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Hi! Only you know the full reality of your situation.

I do understand my opinion is limited by not knowing all the facts.

I wish everything good for your mother and you.

If your mother has the funds to stay in a facility, would she have the funds to live at home? A small home, with live-in care? Sometimes that’s impossible, but I mention it anyway. I don’t mean you living with her.

It’s possible that if we ourselves would live in a facility, we would desperately try to get out (for good reasons) (the reasons aren’t always stupid).

We are young. We haven’t experienced yet living in a facility. There are great ones. There are bad ones.

I have a friend (she’s a good woman), who put her mother in a facility. The mother needs a lot of care.

My friend told me, she herself would never want to be in a facility, and would kill herself before.

What I mean is, my friend somehow thinks “this is not for her”, but is willing to put her mother there.

Sometimes, there is no choice - someone must be placed in a facility.

Your case might be like this.

I ask only if there’s any chance for your mother to live in a little home/apartment/something.

She might prefer to live a while like that (breathing in life again, some freedom) (with live-in care), instead of institutionalized, surrounded by many sick people, etc., other reasons.

Wishing your mother and you luck!! I’m certain you’re already doing your best!

Here I Am
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ArtistDaughter Mar 2022
I looked into returning to home care for my mom at the end of her life, after assisted living, memory care, and nursing home, and found it outrageously expensive, even though she still owned her house. I found out the house would have had to be handicap accessible, which would have put even more expenses into the idea. I didn't know at the time how little time she had left, and had I known that I would have done it. But I found a very small end of life home for her in the neighborhood and hoped she would have many months of peace, quiet, beauty, one-on-one care, with long daily visits from me. I imagined pushing her around in her wheelchair and her former neighbors saying hi, seeing all the doggies like we did before when I Iived with her. But she was gone in less than a month. Autumnsfalling's mother will most likely live a long while in her current situation and so 24/7 home care would be very expensive and I wonder if even that sort of situation would make the complaints stop.
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Sympathize and wait. How long ago was the stroke?
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autumnsfalling Mar 2022
Thank you - waiting is hard. The main stroke was in early Aug of 2020 but the neurologist said that her brain imaging showed that she had had a series of prior mini-strokes due to the damage he could see. Didn't surprise me. She had been diagnosed with significantly high blood pressure years and years before but always adamantly refused any medical treatment or even follow-up. She only went to the Dr. that once (when she was diagnosed with HTN) because she had to, to get her Medicare coverage. She still has residuals from the stroke, some have improved a bit and others haven't.
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Simply stand your ground and refuse to take any papers. Legally for the most part, people are not allowed to engage in any legalities such as changing will, POA, etc when they have dementia. Her Dr, nursing facility staff can vouch for her inability to reason. She's in denial and is using every tactic she can to escape the facility, which is quite normal for a person with dementia. Stay strong and refuse her orders. YOU are in charge!
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autumnsfalling Mar 2022
Thank you - the reassurance is helpful! I agree - she is in denial and it's strong. Just difficult to deal with.
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You are in charge now through your POA (IF mom has a DIAGNOSIS of dementia) and you will have to own that and accept it.
Do know that your MOM may NEVER own it and accept it. She is no longer competent.
That is why you must now act for her.
SO........do discuss with the facility so that they are aware; make certain they have the paperwork. Sign what you must to hold her.
THEN go to Mom and tell her that you are now her POA. That you are acting in her behalf now because she isn't able to make competent decisions for herself. That no one wanted this duty less than you do, but now you are responsible for her safety. Tell her that it is now too late to do anything about the POA.
Warn the facility that you are to be notified just in case your Mom is capable of calling doctors. Many elders with dementia are capable of confabulating well enough to fool an attorney short term. Tell the facility that any attorneys should be warned that Mom is no longer competent.
SHOULD Mom get any attorney with no one knowing this could become a court case in which you would need to get guardianship over Mom, and do know that without a DIAGNOSIS from two MDs and letters attesting Mom is incompetent she may win.
At that point, were it me, I would withdrawn completely, and notify APS of adult at risk. Do not enable anything outside the facility.
So sorry. This is major tough. But this isn't something you can dance around. You must take the reins so to speak.
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autumnsfalling Mar 2022
The facility has copies of all the POA paperwork and call me for all decisions related to her care. After I got the POA, I had hired an elder law attorney to represent her and to oversee things and make sure that I'm doing everything right in regards to my mother, her care and her finances. I have an estranged sister that can be very demanding/controlling and I want to make sure I'm doing everything above-board. The attorney is very supportive of all of my decisions and has been very helpful in dealing with the paperwork, financial decisions, etc. The facility is aware of the attorney and at various times they've interacted. I know that everyone at the facility is on 'their best behavior' when it comes to my mom.

I am trying to do everything right it's just hard when mom's fighting so hard against everything and is blaming me.

Mom isn't capable of calling anyone. She can't even dial my phone # (which hasn't changed since the late 1990s. The nurses told me that they have offered to help her dial me and she doesn't even want to try.

I worry that she will try to convince her Dr. to sign the competency form that was included in the POA paperwork (which would revoke my job as POA) but I don't think that any Dr. worth their salt will sign that form with someone with a diagnosis of dementia and on Aricept. However, she can be very convincing at times. Then other times she'll say something "off" and I'll think, "oh, there it is... there's the sign of impairment". I hate seeing those signs but in another way it's reassuring that she is in the right place.
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I just wanted to mention that after years of my DH aunt (95) taking Aricept, we took her off. She is much better without it.
Her pulse returned to a normal rate and she is more cognizant. This was added after she had anesthesia and perhaps the anesthesia hadn’t cleared. She did have signs of dementia before but it was increased after the hospital stay.
I only mention this because sometimes we cause problems by treating symptoms. The aricept has not proven to cure but some believe it slows dementia for awhile. I wish I had never agreed to it for DH aunt. Many people take it.
Your mom will hopefully continue to improve from her stroke. That also can take a long time. Is she continuing to receive occupational or physical therapy? I sure hope so.

I would also deflect as Geaton suggested, encouraging her to get better before considering a move.

“The nurses/staff know that her stay is permanent and don't mislead her.” Are you saying the nurses tell her she can’t go home? I might have a conversation with them so you can all be on the same page.

Could she see a mental therapist or someone from her church? She has a lot to deal with.

If she is truly incompetent, as well as handicapped, then I’m not sure she can revoke your POA. I wouldn’t think so.

Oh and it is so easy to convince ourselves nothing is wrong with their mind because sometimes, nothing is and then the next day, you see the dementia clearly. It’s hard. Big hugs.
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autumnsfalling Mar 2022
My mom went straight into the skilled nursing facility when she was released from the hospital after her stroke diagnosis in Aug 2020. At the time of going into the nursing facility the Dr. diagnosed her with 'mild cognitive impairment'. About 9 months later the Dr. formally diagnosed her with vascular dementia and started her on Aricept and then Namenda (her cognitive impairment had gotten steadily worse). The Namenda was recently stopped because it was no longer showing a benefit. She has improved a bit on the Aricept and seems pretty stable (better than she was before it was started). I agree with the Dr. and nurses that it is helping slow her cognitive decline.

When I said that the staff knows her stay is permanent and don't mislead her what I mean is that they don't say 'do this and you can go home'. We don't want to give her false hope when we know it's not realistic. They encourage her through her multiple therapies (occupational, physical and speech) to improve so she can be safer. I've had many conversations with her nurses, therapists and the Director of the facility. Mom hears 'encouragement' from nurses/therapists and misconstrues that as she's going to get well enough to leave. She insists on believing what she wants to. Doesn't matter what we say. I've had many conversations with her telling her that the therapy is to make her strong enough so she doesn't fall and that she can swallow better (and choke/aspirate food into her lungs). I don't want to cause her undue mental stress, but I worry about the level of false hope she has. I don't know that it will ever change, but I struggle to handle her questions/demands about leaving when I know that it's not realistic.

There is a psych Dr. that visits her at the facility and diagnosed her with depression and anxiety disorder. We had tried taking her off her depression med when she seemed to be doing better, but she quickly reverted back into a depressive state so we had to restart the med. She does better on it.

She is completely convinced that nothing is as bad as me, the nurses, Drs, etc say that it is and blames me (and the rest of us) for her current situation. It's just hard to deal with.

I appreciate all the feedback - it really is helpful to know that others understand how hard this is.
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Just nod, say OK, and change the subject. She's not competent to revoke POA, so you're fine.
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autumnsfalling Mar 2022
Thank you - it's just hard. I'm constantly second guessing myself but everyone that supports me confirms that she's in the right place to keep her as safe and as healthy as possible.
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My MIL is bedridden in LTC. Every time we visit she asks when she can leave. We tell her that she has to be able to perform her ADLs for the doctor to clear her to leave so she can live safely on her own. She insists she can walk (she can't). I say, "Great! Talk to the doctor tomorrow and show him you can walk." This satisfies her and we move on. Even if your mom doesn't "move on" you are at least telling her the truth and deflecting the responsibility back onto her, which is also the truth.

Tell her you'll bring the paperwork once her doctor ok's her to leave on her own unassisted. Don't let it bother you...she may not relent so just keep your story the same. That's as much as you can do.
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autumnsfalling Mar 2022
Thank you - this is helpful. I appreciate you saying that the responsibility is back on her. My mother has never (ever) taken responsibility for anything bad that happens (it's ALWAYS someone else's fault). The blame for her situation is now being directed at me and as her daughter it's difficult. I'm the only support she has. I'm trying to find something to say that she will understand. I know that it's unlikely but to mitigate my own level of guilt for her situation I want to try to get her to understand as much as I can. Not that she ever will. She had the stroke due to "decades of uncontrolled high blood pressure" per her neurologist. She knew about it and refused meds because she "didn't need them". She literally caused the situation she's in and will forever deny all responsibility. So... it's all my fault instead.
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