Hi! First post and will be a doozy. (TLDR at bottom).
My 78 yo mom is currently living in a hotel because she accidentally set fire to her house. While she was still at home, over the past 3 years, my husband (and our 2 adult kids) would cook meals and deliver every day; pay her bills and manage her finances; clean her yard; and until 3 years ago, clean her home.
Three years ago, my father died. After he passed, my mom stopped allowing us entry in to her home. Things got bad. Really bad. We could see (and smell) from the doorway she was no longer picking up trash. She had her two dogs (which we confiscated a year ago) go to the bathroom inside her home and would not clean it up.
Worse still, she developed incontinence issues (both types) and would either not wear the diapers we purchased or would wear them until they leaked. She would not wash her clothes. Would not shower. Her clothes would be stained with all manner of waste and she would not even change her clothing.
After the fire, I managed to obtain Power Of Attorney for her as I’m handling her insurance and home rebuild solely. She is unable to help—so she gave me the ability to manage that for her.
Now, while in hotel that insurance pays for, her lack of hygiene and squalor persists. She will chose to lay in her own waste rather than let me assist her. I don’t understand that.
I have no idea how to proceed. I’ve broached the subject of in-home aids, assisted living, etc., and she is adamant that she doesn’t need or want help.
My POA does enable me to make some decisions for her. But, it’s tricky…she is so stubborn about not wanting the help she clearly needs that whenever I suggest help she becomes angry, cruel, etc.
Yesterday, I went to her hotel room and cleaned as she won’t allow housekeeping to enter. Her bathroom was a diarrhea “crime scene” if you can imagine that and she had soiled her bed down to mattress. She was laying in the waste instead of using other side of bed.
“It’s not that bad,” she said. “It’s not that dirty!” Yet it took me (no exaggeration) 5 1/2 hours to remove the smell from her clothing.
TLDR: 1) she needs help 2) she refuses help 3) she lives in squalor and sees no problem with it 4) she is clearly mentally ill and refuses medical help 5) I have POA and no clue how to proceed. And a big btw—I’m disabled.
help!
If she is not diagnosed as incompetent the short and sweet answer here is that there is little that can be done. When the Hotels/motels find out the conditions of their property she will be evicted.
If you are disabled in a way that precludes your being able to act for your Mother it may be time to let the state take on guardianship, because once APS calls them and arranges that you will have no input, but it will all be out of your hand.
The unfortunate thing is that mental illness doesn't usually qualify for guardianship by either you or the state. This is but one of the reason there are so many homeless on our streets, clearly mentally ill, who have no access to care and nowhere to live.
I am so sorry. I cannot begin to imagine what you are going through.
as I stated above to others, I had APS look in on her and they found her competent.
My brother is a physician and he says she has her faculties but is living this way by choice.
Without her agreeing to see a doctor (who isn’t her son) I fear I won’t be able to push for guardianship.
maybe hiring someone for home health, another for housecleaning???
This is so frustrating and hard!
2) once she has a diagnosis, your PoA is active
3) with active PoA you can "do what it takes" to get into MC (because she may be beyond AL at this point and could be a flight risk)
4) work on peace in your heart that there aren't any other viable options and you're doing the best thing for her
I think she needs guardianship. Mom isn't competent to grant POA now and probably wasn't when she did give it.
Call an attorney today.
edited to add I’ve got calls in to attorneys 🤞🏻
I’m learning that there may not be a darn thing I can do.
she’s not grateful (often verbally abusive) when I do/try.
I just can’t stomach the idea of my mom living that way. Makes me mad. Makes me sad. Frustrates me to no end.
Your mother is exhibiting classic signs & GIANT RED FLAGS of dementia that others are ignoring and/or in denial about, mainly your Brother the Physician. Men in particular are very hesitant to admit their mothers have dementia; we see it here on the forum all the time.
So your mother accidentally burned her house down, no doubt by leaving a pan on a red hot burner (classic dementia). Before that, you were bringing her meals, paying her bills and taking care of all the chores she could no longer take care of herself; managing her entire LIFE, in other words: also a sign of classic dementia: no longer able to manage one's own life. Her being 'verbally abusive' to you when you try to help also fits under the classic dementia umbrella behavior, btw.
Now she's living in squalor in a hotel and not allowing housekeeping in to clean, also classic dementia: Hiding out & stubbornly refusing help. Meaning YOU or SHE will be responsible for paying a HUGE bill upon move-out of said hotel. The mattress is ruined, at the very least, all the bedding, and the carpeting, bathroom fixtures may need replacing, etc. HUGE bill forthcoming. I'm actually surprised the hotel is allowing her to insist on no housekeeping!
So while everyone sits around pretending mother is fine, not riddled with dementia or mental illness at the very least, havoc has been & is being, wreaked at every turn. Follow MJs advice & contact a certified Elder Care atty immediately to get the guardianship paperwork going.
Actions MUST be taken right away to stop the bleeding before everyone is bankrupt! The EC attorney can hopefully guide you about what to do NOW.
Good luck and Godspeed, my friend, you are going to need it. My heart hurts for what you're going through.
PS: I also wanted to add that it's common for an elder to decline dramatically after the loss of a spouse (my condolences on the loss of your father.) If mom was going down the dementia highway prior, she likely started RACING down that highway afterward.
I have calls in to attorneys. 🤞🏻
I think you'll have to step away and stay away until she crashes. Go back to APS, explain your absolute inability to influence or alter this situation, keep in touch with them for communication purposes, and wait. Your POA - if it was created solely for the purpose of allowing you to supervise the rebuild, is that right? - won't extend to any health or related decisions so you can't force the pace.
I have nothing hopeful or helpful to say about how this is likely to go. We had a client who would not get out of bed except to go to the bathroom and had had total urinary incontinence for years. Her friend (very loyal younger friend, brought groceries, loved the lady regardless) described a visit to the *friend's* house when this lady had peed on the sofa, then stood up and calmly turned the sofa cushion over and sat down again without saying a word about it. Never answered any offer about help or support or medical advice with anything but "it's fine." Well. It took adult social care a year of negotiation to win her agreement for us to visit her twice a day, and we were all warned not to antagonise her for fear of getting the whole team thrown out. She was the sweetest lady in the world. Always welcoming and appreciative, called us angels, thanked us for every snack and drink and sandwich we brought to her, thanked us to for every suggestion and offer about personal care. But in three months the only co-worker who had any success at all that I know of got her to change her nightdress. The ammonia in the room was pretty terrible (not the worst I've ever encountered, mind - that award goes to Seven Dachshunds Client). I was working on trying to tempt her to a foot soak, more in hope than expectation, but then they pulled the plug on us and ended her service (because we weren't getting anywhere to speak of, not for want of trying I assure you). As far as I know, the lady is still in bed.
She had mental capacity. There was nothing about her situation that she did not understand. She simply and flatly refused to discuss it, and no one could make her, and it was her house. What do you do?
Meanwhile - so where has the rebuild got to? What's the next step of the plan?
I only hope they get further with her than we did with our lady :(
They would agree to assist with bathing and meal prep (microwave her food as she only has a kitchenette) and light housekeeping BUT it would have to be 4 hours worth.
My mom would kick them straight out of the room after an hour. She would NEVER agree to having anyone (including me) hang around that long.
Also called APS again. APS said they will see if they will agree to reopen her case file and I can call tomorrow to see if they agree.
Attorney #1 says that I will have a very long (very expensive) battle with her to gain guardianship. I would first need to go to court and ask a judge to compel her to get a neuro-psych eval. If judge agrees, I take her. Regardless of result, attorney said that if she “disagrees” with guardianship it will be a court process.
said if APS does agree to open case again, depending on their disposition, judge may or may not be more willing to compel.
Attorney #2 is tomorrow.
{…and cue Kate’s exhaustion!}
I was even told—deadpan—“it’s not the first time someone sh*t the bed.” 😳
wish me luck! 🤞🏻
"4) she is clearly mentally ill and refuses medical help"
This is squalor & self-neglect.
Cause could be anything.. ?Stroke, ? Depression, ?Breakdown (?brought on by grief).
Only way to find cause is a psych eval.
I've heard some areas will only send emergency services for psych if suicide or homicide risk.
She is at risk of eviction. Advise the hotel she is showing signs of MCI - dementia. That if the hotel needs to evict, to please call EMS (rather than sent her out to the street. They have no duty of care & could do that).
A present it does seem she can 'show-time- for the hotel staff - but this won't last forever. Especially of hygiene is an issue. If no UTI yet, soon will be. Or some other infection.
If she is evicted, she could land on your doorstep. In that case, do not let her stay. Call EMS for psych review.
That seems tough. But it will hopefully get her the help she needs.
I would start the process of having her deemed incapacitated. Seek out an elder care attorney and ask his/her opinion. But mom is a danger to herself and others. And is clearly incapable of caring for herself. She may become abusive to you for your actions. Be prepared for that. But you are benefiting her by taking the reins of this horrible ride she’s on.
The problems with you and your family helping:
1. You’re disabled. That has got to be tough enough on that level.
2. Your precious kids don’t need to see that. Their to tender to need to see grandma in such a frightening state.
3. How is this affecting your marriage?
This is a bad situation for you, your family, mom, the hotel staff and guests in neighboring rooms.
You must act for the protection of all, INCLUDING mom!
Prayers that you can find out where to put your mother I don't think its the best in her house after its being built unless there are people to take care of her. Sounds like a psych evaluation might need to be done too.
then I'd suggest the old saying when we were kids and to our kids....
it hurts me more than it hurts you and get her some psych aid.
she doesn't see the squalor. She's still swimming in mud and can't get out on her own. It's severe depression and she's fighting.
help her by understanding her first. Then take charge and remove her from the situation. Is assisted living it what it takes then do so. You have to be a POA for that as you said.
it will come out in the wash hen she wakes up in her time.
It is awful what you are going through. I could never do it.
"Plot thickens: I called two home healthcare services this afternoon. Both said that they “have to protect their caregivers” (totally understandable) and can’t assign them to laundering feces."
I am speechless. I have no words.
ROFLLMAO.
Understandable my foot. Find an agency whose workers are from this planet. And demonstrate at least a flicker of interest in assisting their clients' wellbeing.
Also - don't be apologetic about the requirements. This is the situation, this is the support required initially, can you help, yes/no. Don't give them tacit permission to have a fit of the vapours about it.
Whatever you do, do NOT assume responsibility for her, financial or otherwise. In your shoes, I would inform APS that this situation is beyond your abilities. She belongs in a skilled nursing home - not an assisted living.
Your only involvement at this point should just be a periodic visit that will allow you to be the loving daughter, listen to her woes, tell her you love her and take your leave. -
She refused to go.
I practically begged her.
And despite what many believe, being a POA (unless it’s a explicitly medical—which mine is NOT) has no power to compel her to go to any doctor.
The best I can do is ask.
But that all said, she finally agreed yesterday to allow me to make an appointment and allow services.
You say this started after your father died. How long were they married? How was their marriage and companionship? Has Mom ever verbalized wanting to die?
Other question: Is your brother, the physician. her PCP? I think it would be bettet if he were not since it's easier to motivate an elder to do what's necessary with the medical advice of non-family member.
Do you go with Mom to all her dr appts? Does/will Mom go to drs other than brother at all?
About POA. You only have so much power. Is it durable? What's in the language regarding powers and limitations? Did an attorney draft it, did you write it yourself, or did you use an online template? Does Mom have advanced directive and living will, etc.?
While she may have UTI or early dementia, my money is on DEPRESSION. It's been 3 years, and if untreated that long, it's become severe. Compare Mom's behavior in the last three years to before her husband passed. Was it a slow decline or an abrupt change?
IMO, your first action is to get her to a doctor for a complete physical and mental health consult for depression, not incompetence. Depression is awful and takes over your life to the point that you don't care about ANYTHING.
Have you had a candid conversation with your Mom about her feelings and will to live? You may be able to have her admitted to the hospital for suicide watch and evaluation. Sounds like she needs meds for depression and anxiety (that's underlying all of this - suddenly alone, without her life partner, lost and in despair). If this is the route, then Mom will need ongoing professional pysch visits with a psychiatrist, not a psychologist. You should insist on attending with her at first until the psych dr can see her alone (although I rec you take her and be available).
Make multiple copies of your POA and any other end of life documents; carry them with you to distribute to all her drs. etc. Designate one copy for you to track to whom you give them (I made a 1-line signature record on the back of mine with date, facility name/Dr name, name of person who actually took it, and made them initial it.
You actually need. at minimum:
Financial POA
POAHC (health care)
Advanced Directive/Living Will.
You can PM me if you want, and I'll email you copies of what I had for my Mom (Mom passed last Thanksgiving).
Bottom line, sounds like Mom is competent, but SUFFERING with severe depression. Please have her diagnosed asap. Mom needs help, even if you must strong arm her to get to the drs using your POA. Hopefully, you have a POAHC, not just a standard POA, and your POA needs to be DURABLE.
I think it's imperative that YOU go with Mom to all her dr visits to 1) listen and take notes and 2) speak to the drs yourself and rat Mom out if she plays down or lies about herself. It's helpful to sit behind Mom so she can't see you making eye contact and shaking your head to the dr. Try to speak with all the drs personally first before Mom sees the dr. Be creative. Wisper to the register that you need to speak privately with the dr - not just the nurse/PA - tell Mom you need to use the restroom there, whatever. If any dr won't allow you time, dump them and find another one. You need drs that will work with you for the benefit of Mom.
Colleen P. Pell
https://www.pa.gov/guides/mental-health/
https://www.bricker.com/people/tess-tannehill/insights-resources/publications/best-practices-for-resolving-patient-incapacity-issues
Look up this in yor state. I still believe non emergency police #. And have her removed to hospital.
It doesn't sound like that you have been successful in getting the help, so the next step would be APS.