Today, I called my Mom twice and after finally reaching her, she told me ale was trying to pay her electric bill as they were going to shut it off today for non payment! She couldn't figure out how to pay the bill even with the prompts that were given over the phone. As soon as I found out, I used their bill pay service to take care of it for her. There's still a chance she may be sitting in the dark tonight if they didn't see the payment in time. She's well off and paying her bills is not a hardship, however she has forgotten to pay 2 of her bills in the last month. I was able to put both fires out, thankfully. She truly doesn't see that she is having memory issues. Denial is where we're at. These 2 bills are just a couple of things that have been going on with her and her memory failing. How do you deal with someone who's in denial? Even her doctor doesn't think she should be living alone. I'm at a loss how I can help her?! She already harbors resentment from me trying to get her tested for dementia last spring. She thinks I'm trying to be the "boss". I've had to pull back and spend less time with her in order to protect my feelings from being battered. (Life long story of self-centeredness.) She's getting worse and I'm at a loss as to what I can do. Fyi, I do have her POA for her health while my brother has her POA for her finances (he lives in another state). She's turning 90 this April.
Is the POA in effect?
If so your brother should be arranging that bills are paid on line. If this is not something he wants to do the bells can be sent to him rather than your mother. then he can pay them from her account.
If the POA is not in effect and you have no indication from a doctor that she has dementia then as difficult as it is you need to step back and wait for something to happen that will force some sort of action.
But given what you have said she should not be living alone. And if she drives she should not be driving.
Then the difficult decisions...does she go to Memory Care or move in with brother.....no way you should care for her given what you have said in your post. Or Caregivers move in with her.
Yes I agree it's time for an assessment. Starting with a quick screen test at the local Doctor.
If POA is already arranged, any further full neuro evals may not be needed.
Do you & your brother get along ok? Can you arrange a meeting (video call) to discuss? Can he take on the financial POA duties asap?
Does he want/need to visit & get the real picture first (ie get his boots on the ground?)
As there can be the "Oh Mom is fine I'm sure .." folk who need to see which their own eyes.
That can leave you in a very tricky spot. With care duties creeping up (ie 'mission creep') but no authority to make changes.
PS Look into the care topics under Anosognosia. This is the medical term for the lack of insight regarding memory loss you mentioned. It differs slightly to denial but is similar.
When there is damage to the brain, the brain may not know it.
I will try to find a link.
Your brother needs to take over paying her bills as her financial POA while you handle her health decisions that now she is unable to do for herself. She should be moved into a facility as a safer placement.
Also, for those rare bills like an ambulance transportation bill, those too can be added to a one time pay in one’s bank bill payer plus so there is accountability. No cash should be involved in paying anything.
We live in a modern age of caregiving. Using the modern conveniences will make less stress for caregivers and more time for other things.
Put all her bills on auto pay, switch them all to paperless statements that go to your email address or change the mailing address to your house so she only gets the “junk” mail. Remove the stress of wondering if her bills are getting paid. If she asks where her bills are, just say, “Oh you must have already paid it if no bill has come”. Eventually she won’t even remember she has those bills. Out of sight, out of mind.
I started slowly with my dad when he was in very early days. I would put one on auto pay and then wait a month or two and then do another. The slow trickle of the bills not coming in was not jarring and as long as he had one or two to pay every month he wasn’t suspicious. Now he only writes checks for a few bills every month and I monitor those on line to make sure they got paid. Start with the important ones first like the power bill and go from there.
My mom digs in further, total denial when she’s scared because part of her knows she is becoming less capable. In fact we know when she’s falling a step down in her dementia when she starts trying to take back more control. Gets mixed up with UTI sometimes but similar behavior. We try to use humor which 80% of the time works so laughing about something rather than telling her it’s wrong or sounding concerned about it. Now it’s a bit easier for us because she had a stroke in 2016 which left her with aphasia and we blame her miss wired brain on the stroke rather than dementia which we know she has. When she gets worked up about not being able to follow directions on the phone just laugh and agree about how tiresome jumping through all those hoops can be to get to where you want to go. But what difference does it make wether she can do it or not, she has you and your brother to do it for her rather than wasting her time on hold a million times…
“Maybe it’s time to think about downsizing Mom.” Wouldn’t it be nice to move into a community where all your neighbors are closer in age and you have your own “people” to do things for you that you don’t want to? I keep hearing about friends who have finally done that and how great it is.” When she resists because she can do stuff on her own where she is just agree, “I know you can but why do you want to if you don’t have to?” Don’t press just keep revisiting the topic from time to time. Maybe you are going to just look at places to get a feel for what you will want to do when your ready and she could go along to offer her opinion (lol) or maybe your brother brings it up every so often as well.
Every time you are able put the weight of necessity on the doctor, this is what they are saying or better yet make sure the doctor is expressing their concern that she is still living alone so when the time does come the “blame” can be put on the professionals if necessary.
Denial I think is inevitable both with aging and especially with dementia and I get it as I age. Can you imagine knowing you are loosing your ability to think clearly as well as loosing the ability to simply walk down the stairs without pain? It’s no abnormal, nor does it render us useless or ashamed of and that’s something we as a society need to alter our views on. In my opinion.
maybe she needs to sit in the dark for a few days and have consequences of lack of Bill paying. If you think that would make her aware. The other thing is to arrange another place and just tell her that due to non payments the house has no power so she has to move.
do you have a POA? That helps with your authority to step in
Then contact all her utilities/credit cards/whatever bills she has, etc and make arrangements to have them paid either by your brother or auto deducted from her bank account.
You can tell her about this, but as you know, she’ll claim she doesn’t need/want that. Don’t worry about what she says…don’t argue or try to make her understand…it won’t work. Just go ahead and do what needs to be done. Take her checkbook/credit cards if she’s spending irresponsibly or still trying to pay bills that have already paid.
You (maybe your brother too) will be the bad guy. It’s so common, Get used to it. Start making arrangement for help to come in daily and help her with meals, cleaning etc. She may be better in an assisted living place. Start doing your research on what’s available near you (or your brother). Again, don’t bring this up to her at this point, it’s still early in the process. You don’t want to take her finances and try and move her all at the same time…that’s too much too soon.
However, she needs daily assistance and if she has the funds, then by all means hire someone. She won’t like that either, but you need to start somewhere.
You brother who has POA should start managing her affairs. He has legal documentation that allows him to manage her finances, while you do not. Some entities, such as banks, insurance, Social Security and cable companies, will require copies of the POA for a change of address. As previous posters mentioned, auto-bill pay should be set up.
It is important how you phrase your help. You both need to be her friend "assisting" her. Gradually, the two of you will take over her affairs. If you do it gently, she will acquiesce and even appreciate your help.
If she will not see such a specialist, talk to an Elder Law firm about starting court proceedings and filing for a forced evaluation. Other than this, your waiting for her to be compliant and realistic. It will come to this sooner or later like it did our family and be forced by a doctor down the road anyhow. Better to go into this on your terms and timing than that be chosen for you later by a stranger when it is not a good time for yet, another stressor in your life. Good luck!
* You do need to be 'the boss' in terms of handling her accounts / payments (or secure geriatric case manager who can). This should have been in place yesterday - perhaps months or even year(s) ago.
* Yes. She will resist you. This is what people with dementia do.
* Do not argue with her.
* You need support / education on how to interact with her 'now' and manage your feeling about your history with her.
it is inexcusable that her electricity may be turned off due to lack of paying bill(s) on time. If you do not have the time to do this, hire someone (a geriatric manager) who can take on these needed responsibilities.
* You and your brother are legally responsible for her. Allowing her to have her electricity turned off is - or may be considered - abusive care. A 90-year old woman with no heat . . . how can you allow this to happen?
* If you feel you need to pull back as you say, do that --- hire a get a manager to manage the needed care. There is no excuse for not doing this.
* If your brother cannot manage finances from a distance, he needs to find someone who can. When you / your brother take on these legal responsibilities, it is imperative that you do what is necessary. You are legally required to do so.
Get a geriatric case manager in there ASAP to help you manage these needs.
* I agree. A woman in her situation / condition - who is 90 - should absolutely NOT be living alone. She will 'fight and scream' all the way to assisted care or wherever she goes. In the interim, get someone in there to ensure bills are paid and that she is warm ... and eating ...
* Get her moved into assisted living or somewhere where she will be well cared for - this is critically important.
This is how you help her (you say "I am at a loss how I can help her"). You do what is legally necessary and required for her well-being. Not allow her to be in a situation where her electricity may be turned off ...
ou need help / support. Get it. I only 'wish 'I lived closer to your mom to help her. This is the quality / kind of work I do.
Gena / Touch Matters.
Realize that every time you say and communicate to your Mom, you are demonstrating trust or lack of trust. So before you say anything about anything, think about what you are saying and make sure that it promotes trust. In addition, trite phrases like "I'm only looking out in your best interests", sends warning bells and subtracts from trust.
My Mom was old school. She liked checks and cash. She also was very disciplined about her money. Each month, when the checking statement came, the checking account would be balanced and she would go over every single bill. She knew that between her pension and Social Security, it paid for all the bills. She rarely used her credit card and had no idea what a debit card was. When the account was balanced, she would figure out what she needed the next month, and ensure that money was in the account. At 97, she had a severe fall. She told me what to do, and I executed, and she reviewed. Slowly, she trusted me and now, I watch over all her finances.
Because she couldn't keep track of the days, my brother and sister-in-law put all the monthly bills on automatic payment. That included the electricity, the HOA, the credit card, the telephone, and the insurance. She wrote the checks and paid cash for the property tax, maintenance work, groceries and housekeeper. My brother took care of the car so she reimbursed him after he submitted the bill to her.
So what are the learnings here?
1. Talk to your Mom about her overall budget. See if she is cash positive or cash negative on her income. If she is cash negative, find out where she gets her cash from....and put the checking account on automatic replenishment.
2. Use 1 checking account and only 1 credit card, max 2. See if you can get her to put your brother on the account as a joint owner. Then set up online access for all of it. Your brother is NOT to use the account. His name is on there only because someone might need access to the account other than your Mom. If your Mom balances her checkbook, pay for the paper statement to be sent to her.
3. Convince your Mom to put in backup authorization on all the other accounts like electricity, gas, etc. Get all accounts set up for online access.
4. Convince your Mom to put all the monthly payments on automatic payment. Don't tell her that it is because she can't remember, tell her that she is such a busy lady that putting these bills on automatic payment will free her up to do more of what she wants to do. Then change the statements to paperless so that she is not reminded that she has a bill to pay.
5. Check her accounts from time-to-time and make sure there is enough money in the checking account to pay for all the bills. If you find the balance too low, then ask her about some bill....something that will make her log in and look at her account. For instance, our electric company raised their rates....my brother in talking to her said "Mom, did your electricity bill go up? Because mine went up over 30%. How high did yours go?" My Mom always went to her checking account to answer those questions, because it was too hard to remember all the different usernames and passwords for the individual accounts.
About paying bills by telephone...I have hearing loss. Hearing aids help, but my hearing is still horrible as before the loss. In addition, seniors have trouble comprehending what is spoken on the telephone as the speaker may have an accent or speak too fast. Don't rely on getting bills paid by phone...put them on automatic debit. Your Mom's experience is common.
My Mom lived independently until she was 97 and had the hip fracture. She was in early dementia stages for years and we didn't know. Work to keep your Mom's dignity and independence....that will build trust.
Then, you and your brother MUST take over her financial and medical needs.
You have to put her bills on Autopay. Buy an Alzheimer's clock, and baby doorknob covers. You will need to take her to all medical appointments and take notes. And, manage her medication for her.
If she refuses a Dementia evaluation, you will have to employ "Therapeutic Lying." Say, "Will you come with me to my medical appointment to keep me company?" to get her to the office.
No person with Dementia understands that they have memory problems. They are not in denial. It's the disease.
You have to take care of all affairs, and consider finding a facility.
I took my Mum to doctors. They do a baseline memory and cognition test. She also had brain MRI great but so what. Don’t need these to know one has dimentia. And these don’t delay or cure it. Doctor said there is no cure and drugs are only effective temporarily with some patients. It’s added med doe caregiver then.
If patient had Medical power of attorney for no medical intervention in terminal diseases then can’t give such drugs anyway. The false hope these meds give is only aggravating. Ao what if a Senior can’t recall date, time, where they put glasses, names and events. That’s normal for all aging. That doesn’t stop them from living in their own home legally even alone as they wish to. Legally they can even still be in charge of own legal estate plans at least under CA law if they know who their family is, can articulate general meaning of wills, trust, POA and consequences of signing such documents. (See probate code).
Those with mild and moderate memory loss dimentia can know and explain all this, so still have legal rights until two licensed medical physicians, one the regular doctor for years, signs certification patient cannot care for oneself.
There are many all natural brain exercises, vitamin supplements, herbal memory enhancers out there for brain health memory. These are temporary enhancements also. Those are less expensive and may be more practical then memory drugs that in the end wouldn’t stop the disease only slows down the torture of dimentia which my Mum’s doctor believes is cruel to do so doesn’t want prescribed memory drugs.
Swallowing pills is harder for dementia patients anyway, so giving elderly more pills which are not necessarily needed unless for behavioral or pre-existing mental illness like schizophrenia, bipolar, depression, anxiety and the like in opinion of more and more modern health care.
When life expenxtancy is low, and torture of dimentia increases perhaps humane thing to do is reduce meds and respect senior’s life and the senior’s wishes to pass away naturally, organically eliminating need for anti-cholesterol, blood thinners, cancer treatments, dimentia memory drugs, forced feedings by hand, not to add optional drugs. Of course treatment for bladder infections, headaches, flus, falls, infections, pain, and more comfort related medical issues would still be done to protect the comfort and non-life-ending medical health conditions of patient. More and more health care believe this.
We will all die from something. It’s okay to die naturally after a long life. We should stop fearing death by medicating everything when life expectancy is short. Quality of life matters most then. Doctors appts for memory loss dimentia don’t cure, stop this cruel disease and only disrupt the peace of the patient as my Mum with dimentia says.
As caregivers, we want to help and do, but with memory drugs in dimentia are you just lengthening punishment of dimentia? It’s an important question. Is it to help you feel better that you helped, or to help patient live longer and better? Memory drugs don’t stop other aspects of dimentia.
Good luck to everyone on this Important point. Answer is different for all, but it should not be the caregiver who decides, but the senior in a prior medical POA or their doctor. It’s their life. Feeding lots of drugs isn’t going to suddenly make anyone not have dimentia. It lengthens the slow attack on the patient’s memory. Is this what is best for the patient if they already have dimentia? And they can’t remember to take the pills. So you must give the new memory pills that have side effects. Dying naturally is okay.
My Mum is like yours- Denial of memory issues, false accusations, paranoia. She hides anything important in her bedroom close to her. I have found property tax bills, Covid checks given by then President Trump in 2020 Covid relief Act, inside pages of books and magezines.
Mum wore her solid gold, Diamond watch out to Senior center then returned without it having no memory of how or who took it or where it went so cannot file stolen report. Hurt our hearts since it was from my Father. She had right to wear it, bc it was hers and memory issues alone are not legally right to deem her incompetent or activate POA.
She wants to stay in her home. As time progresses, she will need more help but is in denial that she will, bc she says she is “not American” like “cushy Americans.” Makes no sense. She is from UK.
She misthinks she is immortal; although, we help her and drive her, in her mind she in independent.
She has lost her ATM cards and ID so many times and had to reorder, we stopped giving her the cards. They are in safe. Then when she finds her old ones we let her keep them, but put sticker on back, so we know they are invalid. This gives her feeling of independence that is very important for her mental health. We have her pay her own groceries and give her the correct ATM upon purchase.
We review summary of all her expensives that come each month. While she is below poverty, especially since all inflation, since Biden took office cutting off US gas production for transportation in US making everything more expensive, she gets $800 now in SSA a month and a small annuity of once a quarter yet she always says “I have no money coming in”. We won’t let her fail. We pay for entertainment, expensive items. So she has us as backup. But it adds up fast especially with all the transportation with our gas back and forth.
If she were to merely trust in those who help her most instead of those that don’t help her and TV ads and other elderly folks who are half out of their minds she meets at Senior center, she would feel safe, have peace and enjoy life more.
This is same for most with mild and moderate dimentia I think. Not until it’s too late to enjoy life, and they have severe dimentia do they give in and stop being so obstinate and worried. It is a torturous disease no attorney can resolve w legal papers or advice.
Not even doctors can stop it. so as caregivers we have to let it take its course. My Mum has been at 77-86lbs for years and is going strong physically. So the end of her suffering isn’t near. It’s amazing how long the body can live on near nothing yet she choses lots of sweeties. That’s her right to eat or not and what to eat. Makes me sad though.
Point here, I feel your pain. All you are experiencing with her is unfortunate routine of dimentia patients. It is why the one providing the hands-on day to day care of dimentia parent should legally get more assets in estate by law. These caregivers are aged, abused, exhausted by both the dimentia parent and rest of family who are unempathetic and highly falsely judgmental against caregiver.
Much good luck to you as we keep going, doing “the right thing,” bc no one else wants to, to honor our parent’s wishes to stay in their own home. Moving them to unfamiliar memory care or assisted living often makes their condition worse anyway but sometimes unavoidable to work or have mental sanity back to caregiver.
Cheers from CA.
Several options: If brother is financial POA he needs to get his act together and do his job. You should not be wasting your time helping him. He agreed to be POA by signing document. It’s his job to find and resolve overdue bills. It is NOt your job to handle financial or be his assistant. Is he helping you with medical care and daily things with your mother? No. It’s easier to be financial POA then medical POA.
When does mother medical POA become active. It’s other by a date or event? When doesn’t Financial POA become active? It too is either by date or event like in CA two doctors verifying in writing mother cannot care for herself or is incompetent. Having POA’s doesn’t mean they are active yet. First determine that.
Sounds like your brother is taking advantage of you, since you’re local. Try to back away from doing financial vetting for mother to reduce your stress. Send bills to Financial POA if POA is in effect.
If doctor thinks mother should not be residing alone, doctor needs to put that in writing. Ask doctor to do so. But know this, it causes your legal responsibility to care for mother to go up. You then can’t let her live alone.
So first go to assisted living places and get brochures and tours or contact a senior assistant person who is paid through the home you chose for your mother. But then this means huge endeavor of much time and effort to pack up and throw out and move Mother’s things out of her home to sell her home.Brother should do all things hassle, since it’s financial assets. He will probably ask you to. That means he is not fulfilling the duty of POA as he signed up for. He is negligent then.
Do NOT pay for dumpsters out of your own money. Brother may not reimburse you from mother’s accounts. He seems not to want to do work yet have controll over your life as well. Make accounting daily of your hours and what you did. I recommend writing list of usual things and then blanks for odd or rare tasks and things and then just check what you did each day. If your Mother has active medical power of attorney and you are cooking, transporting her, getting her groceries,meds, showering her, getting her mail, trash, and so forth write it down even if they are not medical. They become medical help if she has disability, dementia, unable to care for herself, and it is in her medical records.
And if two doctors (per CA law; Check probate code law in your State for requirements of incompetence versus competent) has certified in writing your mother is disabled mentally, incompetent or unable to care for herself, you need to keep these records of your time and put claim against her estate when she passes away. You can also ask brother to pay you for your expenses. He cannot say no if POA is active. But POA needs to specify reimbursement for your time separately to be reimbursed for your time via financial POA/your brother. Give an accounting only once a month for out of pocket expenses and your time. If he doesn’t reimburse you, when mother passes away out claim against trust or estate with your own attorney for your time feom date medical POA becomes active. Be aware you have no duty to tell your brother anything medically about your mother unless your mother specifically stated you shall disclose medical info to your brother or others. Your mother has medica privacy. This will also end your brothers interfering and harassing you if it comes to thst. It will help keep the peace for you. You work for your mother in her medical care which could include day to day care like food and showering, not for your brother. And he works for his mother financially but for you. He will probably also be eligible for work he doesn’t financially for your mother. But sounds like it’s on auto pay and you are having to do his job