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We have been dealing with "Mom" issues for many years. She is 94 years old and until recently, lived in her own home with sporadic aides. She has mobility issues, incontinence, severely hard of hearing (refuses to wear her hearing aides), is addicted to opiates and ambien (thanks to her primary doctor) and more. She does not want to pay for services but her assets are too great for her to be eligible for social services. I live out of state but until December 1, I had spent two years near her. I actually took a job near her to do this but left my house, children, spouse etc. to do so.

On December 3, Mom fell. Ended up in the hospital. Then a rehab facility. Then to a beautiful assisted living which she agreed to as the plan after rehab. She lasted less than one day and then wanted "out"!. Unfortunately she tested positive for covid and was transferred to a skilled nursing facility. She did not have to leave the AL but refused to isolate so they transferred her to a covid unit where she could get out of her room.

I have been called repeatedly to take her out of the SNF unit. She has demanded that I care for her in her home and threatens to take a taxi home. I am in her home now. I left my home so I could be here to support her transition to AL. Not enough for her. My siblings, who live closer, are separating themselves from her. This is truly an untenable situation. I do not feel capable, in my 60's. to provide the extensive care she needs.

My mother is coherent and appears to have good mental health. She is, however, a hoarder and an addict. She has had a fire in her home and fires aides at a drop of a hat. (one because she was fat and would eat too much).

What to do?!? Does anyone know of a legal reason I can keep her in assisted living? She is a hairsbreadth away from requiring nursing home care. I would prefer AL if possible. Please, I need advice.

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We had a poster here for a long time who had a 96 y/o mother who was also 'coherent and in good mental health'. I put those words in quotes because hoarders who live in, and surround themselves with garbage & filth, are NOT in 'good mental health' at all but suffering from anxiety & OCD issues. Anyway, this gal did everything she could possibly do for mother, who was stubborn as an ox and refused 'interference' from her daughter and to move out of her hoard. She'd call 911 all the time, though, and the EMTs would have a fit and blame the daughter b/c they didn't have a clear path to reach the mother! As if it were the daughter's fault, who tried in vain TO remove all that rubbish from her mother's home, only to be met with anger & thrown out the front door. So she called APS to let them know mother was living in a dangerous and unsanitary home. APS came & checked on mother, found her to be 'of sound mind' and as such, entitled to live however she wanted to live, w/o interference from her daughter or forced into AL or a nursing home, much to the daughter's chagrin.

The daughter, like you, had no other choice but to leave her mother be to live her own life on her own terms. She had to wait for a crisis to hit before she could have mother placed in a SNF at the demand of the hospital doctor. That never happened though; mother wound up taking a fall and was found on the floor by the daughter who called 911. The mother was rushed to the hospital and placed on hospice care; she'd had a stroke, if I remember correctly, and passed away a couple of weeks later.

The mother lived life on HER terms, but at her daughter's expense. Yours is doing basically the same thing.

You will likely have to wait for a crisis to happen before your mother can be placed, against her wishes, in a Skilled Nursing Facility permanently. Too bad she won't accept AL now, which we all know is preferable to Skilled Nursing, but this is what often happens to stubborn elders who refuse to be reasonable. Sad but true.

Don't wind up like the daughter in the first part of the story; she felt so guilty about her mom passing away that she left our forum permanently. She was in no way responsible for what happened to her mother, but she felt that it was her fault. An elder's stubborn behavior is NOT something we daughters have any way of controlling, so we should never take the outcome of that behavior as a burden onto our own shoulders to bear.

Wishing you the best of luck with this situation, no matter how it turns out.
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sameoldstory Jan 2022
Thank you for your reply. For a long time, my caring was a combination of "mom needs care" and "you don't want to have regrets when she is gone". I know I have done my part.

Surprisingly, Mom lives in a lovely upper middle class neighborhood. The police and fire chief have been in her home. They have never acted. Very disheartening.
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sameoldstory -

DO NOT not move in with your mother and become her caregiver. She will eat you alive and spit you out by lunch time. Your siblings decided to stay clear of her, and for very good reasons.

Call the SNF where she is currently, tell them clearly that there is no one to care for her at her home. None. You are not available. No one is available. They can't discharge her if it's unsafe to do so.

If somehow, your mother manages to call a taxi and get herself home, call APS and report vulnerable elder and let them take it from there.
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sameoldstory Jan 2022
Thank you for your response. I am going to take some of the comments here and use them to compose a rational letter to the SNF outlining this information. I will make it clear that it will now be their responsibility to discharge her safely because there will be no one in the home to care for her. I also will ask for monitoring because she will get home and fire the 24/7 aide after 24 hours. Wish me luck!
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Move back to your home and family. A hoarder and addict does not have good mental health. She’s dealing with too many issues to be handled living alone, and you living there isn’t a fix either. Talk to the social worker or director of nursing where she is now, inform them that mom doesn’t have any help at home and isn’t safe to return there. If she’s still released you will join many on this forum in “waiting for an event” that makes her decisions for her. You can’t prevent these events and that’s okay. It may take this to get her the right level of care. Your siblings have done a wise thing in stepping away, please see that as a sign that you need to the same
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How is it possible to describe someone who is an addict and a hoarder as someone with "good mental health"?

In my book, I will go to the nth degree to support an elder in my family who has insight into their limitations and who cooperates with care plans.

If they start thinking that they can direct me to do their bidding at the cost of my own self-preservation and health, that's when I step away and let the state take over their care.
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sameoldstory Jan 2022
I agree but the doctor will not sign off on it. I have asked. She is threatening to go against medical advice and I have been told she can do that after the period of covid isolation. Since she is lucid she has the right to make her own decisions - even if they are poor decisions. Crazy, huh?

I did point out that a cohesive conversation is not an indication of stable mental health and reminded the doctor and facility of her history.

I know I should step away. So hard to do though...
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I think that your siblings made the right decision. I would follow their path. If I were to be contacted by the rehabs,hospitals, and etc I would tell them that my Mother is a hoarder who is also an addict; that she doesn't wish to be placed and that she is rational. If they feel that she is a danger to herself I would tell them they are willing to contact those in charge and have the state take guardianship of this woman.
I can tell you right now that even WITHOUT doing any caregiving, being responsible legally for someone is a tremendous amount of work. In the case of someone uncooperative it is impossible.
Your moving in with your Mother or having her move in with you will only delay and complicate current problems exponentially.
You will, of course, have to make this decision for yourself. I wish you the very best in coming to your own conclusion. Just because you are the last man standing doesn't mean you are obligated to go down with this ship.
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sameoldstory Jan 2022
Thank you for your response. My siblings have turned away from her before only to be lured back in when a crisis occurs - this last fall was an example. I am having them read these posts to embolden their resolve as well.
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You say that she is “coherent”, but you also indicate by her actions that her judgement is impaired.

Arrange for cognitive/neuropsychiatric/social competence testing, done by someone with appropriate credentials and geriatric experience.

It may be both helpful and necessary for you to stop answering her phone calls.

If you are sure that you are not legally responsible for her, refuse to take her out of the SN unit on the grounds that you are not capable of caring for her.

In your situation, I’d also confer ASAP with a lawyer with an established practice in the field of family/geriatric care.

If she is able to leave she may wind up placing herself in a situation in which she will be vulnerable to injury, but there is no fair reason for you to feel obliged to be responsible for her.

Has she granted anyone her POA? If she NEEDS SN care, it is in HER best interest as well as yours, to place her there.

Your situation is difficult, but it’s by no means unique. Take good care of yourself. You’re important too!
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sameoldstory Jan 2022
My sister is the POA. The AL does not feel comfortable keeping mom there because my mother told them she will report them to the state for abuse and being held against her will. We will be consulting an attorney tomorrow.

Thank you so much for the suggestion for competency testing. We will investigate that as well.
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At 94 it's hard to know if she's stubborn or if it's the opiates talking. If you are not her PoA or legal guardian, and she has no medical diagnosis of dementia and won't cooperate with getting one, AND she's a hoarder... please get out of the way and let the county APS get called in to eventually acquire guardianship of her. Then they will get her what she needs, not wants. I understand it won't be pleasant to "stand by" and watch the train wreck but at least you won't be on the train with her.

Your siblings are wise (and probably not co-dependent or enabling) to put up a healthy boundary. Your immediate family has priority over your mother. I'm sorry...unless you want to lose them as well as your own sanity. Leave and call APS to get her on their radar. When she calls you tell her you can't do what she is asking. No. Nope. Negatory. Don't take any verbal manipulation or abuse from her. Hang up. I wish you much clarity, wisdom and peace in your heart.
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sameoldstory Jan 2022
Thanks, Geaton77. I have stopped taking her calls. Now I get calls from friends and extended family. She is reaching out to everyone to complain about how she is being abused. I have called APS but will do so again. I am compiling data on the number of times she has fallen, called the police inappropriately ( " I dropped my tv remote and can't pick it up"), etc. I need to have all the data ready and easily validated.
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".. combination of "mom needs care" and "you don't want to have regrets.."

I've just snipped out that part as that looks to be as the super-glue keeping you stuck here.

It may be F.O.G wafting over you? (Fear, obligation, guilt)

I wonder if between the "Mom needs care" part & the "no regrets" there is an invisible sentence..? Something like *I need to provide her care*.

That's where I was. I was acting on this invisible instruction. When I caught a glimpse of it, I looked hard to understand it. In my case if was a childhood of having younger siblings to be responsible for, to look out for their safety. Not only would this gain positive attention from one parent, extended family & society, I also tried to shield them from the mental health issues of the other parent. I had to re-assess & step out of the FOG. Let some real life consequences fall.

Sameoldstory, in your case some real world consequences DID fall on your Mother: she was moved from AL for not isolating into a secured setting. This makes good common sense for the protection of others.

Now your Mom is no longer independent enough to live alone. That has been established. AL would be a good fit... IF she wants to be there & IF she will/can abide the rules.

So advise Mother of her options. Let her decide. The real world consequences will fall.

"Live alone, with home help.
If you fire home help, you will be removed from your home at the first accident, fall, other crises".

As a Doctor once read the riot act to his patient on his rounds in front of me "Sir! Choose your nursing home! I've told you many many times. Choose or others will choose for you! You cannot look after yourself anymore. You are old, sick & need to move. So move yourself or others will!"

The decisions to accept aging, downsize & move are easy & make sense to some.

For others, due to cognitive decline, dementia, stroke damage, mental illness, substance abuse or personality - they cannot.

Chips will fall.
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Sameold, so, if mom tells the AL that "she will report them for abuse and for keeping her against her will" they are not hoing to touch her with a 10 foot pole.

Tell the NH that you are going back to your home. Give them POA sister's phone number and let them figure it out.

Your mom sounds like her own worst enemy.

It's sad when people can't see where their own best interests lie, but that doesn't make you responsible to give up your family to cater to her notion that she's independent.
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"I know I should step away. So hard to do though..."

Are you on good terms with your siblings? If so, talk to them, get their side of the story and why/how they were able to step away. Get support from them so you can step away for your own sake.
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