How to we get Mom to leave for a nursing home (against her will!)?

aj1840

I do have dpoa, on healthcare directive- drs say tough luck if she wont go voluntarily or is not easily tricked then wait for a crisis. So many mentioned she could just be tricked- no it's just not possible and despite having a diagnosis of severe, she IS aware enough to know what is going on.

drs have classified as severe dementia and highly recd she not live alone. They state there is nothing we can do other than wait for a crisis here (Kaiser-California). Mom will not fall for any tricks like she has to move out due to building work or things like that- so those things are off the table. They say to just wait. This seems awful- but is there really nothing else we can do? Drs say no.

aj1840

caregiving daughter

Doctors are professionals and we are not. Having said that, my thought would be to consult with other professionals like an attorney.

I am assuming she is not driving but if she is, remove the car or make it not work. Are there any areas she is hyper focused on where a change could present an opportunity. For example, my mom was hyper focused on money. Could a sensitive area be an opportunity to negotiate with her. Does she require any clinical care that you drive her to. Could you put your arm in a sling and explain you are in pain and can't drive or help with meals such that she needs to have several overnights, i.e., respite care at a memory care facility. I could explain things to my mom for hours but a quick visual seemed to immediately click.

Can you get yourself to a live dementia support group. Folks may have gone through what you did and have some ideas oriented to your community.

My ideas are not great but they are intended to create more ideas as I can tell your situation is very, very difficultt. It's possible that if her dementia has worsened that she could have an infection like a uti that could be dealt with. I know you know that and are only trying to keep her safe.

aj1840

she is not driving, is hyper focused on money. I dont drive or cook for her. she's not totally helpless that's the issue- she just wants me around just in case- she's a narcissist which is why she can't concive that i need my own life.

H1235

When mom was fist diagnoses we tried to talk with her about future care. Her response was “It really doesn’t matter what nursing home you put me in. By the time I need a nursing home I will be so out of it it won’t matter.” At the time I foolishly thought she is probably right. Boy was I wrong. Someone can be capable of normal conversation, taking care of their own personal hygiene, able to feed themselves, express their opinions and still not be safe to live alone. Many people with dementia lack empathy, it’s a common symptom. If she was a bit of a narcissist before dementia this can make it really hard to distinguish between dementia symptoms and a difficult personality. I’m kind of confused, you said the doctor said she has advanced dementia and should not live alone, but then said she is not totally helpless and only wants you around just in case.

aj1840

yeah- it's confusing- she does have severe dementia yet also can kind of live alone- the damage is severe around making decisions/getting scammed/taking meds. but she's smart and isn't going to start a fire or forget to eat or get lost- so it is severe but NOT late stage. most of her scoring on the tests was in the bottom 1 percent- as high as 15 percent and maybe around 50 on a couple things.

aj1840

i really dont have any worries about her starting a fire- the rare times she uses the cooktop she is very careful. Plus her diet IS already basically cold sandwiches which she LOVES. and cereal! I just asked her PCP and she said nope nothing we can do other than wait and send a nurse for weekly visits- she is good enough. Severe in certain areas but NOT advanced dementia. It is very confusing. Basically the biggest fear is being taken advantage of financially which has happened- and not having executive functioning which means it is too abstract to be able to decide she must move- so there is no convincing her- it's simply not something her brain can do.

Phoenix1966

She will be very careful with the stove until the day she isn’t. And that’s when a fire can start.

As an example, my grandmother was an avid coffee drinker. But she eventually started to forget about the kettle on the stove, letting the water boil away completely, damaging her cookware. I figured, “hey, an electric kettle is a great solution. They shut themselves off after the water has boiled.” And it was a perfect solution until the day she fell back to muscle memory and put the electric kettle on the stove.

The only thing that saved her life was the professionally monitored smoke detectors. She was fine alone right up until she wasn’t.

aj1840

also just to add that i did contact an atty- they said conservership is the only option

aj1840

https://alzconnected.org/discussion/comment/271423#Comment_271423

thanks- great info. I have removed her as trustee from 95% of her stuff or more- there are still some accounts remaining would not be great to lose them but also it's relative to the other portion not so much- i was able to put alerts on the acct but bank would not let me do other things- i do have dpoa at her bank though

aj1840

https://alzconnected.org/discussion/comment/271403#Comment_271403

possibly so- there really is nothing else we can do, talked to 2 lawyers, a nursing home coordinator, and 2 doctors- they all say too bad- wait is the only option! terrible system

H1235

What they may be telling you is they can do nothing. They can’t force her, but you can. I signed all the paperwork when I moved my mom to assisted living. She did not sign a single thing. I was extremely concerned about her physically refusing to go. They told me just get her there and they would help get her inside if necessary. I was told the same thing when I moved her to a nursing home. I would talk to a different facility! Find her a place sign the paperwork and then tell her you are taking her to lunch. Yes she is going to be very very angry. But she will be safe.

Bowerbird

Like @H1235, I did not tell my LO that he was going to an MC facility. I had already signed all of the paperwork and placed some of his things in his room beforehand (not an easy trick when you live with the LO.) He happened to be in a great mood that morning and I was a nervous wreck. He readily agreed to go for a drive to "do some errands." I went straight to the MC, which is a few miles from my home. Took him inside and the DON took over, as I slipped out and did not even say goodbye. It was a very wrenching experience, but he never would've agreed to go, so it was the only way. He was angry, so I was later told, but they encouraged me to phone the staff every evening to get a report on how he was doing. It has been 4 months and he has adjusted, though given his preference, he would probably prefer to go home with me.

aj1840

yes have been told these things before- i have called many nursing homes and coordinators NONE were willing to do this. Lawyer was unwilling to try for conservatorship just due to the time/money and that it would likely be useless in the end bc by the time it goes into effect, she may be really far gone- he estimated at least 10k for this

H1235

I have never heard of this happening. What is the point of the DPOA if it won’t allow you to do what you need. Can the lawyer explain this? Is it the wording on the DPOA? What are these facilities telling you is the problem? What do they want? Do they expect you to have a document stating she can’t make decisions for herself? I would find another doctor!

aj1840

i was in the US when I spoke to an atty- so it is not that.

aj1840

honestly i think i'd hold the drs and bank accountable- i've asked so many times and they have refused

aj1840

Respectfully, I think you may be misunderstanding both the legal and practical reality here. A DPOA does not give me the power to physically force my mother into memory care if she refuses and is not yet on a psychiatric or medical hold. Multiple elder law attorneys, APS, her physician, and now an experienced geriatric nurse have confirmed that.

I have not “refused to take the reins.” I have spent months arranging assessments, activating trust documents, consulting attorneys, coordinating with financial institutions, and trying every non-coercive route available. Placement requires either cooperation, a qualifying hospitalization, or conservatorship — and conservatorship in our county is estimated at months and significant expense.

It’s easy to suggest “just arrange lunch and leave her there,” but many facilities will not accept or retain a resistant dementia patient without the proper legal and medical framework in place. This is far more complicated than it sounds.

I came here for practical advice, not assumptions about my effort or commitment.