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She has been to her family doctor twice in the last 4 months and completed a memory test. Score in Sept 2023 was 29/30, and score today was 23/30. She lives on her own in an apartment and has continued to work full time in a government job (don't know how), even with her growing memory and mobility issues (has needed a double-knee replacement for over 10 yrs, but doesn't advocate for herself with her doctor). She was just here to visit over the holidays (needed wheelchair support to fly) and I continue to notice a decline... eating less, no interest/energy, angry/grumpy to my 7 year old, lots of word-finding and memory issues. Since returning home over a week ago, she has been increasingly upset, struggling with basic activities like answering the phone or letting people into her apartment building, occasionally leaving her apartment and becoming disoriented, and hearing and seeing people that aren't really there. My extending family (aunts and uncles, I'm an only child) are doing all they can to help her with appointments, finances, groceries, etc. Last night a family member called me to tell me what was going on with my mom and basically wants me to fly home. I have 3 kids (14, 12, and 7), a full-time teaching job, and another side hustle to ease financial strain. I can't just fly home and sit with my mother while she waits 6-8 months for a geriatrics appt and babysit her (may sound harsh). She has not even had a CT scan (scheduled Feb 2) and has no formal medical diagnosis of dementia. Having her move here and live with us is also not an option. Our house is filled with stairs, and even if she was here, she would be home alone 5 days a week. I also could not tolerate the way she engages with my youngest, when she engages with him at all. A year and a half ago, my MIL (who also lives across the country) stayed with us after her partner died, and she has full-blown dementia. It traumatized my kids. Can't do that again. I have no problem going to my mother and putting a plan in place once she has a diagnosis. She has no will or POA, so I can't enforce or demand anything on her behalf. Feeling guilty, and not sure of next steps. Thanks for the place to vent.

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A score of 23 on a MoCA or SLUMS test indicates mild cognitive impairment (18-25=mild cognitive impairment). When my mother first scored an 18 in the hospital on the exam, she was accurately diagnosed with progressive dementia on the spot. CT scans do not generally show much of anything, and neurologists test for many hours and often come up with the same diagnoses as the MoCA and SLUMS tests but with 10x more anxiety involved.

Government jobs have a VERY hard time letting long time employees go. So unless they've spent a year already building a solid case against your mother, they aren't likely to let her go anytime soon.

I was an only child too living across the country from my elderly parents, both in their 80s. Dad had to stop driving after 3 minor fender benders, so I moved them out to Colo to be near me, in an independent living senior apt bldg. Then they segued into Assisted Living after dad broke his hip and mom developed dementia, and then mom went into Memory Care Assisted Living 3 years before she passed. I wanted them nearby so I could help them and advocate for them w/o actually moving them into my home. I was POA both medical and financial for them, and managed their lives along with my own life, full time job and new marriage. Who else was going to do it if not me??

Decide what you want to do for your mom and go from there.
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Reply to lealonnie1
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Your Mom needs a neurologist not a PCP. The Neurologist will do a more thorough test and order labs. There can be other things that are causing her problems. Low Potassium, Thyroid, dehydration, B12 deficiency. I am surprised her employer has not seen signs and has let her go.

Dementia is very unpredictable. One reason my Mom was placed. I like order and there is no order in Dementia. And I see where this would upset children. But your 14 and 12 year old can be taught, this is not your grandmom and explain to them what is happening. The 7 yr old, you can explain on their level of understanding. This will make for more empathetic people and know its not something to be afraid of. Not saying she should live with you, caring for 3 children and holding down 2 jobs is enough. But you will have to go to where Mom is to figure out what she needs. Maybe you can get family to help but they probably will not take Moms care on.
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Reply to JoAnn29
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I caution you NOT TO BECOME POA.
You are not in a position to do the duties that you would need to do for an elder who has become incompetent.
You are not allowed to do those duties when the elder IS NOT INCOMPETENT.
You live miles away and have three children and two jobs.

POA WOULD BE THE BIGGEST MISTAKE OF YOUR LIFE.

Now, you DO have other family there and they are keeping you informed, but as they are asking you to fly there, it is pretty clear THEY also don't want to do this task of getting an unwilling elder into testing, out of a job, and safely placed.
It is time for honesty with your Mother that you are getting these reports. That she needs to get fully tested and to enter an ALF for her own safety.
If she says "no", then guess what. The answer is no. And when this all gets too much she will be alone. And you will have to call APS to check on her and to try to get her into care.

I don't see what else can be done.
Now you CAN attempt a weekend trip home to tell her this.
But again, my caution to you is not to get POA.
Others will tell you the opposite.
I was POA and Trustee of Trust for my brother who lived clear across out long long state. It is very difficult and that is for a knowing and fairly with it and very cooperative and organized person. It is a task and a full time job in and of itself, impossible to do from far away, and you won't be moving and the last thing you need for your life is her moving near you.

I wish you the best of luck. Make that weekend trip and have the honest conversation with her and the rest of the family. Then go home. If she refuses the disaster will come quick enough and all will be on the phone to you again. If mother won't take care of herself and becomes incompetent then allow state guardianship to appoint a fiduciary to care for her.
You have THREE CHILDREN AND TWO JOBS.
DO NOT ATTEMPT this.
Sorry to sound so cruel. But this would be an impossible situation in my humble opinion.
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Reply to AlvaDeer
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A hard situation, made harder by the distance.

Hmm.. Maybe consider how to build a network as best you can from where you are?

Collect neighbours & closer relatives phone numbers. Get Mom's Doctor's number. See if she has you (or someone) listed for an emergency contact.

Get more *eyes* on Mom.

More eyes can be home help services eg cleaning person, meals on wheels, falls alarm service.

If Mom has any medical complaints, even not sleeping so well, suggest she see her Doctor. Keep suggesting she make contact for each new issue. Another set of *eyes*.

I remember a poster who's Mother just 'didn't feel right'. Was getting very anxious (this was new). The lady was so frequently in the waiting room it nudged along the processs of getting more thorough investigations happening.

As well as network building, I guess bigger, values type questions can be discussed.

Mom, if you got very unwell, who do you want to speak up for you? Who would you want to arrange to pay your bills? (This sets the stage for POA).

If you had to move, would you stay in your town/city? Or nearer me? (This may help guide your AL/MC location choice).

See what others suggest or have done here, as many are in the same boat.
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Reply to Beatty
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What is your concept of "support"? You won't be able to do much long distance. You won't be able to do much if you're not her PoA or legal guardian. You aren't obligated to be involved in her care at all, but you can choose to help her to figure things out.

I think you will need to go visit her for at minimum of 1 week. This will allow pre-scheduled appointment with an elder law attorney so she can assign a PoA. Then if she does that, take her to a pre-scheduled appointment with her primary doctor so that you are in the room while she's tested and can hear (and remember) what her doctor tells her. Often dementia is diagnosed by discounting any other medical problem, like a stroke, tumor, dehydration, vitamin deficiency, thyroid problem, over- or under-dosing on medications, diabetes, etc.

You will need time to have a family meeting with those who are local to her and are currently orbiting around her providing care. They also are not obligated to do it. If your Mom does indeed have dementia then she will need a caregiver and a PoA to manager her affairs. How will she pay for the care? Residential group homes for elders may be less expensive than other options. Hired care can be affordable at first but as her needs increase, so does the cost.

She can contact social services for her county to see if she qualifies for any in-home help.

First, she needs to get her legal ducks in a row while she still can.

Next, she needs an accurate diagnosis.

Then, and only then, can a plan to help her be formulated.
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Reply to Geaton777
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