My mother had a stroke and has since been diagnosed with mild dementia (she's on Aricept and a depression med amongst other things). She has some trouble swallowing (soft foods only), can't walk on her own, etc. She is in complete denial of her situation. Right after the stroke (before her dementia diagnosis) I got POA for her (she agreed at the time). She has since consistently been asking for me to 'get her out' of the nursing home and now she has switched to demanding me bring all 'the paperwork' so she can review and figure out how to revoke the POA and sign herself out since I'm not helping her. The nurses/staff know that her stay is permanent and don't mislead her. Besides my normal tactic of deflecting, changing the subject, and just listening to her... anything else I can do? Her dementia appears mild (to me) and mostly appears to be mild word-finding issues and some minor mis-speaking (referring to her ex-husband as my son's father instead of his grandfather for example). She has already told the nurses (once that I know of) that she doesn't need her meds, but ended up taking them anyway. She is a fall risk (has had multiple falls, but none in months) but can transfer from her wheelchair to the toilet by herself (the surfaces are stable enough). She cannot get out of bed or her recliner without help (too soft). Since she can do little things, she thinks she can live independently. In the skilled nursing facility she is at their level 4 (highest) of required care and I know that she can't take care of herself. Any advice on how to handle?
I do understand my opinion is limited by not knowing all the facts.
I wish everything good for your mother and you.
If your mother has the funds to stay in a facility, would she have the funds to live at home? A small home, with live-in care? Sometimes that’s impossible, but I mention it anyway. I don’t mean you living with her.
It’s possible that if we ourselves would live in a facility, we would desperately try to get out (for good reasons) (the reasons aren’t always stupid).
We are young. We haven’t experienced yet living in a facility. There are great ones. There are bad ones.
I have a friend (she’s a good woman), who put her mother in a facility. The mother needs a lot of care.
My friend told me, she herself would never want to be in a facility, and would kill herself before.
What I mean is, my friend somehow thinks “this is not for her”, but is willing to put her mother there.
Sometimes, there is no choice - someone must be placed in a facility.
Your case might be like this.
I ask only if there’s any chance for your mother to live in a little home/apartment/something.
She might prefer to live a while like that (breathing in life again, some freedom) (with live-in care), instead of institutionalized, surrounded by many sick people, etc., other reasons.
Wishing your mother and you luck!! I’m certain you’re already doing your best!
Here I Am
Do know that your MOM may NEVER own it and accept it. She is no longer competent.
That is why you must now act for her.
SO........do discuss with the facility so that they are aware; make certain they have the paperwork. Sign what you must to hold her.
THEN go to Mom and tell her that you are now her POA. That you are acting in her behalf now because she isn't able to make competent decisions for herself. That no one wanted this duty less than you do, but now you are responsible for her safety. Tell her that it is now too late to do anything about the POA.
Warn the facility that you are to be notified just in case your Mom is capable of calling doctors. Many elders with dementia are capable of confabulating well enough to fool an attorney short term. Tell the facility that any attorneys should be warned that Mom is no longer competent.
SHOULD Mom get any attorney with no one knowing this could become a court case in which you would need to get guardianship over Mom, and do know that without a DIAGNOSIS from two MDs and letters attesting Mom is incompetent she may win.
At that point, were it me, I would withdrawn completely, and notify APS of adult at risk. Do not enable anything outside the facility.
So sorry. This is major tough. But this isn't something you can dance around. You must take the reins so to speak.
I am trying to do everything right it's just hard when mom's fighting so hard against everything and is blaming me.
Mom isn't capable of calling anyone. She can't even dial my phone # (which hasn't changed since the late 1990s. The nurses told me that they have offered to help her dial me and she doesn't even want to try.
I worry that she will try to convince her Dr. to sign the competency form that was included in the POA paperwork (which would revoke my job as POA) but I don't think that any Dr. worth their salt will sign that form with someone with a diagnosis of dementia and on Aricept. However, she can be very convincing at times. Then other times she'll say something "off" and I'll think, "oh, there it is... there's the sign of impairment". I hate seeing those signs but in another way it's reassuring that she is in the right place.
Her pulse returned to a normal rate and she is more cognizant. This was added after she had anesthesia and perhaps the anesthesia hadn’t cleared. She did have signs of dementia before but it was increased after the hospital stay.
I only mention this because sometimes we cause problems by treating symptoms. The aricept has not proven to cure but some believe it slows dementia for awhile. I wish I had never agreed to it for DH aunt. Many people take it.
Your mom will hopefully continue to improve from her stroke. That also can take a long time. Is she continuing to receive occupational or physical therapy? I sure hope so.
I would also deflect as Geaton suggested, encouraging her to get better before considering a move.
“The nurses/staff know that her stay is permanent and don't mislead her.” Are you saying the nurses tell her she can’t go home? I might have a conversation with them so you can all be on the same page.
Could she see a mental therapist or someone from her church? She has a lot to deal with.
If she is truly incompetent, as well as handicapped, then I’m not sure she can revoke your POA. I wouldn’t think so.
Oh and it is so easy to convince ourselves nothing is wrong with their mind because sometimes, nothing is and then the next day, you see the dementia clearly. It’s hard. Big hugs.
When I said that the staff knows her stay is permanent and don't mislead her what I mean is that they don't say 'do this and you can go home'. We don't want to give her false hope when we know it's not realistic. They encourage her through her multiple therapies (occupational, physical and speech) to improve so she can be safer. I've had many conversations with her nurses, therapists and the Director of the facility. Mom hears 'encouragement' from nurses/therapists and misconstrues that as she's going to get well enough to leave. She insists on believing what she wants to. Doesn't matter what we say. I've had many conversations with her telling her that the therapy is to make her strong enough so she doesn't fall and that she can swallow better (and choke/aspirate food into her lungs). I don't want to cause her undue mental stress, but I worry about the level of false hope she has. I don't know that it will ever change, but I struggle to handle her questions/demands about leaving when I know that it's not realistic.
There is a psych Dr. that visits her at the facility and diagnosed her with depression and anxiety disorder. We had tried taking her off her depression med when she seemed to be doing better, but she quickly reverted back into a depressive state so we had to restart the med. She does better on it.
She is completely convinced that nothing is as bad as me, the nurses, Drs, etc say that it is and blames me (and the rest of us) for her current situation. It's just hard to deal with.
I appreciate all the feedback - it really is helpful to know that others understand how hard this is.
Tell her you'll bring the paperwork once her doctor ok's her to leave on her own unassisted. Don't let it bother you...she may not relent so just keep your story the same. That's as much as you can do.