If we can address our relative’s dignity, the rest will follow. I say this with a hefty degree of awe for what it may take to put all the pieces in place, sometimes amidst family strife and in the context of geographical or financial challenges.
I feel badly for people who lose their filter. 
We’re not worried that he’s going to assault anyone. Although he’s mobile, he’s quite frail and small stature - not threatening, again mid 80s and a feather could push him over. He has an outgoing personality and, before the illness, never thought twice about striking up a conversation with a stranger. If this is now a risk, the caregivers won’t want to take him shopping, which he loves to do. It’s also upsetting for his wife, and that’s really our main concern. She doesn’t want to be around him. I wondered if anyone has recommendations for meds - he’s currently taking an anti-anxiety medication, but it doesn’t help with this, likely because this is not an anxiety behavior for him. One of the caregivers mentioned Lithium - says its commonly used for this, but we don’t want to see him sedated and out of it. He attends a memory loss day program, and they are great…although I’ve noticed that most of their activities are separated by gender, which may be why he hasn’t done anything inappropriate there. He’s most disinhibited with his female caregivers, and they’re very good about redirecting him. Scolding or chiding him doesn’t seem to work - redirecting does, especially to an exercise activity. He’s a handful, though.
@Gourmetmom , I haven’t any suggestions, just a hug. it is so hard to live through declines of people we love and respect.
I meant he might assault a woman by grabbing her or touching her private parts. Some dementia patients begin to do this as their illness progresses.
Aren’t there pants that are harder to pull down? Eg, snap is on the side. Many older men wear a jumpsuit. If he’s got help, are they near him often enough to then help when he needs to use a bathroom?
The idea of “fancy pants” LF suggests may be helpful for outings. It makes sense that reminders don’t work; the brain can no longer process and retain such input. Perhaps speak with his day program director about what they would suggest about his behavior and if they have or know possible support resources for his wife. It sounds like she may be bewildered by his behavior and perhaps grieving her partner. Pros help separate the disease behaviors from the person and provide support.
I am not sure about meds being used is this very specific context. Does he take many meds? Sometimes a consult with geriatric pharmacologist or geriatric psychopharmacologist can be helpful to assess options. If he has a primary dr with expertise in geriatric care and dementia, they may be helpful. Day program staff may have names. (Lithium is not a sedative per se.) It is worth noting that many with this illness function best with structured routines, in a very consistent environment. This can be achieved in a variety of settings.
Having the next step level of care options researched ahead of an immediate crisis can also bring peace of mind. While some with dementia are safely cared for at home throughout their lives, many reach a fork in the road where an elder community makes all the difference.
Best to all of you. This is the tough stuff.
Do any of you have experience with filing a W2 for wages paid to a caregiver? MIL moved into SIL’s home in Oct. MIL is helpless physically but is still somewhat competent mentally. SIL has obtained POA at mom’s bank and is writing checks to herself for nursing care in addition to using ATM card for restaurants. She also charges for home expenses. Four other siblings, including DH, are not allowed any contact with mom. SIL is attempting to force a sale of mom’s house where BIL has lived all his life. DH is going to see an elder attorney about the undue influence issues, but we are also concerned about maintaining Medicaid eligibility. At the current rate of spending, mom will be out of money in about 20 months. Should we be filing a W2 on the half of $7200/10 weeks which she identified as nursing care? My understanding is that in PA, companionship is not a qualified expense. Is there a limit to what can be charged?
Hypersexuality is a side effect of various medications, including psychiatric medications. My dad groped a helper but honestly I was there and he was reaching out to grab onto her like he was falling. He was scared by the look on his face so she just grabbed his hand to steady him (they were moving him). He certainly has not made sexual comments, but while hallucinating from the dementia, he made what sounded like a racist comment.
I do wonder how many cases of dementia are medication-induced or at least aided, because once my dad’s geriatrician heard that he was on a muscle relaxant as well as a psychiatric drug, she said he had to stop the muscle relaxant because it adds to the psychiatric side effects.
juniebug, I know from my side of it, my one sibling said that I “didn’t allow contact with my dad” which was an out and out lie. If they never tried to contact him, or me, how am I keeping him from them? That one sibling also wants to put him in a nursing home regardless of his ability to walk and take care of himself.
Also, SIL cannot “obtain POA” without your MIL’s consent. But yes, an elder law attorney might be a good idea. Another of my siblings has bilked my dad out of thousands of dollars without his consent, but now with my dad’s health issues, it has gone on the back burner. My point with mentioning that is that if your mom is somewhat competent, you should be able to contact her.
I don’t understand why you would file a W2 though, unless your DH is in charge of your MIL’s money. As for “companionship”, you mentioned your MIL is helpless physically. Being available to take someone to the bathroom, and/or clean up after them, and make food for them is considered a job.
Here’s just one example of hypersexuality as a side effect of a medication:
http://www.movementdisorders.org/MDS/Journals/Clinical-Practice-E-Journal-Overview/Clinical-Practice—Volume-2-Issue-2/Hypersexuality-Parkinsons-Disease-Systematic-Review.htm
Another mentioned is too much Valium (more than prescribed) taken by an elderly patient, but there are far too many to list.
The main treatments appear to be behavioral but they can try pharmacotherapy.
(note that hypersexuality IS considered a medical condition, so though it may be embarrassing, it might be best to mention to the parent’s doctor)
Some states allow a family member to certify as a caregiver. You’d have to research in that state and, I think, also learn who is qualified, This site gives a little initial info. Yes, it says, “In having the parent pay a family member for caregiving, it will be an employer/employee situation and payroll records must be kept with payroll taxes paid.”
@rhandco SIL has gone from claiming mom was unavailable when we called to not answering her phone. Mom is blind and partially paralyzed, so is unable to reach out to us. DH has general POA, but his sister presented mom to the bank in her wheelchair for a bank POA. Basically, they both have POA at the bank. “Someone” has attempted to establish a bank to bank linkage, but DH put a stop to this. Mom is 92 yo and probably doesn’t know what is going on. Mild dementia but not incompetent. DH, His brother and another sister have all lurked across the street hoping to catch a glimpse of mom. No luck and no answer at the door even when lights go on and off. We are considering asking for a police welfare check. SIL has gotten aggressive with people at the bank and with mom’s lawyer. Pretty sure there is significant mental illness.
@lookingforward Thanks for the link. We would like SIL to sign a Medicaid compliant caregiver agreement so that when mom’s money runs out (along with her interest in caring for mom) that she will be eligible. SIL works doing freelance massage and I doubt she pays taxes on much income. We don’t begrudge her being compensated for the caregiving and extra household expenses. I believe if MIL doesn’t report the payments, they will be considered gifts, and non-compliant.
Mom’s lawyer has recommended DH get his own lawyer and see about having mom moved to a nursing home. This is after she advised us to avoid at all costs. She said the total lack of contact plus the aggressive moves on mom’s assets leave us no choice. I should add, SIL was estranged from the family for many years until about two years ago. Mom went several years without even a phone call.
Juniebug- that is a lot! It is a bit unclear as to why there would be hesitation to proceed quickly with ensuring mil is okay and that her designated PoA can act on her behalf. She sounds extremely vulnerable and prior statements against nursing homes are not likely a relevant variable now, particularly if SIL is as troubled as the family seems to fear. I’d move forward with lawyer’s guidance at every step. Best to the family.
@juniebug, I am so sorry you are having to deal with a difficult SIL on top of the stress of caring for an elderly parent. It sounds like a consult with a lawyer is indeed in order, and document, document, document!
That sounds very rough. The only way more than one person with a POA is supposed to work is if they both are co-POA, which a friend of mine did with two other people. Yes, it was pretty crazy because in some cases, only one was necessary, but most of the bank transactions needed all three to sign.
My understanding is that the last POA is the one that counts. That is, if the bank POA is after the lawyer POA, the bank POA wins. If your DH has a POA after the bank POA, his POA wins. My eldest sibling had POA before I did, and now that new paperwork was filed, he cannot act as POA because I am the only one listed. If you said yourself that she is competent, then she signed the POA at the bank willingly with your SIL. Unless you want to consider her held against her will.
https://www.caring.com/articles/senior-visiting-service-senior-calling-service
This is rather interesting, made me think:
https://www.reddit.com/r/AskLEO/comments/2klr4p/have_you_ever_done_a_wellness_check_what_for_how/
(We have security cameras at my dad’s house, including one inside. They’ve really helped our peace of mind.)
Hello all,
Thanks so much for the support comments. Amazing how just someone knowing what you are going through makes you feel better. It seems so long ago that I was worried about my dad falling in rehab. Now he is due to be released back to his assisted living but I got a call that assisted living place doesn’t feel he is appropriate for there any longer. He is too cognitively impaired to stay in the restorative section–wouldn’t remember to call someone to help him get up and might pull his catheter out again. (and again.) He also is too physically impaired to switch to their dementia unit-- not quite that confused plus dementia unit doesn’t deal with health problems like catheters and doesn’t allow wheelchairs due to residents forgetting they can’t just get up and walk.
SOoo, they are suggesting skilled care. The place he is in now (past 5 years) is wonderful. He has his own furniture in a large studio. Double bed, sofa, farm table, etc. All local skilled units seem just like being in the hospital which I don’t think he will like. Consultant I called suggests that there are assisted living places nearby with a model that could accommodate him. May have to go back to his assisted living apartment and pay for 24 hour aids until we figure something out. $$$$$
Friday he walked 205 feet to therapy and 205 feet back to his room afterwards so stamina isn’t the problem. The problem is balance and being safe getting up and getting down, bathroom etc.plus he might not be really safe to just go walking around alone.
After reading other stories I’m thankful my brother isn’t a problem. He’s out of state and can’t visit often but will be here Jan 25th for 4 days.
When we were facing the need for Skilled Nursing at $8-9k monthly, we discovered board & care homes, they are popular in CA, not sure about your area. The ones we saw were anywhere from $2500 (shared room) to $5k monthly. A home is converted to house 6 seniors and they have live in caregivers. We could move the parent’s furniture there, a TV, life chair, dresser, but used a hospital bed, and they definitely provide more personal care than a more institutional setting. We were happy with this choice for both MIL & FIL, at different times.
We have board and care - spotty and spotty situations. In some areas, you may be able to hire someone to live in.
Friends in Switzerland hired a wonderful lady Barbara from Romania to care for her parents in the parents’ home - Barbara is a dream come true. Very well educated; on her time off, she has a niece come and be there 24/7. They first hired her through a German agency, and when the contract ended were able to hire her directly. She is delightful and amazing - cares for these folks like they were her own parents. She earns 5,000 SF a month and has no expenses - win/win situation. They would be paying much more than that for one parent in skilled or assisted living situation, and both parents need the care.
I looked at B&C for my grandmother, in AZ. Very impressed.
Earlier in this thread, we talked about how, when you direct hire, there are regulations to meet, eg, work load, time off, and the big one, tax implications. Plus you may find yourself relying on just that one or two independent caregivers, sunk if something prevents them from showing up.
Yes some states have heavy regulations. I just know from what I have seen here and heard about.
Any time you can find the right answer to solve the situation with elder care - what works fiscally and with getting proper care.