My mom has been in and out of the hospital the past year. She's had pneumonia 2 times and been discharged. The last time she ended up in the hospital (2 months ago) she had sepsis (she has bladder problems), and flu a&b. This turned into pneumonia (3rd time). She has congenital heart failure, afib, low blood pressure, incontinence and memory problems (which are severe to us, but we are having trouble getting doctors to see what we see.) She has respiratory distress last week and ended up in ICU for her pneumonia that they thought had cleared up. She was severely anemic and they gave her a blood transfusion. She's breathing without oxygen now and responding to the antibiotics (stable vitals/no fever) so they are about to discharge her. I am worried about her at home (alone) since she lives in unsanitary/filthy conditions. Mold around, over 30+ animals and feces all over the floor, tons of dust, etc. She's also very stubborn and does not want to change her way of living and doesn't want any help. I'm worried that her living conditions are contributing to her constantly being hospitalized for pneumonia since the air is not clean in her home. She has trouble remembering conversations from earlier in the day, or even if she visited a doctor or not. She cannot drive and cannot get herself to doctors appointments. We have set up a car service for her, but she's so difficult in even telling us when her appointments are. What can we do? Do we just let her live how she is living? I feel like she's so sick and has recently escaped death with all of the issues that she's been having. I hate to think that we will put her back in this environment and she'll continue to decline.
Honestly, I have no advice short of filing a self-neglect case with APS, and have them go by and assess the situation.
Good Luck to you
Best of luck!
They likely cannot force her into any kind of care immediately, but ask if they will be reporting her self-neglect; they should send someone to the home to check if it is a safe place for her to return to.
Once she is home, call her doctor and ask how to obtain a complete neuropsych workup. This generally consists of a neurologist, a neuropsychologist and a psychiatric nurse. This is a very thorough (6 hour or so) pencil and paper examination that will document her reasoning, insight and thinking skills, as well as memory.
Good luck! And let us know how you make out. We learn from each other.
The atmosphere of the home MOST DEFINTELY is affecting her health. Full to overflowing litter boxes and poop spread all over the floor--cats are notorious for being on ALL surfaces--I'm gagging a little here.
I just called CPS on a neighbor who is 70 and has had her 3 grandkids dumped on her to raise. Never a 'stellar' housekeeper, she has simply given up and one of the kids' beds is actually a pile of laundry, clean and dirty mixed together. The huge dog runs through the basement apt where they live and spreads the litter box contents all over the place. I can't be in her place for more than like 10 minutes before my eyes are burning from the ammonia and other smells.
Since moving from the upstairs (which was filthy, but had adequate fresh air supply) to the MIL apt in the basement, all 4 of them have had pneumonia, the little girl is covered in eczema so badly she is often bleeding from scratching at herself. I am POSITIVE that the mold, cat feces and such have made all of them sick. It's a 'sick house' that no one should be living in. I have no hope that CPS will really do anything. But I did what I needed to do and stepped back.
Call APS and report her as endangered adult. Give them as many details as you can. They CAN remove her from her home, but most likely they'll do an in home evaluation and try to 'help her'. Really, only in the most dire of situations will they physically remove her.
I am not even going to suggest you try to clean for her. A person who has lived like that cannot and will not change. Her hoard is her hoard and to her, it's probably comforting.
Having her move to some kind of assisted living or NH is what's best--but that's a long shot if she is not declared incompetent.
I'm so sorry for you--I know exactly how you feel (hopeless!) and frustrated and angry all at the same time.
I would call animal control for the animals. Very possible that if the employees from animal control see the living conditions they may report to the Health Department. They may take steps to force a clean up. If she is non compliant with that they may force eviction (after a few court dates)
Unfortunately unless she is declared incompetent she can not be forced to do what she does not want to do.
You could try to obtain Guardianship but again you would have to have a doctor confirm that she is not competent.
If you requested "Home Health Visits" for a period of time maybe they could report conditions and that might prove to be more helpful.
Unfortunately it often takes a catastrophic event to get things in motion that can help make her safer.
Also keep in mind Hoarding is a completely different mental condition than is dementia it might be easier to have someone declared incompetent than it is to get a Hoarder to accept help cleaning up their living conditions.
time case is opened to their arrival.
Just sayin they can be helpful but maybe not always Johnny on the spot.
What have you told anyone at the hospital about your mother's environment?
How long would you say she's been struggling to cope? I assume she's never been a clean freak, but there's a difference between someone who's not interested in housekeeping and someone who can't maintain the routines that she herself considers acceptable.
Don't try to change too much at once. It's partly because she's afraid of losing everything that she won't let you help with anything. Be very careful to pick only the key battles.
I did that for my mother against her will but it ended up being the best solution.
Your mother's doctors probably haven't cooperated because it sounds like your mom can perform most of her ADLs and she continues to recover when she gets sick. Our medical system looks at that situation and says "she can take care of herself once we take care of her current physical issue". It doesn't seem to care about prevention at all.
You may need a guardianship to "force" her into a facility. No POA will allow you to force her into a facility. If she qualifies financially and she is unable to perform the majority of her ADLs, Medicaid will likely pay but it's difficult to get and few facilities take Medicaid. While they aren't very good she would be better off than where she is now. Hopefully, she or you have the funds to private pay for her care. Also, you might look into what we call assisted living. In California if someone doesnt make enough to pay for a facility that's a lower level than a nursing home, the state will make up the difference between your mother's social security or disability income and what the facility charges. You have to apply for that waiver. Here the waitlist is 4 to 14 months long.
I would call your local city officials about the filth in her home. That's also a danger to her neighbors and her animals.
Good luck. I faced a similar situation with my brother. Since he can now perform most of his ADLs - but none of his IALs - it has been very difficult to get Medicaid to approve him. One of the biggest hurdles is getting a doctor on board. He's now in a facility - first in rehab paid by his Medicare 100 days after hospitalization and now under his Medicaid. But Medicaid has only been approved for 6 months.
Things are changing but Medicare and Medicaid still look more at the physical abilities rather than the cognitive abilities. While there are a number of older people with dementia in this current facility, they are mostly there because they were no longer able to perform their ADLs.
I don't recall if she was the existing or former leader, or played some other role.
When visiting at her at her house, as she was cleaning up after dinner, she took a pot with something in it, spaghetti if I remember correctly, put it on the floor and let the dog finish off the leftovers.
I was kind of shocked, but didn't say anything, which would have been very rude. Her house was "lived in", but not anything I would consider close to being undesirable. And she was a doctor, so I assumed she had a busy schedule and had better things to do than worry about housecleaning.
Sometimes clutter is how it's viewed, and by whom.
Sounds like the Humane Society would take the animals out of the home - not an appropriate or healthy environment for animals, either. Clearly, your mother should not be living alone. Yes, file a self-neglect case with APS. Good advice provided here.
My elderly mom was also very stubborn, a hoarder, and suffering from dementia. Luckily, she only had one pet which sadly ended up dying from neglect. I lived several states away.
It took many thousands of dollars, several lawyers, and years of my life to get guardianship that enabled me to move her out of her house, to my state, into my home, and ultimately into memory care. Somehow, I managed to clean out and sell the house, which is a whole other dismal story. The agencies that were supposed to help (e.g., APS) acknowledged that she was a danger to herself, but fought for her rights to do so. Worst of all, Mom resisted my every effort to help her and our relationship has suffered for it.
I am not telling you this to dissuade you because from what you wrote you will probably need to act similarly to save your mother and those poor animals. I am telling you so that you will prepare by getting your own moral support for what will likely be a very trying experience.
I suggest that you start by circling the wagon of family, friends and faith groups. Next, you should contact the Alzheimer's Association and your local Agency of Aging since they have a wealth of experience and resources. Also in addition to posting here, consider joining a local support group and if money allows seeing a therapist. Finally, find respite when and where you can.