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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!

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The best advice here comes from lealonnie1. Call immediately as she is a danger to herself. The social worker at the hospital will be a tremendous help.
It's difficult when we have to take charge and place our parents in a facility, but she needs help now.

And I echo what's been said about the hotel. What in the world us wrong with them.

Also, in some cities the city council representative can be a tremendous help.
Describe the situation as you've done here.

May God bless you and your family. This is hard.
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Obviously there are huge negatives here some of which thankfully seem to be improving. At some point you brought up Assisted Living. I seriously doubt she would be a candidate for that form of living. There has to be a general willingness for a person to live in that environment. I seriously doubt they would put up with the serious incontinence issues. If you can start by getting her back in her home with help and she cooperates with the incontinence issues that would be a positive step. If that goes back to what it was she basically gives up having any choice and you should give up helping. I can't imagine you want to spend hours cleaning up after her because for whatever all the reasons are she refuses to either use the toilet and or use the proper products for that issue.
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She qualifies for and needs to be in a long term care facility. Call Adult Protective services and give to assigned case worker "the above" and ask for help he or she can give to get her into a facility that can meet her needs.
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I hope the comments below are hitting home with the theme of Dementia. You should not be rebuilding home for her to return to unless you are prepared to supply in-homes aides. Since she is out of the house, this could be clean break to a facility and seek medical attention to see if she can be medicated or receive professional counseling.

You may run into trouble for a memory care facility to take her if she is unruly, so this is why you should seek professional help first for a diagnose and potential medications.
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The hotel your mother is staying in will throw her out if the despicable filth and squalor does not stop. Hotels are not nursing homes. They will not allow a person to stay who is wrecking the place.
Is rebuilding your mother's house really the best option? From what you've told us here about her she is clearly incompetent and cannot live alone unassisted any longer. She will not accept a live-in caregiving services in her home, and no caregiver will move into a home that is filthy and squalorous. Or live with a client who will sit in their own sh*t and refuses to clean up.
Forget about your mother being "stubborn". You have the POA and are making her decisions.
She needs placement in a care facility. Look around and find her one. Use the money the insurance company is paying out from the fire to pay for it.
Your mother will likely put up a fight and not go willingly. The facility you choose can handle such a situation if they know it will be a hostile transfer. It's for her own good and safety.
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Kate4620 Jan 2022
The filth has been mitigated by me cleaning up before hotel staff. We approached it as a team. Her incontinence has resolved.

I’m rebuilding her house because 1) it was paid off; 2) she paid home owner insurance faithfully on it for over 50 years; 3) she’s entitled to have her property fixed. *Whether she moves back in to it is a separate issue.

My mom was evaluated —again—by APS today and SHE AGREED TO SERVICES!

I’m relieved
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Agree with all the suggestions about a call APS and if necessary local police. Hotel bill will be astronomical so I wonder if you might enlist their help in calling the State Dept of Health and APS.
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Sarah3 Jan 2022
Im curious why on earth would you recommend also calling the police on her 78 yr old mother? She’s not a criminal, wouldn’t having a social worker come talk to her be more appropriate and relevant??
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Kate4620: Imho, perhaps you shouldn't proceed with a home rebuild for your mother before first addressing her mental illness. She requires a psychiatric evaluation. The hotel that she is living in is going to be livid, to put it mildly. Living in and lying in one's own human waste is appalling.
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cherokeegrrl54 Jan 2022
I would hate to see the bill from the hotel for cleaning and for damages that this woman is causing. I agree that OP should talk to hotel management to call APS and dept of health ASAP! I feel for the daughter having to deal with a mom that is that stubborn……like you, someone that lies in their own waste because they don’t want to clean it up or won’t allow anyone in to do it, needs to be in a Geri pschye ward for treatment……wonder if a judge has deemed her incompetent? Sometimes I think the legal ppl should be made to go see how the “competent “ppl really live like. Then maybe their family could get the help they need instead of living in hell trying to care for them….,just my opinion….,Liz
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You should look for in home care for her, possibly yourself too if you need help! There is a program called IRIS here that helps out financially. You could hire someone that yourmother agrees to that would help with her care and help clean up too.
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Kate4620 Jan 2022
She finally agreed to home care! I’m relieved 😌
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Not quite sure what type of 'physician' your brother is, but clearly he hasn't had to go and clean up after her. Has your brother done all the necessary tests on your mother to make such a determination - I don't think so - I just think he is in denial and this is what he wants to believe.

Contact her physician. Ask for guidance on how to handle this clearly not safe environment your mother is in. That way you are on record of 'trying'. If they are unable to assist, contact APS (making sure you have all the video recordings/photos as well) -

And yes, as someone said, when your mother moves out of the hospital, you will be totally liable and responsible to get the room back to where it was - huge cleaning bill because human waste is deemed hazardous, new carpet, new paint, probably retiling the bathroom, etc in addition to replacing all the furniture. Hopefully you have an extra $10,000 sitting around.

You have POA; your mother is no longer able or capable of taking care of herself nor is she capable of making decisions for herself about her care. It is time to find a memory care facility for her.
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Kate, unless your Mom has ample funds, you may want to pause the home remodel.

The hotel bill is going to be $$$, when they sanitize and remodel the room. Also, if your Mom ends up in care, the money may be needed there.
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BurntCaregiver Jan 2022
The hotel bill is covered by the homeowner's insurance policy on the mother's house.
They will not pay for damages done to the hotel though.
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This woman is SEVERELY MENTALLY ILL and a narcissist in the process. She cannot live alone and under no circumstances, no matter how mad she gets, can this go on. You do, thank god, have some legal authority but for whatever reason you can't (and you never will) get her to cooperate. Speak to the doctor and keep the doctor informed. Then go to Adult Protective Services and ask for help - they will come in and investigate and start the process of placing her - soon as possible. This is disgusting and revolting and shameful and something has to be done to stop it at once. I would also consult an eldercare attorney (some offer a free one consultation) for advice on how to proceed and get her moved. This is too much for any human and no one should ever allow themselves to take this nasty lack of cooperation - dementia or not.
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Riley2166 Jan 2022
And the fact that YOU are disabled should make things happen even more quickly. You could try calling the police and tell them you are disabled and she is in a serious medical crisis - can they help bring her to a local hospital in view of her behavior. Once there, walk away - NEVER, EVER LET HER RETURN HOME AGAIN. Worth a try.
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Take photos and videos without cleaning up.
Call police non emergency number, don't clean up. Tell them she is a danger to her self, they need to respond. Describe in vivid terms the condition of her room. If they balk, tell them she's at the hotel because she caused a fire in her house. They sure don't want to risk a hotel fire! They then can be responsible for getting a mental health hold on her.
If that doesn't work for some reason, call Adult Protective Services. Tell them it's an emergency.
You cannot continue dealing with this. Stop trying. Advice to take her to her doctor is well meaning and maybe workable, but you need to care for yourself. Stop subjecting yourself to her tirades and the messes. Let it go.

The following you can skip, only read to determine why I say the above, if you want. I had a rental property. Neighbor says the older lady tenant hadn't picked up paper in 3 days. Manager called police who checked on her. She was lucid, said she didn't need help. They did say there were dirtied pants on bathroom floor. The woman had been a meticulous housekeeper. Later her daughter who lived 3,000 miles away called as Mom was not answering her phone. Police again responded, had to break a window to gain entry. She was found in her soiled bed. They called for ambulance which took her to hospital. She'd had a slight stroke prior to first visit, and more prior to 2nd visit. Agencies took charge after that.
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As a disabled person, you can resolve your mother's issues by picking up the phone and not taking "NO" for answer. Every day, make a promise to yourself that you'll at least two organizations for solutions.

Start day one with these
911 - 72 hour psych evaluation hold
Adult Protective Services

Anytime someone answers your call and claims they can't help you, turn it around and ask them to refer you to someone who can.

State Conservatorship (i.e., ward of the state)
Your local Congress Person
Local Mental Health Services
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rovana Jan 2022
How about local Health Department!!
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I would contact Adult Protective Services and explain the situation to them. I've read some of the responses and laundering feces can be a health risk since you don't know what is causing the diarrhea. If it is C-Diff, this is a highly contagious disease. If an agency looks out for their aides, they are not going to send anyone in there to assist unless the situation has been evaluated and treated by a doctor.

It doesn't sound like that you have been successful in getting the help, so the next step would be APS.
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Wont let me delete:(
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Mentail health crisis hotline.
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.
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She’s mentally incompetent. You’ll need to get an attorney to have a court proceeding to rule she can no longer care for herself and needs you to be her legal guardian. Then you can make decisions fully on her behalf. Do you have a medical information release signed by her? That is the first thing I’d get if not. Then you can freely talk to her doctor about her condition. I’d need taking photos of her living situation to back it up too. Anyway, I’d be consulting an elder law attorney on what steps to take.
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I may be wrong but it seems as though before APS, or physician brother arrives, you clean your mom and the place making all appear tidy okay.
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cpell122112 Jan 2022
i disagree. the point of the visit is to see the situation as it truly is. by cleaning up before anyone arrives, they'll consider it a wasted trip, they'll never get help unless they can prove they desperately need it.


Colleen P. Pell
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I had a friend in a similar situation. Her mother would not accept help and was a danger to herself. After trying everything unsuccessfully to get her mom to agree to be admitted to a care facility, (including tricking her into a “one night stay” hoping her mom would be comfortable enough there to want to stay but she up and left in the middle of the night) she finally had to call APS and they admitted her to a psych ward. Eventually from there she was admitted to a care facility. It sucks but sometimes you have to take the most extreme measures to get them into a care facility.
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My 2 cents.

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.
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babziellia Jan 2022
And another thing I forgot to mention:
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.
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She does sound mentally ill and/or depressed. Have you tried bringing her to a psychiatrist? If she won't go, you can do an online session. Perhaps a Psychiatrist can prescribe antidepressants or antipsychotics to start and see if that helps. Unfortunately it can take weeks for them to start working. If she refuses, you can put them in her coffee or food. You would be surprised how something as simple as that could turn the whole situation around. Good luck.
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Kate4620 Jan 2022
I would have loved for her to be seen by a psychiatrist after my dad died.

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.
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This is way beyond your expertise and you've done all that could have been expected of you.

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. -
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cpell122112 Jan 2022
that's cold. this is her MOTHER. the one who took care of HER. if she was my mother, nothing on the face of this earth could/would stop from caring for her. ok, yes i'd need help doing that, but, i could swear on the Holy Bible, both my sisters and my brother would be there like a shot if need be.
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Call the authorities. Your mother needs to be admitted for evaluation and treatment against her will since she is a danger to herself. Once she is in treatment, allow case management and social services to place her into a memory care facility where her needs can be met. This is my advice as a nurse.
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cherokeegrrl54 Jan 2022
Thank you, Taarna. Excellent advice. Liz
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Kate, sorry I only just saw your reply:

"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.
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rovana Jan 2022
I believe it is essential to protect workers from biohazards. Contact the appropriate people to deal with it.
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Adult Social Services. Your state has something under this heading or Department of Human Services. Contact them yesterday. She needs to be in a care facility obviously. She of course won't like it but she can't live the way she is. Even the hotel will eventually have her removed. I don't know if your POA is just financial or also medical but the social workers will see the problem and act on it.
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DrLokvig Jan 2022
We call that agency APS Adult Protective Services (under the Aging and Longterm Care division of the health dept)
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I don't understand how the hotel staff has any interaction with her if she doesn't allow anyone in the room and you always find her in a mess. There is no way that she would be welcomed to the lobby if she wreaks of urine and feces, worse yet if it is visible. What would happen if you stayed away a few days and asked the hotel staff to check on her? They might be the ones that can get the ball rolling if they see her in the state you've described.

It is awful what you are going through. I could never do it.
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Kate4620 Jan 2022
I think they interact with other her when she leaves the room.
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You have to walk away for awhile.  Leave APS your phone number and when they call state you do NOT have the facilities physically to care for her. If it wasnt' for my dad I would be in the same boat.
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Is there a mental health crisis intervention team in your state or jurisdiction? If so, they can come and do a psych evaluation. Another idea is that you can reach out to NAMI (National Alliance of Mental Illness) in your state/jurisdiction and ask them for advice. They can also provide additional numbers and/or support resources.
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My first concern would be some grief counseling. Let her know it's for her and not at her and that you see and understand her feelings.
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.
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babziellia Jan 2022
I was wondering when someone would mention depression. Going to post further down.
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Reading all these answers to your questions the best one I got for you do you have a phone that will take videos? If you do start doing it then transfer them to a cd or flash drive so that you can have a record of them. I would go to APS and show them these videos of her and her living accommodations what she is living in because that will get her sick and they should know about it. I would do a welfare check on her with the smell coming from her living quarters it should get you someone involved with her. Also send an anonymous letter to APS or where we live its Dept of Human Services they will send someone out without warning that person to see what is going on believe me we had that done to BIL. They don't announce themselves coming they just come.

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.
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