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My sister was diagnosed by The UCSF Alz & Memory care after many tests, scans, etc. nearly a yr ago. They said she should not/cannot live alone, but no Dr. will sign a letter of incompetency. On a good day she can talk a good game and says she is not leaving her home or dogs and will not allow anyone else to come into home. We had two intro mtgs, she refused to allow strangers in her home. I am forced to handle everything, but she signs up for every Medicare plan that calls her (just discovered last night she changed her Medicare plan again for new year, last yr she signed up for a new plan 3 times). She has been scammed for gift cards twice, turned off pilot light to water heater, put dawn in dishwasher causing overflow that she claimed blew up. She cancels everything: internet/wi-fi, phone, TV, homeowners’ ins., Dr. appts. then of course says she didn’t. We spend hrs and entire days just undoing the messes. She sees people in her house every day, “the eaters”. We have cameras and an Alexa show device for calls and to keep visual on her when we are not there. This week she missed 2 important Dr. appts. She refused to get out of house at last minute making us too late on Monday by 8 minutes. When we arrived she refused to get out of car. We were refused and rescheduled for Wed. We started early, it takes me 30 min to get to her house and 35 min to that Dr. I am at her house at least 90 minutes before and at the last minute she stalled and refused again until we would have been late. I called, explained and cancelled. I had to take her to 4 various lab/scan appts for this final evaluation for back pain. All so stressful. I pay all her bills, undo her messes, and buy all her groceries, cook meals, my husband takes care of everything at her house. She expects it. Everything is all about her, always. Never appreciates. Resents when we are there and goes in her bedroom and shuts door. Still her personality, never did anything for others or me. Her daughter is out of state and has not been here for 8 yrs. We were not close and not raised together. I am stuck. I retired last yr and she is my full time job. We had to put our own life on hold and How long do we have? She used to call the sheriff 2-3 times week. She sees people, eating her food, living in her closet. These people are numerous and cause anything that went wrong, or is lost, as they took it. She put all her food outside over the summer with a note they can’t leave their food in her house and to take it now, (twice) refusing to believe it’s her food. She hides everything from these people so every day is scavenger hunt. She hides food under the bed, wrapped in newspaper, foil, bags, hides all mail, toothbrush, makeup, heating pad, dog food. Literally Everything. Because she can’t find anything. Since she refuses to consider any other living situation insisting she is fine and perfectly capable of taking care of herself telling anyone she is capable, pays all her bills, goes to grocery store, takes care of her dogs, etc. When in reality she does none if it and hasn’t for over a year. She is impossible and I am done. What can I do? Who can do it? Trust and POA lists me and daughter but that doesn’t kick in until Dr. states she is incompetent and unable to handle her own affairs. They all say that emphatically, but will not sign letter. She is getting her way as she always has, I took care of mom with ALZ for 6 yrs 20 yrs ago and now this? She was a walk in the park compared to this! Sister is mean, combative, belligerent, and cannot remember a conversation, a document, anything - from 3 minutes ago! Since she doesn’t remember she is always mad. “When was anyone going to tell her she had appt? Why didn’t she know? No one tells her anything. (White board with all ph #s and appt dates on wall)



What do people do? Memory care facilities do not allow dogs, she won’t consider visiting any “home” - she is not leaving her dogs nor her home. I don't want to ruin my marriage but I am depressed, angry, short tempered.

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Three ways to do this. You can call adult protective services and tell them what is going on. Alternatively, get ahold of a lawyer who can help get ahold of the doctors. Third, you can go to your local probate court and petitionq judge to file an emergency review of her mental status. You would have to write down an explanation.
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Take her to the ER. She has dementia as well as undiagnosed and untreated mental health disorder. She is a threat to herself with all you have listed. Get her an involuntary admission. That should get the ball rolling.
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Hi. My heart goes out to you. I’ve read a few of these answers and here’s my additional two cents.

Document everything. However tedious, document it. I’ve done it several times for several things and have won my money back many times (even on taxes). But it took time. Your situation is a little different but it’s no different in regards for getting that letter signed. Never give up the fight.

So like someone else said when she gets combative called the police; get her to the ER then sent to a rehab, letting them deal with her and start seeing her behavior and document it. names, date and time, what was said & done as much as you can.

start with a laundry list of events from your memory as far back as you can go with dates, times and people; it’s OK if it’s not perfect because you’re recreating but from this present day forward document in real time.
An elder attorney is good to consult but expensive. You might try the way of the office on aging and find a social worker for advice.

oh and document what the doctors say as to why they won’t sign the paper. Names date time and exactly what they said. Even document what case you presented to them for asking them to sign the paper. I would even go as far as letting them know you’re going documenting Because this is a serious matter to you. You just might intimidate somebody to get off their lazy butt and support you. It’s not illegal. Thus its a trail on them against the contradicting stories of others and show that to every new doctor. Something will have to give.

isn’t that how it is in contracts and when you go to court? Who’s got the documentation? who can prove it? This is how you prove it.

we all have someone in our life that we can say “they are always like this” but without proof it can just be your slanted perspective. Get it in writing. And take pictures of all the hidden things and crazy things she does.

good luck! We are behind you!
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Oh my gosh. Print out your comment and e-mail/USPS it to a social worker or APS. E-mail/USPS to different doctors in her group, if they are covered. This is impossible. Others have already said everything that I would say. But, as was said to me when I posted about my MIL making everything about the dog, who is taking care of them? Is she capable of feeding them, brushing them, walking them, cleaning up their messes? If not, then they're being mistreated. (I worry about my MIL's dog, but the caregiver is keeping an eye on her for us.) And when we talked to AL for MIL and the large dog, we were told she could have her with her in the apartment, but only as long as she was able to care for her (walk, food, brush). Just FYI. It's hard to find a place that will take a large dog - MIL's is 80 pounds - and it may be difficult if she won't/can't care for it/them regardless of size.
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Some options to consider:

1.Call APS, Adult Protective Services and report unsafe condition in home. This may or may not help but at least you can start a paper trail of reporting the unsafe environment. Call as many times as events present themselves.

2. Call 911 when she becomes combative and, have her transported to ER. Once there they can further assess her and, you can confer with social services/ case management re options . Be sure to state emphatically the " unsafe" and " non compliant" behaviors. Do not let them just send her back home with follow up appts which you know she will not keep. Consider having her sent directly from ER to a facility of choice. Once there, staff can take over the behavior management.

3. I do not understand why the physicians are not declaring her incompetent. You may want to confer with an Elder Care Attorney about the situation.

4. Tell her and her Physician that you are no longer able to provide care for her and, you will not be available. Stop being a part of the " enabling" process of allowing this individual to put herself in unsafe conditions and, place you in unsafe and unhealthy positions. You certainly are entitled to your life and you must start advocating for yourself too.

5. Put cameras up in the home / relevant places to capture her belligerent , non compliant, unsafe behaviors.

Seek counseling for your own health and well being.
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tygrlly1 Dec 2022
"She is unsafe and a danger to herself and others (you) "
"She is failing to meet her medical and mental health needs "
" I refuse to continue providing care "
"This will be an unsafe discharge and I will report it as elder abuse"
And inform her Dr of the same. Sometimes Drs get kickbacks and incentives to avoid declaring someone incompetent and needing public funded care. Sad but true.

These need to be your mantras..Stay strong and do not look back. She is destroying you.
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Redsister: You cannot nor should not continue taking care of Sherry, who unfortunately suffers from Alzheimer's. Step aside for your own sanity. Sherry will have to opt for managed care facility living and other arrangements be made for her dog.
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Without reading further comments I can say it is totally clear your mother is far into dementia, a danger to herself, etc. And her care is going to totally burn you out; it is not uncommon for caregivers of dementia/Alzheimer's to die before the patient due to burnout/stress illnesses. You and your husband have gone above and beyond but it is clearly time to get your mother into care no matter what she says. Now, as an 'animal nut' myself I fully get never wanting to be separating from our animals, so as some have suggested there may be places who would take her pets too. And, as hard as it sounds, because my own mom was stubborn about no one in her house, etc., (and also hallucinating scary beings), I was told by Adult Services some elders simply have to be left 'as is' and the state takes over, places the elder wherever there's bed, so make it your priority now to find the right place for your mom so you and your husband can reclaim your own lives. She deserves safety and comfort, you two deserve peace. Oh, I had a doctor strangely not budge on a letter when circumstances clearly warranted one, so find another doctor; don't rest until you find that one who gets the situation; use video footage, whatever, to document if the doc cannot witness these behaviors in person. All the best for everyone concerned.
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Llamalover47 Dec 2022
OP is taking care of her sister, not her mother.
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Based on what you've told us, she's deep into dementia. If her doctor won't sign, find one who will. She is in danger, and you're at your wits end.

A memory care facility near me advertises that they allow dogs after the dogs are properly assessed. The owners have their own dogs that live on the property and when they have puppies, the residents play with them. My mother lived in assisted living for a time where there were many dogs and cats living with their owners. Where I live now, a retirement community, lots of people have taken their pets to independent and assisted living, where they are welcomed. At least one facility has their on-campus dog, and the residents can take him for walks. He attends all events and gatherings and the residents enjoy him so much. Please investigate for yourself to find out if there's somewhere your mother can go and take her pets.

Nursing homes and memory care are not all rows of beds with sick skinny gray-haired people lying in them waiting to die. Do your research.
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I’m am in similar situation but with an undu influence boyfriend . He has interfered with my duties of caring for my mom and she only trust him. Several years and costly lawyers dealing with my mom incompetency. court orders to get the doctors appointments even though declared incompetent yrs before - probate and civil courts. I am still locked out by boyfriend to my moms house . Courts saw she was incompetent got professional care by private company they have conservatorship and they are dealing with my mom and the boyfriend . I am thankful to have the unity and support from our family. What’s difficult is my mom always wanted me to be her caretaker before she got Alzheimer’s. Maybe it’s a blessing in disguise , I did get the professionals involved, aps , doctors , lawyers etc.
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Call a social worker ASAP.

Then stop.

Stop trying to assist when you clearly can’t. She is not your problem. I know this is harsh and difficult, but something doesn’t sound right when she’s been told she can’t live alone, yet they won’t write a letter stating that. There must be something more to this.

Let the county and state do their job. Report to a social worker, Adult Protective Service and then call her daughter and explain her mom needs help and you can’t help her and you will not be responsible for her. Remove yourself as POA. And then stop.
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Barbarasfriend Dec 2022
I absolutely agree 100%. Call social services or APS and let them deal with it. That is too much stress for anyone to deal with.
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You may need to get a social worker involved. Call APS and explain she is at risk and there is nobody to help her. They will take it from there.
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I don't understand why you say "I am forced to handle everything,"
Unless you are legally bound, you are not forced to do anything you do not want to do unless you decide to take on yourself.

I would say seem to you feel forced for internal reasons, i.e., emotional, guilt, low-self esteem, fear(s), allowing her to intimidate you.

The issues and concerns you outline above will continue on and on... and on.
If you do not want this scenario to continue:

STOP. Get out of this toxic situation.

Continue to vent here although the frustration will continue until you make a decision. She is running circles around you. If you don't want her to do this, then stop encouraging her.

Gena / Touch Matters
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These days, many memory care places allow pets.

don't talk about moving, talk about visiting. i told my dad it was just for rehab.
the power of attorney does not need anyone to declare her incompetent. you have all rights right now. YOU get to make the decisions.
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Caregiverstress Dec 2022
Sometimes the POA does require a letter of incompetency from a doctor. My father’s does. I needed two letters from two doctors “unrelated to each other or any member of my family”.
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Your sister needs more help than you can sustainably provide, not your fault, just a fact. Stop trying and back off. Report her as a adult in need of help to Adult Protective Services and let them take over. Sounds harsh but you cannot continue this alone, at least not without great cost to your own well being
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I have read everything here and there are some good answers to your dilemma but one thing I have to say to you is this" STOP ENABLING HER". You have to look at it this way to WHAT IF YOU WERE NOT THERE NO ONE WAS THERE where would she be I bet in a place to take care of her.

If you can get a doctor to sign paperwork for representative payee for her social security if she is on that I would do that. It will stop some of the buying.

The other is to call Dept of Human Services and tell them that you are done taking care of her and you can't do it anymore. My SIL was taking care of her brother with dementia she was told by a doctor to take him to the ER and tell them you can't do it anymore they will in turn find him a place to go. Which they did for her.

Prayers
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Redsister Jun 2023
I just wanted to take the time to tell you I re- read your post to my question in December. I re-read them all but I am still “stuck” in same position and here it is 6 months later. I have had a few mental crisis of my own and I have called the Public Guardian’s office. I will have a Phone Appt in a half hour with the Attorney that put my sister’s Trust together years ago. I have had 2 prior as well in the past. You have words of wisdom - and I am working towards some exit strategy. But I am near the bottom of despair and need to see daylight. I feel the sands of my own life trickling away during all this and do not like the person I have become. My marriage is on thin ice. I will come back and report progress…..?
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We took my mom to an ER when she was having a severely bad dementia day..yours can be a 911 call if need be…with Lewy Body dementia my mom also had some “clear” days but was generally unsafe at home and refused to eat. the hospital told US she was not competent to go home…a social worker took over…we took her to a memory care and cleaned out everything at home. Our job is to make them safe not honor their wishes . If she is unsafe ….she needs a facility. My mom adjusted. Not easy…
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My mother was similar, refused to leave, get help and was mean to me. I took food to her house, righted things for a couple of hours and left. I would go every couple of weeks. I could see decline and disorganization.. One day I found her dehydrated on the floor. Rehydrated her some, loaded her in my car and took her to my house. She had a hissy fit. I convinced her to go to assisted living while a went to visit my kids for a couple of weeks. I never went back for her, I keep paying the bill. When I do see her she wants to go home. I hand her the phone and say organize it. End of discussion. The woman can't make a meal and has no idea when the last time she ate. She has always been difficult, my sibs will have no part of her. My suggestion is walk away for the most part. Make sure there is food and the bills are paid.
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Sometimes seniors need to discover that they need to transition from being "independent" to being "responsible" for their care, well-being, and happiness on their own terms, you will never convince them. News Flash!! old folks are stubborn!

Once they get they need to be responsible, they will start finding creative ways to make their lives easier. (use a pickup stick or walker, buy shoes without laces, etc.) and eventually, they will discover the need for an aide to help them out.

Right now, mom thinks she's living independently because her two "elves" are caring for her. She has no idea how much work you are doing, and even if you tell her, she won't comprehend it.

Here is how to give her a "push" toward discovering what you already know:

Let her know that you and your husband are going on "vacation" for two weeks. Have her make a list of everything she will need while you are gone and give you the phone numbers of those she will call in your absence (there probably won't be any). Don't make it a big deal, but create a reminder for her (maybe X out the days you will be gone on her calendar). Remind her often and let her think about it... ALOT! Don't offer much in the way of help. This is her puzzle to solve!

In the meantime, hire a reputable agency to provide care for 4 or 6 hours a day to check on her well-being and do anything she asks. If she kicks the aide out on Monday, no problem, have them come back on Tuesday and keep coming back until she's ready to accept help. Call her every couple of days to check in, and insist you will see her when you are "back". Tell her to let the aide know what she needs. (You can also call the aide or the agency to give them instructions so it occurs as more"magical" for your mom.)

My plan is a bit dubious, I know. Mom might be miserable for a few days, but she won't die! When you come back in two weeks, bring her a pineapple from your trip (to Hawaii) and give her a big hug! She will be thrilled to see you and tell you how much she loves her new aide. And it will all have been her idea!

I don't know if this is possible, I am just speculating.... but maybe you could let DCFS know what's going on with the "vacation" and see if they could check in on her too. It might make proving your case for incompetence go faster...
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I was going through the same thing with my husband until he got so angry about life that he called 911. The police came out and took him for 72 hour hold and now he is placed in an assisted memory care. I dealt with this for 12 years after he suffered 3 ruptured brain aneurysms and multiple strokes. I was so grateful when the police did knock on the door. Where we live we have a program called PERT which stands for psychiatric emergency response team. I had called the hotline many times and they told me to call 911 but I didn't really want to do. I was so grateful when they came to the door. They sent Police, a social worker and an EMT. Of course he’s still angry with me when I go visit him in the facility and he wants to come home but he too thought he could do everything which resulted in a lot of falls leading to ER visits and multiple CAT scans due to him being on a blood thinner. Now that he’s in the facility all my friends and family members say I look more relaxed then I have looked in years. There are facilities that allow pets.
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Daughterof1930 Dec 2022
So glad you got much need help
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You may have to wait for a hospitalization before you can get a doctor statement. You could go the legal route for guardianship from which her doctor will receive a statement sheet that he cannot ignore but that will cost thousands. Or you can wait until you visit her and see behavior that she is a danger to herself or others then call an ambulance and tell them and the ER staff the word "baker act"
Keep recording and make frequent calls to APS. Even though she may bar them at the door, you are creating a record.
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I always thought a POA was written that a Doctor needed to declare the Principle incompetent for it to take effect. I found out from this forum that their are two POAs, one Immediate and one Spring, which is the one that you need a doctor to make it effective. I found on my Moms I was Immediate for financial and Springing for Medical.

I would call APS and tell them you no longer can care or financislly support your sister. That you cannot get a doctor to sign a letter saying she is not competent. Maybe they can evaluate and get her doctor on board. Really, Doctor's have some responsibility here. You may just want the State to become her guardian. They can get her placed much faster than u can.
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Call social services tell them about your sister, tell them that you are unwell and can no longer care for her. Call the doctor and state you cannot help your sister anymore and the doctor has a duty of care.
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You have a few options-
you do not have to do this alone!
first, I am very sorry you’re dealing with the situation. You are a great person offering your assistance to your sister. There is always the option of going to a state or local representative as they have help in your communities, separate from that my personal opinion went to find a home visiting doctor, and due to the situation she doesn’t want to go as far as the incompetency goes there’s always those legal guardianship issues, however there is a way to get legal services involved with minimal cost via legal shield. If you need more information you can reach out to me directly.
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Is her doctor male or female? My mom passed recently but I was working with the Department of Aging in her State and Hospice in the process of having her declared incompetent to make decisions since she trusted no one and would not sign a POA of any kind. There was a remark made that my mom’s doctor may not sign the Physician’s Affidavit until I mentioned her doctor was a “she” and then that changed the thought from it would be hard to maybe there’s a chance that it’d be signed…which it was. Seems as though male doctors have a harder time signing such documents than female doctors for some reason. Don’t know if it’s a fear of being sued or just unwilling to deprive anyone of being characterized as such unless they’re comatose or something.
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What would happen if you stopped helping her? If your Husband also stopped? If she had to buy her own food, medicines etc?

When I explained that to my sister, I got a blank look. Followed by "I can do it myself".

I was in a similar spot to where you are. Not doing so much as others did the lion share, but the needs were a bottomless pit.

Sought help from Doctor, who said to let her 'fail'. Don't help. Don't even buy milk.
As Barb said, "step aside". This forces in other solutions.

Before you jump to "she won't change".. Stop. This is about changing what YOU do.

I wrote out a list of tasks as described, I crossed my name of some tasks. Then as time went on, crossed off more & more. Each time it forced services to replace me to be trialled.

Now my sister is really happy with her 'ladies' that come to help her. It has extended out her living at home. It won't last forever of course, nothing does.

But it gave her the dignity to choose for herself.
Choose the home services help. Or not. Stay home with help, or risk having to move. At present the choice is to accept a replacement person from an agency if the regular is away/ill etc or have no-one. I will not be backup. That just opens the door to more cancellations knowing I would fill-in.

Your sister will need to choose things like a helper to walk/groom, help with the pets or risk having them taken away. I'd start there. Something she cares about.

Time to get learning.
Ready?
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Redsister, I agree 100% with what BarbBrooklyn had written.

If you feel you cannot step aside, then write down everything, and I mean everything you and your husband do for your sister. Every little thing not just a general remark. Now take that list and scratch off half of those items. Not scratch off a few more. What is left is what you will do, and nothing more. If you sister can understand just say "I can't possibly do that".

On my parents' Power of Attorney, nothing was mentioned of the POA not kicking in until a Doctor states incompetency. My Dad had no medical tests for dementia. The POA kicked in when it came apparent that Dad could no longer do certain things or want to do certain things, such as writing out checks for bills. Thus I was able to transfer all bills and statements to my home, and I was allowed via the bank signature card to write out checks and put my signature on the checks.

For grocery, the local grocery store had an on-line service which was great. I would order what was needed, set a pick-up date, and just drive up to the curb where the groceries were placed in my vehicle. What a godsend. I've been doing that for myself for the past 7 years :)

For Dad, I would tell him his doctor appointment was at an earlier time than what was scheduled as Dad always waited until the last minute to get ready.

So many times for those of us taking care of a love one, we need to wait for a medical emergency, 911, hospitalization, rehab, and then move to senior living or nursing home.
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Consider walking away and calling APS to report her as a vulnerable adult in need of supervision.

Unfortunately, as long as you are providing care, she will not get what she needs. Step aside
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