Partner's elderly mother's undiagnosed dementia - abusive and constantly nagging. What next?

So. You are in a relationship with a man who lives with his parents. You describe you and him as "partners." Does your relationship really amount to that as yet?

How long have you been together?
How long has he lived with his parents?
Does he think there's a problem?

I ask these questions because I have the impression that he is used to the set-up, but you are comparatively new to it. What changes would you like to see?

Your partner is "paralyzed" because he is overwhelmed at having to deal with not one but two people who are dependent upon him every single day, not maintaining their abilities but in active and rapid decline.

Is your partner the PoA for either of his parents? If not, first and foremost he should work with his Dad to get this done in order for him to legally be able to act as his Dad's advocate. Sounds like his Dad has enough cognition to do this, so he should do this first. After this is completed, he should help his Dad go for a physical (and your partner should be in the room during the exam). Your partner need to request the Medical Representative form at this visit and have his Dad designate him as his MR. This way your partner can exchange info with his medical team without his Dad needing to be present. They won't talk to your partner without your Dad being present if this HIPAA form isn't filled out. At this same exam your partner should discretely pass a note to the staff requesting a cognitive exam for his Dad so that there is at least a baseline measurement in his records.

Then, there's his mom. If your partner is her PoA, then he needs to tell her a "therapeutic fib" in order to get her into the doctor's office for a cognitive/memory exam. He can tell her it's part of the requirement for the "paperwork" she is always wanting him to fill out. Then he does what I suggested above with his Dad to get a record of it in her medical files.

If he is not PoA for his mom -- and they have the financial means -- he can pursue guardianship through the courts. It can be costly. The only other option is for the county to step in for guardianship. Please know that there is no legal pathway to make decisions on behalf of someone, or manage their affairs, unless there is an authority granted through our legal system.

if your partner thinks his Mom can comprehend what a PoA is and does (she doesn't have to remember it -- just understand it), and your partner has no other siblings or relatives who would ever contest a newly created PoA for his mom, he can go through Legalzoom.com or Rocketlawyer.com to get one completed with her (he will still need to take her to a notary and sign it before 2 non-family witnesses to make it legal). Don't listen to anyone on this forum who tells you to never do it this way. My mom has done it this way, as she is single and I'm an only child. It is working just fine for her and it was way more affordable, fast and convenient than going through a lawyer. If it means it allows your partner to help your mom better, then he should consider this.

Educating himself to dementia needs to happen. You should watch some Teepa Snow videos on YouTube -- she's an expert in this field and gives very excellent layman's explanations of what dementia is, how it changes our LOs, why they behave the way they do, and how to better engage with them as caregivers so as to make it the least stressful. After you watch a few, then you can recommend he watch them because they were so helpful.

Dementia is a progressive disease. Your partner has to work hard now to get on top of managing the poop show because it won't get better and it won't stop. He may want to consider touring some good, reputable facilities (without his parents) so that he sees there are many very nice ones. He should consider consulting with a Medicaid planner, to make sure his parents can qualify if/when they need it (and many, many elders do because they live so long they outlive their retirement savings).

Your partner is part of a vast fraternity of caregivers who have been in his shoes. I'm hoping he will "go to school" on the experiences of others so that he doesn't burnout unnecessarily. Bless you for helping him!

I'd ask yourself what the future is for you and your relationship. Do you want to live with, marry someone who lives with his parents? Do you want to live there yourself?

Well, I think you’re calls on dementia are correct, though it could be Alzheimer’s. I’m seeing a lot of red flags that we saw with my MIL. She moved in with us after it became apparent that she could no longer take care of herself. LTC homes here require a diagnosis and have a long wait list. But, we pretty knew that going in, but options are limited. Sometimes you just have to do what you have to do.

Hubby and my SIL were in denial a long time. I could see big, giant, red flags waving everywhere, but they had to be ready to deal with the problem. As I’m sure you know, it is a degenerative disease and will not get better on it’s own (sometimes medication can help, but only temporarily).

Start by pressuring your partner to get help. I don’t know about where you are, but in my area there are geriatric outreach teams that come to your house. There are some exhausting intake forms, cataloging her life and overall behaviors and problems. As they’re in the house for over an hour, they will also write down what they see. She will only be able to pretend so long. There is also a cognitive memory test that the psychometrist came and did with her. The score is out of 30. Anything less than a 27 shows memory loss and cognitive function loss. MIL was scored a 16…

I think working on getting a diagnosis woke both my husband and SIL up to her ability level, which they had become accustomed to and didn’t want to rock the boat. I kept warning about the dangers until they started to do something. Ultimately, she’s their mother, not mine, so I could only push so much.

Your concerns are spot on. Keep talking to your partner about SAFETY. What happens if she leaves the stove on? Sets a fire by accident? Falls and can’t get up? Wanders off? These dangers are real and likely if left ignored.

Keep supporting your partner. You’re doing an awesome job!

His mom is past showing signs of dementia. Forgetting her husband etc. are pretty clear signs that she is well into the land of dementia.

Where is his mom getting all this paperwork that she's nagging him about? I hope he is actually the one handling all this type of financial work for them. If not, it's time. And, poof!, the paperwork disappears and she does not need to see it and worry about it and bug him about it all the time. Of course, she will obsess about something else but it might be nice to have a break from this type of thing.

She definitely needs an evaluation. When was the last time she went to the doctor? He may have to tell a little, harmless, white lie - Mom, the doctor says you need to go to see his today. It's been too long.
She may not like going, but that's OK. She could benefit from some blood work and determining if there is anything besides just good old dementia contributing to her behavior. I wonder if she has some anxiety, apparently, and could be helped with a med for that.

Is the dad still capable? Once he's more recovered, does he help with the mom and do anything around the house?

So now your partner needs to start taking care of himself. He needs to hire some help for his parents, with their money, ASAP. He is going to burn out. Caring for 1 high need parent is more than enough, but 2 will cause him some serious issues. He can do the simplest thing to start with like hiring cleaning people. Getting as many things as possible delivered to the house to cut down on errands. Though he should have someone who can be their sitter, under the disguise of being a "maid" if needed. The helper can try to do light cleaning, laundry, etc. And your partner can take you out for dinner!

You are doing the right things, by just being supportive and being there for him. It's hard for a child to admit that their parents might be more than they can handle, but it does sound like it's time for him to consider added help. His mother needs a work up with a doctor. Those are symptoms of dementia and anxiety. And yes, it's often hard to get them to go to the doctor. What needs to happen is your partner should understand that he can't keep up the current pace alone, he needs adjunctive support for himself and them. If Mom has a general practitioner, he should get the number and set up an appointment with them ASAP. He may need to call in, ask for a virtual or tele-consult so he can speak to the doctor alone, by himself OR, at least get an appointment on the books for an appointment but he's got to communicate to the person making the appt. about what mom's doing and that she won't come in on her own or by his suggestion alone. I would ask the staff/doctor on the phone, if they themselves could CALL HER directly instead(at a time when he is there with her at the house) and speak to her about making an appointment to come in for a well check. This might help her feel more in control of what's happening to her, rather than it feeling like her son is pressuring her or that it's coming from him alone. Alternatively, he could set up a virtual appointment if she absolutely won't go in. But he has to get doctor or someone on the phone first to describe the problem, or else Mom will "front" when the time comes. Yes, they can mask as if on cue and behave perfectly normal for a time when they want to. Doctor and staff also need to know what his father is dealing with healthwise too, and how she is behaving towards him. Basically, your partner should start the process now, which essentially documents or shows that his mom is in need of medical assistance, which also means both of his parents require someone to become their POA and oversee their medical and financial business. With his dads health failing and his mother's cognitive decline, it's pretty obvious that the time is right.