My MIL is living with her daughter and her daughter’s disabled husband. Over the past month, MIL has shown signs of dementia although her primary care doctor refuses to diagnose her with anything other than cognitive impairment. We found an assisted living facility with memory care and they are holding a room for her. Even though she has exhibited violent behavior at her daughter’s house recently, resulting in broken windows, sitters being bitten, hit over the head with lamps, escaping in the middle of the night, etc. When the police and or EMS are called, she passes any questions they ask her with flying colors. She acts like a sweet old lady to police, doctors and paramedics but turns into a woman possessed with her caregivers and family members. Her attacks have been both physical and verbal. She is refusing to be moved to any care facility, refuses to take her medicine, refuses to bathe, etc. We’ve contacted her doctor, the police, the coroner’s office for an “Order of Protective Custody”; she’s been to the ER 3 times over the past 3 weeks in the hope that they will hold her for observation with a PEC. In every single case, she turns on the sweet old lady charm and they release her. We’ve even recorded her evil tirades so that people will believe us but no one wants to listen. We are at our wits end and are concerned for her safety as well as ours. My bed ridden disabled BIL is fearing for his life. Her son (my husband) has POA but we’re finding out that means nothing if she’s of sound mind and can make her own decisions. I’m totally convinced that this isn’t dementia but an evil woman who has figured out how to get her way, at the cost of her children’s mental health and well-being. Any advice would be greatly appreciated.
I'd find a geriatric psychiatrist for her immediately; tell her a story about how Medicare requires a physical/mental assessment every year now in order to keep her benefits, and go from there. There is more going on that MCI, and she's obviously not 'of sound mind'. A geriatric psychiatrist can also diagnose her with mental illness if dementia is not warranted, which I believe it IS. MCI almost always leads to dementia, and she needs a MoCA or SLUMS test to see where she scores on a scale from 1-30. Simply asking her who the POTUS is isn't enough. Her current doctor is not taking things seriously enough, imo, and a new set of doctors/psychiatrists/neurologists is in order here.
Wishing you the best of luck with a terrible situation.
Ask the AL/MC who they use as a geriatric psychological/psychiatric diagnostician, and invite that person to her present home to “visit”. Brief that person before the visit about her behaviors and actions toward others.
A skilled specialist will ask the right questions and hopefully get useful information. Ask about the possibility of some mild medication to help her manage herself more appropriately. She will not have to be drugged unconscious to become more manageable.
Your goal will be to get a written document stating that she needs supervision.
If she DOES, you will arrange for her to “visit” the residential care center.
If she is deemed able to manage and modify her own care you will draw up a “behavioral guide”, and she will follow it or you will inform her that she will be moved involuntarily to her new care setting because she has not accepted her current living arrangements.
This forces her to be responsible for her own welfare. List everything in her behavioral guide as specifically as possible.
”You will not bite anything but food”- VERY SPECIFIC!
Also, “babyproof” her surroundings- nothing that she can lift (and throw) in her quarters.
You and her daughter have treated her kindly and respectfully. You DO NOT have to accept the role of whipping boys.
I would call 911 for any & every act of violence. Insist on transportation to hospital for behaviour ax & neuro/psych exam.
Then the main caregiver speaks to the hospital social worker & to advise situation (again). Use clear direct phrases eg I cannot take her back my home. I cannot care for her. It is unsafe - for her, me & others.
Please arrange immediate emergency guardianship.
Does your state have involuntary psychiatric holds? She needs an in-patent workup to trial meds.
If all else fails your daughter and BIL may have to actually evict her from their home. To get her out.
Hopefully the evaluation on Tuesday will yield the diagnosis and results needed to get her out without going the eviction route.
If not how old are daughter and BIL? If they are older themselves adult protective services may be of assistance for at risk seniors being abused by MIL to get her out.
Also, when you take her to the ER--go out in the hall and snag whatever Dr is assigned to her. Talk to them plainly and with no ulterior motive other than getting mom placed.
I know a couple times I had to take DH to the ER b/c he will get sick and then he has this scary panic attacks (MEN DO NOT GET PANIC ATTACKS!) (Oh, yes, they do).
The dr would come in and do a once over, and DH would insist he was 'dying'; when what he was having was a panic attack. I would go out of the room, corral the dr and tell him/her what was really going on. Not one doc in all these years has been ungrateful for the information. A dose of Valium and DH is his normal chatty self, wondering why he decided to go to the ER. Literally, this has happened 5+ times.
No Dr has told me to 'mind my own business' or to 'step down'. They have always been kind and grateful for the information.
99? OMgosh--and she'll be one that lives to 105! I am so amazed by the lifespans that some of these folks have. I can imagine she's not real thrilled to wake up every morning and find out she's still here.
I'm no psych doc but it sounds like she's a good actor...and you need to get an ER doc to see past the 'sweet little old lady' routine.
Again, she needs to be evicted and a good eviction lawyer may arrange that. Regardless of age, if this is NOT dementia, and IS psychiatric illness, there will be little to nothing to be done about it. I really suggest Liz Scheier's book Never Simple, a memoir of her years attempting with all the resources of New York, city and state, to make a difference for her mother. Nothing did, and the outcome, death, was the inevitable and only outcome. Advanced in age as your Mother is, this will be sooner rather than later in her case. She clearly is out of control, with with the calls made, the ways addressed, she seems only to THRIVE on the attention.
The answer now --the only answer I can see--is to get her out of the children's home's and to never allow her into them again. That needs to be made clear to her. Careful diaries, documentation may be needed in a court case. See to it that it is gathered.
Thanks for all your responses to us, as they help clarify your situation, and so sorry there is so little to help a family in these situations. We see it often in young mentally ill, less often in a strong 99 year old.
I long for an easy answer to this so I can pass it on to others.
Take care.
Your MIL needs to be out on a Psychic hold for at least 72 hrs. Baker act her. With you going there and showing how she acts towards her family. And her daughter needs to tell the police that her mother is a danger to her husband who is disabled. That she will not be taking her mother back into her home. And you will not be taking her into your home. Stand your ground. There is something wrong with this person.
If she truly is of sound mind and is just choosing to be hateful because she can....let her paint herself into a corner.
If she truly has some dementia related violence going on, they can medicate her appropriately.
Bottom line is that everyone will be safe and MIL can get the care she needs and that care included medication!