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I have a 70 year old relative I've recently reconnected with. They have pretty bad memory issues from a stroke, moved here to Southern California to live with one of their children. This situation is honestly not ideal for anyone, for several reasons, and I've been listening to their complaints and fears and trying to help as I can. However I've learned from another of their children that this is more than dementia, it is mental illness that goes far back into the sons' and daughters' childhoods. My relative refuses to take the medications that were prescribed in the past, and just continues to make life miserable for all.
I've given some advice, such as getting POA and other legal docs in order before incapacity is diagnosed, if possible. There is some, but not a lot of money in the bank, plus SSA income. It's looking like involuntary placement is going to be in the near future, but what kind of facility, and where to start? I did mention an elder law attorney, but the response was rather skeptical.
I know this is not my responsibility, but I'd like to help as I can. I've been through some of this before and know how daunting it is. Do any of you have advice?

I DO have advice.
Stay as far away from this as possible.
I don't know what connection you have, whether to this person him/herself or to one or more of his/her children, but keep it down to SYMPATHETIC LISTENER.

If you do choose to intervene in any way then PROMISE me you will not do it without reading the memoir by Liz Scheier called Never Simple. Not a new book and cheap used on Amazon. This is Ms. S.'s story of her attempts LIFELONG as an adult to caregive her mentally challenged Mom. She was a smart woman, enlisted the help of the Social Services network of the entire state and city of New York. ALL TO NO AVAIL.

Dealing with dementia is nearly impossible. Dealing with mental illness IS impossible. And being POA for an unreliable and uncooperative person is a nightmare whereas doing it for a very cooperative and loving senior is only a bad dream. To put it another way, it's impossible. It is in my humble opinion ever so much better to leave guardianship to the state. The legal system will not do anything to help management of a mentally ill adult.

Not everything can be fixed. It is impossible to comb out what is dementia versus what is mental illness, and 1,000 doctors can't help that fact.

I would listen to family, and I would sympathize. I would point them toward APS and wellness checks. The outcome here is not going to be good and you need it not to be in any way your responsibility.
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Reply to AlvaDeer
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TxPonyGirl Oct 5, 2024
All I can say is Wow that is partial true and some I don’t have full knowledge to know about the legal system. I agree that the dementia can overlap mental illness personality disorders. My 95 year old mom has both and it is getting impossible and exhausting. I love this statement. “Not everything can be fixed.”
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Definitely you would need a memory care unit they can be found inside of assisted living facilities and the med staff would deal with the other type of mental illness with her drs for medications .
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Reply to Trixipie
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Agree with Alva. I would listen and provide support to the children but not get personally involved.

It is legal in the US to be unmedicated for mental illness.

The best thing you can do is provide supports to the children.
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Reply to brandee
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Dementia is a very tough disease and nearly impossible to navigate alone. I say nearly because I’ve been doing it alone with only the support of my23 year old son for my mom who has advanced dementia. For you, it sounds almost too late for POA, no good lawyer would allow a person who already shows signs of dementia to sign legal paperwork. It might be time for guardianship, which can be a long painful road. I had to go to court for guardianship, which cost me $20. K of my own money and caused a huge rift in my family. Those who think the person with dementia has money suddenly appear after years of not being involved. My mom was combative and paranoid. Almost totally opposite of who she has been her whole life. It’s heartbreaking. She’s finally in memory care and on medication, but it took 2 years and my own health and well being suffered. I almost lost my job and thus my house and I lost my own self. It sounds like your loved one needs memory care. But you will likely need legal guardianship. Many facilities will not take a patient with dementia without the proper guardian or POA. Once your loved one is in care and on medication they will be less combative and more calm. Just watch the doses of medication close so the doctor can adjust to give them the best quality of life possible. Your loved one’s children need to step up and do this. In fact, in many states they may be responsible whether they like it or not. You can be supportive and helpful without making yourself fully responsible. Good luck and prayers!
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Reply to reneeantonia
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I've read the four responses below.
I am always cautious when I hear a response from others that is 'black and white' ... do this. To me, support is encouraging a person to find their own answers, although certainly everyone here means well and generally respond based on their own experience ... which, in part, is what this forum is about. With this said,

I sense that you need to process your feelings 'more' - to understand the boundaries/ limitations of your 'I'd like to help as I can' - what this means to you.

* And, I realize that perhaps this is why you are asking us for feedback; you are unclear about how you feel in relation to how much you involve yourself.

* A person who refuses to take medication may be due (from/) to:
1) mental illness interfering with their cognitive functioning;
2) a clarity of knowing they do not want to be kept alive by medication; they are ready to let nature take its course.
3) A realization of what they went through with prior medical issues and not wanting to 'go there' again (understandably).

* From my experience (both personal and observed) is that the 'wanting to help' person doesn't understand the magnitude of what it means to 'get involved - wanting to help' - and (may) get on over their head emotionally, energetically, physically, and mentally - and without (knowing how/) setting boundaries, they burn out ...

If I were in your place, I would do a thorough inner processing of what is motivating you and assessing what you can realistically handle / manage.
In addition, there may be more value (?) contributions you can make by supporting the immediate family.

- If you meditate, this might be a good time to go inside, quietly, and see what comes up.

Lastly, the reality is that a person wanting to help can only do so much. There comes a time to realize that 'letting go' and letting nature take its course, trusting in something larger than yourself needs to be considered. It is a way to 'let go' of the self-imposed pressure to 'help' when the actual help could be being a good listener (really important) and nothing more ... to help / support OTHERS to examine their beliefs, values, decision making process so they can figure it out.

None of these situations are easy to manage; they are hard.
We are talking about the nearing of / ending of life and / or the pain that is being caused in the transitioning towards the end.

First and foremost: take care of yourself as without doing that, you are unable to be present to support another - be it the person themselves or the immediate family.

I appreciate you asking us for support and encourage you to go outside and look at the flowers, do gardening ... look at the cloud formations ... the wonder of nature. This will give you a shift in perspective ... and hopefully re-center yourself with loving kindness.

Gena / Touch Matters
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Reply to TouchMatters
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This is not your problem to solve.
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Reply to ZippyZee
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Just try to support the caregivers. Offer to babysit for a few hours or bring in a meal once a week. Those kind of things will be greatly appreciated. Unless they ask for help with more intrusive things, hard feelings could be inadvertently triggered.
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Reply to jwellsy
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IMPinky: Step away.
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Reply to Llamalover47
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I think you are sweet and kind to want to help, but there is that saying “the road to hell is paved with good intentions”

Its going to go how it’s going to go and I’d suggest you step back and let that happen.
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Reply to Southernwaver
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The brain is an amazing thing.

We have the brain we are born with + our personality + life experiences that shape us + our mental health at any given time.
Then add the expected affects of aging.
Then add effects of illness & disease.

The brain controls so much. Brain changes can effect so much: mobility, mood, behaviour, communication.

As a whole package, at age 70, with Hx of stroke & mental health issues, it may not be productive to differentiate - between the brain injury damage from stroke, any new or getting worse vascular dementia & mental illness.

It's all mixed up together.

Therefore a more wholistic approach may highlight what this person will need. Eg supervision & assistance. Plus a big team of caregivers.

All I think you can do is listen. Maybe offer an ear when the main caregiver is overwhelmed. At a level that is not burdonsome to you eg not become the everyday listening post.
Suggest getting help eg a bigger team.
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Reply to Beatty
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This is definitely a he!!ish combination for someone who has a mental illness with dementia layered on top of it. I think by this time, doctors and professionals are not going to try to untangle the two. Many people with bipolar or another type of brain chemistry disorder will sometimes lead into dementia.

I would keep my distance and sort of help on the sidelines, but it doesn't sound like it is much anyone can do at this point.

I've seen cases where someone suffered from Wernicke Korsacoff (dementia caused by long term drinking). The strange fact is that I couldn't tell the alcoholic behavior from the dementia since they both mimicked each other.
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Reply to Scampie1
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If person is a threat to self or others, a visit to the ER for an involuntary admission to the hospital is in order. The doctor will get the loved one stabilized and then family can work with case manager for next steps: placement, home health, or community housing.
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Reply to Taarna
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I'm in a similar position with my mother. Her doctor suspects she has bipolar plus schizophrenia. However, her auditory hallucinations did not start until she was in her late 70s. A psychologist I know believes she has dementia because of the late onset of symptoms. I honestly do not know but I believe a lot of factors in her earlier years have likely contributed to her dementia including hearing loss, depression, diabetes, high blood pressure, and some traumatic life experiences.

When someone is in their 70s, 80s, and 90s, it will be common to find cognitive decline regardless. I'm not sure if most doctors would be certain if it is mental illness or dementia without testing with a geriatric neurologist or neuropsychologist. A POA is a must and your relative's children should discuss best options with a geriatrician and therapist. All you can do is be there for emotional support for his children. That is huge and I wish I had a relative who could just be around to discuss things with along with offering some assistance around the house.
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