Mom and the Future

[bjarvis]

I've been feeling a bit down the past couple of day because of some family issues. Given a choice between venting here and eating my feelings/my body weight in ice cream, well, here we are. You're welcome.

Reports from family indicate my Mom's mental health is sliding dramatically. Memory loss, emotional instability, cognition impairment. We've reached the point where intervention is required.

Problem: Half of my siblings are simply staring at me, insisting that I do something. Why me, you ask? Why don't they do something themselves, you ask? Largely because they don't want to. They want something done, but they don't want to be bothered.

Problem: Mom doesn't think she has a problem. She knows something is off, but insists it is the universe with issues, not her. Her memory is perfect, it's the other 7 billion people with memory loss. Her thinking is clear, everyone else is messed up. Olympic gold medalist denial.

Problem: Mom lives on the farm alone since Dad died this time last year. The nearest relative is 250 miles away. The nearest town is 8 miles away. There is a nursing home in that town, so that's an option, but.... that implies either institutionalizing her near her friends & social connections, but away from family. Or bringing her closer to family, but ripped away from her social network & home of 50 years. Both options suck.

Problem: When/if she's declared incompetent, I have medical power-of-attorney, but I live in another country. Two other siblings have general power-of-attorney for all other matters --and one of them didn't know it until I sent him a PDF of the docs a few days ago. He's not happy.

Problem: None of us even know the name of her regular doctor or what meds she's supposed to be taking --when she remembers. How does one legally intervene? What are the ramifications? We have a lot of homework ahead of us.

Plan: I'm going to head to northern Ontario as soon as I can to spend a week with her. I trust the reports from family, but I also need to satisfy myself of the necessity of any intervention.

I went to high school with the lawyer who made the wills, powers-of-attorney, etc.: I'll have an appointment with him to catch up on the legal issues. One of my sisters went to high school with her pharmacist: we can find out more about her meds. Did I mention this is a small town?

We need an expert medical evaluation. I expect however that Mom will fight us at every step and will not cooperate with any exam. There is a real possibility she will see this as a global conspiracy including her own doc & lawyer, cut off all contact and refuse her current meds.

It's not so far fetched: in Dad's last two years, she was convinced that only she could treat Dad, and that all doctors were in cahoots to secretly murder him. She even accused two of my sisters of being part of that conspiracy. She was almost barred from two hospitals because of her threats of violence against the staff. It was ultimately dismissed with a warning as the ravings of a scared, distraught wife watching her husband suffer, but we had to monitor her while she was monitoring Dad.

So in all, I have a mess of stuff happening back in Canada and I don't have any good answers at the moment. I'm trying to thread my way through, but I'm not getting much sleep and the weight of it sometimes makes it difficult to breathe.

A year ago Monday, my Dad died. The Mom I knew is nearly gone, while a stranger like her but not her inhabits her body. And we have to come up with a plan to care for this not-quite-Mom that won't destroy what's left of her. Ugh.

Comments

[bitterlawngnome]

Familiar territory unf. Be careful around getting a diagnosis of NCM, because you (and sibs) then become liable for everything. My experience with the eldercare system in Ontario was that everything is blocked and unavailable until patient presents a clear danger to herself amd/or others, and then if one can afford a private or semi private room they suddenly become available. The drive to the home was among the worst moments of my and her life, so have support.

Into the breach. I wish you strength and luck.

[bjarvis]

Yeah, I'm wary of pushing too hard to have Mom institutionalized because of the responsibility involved: we'd be responsible for everything about her for the next 20-30 years. My dear siblings, in their rush to Do Something Now have not thought this through, I think.

If we can find something she likes and can provide her needs, money won't be an issue. She still has pension income from CPP, OAS, Dad's union, etc., and funds from the sale of the farm if she wishes. And I can make up a chunk of the rest as needed. But making a plan she won't fight? That's like folding space-time.

[bitterlawngnome]

There's also the twilight area of suicide. If you think she might have planned that as an out for herself, putting her in a home (24 h surveillance) will effectively prevent that. Not an easy idea to contemplate of course.

[apparentparadox]

Mark worked with a private care management company to help with his dad. They were able to do a lot of the things that one would do if one lived closer (attend doctors visits to help make sure that all the appropriate information made it to the doctor and all the doctor's instructions were understood). In some ways they were better than us being closer, because many of them had a nursing background and all of them had experience with elder care, so they were ahead of things, whereas for us, it would have all been a learning curve.

Have you read "Being Mortal"? It can help with the whole process of letting your mother make decisions differently than you would. Yes, there are risks with what she is doing. But you take risks every day when you drive on the freeway or get in an airplane. If she's truly incompetent, that's another issue, but if she is competent, but just not making the decisions the way that you & your sibs want, that's something else.

One of the things that was hardest on me with Mark's folks was that there *wasn't* a good solution. I"m used to coming up with ideas for things and solving problems, but there just wasn't a solution that would be good. There were bad solutions and worse solutions. Try to make peace with the fact that there are some things you just can't solve in a good way. That will at least remove some of your stress.

[excessor]

These are not all the same problem. Your mom's health is one problem; each of your sibs is another; the family house is the third.

Making decisions is one thing; getting help from sibs is quite another. Everyone deals with age-related and end-of-life issues differently. Getting professional advice and figuring out next steps (and overall goals) is hard to do but probably necessary.

I wish you well on this.

[bjarvis]

Yup, they are multiple problems, but they overlap. And in some spots, they compound each other in an unholy civilization-ending nuclear chain reaction of pain, suffering, anger & despair. On bad days, it gets worse.

Fortunately, I live in a different country and well outside the immediate blast radius. Apologies to the residents of the rest of Ontario though.