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To keep this very complicated issue short:



Only child son living with not-officially-diagnosed ALZ or LBD (dx is cognitive decline) mother and is the only caregiver available.



Because of a incorrect legal description, during the deceased dad's name removal the house HAD to be transferred to son in violation of the Medicaid 5 year look back rule to correct the deed.



There isn't enough cash value assets to pay for care without Medicaid.



Living in very rural location -- limited help of any sort.



No one is taking clients in either home care or private care, friends can't take her and since every one is in on the conspiracy, she trusts no-one.



Capgras has made son an imposter.



Wife/DIL goes to house to provide respite care because son is in high burnout mode. Verbal fight ensued when Mom/MIL puts together that imposter and DIL are married.



Now in her mind Wife/DIL has killed her real son, married her caretaker and betrayed her and her son.



In her mind, they are trying to get her taken away and take her house from her.



She calls law enforcement to have DIL and her husband removed from "her home" and before they arrive, threatens to do it herself.



When that didn't work, she is now scheming to have her church members and friends get rid of her "former DIL" and "her husband" from "her home".



It is one big conspiracy in her mind that everyone wants her "gone" and take "her home" and wife/DIL is behind it all!



One can't make this stuff up!



Any ideas on how to get her help to alleviate the abandonment issues of leaving her home alone while son gets some respite?

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FWIW, here is a little more clarity that might help someone else.

She lives in a state that gives 100% full physical autonomy as long as her rights have not been removed by the court. Her rights are fully intact. First responders can only transport if she agrees to go with them. This law was passed as part of the PAS/Death with Dignity Act. The DPOA, the medical POA and Living Will are absolutely useless and can't even get her medicated. While the legal backing allows anyone the owner/son wants in the house, anyone else "invading her space" keeps her angry and agitated. Leaving her alone became the only option.

Don't blindly trust the legality of any planning documents. Always double check with the state the patient lives in regarding any planning documents as they may/may not work as intended.
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Aging care forum comes through again. Thanks for the advice.
 
We've gotten in touch with an attorney and have directions for both the house issue and long term care. For now, she is living alone with the appropriate agencies having been notified. Additionally, the adult grandchild (AGC) is looking in on her daily with the option to stop that any time AGC chooses. Our duty of care responsibilities are met and that is all that can be done for now.
 
With that said, here are a few tips learned:
 
1) Double check all documents for good/legal/if it even matters -- even if it comes from an attorney. No matter what a PoA contains, there is at least one state that limits the document to financial matters only! This bit us big time as we thought we had the long-term matters covered via a legally tight PoA.
 
2) Somehow, before it is too late, get a doctor to put the term dementia in the patient records. Even if it isn't called out as anything other than "dementia: not otherwise specified" it is invaluable to have this in the patient records.
 
3) Never, never, never, never, (did I say never (-: enough) ever mix finances with someone suspected of dementia or separate the finances if they were mixed before the dementia. We mixed and didn't separate before the dementia hit and now it is another huge bite to us/son.
 
4) There is a thing called Capgras (imposter) syndrome. While it is generally known that someone with dementia/ALZ forgets, this rare and little talked about syndrome really bites hard for those that is deemed the imposter. It can cut off support avenues that are otherwise there in other dementia situations re: respite, private help, AL and MC. Read up on it, ask questions and believe me when I say IT CAN and does HAPPEN.

5) Quickly get over the guilt! The bad decisions of the past made by the person with dementia do not constitute emergency and guilt for anyone else involved. Always place yourself first because if the patient doesn't have you, there are times it means they have no-one.
 
We no longer believe in the "you'll miss them once they are gone" or "it is the disease talking" or "family as caretakers" theories of surviving this [H E double toothpicks] disease. So long term care insurance, here we (son, DIL and AGC) come!
 
Later...
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I had a father who was a raging antisocial Narcissist for most my life that just got worse with age. Hoarding, lying, cheating, bad temper, verbal abuse, paranoid delusions, non-compliant with anything to do with his health, incapable of empathy, selfish, etc, etc. He was not a good person. After I got him placed in AL, I lived in constant fear that he would do something to get himself evicted. I don't know how the staff dealt with him; I sure couldn't. In a meeting with the head of nursing, I signed a DNR as his DPOA and I told her if he gave them any trouble, they had my permission to "Baker Act his a**."
His behavior couldn't even be blamed on dementia; he had always been that way. His verbal/emotional abuse of my mom for 64 years of marriage was the long term stress that ended up killing her. Some people are just so disordered that there is nothing anyone can do. His hateful personality and behaviors alienated everyone and he died alone. I did not shed one tear.
Please find a way to rescue the only child son from the nightmare he is living and have the mother committed.
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AinSeattle Jan 2022
"After I got him placed in AL, I lived in constant fear that he would do something to get himself evicted"

Exactly what we fear too -- that if we can even get her in AL/MC, she will get herself kicked out.
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I agree with the others that admission to a psych unit to get some meds to help alleviate the situation would be helpful. Call the local Behavioral health hospital and ask how to do an involuntary admission. Also, find an eldercare attorney. Even if it's a little outside the area, maybe they can do a zoom consultation and give some direction.
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Your Mom would not be allowed into Long-term care if its thought she is a threat to other residents. You need to try and get her to a neurologist to have meds prescribed for her to help with the paranoia. Maybe he could also send her for a psychic evaluation.

I agree you need an Elder lawyer well versed in Medicaid rules to straighten out this house thing. Its may be just a matter of turning it back over to Mom or selling it and using the proceeds to pay for her care. When almost gone, then you apply for Medicaid.

If your Mom ever becomes violent/agressive, that includes hitting, call the police and say you need the baker act instituted. She needs a 72 hr psyhic evaluation.
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She needs admission, probably via the ER to a psychiatric facility. She desperately needs nedication to calm her agitation.

Has a competent elder care attorney been consulted about the deed?
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