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OK, my mom went to the doctor yesterday. A neighbor drove her. (I couldn't because it clashed with my work schedule and she canceled the one I'd made that didn't clash.) So she is 76, has some dementia. Showed up at the doctor's a bit confused. They were concerned and want her to get a few tests (a stress test and an EKG) and to send a social worker to visit her. I'm fine with that, as she's been super stubborn, basically expecting me to get her cigarettes or shop for her a bit, when she wants it, and it's been rough with her moods (telling me not to talk to her anymore, then forgetting it, or accusing my husband and me of stealing or other things that never happened). But what kinds of things happen with these visits? The doctor said I could be there, and I want to, but what might they do? At my mom's place they she might react better, be less confused, so they might only get one side of her. I really would like them to be able to suggest something that'll be of help. I'm working two jobs now, and my house is neglected, the yard is neglected and I'm just so tired I want to be like an ostrich sticking its head in the ground, which is good for no one, but that's what it feels like now!

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Last week a social worker came and listen to my problems for an hour. She is such a special person and is so supportive so my husbands has been sectioned under the mental health act and he is in a unit for assessment and the team will decide where he goes from there. The last 7 years have been so hard. But now my husband does not recognoise me I have been able to let go.I hope you get the support that you need before it makes you ill. Good Luck from the UK
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Who is sending the social worker {i.e. who does the SW work for)? Important to know for paying for SW services. Is this SW coming on a one time basis or will there be regular visits?
Is the visit to evaluate your mom for the doctor(s) or for providing counseling for your mother? Is the SW coming to do a home inspection? You can and should ask questions of the organization sending the social worker,

You will discover just about every care provider may have a social work degree.

I am a inhome caregiver for my ADW, the stress is terrible. Alzheimer's damages the brain so rational conversations become impossible. My social worker comes through an agency (insured) and she is here for me to talk with about all issues surrounding my ADW and my family, No questions are taboo, she is the person for me to talk to ...She know the resources I need to get help, knows the what is going on,

I see a social worker VS my wife seeing the SW. She sees a ALZ doctor (i.e.shrink) who selects medicines and such. PCP and shrink collaborate on health concerns.

Alzheimer's disease and dementia, there is a distinct difference,
other dementias: Vascular dementia, Parkinson's disease, dementia with Lewy Bodies and Frontotemporal dementia.
Some causes of dementia are treatable and even reversible. source: Mayo Clinic http://tinyurl.com/qdgj9g

YOU need to know correct diagnosis.
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Heidi,
Time to get your head out of the sand. The doctor probably requested the social worker. Is the social worker with Adult Protective Services? They check in on people to determine if their needs are being met and that they are living in suitable conditions. If social worker is APS then the county pays them. Who has Mom's POA's. Doctors are required by law to ask APS to visit if they are concerned about a patient's welfare.

My Mom and hubby had an APS visit two years ago at the request of my sisters. They had alleged that I was taking things and money from each of them. When, in fact, nothing of the sort was going on. The investigation was closed quite promptly. Whatever you do cooperate with the social worker! A defensive attitude will only harm the potential outcome. The social worker will evaluate her living situation and care to determine if changes need to be made.

Good luck. In my case everything turned out perfect.
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Most times the APS and the social workers attached are there to help. But people with outside agendas call the APS if they think that the reporting will gain them some sort of advantage...or they are truly concerned about the welfare of the elderly person in question. In any event, APS may seem intrusive but they are just doing their job...which is a necessary one.
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As a Practice Administrator, we will request a SW visit for the following reasons:
1. Safety evaluation
2. Environment of Care evaluation
3. Identification of outreach supportive services that the patient may be eligible for and/or would suit the patients internal dynamics.

The goals are not only improved quality of life for the patient, but we understand the stressors that are applied on the caregivers as well and we strive to alleviate these the best way possible before a caregivers own health and family dynamics are disrupted.

I would encourage this opportunity to seek additional answers and supportive opportunities as you take care of your loved one.

Personally, I went thru this with my father, and it is quite fatiguing and emotional to see the decline of the person you love who is not the person you grew up with, and it takes the TEAM to manage and find the best solutions for the patient and the caregiver.
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If you are concerned that your mom will not be showing her 'true colors' when the social worker is there, maybe you'd better be there, too. That way you can talk with them about her usual behaviors, rather than just how she's performing when they're there. Social workers are pretty good at detecting dementia even if your mom is show-timing.
Also, if her doctor ordered a visit from the social worker, based on one office visit, your mom probably has more than "a little dementia."
Be sure to be clear with the social worker that you are NOT able to provide full-time care for your mom. You don't need to put your head in the sand (I know that feeling), but you will benefit from making sure the social worker understands that you are not in a position to be the main caregiver for your mom.
Stay strong and take back your life.
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Social workers and the APS are bound by law not to share anything with outside sources unless action must be taken to immediately improve or change a situation. In that case only thoise immediately involved and authorized may share information...usually with some kind of approval either from the client or the person with the POA...or both.
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I don't know if this is a UK thing, but I agree with Lillybo that every encounter I've had with social workers has been either highly positive, or at the very least has got me no further forward; but never anything worse than that. They are not sniping, nasty-minded busybodies who are out to cause trouble and order people around; they are professionals whose role in life is to safeguard their vulnerable clients and improve their clients' and their families' quality of life. So, if you were worrying, rest your mind.

Whether you should be there or not: ideally, if the SW has time, split the visit. Be there when she arrives, introduce her to your mother, back off, then return to clarify anything that really needs clarification. The SW won't contradict your mother, but that doesn't mean she'll take everything she says as Gospel, either.

This visit is A Very Good Thing. It will get your mother onto everybody's radar, it will enlist allies for you, and it will give you (almost certainly positive) feedback on how you're doing in your role as family caregiver. Look forward to it, and don't worry!
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They will see how she functions in her environment, is it safe, is it convenient for her, they will look for signs of self neglect such as: no food in the home, medication(s) not taken, dirty house with trash laying around and they will assess her needs, what can she do for herself and what does she need help with. They can make referrals to programs she would benefit from such as senior care or other home and community based services. She can also make a referral for you regarding caregiver services such as respite or caregiver support. It's a good thing and it's important. They will help you locate services so your mother can stay at home for as long as possible.
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Social Workers are on a fact-finding mission and likely to try communicating with your mom first. Other involved persons (family or caregiver) may be questioned. A report is forwarded to doctors, mental health professionals OR law enforcement. Law enforcement enters ONLY in a small percentage of cases. In fact, local police are usually really good about helping families when the person wanders or just gets too combative - much like they do with children who wander off. Usually the case is closed and/or referrals are made to agencies that may be able to help. All things considered, keep providers abreast of problems, be present when the SW arrives, and tell them you want help in maintaining quality-of-life and safety for ALL of you. You and your husband deserve to have a life and providers are usually advocates for each of you. Please check back with all of us to let us know the outcome of the visit.
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Whoever the social worker is, I would be there. We had a family member who had not had a bath in a year. She was no longer keeping house or doing laundry. She successfully hid all of this by use of perfume and not leaving dishes out and keeping her clothes picked up. The yard was always mowed by someone else. Social workers were none the wiser.
Her daughters caught on when they realized she wasn't taking her medicines and wasn't eating right. The house had begun to smell and became dusty.She is now in an assisted living home Her long term care insurance would have paid sooner but she had hidden everything from them as well.
Dementia patients can still be smart enough to hide things. You need to be there to be sure that she doesn't.
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I would suggest you try to make these sorts of appointments in mid afternoon. When a dementia victim starts getting a little tired they reveal their real mental state to strangers more readily. They can't conceal their issues for more than a few minutes.
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When our social worker came he was very informative. Unfortunately my dad has too much income to be able to have home csre covered by medicaid. He recommended companies that could help us and told us the cost snd the correct questions to ask the company so we would feel comfortable with knowing their workers were trained, background tests, drug testing, etc. Was very informational and even though he couldnt do anything, it felt good to talk to someone! Good luck I'm sure they will help you or send you in the right direction.
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Thanks, everyone. As someone pointed out "a little" dementia probably doesn't apply. I look forward to the social worker coming. (Though I'll find out about the costs.) I'd welcome them to come and talk with her while I'm there and hopefully they can offer some kind of neutral assessment that benefits my mom's situation and helps me help her more effectively, and maybe reduces some stress for all parties involved. At this point my mom fights everything that she finds inconvenient. She cancels doctor's appointments because she doesn't like the time (even though I have to take unpaid time off to take her), or doesn't follow their treatment (she broke her arm -- a mild break, fortunately and removed her cast after 10 days instead of wearing it 4 to 6 weeks) and so on. One big problem is she thinks they're sending a social worker to help her get her driver's license back, which isn't a good sign. I mean, a doctor's office isn't going to send someone to help a patient pass a test to reinstate a driver's license! But I'm not bringing that up to my mom because otherwise she'll refuse the visit. An acquaintance also suggested maybe finding someone to help my mom, drive her once a week for a bit of pay. I am looking into that. Hopefully I could find someone my mom likes and who I trust. In the past I've arranged for a home nurse, after my mom had a stroke, and my mom fired her after two weeks because she didn't like the woman, and everyone else I've hired to help in the past, my mom has also fired them for one reason or another. (Usually she doesn't like them.) But maybe I can find someone to taxi her around weekly just to get her out on her time. ..
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What country mouse said!!!!!
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As a social worker, all that happens is one would take down how your mother is managing her resources, who provides her daily care, doctor info, anything having to do with her social environment. Then a report is made which outlines recommendations for your mother. It is like a roadmap to guide you in things she will need and things you can do. Don't be afraid of it, it is supposed to help her and you. While I was doing my social work internship, there were so many questions about medicines, and social workers do not infringe on the medical aspects of a person, I also became a nurse because I thought I could really be more help knowing the whole picture of a person and being able to comment on social and medical issues. Hope this helps!
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"Some causes of dementia are treatable and even reversible".???? This is a false statement. Dementia that people are concerned about is not reversible and there is no cure. Something you just have to deal with. Something that is reversible is not correctly called Dementia.
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I think you have recieved all the necessary advice and information. the SW will be able to slip in questions that will assess mom's mental capabilities without her realizing it. She may ask about things like hobbies and ask to see stuff mom is working on. her report back to the Drs will enable them to recomend further tests and treatment. Let Mom talk privately with the SW then have a few words while walking out to the car. i said a few because Mom will not like you talking about her.
Before the SW comes write down all the things you have told us here and give it to her privately as she leaves and ask her to call you to discuss the visit.
Talk to mom about the visit if she is willing and find out what was discussed and if mom might consider any of the SW suggestions. in future do not tell mom about Dr visits if she makes a habit of cancelling them. Make the appt yourself and show up when it's time to pick her up. if she refuses nothing you can do. if she makes her own when it;s not convenient for you then she is on her own to get there. from what you are telling us she has more than a touch of dementia. Good Luck
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I suspect the doctor wants to have an assessment on whether she is able to live alone, eat well, care for herself like taking baths, eating enough etc. She may check the refrigerator to see if things are there and fresh, does she know how to manage her medicines etc. If she isn't capable then the decision will be who or how to care for her. Working 2 jobs doesn't make you are reliable choice, is there another family member with time and the energy to pick up these caregiving duties? Can she pay for in home help? If not they may suggest getting her a placement which when she uses up her funds will be paid by the taxpayers via Medicaid (the health care program for the poor and also pays for most nursing home placements).

Good luck. Your mother and you may be at a turning point.
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The Social Worker may say it's time to move mom to Assisted Living. I would say "Fine. You tell her. She won't go, and you can get the court order, because I can't afford $10K in legal fees."
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My mom is 89 and my brother is her poa he keeps all her money will not answer his phone when.she needs things i use my money to help her the best i can.I have ask for help from socail services for 2 years.They come in and nothing is done.
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In our case, my mom's Social Worker was and still is an answer to my prayers. She saw right through my mother's Showtiming from the get go. Remember they have all the tools to evaluate as well as the experience. She has helped me to understand what is available to help etc. She has reassured me that she will be there if the time comes to move mom to a facility which keeping her home is our goal for as long as her health allows. She talked to my mother to see how she communicated etc. I'm in the US, but I'm sure you will get a read on how things work from this Social Worker wherever you are. Use this as an opportunity to ask the questions you need answered for your own piece of mind. It sounds like the Doctor is already seeing that help is needed, so that is a good thing. Also do not try to be "super" care giver. You already sound like your are over doing it, and that is a road we have all been on. Take the help the Social Worker offers even if your mother says she doesn't need it. It will actually make her happy in the long run. Even if it is someone else for her to boss around :-) Take a deep breath and use it to the positive.
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I think that your mom has a wise doctor who sees that you can't be with your mom 24/7, that she is uncooperative with your parameters (she cancelled the appt that you COULD be there for) and she may be giving what sound like unreiliable answers to his questions. DO be there for the social work visit, but let you mom answer all the questions.
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This is the same situation I am in with my mom right now.
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Everyone, I called my mom tonight to check on her and tell her about the tests the doctor ordered, because the doctor was concerned. Because I'd have to drive her, they let me know the time for the appointments and gave me instructions for her to follow. I call my mom and tell her she has an appointment to get more checkups to make sure her heart is okay and stuff like that. She won't be able to smoke 12 hours prior to the appointment and no caffeine for 24 hours prior. (If there was no pre-appointment instruction, I probably would have just said let's go to lunch or something and just taken her to the doctor!) But talking to her, mainly I try to be casual about it, saying it's just to be sure she's okay, etc. Well, my mom has an absolute fit about it and says she's going to call the doctor's office and make them cancel it and she's not spending any more money on medical stuff.
She's now in a huff about the social worker, too. Complaining because she hasn't been contacted yet and now she's sure they want to come in and see her place. (Well, yeah, kind of.) I try to tell her it can't hurt to have the SW visit, that they'll just make recommendations that could help her. I suspect my mom is going to shut out everything the doctor recommends now, at least for a while. I'm going to visit her tomorrow and see if I can talk her into at least considering it, but if she decides she won't do it, then I'll let it be.
And as for other family helping. There really isn't anyone else. My mom has cut off all contact with her family and I got caught up in the mess. At the time, many years ago, I thought my mom was right, etc., but now I realize it may be mental illness. My mom has cut off contact with all family and friends over the years, and at times told me to keep out of her life due to something she's imagined.
So I hope I can get her to at least see a social worker, and as for the rest of it, I'm not sure what to do. She still keeps her place up nicely and knows when her rent and other stuff needs to be handled. There's at least that.
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social worker??
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Oh jeez. Today did not go well. Went to see my mom and it was all about how she was not going to go to the doctor. Tried to change the subject several times. All she would talk about was the doctor or about how family has always screwed her over. She wants to sell something my dad (who's been dead for many years) had and I told her I'd like to have it as a reminder of him, since I don't have much from him except some books and a pair of earrings he bought me as a teen. She told me all I wanted was to sell the item -- a stamp collection. Truly I don't. They're just shoved in a plastic bag and I thought they'd be nice placed in a photo album or even put in a frame. I seriously doubt they're worth much of anything, it's purely sentimental. I told her, since her father died when she was very young, wouldn't she like to have something from him? All she would say was "I lost my father when I was young" or "I was a nicer mother to you than my mother was to me." Clearly her brain isn't working well today and I was in no good mood. It escalated with us getting louder, and finally I just left. At this point I'm wondering if I should even have contact with her. I have too much anger, too many issues with her and she has too many issues with me. I'm hoping that the social worker can get in to see her (she might not even crack the door) and offer some advice. I'm at a total loss. I feel like a jackass for getting angry and emotional, and I do still feel very angry and emotional about the whole thing.
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You poor dear. Your mom sounds just like my mother in law did. She was stuck in the ruthless of "I've always gotten screwed" drove away friends, family. She accused my husband of elder abuse when he suggested that she stop smoking when she complained about her COPD. Sounds like mental illness and dementia both. You should notify the doctor that she's acting irrationally and that you have no influence. Also tell him/her that you can in no way be responsible for her care, because she fights you at every turn. This is a case for professional intervention. Don't feel guilty. You didn't give your mom this disease and you're trying your best. Let her doctor guide her care.
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Thanks, ba8alou. I plan to call my mom's doctor on Monday and let her know the latest. The situation with my mom just gets worse and worse. Even when I go in determined to talk neutral or play a card game or something it just doesn't go well. Today I swear she was looking at me with such loathing. It might pass in a day or two but it was disturbing!
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I just told my husband your mom's story. "YUP, just like my mom" he said. I will tell you, he walked away and let others care for her. He knew how irrational she could get and how much damage she was capable of doing calling the police and local politicians. Don't allow this sad situation to damage your health, physical or mental. Manage her from afar and keep in touch with the doctor. But draw a firm boundary.
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