Putting On My Big Girl Panties

My mother was always a very strong-willed, independent woman so my brother and me couldn't figure out how to tell her it was time to seek help.

Her living conditions had become deplorable. She had lost her dentures and wasn't eating properly. Medications were taken haphazardly if at all. It appeared she was basically sleeping 24/7 and she didn't know if it was day or night when I called.

I hounded her to get a will and POAs drawn up and suggested she move out of the house into an assisted living facility almost to no avail. Then magically, it seemed almost over night, my brother texted me to inform me she had found a place in town and was moving within the week.

Had she never made the initial move, I'm not sure to this day what would have happened. While this move was a game changer, it wasn't long after that things started going south. I discovered payments hadn't been made, she was starting to receive collection notices and she only had a particular amount of money left in her checking account. And she still hadn't finalized the POAs.

After commiserating with a cousin and picking his brain for suggestions of what he and his sister did with their parents, he basically stated, "It's time to put on your big girl panties." I knew he was right, but wondered, "Can I really do this?"

Basically, I felt like I became an overbearing, bossy broad. I have a better word, but can't bring myself to use it! I made an appointment with the lawyer she had originally gone to. It was iffy, but basically he told me that if he felt Mom was capable of understanding what was transpiring he would agree to finalize the paperwork. After all, she had drawn up these papers the year before and nothing was being changed. Also, it was her children who were seeking assistance so they could help her and not a stranger. The day we went, Mom was in top performance and everything went smoothly.

Now we had the means to make decisions for her. Originally, my brother was going to be the Medical POA as he lived in the same town and could take her to doctor appointments, etc. I was to be the Property POA and would pay the bills.

After she moved out of the house, I had the freedom to take all her boxes of documents dating back to approximately 1965. She also had a metal box that she always referred to as her Death Box. We always joked about it, but I must say it came in handy for the most part as it contained information regarding banking accounts, bonds, insurance policies and the like.

At this stage of the game, Mom was able to go with me to a lot of the appointments I had to do. The first thing I did was have her cash a bond that her mother had purchased for her at the time of her birth. This helped get us some money so we could start paying off all the delinquent bills. I also had my name added to her checking account and then created an online account so I could pay bills electronically as I lived 3 hours away from her.

Schmuck is an understatement of how I felt about myself during all of this. I had taken her Death Box, cut up a credit card, eventually took away her checkbook. But I also knew she was now protected and we could make decisions for her.

Over the past 3 years, we have sold her car, had a sale and sold most of her possessions, gave the rest to charity and finally sold her home. All this without her knowledge. Most of this took place after she declined further and had moved into a memory care unit, but it still felt wrong. And mean. And ugly. I guess that's why they call it Tough Love. Not sure if that means tough on the person you're trying to protect or tough on the person doing the protecting. Either way, it's tough.

Guess that's how big girl panties feel.

Is It Time To Move?

When do you know it's time for your loved one to move into a facility? And what type of facility do you choose?

Living a few hours away from my mother and only visiting every few months, it was difficult to ascertain at first, but here are the 8 categories I have determined to view: Diet, Medication, Falling Risk, Socialization, Sleep, Finances, Safety, Wander Risk.

1. Diet - Are they eating properly? My mother was always thin, but when she lost her upper dentures and wouldn't go get new ones, she had lost a lot of weight. What she was eating was also questionable. It was either take out or anything microwaved. Nothing of good quality.

2. Medication - If your loved one takes medication, it is important to be taken as directed. When visiting, I would find pills on the floor, in the shower caddy, on the kitchen counter. Because she wasn't taking them as directed if at all, it caused a lot of confusion to the point that sometimes she wouldn't know if it was 8 in the morning or 8 at night when I called.

3. Falling Risk - Do they have balance issues and are at risk of falling? Accidents happen and you can't think just because someone falls that there is an immediate danger. But have they fallen several times? What is causing them to fall? Clutter? Declining eyesight? Dizziness? My mother had been sitting on a stool doing the dishes and forgot her feet were behind the rungs of the chair so when she went to move, she fell straight out of the chair.

4. Socialization - Not everyone is a social butterfly. But everyone does need some sort of stimuli. Is your family member getting outside for fresh air and exercise? Or have they isolated themselves indoors and come up with reasons of why they're just fine staying indoors 24/7.

5. Sleep - Do you notice that your loved one isn't getting enough sleep? Too much sleep? Strange sleep habits? For me, it was realizing my mother was sleeping on the couch for a nap. And then using it as her bed at night. And eventually sleeping constantly. Between her lack of medications, depression or a combination of both, I realized all she was doing was sleeping all the time. To the point she was even having accidents on the couch. This was something I knew my mother would never have done before.

6. Finances - Are their finances in order? I didn't find out until it was almost too late that she hadn't been paying any of her bills and already had debt collectors starting to send notices.

7. Safety - Is it safe for them to operate the stove? My brother and I didn't have a definitive answer of what was happening with Mom, but felt there could be a fire risk should she forget to shut off a burner.

8. Wander Risk - Has the confusion become so great that you are fearful should they go out of the house for a walk they might not find their way home?

Once you realize that their general welfare is no longer able to be maintained, it is time to determine how their needs can be met. Everyone's needs are different depending on if the person with memory issues is a spouse or a parent. Whether you're working and don't have the luxury of staying home to care for them or if you're retired and can't physically care for them any longer.

It comes down to can you care for your family member yourself, can you afford to hire someone to come to your home or do you find a facility for them to live in? For the latter choice, what facility works for your loved one's needs?

I have found it falls into 3 categories: Assisted Living, Memory Care, or Nursing Home. This can be tricky. Assisted Living can be perfect and many take Medicaid, but if your Mom is a wander risk, this won't work. Memory Care is awesome, but few if any take Medicaid. Most are private pay. And if your parent is still fairly young, you may not be able to afford 20 years at that type of facility. Nursing Homes also take Medicaid, but if your family member isn't in a wheel chair and is a wander risk, that type of facility still doesn't fit your needs.

Don't despair. While you don't want to make a rash decision, just do the best you can for the present moment. If there's one thing I learned in the past two years, I only worry about what is in my control. My mother started at an Assisted Living facility. When she allegedly struck a health care worker and then not long after was found by a police officer in the middle of a divided highway, it was a no brainer to realize this community was no longer a good fit.

Next stop was Memory Care. We found one place that supposedly would take a certain percentage of residents to be covered by Medicaid, but had to wait until there was an opening. Since we didn't have a choice, we found a lovely private pay facility about 30 miles from her hometown. Eventually the other place had an opening about three months later and she made her third move into her now present facility.

Will this present facility honor the Medicaid promise for us when that time comes? I can only hope  they do. But that is not in my control. And my mother is too mobile for a nursing home at this point. So we wait and see. And pray.

Do your best. Do your homework. And learn what is in your control. Take each day as it comes. And breathe.

Our Journey Begins

My mother has dementia. When did this begin? We may never know, but in looking back over messages between my brother and I regarding Mom's health, we know that it was at least three years ago when he started noticing her confusion and constant sleeping.

There never was an actual, concrete diagnosis, but it was made fairly clear from the doctor that she has some form of dementia. Since that prognosis, the past year has been a blur with getting her affairs in order so that I can oversee her care. Perhaps if I share her story, your journey can be less confusing as you begin the process of what to do first. Here is my recommendation for the first three things you need to do for a parent preferably before anything mentally or physically happens to them:

1. Obtain power of attorney (POA) both for property and health
2. Obtain power of attorney (POA) both for property and health
3. Obtain power of attorney (POA) both for property and health

Did I mention to obtain POAs? When the family began to notice small peculiarities, we suggested she go to a lawyer to have both a POA and a will written up. She insisted she was fine, and truthfully, we didn't know what was going on with her. We would agree with her that she was fine and that was why she should do this now. We gave her scenarios of what ifs. What if you fell and hit your head and went into a coma? What if you needed surgery and had complications with anesthesia? What if, what if what if? We wanted her to know this paperwork was not to see how her property was divided between the family, but to protect her by allowing us to make decisions for her and not the government. I think it was the threat of the government overseeing her care that convinced her to make her decision.

Eventually she went to a lawyer and had papers drafted up, but never finalized. Long story short, a year passed and by that time she had moved into an assisted living facility. We finally convinced her to go to the lawyer and all of us went together. While the lawyer was hesitant as to her cognitive ability to understand what she would be signing, I suggested he make that decision when we came in.

It was a good day on the day of our appointment, Mom understood everything. Being it was paperwork that she herself had written up the year prior, and that it was my brother and me who were to be the power of attorneys, the lawyer agreed it would be okay for her to sign.

We were fortunate. Six months later and it would have been an entirely different ball game; most likely going to court for legal guardianship. Because we now had POAs for both property and health, we could make decisions, pay her bills, talk to doctors. Without it, we could have done nothing. 

So here I am, three years later from that first conversation with my brother and anxious to share what we have faced so far. I realize this is only the beginning, and the difficult journey of watching her slowly recede into the abyss of her mind is just starting. But, for now, life is good. She laughs, she knows us, she is healthy and happy. Most importantly, she is safe.