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93 y/o anarchistic MIL has dementia that has progressed. The police were called to her condo complex because a passing motorist attempted to engage in conversation with her and her speech was incoherent. About a week later a neighbor called the police who called EMS who had her transported to ER for an evaluation. She was combative, paranoid, and when asked to put on a gown felt she was being sexually assaulted. She called my husband as this was going on and you could hear how confused she was. She was discharged about 24 hours later. Office of Aging has seen her decline and contacted APS. Neighbors, responding police and hospital staff also contacted APS. She has an active case. When my husband contacts them, they say she has a caseworker who will see her 1x month. Somehow her insurance company contacted my husband and offered a visiting nurse. My MIL doesn't believe in modern medicine and avoids doctors at all costs. She was cooperative w the nurse despite making threats to my husband that she wouldn't be home. The nurse told my husband privately that MIL needs to go into a home. MIL is more and more demanding with my husband, torments him with phone calls, will walk to a neighbor's place (same age but coherent) and make her call my husband. It's always an emergency but realistically it never is. Another neighbor found her sleeping in their common stairway late at night. A different neighbor has found her cowering down in laundry area, terrified of thunder and lightning (always was). She is very confused at times but sometimes somewhat coherent. She once was screaming out of her window to passersby that she was locked in her apartment and needed help. She was not locked in. She somehow couldn't turn the knob. She misplaced things like money and keys and my husband has had to change locks several times. We both work full time. He works where it is chronically short staffed and often has mandated extra shifts. My profession involves a lengthy commute so her living with us is not an option. She alienated my son who wants nothing to do with her. She alienated my 2 daughters who were always kind to her but they are from a previous marriage and she has always been mean to them. I didn't have this experience with my own Mom so idk what to do here or what to suggest to my husband. I don't really care for her as she enjoys hurting my feelings with criticisms about my weight. Any suggestions are appreciated. Thank you.

Where is your MIL now? In your home, or back in her condo? Your husband should have left her in the safety of the facility while he researched and arranged for a safe placement for her in a secure memory care (dementia) facility. He needs to do that now, for her safety. What does he want APS and the Office on Aging to do? He can either turn her care over, in which case he cedes control, or he can get guardianship, which puts the responsibility of finding a placement for her on him. Once he has guardianship he can access her finances to use for payment. Medications are necessary to calm her and help her focus.

I'm sorry that you are experiencing the stress of his apparent reluctance to accept reality. Please keep your own safety in mind also.
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lavidaloca31 Dec 20, 2024
APS assessed her and she was taken to the ER and will be placed again.
Thank you for your response.
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Lavid,
Thank you for your update below.
Your husband is looking for perfection somewhere in this, and he won't not find it.

He's overwhelmed, and you're the last one to be able to help him now.
He's furious even with APS and at some point, if they feel he cannot care for MIL (and I doubt he can) they may intervene. To be honest that may be for the best, and it may not.

At this point you don't have a MIL problem but a serious marriage problem. I'd begin to consider for yourself whether you have an option to separate should you need/wish to do so.
At this point your husband is seeing enemies where there are none, and is feeling angry/victimized. This is a volatile situation.
He needs help and has refused it because it isn't perfect.
He needs counseling and I doubt he will get it.
He has taken on care that is impossible with his qualifications and his being one person--to do.

Almost worrying for your own private safety in this situation.
It is certainly one that you cannot get help from a Forum of strangers with.
I hold some hope that you may be able to speak with APS privately and honestly.
I'd contact them and tell them you feel it may be crucial to safety to speak privately with them in a secure manner due to your husband's current state of mind. Then be honest to the best of your ability.
I'm so sorry. This situation is unimaginable.
As to care plan in this chaos? No. No care plan will matter whatsoever.
This isn't doable in the home. I think you already know that.
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lavidaloca31 Dec 20, 2024
APS assessed her and she's in the ER. I think my husband had to hear it from several people that he should not have taken her out of the facility. He did look into another one that he liked and had great reviews online. This is a learning experience for us both. He actually broke down and cried today. He needed to do that.
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Here's an update. After Thanksgiving my husband found his Mom butt naked on the kitchen floor, incoherent. EMS was called and she was admitted to the hosp. The hosp found a rehab for her. Once she was assessed at the rehab, they diagnosed her with Dissociative Identity Disorder and said that her dementia requires 24/7 care. Things have gotten quite complicated. My husband was very upset with the conditions ("it's a prison"). Shoes and clothes went missing. She was wearing other people's clothes. No one seemed to know where her belongings were. It was after 1pm and she was not given lunch. He became so frustrated that he took her out against medical advice. At one point (prior to her leaving) the insurance company called to say she would be discharged on a certain date but since my husband took her out earlier, there were no home care plans. He has been quite vocal w APS, our county Office of the Aging, and other agencies. I am hoping that it is all resolved and she gets the help she needs. It's been stressful on my marriage though.
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If your husband has no POA and does not want one then let the State take over her care. Seems APS is involved. Just tell them that it seems she is unsafe at home and you cannot take her in because you have jobs. If they suggest you taking her in and they will help you find in home care do not believe them. Tell them you are not personally paying for her care and your not sure if she can afford it. Because of your relationship with her, you cannot have her in your home. She is a verbally abusive and you are not putting up with it. The State can become her guardian.
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lavidaloca31 Nov 9, 2024
Thanks JoAnn. She has not and Will not sign POA. She's paranoid that my husband will do things with her money. This was even before dementia.
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Your husband should turn off his phone. She most certainly belongs in a facility, the sooner the better. Do not discuss this with her because based on past episodes, she's likely to freak out and delay the process. No family member should be expected to take her in or care for her because it's beyond what family caregivers can handle. She needs professionals, she needs meds, and she needs to be safe in a lockdown facility.

I'm so sorry this is happening to all of you, and I hope you find the care she needs ASAP.
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lavidaloca31 Nov 9, 2024
Thanks Fawnby. The visiting nurse told my husband not to mention facility to her. MIL has called my husband several times today, mostly incoherent. He just went over to see what is going on with her.
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Even if she lived next door, living with you is not ever an option! She’s cruel and mentally ill. Call 911 next time she’s off the rails and tell the social worker or whoever that she is an unsafe discharge. They will push you to take her back home or have her live with you. DO NOT BUDGE. Repeat “unsafe discharge” until you’re blue in the face.
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Next time she lands in the ER for a UTI check, you start repeating “insafe doscharge” and they will have to figure something out.
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Tell me about the neuro-psyc evaluations for dementia that have been done.
Tell me if there is a POA or guardianship in place here.
It is clear that MIL has dementia, or has had a stroke that has debilitated her.
I am wondering what medical evaluations here are done, and if APS is not at all interested in that question themselves.

If no family wishes to take on any guardianship here then there needs to be followup with APS who need feet held to the fire reqarding leaving a woman of this age alone, helpless and clearly completely debilitated.

To be honest, if things are as bad as you say I would call to EMS for medical transport to a hospital, and if they dared to try a discharge I would tell them that they will lose their license to operate once you discuss the "unsafe discharge" of a clearly demented elder. Call JCAHO (they will be listed online) to report hospital if they attempt this. Contact Social Workers in hospital. You need emergency guardianship if you are not next of kind, and she needs placement through discharge planning.
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lavidaloca31 Nov 9, 2024
The hospital paperwork is sort of a joke. Yes, UTI. Given meds while there. Nothing for follow up. The brain scans indicate history of stroke but who knows when. I am amazed with her behaviors that they let her go home. No POA. She's been funny about that even prior to dementia. It's weird because we know she has the dementia but she appears to have moments of clarity, though few and far between.
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If your husband isn't her PoA and doesn't wish to be her legal guardian, then you both will just need to let APS do its work over time. He will need to block her so she can't call him and stress him out. Eventually the county will have a judge assign her a court-appointed legal guardian and they will place her in a facility. Once a guardian takes over her family won't have any ability to access her condo, or accounts. The guardian will make all decisions and manage all her affairs.

If she does have a PoA then this person will need to read the document to see what activates the authority. Then they will have power to get her placed (but she won't go without a physical fight, apparently). The PoA can call 911 and say she is delusional and combative and might have an untreated UTI. Once in the ER the PoA tells them she is an "unsafe discharge" (or needs a "social admit" if no UTI is found). WHat might happen next is they move her to the psych wing to get her to comply with meds that might help her agitation. If/once this happens the PoA may have more options to set up in-home care aids or transition her into a facility (if she can afford it). She will need oversight to make sure she takes any meds prescribed.

I'm sorry this is such a messy and stressful sitution. It will be bad for a while and then eventually a solution will be put in place and things will improve. May you and your husband receive peace in your heart on this journey.
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