Mom

Tracy L

Hello everyone, I'm knew here. Where do I begin? Mom lives alone in her house, I'm an only child and I have a special needs adult child, who has mental health issues. Now that I got that out of the way. Mom was starting to lose a little bit of her memory before her fall last may. My mom is 78 yrs old with osteoporosis. Last May, the neighbors dog threw my mom on the ground, twice. Now mind you, my mother is only 5'1 and 106lbs. A tiny little thing. Just to be clear, this dog did not come for my mom and attack her. It ran over to her with full force and knocked her down. Mom was in the hospital twice, had two surgeries, was in rehab twice and lived with us twice. January 1st she finally went back home. She'd had some memory issues in the past, but not like this, it's like she's a different person, dates, times, events, names, she forgets them all, repeats the same questions all the time. That fall messed her up so bad. I offered several times to put her in assisted living and she said she will die in her home. I don't blame her, I just want her to be safe.

Thankyou for letting me vent!

M1

Hi Tracy and welcome to the forum. So sorry for your difficult circumstances. Couple of thoughts/questions:

Has your mother been formally diagnosed with dementia? This may matter, legally and otherwise (especially that other conditions have been ruled out). i assume you've discussed your concerns with her docs?

Do you have her power of attorney? You are going to need it, because in all likelihood you are going to have to make this decision for her and cannot expect her agreement. Most people with dementia have anosognosia, where they can't perceive their deficits and think they are fine. But safety has to drive the decisions, and if she's not safe to be alone the sooner you make a move, the better. Most families wait too long, and for many, by the time assisted living is considered, what is really needed is memory care. Some folks use compassionate "fiblets" to accomplish a move, such as there's a problem with the house (sewer, radon, gas leak etc) but I've found a place for you to stay temporarily, etc.

glad you found this supportive community, it can help.

Tracy L

I really don't know what to do with her house. The deed is in her name. I cannot sale the house, it's legally binding to her. So if she was at Mc, what am I suppose to do with her house? It will just be sitting there, with nobody living in it.

M1

Tracy, if you get power of attorney meaning that you can legally act in her name, you sell it (after she moves) and use the money for her care. Sounds like you need to talk to a certified elder law attorney (CELA). They can also help you with financial issues such as getting her qualified for Medicaid if you need to. You can find lists of these attorneys by location at nelf.org.

Jeanne C.

Hello and welcome. I'm sorry you and your mom are going through this.

How do you deal with the house? That goes back to HB's question about power of attorney. You need to become your mom's POA so you can manage her legal, financial, and medical affairs. Start by seeing a certified elder law attorney (CELA). You can search for one through nelf.org. They will be an expert in what's needed to properly manage her legal affairs as well as getting any assistance she is eligible for from the state. If she is incapacitated, you will need to handle this for her. Above all else, her safety is the top priority.

harshedbuzz

@Tracy L

Hi and welcome. I am sorry for your reason to be here, but pleased you found this place.

@M1 asks two important questions

Has your mom been evaluated for cognitive changes and diagnosed? This needs to happen if it already hasn't. There are other conditions, which may be eminently treatable, that mimic dementia and need to be ruled out.

It could be your mom had subtle signs of dementia at the time of the fall. If she had surgery with anesthesia, it could have hastened the progression of the changes in her brain which is why you're seeing obvious memory deficits.

Do you have a dPOA and the power to act on her behalf? If you don't, this is your next step. A well written POA would give you the right and obligation to handle her affairs and make prudent decisions on her behalf to keep her safe. If you don't already have this document, you should find a CELA to help you get this assuming she is still competent to sign. Otherwise, you'll be looking at obtaining guardianship through the courts.

Safety comes first. Your mom is going to need significant supervision soon if she doesn't already. Do you see evidence of not being safe in the home? Spoiled food in the fridge?, scorched pans and tea towels?, not showering/changing clothes?, are her prescribed meds on hand and being taken as directed? Is she a risk for wandering and getting lost? Can she manage her money and recognize a scammer who reaches out on the phone or avoid spending money on random things or questionable charities? Would she be able to handle an emergency? OMG, a friend of my mom's had a dryer fire last week and phoned her daughter at work instead of 911.

If she doesn't have LTC insurance, this will be out-of-pocket and can add up quickly. We were paying over $30/hour for an agency aide with a 15 hour/week minimum which adds up quickly. Given your description she's progressed beyond a stage where a hospitality-model AL would be appropriate. She likely needs to move in with you or go into a MCF.

IME, no one with dementia willingly agrees to go into a facility. Most seasoned caregivers would suggest touring several alone, making a choice based on what will work best for them and their LO and then just moving them in. I brought dad to the MCF telling him he had an appointment with a new doctor who then said he needed to stay for rehab. Other explain the move as a temporary situation while a mechanical system or termites are taken care of. Rinse and repeat as long as it takes for them to settle in.

A MCF is going to cost $7-10K/month depending on where you live. As a POA or guardian, you have an obligation to manage her assets prudently. I used POAs to sell both my parents' homes. In most cases with an unmarried/widowed PWD, that means selling the house, which a POA/guardianship should allow, to pay for her care. If she has LTC insurance, $$$ and/or income from a pension/investments to cover her monthly fees, you don't have to sell but you might want to be rid of the responsibility. You could also rent the house if it makes sense. I did this for a time while I figured out next steps.

These might be helpful for you.

https://tala.org/wp-content/uploads/2019/04/Tam-Cummings-LLC-Handouts.pdf

https://www.smashwords.com/books/view/210580

HB

psg712

Agree with all of the above. I know it sounds so harsh to think about making unilateral decisions for your mom without consulting her, but if she truly has dementia, the details will confuse and upset her. It is kinder to take over those tough decisions without much conversation. She will be upset at the changes, but in the right facility will be more secure without struggling to figure out daily life tasks. And to your last point ... safety is the primary goal.

Anonymousjpl123

@Tracy L , others above have given solid, practical advice all of which I heeded when I found myself caregiver for my mom having no idea how to handle it. Like your mom, I had noticed memory issues but after my dad (her husband of 60 years) passed away she was like a different person.

In practical terms, all of the above - diagnosis, legal, financial - are actually the first priority. On an emotional level, this is one of the hardest things we face as adults and given your child’s needs, this will be tough. That said, please know you have support and can ask questions - both practical and vents - and people here will understand. It is very overwhelming, but very common to have a LO get a lot worse quickly after a trauma or major life change.

I’m sorry you are in this position but know you are not alone in this and there is a lot of support out there.

Tracy L

Hi everyone, ok there's alot I left out. First of all mom's house will never be used for her care, because it's protected by the " look back law" so the state or anyone can not touch it. My mother was never tested and she will never let me test her. I already know what she has, testing isn't going to change anything anyway. I told her doctor all about it though. She might sneak a few tests in there when my mom has her next physical but my mom catches on very quickly when it comes to things like this. If she figures it out she will refuse. Believe it or not she still does her own checking and drives a car. I'm gathering all this information, I just think it's a little to premature yet, on placing her somewhere. I foresee this in the near future though, just not today. My therapist says do not worry about tomarrow when she's fine today. Otherwise that can make you crazy. I'm just kinda getting my feet wet and getting my ducks in a row, sort of speak. DON'T LOSE THE QUALITY OF TODAY, WORRYING ABOUT TOMORROW.

My mom use to always say this

Jackie_K

@Tracy L welcome to the forum and I am sorry you are going through this. I agree with all of the above advice. I would really encourage you to speak with an elder care attorney sooner rather than later. I am not a lawyer, but my understanding of the "look back" law is much different than what you are alluding to. The "look back" law means that an individual does have to spend down all of their assets, including selling their home, before Medicare benefits kick in to pay for their care.

Following the advice of many on this forum when I joined last year, I found an elder care attorney by calling the Alzheimer's Association, and they gave me a list of recommendations for lawyers in my area. My mom does not have much, but she does own her home, so this was shocking information to me, but I am glad now that I know this information so that my siblings and I can plan for her future.

I know you are just starting on this journey, and you're not even sure if it's dementia (I hope that it is not), but I know from experience that it can be a scary and frightening time. Knowing that others are/have gone through it helps so please do continue to come to this forum for help and support. Good luck!

concerned_sister

Your mileage may vary. I'm under the impression that whether you need to sell your home can vary by state.

Jackie_K

Thank you, I had no idea that this varied by state. This disease is so unfair across every dimension… the fact that some people may be required to sell their home and others do not feels like yet another layer of cruelty. Glad to hear that some are spared this indignity, however.

concerned_sister

As I understand it, Medicaid is administered at a state level, with each state setting their own rules. We meet with the CELA later this week, so I can confirm my understanding re my state, CA. There is another related item that varies by state that goes by the acronym PACE  (Programs for All-Inclusive Care for the Elderly) to cover costs for care. In my mind, I equate it roughly with a LTC policy as to what it covers when our LO can not perform a number of the ADL.  I already put a feeler out to my insurance agent on this. I sent an email to myself on this on March 25th after someone in this forum mentioned it. Some states, (Calif is one), those who don't qualify for Medicaid can still enroll for a premium. I need to find out more about the premium to see if this is a realistic option for DB.

Tracy L

There is a name for my mom not selling her house, it's not called look back, she had to do "this" for 3 to 5 years, so they could not take her house, it is protected.

Jackie_K

Interesting, I did not know - I guess this is why it is so important to talk to a lawyer either way to understand your specific situation, as so many have mentioned. Tracy, what you're describing does sound like the look back, or at least similar to what our lawyer described - but we did not think mom could make it for 5 years until she needed more care, and we did not want to make decisions either way about her care based on that timeline. I am sure others have a different experience though.

Mom's house isn't worth that much and we (me + my siblings) don't care about the money - but it means a lot to her so it is a really difficult thing to put her through. Either way, I am glad your mom's house is protected from this and that others are spared this as well.