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My mom has dementia. APS has accused me of neglecting her- their allegations are simply not true. They are quite threatening. What can I do?


My mom has lived with me fo 6 years. For the last 5 years, she has attended a county run adult day care program. She has dementia but no physical health problems. At first, she was there 3 days a week and really seemed to like it. About a year ago, they insisted she attend 5 days a week. When this started, her behavior started to deteriorate at the center. About a month after she started to attend daily, they informed me that they had stopped serving breakfast "last year" and I needed to send food with her. I did this and also started getting up earlier so she could have a hot meal instead of cold snack food or expensive microwave meals. Then I got a call reporting that she had yelled and used foul language toward a staff member. A month or so later, they reported she had cursed another client and made them cry. About 6 weeks ago, they reported that she had acted up again and terminated her from the day program.


My mom has always had a sharp tongue, and with the dementia, she doesn't have much of a filter. However, I did not see this kind of behavior at home. I did see her getting irritable and she was regularly balking at "going on the bus".


At the same time, the center complained about her hygiene and reported that at times she had body odor. At times this was true. It was a battle to get her to wash her hair and body. She refused to shower and just washed in the sink. This worked well enough, but the next challenge was getting her to change clothes. Especially after she started going to the senior center 5 days a week, she would go for a "nap" shortly after getting home and often sleep through the night in her clothes. In the mornings, I put out clean clothes, but she often put the dirties back on or would change the visible clothes and not her underwear. Then the bus to the center would arrive and there was not time to get her changed. So yes, sometimes she smelled bad. Two years ago they told me they would make a referral for home hygiene services. They finally did it 2 weeks ago.


In January, about a week after she was terminated, a social worker called and asked how she was doing and if she was ever at home alone. I answered that she was home alone at times. A week later Adult Protective Services sent a worker to deliver an accusation of neglect saying she was always hungry (almost daily we will eat a full meal and within an hour she will ask when I'm going to make lunch, dinner etc. I'll ask if she's hungry and she can't decide, I give her more food, she maybe takes a bite. Her weight has not changed for years.), and had body odor (sometimes) and matted hair (no).They stipulated that she must NEVER be left alone or the county prosecutor would immediately take guardianship and put her in a nursing home.


I was blown away! I had largely started sending her to the day program so she could be around people her age and not be stuck at home all the time. When they insisted that she go every day, it just got to be too much for her physically and socially (there are 50-60 people there, and they spend most of the day doing activities as a group. Not really her thing). She has a routine here at home and has done the same things every day she is here for the last 6 years--up for 2-3 hours, dress, make her bed, eat breakfast, read, let the cats in and out a few times, go back to bed. 2 or 3 hours later, up again, same thing again until it's dark and then she sleeps through the night.


Meanwhile I am off work on FMLA jumping through all APS's hoops and trying to figure out how to get someone in here without bankrupting her. The bottom line is that I truly and genuinely believe she does not need someone here 24/7. They have been clear that it doesn't matter what I think or what she does, the case is open and the expectations stand.


Has anyone else been in this kind of situation? Is there any way to get them to back down? I could see having someone come in for a few hours a day when I'm at work and my daughter is at school, but all day every day is just not necessary! I appreciate any advice, thanks!

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In my situation, with Child Protective Services, the guidance counselor who called this in called me right after he reported ( that's the protocol for guidance counselors, socials workers and psychologists here in nyc). My teenaged daughter had reported, rightfully so, being beaten by her dad. He thought it was acceptable punishment. It wasn't. It was abuse, and i was blind to that at the time.

The report to CPS, the visit from the very kind, but VERY tough ladies, showed me a clear path. Husband needed to go. Or i would lose my license ( and my livelihood).

" you love your license more than you love me", he said. Well, not exactly. But he really did need to leave.

20 years on, we're both happily remarried and the kids all have a decent relationship with both of us.
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Why ever would you feel Convicted, if a concern was voiced, and an evaluation was completed, and it was established that All Was Well!? You did everything Right, and had been doing everything correctly in regards to her care! If this was reported in error or in some form of maliciousness from a sour family member, then that's on them, not you! Be Proud of Yourself, nobody convicted you in advance, though I understand that this is how you might feel, but you weren't! That is their job, to evaluate every case, you did Great! Think of all of those cases, where they show up and find horrific situations! What would have happened if those weren't reported? APS is there to protect the innocent and the injured and abused, you were and are innocent, case closed. Hallelujah!
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If your mother is under the slightest impression that *she* has done anything in any way wrong, please correct that impression immediately. APS came to check that she was okay. She is better than okay. There is *nothing* for her to be worried about.

Unless you have an unusually limited acquaintance, it is statistically unlikely that you do not know *anyone* who is ever abusive. You just don't know about the abuse, because it happens behind closed doors, and the victims tend to be ashamed, and you don't believe in asking questions.

I agree with you that it would be *helpful* if APS would explain the context of their visit. They can't name names, but if they were able to tell you "such and such was noticed about your mother and we were asked to make sure she was ok", at least you'd know what the heck they were talking about. As an example of a such and such, I had to sit hangdog next to my mother in the doctor's waiting room while at least fifty people walked past and did a double-take - my poor mother looked like she'd gone the distance with Mike Tyson. In fact the only fight she'd had was with her bedroom floor, but how can you know that by looking? If we hadn't already been at the doctor's premises I would almost hope that somebody would have called social services.

I also agree with you that it is better to give your name if you make a report; but it shouldn't be a matter of courage. You shouldn't need to be *brave* to report something you're worried about. Just worried.

Is your anger actually to do with the distant family member you've fallen out with and suspect of reporting you?
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Bye Falicia!
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Sarajames 12. You're welcome. It's sad you had to go through this.
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It wasn't her primary care doctor, we have known him forever. If it was the doctor at the clinic, then he has a problem,,, I should not be blamed for my mothers bladder irritations, She is diabetic, has thickening of the bladder walls, which unfortunately happens in some diabetics If they blame me for that, then they should go back to med school . Its very common for the elderly to have bladder problems, any doctor will tell you this. I thank you for your comment. Babs. I guess you don't understand when asked to move on yourself. The scenario I gave you was not different, if a husband cheats, you get a call telling you so, he comes home, you confront him, he tells you he isn't,you would not drop it and move on. You would want to know who made the terrible accusation, if you're telling me you would "move on" then you are a liar,,,,Its too bad you are offended by the remark, "if you work for the state you are freeloaders", I do believe that comment was made by another poster, so perhaps you might want to get your facts straight. However, your benefits and perks are ridiculous, which is paid for by the taxpayers, such as myself. So move on honey. You can dish it out, obviously you can't take it... Btw, my mother worked for the police department for over 30 years, so I know what goes on... For the record, I would hope if anyone ever sees anyone being abused, they would, as I said before, call 911, get the police out there and own it, not be a coward hiding behind a 211 call and "wait" for the state to show up.@Stacey,jump on the bandwagon, its fine. There was nothing to be called for, as you might have read. If you would have reacted with "WOW, that was interesting", bless your heart...We are all different in how we handle things. However, you are not one to give an opinion, unless this happens to you and I hope it never does. You know, if someone kills somebody, they are considered innocent until proven guilty, by a jury.. Their rights are better than those of us who are accused of these false complaints. 911 is the only way to go and I don't think anyone would have time to cover up anything, as you stated . They would get there much faster. I will now unsubscribe to this site as some of you here know nothing about this ridiculous, broken system..
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Sarajames12

Her primary care doctor or someone in his office could have called APS.
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There was a concern, it was reported, APS did their job (and thank God they didn't just blow it off) by coming to your house to check it ou unnanounced (if there was something terrible going on with a child or a vulnerable adult, would you prefer that the abuser had time to cover it up?), and you were able to quickly and easily PROVE that the anonymous call was an error, and that your Mom was PERFECTLY OK! I see no problems in this situation! This is a Success in my book! BTW, I've never had any experience with APS, nor have I ever been reported, but if I was, I would be scared, yes, but I wouldn't have any problems with them popping into my home for a surprise visit, to find that everything was A-OK, and think, WOW, that was interesting! I wouldn't feel the need to find out who why, and what the hell, I would wonder, but I wouldn't act on a system that is in place, to protect each and every one of us! Thank God for APS! I'll bet, that most of the time, these cases turn out exactly as yours did, and thank God for that!
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Husbands cheating and children and/or elders being abused are two very different issues. I'm sorry that you dont9see the need for a system of anonymous reporting.

And by the way, I work for a municipality and I am deeply offended by your remark that folks working for State/City government are freeloaders.
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@ Churchmouse@ Babalou, are you people insane? Babalou, you have a difficult job, but I would expect that you are making that judgment call on what you are seeing, at least I hope that is how you decide what is right or wrong. I may ask, how did you find out who called to make the complaint against your family? At least you were privy to that much info. I have no idea who made this call. Don't tell me it wasn't done in maliciously. My mother is always meticulous of her appearance, right down to her pedicures. I live in a beautiful home. She is taken out daily, when she is in the mood. I know her PC physician very well, for all the years she has had him. Its the same with her other physicians. So this obviously came from someone who A: was either fooling around on the phone with nothing better to do, or perhaps a distant family member who has not been welcomed to our home and now that mom is loving here, is upset at the fact they will no longer be seeing her. When my dad was alive, family would come once in awhile to visit. When he passed, she was lucky of she got a phone call once in a blue moon. In other words, she was very much a second thought, Oh she got plenty of invitations to weddings, party's, you know , when money gifts were expected. It was sad,, She finally realized, on her own, she had been used for many years,, You are correct that this is an imperfect system. I am sorry you are part of it. I just hope you are absolutely sure when you call and make your accusation, that you indeed know of what you speak. Yes they came out and did their little investigating and yes, they left knowing that whoever made that call was very wrong. I will not move on and I am sorry of this isn't something you expect me or any other person whose been accused of such a terrible thing. You know ,my mother is very upset , thinking she has to look over her shoulder for the rest of her life. I suggest you soften your tone and attitude when speaking to people about being accused. Perhaps you should move on to another profession, its obvious you are a very non compassionate person. As for Mouse, case is not closed, what is wrong with you... I do not get involved in other peoples problems. I do not know people who abuse their children, or spouses. Perhaps we come from different backgrounds.. yes I care about horrible stories I read about, but that does not come close to what I am talking about. I was accused of a ridiculous happening, I am not going to laugh it off, shake it off or sweep it under the rug... I am owed a reason as to who and why this person felt the need to do what they did. The system is a joke. as are those working in it. If someone phone you and Bab's, telling you your husbands were cheating on you, don't tell me you would do nothing, even if he came home and told you it was ridiculous, you wouldn't let it go.. So don't tell me I should let this go... If you have legitimate proof of something bad, step up to the plate, don't hide behind a anonymous name, make the report. If you don't, you are a coward... Pass on anymore suggestions, for you don't know what you are talking about. Garden, is the only one who understands that the State is not always right, actually, their workers are usually freeloaders anyways... Have a good week.
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APS could care less about the elderly person. They're protecting themselves, hospitals, and NH, AL from lawsuits
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I'd like to share my limited experience with APS. When a relative was dying, 3 of my relatives and I contacted APS after observing what we considered improper care, medication and confinement of my elderly relative. Detailed, extensive photo documentation was provided, including one showing a cat littler box so full that the cats couldn't get into without stepping into accumulated piles of feces, which was subsequently being deposited by the cats directly onto the floor (the floor pile seemed to be about 6 - 8" long and a few inches high).

There were photos of other unhealthy situations as well.

Access to close relatives was restricted.

APS contacted the so-called caregiving outfit hired by the relative, and based its decision on the report of this outfit, allegedly a "faith-based" organization. It supported the "caregiver"-relative; APS based its decision on this report.

Although APS never admitted that it didn't even come to the house, that was the inference. What I was told was that this agency felt the relative caregiver was "doing a good job."

(The history of medicine abuse extended back for years and included OTC med abuse to the point that our older relative's colon was affected and needed to be partially removed.)

But the really insulting comment from APS was that this relative was only a few weeks away from death anyway, based on the caregiving agency's assessment. She actually lived another few months, in discomfort, being financially exploited, restricted from seeing the rest of her family including her brother, unable to move, and at the mercy of the mentally unstable daughter who was so unstable that she wouldn't even care for herself and hadn't for years.

As one of my relatives observed, if the vulnerable person was a baby, CPS would have been on site to investigate the situation instead of just relying on the report of a so-called faith organization which I later learned was not considered a qualified organization by other caregiving agencies which had had experience with it.

There's a lot more history, including abuse of another relative, as well as documented mental disturbances from employers.


There was also blatant financial abuse, but the physical concern was the justification for attempting to involve APS.
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Sara. Pleeeeeeeeeeeeeeeze don't take this any further, I beg you.

One of the reasons neglect and abuse carry on as badly as they do is that people are terrified of reporting what they think they have seen and being wrong about it.

And that is because people feel that it is shameful to be reported and inspected, and are deeply offended when it happens. As you have been.

But it isn't an insult! APS had a concern reported to them. They checked it out, quite correctly. There was no problem. Case closed.

Think of everything you read in the papers about what happens when people hesitate to report a slight little something they've noticed. Nothing much - a bruise, an expression on a child's face, an elderly neighbour who is suddenly more withdrawn than usual. Maybe you should tell someone - but what if you're wrong..? [horror!] So you mind your own business, and keep looking the other way, and then weeks or months later you read the headlines and wish you'd said something... but how were you to know...

I'd go one step further than Babalou, while agreeing with her that the report was very unlikely to have been malicious. The critical thing is that it was not defamatory, not an insult, not an accusation directed at you personally - it was just a question, which you answered to everybody's satisfaction. It has to be ok for people to *question* whether elders are all right. Otherwise the real abusers will go on abusing without anyone ever challenging them.

Don't be offended. They asked, you answered. Everything is fine.
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Sara, I'm going to play devil's advocate here. I'm a mandated reporter of child abuse. I HAVE to call an 800 number and voice concerns if thhere is any appearance of neglect or abuse. Most of the time there is no finding. But i still have to call. And by the way, someone showed up on MY doorstep once because a teacher had called my family in for possible abuse. I could have lost my license had that been upheld.

This is an imperfect system. I doubt someone did this maliciously. Vulnerable populations ( elders, children) need and deserve all the protection they can get. You are providing exemplary care, and you demonstrated that. Move on.
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Thank you Garden,
I just finished writing to the Atty General , here in Ct..
If he does nothing, next step is an attorney..
Someone has to be an Advocate on this matter, and I will.. :)
Have a great week...
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My mom's spine is deteriorating badly and her high pain level not only requires her to take some strong meds, but also kicks up her blood pressure. She is currently in a regular apt, and caring for her beloved cat, but she has about 7 people and various devices keeping her there (hsskp, laundry, RN, ME, etc.). She micro manages, which drives me CRAZY; thank God it doesn't seem to bother the others.... She says she will never go to Assisted Living or a nursing home, but I have visited a lovely "group home" with only 10 residents and 3 helpers on duty at all times. The owner is a medical professional, they do everything for them, and take them on outings and have entertainment come in. I'd live there myself if I could; not only that, the price is 1/2 what the local AL is.... look around; it appears you are at the end of what you can do for your mom, and this might be the answer. By the way, I worked in two group homes when I was younger; they were like a family, the residents often helped us and each other..... also, we had my mom with us for 3 years several years back - it was not good; too many family issues. After 6 months we were all tired of it and of each other - don't let that happen to you; she wouldn't speak to me for months after she finally moved out. Hope this gives you some ideas....
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Sarajames, good for you for planning to stand up to this false accusation! You have my best wishes for success.
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My mom was living on her own for 5 years now, since my dad passed. She is 88 years of age and we decided after her last hospital stay, and horrible 6 week stay at a local rehab center, she was going to live with my husband and myself. She has her own lovely room and private bathroom, on the first floor. We have hooked up an alarm in her room, so if she ever needs us she can just push the button and we are there. She has been with us almost a year now and yes there have been times when a trip to the ER was in need, due to digestive problems. Last weekend she told us she was having a female problem, so off we went to the local clinic. That was on a Friday. Sunday morning she wasn't doing much better and the doctor had called and said that her urine culture had to be repeated, So, off we went to the clinic, she took another urine test, they examined her and we left,, I may add she had been taking Bactrim since Friday. They phoned again on Tuesday and said her culture showed nothing and she should stop the Bactrim and follow up with her primary care. Now,, its Wednesday, we are sitting on the porch , waiting to leave for her dental appointment when this woman comes up the stairs, lets herself in and proceeds to tell me she is here to check on my mother, as she was just released from the hospital???? What???? She said someone had called in their 211 and without having to give a name or anything else, they put in a complaint that my mother was being neglected and that I said something, in this persons presence, that made them worry for her... I must say, I left the room after speaking with the doctor because of my mothers request, she said she would be embarrassed, while getting examined, so I didn't have a chance to say anything. Nowm this woman, was not going to tell me the usual "who , what, where nor why", of which I asked... I was furious.. She looked at my mom and said she could see the complaint was unwarranted and that she was reporting her findings to her supervisor , thus closing the case. I brought her into my house, showed her my mothers living quarters and asked if it looked like my mother was neglected... Again she apologized and said the case was closed... No Felicia , the case is not closed. I called the State of Connecticut and voiced my concern not once but twice and was told that anyone, can call that number and make a false claim. The state does not ask who is calling, they just take their word and send out the hounds. Oh, I got the "I understand and I don't blame you for being upset", but they still would not give me an inch.. So in other words, I should forget about what happened ,, Oh hell no,,, I think the State of Ct fails miserably in this aspect. I fully intend to write the Atty General in Hartford. If he does nothing to rectify the matter, then I will hire an attorney and I will take them to court. Defamation on a person is not to be taken lightly. Why should I sit and accept a false claim against me, while the person who made it, just walks away... I just want people to know that this can happen to them. Its unfair and I will not stand for this. Beware, you never know who could do the same to you. Wish me luck, as I said, something is going to change with how these complaints are made.
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Please update us on how this turns out!
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It's going to be tough, but you need to show them that there is someone in the home with her 24/7. Do you have any relatives, adult cousins? Can you take extended leave at work? Good for you, that you got FMLA! My work didn't qualify! Truth is, she can't be alone 40 hours a week. Can you advertise for a retired person, or a lady from your church, who could come sit in the house for a few hours, then another one for the other few hours, while you go shopping? Can you rent out a room to a graduate student, in exchange for the person staying home to study? Basically, if you think she doesn't need too much physical care, you just need to show them that she has someone here "in case of fire." Show them you have a medical alert on her wrist (whether or not she can use it.) Show them grab bars, shower chair, no throw rugs, and fresh batteries in smoke alarms. Show them her setup for TV and Water and snacks that keeps her happy. Also, check her urine for infection. That causes a lot of crazy and uncharacteristic behavior! Get a house-visiting doctor. Hire a bath aide -- even one who is currently in training (costs less!) can be good. Make it a routine. There are other threads here for how to coax a recalcitrant elder into taking a shower. Warm room. A choice between a shower and a sponge bath, but those are the only choices! Happy music. Favorite TV program as a reward. I think this will work out all right for you. Just tell them they are wrong. That she is getting great care and show them your organization, shelf of diapers, meds, routine and checklist pasted on the wall, logbook where you record daily changes. Show that you are on top of things. You can. Good Luck!
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I realize I am jaded, but it comes down to whether they can make more money off your mom by taking her as a ward, institutionalizing her, or leaving her with you and assigning case management and home health. They will look first at what insurance she has and what it covers. Everything bad that happened to my mother, including falls and infections, happened AT NURSING HOMES. I took her home and cared for her to the end. The truth is that at facilities, they often go hours without their diaper changed. And many other things are worse than at home. They'd like you to think they are so much "safer" and that is just not true. They don't have someone with her 24/7. They have one nurse and one aide at night for two whole hallways. Your parent will get a look-in twice a night, at most. I am disenchanted with the claims that medical professionals can care better for the loved one than those who love her. Of course you need help and respite or you go crazy. But you still should direct that help and make the decisions as you know your loved one would want things done. In my experienced opinion!
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Pamstegma, you know that I almost always agree with you, but sometimes you are so direct and blunt, you do cut to the quick! I think I prefer Judes approach on this one. This poor girl is juggling so many balls, there's going to be one dropped now and then, it's agonizing not knowing exactly what to do. Perhaps she will run into the right person or people w3APS, that are willing to find the resources she needs to either continue on with that help, or to guide her into getting her Mom into a Nursing facility where she can continue in a Cargiving role, just not so consuming. Try to be a little gentler please!
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Lynnsy,
I am sure you have nothing but the best intentions and love for your mom. Maybe right at this time mom would be OK with some time on her own, maybe she would not wander off, maybe she would not fall...BUT dementia is progressive and eventually something bad would happen, you have no way of knowing when or what. Much like toddlers, people with dementia require supervision. Their mental capacity does not allow them to be responsible for themselves. As a one woman show - with help from your daughter - you may have done as much as you can, these situations do evolve into more than a mere mortal can carry. So instead of fighting APS, maybe they can provide resources to help and get her to an appropriate home, where you can visit daily if your like and still be able to hold down your job.

Daily, in home care can add up very quickly. We did this for my dad for a short period of time and it can get very expensive.

Do not feel threatened, but try to consider the alternative of a home with an open mind.

God Bless,
L
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The trouble is that they very often DONT see a difference between caring and care giving. They don't actually give a toss as long as they can tick boxes (actually thats a little harsh they do care but don't always know how to in a supportive way.)

If of course you go on the offensive and demand help........ooooh well maybe . I did and was told the waiting list for a bathing assessment was 1 year A YEAR? REALLY?

So I diaried it as I do everything, then if I am ever accused of neglect I can say uh uh. I requested help a year ago and am still waiting. You KNEW I wanted respite, you KNEW I needed an assessment, you KNEW I needed a hunky man for the colder nights!!!! Just testing that you were reading this!!! SO far you have evidence if you diaried it that they said they would make a referral for home hygiene services 2 years ago yet it has only just happened? How is that supportive.

I think I might be tempted to challenge this softly. They won't back down but if you go in and say something like I wanted help I was told there was a referral made for help and I have struggled. I have really struggled with no support and no help for 6 years, now you tell me I am doing it all wrong.....why wasn't there help for me in the beginning when I needed it so that I could have had all this in place from the outset? I am trying to juggle work children and mum because SHE doesn't want to go into care and I don't know where to turn for help. All I seem to get is one accusation after another. I am asking for help support advice so please will someone help me. Copy it in to your councillor see if they can help or the mayor or the congressman - someone has to be responsible for HELPING...haven't they?
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Very good points, Jude. I've often wondered as well what training APS investigators have. Perhaps one of the requirements for working in APS should be that they had to care for an elderly parents for a few years.
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This is so much an issue and one that is only going to really ramp up once we start being that generation because there are going to be one hell of a lot of us baby boomers. The biggest problem is that many of the people who are charged with dealing with neglect don't understand the day to day issues that we encounter and as I have banged on about for ages WE ARE NOT TRAINED PROFESSIONALS so instead of trying to put huge barriers in our way why don't they take the logical approach and help? Oh silly me that would be a sensible thing to do and I can't see that happening any time soon wherever you live
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This thread is terrifying, as like Jessie wrote, we (my husband and I) are in entering the Double Blind phase of caregiving for his Dad, in our home. Whe my FIL moved in, whe he was 75, he was perfectly capable of preparing simple meals, driving wherever he wanted, the stores, bank, post office, his Dr appointments, and his best intentions were tha6we go on living like we always had done, going to work, our outings, vacations, and this all worked out well in that respect, for the first 5 or so years, but his decline in ambulation and his fear of being alone has ramped up considerably, and now we are prisoners in our own home. We are unable to leave him for more than a couple of hours, and only then if we pre-plan and prepare a meal, and his bathroom break ahead of time, as well as see to it he has ours and an alternate contact number at the ready. No longer can6we leave him overnight, so reading this and so many other threads on here is eye opening! To think that APS, could come into our home and decide to remove him after we have given up our lives caring for him is unfathomable! We do our very best, until our best is no longer good enough, but at what time do we call it quits? That is the question! I see it coming sooner every day, and then we are posed with the question of how do you tell them that you are no longer capable of caring for them, as they made us PROMISE! We would never put them in a home.
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Oy, I understand all of this so well. As caregivers we are expected to take care of our parents as well as we would our children. But there is a huge difference. We can make children do things -- hopefully kindly. We can't make our parents do anything they choose not to do. I think Igloo's advice about working with the state is good, lynn. If your mother is combative to the point that she is jeopardizing you legally, having some help would be good. I understand the position you're in. People can say that they need a bath, but what can you do? Drag her kicking and screaming to the shower? That would be called elder abuse. Or even keeping on after them to do things could be considered elder abuse. It can really be defeating after a while.

Your mother's dementia sounds pretty advanced if she is causing trouble at day care and refusing to bathe or change clothes. It does sound like she couldn't be left alone for long. I personally won't leave my mother alone for longer than a couple of hours, even though there's not been many problems to justify my hovering about. I know there is a potential, so I'm not absent for long -- too many what-ifs. Soon I know I won't be able to leave at all unless she is in a NH.

We do get caught in a double bind. We're expected to have them do things, but we can't make them do them. And the elder can get so verbally and physically abusive when we're getting them to do things that it can make our lives miserable. So what to do? I think it is a good point to look for outside help, rather than to go down with the ship. In this instance, don't let your mother's dementia end with you being in legal trouble. Be truthful about problems you are having with her and accept whatever help is offered. I don't think there are many people who can deal with an obstinate dementia patient alone.
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If any of moms $ is being commingled with yours OR if her $ is being used to support you & your daughter, you can expect APS to be very aggressive on the financial impropriety aspect as well. Having yourself investigated for financial can morph into quite serious issues for you......like if you need any clearance for work. If your daughter is young, and the home is inspected & found unsafe..& you are commingling funds...., it could morph into issues with your daughter as well.

I'd bet APS has already sent an inquiry to SS to ask if there is a representative payee on file for mom & who the RP is. If there is not RP paperwork done, SSA is going to require one to be done and if you are still being investigated by APS, it's not going to be you. It sets it up for mom to be a ward of the state with a state appointed guardian.

Unless you are a licensed health care provider, you yourself cannot determine that mom does not need 24/7 care. If you are pressing this as a fixed viewpoint with whomever you are speaking with in APS, they are going to be totally frustrated with you. They are going to do a ward of the state request.

The program mom was in for 5 years probably has a thick file showing moms change over time and her families (you) inability to take advice or requests or changes needed by the day program to be carried through. It sounds like the last year there has been quite a few distintive incidents with mom....the making another elder cry, her cursing staff, multiple foul & dirty clothes days....and family has just not dealt with it. Someone at the center is a mandated reporter and has shared their notes with APS. It just does not look good for your ability to provide the oversight needed for your mom.....

Your likely not going to like my suggestion, but honey, cut your losses, let mom become a ward of the state, work with APS to get this to happen, and you get back to work and focus on being a mom & enjoying having a daughter & being a daughter. Let the state appointed guardian deal with all the many issues of your moms care & needs.
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No, they will not back down, and they have documentation from day care that she came in stinking. No, she is not safe alone during the day. You are about to lose custody to APS. They will get a court order and take her to a safe place. Oh, and they take control of her money, too. Sorry for being blunt.
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