Reluctant participant for moving to M.C Facility

NatA77

It's been 3 years battling with our mother who was diagnosed with MCI in early 2020.  She has been declining ever since and still living in her home alone refusing to believe anything is wrong.  We have POA's, we have end of life, a will, a trust but didn't have control over her medical decisions till this past September.  Yes, we took mom to court and got guardianship of her.   However they put a stipulation in there of keeping mom in her home for at least 60 days with a trial of in home health care.  My brother and I have had her on waiting lists for the last year for a MC Facility.  There was an opening last May and I was able to get mom to doctor appointment for the papers to be filled out for the facility but that was as far as we could get.  She put up quite the fight.  We were called every name in the book and disowned.  Now that we have in home health care coming in it is going exactly as we knew it would.  Mom is refusing the caregivers entry, she doesn't need a babysitter, she accuses them of stealing, she won't let them do anything around the house, she is refusing to shower, take her meds, etc.  All that we knew what would happen if we brought in healthcare based on her past behaviors.  Now another opening is available in MC at a REALLY nice place.  We have taken it.  I can get mom to the first appt with primary doctor to get the papers signed for the facility but how does one get her to the assessment appointment at the facility once the "cats out of the bag"?  Has anybody every gotten this far?  I'm afraid she has dug her heels in and is never leaving her house even though she can't take care of it or herself and based on her behaviors it is no longer safe for her to be there and any type of reasoning with her is out the window.  The in home health care is exceeding the cost of living in a MC facility and is clearly not working.  Any thoughts from somebody who has been in our shoes?  I know there are families out there in the same boat and are awaiting on how we are going to get mom there to MC facility.

   

TC unknown

I am so sorry to hear your LO is having a difficult time, and causing you distress. Please communicate her behaviors to the doctor who is managing her medications. Ask the doctor to provide you with a PRN medication to help her relax and avoid uncontrollable verbal and physical outburst. I'm an RN with years of locked Alzheimer's Unit experience. I knew I had to have the proper medications, to handle my MIL's extreme behaviors, and to keep her safe and stable. Let me be clear, she is not sedated, it just takes the edge off, so she can return to her baseline. She is usually compliant with care, and comfortable, but that can change for no apparent reason within minutes. I've learned to recognize her early signs of agitation. This allows my spouse, POA, and I to keep her safe and make the best decisions for her, because she clearly and simply is no longer capable. Medication, along with an appropriate response to her agitated behavior will be effective, to allow you to manage her care. I had to to be very blunt, with her long term Primary Care Physician, in order to make him realize, I would get the medication I needed, or I would take her to a Psych doctor to get them. Now, he and I are on the same page, and are working as a team to ensure that the MIL, gets the best care possible. I know you are planning MC placement, but if her meds are adjusted, she may be able to stay in her home a bit longer, if she could be compliant and accept home healthcare. Otherwise, she would be cooperative with the MC assessment, if medicated properly. I wish you peace and harmony, as you struggle with this difficult situation.

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Iris L.

NatA77 wrote:

  refusing to believe anything is wrong.  

Your mom has anosognosia--she truly believes there is nothing wrong with her,  and that YOU are the problem.  If you try to confront her with reality, she will become upset, as you have noticed.  Anosognosia is a characteristic of dementia, and it will not go away.  You will have to learn to use the work-arounds that the members suggest to get things done.

Iris L.

NatA77

Iris - You are correct!  I need to read up on anosognosia.  Mom's testing also shows an under lying behavior issue on top of the dementia.  And as some had suggested to get medications involved.  Yes, I have those too.  Anti depressants and memory care medication.  The unfortunate thing is my mom has been deathly afraid of taking any meds all her life so you can imagine the bag of medicine I have for her that has been prescribed and never taken because of her refusal and poor excuses.  She won't even take a vitamin.  Time is ticking and we have the dates in place for primary doctor, facility appointment and move in date.  I will try to minimize the stress as much as I can but am expecting the worst once she finds out we are moving her.  I will post once again how it goes because I know there are many out there in our shoes and every bit of information helps.

NatA77

I appreciate all the sound advice and I'm going to definitely look into Elder law if we can force the move since we already have guardianship.  Many have suggested and from what I've read online say to get with the doctor to prescribe meds.  Her doctor has done that.  My mom has many allergies to many drugs and even if the doctor assures her it's okay to take she will NEVER pop a pill.  So I do have those filled prescriptions at home just sitting in a bottle.  When we are in the appointments mom says she's willing to take and the doctor prescribes.  I go get the prescription filled, administer the drug and mom says I'm not taking.  And the in home care that we have coming in isn't going to force the pill on her either.  Others have also suggested we say something is wrong with her house to get her out. LOL!  Mom is too smart for that.  Mom is not that far gone for us to try that.  Our mom is one in a million.  Her kids are out to get her.  Any time she needs to leave the house for a doctor appt she is reluctant to go because we've already tricked her.  She thinks all outings outside of the house is to force her into a MC facility.  HA!  She is right. And what facility is going to take a person who is very combative and verbally abusive before we can even get an assessment done.  She is sabotaging before we even get an acceptance into a MC facility (our experience to our very first facility we tried).  Some reading this may wonder why we are even doing this?  Mom can't remember day to day. She is delusional (man coming in the house), she's refusing to eat at home from Care givers, refusing to take meds, refusing to take showers, accusing anybody and everybody of stealing from her daily, she is living off of coffee and cigarettes, she is shutting off the furnace, can't cook for herself and wont because of her paranoia and her anxiety of burning down the house, she is a risk for falls with her severe osteoporosis, and all she is focused on is staying in her house.  She is not leaving!  Hence why the primary geriatric doctor suggested to call 911 and start the process of a geri-psych hold.  Is it really coming down to this?????  Sorry to vent here but its very frustrating...we are doing things by the book, by doctors care, etc and mom is THAT person that doesn't fit the normal mold.  We've increased her care to 7 days at home but that will only be sustainable for only so long till we can figure out a plan to get her into another MC facility that will actually deal with her behavior.  I'm searching again for another opening at a MC facility and also waiting for a call from the social worker (referral from doctor) to try and assist us in our dilemma.

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