else for her as I live halfway across the country and our other brother lives in England (who my Mom keeps forgetting).  

We know that Mom is at the point where she should no longer be living alone.  She cannot cook for herself and is a very picky eater.  Mostly, she subsists on english muffins and Eggo waffles (when she doesn't burn the jelly in the microwave). She rarely showers and spends most of her days laying in bed reading books that she does not appear to comprehend.  In fact, it seems that she is reading a different book every day!  But, just like I read on one of the forums, she is really good at "show timing".  She almost had me convinced that my brother and sister-in-law were trying to steal her money.

None of us have POA and we wouldn't be able to blast her out of her condo even if we could find a place for her.  We are thinking that the only thing we can do is wait for her to have a fall.  Is there something else we should be doing?

M1

Hi Laurie and welcome. You should talk to a certified elder law attorney (look at nelf.org) about what your options are. There are huge implications, financial and otherwise, for not acting. Who is controlling her finances? What if a neighbor calls adult protective services? What if she burns the building down? I know it’s not easy, but you need to step in. Have you talked to the condo association? I wonder if they could help in some regard and you definitely don’t want them working against you.

Good luck, but I would get legal advice quickly 

jfkoc

I would not wait for a fall which might very well leave her on the floor with no help for hours. Your mother can not live by herself. It is no longer safe for her.

Please have someone meet with a nelf.com attorney. They will explain what documents you need to get her affairs in order, I would do this even if there is no diagnosis.

LaurieBr

Thank you!  My sister-in-law also just joined this group and saw the responses.  We will be looking into legal advice immediately.

zauberflote

Laurie, you've gotten advice from the best so far. I just will drop a word about the repeated questions. If it's an anxiety about "did we miss dinner/tv show/church/dr appointment", you can use this to reassure her that you/bro/sil will always see to it that she never misses anything, and then change the subject and even location-- "nope, dinner is soon, we're eating together (or whatever, you know), and you really have to come see these roses!" Or whatever might distract her for part of a cycle. My mom could be pretty persistent, though. It was her general anxiety. We had a few key answers for some questions that completely comforted her. These would be unique to each family. For Mom, who worried about having enough money (child of the Depression and living back then in her mind), all we had to say was, Dad set that all up for you before he died (23 years before Mom's passing, so she always knew he was gone), and Bro is taking care of it all. Sure you can pay for lunch today!!" She wouldn't ask again for a long time.

harshedbuzz

Hi and welcome. I am sorry for your reason to be here, but glad you (and SIL) found the site.

I feel like you have two tasks here that need to be addressed simultaneously- getting mom evaluated and getting mom into a safer living situation.
 
Previous posters have weighed in on the legal piece. You need to see a certified elder law attorney to either get mom to sign off on a POA for financial and medical decisions or to start the process to obtain emergency guardianship. CELAs are often very adept at convincing PWD earlier/mid stage dementia to sign the necessary documents even when we feel it's not something that will happen. Should they deem your mom incompetent to sign or if she refuses, guardianship (conservatorship in some states) would be your other option. IMO, it is generally best for the local person to act as POA on both with the distant person as successor. Co-POAs can be a logistical nightmare at best.

IME, one aunt obtaining guardianship of her sister, required some cognitive testing to be done and a physician to sign off on the PWD being unable to manage any IADLs and some ADLs. (IADLs are the sorts of things one learns as a teen/young adult- cooking, driving, money management. ADLs are the things one learns as a young child- hygiene, toileting, etc) 

National Elder Law Foundation (nelf.org)

The other piece is that your mom needs to be evaluated. ASAP. 

While it is most likely she does have Alzheimer's or VD for which there isn't much in the way of treatment, there are a few conditions that can mimic dementia that are eminently treatable and reversible to a degree. At the very least, she needs to have a blood panel done to rule out a vitamin or hormone deficiency. It can take up to 6 months to be seen at a memory center or specialist neurologist for diagnosis, so I would start with a PCP for the bloodwork and imaging to rule out any lesions that could cause similar issues.

FTR, my dad had mixed dementia-- one was Wernicke-Korsakoff's which is caused by a deficiency of Thiamine-- once he was treated with IV Thiamine, he regained a significant amount of cognition until Alzheimer's and drinking caught up with him. In dad's case this was a function of alcohol abuse, but it can be triggered by other things like disordered eating (waffles and English muffins only is disordered eating). I mention this because neither of those foods include Thiamine on their nutritional labeling. 

I'm posting these links just because I found them useful for me when I was helping with dad's care.

Stages of Dementia Dr. Tam Cummings

understanding-the-dementia-experience.pdf (alzconnected.org)

Good luck.

HB

LaurieBr

Update:  We did find out that we are in a bit better situation.  My brother managed to grab a bunch of papers from my Mom's and my SIL went over them while I was on the phone.  It turns out that we do have guardianship, POA, and that a trust is in place for other assets. We are planning on meeting with a CELA when we are all together in a little over a month.  

She did have blood work done just a little while ago as she started with a new doctor.  Everything came back fine (thyroid and Vitamin B12, but not sure about Thiamine).  We are talking about telling her that the doctor got a late result back and needs her to come in.  She cancelled the original follow-up appointment.

You all have been wonderful with your advice and I feel so much better that there is someplace I can "go" for support.  We have felt very much alone and out of our element with this.

jmlarue

There is a work-around for getting mom to move. At first, we all regard this as deceptive lying, but with the dementia journey we accept the kinder definition of using "fiblets" to overcome the obstacles of our LO's dying brain. The most common fiblet employed to make a necessary move is to say that their current home needs a major repair (electrical re-wiring, replace plumbing, a terrible infestation of termites, etc) that will mean heavy construction, lots of noise, and a need to move her out, at least temporarily. Look for a facility that offers an increasing level of care, starting with assisted living and progressing to skilled nursing. Repeatedly having to move your mom as her dementia progresses creates more problems later. Better to find a facility where she more likely to be able to stay put and get an increasing level of care as she needs it. Once she's moved, you then resort to deflection and distraction fiblets to handle demands to return to her condo. Deflection: "The repairs aren't done, yet. The contractor quit and they had to find others to finish the work." Distraction: "I've been craving ice cream. Let's go out for a drive and get a cone." Be creative. Rinse and repeat.

Bob in LW

Laurie, you mentioned having to answer the same question several times a day, and you are not alone there.  My SO has severe short term memory loss, and I deal with that all the time.  I have found that a short answer is best because she won't remember it, anyway.  I also do not remind her that she has already asked it because it just makes her frustrated and depressed.  I have also learned that, when I bring up a subject which we have previously discussed, I have to start from the beginning, as if explaining it to a child for the first time, or she will not know what I am talking about.