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You have gone above and beyond to care for a "difficult personality" person who happens to have dementia. Your only job is to keep her safe and healthy - not necessarily happy and not necessarily to do all the work yourself. The state may consider that since you live with her and pay for everything and do all the care... that she doesn't need extra help.

Please consult with your state's Medicaid to see what she needs to qualify for their assistance as well as Medicare.

Please consult with her doctor to get her declared "mentally incompetent" so that it is documented that she needs helps from others.

Since she has problem behaviors, she may benefit from a short term stay in an inpatient psychiatric geriatric unit. They can help her to get established on anti-anxiety medications and therapy to decrease her emotional outbursts. From there, you can work with their social worker to have her placed in a memory care unit. Take whatever placement she is eligible for.

Consider starting to separate your life from hers: finances, insurance, housing... so your claims of "hers" versus "yours" will be easier to delineate when it comes to Medicaid.
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First , I strongly encourage you to take care of yourself and your poor dog..move out as soon as possible —hopefully you have the means to do so , if you are old enough you may be able to get a subsidized apartment in a seniors building but there is often a wait list for this..and I don’t think you should wait that long , just get on list but find a place for interim.
I strongly question why you would even have moved in with her since you had such a miserable childhood and relationship but perhaps that was part of your conditioning . In any case, not cohabitatng will help with getting mom assistance. Move yourself and anything you want to keep out of the place. Then try the “er dump” method ..which seems cruel but also sometimes necessary. Don’t go along , just call 911 , perhaps be there to help give information. Will be better to be able to say that you came to visit and found her “on the floor” from a fall or whatever but this will establish she lives alone without someone to care for her. Call and ask about her condition ..don’t go to visit, say you are working and can’t if pressured. Don’t sign anything for her. Make it clear that there is no one to care for her at home so it is unsafe. They still may try to send her home but if they succeed, by just dumping her on discharge...repeat. If she truly cannot care for herself this should eventuallly work. Yes, she may be placed in a nursing home that you don’t really like. In some you may be able to optimize her care by just visiting , for brief periods, often. You don’t even have to really expose yourself much to her if you don’t want to...just check on her condition . This may be complicated during covid. ( I honestly wonder how well our seniors are fairing during this pandemic becasue vital family oversight is impossible ). But , your well being is at least as important as your mother’s. It is not your fault that she is in this situation and it seems as if , she was not a nice person even before the disease started to affect her.
Make a home for yourself. Take walks with your dog, you are lucky to be in a place where it is not cold for winter. Read, paint, crochet, etc ..some kind of hobby that will calm you. Perhaps volunteer at a dog shelter or make hats for homeless... join a church group or even online community since covid , but do something to get involved with people. Perhaps your own children ? You need connection to others. Perhaps sign up for an “inspirational quote of the day” or find one for yourself and write it prominently for each day. Make an effort to smile and be friendly to others..even just a grocery store or coffee shop...what at first you have to force , will start to become ingrained and people will initiate to you also. Having a dog might help with this as they are good ice breakers.
If you insist on remaining with mom ..at least get counseling which is available through Medicare for caregivers. Also they will provide some respite care. If she has LEwy Body there should be no reason she doesn’t quailfy .
please stop putting so much pressure and pain on yourself. You DON’T deserve it . You are a good person and deserve to live a happy life and not be miserable all the time. This is a toxic relationship and you need to free yourself. Let yourself be loved if only by your faithful friend , you dog. Don’t let this bad situation continue to spiral downwards.
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Imho. this dynamic must be amended, else you fall faint and ill and are good to no one. Prayers sent.
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Hugs. Your Mom may not qualify or need to be placed in a SNF. Residents there are usually in poor physical shape or bedridden. The staff has to have special training to deal with combative or restive people.

Sounds like she is better suited for Memory Care which many SNF do not offer. I know this from looking for a placement for my own mother. Most AL facilities have a MC wing for those whose physical status is relatively good but whose memory issues make it unsafe for them to live alone.

Unfortunately, at least in Ohio, AL's are not required to accept Medicaid Waivers. They have the option to do so after a resident has been there at least 2 years and even then it is not a given, it’s up to each company. Talk to someone at your bank about how to budget to eke put your Mom's assets to last that 2 years.

Sell the house if necessary, if it is in her name Medicaid will require it be sold and the money used for her care anyway if she is not living there. I’m not sure how that works if she continues to live there.

In Ohio there is a program called Passport that has lots of assets to help the elderly. One program provides a free, 30 minute consultation with a law student. It was hugely helpful to me and saved us thousands in lawyers fees.

Check to see if your doctor's office has a social worker that can advise you, your Mom's insurance provider might be able to help. I got a lot of good advice from Catholic Family Services (they help anyone) and A Place for Mom can at least give you a few names to check out.

As a last resort you might have to call Adult Services and tell them your Mom is at risk of being left alone because you can’t cope. If nothing else you might be able to get into a respite program.

Good luck and let us know what happens.
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There are so many great responses! I did not read through each one yet so please forgive me if I’m being redundant. You are in a very difficult situation and are at a breaking point. I had a few different thoughts as I was reading your post
1)If you feel like you can handle the amount of time it will take, contact a memory care facility, fill them in, get them all of the information they need, ask for them to come over for an evaluation. Tell your mom a “friend” is coming over for tea/coffee, whatever.... You have to take care of you and your well-being.
2) I am not sure what the elder care laws or children responsibility laws are in Arizona but you could call adult protective services and let them handle it going forward. The almost beautiful part of dementia is your mom will most likely forget that a family member placed her in a memory care facility and eventually you(if you wanted) could have a better relationship w/ her.
3) It sounds like you are most likely fighting a lot w/ her. If she’s doing something wrong but it’s not hurting anything, stop arguing w/ her. Do a lot of things behind the scenes and “jump into her reality.” This is a fantastic technique I learned from Rachael Wonderlin. If you have a few min, check out her site. Dementiabyday.com
She offers very realistic and practical ways of handling daily situations that are arise when caring for a loved one with dementia. I refer to her site a lot. I am a caregiver for families living w/ dementia and my father in law had dementia as well. He was a very stubborn man and we did a lot of things behind the scenes that made him feel like he was still in control.
4) Call 911 when she is having a really bad day and ask for an evaluation at the hospital. I think you can request a 72 hour non-voluntary hold for psychiatric evaluation. Sounds dramatic but I think you are having a serious crisis.

Hope this helps!
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Bless your heart. I was in much the same position, but not nearly as long. I cared for my sister. We loved one another and we had such fun, until all of a sudden, she turned very ugly. For a while medicine (Risperdal) helped immensely with the anger without sedating effects.

Hard as it was, and I sobbed when I did it, I did call 911 when she hurt me. Not horribly bad, but I knew it would get worse. She needed help and the dr just seemed to stop caring about her.

My goal was to get EMS to take her to the hospital at 3am. I did not go with her. I wanted them to see her in all her glory. She screamed, bit, punched And carried on till they had to provide 24/7 care to try to keep her calm. She still acted up, largely because I wasn’t there. That was my intent. Knowing they would have to discharge her to a memory care facility hopefully to get the magic concoction of medication to be able to bring her home. She got much, much worse.

I’m leaving a lot out, but to make a long story short, the insurance company said they weren’t going to pay any more. The facility called me and said to pick her up. Ackkk! She was all but catatonic.

technically, they have to do an “orderly discharge “ which they violated. They were supposed to place her somewhere else. Tearfully, I called Hospice and told them what was happening. An angel answered the phone.

ultimately, I brought her home on hospice with all the necessary medications. It was amazing how peaceful she was. We still had visitors, went for walks, etc, and eventually she was bedridden. But she was not angry or hateful.

ultimately, after a few months, she passed away in my arms.

-Call 911
-Don’t go to the hospital with her
-Call the head nurse to check on her.
-Visit the following morning.
-Tell Dr her condition has deteriorated and you fear for her safety and yours. (No need to mention the dog. )
-Ask to speak to a social worker.
-You are not at all responsible for her bills.
-Pay utilities, mortgage/rent and food out of her money.

Are you willing/able to care for her if she’s calm and not abusive?

if not, make sure you adamantly tell the social worker.

Prepare yourself for moving out on your own. Medicaid will eventually take the house, it’s not your fault and you don’t owe anyone a damn thing. YOUR sanity is what is important here.

If the Dr is willing to order hospice or a home health aide, and you are willing to do it, you will at least have some help giving you time to decompress. That worked out well for me.

I pray for you as well as your mother. I hope you will find peace.

Know that you’ve done all that you could for as long as you could and be happy with yourself. You’ve done more than anyone else did, so don’t take any crap.

I truly feel for you. God Bless!
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You have to continue to find help to place your mom in a facility. There are many companies that help with placement. She seems miserable now, so you shouldn't worry too much about where you get her placed. She'll just continue to be miserable whatever you do. Trust that as soon as you get yourself out of this you will most likely be okay without therapy, but therapy won't hurt. Once you have your own life back, you can begin, step by step, to build back some happiness. You are not too old to do it. There's time and it is your time. So sorry for all your pain and loss.
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Along with the other excellent recommendations here, you might consider an organization that has healthcare advisors to actually help you research and evaluate all of your options.
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I feel you, oh GOD do i feel you. I'm in very close to the same boat. Only child, her husband wants nothing to do with her yet will not divorce her for financial reasons. He set her up 8 years ago in a proverbial golden cage. A nice house and an amount of cash every month to pay bills, food and essentials, then washed his hands of her.

And then she started to decline. All the early symptoms were there, but we didn't realize what they ment. The withdrawing from everyone, refusal to leave the house, etc. she couldn't (wouldn't) even do shopping, I was doing it and everything else for her and since i was divorced, eventually I just moved in to stop wasting so much gas going to her place every 2nd day. Suddenly over the last 2 months everything fell apart at a horrifying rate. She couldn't walk the stairs without help, just went downstairs to sit in her recliner infront of the tube or reading, i took care of her dog and all the cooking and cleaning and shopping, paid the bills, did all the things she was now unable to do. At least she was very grateful, until her lightning fast decline decline into dementia.

Suddenly one day, she fell off the bed and was completely unable to get herself back up. Nor could I get her up alone, as she weighs a little over 200lbs. She was instant dead-weight. So she was hospitalized for a couple of days where they found pneumonia that had been undiagnosed or treated for almost a year. Shortly after the treatment started she signed herself out against medical advice, mistrusting the hospital and doctors (yet another sign no one noticed) and this repeated twice more before we finally got a hospital bed installed in the house along with a sling to pick her up and put her down on the commode, or her wheelchair. She tore the first sling thrashing around on the bed as it was too small, and refused to let the occupational therapist install a new one calling him dishonest, a liar and a criminal. Same to the woman who was going to give her twice weekly sponge baths. So now i have to put up with her screaming she has to go to the bathroom, set her and the bucket up over the side of the bed so she dosen't pee all over it, and at least half the time it's a false alarm. So it's reverse the process, haul her back up on the mattress and put back on her depends and PJ bottoms. We repeat this every half hour to an hour. ALL NIGHT LONG. I haven't had any sleep longer then a 2-hr stretch since the end of September. And I am losing my mind. She won't eat, so she dosen't poo much, but when it comes it's gigantic, literally over 2lbs. Thankfully I was able to get pet piddle pads under her so cleanup wasn't QUITE so horrible as it could have been.

Half the time she recognizes me as her son, the other half i was her brother or her husband. and EVERY time, i had 'kidnapped her' and why did i do this to her? why cant we go back home? and 25% incandescent rage and how much she hates me more then she's ever hated anyone. Followed by an attempt to get up that will have her collapsed on the floor once more.

I don't think I can do this any more. I'm losing it and if i don't get some sleep soon i am going to crack completely.
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Like children, confused adults can sense your emotional state better than you. Your Mom is demented. She is not competent. It probably is not healthy for the two of you to be in each others exclusive company.

She is never going to appreciate you if she hasn't to date. Don't take it personally.

Contact the Area Agency on Aging to determine what services they have available. If you are in Kentucky:
Kentucky Area Agencies on Aging: http://chfs.ky.gov/dail/default.htm
State Senior Services Help Line: 502-564-6930

If your Moms mentation has changed remarkably, take her to the ER for evaluation. She could have a urinary tract infection that is making her more confused. Once she is in the ER, refuse to take her home. The hospital will get her placed.
If she is able to stay in the hospital 3 days, she will be eligible for rehab at a Medicare approved nursing facility. The state will confiscate her home for payment of the nursing home once she dies if Medicaid funds are used.

Your Mom could outlive you as she is not stressing about her situation.

Finally, she really does believe the dog is hers. That is her reality.
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