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and stepfather who live in another state?


My mother is in the early stages of dementia, they are still living well and independently in their own home, but something will need to change soon. I am overwhelmed by the variety of options and don't know where to begin or how to make decisions. Where is a good starting point?

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The first step is to make sure you or someone else has Power of Attorney (POA) for mom for both healthcare and property (financial). If you (or someone else) has POA, then you/they can take over when your mom isn't able to handle her own decision-making for both her healthcare and her finances. If you don't get those, and no one else has them who can make good decisions, life will be much more difficult.

So stepfather is also resistant to any outside help? If that is the case, sometimes you just have to wait uncomfortably until some kind of emergency (like a fall or hospitalization for example) makes them open to outside help.

How far away are you and do they have decent financial resources?
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They have done a lot of good planning, and there's a trust that grants my brother and me decision-making if a doctor decrees her incompetent. They have long-term care insurance and are in decent financial shape. But they live in VA, I live in FL and my brother in MA, and we both have demanding careers. I have tried to convince them that they should move here, but they love their life and friends and community, and I realize with my mother's memory loss that moving might make it worse. Their health has been good (in spite of a variety of serious issues, they still go to the gym or walking nearly every day). But I'm terrified one of them will fall or they will get ripped off (my mother has become obsessed that they need to have the kitchen redone). I've talked with numerous friends, but I don't have any way of really sorting out options.
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Can they find a nice AL near where they live in VA? Have you given thought to looking into getting a geriatric care manager who is familiar with communities near them.? More thoughts later.
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I've been dealing with a similar situation for about 5 years. I'm 12 hours from my folks. It's sounds to me like you have a good start with a trust and decent financial status. As I saw things going downhill with my folks I made the trip and spent a few days compiling all the info I would need to take over the care and finances. EVERYTHING.....Utilities, charge cards, taxes, medical info, Doctor info, meds, insurance, pension etc.

And you do have to get an eyeball on things occasionally. I call every day and Mom wil insist it's all A OK. But when I go down I always find some alarming new developments that must be dealt with.

Others have mentioned POA. Even though there is a trust I would look into a broad DURABLE POWER OF ATTORNEY as well. I was able to get this as well as permission to join the checking and savings accounts just before my Dads dementia got worse. I would have been screwed without this as I'm now taking care of all bills and finances.

And as Blannie says, unfortunately, it usually does take a crisis to make change happen. I've begged and lectured my folks about getting in home help or moving to assisted living to no avail. I've come to realise I can't force the issue. It will take the bad fall, trip to the ER or a major event will force the issue.

Get used to the idea that you can only do so much and that's true whether you live next door or three states away. Good luck.
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Get online access to their checking account. Quietly make sure they pay their bills each month. Mom had a habit of not paying bills she did not like.
Also track their Rx refills online, although this won't completely tell you if they are messing up the meds. Some MD's have online access to tests and reports, which would keep you up to date on what is changing.
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Great suggestions above. I like the one about getting someone in their community to work with them weekly to check on things, make sure the utilities are on, no dents on the car, roof not leaking, no spoiled food in fridge, medications are being taken correctly, in, etc. And if they will allow you to have bills set up online and/or automatic draft, that would be good too. They may be very susceptible to cons. My cousin let two strangers into her house who were selling alarm systems, gave them her driver license, social security number and a check!!!!!! She did know enough to call me afterwards and I was able to confirm who they were and thankfully they were not criminals. But, still......it's difficult to protect them.

From my experience, it's crucial to have someone monitoring them weekly. The dementia may progress gradually or in step downs. Her husband may or may not pick up on this. Is he in denial about her dementia? Does he have it too?

It's very stressful to care for a person with dementia, depending on their symptoms, but once she begins constantly repeating, misplacing things, having delusions, falsely accusing, wandering, etc. her husband may be overwhelmed. I would keep check on that. He may resist help now, but when she is difficult to control, he may feel differently. I'd look into options for placement while you have the time to look around. Just in case.

The problem is that with the dementia, it's difficult to convince the person that they need help. Usually, it has to be done under the guise of something else. There are varying ways to do that. I'd survey the situation, make a plan and then get ideas on how to carry it out. You can get help from her doctors and on sites like this one, where lots of caregivers come to post.
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