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The family member is in danger of falling (uses a wheeled walker and was hospitalized once), has no sense of danger, has no sense of time (we understand this is not unusual), leaves the oven on and refuses the help of an aide; they have sent nine aides away by yelling 'get out of my house'! My family member is due for their annual appointment with their memory care specialist and insists they won't got. (This is a smattering of what's going on.)


Our family does everything for our family member: all paperwork/bills, shopping, laundry, cleaning/vacuuming, appointments, outings, visiting, etc. but due to the changes in the last couple of months, we/they need help.


Is there a point someone (doctor, etc.) will declare she needs to have 24-hr care? If so, when this happens, what do we, the family, do? If we're told she would be best served by living in a community that services folks like them, what do we do? We feel utterly blind.


Our family member needs more help. What can or do we do? (We are not in a position to use an Assisted Living community; there aren't funds available for this.)


Please... Any input is appreciated. Thank you.

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I really feel your frustration and fear and all of the emotions. I don’t know what to suggest except call an elder law attorney for a consultation to find out what the realistic options are in your state and maybe neighboring states? My sister and I did this. We paid elder law attorneys in 3 states to find out what we could do for our mom who was living with me for years until her dementia got worse and I couldn’t care for her any more by myself. Elder law attorneys can tell you all of your options. The consultations weren’t all free (some were, some weren’t) and cost about $200. It is absolutely worth it, in my opinion. Others here might have better ideas, but I think it is a great place to start.
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Well, it took me about 10 years to get Mom to go into a studio apt. in Memory care.
She was asset free for decades living off me, and her social security check. I finally had to obtain what is called an elder wavier to pay for her memory care (the county) and her social security check pays for her rent at the place. It is really tough and it has taken a toll on my career and relationships. I wish you the best and depending on where you live their may be social services and or people who can help you navigate the transition into care. In the mean time take care.
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You can always get your loved one to the doctors - lie - tell you loved one you are going to ABC and that they need to assist you - you cannot do this by yourself! Make that loved one feel needed. Have a talk with the memory care physician. Also, if you loved one falls - DO NOT HELP - CALL 911 AND HAVE THEM TRANSPORT TO E.R. When at the E.R. get that social worker involved and they will assist in getting a place for your loved one - help you in finding correct forms to complete if your loved one cannot afford a place. My experience is this is not easy but ask questions, inform them that your family member does not have the money, etc. I found my social worker a dream I just laid everything in front of her and what a help. Also, when there was a problem I just called her and she helped me fix it!
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I have an aging mom in her 80's and I am OK (my sister is ok too) with her living alone right now. The reasons are that she is safe and healthy. If she was unable to keep herself and her home safe, then she couldn't live alone. If she was not able to keep her self healthy: take her medications correctly, eat healthy meals, keep up her hygiene... then she could not live alone.

As a Registered Nurse, your post has all the signs that you need to intervene now. Your loved one is unable to stay safe - the oven on, the lack of sense of danger... Your loved one is unable to stay healthy - falls, unable to use the walker safely to prevent falls, chasing away caregivers... You want the doctor to tell this loved one that he/she needs 24/7 care. I am telling you she needs 24/7care NOW.

What to do?
1 - Get a doctor's appointment now to determine mental capacity and to rule out other causes of her behavior. Sneaky medical conditions like infections, poor oxygenation, imbalances in blood chemistry... can cause all of us to act in ways like you have mentioned. Since your loved one has these behaviors in the more recent year(s), he/she most likely has a form of dementia. The usual medical doctor can evaluate for mental capacity and break the bad news that this person can no longer live alone.

2 - If dementia is diagnosed, ask for a referral to a neurologist. The neurologist can evaluate, diagnose and treat the specific form of neurological issues your loved one has. In early stages, most forms of dementia can be treated with medications to "sharpen the ability of the brain". In later stages, medications become ineffective and the sufferer must be cared for.

3 - If your loved one can not live alone, there are options:
A - Family/Friends plan - gather a large group of volunteers to help your loved one so he/she is never alone. People can take turns caring her this person in their home or having them come over for a "long visit". Somebody will need to be in charge of calendar. Home health aides can fill in the gaps - just don't allow loved one to chase off the helpers.

B- Home health care at home. Find a home health agency or a couple of live-in caregivers to stay with loved one in his/her home. Given your loved one's anxiety and habit of "running people off," talk to the doctor about medications to help calm anxiety.

C - Long Term Care Facility. Generally, assisted living facilities or senior apartments are for folks that can take their own medications, cook their own meals on a limited basis... meet their own needs. All are private pay. Seems loved one will not qualify for an alf. Skilled nursing facility is usually covered to some degree by insurance. Folks that require this type of care can not remember or administer their own medications or care for themselves. Memory care facilities are for those with later stage dementia issues. Ask the doctor which type of facility your loved one needs. The doctor can help you with next steps. The doctor may also direct you to a social worker who knows the ins and outs of dealing with this level of need.
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KNance72 Jun 2, 2025
Excellent advice
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Let her chips fall where they may but hope she doesn’t burn the house down before help arrives!
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You have loads of great answers so I won't repeat what everyone has written. I would cease all help EXCEPT I'd still pay the bills so she doesn't get into financial trouble. I pray you can get the help you need. She needs to go to a home because she's a danger to herself.
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You are making the LO think that they are independent when they are not, stop doing everything for them you and others are their crutch.

Back off, let the chips fall where they may.

If need be after you have stopped enabling, call APS. If this person has no money then Medicaid can step in with home help.

Does anyone have the DPOA? If not, this needs to be explored.
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JJDFLT: Cease enabling said family member.
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I agree with the advice to STOP doing everything for her!
Let her fail or accept another solution.
When she does go into a nursing home or memory care facility, the family does not pay for this, the care recipient does. When admitted to a hospital for an emergency, there will likely be a social worker who will meet to discuss financial assistance, such as applying for medicaid if the patient doesn't have sufficient resources.

The reason so many here have advised you to stop doing everything for your family member, is because you are giving them a false sense of independence.
They don't think they need outside caregivers, or to live in a facility specially designed to provide for their needs, because the family will continue to allow them to feel secure living at home on their own.
Unfortunately, for many stubborn elders who insist on living alone at home, it will take a serious life threatening emergency to get them out of the house.
If you are concerned about their well-being, you can install a couple cameras around the house to look in on them.

When the emergency does happen, and they are taken to the hospital, DO NOT take them back home. Ask the doctor to refer to a suitable care facility.

The emergency may be that the person dies in their home. That is not the worst thing that can happen. Many people would rather die in their own home than to live out the rest of their days in a nursing home.
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Bunny567 Jun 1, 2025
Amen to that last paragraph!!
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For my mom, it took her breaking her hip. They saw at rehab and would not sign off for her to live alone.
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Does she have a family Dr.? If so they can recommend a nursing home memory care facility. That’s what I did with my mom. They said she needed to go and would not send her home to be alone. I know you have a lot of help going on with all the family involved. But sometimes you have to do what’s best for her . I had to sell my mom’s house and get her on Medicade . I guess you all have to get together and decided what’s best for your family . Hope any of this helps
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My MIL (86 no dx and I’m not sure she would be dx) says she is lonely and doesn’t have any help.

I replied that we are doing what she wanted: she doesn’t want my housekeepers to clean her house. She doesn’t want a companion. She doesn’t want elder meals. She doesn’t want me to grocery shop for her. She doesn’t want home health.

She had nothing to say as a reply.

Another family here waiting for the “BIG EVENT”
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KNance72 Jun 1, 2025
The Big Event does Happen .
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Just my experience with Arizona APS. I feel your pain - I’m in a similar situation with my unsafe, stubborn, demented, 90-yr-old mother, but I live 1000 miles away, and my brother lives in Europe. My mother now has FIVE separate reports on file with APS, from five separate episodes/reporters (including her physician, a geriatric neurologist). They send an affable young man to visit her, she showtimes and refuses all services. She is physically mobile and keeps her small condo neat and clean. They shrug and say she is not endangering herself or others, and close the case. Till next time she pounds on the neighbor’s door, demanding they call the police because another neighbor may be coming to shoot her. So don’t rely on APS to do doodly. You may need to put extra pressure on her neurologist and/or social workers associated with his/her medical facility. Calling 911 for a trip to the ER May not work either (been there, done that) - if she says she doesn’t want to go, they can’t force her. So yeah, you might have to just wait for a catastrophe of truly dangerous proportions and then pick up the pieces. I am so sorry. It’s a nightmare.
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Bulldog54321 Jun 1, 2025
Unfortunately this is true for many— sit back and wait for the disaster.
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Your loved one is no longer safe living alone, and you should not be burdened to take on tasks your loved one is unable to do any longer. All tasks, excluding financial which should be managed with a POA member. Hopefully someone has that authority.

Your loved one requires a 24/7 memory care facility or appropriate home care and applies for Medicaid when funds are three months from running out. Care is paid from his/her funds and benefits, not his family's.
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Sounds like she is pretty much homebound. Palliative care focuses on keeping people comfortable. Its a way of providing gentle and kind treatment. Can she get home health nurses to do wound care and pain management at home? They also provide social workers for community resources.
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Hello! Answer to your comment, first you should have her evaluated by her Physician. Then they can determine what level of care she needs, I have been a Caregiver, for 20yrs, their are different steps in the progression. Hope this helps.
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Stop doing for this family member. If she is lucid sometimes, tell her that she has exhausted nine aides who were assigned to help her. Aides will bathe, cook, grocery shop, laundry, light housework, and in some cases will drive and accompany the patient to doctor's appointments. The family would do the bill paying and paperwork since aides do not handle any financials of their clients. If you decide to go the aide route again, don't try to use shorter hours and pack all of the above in one visit. Stretch out the duties throughout the week. Opt for one long day and maybe two short days just to keep things going.

It sounds like this has gone beyond homecare, and the patient is ready for placement. Assign a guardian. I would let APS handle this. Call and report a vulnerable adult who refuses help.

Don't quit your jobs or move in with your loved one or move them in with you. It is all downhill for you if you do this. You have to make money for your own social security, pensions and such. Don't spend your own money on things she needs.
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Stop propping your LO up and let them drive the bus into a wall.
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Who has POA?
the person that has POA is the one that can get the proverbial ball rolling with getting your family member placed in Memory Care
If NO ONE has POA then at this point the Court will appoint a Guardian. It could be a family member or one the court appoints. Being a Guardian is not an easy task and there is a lot of paperwork involved as well as at least yearly meetings or court appearances.
You all STOP what you are doing for this person.
Your report this person as a "Vulnerable Senior with dementia" and is living alone and is unsafe. APS will follow up and if it is determined that they are unsafe and a danger to themselves they will be placed in a safe environment.
You can begin the application process for Medicaid,.
The house they are in will and should be sold to pay for their care.
There is no way that any family member should be supplementing this person by paying for food, housing and other expenses. Anyone that is "helping" is placing their own retirement in jeopardy and the cycle comes around by other family members having to "bail out" another person. It has to stop!
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If no one is her PoA then no one is going to declare her anything -- except APS. Your strategies now: 1) step completely away from helping her: no doing paperwork/bills, shopping, laundry, cleaning/vacuuming, appointments. Call APS and report her as a vulnerable adult. She will get on their radar and will eventually be assigned a 3rd party legal guardian by the courts. Then she will be transitioned into a facility and receive the appropriate care she needs. It may take a while for this to happen but if you prop her up then it will take even longer. 2) you call 911 and have them take her to the ER (telling them she may have an undiagnosed UTI, she is confused and aggressive and is refusing care). Once in the ER you talk to the discharge planner to tell them she is an "unsafe discharge". No one takes her back home. You ask to talk to the hospital social worker about discharging her directly into a facility. Your LO won't like it but it doesn't matter, it's what she needs. She is only going to get worse. 3) "someone" in the family pursues guardianship for her and then has to wrangle her into a facility since she is shooing everyone out of her house. It will be expensive and time consuming and the guardian will need to figure out how to pay for her care. I'm so sorry for this stressful situation. It will be rocky for a while and then she will get the appropriate care she needs.
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