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Mother, 74, was married 7 times to mostly freaks and losers. My beloved dad died a year ago. They had been long long divorced. My childhood and early adulthood is something a therapist would gasp at. My brother walked away 18 years ago, and for me it was 10. And then she showed up. Said she'd been in hospital with Covid, her 'neighbor' had her power shut off and would come in her yard and make noises to scare her. Said nurses in hospital had tried to get in shower with her. Crazy stuff. I pulled police reports for last 4 years, lots of calls for thinking there's a prowler, that her kids had left her car doors open, etc.
She'd been on community Medicaid and had home providers at some point before the hospital stay. Her agency washed their hands of her, due to her behavior. The lady who brought her to my house, who had worked for that agency, told me this. I called APS on Nov 1, after seeing the filthy house and needing repairs too. Hole in roof and wall, etc. APS said they would get repairs done and a deep cleaning. We are JUST now getting repair, still no date on the cleaning. We went ahead and paid for pest control.
She had two accidents in one weekend, a bad fall and hit her head, and a very minor fender bender in a parking lot. She's still driving. Psych office has noted this. She showed up a day early for appt (when I 'd already planned to take her). She lied and said I didn't bring her because I was busy with my husband. I told them this was false.
She has very bad cervical spine stenosis, legs getting weak, chronic pain. She'd initially refused seeing a surgeon, but now wants to go. We see neurosurgery tomorrow. Over the summer she had a couple of incidents of passing out outside. The hospital diagnosed opioid abuse. Her PCP, who is probably trying to cover is butt for over prescribing, says her neck caused the fainting. She's been abusing pills since the 90s.
I fear this surgery, she has a history of ICU delerium after knee replacement 10 years ago. I have from a police report when she was released from the hospital in Oct, she was at home, confused, and they'd contacted the hospital, who said she was supposed to go to a home. I am sure she refused.
I think the surgery is going to bring on the delerium, plus her usual mental illness, which her psych NP says is major depression/anxiety. I think it's depression with psychotic features. Her PCP says her psychosis is low B12 and started shots. I'm not convinced. She was angry last night when she saw I had written hx of ICU delerium on her neurosurgery form. I said they MUST know what they are dealing with.
She'd hidden a 4K IRA when she got Medicaid. She has a safe deposit with maybe 1K in it. I now have springing POA. I think if this surgery causes big issues, I will have to cash out her IRA/spend down on nursing home to legit qualify her for nursing home Medicaid? I won't sign anything for that unless I do it the right way. Can I access her box as POA? So far she's not been declared incompetent, though her psych NP said she needs assisted living. She had just told me she was ready to go, and then her stupid PCP says let's just fix her B12.
I fear her house. I can't stay there to help her after surgery. I am willing to go during days, but not sleep there. The weekend of her ER visits, I spent a night on her couch, and a roach nearly got on my face

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Just read OPs reply to Barb. If Mom is on Medicaid, it will cover whatever Medicare doesn't. She must use a surgeon who takes Medicaid. No other surgeon should take her. She is not suppose to be able to afford any upfront money. I was told by nephews doctor if a patient is Medicaid a non-medicaid doctor cannot take payment from them.

Mom must not have told them about her IRA. In home criteria is similar to LTC. I think ur asset cap maybe the same.
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Seek an elder Law Attorney to request court appointed guardian and to file for Medicaid to have her placed. A Geriatric Psychiatrist can get her on meds to, hopefully, stabilize her or place her in mental hospital.
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Now that you have POA. The process starts. As someone suggested - have a psych eval done on her. Her house have her sign a quit claim to you so you can do with what you need done and that will help pay what needs to be paid. She needs hospitalization for the mentally ill. You're smart not signing anything!
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This is not a matter of "deserving" surgery. The mom deserves the compassion and assistance of the medical community to relieve pain she's in.

AND since she's mentally ill, she should have supportive services to assist her living AS INDEPENDENTLY AS POSSIBLE without becoming an albatross around her child's neck.

Her daughter should not lift a finger to assist. That's enabling, not helping.

There are some folks who can't be "helped" by mere mortals like us.
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sp19690 Jan 2023
Since the medical and mental health community think it is ok for mom to live this way they are not exactly showing her compassion in my book.

And just like drug addicts or alcoholics are denied transplants the same should hold true in this case. Unless the surgery will free her from her daily physical pain whats the point?
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Personally I dont think mom deserves any type of surgery.
What's the point with someone this messed up? So they can live even longer and make other people's lives miserable?

It's so stupid that you cant stop the mentally ill from ruining their lives with insane behavior.

What you can do is completely remove yourself from this person and their choices and offer no assistance and help. No talking to doctors or APS or anyone. It is the only way to save yourself from this damaged person who clearly does not want to change.
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AlvaDeer Jan 2023
SP, spot on. You are, imho, 100% correct.
If this OP continues to intervene in this, then it is her or his own choice to do so, and she or he will pay the consequences of doing so.
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Put her back outside and then close said door, and resume estrangement. It sounds like if she dies alone in her hoarded house nothing of value will be lost. Do not go to the hoard for any reason, for any amount of time.
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sp19690 Jan 2023
I agree completely. If OP gets involved it will be her life and health (from the stress) that is ruined not her mother's.

If the state thinks it's acceptable that the mother lives in a disgusting hoard then so be it. OPs hands are tied by do gooders who created laws that allow people to destroy themselves. Ironic that assisted suicide is banned in most states but killing yourself slowly like this is perfectly acceptable.

She needs to wash her hands of mom and stop trying to help. There are homeless shelters mom can go to if she has no place to stay.
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OEdgar, proceed with extreme caution. Remember that just because APS says they won't "take" her does NOT obligate YOU to do a D@MN thing.

Mother is competent. She gets to decide about her medical treatment and gets to chose the discharge options ON OFFER. None of them is your home, nor any thing that relies on you supplying care or support.

Mare sure discharge planners send someone to evaluate the home before discharge. Do NOT provide transport after surgery. She signs her own discharge papers and is taken to HER home by hospital transport or by cab.

My maxim is if a person is competent and independent, let them show it without my help.

If you want my help, I give that on MY terms, not yours.

Keep in touch with the discharge planning office, not your "mother". Assume that every word that comes out of her mouth is untrue.
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Oedgar23 Jan 2023
you nailed it. Many lies and half truths come from her
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Folks, it's extremely important to know you cannot act for someone mentally ill if they don't want you to, even if they are out of control. Not with a POA. And you are unlikely to win guardianship of someone mentally ill. It is almost impossible to get to act for someone mentally ill. You will be told that it is "not illegal to be mentally ill" and you cannot stop people from making bad decisions. Please, everyone, consider reading Liz Scheier's memoir Never Simple. Order it from your library if you have any interest in this subject at all. A spring POA cannot be instituted on someone mentally ill. That is a HUGE court action which the mentally ill person will almost certainly win.
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Siouxann Jan 2023
Yes, that book- Never Simple- I read it this summer and thought of so many posts from this forum.
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Shut the door and move on with your life. If you are the POA send her a letter certified return receipt required resigning as her POA, there is nothing mystical or magical that needs to be done.

There is no future with continuing this toxic relationship with her. She is a garden variety addict doing what addicts do.
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The recommendation that you see an elder law attorney, find out how to resign a POA and take that advice. Likely to involve a registered letter or hand delivered letter by a constable to ensure that your mother has documentation (you have documentation) that she did receive the revocation.
Then, stay away. When any agency or person calls, just say that you are not responsible for her, you do not have a relationship with her other than occasional social visits. No caregiving role. You don't have to explain or justify. As other wise voices have posted, the fact that when she was out of your life you were happier is your business and your responsibility to you.
"The system' will resist taking over her care and safety as long as there is anyone in community who will try to do the job, and when a patient is competent. (We are all presumed competent until a judge says otherwise.)
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AP won't step in, yet they already have by getting house repairs and a deep cleaning done.

How did the agency lady get your address? Did she also try your brother? She was only trying to dump the problem on someone else.

And today you're bringing her for a neurosurgery consult? Is the neurosurgeon going to assume that you will be her transport to surgery and after care?

So with springing POA right now you can do nothing, since she has not been declared incompetent.

You should strongly consider extricating yourself from this situation entirely. Your brother apparently did, and so can you! Do you want to ruin your life? Because that's where you just steered your train of life by getting involved.
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Oedgar23 Jan 2023
The agency lady brought her to my former address, which is unfortunately practically across the street from my old house. The resident there informed her where I live.
My brother lives 350 miles away.
I told the surgeon yesterday that I can’t be her 24 hour after care.
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Do you want to have a relationship with your Mother? (Or was being estranged working out fine for you?)

If you do want some sort of contact - how much? Send cards twice a year, a phone call once a month? Weekly catchup at a coffee shop?

Because taking her in, being her discharge plan, staying in her hoarded up home sounds less like a relationship & more like taking on all her responsibilities. Like living HER life with her. That is what happens when boundaries for self-protection are not in place or not strong enough.

Take a BIG step back. Clear your head from fog. Physically take a hike up a mountain, call a crises line to chat, whatever it takes.

But please stop & think. Her opioids, her B12, all of that - is between Mom & her medical team. Unless you become her Guardian, or medical POA, that level of detail is not required.

Unless you actively choose more, the current level *as an astranged but concerned relative* is pointing an unwell person towards medical help. Stops there. That is the boundary line.
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Oedgar23 Jan 2023
I was absolutely fine being estranged. It just reached a point where I figured there is no escape. Her friend was tracking me in a public face book group. Also, a few days after she’d arrived she sent the police to my home (20 mins away from hers) to give me her new phone number. I felt there was no escape.
also when I saw her living conditions, I could t walk away. And of course her whole mess had more mess the deeper I got in.
Before I got involved, I tried to contact three lawyers for advice. Two never got back to me, and one was too expensive. I wasn’t sure I was going to be in some sort of trouble.
Im definitely not her discharge plan if it involves 24 hr care and told her that.
I only sight POA because I figured this nightmare has landed on me, might as well have “some” tools to deal w it.
The springing POA is not ideal. She refused the other. It’s a sign of just how selfish she is
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I hate the thought of you in the hoarded house with pests… Can you possibly set a boundary with her and all authorities dealing with her that you will no longer be entering her house because it is unsafe?
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Beatty Jan 2023
I will not enter that house.

That would be my line. In thought, words & actions.
No ifs or buts. Just a hard no.
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If you can video her erratic behavior, perhaps you can call 911 and request a 72 hour psych-evaluation hold? Let them know, that they cannot call you upon release because you're not available or responsible. Just say, "NO."
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A few added things: She refused to sign immediate POA.
She’s not currently on drugs, because her PCP cut her off. But she’s eager to get the drugs back, which will restart the process of her passing out, behaving erratically etc.

I asked APS and they said until she’s declared incompetent, they can’t “take her” or become her guardian.
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AlvaDeer Jan 2023
You cannot make decisions for her even with a POA as she is likely only mentally ill, no demented. It doesn't count and you can still make your own decisions when mentally ill.. You are lucky you are not POA. I think it a great mistake to take that on.
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Walk away, as others have said.
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You should have gotten Immediate POA under the circumstances. A Springing means you have to get one or more Doctor's saying she is incompetent for it to come into effect. You cannot cash her IRS in or open her box until the POA is in effect. And before you cash in her IRA make sure Medicaid requires it. If they do, you can prepay for her funeral to spend down her money.
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I hope you take the advice given here.
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I want to recommend a book to you, a memoir by Liz Scheier called Never Simple. In Ms. Scheier's case her mother was mentally ill, but over the lifetime of that Mother Ms. S. tried to help her, along with the full help of the City and the State of New York and all they had to offer.
There WAS no help for the mother, and eventually, in her 80s, she died, but not before she caused a good deal of mayhem in the life of her daughter and all who came in contact with her.
I am sorry to sound hard hearted, but at 80, having spent a lifetime watching people as an RN caring for them and their families, I can tell you that often, no matter how many resources you have, no matter how much money, no matter how good your intentions, a person such as this can spell absolute RUIN to your life.
The City and the State are there to take care of people who are unable to care for themselves. Provide your mother with the names and numbers and resources you can come up with, and, if necessary, let the state take on guardianship before you sacrifice your own life on an altar to no avail.
I am very sorry you have taken on POA. I would resign that and would see an elder law attorney to help me do that at once. That's my advice. As to the rest of it, if you take on this task, I wish you well. At least Ms. Scheier got a book out of it. Most people end with broken mental and physical health and nothing else.
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As a drug abuser she has not hit rock bottom. She sought you to be her most recent enabler. You just are not seeing the big picture
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This is too much for anyone to take on even if you weren't estranged from your mother.
She needs to be placed and you should let the state handle it. It's in the hands of APS and they are responsible for her.
You can still be in touch with her. You can even advocate for her to make sure she gets decent care wherever the state places her.
You should not try to take this on though. Your mother needs professional help and should be living in a safe, controlled environment where she is cared for.
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Oedgar23 Jan 2023
APS told me they act in the least restrictive way towards the person. Since so far mother has not been declared incompetent, they will not take her. Believe me I wish they would
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You walked away 10 years ago. Walk away again. You can destroy yourself trying to help, but you can’t cure anything. If anyone else turns up with her on your doorstep, refuse to take her in. Don’t feel bad about it – the ‘lady’ was trying to get rid of the problem onto you for her own sake, not to help your mother. This is one for the professionals. Don’t even try yourself.
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"The hospital diagnosed opioid abuse... She's been abusing pills since the 90s."

Is she still abusing prescription drugs? If so, I would walk away and let the county become her guardian. She is a hot mess that you can't fix, especially if she's not cooperative and has undiagnosed issues.
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