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My 85 yr old mom lives alone in a small apartment. Over the past several years she does nothing but sit on the sofa watching TV. She refuses to make friends or socialize. I have noticed in the past years her hygiene is not good- not bathing, hair unwashed. She gets weaker by the day because she does not walk much or do anything at all, so it’s even hard for her to use her walker. She is extremely manipulative and stubborn. She fell the other night (we have a Life Alert system for her to wear around her neck, but she won’t wear it) and was on the floor until her grandson found her the next day. She had been there for over 12 hours. She crawled to the door and opened it for him, but did not try to reach the Life Alert because she said she just wanted to lay there and die. She has refused to let us come over for weeks and has cancelled dates with me, my brother and her 3 grandsons for various reasons. When she was found, she had 4 bags of garbage on the kitchen floor crawling with maggots and flies everywhere. She told my som not to tell anyone. I will spare you all the disgusting details, but the apartment was so filthy that the health department or social services would have condemned it as unhealthy and toxic.
She is currently in the hospital for evaluation and seems fine. When she said “you have no idea what I’ve been through”, I confronted her with the condition of her apartment and asked her how she could live like that??? She was always a clean person and kept a tidy house. We have tried for two years to get her to agree to a weekly cleaning service and she refuses, saying her place never gets very dirty. Every dish, every utensil was covered in dried food and piled all over the kitchen. She said that it was a little messy and it wasn’t a big deal.
She has lies to all of the doctors and nurse and because of Covid no one can go into the hospital to speak with her doctors. I have tried calling but each time I get a different nurse and never a doctor.
I don’t think that she can continue to live on her own. For the sake of my sanity and my marriage she cannot live with us.
She has no money and we cannot afford to pay for her care. She is 85 but in the shape of someone 100 and has the mental capacity and judgment of a toddler. She does not seem to have dementia and I do have a medical power of attorney and I am the agent.
She will hate me if I decide she needs to live in an assisted care environment, but she won’t do anything I say or suggest and expects everyone around her to deal with her bad choices. I am 65 and cannot physically or mentally deal with her manipulative ways (lying) and lack of thought to her actions or inactions any longer.
She has not made good life choices her entire life and I refuse to let her drag me down with her.
I honestly don’t know what to do. I am usually a take charge problem-solving, proactive person but I am just at my wits’ end this time.

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How far does she live from you or from a family member that would be willing to help? Maybe someone she trusts can go over and "visit" and just happens to start cleaning and make it a weekly or bi-monthly thing? My mom also isn't the Life Alert type of person, so I set up indoor cameras (without her knowing) to keep an eye on her and to monitor her daily habits (incase there's something alarming that she won't tell me about) and it's been wonderful! It's given me peace of mind, knowing that if something does happen, I can call for help and without her knowing, it still gives her a sense of independence.

I know it's easier said than done, but just breathe and take it day by day. You're doing an amazing job by caring and reaching out for help.
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I am not understanding these two thoughts: "she has the mental capacity and judgment of a toddler. She does not seem to have dementia..."

She has dementia.

She is in a hospital. You call the discharge planning unit and tell them about the condition of her apartment. You ask them to have her seen by psychiatry and assessed for her ability to live alone.

You make sure to tell them that family will not be providing more than casual support (she may be telling them that someone lives with her or that one of you comes every day).

You tell them that allowing her to go home would be an "unsafe discharge". Use those words.

You do NOT agree to discharge and you sign NO papers.. if they send her home in a cab, call Adult Protective Services.

People who are competent are allowed to make their own bad choices. That does not obligate us to crawl into a hole with them.
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Riverdale Aug 2021
Perfect concise helpful answer as usual for you.
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Follow Barb’s advice, which tells you exactly what to do. The ‘system’ then takes over. You aren’t the one who has to organise where she is placed, or is to blame for it. The ‘system’ should then take over her Medicaid application. Don’t do any more cleaning up in her apartment – the ‘system’ also needs to see what’s been going on. The more you try to 'take charge', the more you are at risk yourself of getting stuck in an impossible situation. So is your mother!

If you can go down this track, you won’t be ‘at your wit’s end’. Stop worrying, and good luck!
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These are going to be very important phrases for you...
"She can not be discharged to her home". "It is unsafe for her to return home." "She has no one at home that can care for her" "I can not care for her in my home"
Ask to talk with the Social Worker today and discuss with them what the options are. Good possibility is that she will be sent to Rehab for a time and determination will be made by PY, OT and her doctor if she can be discharged to her home.
IF she is discharged to her home expect a repeat of the above.
If they do not find that she can be discharged to home you will begin the process of
Seeing an Elder Care Attorney (are you POA? if not if she is diagnosed with dementia you will have to obtain Guardianship. Or refuse and let another member of the family or the Court will appoint a Guardian)
Application for Medicaid.
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So many of your comments reflect those experiences we had with my mother.

Filthy condo.
Unwashed.
”Lying”.

It was all dementia.

She “seemed” fine, but her living conditions and personal care told us otherwise.

The “lies”, in my mother’s case, were just words. Sometimes they were to cover herself with an “answer”. But, the answers weren’t logical.

Her life was no longer safe.

It was dementia.

Take Barb’s and Grandma’s advice.

Step by step.

It can feel overwhelming, but you can help your mother to be safe, as well as keeping your own sanity.

Keep coming back here. You’ll see your story, in one way or another, repeated.

Best wishes.
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She absolutely has dementia. Do what BarbBrooklyn suggests. Unless you pursue guardianship through the courts for the purpose of making decisions for her and managing her affairs, the county will attain guardianship and do that for her. She will go into a care community where she will receive housing, healthcare, meals and the option for social interactions.

One of the most challenging things now will be to look at her with different eyes. She is not intentionally manipulating you, she has dementia. She's not stubborn just to annoy you, she has dementia. Her brain is broken and can't be repaired. To treat her otherwise would be like insisting someone with an amputated leg should be able to walk as if they have 2. The leg is gone and isn't coming back any time soon. In fact, the other leg is slowly disappearing.

I learned a lot about dementia behaviors and how to interact with LOs from watching Teepa Snow videos on YouTube. They were very helpful. Wishing you much clarity, wisdom and peace in your heart as you work through this in your mom's behalf.
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My daughter has worked rehab/NHs for 20 yrs as an RN. In our area she says Hospitals are not under the "safe discharge" law. But Rehabs are. So if Rehab is suggested, send her. While there you ask for an evaluation. Ask that before she is evaluated the doctor call you. Or write up what has been going on and attach pictures. Email or hand deliver and ask that the doctor who evaluates sees the letter first.

You do not want to get the State involved if you don't have to. A guardian will be appointed and that person will make the decisions for Mom. You have POA make sure the hospital and the rehab have a copy for their files. If she gets evaluated and its found there is Dementia and she needs 24/7 care, then you decide to place her in MC, with her paying privately or LTC with Medicaid paying. Do not allow the facility to be in total control of the Medicaid application. They can help but you should understand the process and be on top of things.

A while back a poster was getting bills from the same NH that was suppose to be doing the Medicaid application that was started something like 6 months before. I explained that in my State you have 90 days from applying to spend down assets, get the caseworker info required and have a place set up. If these things are not done in that 90days, you start all over. The NH failed to follow thru with the application.
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This IS DEMENTIA.

PLEASE copy all previous steps described here, for HER SAKE and FOR YOURS, FOLLOW THEM.

Her problems, and your difficulty dealing with them, ARE NOT UNIQUE. Many of us have found solutions to problems like yours. The solutions are not often too happy, but you can design a safe life for her and she can be taken care of.

Her brain is broken, and she needs ongoing safety and protection.

Do NOT attempt to discuss this or to reason with her. She can no longer benefit in anyway from explaining.

It is OK if she hates you when she is placed in a safe residential environment. Nothing she “expects” is meaningful, because her brain cannot “expect”, and that cannot be fixed.

Move forward based on the advice you have received here, because those who have offered the advice have LIVED THIS.
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It sounds like she doesn’t trust you & doesn’t want to leave her home. Before you pull the rug, have you tried hiring a health aide to check on her & help her out a little every day? Also maybe a cleaning service? You do have to be careful to screen people (background checks through care.com or hire through an agency that has already screened their employees). You might also put a camera in the house where she sits the most so you can check on her & even talk to her through it. If she is mentally fit as you suggested then it just seems like things are harder to do as one ages which is normal for us all. Also flies have been bad so maggots would start quickly. I would empathize with her situation more than critically make drastic decisions. See if someone can just help her out. We all slow down & wear down. She might end up enjoying the visits from a house cleaner & an aide :)
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Taylorb1 Aug 2021
If you had read the story they don’t have the funds to hire anyone it’s not as simple if you can’t afford to
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"I honestly don’t know what to do"... yes, you do. Mother needs a facility. You're just having a hard time admitting it to yourself and then taking the action. And it's okay to have that internal conflict! It's very common. This is just one of those areas where emotions cloud the problem-solving part of you.

"She will hate me if I decide she needs to live in an assisted care environment". Yes, she will. But she will hate you no matter what you do. You can't win. She's better off being hateful in a facility than in her apartment!

There is no decision to be made. You know she cannot keep living in the apartment. She cannot live alone and she cannot live with you. That leaves a facility as the only route. There is no "I don't think" she can live alone.

Sounds like whatever emotional issues she had got amped up x10 with dementia, which is common. Placement will ensure she is safe, not living in filth, and getting the medical care she needs.
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Harpcat Aug 2021
This is the best no nonsense answer and spot on! Listen to Loopyloo! She is correct.
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If your mother has no money, she will not be able to go into an assisted living. Medicaid will not pay for that. She will have to go into a nursing home. Having a live-in caregiver won't be an option for her in the apartment.
While she's in the hospital ask to speak to one of their social workers. Tell them what the apartment was like and that she cannot live independently anymore. Also, make sure to tell that that you will not and cannot have her at your house because you are unable to provide the care she needs. This is important because they will try to talk you into taking her in and will promise all kinds of help. They never deliver on it though. The hospital will find her nursing home placement.
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My mother is early stage Alzheimer's also has life alert but doesn't want to call for fear they'll take her out of her home permanently. It could be yours fears the worst thing possible too? Wanting to lay there and die? Maybe she's ashamed of her living conditions and her appearance? Who knows what they're thinking! I say something and 2 min later forgot. It's not going to get any easier as anyone here knows. Definitely needs attention and someone who can inspire her that she's loved and needed. You've come to a great forum, there's plenty of people here with more experience than myself. Just know you're not alone but your mom must feel that way if she isn't asking for help. Even the strongest, stubborn and manipulative people grow up and have to accept they're no longer in control. Hope you find your answers.
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BurntCaregiver Aug 2021
JuliaH,

Your mother has good reason to fear that she'll be taken out of her home. I've known more than a few seniors who were put into nursing homes even when they had adequate care at home. Sometimes it was an over-zealous visiting nurse or social worker who thought they were Mother Teresa. Or their adult kids were not in agreement on the family care plan. Some would want the parent in homecare, some would want them in a facility care.
Never accept anything from the state for a senior still living in their home. No matter how many times some state program claims to be "free", trust me it never is if the senior has a house, or some other valuable asset. They become very invasive in an elder's home and life. Also, in the life of their family.
I worked for a lot of folks who had LifeAlert and used it. That company doesn't report any seniors to APS. The paramedics or police who respond don't either. The cops always try to talk to family first when they respond to a LifeAlert call. They told me this.
If the senior goes to the ER it will be a hospital social worker who tells APS. They also don't have to tell the family when they do either. So, your mom still has enough mentally to have this fear. Maybe she could do just fine with homecare help?
When the situation in the home gets to the point where the elder stops washing up and is living in filth and squalor, they need to go to a care facility.
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She sounds EXACTLY like my MIL…. It’s eerie.

She was lonely, so we played on that and have moved her in with us. She’s been with us a week so far and, so far so good (except tonight she had another “episode” and got very upset, saying she’d never seen me before in her life and when was I going to leave “her” house - oh dear…)

With covid running rampant in the nursing homes, we knew that was not an option. This isn’t for forever, but this is the best we can do right now. We are currently paying for care out of pocked for 6 hours a week, and are working on getting more. Right now she demands SO much of my time and attention - I have a 5 and 7 yr old at home, so she cannot be my focus all the time. This week has made it very clear to me that she needs more care. Due to covid, it will be in our house until her “episodes” can no longer be managed.

I totally get that you’re stuck between a rock and a hard place. You’re feeling guilty, but in the end, someone has to make the hard decisions.
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CTTN55 Aug 2021
Your SIL appears to be local (you wrote in another post that she drops off toys for your children). Why isn't she helping out? Why isn't she helping to pay for the Personal Support Workers?

You say that MIL demands so much of your time and attention. I hope your H takes over when he is around.

What's the plan for when her "episodes" can no longer be managed?
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Wow, this was my life a year ago! Mom at 86, she kept her apt clean but everything else is spot on. One night she wandered and was sent to the hospital. That was when I able to put her in MC/AL, it was a smooth transition. She wasn’t happy at first but she needed the care and to be safe. She never would had agreed to go on her own. It unfortunately took an incident to make it happen. While there she refused to use her cane or walker (still being difficult) fell and broke her hip. Now she is in a skilled facility, cannot walk. Needs care for everything. So upsetting. The dementia has progressed and it’s horrible for everyone.

Look into Medicaid so if and when a bigger incident happens moving her into a facility can happen smoothly. Good luck. Reading others posts a lot of people have similar stories.
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I know the feeling I’m in the same situation but fortunate enough to have Carers as I was struggling to cope I’m not sure what area you are from but could social services not step in as it seems she would be better off in a home I understand the strain on you as I was at breaking point and I have had to stop making daily contact as it was affecting my health hope you get this sorted stay strong
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Hello sisters and brothers! Your not in the struggle alone. I am going through the similar thing! My mom is an chronic alcoholic with breast cancer in both breast and still smoking and drinking and not listening to the doctors or anyone at 70 this year and she falls on the spectrum of NPD (Narcissistic Personality Disorder) and she is in serious mental decline-these are the hardest people and when they age it’s harder. Doctors and hospitals are not neurologically testing (you can start here if you think her doctors will listen to do so) difficult elderly people. If they did these or similar evaluations for mental decline, they would most likely see she’s in some kind serious cognitive decline, which affects behaviors tremendously. I have a Masters degree in this area and I have been able assess and understand the outcome for these types of behaviors and mental reasoning. In most cases, when we see this serious decline, there should be neuro-psych tested. It’s expensive why Medicare doesn’t do it I think (my opinion). Depending on their stage, the state will have to take care of them when it gets to this stage and we don’t have resources or will to care for them (your mom and my mom too). My mom owns a home. I know Medicare are going to take it and eventually put her in an assisted living facility. She constant lies and tells the doctors “don’t listen to me” (I am crazy war vet with PTSD) as I try intervene on her behalf with her health/behaviors (FYI-California is the worst when it comes to mental health laws, there too liberal on the side of the patient). She lies and she accuses my daughters (one at Cal Berkeley who is studies chemistry and my other daughter who works for a social media giant in San Francisco) they’re both beautiful and good young ladies as they try to live with her to help her keep the mortgage and put themselves through college and work. They’re leaving soon and as I write this, because of the state of my mom and the house! When they come home and clean it, she lies and tells people they “dirty the house” and she leave soiled diapers everywhere and blames them for the filth she creates daily. As a child, I went though serious mental abuse as a child and later ran away to join the military when I was young. She has early stages of sundowning as she hates to go out at night and she is regressing back to her horrible ways. My younger and only sibling, my sister checked out and she lives 35 mins away too.

I cannot get a neuro-psychologist to examine her because she deflects and lies to the doctors and rehab/counseling has been useless as she lies and plays the victim. And usual since I was a child, she narcissistically smears (character assassinates me-always) even though I evaluated over 409 people (K-adults) with learning and behavior issues as a past Pre-Doc student In Education Psychology. Recent as two weeks ago, I’ve blocked her (abusive texts/msgs/rumor mill lies). I’m having to walk away and telling my daughters to prepare to leave. No one is going to continue to stay or rent from her and the nastiness and nasty abusive behaviors.

My best advice is to keep pushing for a neuro-psychology evaluation. Until that is done, there’s nothing legally we can do to prove she is unfit to care for herself and a danger to herself or others. Once and if serious cognitive decline is found, then care options through Medicare through your Mom’s “local county aging services” should tell you EXACTLY what options are available through Medicare. I’m a 100% disabled veteran from the Gulf War era with Lupus/autoimmune issues and I cannot and will NOT take care of her. We have to wait until she completely falls! “Acceptance and Commitment Therapy” is helping me cope with this and many others take it too. I pray and hope for the best for your Mom and for your family!
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Ellery Aug 2021
Neuropsych testing does not test for DSM diagnosis. You cannot get an NPD diagnosis that way. I've arranged and attended many testing appointments with my husband. They do not diagnose mental illness or anxiety, PTSD, etc.. They diagnose the neurology symptoms of dementia like memory loss, executive function issues like impulsivity, prioritizing, etc. Also, remember: Medicare is for the sick and old, Medicaid is for the poor. Neither of them will "take your home" that your mom lives in. Navigating the journey you may have coming up will give you a whole new education! Medicaid laws vary by state. It may be worth your while to start preparing now for what may be coming. I am sorry about all the problems, and thank you for your service!
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Yes, sadly she will likely hate you…part of the deal when dealing with a parent who has dementia or personality disorder or depression. Sad to say…my dad's last actual words to me before he died were "I almost hate you"….because he blamed me for being in the NH. I knew his brain was broken and had to let that go even though it made me sad. Here is the issue…we so want them to shape up and be who they were before and we are convinced we can help that happen….until we can’t and realize that is nothing more than wishful thinking. You need to face reality and get your head not your heart involved in appropriate decision making for her care. Get her in a facility, where her last years will be with others, with a nurse and 24 hr. Staff, with meals, with cleanliness etc etc. Be prepared mentally for her anger, but at least you know she is living in clean safe environment. If this was you, what would you want for yourself? Filth and maggots, and a dangerous place where you fall and die?
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You need to call (again and again) the hospital and speak to the discharge planner and tell them the condition you found her in and calmly explain she can no longer live alone. You need to be firm that it’s an “unsafe discharge.” List the reasons. The hospital will try and move her out as quickly as possible and say they are putting in visiting nurse and other support services, all of which she will refuse. If you can’t get someone on the phone, then leave long messages, or type something up and fax it to the nursing station, social work office or doctors office - or all three. Just write an objective account of what you have been observing. And include she has no family able to provide the level of care that she needs. Say you can’t support a plan for her to be discharged back to her apartment. They might think you are a pain in the butt - so what. With her weakness and falls, she might be discharged to a rehab which would buy some time and allow you to work with the rehab for options. “Unsafe Discharge” should be your mantra when talking to staff.

Will she hate you if you try and find placement for her? Yes. I am a hated daughter, and there are probably thousands, maybe billions of hated daughters out there! You will not be alone! By making those decisions you are trying to keep your mother safe. Don’t argue with your mother or try and convince her that she will be better off. Just tell her “this isn’t working.” Tell her you can’t support her plan to go back home. She might say she doesn’t “need you anyway” but just don’t respond.

You say she doesn’t have dementia but her bad choices and failure to recognize her need for help is pointing in that direction. She could be great at covering things up. My own mother kept everyone at bay so that no one could see how bad things really were.

Start researching services for her and find out what needs to be done for Medicaid. In some states there are assisted living Medicaid Waivers but they have restrictions.

If she gets sent back home, call Adult Protective Services. Whatever you do, do not agree to take her home with you and do not agree to pay for services. That will be slow suicide and a path to divorce. Get some counseling to help deal with past and present trauma. Good luck! You are being a good daughter for trying to get your mother the help she needs despite her behavior. Remember that.
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Do you have POA? Sounds like your Mom has given up and can no longer care for herself. Do not let her anger with you stand in the way of what must be done. She needs help! Contact her doctor and tell him what's going on. Doctor may be able to assist you in getting her proper placement for best care. Also, if your state has Dept. of Aging, contact them, too and ask for their help. There are State resources available that will assist you in getting appropriate and adequate care for her. Once all that sets in; your Mom just may turn around and be happier and healthier. Good luck!
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Since you do have POAs it is time you act on them. Your mom needs help and she needs it now. Since she nor you cannot afford Assisted Living/Nursing Home care, it is time you make an application for Medicaid. This process takes about 3 months, and you will need to procure bank statements, etc. which may make the process longer. Contact your State’s Dept Human Services ( DHS.) Also look for an elder care attorney.
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you are correct, go with your gut feelings. It is very clear she can not live alone and needs a care facility.
She sounds like my mother, (passive aggressive, )complains but does nothing to make her life worth anything. She does want others to care for her because she is just making no choice ( which is a choice)
You do what is best for her, best for you.
Best wishes.
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Leave your mom alone and let her live the way she wants.
You said she doesn't have dementia so she is capable of living alone.
If she doesn't have money she can't afford a cleaning person.
You can buy paper plates for her to use to not have so many dirty dishes
You can invite her out to lunch, ect and if she doesn't want to go that's her choice.
Lother of people watch tv as what else does she have to do.
You might bring over a large print puzzle or a large print paint by number for both of ya'll to do.
play her favorite music.
Have a couple people over for a Bingo or card Game.
A Nursing Home is the Worst place you could put her and they are all understaffed.
There are many falls in Nursing Homes and they keep you too doped up.
As far as not bathing enough, she can't get that dirty watching TV and bathing or Showering once or twice a week is plenty.

Buy her frozen dinners to eat and she want very many dirty dishes.
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wolflover451 Aug 2021
not all nursing homes are bad, sure some are understaffed now because no one wants to get off their butts and work. my mom is in one, she is taken care of, has good meals.....does she have to wait sometimes to use the bathroom, yes,......but they get to her. she has not fallen and they have precautionary measures to put in place to keep them from getting hurt if they fall. my dad was there for 6 years and only fell one time out of bed onto a thick rubber mattress...........he was not doped up nor is my mother. so saying that they are all bad is not fair to the ones that are really good. and if this woman has no money, they can apply for medicaid. and if she uses paper plates........more garbage to be thrown on the floor.
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Let her hate you, rather that than have something really bad and her lie in pain on the floor or heaven forbid she would cut herself and bleed to death and then someone find her. Sounds like she is depressed for whatever reason. Since you said you have medical power of attorney, stress to the doctor that she cannot go home due to the circumstances and that she is depressed and needs 24/7 care and should be placed. Tell them that she is not mentally capable of making decisions and she should be placed. Again.......let her hate you. at least you know IF she is placed that she will be taken care of (bathed, clothes washed, food given to her and no dishes to do, etc). She might even find some of the activities enjoyable after she has been there awhile. Do NOT let them send her home.........wishing you luck.
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I bet if you let the apartment management know what condition the apartment is in, they would refuse to let her come back. While I agree people have the right to live as they choose, that doesn't mean they have the right to live in filth in an apartment or other multi-occupant dwelling. She needs to be in assisted living, or somewhere that will make sure she is not living in filth.
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Put her in assisted living. Listen, nothing can be worse then the conditions that she lives in. You will be doing her a favor. I have spoken to several families that have placed parent in assisted living and at first, the parents want to go home but later get used to it. What is the difference if she watches TV in assisted living or alone at home surrounded by filth. Good Luck and know that you are doing a great job just by caring.
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Call the president of the hospital, or better yet, have an attorney call him or her. Explain no one has discussed with you her living conditions and that she is not able to return home. Often, there is a social work department that would handle this. Be unpleasant if you need to be, better to let an attorney do it.
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As I often do, I am taking a different approach. Did you by any chance take pictures of her apartment? A picture is worth a thousand words. If not a narrative of what was seen, to share with the hospital, social worker and Mom herself!!
She may not actually be lying but just not living in reality since she was a neat person this reality may be hard to accept. Sounds like therapy may be needed.
Is it possible to hold a family meeting?? Mom may be eligible for a temporary placement, due to her mental state (depression) and physical condition
When she is well enough to return home, conditions should be set and met.
I am for....one more try. Best wishes.
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Hi - I'm sorry to hear that you're having this challenge with your mom...I plan to elaborate more on this site re: the hardships that my mom has caused me as a result of her behavior ...it's beyond. Until then, my thoughts are - if you want to start gradually and if you're uncomfortable implementing certain steps (such as a weekly cleaning service), you can tell her this directive is directly from the Hospital Staff and she MUST follow this - that's really the minimum and there are no other options - she doesn't really get choices and you should let her know that it's out of your hands. I would always strongly tell her that this is coming from other professionals, so the onus is off of you and it isn't personal. Otherwise, she'll need to understand that next steps will need to occur. You can say this firmly and seriously - and when you're just repeating the directive from the hospital, instead of coming from you, it may reduce her chance of manipulating. On top of all I am contending with, I have a single elderly aunt - that I'm also solely helping - and she's not easy to deal with - never was...and this is the way I had to help her - I'm not sure if your mom has insurance, but if she does (or even possibly medicare may cover), I was able to arrange weekly visits from a physical therapist and a cognitive therapist to my aunt's home for to improve her mind, body and spirit...and I made sure that she attended a senior social group (most towns have such)...and she's not a social person, but it got her out. I didn't suggest it...I didn't ask her if she wanted to go (or have these therapists come to her home)...I didn't give her any chance to voice her approval - when she tried, I nicely and firmly told her that there were NO options - it was to help her and the instruction came from other professionals to help her improve the quality of her life. It was the first time she didn't go into one of her usual tantrums and she finally just gave in - and after she got into a regular schedule, she started becoming more positive and receptive about it....I hope your mom will too!! Best wishes!
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It is my understanding that Medical POA only kicks in if she is deemed "incapacitated". Clearly, she is not incapacitated.

Voice your concers to the medical staff, and ask to speak to the hospital social worker. Explain the situation to him/her and see if they are willing and/or able to help.

If not, while she is in the hospital, report the apartment to the landlord. Have them make a decision about terminating the lease or giving her a deadline for cleaning up the apartment. This will be her responsibility, not yours. Of she needs your help, she will have to ask for it. Then when/if you go in to help her clean, she won't be able to be angry at you, since she asked for the help.

As soon as you report her living conditions to her landlord, also contact adult protective services with your concerns. They can meet with you and inspect the living conditions. If things are as bad as you say, they may offer her the choice of being a ward of the state, or allowing her to give you full Power of Attorney, which would give you the ability to arrange placement and manage her finances.

From what I have read, it sounds like she is no longer capable of providing her own care. I disagree with another commenter, she does not need one more chance. She needs physical and emotional support, and a safe living environment.
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Email the social workers at the hospital, discharge planning, her MD and aging and protective services, with copies to yourself. State that it would be an unsafe discharge if she was to be discharged to home. Advise them that you are her medical power of attorney and do not support a discharge to home. Advise them that your mother is an unreliable reporter and may be providing inaccurate statements about her situation.

State that when asked why she didn't try to get help after falling she told family she wanted to lay on the floor and die.

Then briefly list what has happened that supports her inability to appropriately care for herself, starting with being unable mentally to get emergency care when she fell and lay on the floor for 12 hours even when there was a emergency alert device she refuses to use.

If you have photos of her unclean apartment include 1 or 2. List short descriptions of what you found, 4 bags of maggot cover garbage, all dishes and silverware caked with food.

Unable to bathe and maintain her healthy hygiene and refusing assistance.

Ask for her to be assessed for the appropriate level of care. Ask the hospital to begin the application for Medicare and/or Medicare. Ask them to begin the process for placement in that level of care.

At this point your mother is going to hate everyone, but you are doing the right thing.
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