Rhonda and Doug had seen a few warning signs that their very difficult aging mother, Anika, was in trouble. Even as she got increasingly frail, she hadn’t seen a doctor in years. She refused to go. They didn’t spend much time with her, as she never had anything good to say, but they did care and wanted to help. She would not accept their suggestions at all. She was not eating well. She got lost easily. She forgot to take care of her home. She was not able to pay her bills. Still, the siblings waited for a couple of years to take a more assertive step to protect her.
The Breaking Point
One day, Rhonda got a frantic call from Anika. Anika had driven in the city and forgot where she had left her car. She was able to take a cab home but she was sure someone had stolen her car. With some effort, Rhonda found out where her mother had gone and she and Doug went in search of the vehicle. They found it and didn’t tell Anika. They took the car and kept it away from their mom. At least they stopped her from driving any more.
The self-created crisis Anika had put her kids into over the car provided some impetus for the siblings to take action. They were able to persuade her to see a doctor and Rhonda took her to the appointment. She was diagnosed with dementia right away after the doctor examined and tested her memory and function. But the doctor simply told Rhonda and Doug that Anika had dementia and he’d see her again in three months! They had no idea what to do next. He offered absolutely nothing by way of guidance. He didn’t even bother to refer them to the Alzheimer’s Association, a very helpful resource with a Care and Support feature.
First Priority
Rhonda reached out to us at AgingParents.com, where we consult with families of elders on legal and healthcare matters. We had to prioritize the most immediate need—Anika’s safety. Fortunately, she is a woman of means and can afford the best care. Rhonda and Doug were urged to find a home care worker right away, as their mother was clearly unsafe to remain at home alone. They got tips on how to avoid pitfalls in hiring. Anika needed 24/7 care now, no more waiting. This was to be an interim step.
Next Step-Financial Control
Rhonda and Doug did not have control over Anika’s finances, as the Durable Power of Attorney Anika had signed years ago required that she have two physician’s letters saying that she could no longer handle her finances independently. Only with that could they legally assume control over her assets. I urged them to get another M.D. to see her at home. In Anika’s general area, one geriatrician makes home visits and would likely be willing to provide the second letter about Anika’s incapacity. That M.D. is private pay only. This is called “concierge care”. They were referred to her.
Where Should Their Mother Receive Care?
The siblings were in complete agreement that their mother needed to receive care somewhere other than her home, a large, empty house she had lived in for many years. With the many stairs, it was just too dangerous. We discussed the kinds of care available for someone with dementia and how to get lists of their possible choices in mom’s city.
They got to work on the search for a right living situation, given Anika’s stubborn personality, and unwillingness to socialize. “She’s a loner” they said. Given that, Anika would not do well in a large memory care home. We discussed other options, including “board and care”, which generally means a smaller home, privately owned, with only a few residents under care. Otherwise, it has the same state license as an assisted living home or memory care home. Some are high end and that was what Rhonda and Doug wanted.
The Outcome
As of last report, the overall goals had not yet been met, but it seemed likely that these two siblings were quite capable of hiring a helper until a long term living situation was chosen. It was also likely that the concierge doctor would be able to oversee Anika’s care going forward. Anika might resist the move, but her kids would soon have legal authority to manage their mother’s living situation, finances and healthcare.
Takeaways
If you have problem aging loved one, please do not wait as long as Rhonda and Doug did to take the steps to keep your elder safe. The red flags Anika demonstrated by all her failings to take proper care of herself had been visible for at least two years . Rhonda was paying Anika’s bills, but had not tried to push her to see a doctor. Until the car incident, Anika was left to her own devices. They were all fortunate that a person with advanced dementia who was still driving did not hurt anyone else nor herself with her car. They were also fortunate that their crisis did not involve a trip to the nearest hospital emergency department.
Anyone can learn from the common mistake of waiting too long to get control over an impaired aging loved one. Confronting an aging parent like Anika takes courage. It’s difficult! Generally, no one wants to take it on, which is the cause of too many avoidable disasters. If you have an Anika in your life, it’s time to step up. Waiting for “something to happen” can be quite dangerous.
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