My Mother was hospitalized in 1951 for post partum depression. She was given electro-shock treatments for a period of time. She sustained a fall in 2017, admitted to rehab and while there, was diagnosed with “ cognitive impairment” by a physical therapist.
She was transferred to a newly opened “memory care” unit which provided nursing care only. Her family was able to bring her home with a 24/7 caregiver. After 3 months of having this caregiver, she gave us a 3 hr notice that she was leaving. The next day her family received a phone call from the county agency on aging saying that my Mother was “home alone and unable get her medicine” and that we needed to do something about it... We, her family, were in the process of finding other caregivers, however to keep her safe in the interim, we placed her in an assisted living facility. She is currently still there and very unhappy. As her daughter, I visit her regularly and spend many hours with her. Most of her adult life, She has suffered extreme anxiety that are manifested through physical symptoms. Since being placed in this facility, she has regressed, physically and mentally, and has begun to talk about what I feel are experiences that she may have had while hospitalized in 1951.
Where can I find a geriatric psychiatrist to further asses her cognitive status which will help her family to provide the BEST care for her? I cannot seem to find information on how electro-shock treatments affect the aging brain that would provide us with the necessary information needed to give her the care that this WW 2 Navy veteran needs.
Talk to the facility.
Talk to your mother's doctor (ideally in the same room at the same time).
Is your mother competent? If so, get a lawyer to her and get her to create a new Power of Attorney giving you the authority to act on her behalf, and relieving your brother of tasks it is no longer reasonable to ask of him. Healthcare proxy can be done at the same time.
Weigh up the decisions about her care plan really thoroughly. You are, rather, if you don't mind my saying so, making assumptions that her going home will result in her being happier; and it just ain't necessarily so.
So, yes, I would put the plan on hold; but I am not saying Never, and I don't disagree with you that home *could* be the best place. It's just you'd need a ton of evidence to justify taking that kind of risk - there is so much that could go wrong, or just not work very well, so that she ends up back in the facility in a worse position than she was to start with. You certainly need to be on top of all her medical history at the very least.
Take your time, take advice, and think it all through. Then the first thing you need to do is sort out the POA issue.
You are actively putting together a plan which includes recruiting a team of in-home caregivers so that you can discharge your mother from the ALF where she is currently in secure care and take her home?
And you think that because "all" your brother will have to do is sign the checks he will be cool with this?
Have you discussed this with her professional health care team at her facility? Or with any appropriately qualified person?
he is “out of gas”and has given me the job of working with Mom in whatever way I choose. Interestingly, she has told me that my brother wants her to come home!! She views me as the person who can get her home, despite my constant saying to her that her son has the
power. I told my brother this past weekend he has the power to make Mom’s last wish come true. I know that I cannot do more than I am doing, it breaks my heart to know that the woman who gave birth to me and my 2 brothers, who gave everything that she could to us, and that now, the most favored sibling, refuses to help me to help her. I know what he is going through, my husband was diagnosed with Stage 4 Hodgkin’s lymphoma in 2005; I had little support, then in 2009 I was diagnosed with kidney cancer.... and also had little support... we are both cancer free and very thankful for each day we have... so I get what my brother is going through.... I thank you all for your responses as it has given me a direction to talk with the facility. I will put the caregiver plan on hold for now?
You do not leave your caregiving job at three hours' notice because you have become a bit fed up with your client. There must have been quite a lot more to it, whether on the caregiver's or on your mother's part, or both.
Never mind. I just wondered if it might have given more information about your mother's preferences and behaviours, that's all.
Your brother is free to resign his POA. In the changed circumstances, with his wife's illness, that would be not only reasonable but actually the responsible choice.
Would your mother then grant you POA? Is she legally able to create a new one? If not, you might want to get legal advice on obtaining guardianship. You would actually be doing your brother a favour: he must be pretty overwhelmed and may be burned out. There is no "blaming" about this, it's purely a matter of making practical decisions.
Do not make choices on your mother's behalf that are going to impact on your brother and SIL in a way that they have not freely agreed to. That would be an outrageous thing to do. I agree that it is important to listen to people's wishes, and that it is especially important for them to feel listened to and understood, but that is not the same as being under orders to act on them.
Do I get the impression that the bulk of your mother's support previously fell on your SIL's shoulders? How long did that go on?
If you do not already have one, you need a complete medical history for your mother. If she has not been declared incompetent, your mother can authorise this. Discuss it with the ALF managers.
Did they identify a cause of it?
It would be such a shame if the cause of your mother's decline was something that could be treated, but she was too afraid even to find out - don't you think?
Maybe that's a point you could put to her, and hope she'll take it further.
So, you *are* in charge of your mother's healthcare. You do not wish to override your mother's autonomy more than is absolutely essential, which I respect and agree with; but unfortunately as your mother is not able to assess her own needs and make appropriate decisions, there have been gaps in the plan as a result.
What conversations have you already had with what staff at the ALF where she is living? Do you have formal power of attorney, a healthcare proxy or guardianship?
Your mother falls under the loose heading of "fiercely independent," would you agree? So what we have to aim to do is to build support around her that encroaches on her as little as possible.
When was your mother placed in the ALF where she is now? Who in the family has handled this placement? That person - with input from the family, but with just one taking the lead - needs to have a care planning conference with the ALF and discuss your mother's needs overall, including identifying what assessments of her physical, mental and emotional health need to be carried out.
If you won't mind my saying so, some of the history is a little puzzling. For example, a person would not be placed in a memory care unit on the basis that a physical therapist has diagnosed cognitive impairment. Moreover, a memory care unit is not a memory care unit if it provides only nursing care.
The possible physiological long term effects of EST given nearly seventy years ago are probably the last thing I'd worry about. It is quite possible that the trauma of the experiences she went through at that time is re-emerging, but you would deal with that as part of her overall memory care - if indeed she does have dementia.
Even in the gung-ho '50s, EST/ECT was not the first line of treatment usually. Do you know what other forms of treatment your mother has had over the years?
I applaud your concern for your mother, and I strongly support the principle that she is entitled to the very best of care. But first things first: who is in charge of her healthcare?
That I am doing everything. I have no training in the medical field, however have worked extensively in mental health and have assessed my “family” dynamics. I will be the ONLY advocate for my Mother; and I will do what I can to find her the best placement possible. There have been caregivers who have come forward who are willing to help with her care in her home... I currently have 6 people. I am working on a plan to present to my brother which all he has to do is sign the checks.... but we( brother and I) do not talk much anymore and he avoids any contact with me. I understand he is “tired” of dealing with a wife who needs him and his Mother. However, my Father worked very hard to provide care for her, only is NOT the isssue here. I am willing to do the homework, however, due to the family dynamics, I ask myself if I will be blamed for My SIL getting “worse” if Mom comes “home to die”,which is her last request. She told me that this past weekend. I have worked in hospice for four years as a music therapist and know that it’s important to listen to the patient.