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Help! The assisted living facility that my parents are in has called me for a care team meeting because my mom is physically abusing my dad and seemingly denying him food. She apparently is pretty aggressive and barricades the door. They want to either separate them or get her a psych eval and have her medicated. I am at my wits' end as she has always been VERY hard to deal with and I am basically ultra-low contact with them. Can/should they call law enforcement when they see her physically attacking him and get her on a psych hold? I feel like they want to punt the issue to me, but I don't want her attacking me in the car or something. YIKES! Thanks for any thoughts! She has not been diagnosed with anything (refuses to see a doctor & the facility doc wants nothing to do with her) and is competent, at least on paper.

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Your Mom will not be able to stay in ALF.
She needs memory care.

Likely that is what this meeting is about.

Yes to the evaluation. Yes to higher placement. And yes to guardianship in protection of your Dad. If you are POA or next of kind then they aren't punting this in your direction, it IS in your direction. If you feel incapable of handling this then do not take on any POA or higher fiduciary duty and tell them that Mom is going to have to move into the guardianship of the state so she can be evaluated and cared for.

I am assuming that this is not a new and sudden behavior switch that can be due to a bladder infection or a stroke, or something else undiagnosed.

To be frank, you have an amazing facility there. Most would have had Mom in EF whether she wanted to go or not. That is ONE quite way to get evaluation. If it is mentioned as an option I would jump on it as this will get complicated when Mom's care costs easily twice what Dad's does for memory care and she requires Medicaid and separation of financial assets.

There are some hard times coming. No question about it.
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needhelpnm Sep 2023
Hard to say, as she has been physically abusive to my dad in the past.

What is EF? (And it is an amazing facility!).
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- Yes to care team meeting.
- Yes to separation.
- Yes to evaluation. I'd be open to medication based on eval. Could be anything - eg stroke, dementia but a full physical & mental eval hopefully brings a diagnosis & treatment plan.
- Law enforcement - Avoid.
Not sure avout US, but where I am too many people with mental illness/cognitive changes injured in Police confrontations.
- Absolutely no to driving Mother yourself if she is unpredictable. (Barb B may reply with her dire tale of how that can go). Arrange supervised medical transport instead.
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needhelpnm Sep 2023
Yes, you are right about law enforcement. She might be suicidal and lunge for an officer's weapon, hard to tell how lucid she is. We also have real crime here, so I hate to pull officers off the streets. (I posted a few months back about how she called the police because she did not like her food).

She has beaten up on dad in the past -in front of caregivers!- and she was competent then. I don't know how to get her evaluated when she tells anyone who will listen that she does NOT need to see a doctor (and has been saying that for years). I do think the facility is open to having her transported to the ER for a psych workup based on her abusive behavior. It could very well be a UTI or some such.

I really appreciate your insights!
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A doctor has told me in the past that he would (and did) prescribe medication that would help, but some situations are best handled by law enforcement. He advised me to call them if necessary.

This doctor was the chief medical director of a rehab facility where the patient was being treated.
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needhelpnm Sep 2023
That is good to know! I think the staff don't want to call unless it is really bad, but I will tell them that I trust their judgment and won't be upset if they do that. Sometimes strong measures are called for.
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I understand that you aren’t in close contact with your parents. I’m sure that you have valid reasons for keeping your distance.

I do feel that you must respect the facility’s need for you to be involved with this matter, certainly for your dad’s sake, also the staff and other residents at the facility. How is your dad handling this situation?

Your mom has to be evaluated because of her behavior. No matter if she is completely competent or not she isn’t behaving normally at this point in time.

Did they give you a reason as to why the doctor at her facility wants nothing to do with her?

Do not drive her anywhere. Allow them to transport her to be evaluated.

Law enforcement, eh, that’s tricky. It depends on the situation.

I know a woman who has a son in his 20’s who has severe autism and possibly other mental health issues. He is extremely violent with his mom and grandmother. Law enforcement won’t get involved due to his autism. They have left it up to mental health professionals to deal with.

Best wishes to you and your family.
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needhelpnm Sep 2023
Thank you!
Yes, I am definitely planning to go to the care team meeting and work with them as best I can.
Right now dad keeps falling every other day or so. He is completely cut off from the world due to his profound deafness (mom won't let him wear hearing aids, I use an amplifier when I do have to go see them). When he has fallen, the staff has seen her pulling his hair and screaming at him. I honestly wonder if she pushes him. I think my father is just stoically enduring her, as she has always been abusive to him (71 years of marriage!).
The doctor in the facility just was fed up since she told him there is nothing that can be done for her back pain, which she was complaining loudly about.
It's a tough situation, but the only way out is through I guess!
I can't tell you how much just venting to this forum helps me though!
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If my step-father had continued to live, we would have had to separate them. He was a bossy, impatient man who was always hollering at his wife. He refused to accept that she had dementia, which she does, FTD.

We talked to him several times about this, to no avail.

He passed before we had to make the move.
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needhelpnm Sep 2023
I am so sorry MeDolly! Your stepfather sounds like my mom.
My dad has major short-term memory issues (so he is a perfect abuse victim) and mom alternates between telling everyone he has dementia and denying it. I have never seen any reports that abuse/yelling cures this disorder, but you would think she is convinced of that :(
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I think that they should be calling 911 and having EMS transport her to a secure psychiatric unit for evaluation.

I would suggest that at the care meeting. Your mother may need a different sort of care facility from your dad.
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needhelpnm Sep 2023
This is so helpful!

I won't be alone with my mom and they know it, but were still saying I would "have to" take her.

Nope! They have Medicare Advantage, so hopefully it pays/reimburses something...
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Let me add--do not drive your mom ANYWHERE in your car.

My mom, the sweetest person in the world, tried to grab the steering wheel from my husband as we drove her from rehab to a new AL. Don't know why, but if it had been me driving, we'd all have been in a ditch

From there on in, mom was transported by ambulette to doc appointments and the like.
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needhelpnm Sep 2023
I am so sorry that happened!
My mom is a hellcat if she doesn't get her way, so this transport needs to be handled by professionals.
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So I am a little calmer now and have a few more follow-up ideas/questions.

I am an attorney who is trying to make a career change to teaching high school in a high needs urban area. It is very rewarding personally, but definitely not financially. I would rather not walk away from this new path just because mom is crazypants and their care will get very expensive. If they get divorced due to her abuse, I think she should be able to qualify for Medicaid. She would not be able to stay in the AL where she is and dad's costs should be manageable with just a little bit of help from me. I am also wondering if her behavior might be attributable to a UTI due to her hoarding and reusing toilet paper and disposable underwear (eww, but she is very proud of her frugality and also nuts).

Yeah, I will consult a real attorney in due course, but these were just some ideas. It's sad that it has come to this, but I blew up my life once to come and take care of them, I am not doing it again :(
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needhelpnm Sep 2023
Haha, word! I already did a bunch of those and learned the HARD WAY. They program us to sacrifice ourselves, I hate to say it. Thank you so much Barb!
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I would get your Mom evaluated. There is something going on here. You may have to separate them. I know ur a lawyer but you may need to see an Elder Lawyer who is well versed in Meducaid. People like Mom cannot be put in Memory care either, they just aren't equipped for aggressive people and need to protect other residents, So LTC is the answer. (Long-term care) An Elder lawyer can split your parents assets. Moms split going towards her care. When her split is spent down, then u apply for Medicaid for her. Same thing with Dad. If he is showing signs of Dementia, at some point the AL will suggest Memory Care.

I don't think Divorce is the answer, Moms entitled to her 50%. Plus, with Dementia, Dad is not competent to sign a contract. I have given u the basics. An Elder lawyer can go into it more thoroughly.
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needhelpnm Sep 2023
For sure and thank you!

I think the first step is to separate them and make it clear to mom that she cannot abuse dad any more FULL STOP. She's been doing it as long as I can remember, but it was mostly "just" verbal/emotional abuse, and back in the day, he could give as good as he got. (They were fun parents! /sarcasm).

Then tell her that her only chance of living with him again is to get a doctor to check her out and hopefully medicate her. (Heroic assumption that she will understand any of this, but I am happy she is so out of control that she is doing this in front of witnesses). If she can settle down, we can continue as is, with me just pitching in a little bit for their expenses right now. That would be the best scenario.

Divorce is unlikely to work as long as they are competent, since they won't agree to it, and if they're incompetent, it also won't work. Plus they own a house that I live in and take care of (it was borderline a hoarder house & is much better now, but would still take some time to get in sellable shape) and we'd have to deal with that.

This forum has been so helpful- I am definitely going to update you all about the care team meeting. Hugs to everyone who has read my confused meanderings and shared their hard-won experience!
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Yes Yes and Yes.

Abuse is not to be tolerated.
This is a very serious matter.

You need to do whatever to insure NO one is abused or injured.

It sounds like this abuse has gone on for a long / some time and is a pattern, perhaps of their entire marriage.

This is larger than you and your concern of your mom attacking you in the car.
She should not be in anyone's car.

If you are not the legal guardian / authority to manage her care, the person who is needs to handle this asap. It sounds like your parents need someone to manage their care as you have chosen to be 'ultra-low contact.' They need someone(s) who are very high level involved in their care and arrangements.
I sense you are traumatized by your mother (narcissistic personality?).

I recommend that you get into therapy - and step back from ''hands-on' care - decision making if at all possible. Have another family member, or a professional social worker/care, manager manage their needs.

I do not know why you are at your 'wits' end' as you are not involved much based on your words/involvement here. I believe you are overwhelmed with the history / relationships with your mom / parents and cannot manage their needs.

Yes, of course, call Adult Protective Services / law enforcement. Why not?
(You are an attorney ... and do not know this?)

I sense that you do not want your dad injured.
I do not understand your reasoning or lack of understanding the need of immediate intervention. You do sound traumatized. And if you mom is a narcissistic personality type, this is understandable.

Take care of yourself.

Gena / Touch Matters
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IneedPeace Sep 2023
Gena your words are "judgey and "blamey". Touch matters- but words do too. They touch the soul.

"(You are an attorney ... and do not know this?)"

"I do not understand your reasoning or lack of understanding the need of immediate intervention."

"I do not know why you are at your 'wits' end' as you are not involved much based on your words/involvement here. "
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Start with the UTI! My mother started getting aggressive (more than usual) and the facility referred her for a psych evaluation. In the ER, they discovered the UTI. Once it was treated, she was back to HER normal, which isn’t exactly normal. Some of the dynamics you describe are why we won’t have my parents together in SNF when/if it comes time for him to leave the house. Sounds like if it is a UTI, that won’t be the end of the discussion, there are lots of good suggestions above.
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Yes! Remove her from your father's presence until she can be evaluated by Adult Protective Services (APS) and request an emergency 72 hour hold for a psych eval.
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separate your father immediately. He will be so grateful. After that, what they do with her is for them to decide?
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needhelpnm: The facility should be calling 9-1-1.
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I don’t think she’s competent. Assisted living is wrong place for her. She most likely has dementia since she became violent. She needs script Seroquel. Take her to neurologist by ambulette asap . He or she will prescribe. Hugs 🤗
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