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She was diagnosed with Alzheimer's. Her son put her in Assisted living. She has short term memory loss, but does not have Alzheimer's. I have been paying for a companion since I live about 500 miles away. He and his wife and young daughter live 20 miles away but refused to visit her.

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She was diagnosed with Alzheimer’s. How did you decide she doesn’t have it?
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If she has dementia, Alzheimer's is just one type of dementia. She most likely should be in Memory Care.

Hiring an optional companion while in AL is quite unusual.

My mother is 98 and in AL, we see no need to hire someone else to sit with her and hold her hand.

She has activities, made friends, meals are cooked for her, room is cleaned and they do her laundry as well.

Why exactly are you paying for a companion?
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What is the reason for hiring an aid? Most AL's have "a la carte" add-on services for residents. What was the aid doing? Just keeping her company? A good facility (and good staff) will know how to coax people to activities and events -- and even then they can't force people to participate. With short-term memory problems your Mom doesn't even remember what she did 5 minute ago so you need to weigh the practicality of paying for an aid if it really isn't helping your Mom in any significant way. Maybe it's more for your own peace of mind/guilt?

If you are not the FPoA you have no power other than to make your case to your brother. Please stop paying for it out of your pocket. This isn't fair to your own spouse and family. It's unsustainable and probably unproductive -- but I understand your desire to do it.
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The financial POA is in charge of what to spend on caregiving.

I am afraid that your choice to spend money on a "companion" is your own choice.

There is little you can do to change others. So I am afraid that you are left with things as they are.

Certainly you can visit an elder law attorney to explore any options you may have, and perhaps to suggest some mediation between yourself and your sibling.
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If she needs a companion for anything beyond just company, then she's in the wrong level of care.
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"She was diagnosed with Alzheimer's. She has short term memory loss but does not have Alzheimer's."

If "she" has been diagnosed with Alzheimer's, "she" HAS Alzheimer's.

A person with dementia living in Assisted Living and "requiring " a companion needs to be in Memory Care Assisted Living.

It is not "elder abuse" for a POA to refuse to pay for companion care in AL on top of the astronomical costs of AL in the first place.

Son and family not visiting does not constitute elder abuse either, if it's even true. How would you know such a thing from 500 miles away? Relying on info given to you from a person suffering from Alzheimer's? I'd visit my mother who'd call me later to say she was alone like a dawg all the time because nobody EVER came to visit. Take what's told to you with a grain of salt. It's also very difficult to visit a loved one in AL with such a condition. Not everyone is equipped to do so on a regular basis, either, and passing judgement from afar is easy to do when you aren't doing the visiting, up close and personal. #Truth.

You can do nothing if the financial POA refuses to release funds to pay for a companion in AL. Unless you'd like to pay for your cousins companions yourself, I'm sure there'd be no argument from her son.
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BeddaJ Jan 5, 2024
My husband was misdiagnosed with Alzheimer's but it turned out he has a REM sleeping disorder. One in four people are misdiagnosed with Alzheimer's due to incompetent testing. Some of the recently approved Alzheimer's drugs cause brain bleeding in people who don't have TAU proteins which is the test for Alzheimer's. As a result, Medicare has started approving PET scans and blood testing for TAU proteins. Elder abuse is defined by the law of the state in which the patient resides-not personal opinion. If the patient has the means to pay for companion care and the patients's medical and social services support providors have recommended "Companion Care," most courts will hold the POA responsible for elder abuse. There is something you can do. Hire an eldercare lawyer in the jurisdiction where the patient resides. Depending upon who holds the patient's healthcare POA, a well worded letter from an attorney might get the financial POA to disgorge some funds to pay for companion care. If in your opinion, and with the advice of the attorney, you conclude the patient really is being abused by the POA, you can petition the court of jurisdiction for guardianship. There is no question that the quality of life is greatly extended for dementia patients in memory care when they have family that pays regular visits. Given the fact that this woman carried her son for nine months, changed his diapers, and all of the other things Mom's do, he has to be a real jerk if he doesn't bother to visit his Mom at this stage of her life. it is such a small thing to do wehen it can bring so much joy. Even the most imperfect parents deserve some credit for raising their children to adulthood.
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He is paying AL now? Then do nothing. If the facility indicates a need for more help and the POA does nothing then the facility may escalante to eviction. You do not say why you are involved with companion care requirement. Nor why it is important. Then that is your personal preference. But wait, your profile says you are a POA
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My brother lives 500 miles away from our hometown where Mom lived. There is no way he knew what type of condition my Mother was in from day to day because he never visited and either did my other brother. No phone calls to Mom or me to see how she was. I was the one who saw her daily and sat with her at doctor appts.

ALZ like any Dementia can come on slowly. Short-term is the first thing to go. The ability to reason, too. My Aunt lived for 12 years after diagnosis, some people 20. It can be a slow progression or fast. Who tells you brother doesn't visit, Mom. Well that short-term memory has her forgetting that your brother may have been there an hour before. My Mom went to visit the Aunt mentioned above. On the way out she met my other Aunt going in. When this Aunt got to her sister's room she said "I see Peggy was here." My other Aunt said "no Peggy hasn't been here". Like said, take whatever someone suffering from a Dementia says with a grain of salt.

There should be no reason Mom needs a companion. My Mom walked around inside of the building. Visited in the common area. Aides to take care of her needs. What does the companion do for her? Does she make sure Mom is involved with activities and outings. This person should not be doing everything for Mom. She needs to rely on the aides.

Your brother is putting out big money for Moms care. Trying to hold on to as much as possible so Mom can stay in the AL as long as possible. The added cost of a companion would eat into Moms money. You feel she needs a companion, he doesn't. So paying for one is your choice.
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lealonnie1 Jan 5, 2024
Exactly.
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Not much you can do to make someone else believe as you do. People the world over try and many of them are at war.

You have more control over the private care person you pay. You could ask that they work to integrate your cousin into the community where she is.

Have her take cousin to activities and ask the staff at the ALF to help her as well. She has gone to the ALF to live and needs to be part of her community. A companion that keeps her from that is not helpful. If that is the case. I’m not trying to say the companion is doing anything wrong.

You might try visiting yourself and see firsthand what the situation is. Cameras are also helpful to tell how the person is interacting and spending their time. Are you able to call your cousin on the phone? Perhaps you could zoom with her or face time.
No neurologist has ever diagnosed my dh aunt with Alzheimer’s either but she gets that label regardless. She clearly has dementia and it has robbed her mobility and most of her ADLs so she is forced into the care environment where she can have the care required.
I wish she had more visitors as well.
I try to get her as many services as possible because that gives her interactions with others. To do that sometimes requires I work with her doctor. Hard for the fPOA to avoid the doctors orders. So try looking for a therapist who will visit or a church who will take her communion or different services her particular insurance will pay for.
You didn’t design the system she must live in, nor did she or even her son. It won’t make her feel better to be reminded that he doesn’t visit if that is indeed the case. Move on and do what you can do. You are kind to care for your cousin.
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JLC1951: As she was diagnosed with Alzheimer's, she does indeed have the disease and requires residence in a memory care facility. Do not spend your own money on her care.
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From the profile;

"She was diagnosed with Alzheimer's and recently had a stroke."

Your cousin now lives in AL. Will no doubt make connections & find companionship with staff & other residents.

Are there reasons you want her to have 1:1 companionship?

I'd kindly suggest to check if you are overlaying your own ideas about being 'in care' without family onto her situation?

My relative did just that. Oh she's be lonely, scared etc. Our LO was FINE. Lived in the moment, joined the activities, enjoyed interacting with the cheery upbeat staff.

I love my own son. But I have fun with people my own age, with shared music & those up for a sing-a-long 😁

"We were close growing up".

Are you experiencing grief?

Grief at the loss of the close cousin you knew? Feeling sad about her disagnosis & recent stroke. That's totally understandable.

Are video calls to your cousin something you could arrange or be helpful?
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