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Old 07-03-2013, 07:27 PM
 
Location: Michaux State Forest
1,276 posts, read 2,994,947 times
Reputation: 1426

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Hello, as some of you may remember, I have been the sole caregiver and POA/healthcare surrogate for my mother who was recently diagnosed with Alzheimer's/dementia. I cared for her at home totally by myself until a fall brought her to the hospital. After the hospital she was sent to a rehab. Both the hospital and the rehab's doctors and treatment teams informed me that she had Alzheimer's dementia and could not live at home and that she needed to be placed in an assisted living facility.

I did exactly as the doctors and case managers advised and placed her in a beautiful ALF that is safe and clean. Because of this, she is doing sooo much better and now seems at times to be very lucid. Problem is she HATES the alf because all she wants is tl go home, she is literally obsessed. She wants everything to go back to how it was with her at home and me waiting on her 24/7 with no outside help at all, in fact I am not even to call 911 if she falls again. She absolutely refuses to believe that she has Alzheimer's. She has decided the doctors all own the rehab and ALF and that they are running a Medicare scam to falsely and wrongly diagnose healthy elderly patients with Alzheimer's so they can make money by forcing the patients into the rehab and ALF. Obviously this isn't true. Problem is she is now threatening to revoke my POA and healthcare surrogate because she only wants to go home. Plus, she says she is calling the ombudsmen and an attorney to report being held against her will.

I only did exactly as three different doctors and countless medical professionals told me to. She can seem extremely lucid at times especially if you don't know her well enough to know what she is saying is delusional, like she will tell you all about her grandkids but if you knew her you'd know that she has NO grandkids! I am terrified that she may be able to cancel her healthcare surrogate/POA and walk out, she is absolutely unable to live alone, refuses to hire in home care, and I ca no longer care for her by myself. Plus if she calls the ombudsmen and reports abuse, I was told the authorities will automatically investigate me, I have taken nothing and have receipts but I am still very afraid of being wrongfully accused when ALL I have done is give my life almost to protect this woman and fulfill the duties she legally assigned to me. Now I have to worry about her saying something she probably won't even remember and possibly being investigated, and then released to go out on her own? I thought the ombudsmen would look at her diagnosis and realize she gets confused and is often delusional and paranoid and accusatory? The manager at the ALF said the ombudsmen would only listen to what my mother said and wouldn't even look at the doctor's and medical professionals diagnosis. This makes no sense to me!
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Old 07-03-2013, 07:32 PM
 
20,521 posts, read 16,599,446 times
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The ombudsman is going to be privy to her chart which will include documentation of her behaviors as well as test results (for instance the Mini Mental State which is given to all new admissions) which will let them know her level of dementia. Don't worry about that.

I do not believe she can revoke the POA unless she is cognitively intact. Have you gone to the facility social worker? That would be my first step. They have dealt with things like this 1000 times and will be able to answer all your questions as well as work with your mom to help her adjust.

P.S. Take a deep breath, you have nothing to worry about. You are letting her have too much power over you and IMO sound too enmeshed with needing her to approve of the decision you made. I had to do this with my mom, too, and I know the guilt they can pile on. You have to put on your big girl pants and not care how upset she gets - you are doing the right thing. If she berates you every time you go see her, I'd stop going to see her until she treats you better - if she calls and berates you, tell her you have to go. Be strong, and take advantage if the many years of combined experience of the staff at her facility and ask for help. You do not have to do this by yourself anymore.
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Old 07-03-2013, 07:57 PM
 
Location: Michaux State Forest
1,276 posts, read 2,994,947 times
Reputation: 1426
Quote:
Originally Posted by ocnjgirl View Post
The ombudsman is going to be privy to her chart which will include documentation of her behaviors as well as test results (for instance the Mini Mental State which is given to all new admissions) which will let them know her level of dementia. Don't worry about that.

I do not believe she can revoke the POA unless she is cognitively intact. Have you gone to the facility social worker? That would be my first step. They have dealt with things like this 1000 times and will be able to answer all your questions as well as work with your mom to help her adjust.

P.S. Take a deep breath, you have nothing to worry about. You are letting her have too much power over you and IMO sound too enmeshed with needing her to approve of the decision you made. I had to do this with my mom, too, and I know the guilt they can pile on. You have to put on your big girl pants and not care how upset she gets - you are doing the right thing. If she berates you every time you go see her, I'd stop going to see her until she treats you better - if she calls and berates you, tell her you have to go. Be strong, and take advantage if the many years of combined experience of the staff at her facility and ask for help. You do not have to do this by yourself anymore.
Problem is she's not in a large ALF, she's a quiet withdrawn sort and with her paranoia, the placement coordinator thought she'd do better at a 6 person max home. It is an ALF, just one that focuses more on one to one. Downside of this is that there are not alot of support systems like a social worker on staff. However, the rehab that she came from was larger and the doctors, social workers, and care coordinators all guided me to place her in an ALF. The doctor there had also found her exhibiting delusional behavior where as now that she's in a very good and stable environment, she is much better. That would crumble the minute she went home and had to make any decisions or problem solve. The stable environment plus the routine keeps her sane, at home she respects NO boundaries and just does whatever she feels, she must have structure and she will not let me provide it. Btw, three different doctors have all separately diagnosed her with Alzheimer's dementia.
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Old 07-03-2013, 09:00 PM
 
2,491 posts, read 2,527,847 times
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Simply having the diagnosis does not make one incompetent to make any decisions regarding their life. A power of attorney can be revoked at any time.

One would have to have a "guardianship" in order to trump a person's wishes.

She may well decide to nullify the POA. She may be firm in her intention to go home. She may dictate all sorts of things. That doesn't mean you have to agree.

I have worked with families whose loved one did similar things, made similar decrees, etc. For some having a staff member tell them they had to make their own arrangements was enough of an obstacle to prevent their leaving. For others, getting their doctor or the doctor's nurse to tell them they have to make their own arrangements and that previously used family members weren't good enough, was enough of an obstacle. Families rarely can stand up to a parent/relative. (I noticed your comments about "only did what the doctors, etc said to do." and "I did exactly as... advised")

Occasionally, a facility social worker or therapist (speech or occupational) can work with the person to make plans. Plans for obtaining and preparing food. Plans for obtaining and managing medication. Bills and other finance. Emergency response. Exercise. Housekeeping. Transportation. Managing appointments. How will they get their hair done? Hygiene. On and on. The person feels empowered. Usually gets to practice a few independent skills and, becomes more satisfied with their life and doesn't go home.

Finally, if she calls what local transportation is available, has a few things in boxes, and signs herself out, have the ALF staff on your side. They can notify you as she heads out the door and notify the areas' Adult Protective Services office simultaneously! Does she even have a key to her house or know how to get there? I can guarantee some tears and accusations, but, unfortunately, that is what is involved for some people with a type of dementia.
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Old 07-03-2013, 11:56 PM
 
Location: Michaux State Forest
1,276 posts, read 2,994,947 times
Reputation: 1426
Thank you so much for your response. I just find it suprising that someone who hears voices, has that diagnosis,and is a danger to herself and others can just do whatever they want even though they are sick. My mother's legal paperwork state that the poa/healthcare surrogate are to be used in lieu of a guardianship as it is very expensive (several thousand dollars), time consuming, and very difficult to obtain a guardianship. Why have this paperwork if she's just going to revoke it anytime she gets angry or does not want to do or have something done?

I just hate going against her wishes anyway and had always planned for her to come home after the rehab, until i was instructed by several medical professionals to have her placed due to safety concerns. Plus things here had become so bizarre and dangerous at home. She absolutely cannot function independently and needs me to handle everything. I also hate that it is possibly goiing to take someone getting hurt to maybe change things. I obviously love her and don't ever want to leave her but how can I continue to live my life like this, I fear I will have a complete breakdown or end up sick myself-my blood pressure today was 170/95 and my head was pounding all day and I have no insurance as I can't work and look after her. I guess I better just learn to deal with her at home because she's determined to do things her way because she refuses to believe she has Alzheimer's.
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Old 07-04-2013, 06:22 AM
 
20,521 posts, read 16,599,446 times
Reputation: 38519
Quote:
Originally Posted by branDcalf View Post
Simply having the diagnosis does not make one incompetent to make any decisions regarding their life. A power of attorney can be revoked at any time.

One would have to have a "guardianship" in order to trump a person's wishes.

She may well decide to nullify the POA. She may be firm in her intention to go home. She may dictate all sorts of things. That doesn't mean you have to agree.

I have worked with families whose loved one did similar things, made similar decrees, etc. For some having a staff member tell them they had to make their own arrangements was enough of an obstacle to prevent their leaving. For others, getting their doctor or the doctor's nurse to tell them they have to make their own arrangements and that previously used family members weren't good enough, was enough of an obstacle. Families rarely can stand up to a parent/relative. (I noticed your comments about "only did what the doctors, etc said to do." and "I did exactly as... advised")

Occasionally, a facility social worker or therapist (speech or occupational) can work with the person to make plans. Plans for obtaining and preparing food. Plans for obtaining and managing medication. Bills and other finance. Emergency response. Exercise. Housekeeping. Transportation. Managing appointments. How will they get their hair done? Hygiene. On and on. The person feels empowered. Usually gets to practice a few independent skills and, becomes more satisfied with their life and doesn't go home.

Finally, if she calls what local transportation is available, has a few things in boxes, and signs herself out, have the ALF staff on your side. They can notify you as she heads out the door and notify the areas' Adult Protective Services office simultaneously! Does she even have a key to her house or know how to get there? I can guarantee some tears and accusations, but, unfortunately, that is what is involved for some people with a type of dementia.

It sounds like she just came from a rehab where she would have gotten all those therapies, and the team there were the ones who recommended placement.

OP you can always make an appointment at an outside testing facility, a medical geriatric practice, that can give you a thorough assessment. You can also request a psych eval at the facility she is at. You can also hire your own social worker to help you. I did this last with my mom and she was invaluable. This is for your mother's care and you can as POA use her funds to hire the people you need to help make the right decisions for her.

Last edited by ocnjgirl; 07-04-2013 at 07:45 AM..
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Old 07-04-2013, 07:32 AM
 
5,392 posts, read 6,527,506 times
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Or you could find another place to live and tell her you wish her well when she returns home.
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Old 07-04-2013, 09:33 AM
 
Location: Wisconsin
17,006 posts, read 17,320,800 times
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Quote:
Originally Posted by lilred0005 View Post
Thank you so much for your response. I just find it suprising that someone who hears voices, has that diagnosis,and is a danger to herself and others can just do whatever they want even though they are sick. My mother's legal paperwork state that the poa/healthcare surrogate are to be used in lieu of a guardianship as it is very expensive (several thousand dollars), time consuming, and very difficult to obtain a guardianship. Why have this paperwork if she's just going to revoke it anytime she gets angry or does not want to do or have something done?

I just hate going against her wishes anyway and had always planned for her to come home after the rehab, until i was instructed by several medical professionals to have her placed due to safety concerns. Plus things here had become so bizarre and dangerous at home. She absolutely cannot function independently and needs me to handle everything. I also hate that it is possibly goiing to take someone getting hurt to maybe change things. I obviously love her and don't ever want to leave her but how can I continue to live my life like this, I fear I will have a complete breakdown or end up sick myself-my blood pressure today was 170/95 and my head was pounding all day and I have no insurance as I can't work and look after her. I guess I better just learn to deal with her at home because she's determined to do things her way because she refuses to believe she has Alzheimer's.
Do not take her home. After all what good would it do if you have a massive stroke and you need 24/7 care. Will she be able to care for you full time?

Do not take her home. I mean that literally. When she is released from rehab tell them that you are not taking her and do not show up. When they see that your mother is not able to make arrangements to actually go someplace (can't figure out how to call a cab, can't figure out how to get her medicines, hasn't arranged for food, doesn't remember her address, etc. etc.) the rehab place will realize that she can not live on her own.

Let's say, heaven forbid, that you were in the hospital at the time of her release or home sick in bed or lived or were vacationing 1,000 miles away, what would the rehab hospital do? Just push her outside and lock the door behind her? I really doubt that.

P.S. Make sure that the facility and the person who actually handles discharge has a copy of her diagnosis (and, perhaps, a list of the things that she can not do independently). If they see that she can't drive, can't handle money, can't grocery shop, can't safely use the stove or cook food, can't handle medicine, can't be trusted not to fall into the canal or to stand in the middle of a busy street, falls several times per day, can't (consistently) use the phone to call 911, etc. etc. I don't see how they can release her by herself.

Last edited by germaine2626; 07-04-2013 at 10:19 AM..
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Old 07-04-2013, 11:08 AM
 
Location: Chapel Hill, N.C.
36,484 posts, read 43,730,834 times
Reputation: 47257
I have been where you are except it was my brother who decided to take her to an attorney who did not know her and have my 20 year POA revoked.

You definitely need to contact an Elder Care Attorney in your community. Her funds can pay for it. he/She will advise you on how to handle this situation.

After a great deal of turmoil and stress and me literally being put in the hospital for stroke like symptoms, I pulled on my Big Girl Panties and had my mother declared mentally incompetent. It was me against my brother, his money hungry 3rd wife of less than 2 years and my demented mother. I don't remember it costing a cent, certainly not to me. She was appointed her own counsel who quickly saw what was up with my brother and SIL. Hearing took about 20 minutes, was fairly inconvenient and she was mad but she got over it.
Not only did brother have her declare my POA revoked but he had her make a new will leaving me and my family out completely.
I was appointed guardian of her person and judge had himself declared her guardian of financial affairs (at my request) . We worked together very well. As soon as brother and SIL saw they could not get hold of her money they were out of the picture. Brother died a few months later. I took her on a good day to doctor who declared she was mentally OK and then on to attorney for new will. if I hadn't done any of that my SIL would have inherited her estate. i wasn't about to let that happen and even my poor mother realized what was happening and she told the doctor she was unduly influenced by SIL and wanted to make things right.

Sometimes we just have to do what we fear the most. Remember the sacrifices you have made for your mother and what would happen to you both if she prevails with her paranoid delusions.
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Old 07-04-2013, 11:13 AM
 
Location: Chapel Hill, N.C.
36,484 posts, read 43,730,834 times
Reputation: 47257
Before I put my mother in Assisted Living she lived with me and my DH and 2 kids for 10 years. I literally waited on her hand and foot and decided to put her in ALF when I could no longer get in the shower with her.

She was furious and demanded that I "go out this instant and find me a 2 bedroom apartment, arrange for my furniture to be moved and get back the cat you made me get rid of when I moved in here." When I reminded her she could no longer drive or cook and how could she handle those things she said "I can find a nice cab driver who will bring my groceries into the house and maybe fix a meal with me". It was really sad. I remember hearing her scream 'I WANT MY LIFE BACK" . well, don't we all.
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