Please answer two beginner questions

Annanymouse

Hi, My questions:

1. at what point can someone not live alone? 

2. Who can make her not live alone? 

3. OR - who can answer these questions? 

The internet websites I've looked at are very wishy-washy on answers through searches. 

She has strong ongoing delusions, hallucinations, and confabulations. Cannot pay bills, use a microwave, make a sandwich, or work a basic wall phone.

She's sweet when she wants something from someone or is in front of doctors or strangers... then she gets violent, viscious, nasty, mean, and cruel to my sister and to myself. 

She cannot live with me and cannot be around my children. She cannot live with my sister. Her HOA and neighbors are fed up with her antics. 

I do have durable power of attorney, if that helps.

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May flowers

Hello, and sorry you are facing these tough choices.

For sure, from what you described, it is not safe for her to live alone. For example, she may not realize she cannot work the microwave, and end up starting a fire. If she cannot make a sandwich, she probably (as my FIL did) also has spoiled food in the fridge or may forget to return food to the fridge for hours/days, and could get food poisoning, not being able to handle bills is part of a larger risky lack of judgment regarding money and can lead to real financial difficulties,  not working the phone means she probably cannot call 911 in an emergency, etc. if she takes meds, she may no longer be able to manage that, even if you fill the box) She could be at risk of getting lost - and that happens quickly, my FIL walked the same route every day for years (with me keeping an eye) but he ended up at my neighbors house one day with no clue where he was. So, yes, long story short, she is already at risk of living alone. 

Victoria has some good suggestions on the how to’s. I would consider hiring a caregiver / or a move to MC soon, and put some cameras in her home to keep an eye on her until you can get physical help. 

harshedbuzz

ANM-

TL;DR.

You are the person who is going to have to take the steps that allow you to keep her safe. Before her cognitive shift, she elected to you act on her behalf when she could no longer. I would touch base with the attorney who wrote the document to make sure it allows you to place her. If it's a boilerplate off the internet, I would have it vetted by a CELA. A POA doesn't only give you the ability to take steps to protect her, it requires it.

If the document doesn't allow you to move her, you will need her to sign a new DPOA (a good CELA can determine if she's competent to sign and convince her so to do) or start the guardianship process. Guardianship is more expensive and time consuming, but it is doable. My aunt obtained guardianship for a sister and it was a seamless process in both states (she moved sister near her). I have a friend who went to court with his brother for their dad's care. Dad hired his own lawyer but was not able to prove his own competency and the brothers prevailed. FYI- if you succeed, costs are paid by the PWD.

It's pretty clear she can't live alone. Being able to determine if a situation requires emergency services and making a simple 9-1-1 call are necessary skills to be safely left alone for even a short time even if she's not delusional, hallucinating and conflating to beat the band. Plus, her neighbors have already given you a warning-- their next calls may be to APS and that's not ideal.

Depending on her assets or a good LTC policy, you might be able to put together a 24/7 team to provide care in her home. Or you could look into a MCF and move her there using some sort of therapeutic lie to make the move palatable- rehab to get stronger, a senior apartment while the sewer lines are repaired, etc. You do not look for her buy-in around the move or attempt to convince her, you just do it. Another strategy would be to wait until she's having a violent episode and have her transported to the local hospital ER that has a geriatric psychiatry service for a short inpatient stay for medication management and transfer her to a MCF from there. 

Good luck.

HB

Rescue mom

From what you say, she cannot live alone now and be safe. There are so, so many things she can no longer do, that are essential to her safety and well-being. Others have already outlined it.

The hardest thing is when we have to become the parent to our parents. But now, it’s like having a toddler. There are things they don’t like, but still must happen to keep them safe. 

Another hard thing is learning we can no longer discuss, explain, or convince them using logic or rational argument. Their brain is broken, and only gets worse. You have to decide, then do it. This is where using compassionate fibs can be most helpful. But she needs caregivers in place, and maybe a facility.

Victoria’s  points about the HOA and protective services are on target. If you are already hearing they’re upset/concerned, their next step may not be far away.

Annen1014

I cared for both my mother and my aunt  who had moved in with her after my dad died  Both had dementia, expressed in very different ways. My husband was retiring and we were planning to move across country to be closer to our daughters. I really didn't want to have to move them twice, but I knew they needed supervision at least during their waking hours. We had an exchange student who had lived with us for several years who greaciously began helping them with dinner and spending the evening with them, eventually spending the night, and I hired a woman to sit with them a few hours a day. I had a very demanding job, but I took care of their finances, medical appointments, and visited daily. In that way, I could keep them in their own home for two extra years before moving them to a MC facility in our new state.  

There are options to help you. 

JJAz

When you decide that she is no longer safe when she is unsupervised, that's when she should not live alone.  If you don't make this decision, she will eventually do something that will threaten her life.  She may burn the house down, she may slice her hand with a knife, she may wander into a snowstorm in her underwear, etc., etc., etc.  It happens every day.

JJAz

If you wouldn't want her to babysit your 8-10 year old, she's probably unsafe to supervise herself.

Annanymouse

Thank you and everyone who has replied. I’ve handled her finances for 3 years. She also hasn’t driven in four years. I put cameras in, but she unplugged them all. 

It will require a lawyer, guardianship, and more because she refuses to let anyone do medication reminders. 

Last night and this morning her neighbor heard her screaming and crying outside lost in her own backyard.

I caught her praying out loud “dear God please kill daughter(35) baby I hope that b baby dies hahaha” sister is pregnant. She was praying aloud -alone- we die in car wrecks and that our children are murdered. Then laughed. 

So my siblings and I can’t have her live with us. 

I know it’s time. It’s going to be ugly though. For live in or memory care either way. 

Thank you again for the answers.

jmlarue

Given that your mom has demonstrated that she likely presents a danger to herself and others (praying her children die and grandchildren are murdered!?), I would take advantage of the next delusional episode like that to call 911 to have her transported to the ER and insist on them keeping her for an in-patient psych evaluation. Be sure to say to the emergency responders that she has threatened self-harm (even if that is stretching the truth a bit). It's the only way some will transport to the ER without her consent to go.

To keep her longer than72 hours, the psych unit will need a court order to involuntarily commit her for treatment. Don't block that process. Family is not permitted to involuntarily commit a family member even if they have DPOA or Guardianship, so just go with the flow.

Seriously, anyone harboring such terrible thoughts is WAY beyond living independently. She most certainly needs evaluation and stabilization of her violent thoughts with psych meds before she would even be considered for placement in an AL or MC facility. Don't delay and don't have second thoughts about this. She really is a danger to herself and others.

When it comes time to plan for discharge from the psych facility, you'll need to make it absolutely clear that the discharge planner that it is impossible for her to be discharged to family. They'll try. Remain firm that she go to a LTC facility.

yarnball

I want you to know I am praying for you and your family.  You know what you have to do so go do it.  And, know that ALL of us here SUPPORT YOU.  It does seem that it is now time to move quickly.