Mom is 90, lives alone at her insistence with home help 3 days a week. She is mobile, but can’t drive; caregivers take her shopping, Dr appts, etc. Significant visual and hearing impairments. She loathes all the caregivers, and we’re at the point where the agency says they are struggling to find anyone who will work with her. She absolutely refuses to even consider any sort of assisted / supervised living or selling her house. She will not eat, then complains that she’s starving. We send boxes of groceries and she throws them out. She complains that no one “comes near her,” but refuses to allow anyone around her. Got her to a geriatric neurologist; scored 9/30 on MoCA test. She has fallen several times; will not use a life alert system. She’s been reported to APS three times (a care manager, the neurologist, and when I called 911 when she was incoherent and hysterical on the phone). Each time, APS came out, said she did not qualify as a danger to herself or others, and closed the case. She can barely use a landline phone; cannot use a computer or a cell phone, let alone Alexa or any such tech device.
I live 1000 miles away; my brother lives in Europe. We are both POAs. I handle her bill paying. Her money is dwindling. I am The Big Bad Wolf because I’m the one stuck with handling all her crises. The consensus is she NEEDS to be placed in a supervised setting, but she absolutely refuses it and is verbally abusive and horrible to everyone around her. She talks about wanting to die constantly - and has for the last 50 years. Bluntly put, she has poisoned every single day of my life for three years now, my own health is compromised, and I am at my wits’ end. Our relationship has always been very difficult, but she just gets uglier and nastier day by day. If APS is not helping, what else is there to do?! Thank you all.
Next time there is a phone call with hysterics, call 911. Tell them she sounds ill, possibly a UTI
When she gets to the hospital, fax them your POA, tell social work/discharge that lives alone WITHOUT YOUR SUPPORT and it would be an unsafe discharge to send her home.
She is unable to make decision as to her safety, Her care,
She needs full time care. does not matter if she wants it or not it is what she needs.
To that end there are 2 options.
She puts up with the caregivers that are there to assure her safety and care for her the best they can given the circumstances.
or
Placing her in Memory Care. She will be cared for, she will be safe.
I guess there is another option.
STOP all that you are doing.
Let her "manage" on her own. A crisis WILL happen, it is not a matter of IF but WHEN.
I find it incredible that APS does not consider a person with dementia living alone, refusing help as a danger to herself.
Your mother is no longer competent to live on her own or make her own decisions. Whether or not she will "allow" help or to be moved to a assisted living setting really is irrelevant because the decision cannot be left up to her. As for her being so nasty to her homecare help that they are struggling to find caregivers who will work for her. I have a homecare agency. When a client gets dropped from one agency's service, other homecare agencies will not take the case.
What I think is your best bet to do is talk to the local police department in your mother's town and explain what's going on. Then ask them to do regular wellness checks because she has dementia and you're not getting anywhere with APS. The cops will do it. They always do. This will expediate her getting placed.
I blame the patient's bill of rights and the right to refuse care or change caregiving agencies and caregivers. After switching so many caregivers, an agency eventually runs out of options.
Unfortunately, there are no easy answers for this fiasco since APS refuses to do anything when called, and hospitals refuse to keep her. Again, I'm resting on the fact of the patient refusing the right to medical care. In this case, placement in a long term facility setting. I'm quite sure in house services may have been suggested to her by medical personnel, but she is refusing care.
She has a false sense of independence being propped up by you and your brother. Your mother cannot take care of herself.
From what you've mentioned here, everyone's hands are tied including the social worker, APS and the hospital. If she doesn't want care, no one can force her.
I had a client like this many years ago who should have been placed in Memory Care. I called the agency, reported changes and no one passed this information on to her physician.
My little lady was ninety-four years old. She was tired of living. I was sitting at her dining room table when she looked up at the ceiling asking God in a moment of frustration; "Why won't you take me?"
Last I checked, she was still living in her home four years later after I left the case. She was ninety-eight years old and still living alone.
Call her PD non-emergency line and explain the situation to them. Ask for a weekly wellness check. You need Emergency Services' documentation that she's a danger to herself. This is how you get it.
An evaluation by a geriatric psychiatrist or a neurologist should help. It sounds like she needs meds.
When my mother (BPD and narcissism, vascular dementia) was extremely difficult to deal with she was placed by a geriatric psychiatrist into a geriatric psychiatric hospital until she agreed to take meds that made her more manageable. It took 9 months
Then she was placed by them in a suitable facility. They were very good at "leading" her to agree with this though it took time.
Wishing you all the best in this very difficult situation,