My beloved aunt lives alone and has dementia. Her loving daughters are running out of money for a full-time caretaker. How can we persuade her to move to the wonderful assisted living facility in her community (it would be paid for by insurance)? If we cannot persuade her, how can we move her (she is lucid enough to sound competent)?
I have thought of that....and I can understand how it may cause more problems by bringing her home. I brought her home for thanksgiving and it was fine (difficult to take care of her but emotionally fine)... But the next day she told me she should have had us drop her off at her apt. I tried to explain to her that we couldn't/wouldn't do that and if we did, we would have to live with extreme guilt when she fell and hurt or killed herself....but I don't know that she really understands that, she just wants to be home. I am just hoping for the best, but I see the situation getting farther out of my controll. Her body/mind is determining the way things will go now. Very difficult. Thanks for your thoughts on this and for sharing your experiences. It helps me and hopefully others reading.
I have found all of the responses and other peoples stories helpful and is hope that the responses to me did nit take away from you Stephan. Our situations were similar so I hope you benefited from all of the stories too. CarolLyn is so right...each circumstance is very different and each family dynamic is different. Re: convincing to go to AL or NH...I am in the middle of that now so I do not know how to do it but I have no ability to provide 24 hour care in my home unless it can be provided through insurance which I am quite sure is not...my thought now is to find a place in my town or very close by so that I can bring her to my house as much as possible, but still have somewhere for her to be taken care of when I can't do it....not sure if I can get her to go along with this...she just wants to go home...and who can blame her. re: will insurance pay? It will for some I think..but if she doesn't have tons of money..you need to file for Medicaid for her..this requires a lot of paperwork so good to start early. It requires lots of digging through paperwork in her home and trips to her banks...etc. you need the POA to get the info from the banks and they need to bring that documentation with them to the bank. Good luck
But I'm going to take issue with one response in particular:
"Simple answer, your Aunt, unless she raised you.... is NOT your responsibility...................period."
My aunt, my mother's sister, was widowed at the age of 56 due to an egregious hospital error perpetrated upon her husband, also 56, and with no ability for resolution through malpractice. They had no children. Due in full to my aunt and her husband, she and my mother were estranged from 1952 (when l was 7 years old) until 1982, when my great aunt died. Mom & aunt just never spoke of the past and what on as if nothing had happened.
My birthday was the day before my aunt's and she always felt a special connection to me because of that. With my mother's personality, one did not have a relationship with someone she was angry at, so I was also estranged from my aunt during those 30 years. But when it was " acceptable" for me to have a relationship with her, we bonded over love for my great aunt and over our animals, of which both of us had many. In short order, she asked me, if anything happened to her, would I take care of her animals, to which I agreed.
Unbeknownst to me, she went to her attorney and set me up as medical and financial POA as well as her heir. She lived in No. CA while the rest of us lived in So. CA so we didn't realize that, over time, she had become a cranky, reclusive alcoholic. She "retired" early but I found paperwork later that she had been fired. She was an accounting manager and she was treating her employees very badly. They give her time to clean up her act so to speak but she couldn't seem to do it. Of course, it was the alcohol talking, which eventually lead to the dementia.
At the time, my mom and I were dealing with my dads Alzheimer's so we were unable to take trips up north. Over the phone, for short conversations, let's just say she hid it well. It wasn't until she fell and the paramedics reported the squalor in her home, cat and dog feces everywhere and the hardwood floor under the carpet completely warped from urine soaking through. Smell-o-vision anyone?
Without rehashing the timeline, I stepped in and basically saved her. She was near death; the doctors didn't think she would survive very long. But I took care of her for 6-1/2 years and she was probably more well then she had been in the last 30.
Every circumstances different and there are no blanket rules. My and didn't raise me and, due to no fault of my own, I didn't even know her for more than half of my life. But this was my decision to take care of her and not turn her over to a public guardian. I took care of her because I could and because in my case it was the right thing to do. That doesn't mean it's right or not for someone else to take on that responsibility..................period.
From your last comment, I can tell you that it would be wisest and easier on everyone, including your aunt, if you put her in assisted living or whatever is appropriate for her. Your situation just screams no. Been there, done that, don't kill yourself trying to do the impossible. JMHO.
Cindyy, I agree the MPOA is important for any older person to have in place. Even if your Aunt doesn't go into AL, she should designate at least that so that someone can make her final wishes known. I would speak to the dr for sure like we talked about. I don't look at a nursing home like most people do. My father had a great many years where he completely took care of himself and managed his diabetes injections just fine. He ate horribly and junked out on sweets albeit ones with artificial sweetners. He right where he needs to be at this point because every time it tears at my heart to bring him home, I go to Nursing home to visit and help him try to just go to the toilet and with me helping him, He cannot even lift himself and he has even dropped a LOT of the weight that he had put on. So, I am not naive enough to think I can take care of him. If I were to suddenly become rich, I could insource it but at this point I am far from being well off.
In your case, maybe your aunt is still mobile and functional. If that is the case then maybe you can take her into your home. Some people do this for a while until it gets to the point that they can no longer handle their loved one.
My father has fallen 4 times this week because his obsession is to walk and who can blame him, his brain wants to get up. He wants to do what he has always done but his body can no longer do that. They are working on strengthening his legs in PT and I have hope that he will get more mobile at least. He still does not know where he is- he cannot remember that his wife passed away. He often thinks she is still alive. It is very sad, and I guess I get mildly offended when ppl propose to take an elder off of all drugs and that the simple solution is to bring them home and remove them from toxins etc. It sounds great on paper and perhaps that person is able to do that. Perhaps she has the bandwidth and the capital to pull it off. Perhaps that person is married and has a spouse that can help life the person to the bathroom and out of bed, into bed, get meals, wash their clothes and maybe theyhave children around that can watch the elder while they shop for groceries or port children to school.
I for one, don't have those resources. I also don't think you can speak to a person's condition when you don't know their history and you haven't watched their digression. That's just what I think. Srry for this mean person being short with you. Most people are nice on here. xoxo BG
If this happened or happens to you, this is exactly where you jump in and say, "Okay I need someone to assist me with having her admitted!" You are doing it on the advice of a doctor!
It does not sound like your aunt ever had a Trust or a Power of Attorney, if she did the POA could have her admitted, without that you have to seek to be her guardian and she will have to have testing done to provide the evidence that she is legally incompetent and needs someone to make these decisions for her.
I doubt that there are very many people at all who will willingly say, "sure I will agree to move from my home into assisted living or a nursing home, and that is especially true if they have dementia or Alzheimer's.
I would speak to my aunts doctor and lay out the situation to him and see if he can offer any assistance. Perhaps getting a social worker in place or finding a gerontologist who specializes in dementia or Alz to help would work as well. Do not stop asking everyone you know for help. You really will need to have her tested for competency, this is a must. I think when you tell them, she can no longer stay in her home, her daughters can no longer care for her and she is financially broke so hiring a caregiver is no longer an option, I think some doctor will listen and help you.
In my mother's case, she was brought home, we got her to a good doctor who prescribed the correct medications for her and she is doing very well at home with me caring for her. The correct medications in my mother instance where a game changer!!! She sleeps and we no longer have angry outbursts, she is calm and easy to handle. Thank God!!!
So, again, if I or my loved one had LONG TERM CARE INSURANCE (I assume that's what you're talking about when you say "insurance"), I'd be beating a path to the door of the most luxurious AL in town!
Read her policy carefully – many of them cover AL (doesn't need to be SNF) and most have set limits (per day or lifetime). If you're confused by the language, take it to the AL you're considering, they've seen plenty of them. Even if her policy covers a set daily limit, she'd only have to make up the difference and it surely would be less expensive (and BETTER for her and her family in every way) than paying for private aids at her children's expense.
p.s. - A visit to the elder law attorney is advisable, too.
Thank you for the response...sooo helpful...my one question...how did you deal with the decision , or, nit, to take your dad into your own home vs. A nursing home or Al? My aunt raised me and I feel I can't put her in a NZh or naybe even AL...but....I don't know if I can care for her at my home....so hard.....
I would be on the phone and so exasperated because I couldn't get my family to override this man who could not make decisions for himself! arggggh. Eventually I talked to him and he couldn't even make one decision so since I was MPOA, I told them to take him to the ER. My aunt is a devout christian had trouble telling him a white lie that she was taking him to the ER because I told him he had a dr visit. :( Once he got to the hospital, his blood sugar was 700+. It was so high that it didn't register on the machine. Of course he's feeling messed up. He was very agitated cursing so they moved him to a behavioral unit. By this time the dr had told me he can no longer live alone. Up to this point I had agonized over how to get him into a safer environment because we had been through this with my aunt and she kept falling and laying on her floor for hours or days and my fahter and I were upset about that happening and I was determined that that would not be the case for him.
Even AFTER the dr told me he could not live alone, a nurse at the behavioral unit told me the same thing. She almost scolded me that I could not just drive up and deposit my father at a nursing home and that it was a misconception blahblahblah. I was very distressed by this because I was on this forum and people would say, oh it's very costly to get guardianship, you have to get a lawyer $$ go to the court and the person has to go before a judge and the judge has to determine him to be incompetent. I was mortified that this was the system because I didn't want my father to stand there and be humiliated in this fashion after living his whole life. I was so frustrated that they could let someone who couldn't make decisions decide about his care.
Well, I'm here to tell you: someone contacted adult protective services anonymously. I suspect it was the dr's office. That too sounds scary to me but it turned out to be the best thing that could have happened. The drs at the behavioral unit were the ones to do the evaluation and declare my father incompetent. There was no lawyer, no judge. The woman at adult protective services told me that my father HAD to go into full time care or else I would be liable for elder abuse. She followed up with me after I moved him into a nursing home near where I live and finally he is safer than he was at home by himself. The nurse who preached at me was the one to get his paperwork ready to go and she didn't utter a peep to me. I was really angry about this because it was so unnecessary. The whole situation is emotionally charged anyway and it really isn't up to family members to make these calls. If your aunt is unsafe or you feel that she needs AL, then this needs to be brought to her Drs attention and then she be evaluated. No matter even if she can talk pleasantly, these drs have tests to determine their competency and they will tell the family if she is at the point where she needs this care. If so, they can declare her incompetent for the purpose of making big decisions and once it gets in motion, it has a momentum. They didn't go to my dad and announce " you are incompetent!" or anything like that. They treated it like a drs order. I was so relieved. In this region, Texas, louisiana, it is considered elder abuse if they determine they cannot be alone. You can be charged with it so you are forced to resolve the situation. In our case, I could not manage my father from 4 hours away and the family was so wishy washy on it I am happy that he is near me. I would not go paying a bunch of lawyers and getting all of these papers drawn up because of course they will initiate it for you, it lines their pockets. I would talk to her drs. If she is at the point where she cannot be alone, then it isn't up to her anymore.
One thing they told me is that it is much easier on them if they go straight from a hospital to the NH rather than home and then decide. I personally think you have to proceed as if they are like toddlers ONLY in that they can't really make proper decisions because their brain doesn't have the capacity to. Sometimes, you have to trick toddlers into eating or bathing/going to bed. Personally, I didn't sit around asking my father what he thought about it. After the authorities got involved, it was done and I am so glad. If your Aunt has dementia, it will progress so it's not a matter of if, it's a matter of when. It is so much easier without all of this upheaval and I can't tell you how much heartache it caused for people to tell me that he could do what he wanted. I wish the best of luck and PM me if I can help sort it out. hugs BG
Her MD would have to recommend aides covered by Medicaid if she is eligible.
in some ways you are fortunate. Perhaps the dementia has progressed to the point that she doesn't think she has a memory problem. Imagine early in the disease how difficult it must be for them, knowing something is wrong but not knowing what. My moms disease has progressed to the point that she really believes there is nothing wrong with her which is much better than where she was a few years ago, terribly depressed.
Often times people with dementia are very successful in covering up what is occurring. Is there a friend or family member that spends a significant of time with her. I do not mean a few hours each week, a few hours a day would be required at a minimum.