So I will try to keep this as brief as possible but this whole thing requires some background. My mom is 70 years old and lives halfway across the country from me. She's the only living relative I have. I am growing increasingly concerned about her safety and health.
Previously, she came to visit us for a few months because I was not satisfied with the level of medical care she was receiving. To my knowledge, she has been diagnosed health problems concerning arthritis, urinary incontinence, heart issues, and kidney issues. She doesn't tell me everything, so I tend to find out about these things randomly. When she first got here (Nov. 2021), her health was not good. By March of this year, it was much better, and she wanted to go back to her home state so she could sell her house and then come back to where we live. My husband and I practically begged her not to go (for reasons explained below), on at least five different occasions, and she went anyway.
Now she is suffering the same problems she was when she first came to see us last fall. Her house has no running water (due to a pipe/plumbing issue she failed/refused to fix five years ago), so she can't clean herself regularly. She has no regular access to a car, as it is broken and she can't afford to fix it. She has to rely on cab companies, as she had the internet removed from her phone (so no app downloads for anything, including Uber). She has no one to help her - no other children, no relatives, and she doesn't know/trust any of her neighbors.
She now claims she doesn't remember my husband and I talking to her about staying, even though we did more times than I can count. I have also grown increasingly worried about her having dementia. She has shown increasingly poor judgment, behavior changes, and repetition in conversations (to name a few) in the past couple years. Truthfully, some days I see her as more of a stranger. A doctor in our area screened her last year (clock test and 3 word recall), and they didn't seem worried about the results, but I'm not convinced. She could do the clock drawing, but could only remember one of the three words they gave her. My mom is smart and (I mean this with all the love in my heart) she is also good at manipulating people. I want to get her back out here quickly so she can receive better medical care and so she can be screened again for dementia.
She calls me at least 3x a week claiming she's done with everything there and just wants to come back to where we are. Every time she does, I tell her to get on a plane. Then she says she can't because she "can't leave certain things behind," even though the things she has mentioned are primarily things that can be replaced. Then she stays where she is until she calls me crying a couple days later, and we have the same conversation all over again. It's been going on for months.
I want to help her, but the reality is we don't have the room for her, as we are expecting our first child in a few months. Soon, I will be unable to travel by plane and I don't have the time off at work to take for a long car trip. I have thought of maybe her staying with a close friend temporarily - but my mom is someone who needs/demands constant attention and wants someone to drive her everywhere and do things for her. She did that to me the last time she was here. I am not sure if she can truly live on her own anymore. I have previously explored independent and assisted living, but she doesn't have the money and neither do we. She has Tricare for Life for her insurance, so I know most long-term facilities would take that as long as there was a medical need for her to be there.
If you've made it this far, I applaud you and would greatly appreciate any feedback you could provide. How can I get her back here quickly? Does anyone have experience with dementia and think she needs to be re-assessed? Any other advice?? Help!! TIA!!
Your mom is still considered competent, and so has the right to make her own (poor) decisions.
The gold standard for testing for dementia involves testing by a neuropsychologist. It’s paper and pencil testing and takes about 3-4 hours. It involves testing judgement and thinking ability, not just memory.
In your shoes, I would call the local ( in mom's community) Area Agency on Aging and Adult Protective Services both. Your mother is a vulnerable adult who may have dementia and possibly some mental health challenges as well. Let the professionals in the area take a look and let you know what the best course of action is.
It may be that there is nothing to be done now, that you must wait for a crisis like a fall or illness that leads to hospitalization.
I don't believe TriCare pays for Long term care, but I will leave that to others to tell you.
If you CAN convince mom to leave all behind, PLEASE don't move her into your home. At the very least, get HER local Area Agency on Aging to do a "needs assessment" and find out what level of care she needs.
Again, welcome and (((hugs))).
TriCare doesn't cover long term care facilities, according to Google:
https://www.tricare.mil/CoveredServices/IsItCovered/LongTermCare
Your mother can call her TriCare rep to see what all IS covered in terms of benefits in home, etc. But if she has a home, it can be sold to cover the costs of Assisted Living or Independent Senior Living, at least for a period of time. But again, you're in no position NOW to be selling her house and getting that living situation set up for her.
I like BarbBrooklyn's idea to call mom's local Area Agency on Aging & APS both; APS to do a wellness check on her, AA on A to do an evaluation. Living w/o running water suggests either dementia or a mental health issue is at play here. In the worst case scenario, can you possibly afford to send her some money to have the plumbing/pipe issue fixed? Or do you think she'd wind up not having it fixed if you sent her the money?? If dementia is at play, or even mental health issues, that could wind up being the case. Have you any idea the condition of her home? When is the last time you were physically inside of it? This is another good reason to get the Area Agency on Aging & APS involved; they can go inside mom's home & do an evaluation FOR you.
You may indeed wind up having to wait until mom has a crisis before you can do anything for her, especially if she's deemed competent to make her own decisions.
This is a tough spot to be in, so I wish you the best of luck trying to get mom the help she needs. Good luck with the impending birth of your baby, too.
I haven’t been back in that house since 2015, and it was very cluttered and dusty then but not uninhabitable. Since the pipes burst, she hasn’t done anything to clean it up. She seems to think she’s going to get back what she paid for the house - the reality is, I think she’ll be lucky to get $40,000 out of it from a flipper.
My worry about her staying there is that I don’t know how the care facilities there are, and I’m scared I won’t get her back out here if she has to stay in a facility there.
Your mother’s health sounds not much worse than average for a 70 year old - “arthritis, urinary incontinence, heart issues, and kidney issues” and possibly early stages of dementia. She might live for at least another 20 years.
Her behavior DOES sound worse than average for a 70 year old. Remember than many of our carers are 70+ and are carrying serious burdens. Your mother at this age “needs/demands constant attention and wants someone to drive her everywhere and do things for her”. “She is also good at manipulating people”. If she lives close to you, you can be sure that it is going to be a nightmare.
She may be your only living relative, but she is doing what she wants to do. Unless she is diagnosed as being legally incompetent, you can’t force her to do anything. You can’t even drive there, scoop her up and bring her back, if she doesn’t agree. And if you did, who is going to cope with her house problems? Or her housing problems close to you? You and your husband will have enough on your hands with your first new baby, be quite sure about that.
Think about just letting this go, at least for now and perhaps until there is a crisis. Let her do what she wants. Put your phone to record her messages, and phone her back once a week. There is absolutely no benefit to either of you in conversations every couple of days where she cries and you feel awful. Stop feeling that you are responsible (you aren’t), wait for her to move on a bit, and focus on your own life. Get that under control first. Stop worrying. It’s her life, and she’s making the decisions.
Her behavior sounds very similar to my mom's. She started with mild cognitive impairment and now has mild/moderate dementia. So my guess is yes she has some level of dementia. That first test you mentioned? I found it pretty useless. It's so much more complicated than drawing a clock and remembering words. It's also about cognitive things like being able to plan things, make sense of things etc - which that test does not look into at all.
It sound like her house should be condemmed as it does not sound liveable to me. That's another phone call to make and if they say it's inhabitable, they can help figure out what can be done with her next. Support her through this but don't take it all upon your shoulders. It's just too much.
Good luck.
I just don’t know how the places to live there are, especially the care facilities, or whether they’re any good. And she’s hell bent on selling this house above all else, including being here for the birth of her first grandchild.
You say that “she’s hell bent on selling this house above all else”, except that she’s NOT. She says she can't because she "can't leave certain things behind", which you know doesn’t add up. You haven’t seen this house since 2015, when it was already in poor condition although she was only 62. You know that it has deteriorated since then, so she is probably too embarrassed to let anyone in to put it up for sale.
I’d strongly suggest that you put this on the back-burner for now. If she wants to be there for the new grandchild, she can stay in a hotel. This is absolutely normal when grandparents live somewhere else. You can wait to see if things get better or worse. You haven’t visited her at home since 2015, no matter how ‘beloved’ she is. There is no real urgency right now.
You have permission to let her make her own choices, without Fear Obligation or Guilt. You DON'T "have to worry so much".
You know that your mother wants to move in with you, and you want to give that option a firm NO. Just pretend that she accepts that, and think about what she wants as second best if she moves closer to you. Does she want to go to AL or Senior Living? Will she be happy there, willing to make friends etc? How long are the wait lists?
What does she want to happen to her existing house? That’s been confusing, but if she moves she will have to make a decision. Does she expect ‘family’ (you) to go there to clean it up and put it on the market? What repairs does she think should be made to get a better price? Or what other alternative?
Think about what she wants as second best, and talk it through with her. Does she accept it? Can you and your husband accept it? Is your best guess that it will all work out well?
If you think it’s good, you can make a plan that takes into account your own needs. If you think it isn’t OK to her or to you, stop focussing on ‘how can I get her here’. You need to think past that. And it may involve waiting for things to change, so that things actually do become acceptable.