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My mom was placed on a dementia unit by my sister in law and brother who took over POA for healthcare without my knowledge because I live in another state and I am an RN.
She is 96 and has been independent until she went to the hospital with back pain. My brother and sister in law were tired of her calling and put her on a dementia unit because she didn’t pass the mini mental test and was given an incapacity by the physician. Should of never happened. She has been there for 5 months now and talks about going back to her condo and packs up her clothes after being unpacked and placed in the dresser by staff. She thinks a nurse there is going to live with her because she cannot live by herself. I guess she asked him and he just said yes he would live with her and not really meaning it. She cannot live with me.
I am asking what is a kind way to approch this issue because she cry’s after my sister in law and brother visit her and tell her she is not going anywhere and the nursing home is her home now. They are heartless people in my eyes, but they don’t what to say.
My mother is forgetful at times but very aware at other times. She cannot live in her own anymore. She likes the meals at the facility, so that is a plus. I honestly believe she would be better off on a regular nursing home unit that was not for Dementia patients, but that was not my decision. Bad planning. That was coming from a person who’s mother had dementia and does not like my mother. This POA for healthcare should of never happened and I looked into guardianship which is very time consuming and expensive. I do not converse with my brother and sister in law due to there deceitfulness and hurtfulness to my mother.

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Well, you either have to take it on, or let it go. You should know that, as an RN. Right?
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Been a few months now.
Hopefully the Mom is more settled & the OP has also adjusted to the reality & dementia diagnosis. Denial can be tough & stressfull to break through.
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Since you are remote you do not know what goes on day to day.
Let the person that is POA make the decisions for mom.
Another option (that I think is not an option and would be very detrimental)
If you HONESTLY think that mom would do better, that it would be in her best interest to be in Assisted Living..(not a "nursing home" because she apparently does not need continued medical care)..that you are 100% sure that she would not wander away from the facility...then you have every right to seek Guardianship and take over mom's care. I can tell you right no w that it would be a waste of your time and money as I doubt that a Judge would grant this.

What I do not understand is how your brother could "take over" POA.
A person can not just assume the role of POA.
If mom had appointed you as POA then she is the one that has to change the POA. If she is not cognizant then she can not make changes.
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In case OP is still around… maybe this video will help? Tena Snow “I want to go home” https://youtu.be/BLReoWyOehQ

IDK how OP says her family is heartless when she admits her mother can’t live alone.
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Leave it alone. Visit your mom when you can and focus on her, not your likely misplaced anger towards your brother and sister-in-law. They have the POA, the responsibility for the decisions and have regular contact with her doctor and health care workers to help them make those decisions. Your mom would likely pack up and want to "go home" no matter what facility she was in as that is a characteristic of some dementia patients. A dementia unit is the right place for someone who could be a flight risk like her.

A guardianship would likely not be successful as she is in a licensed facility with a family member in the vicinity, a doctor's assessment that she is now incompetent, and with a POA granted to them by your mom. You are out of state and moving her near you is not going to solve her problem of wanting to go home.
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With dementia--every day is new day with new 'memories' and 'problems'.

My MIL is in in home Hospice Care with her 3 kids taking care of her 24/7.

She thinks she IS in a NH. You cannot dissuade her from thinking this.

Ironically, she'll die thinking her kids DID put her 'in a home' b/c she won't ever get back to her non-dementia way of thinking.
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I just went and looked at your previous questions starting with this one.

https://www.agingcare.com/questions/my-mother-wants-me-to-move-to-take-care-of-her-at-93-i-live-2400-miles-away-close-to-my-children-452541.htm

This scenario has been going on since 2019. And in the last 3 years or more you continually talk about Mom not being coherant and not be able to be reasoned with. She has been in and out of hospitals and rehabs. Your first post said she was in a NH on hospice. She is at least 96 now and was placed in a NH a few months back. Now u question her being placed in a Dementia unit after a doctor deemed her incompetent. A better place, IMO, than a NH.

And you are trying to control this from 2400 miles away. Your early posts say you cannot live with your mother. That you do not want to move closer to her or her live with you. Your also worried that brother will get it all. For one thing, if Mom has money its now going to her care at probably 10k a month. So it won't last for long. And maybe brother deserves it all because he is doing the work. Maybe he deserves her condo because he is there through everything. When skimming your previous posts, I did not see where you have visited her even when she had surgery.

It seems you and Mom didn't really get along. I can understand u needing to move 2400 miles away. By doing that, though, you have left all the responsibility to ur brother. As my brothers did with me. But the difference is they never complained because they were not the ones here on a daily basis. Neither were in the position to take on her care. They left the decisions of Moms care to me. I think you need to stop controlling a situation u have no control over. Allow brother to do what he needs to do to keep Mom safe.

I also don't understand how you know how brother is spending Moms money when he is POA. His wife is probably writing checks because brother can't with his Parkinson's. You need to let this go. Enjoy Mom while you can and make life easier for your brother.
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Way2tired May 2023
Interesting …the plot thicken$
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The Only thing you could do is Hire round the clock caregivers But if someone else is in charge of her Money there isnt Much you can do But get Conservatorship and that can take several Months . Your Mother can still revoke POA . The Only other thing you could do is Move her to an assisted living facility closer to you .
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JoAnn29 May 2023
Read OPs previous posts.
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"I honestly believe she would be better off on a regular nursing home unit that was not for Dementia patients"

I guess you have never worked in a NH or you wouldn't say what you did. Like said, this Dementia unit is geared to people who suffer from it. She probably gets better individual care then she would in a NH. Better food too. I would leave Mom where she is and work with brother and not against him. He is there and he has made a decision that is best for Mom. Seems you can't be the solution so you need to let things stay the way they are.

Mom will eventually adjust as her Dementia progresses. She will learn to depend on the staff.
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Way2tired May 2023
I agree
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My MIL has dementia. Initially she would pack daily… always wants to go home. It’s been about a year since she was moved to memory care. My husband had a lot of difficulty accepting the behaviors as part of the disease. If she hadn’t been in a lock down unit , I’m sure she would have wandered off.. Hopefully brother will learn how to handle the wanting to go home .. my husband has learned to say yeah , your set to go next week… and she Accept s that..

regarding my mother, I lived across the U.S. from her. She did not want to leave her home state. After moving her here I realize now she was struggling with dementia. Lots of signs I did not see as she was with it. I regret not giving her more support.

i agree with Polarbear , you need to visit to get a correct handle on things. Open mindedness for clarity sake..
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I wonder how long it has been since moving into MC. It took my MIL 6 months of everything you are saying. She even brings it up, that she is going “home” when she is at the start of a UTI. She packs everything and wants to go “home”. She was moved to NJ from NC, we are now realizing when she says “home” she is not meaning NC. She is meaning the home either her childhood home or the home she raised her children.
my MIL is in MC. She is the highest functioning one there. Have we discussed moving her to assisted living, yes. But like someone said she would not be able to get to the activities or meals on her own. Also beware, facilities are very good at starting you in one location to get you in the door…then weeks later say they need MC.
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I'm sorry there is such hard feelings between you & your brother & sister-in-law. As others have said, dementia isn't a linear disease, and only by seeing someone day-to-day can you understand the effect it has on everyone. Do you know the kind of cognitive test your mother took to prompt the doctor to give the incompetent or incapacitated diagnosis? I went through that with my MIL. In CT, that had to be declared before a probate judge, & it's not easy emotionally. My MIL went to a regular nursing home, but the situation was much different: It was a small home with only 29 patients (that kind doesn't exist anymore), she didn't try to escape because she wasn't mobile. When she realized she was there permanently, it was difficult, but she came to accept it.

Still, if you're looking for a kind way to approach this, it won't happen if you don't communicate with your brother & SIL. You need to be on the same page - or close to it. It's hard is to accept that the person you knew no longer exists - & this goes for your brother & SIL, too. Telling your mother that "this is her home now" upsets her. She may, in time, come to accept it. In the meantime, you all can say you're working on it, but the paperwork got lost or a pipe burst in the condo & it's not livable yet.

The most important thing is not who's right or that you think they're heartless, but how can you all help your mother maintain dignity as she loses her cognitive ability.

I hope you can speak to someone who can explain how this placement came to be and to someone who can help you sort your feelings.
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playing the devils advocate: Your brother and sister in law are there, and as such they have to deal with it all.

You are not. As such, you do not have to deal with it all and that is not your fault, its just the reality

I am not saying your brother and sister in law are perfect, I dont know, but unless you move back there and take care of it, its their issue.
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Onhold1 - I recommend you take some time off and go see your mom and see for yourself her true condition. For at least a month, go spend time with her every day, talk to the staff, the nurse, the doctor. That's the only way to know her current and changing mental health. You, even as a nurse, can't know that from talking to her on the phone. At 96 y.o., physical and mental health can take abrupt turns easily.
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Sounds like your brother and sister in law , did right by your mother. She was diagnosed by the doctor , is exhibiting behavior that warrants her being on a dementia unit for her safety . The packing and wanting to go home is very common for people with dementia . Your mother calling your brother all the time, another common occurrence for people with dementia. My guess is she was having issues for some time and maybe you were not aware of them. Mom may have sounded normal to you during your phone conversations .
You are not seeing the forest for the trees which is common when you don’t live close by. I am on parent number 3 of caregiving between my and my hubby’s parents . Each time some long distance relative has unrealistic suggestions because they aren’t there to see what goes on . You are also letting your mother’s crying to you on the phone prevent you from seeing the bigger picture, which is that your mother is where she needs to be .
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I see two things --

1. I'm a nurse and know better [even if I've never been a nurse for dementia patients?]

2. Denial

Your brother and SIL appear to be looking out for your mom's well-being. Your mom is packing her bags and thinking some guy is moving in with her yet you think she doesn't have dementia.

Memory care units are not intended only for the worst of the worst who are virtual vegetables waiting for the call from God. Many dementia patients do better in surroundings where mental stimulation is the priority, and that's what MC does. If she was in assisted living, it'd be up to her to go to activities and socialize, and I promise you she wouldn't because she wouldn't have any concept of time. Her fellow residents would steer clear of her because she's not "all there," and she'd become very lonely and isolated.

In memory care, the staff ensures everyone is being socialized. They bring them to the activities even if they don't participate. They talk to them all the time, and they're loving and friendly. The focus is not what pills to give them when but to be social and friendly.

I'm disappointed because even though you're a nurse, I'm getting a vibe that you consider memory care or dementia some kind of stigma, and you're not willing to ensure Mom gets the best care but are willing to destroy relationships over it.

Very sad. I hope you come around.
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She’s where she belongs. Leave her be. Stop trying to butt in and cause problems.
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She’s exhibiting clear dementia behavior. They often want to go home. The place you’ve described seems to be the 24/7 care she needs now.

You can’t really believe what she says. Accept that she’s in a safe place and send her some cookies.
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BlueEyedGirl94 May 2023
And quite frankly - "home" isn't always what you think it is. My SIL and I were just talking about this today. Sometimes "home" is the home they left to move to memory care. Sometimes "home" is the one they raised their kids in. Sometimes "home" is the one they were raised in as a small child. And there is literally no way to know which one they are talking about. And it could change from one moment to the next.

Too many times well-intentioned but naive family members take their loved ones "home" thinking it will help, only to realize that isn't even the "home" they actually want! And it just makes things 10 times worse!
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There has to be a physician diagnosis of dementia in order for your mother to be placed where she is. It sounds like she's where she needs to be, most likely, and acting accordingly for an elder suffering from dementia who wants to Go Home, packs their luggage all the time, and feels perfectly fine to live independently, not realizing their own deficits. That's how brain damage works.

Let mom know that she's living where she is under doctors orders. If and when the doctor says she's improved to the point she can move elsewhere, she's staying put and what can you bring her to make her life more enjoyable? What else can you do? Truly, dementia is a lose-lose situation for all involved.

Consider that your brother and SIL know many more details about moms situation than you may be aware of and may not be doing spiteful things to hurt her. Dementia is not something that is linear....where she'll be totally incoherent at any given point. She'll have days where she seems fine. Which is not to say she is fine, or safe being alone, just having a good day. A dementia unit or memory care AL is specifically designed for an elder like her to thrive and where all her needs can be met in one location.

If you disagree with the POA, why not speak to them directly?

I suggest you read this 33 of booklet online about managing dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:

https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

Wishing you the best of luck with a difficult situation.
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ZippyZee May 2023
For real. OP must not be a very good nurse if she doesn’t know this.
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Onhold, when you've posted about this situation in the past, you were advised to take mom to see an Elder Law attorney.

Did that happen? What was the outcome?
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