Expert: Michalene Peticca - 1/8/2012

Question
My mother has been diagnosed with Binswanger's. She is no longer the person that I know as my mother. She is manipulative, paranoid,lies, says terrible things about my siblings and myself and is generally causing all of us alot of heartache. She can no longer be reasoned with. My dad, who has multiple health issues including diabetes has been diagnosed with Alzheimer's. When her judgement and reasoning got really bad about 6-8 months ago my bother and I that live near them went and got guardianship of my mother. At first she saw my dad as the enemy and treated him really bad and he was cooperating with us in getting the guardianship.  Then she changed tactics and has convinced him that we are horrible and now he won't even accept a Christmas present.  My brother and husband are afraid for me to be alone with them as they and I am afraid that they might become physically abusive. They now are so verbally abusive to both my brother and myself that we can not visit them.  I have hired a healthcare worker to be with them 5 days 5 hours which is all we can afford.  I had to stop mom from driving by first taking the car then when I got the keys I put the car back in the garage but disabled it. They keep threatening to lock the healthcare worker out of the house and to take off.  My mother recently told another sister at Christmas dinner that I was not invited to that I had stolen all her jewelry.  The healthcare worker told me that mom was wanting her to take her somewhere to sell it at the same time she was accusing me of stealing it. I am at my wits end as to how to be a guardian let alone a daughter when she is so mean to me.  She has made horrible accusations against me such as that I have an incestuous relationship with my dad and told my dad when she did not know I could hear her to not let me get near him because I was jealous of her. I have been doing their meds each week but now she has convinced my dad to take his back and do them himself. (He takes about 13 or more different prescriptions four different times a day. He is easily confused and nearly blind so I know she will actually be doing his meds for him..scary thought) She has found a doctor that will not cooperate with us in her care and will not acknowledge the court ordered guardianship. She is trying to get all her meds.  A little over a year ago I removed two shoeboxes full of meds that she had been self medicating with.  Among other meds she takes Opana 20, Clonazapan,Aricept, Namenda and other drugs but none of it seems to help anymore. she was suppose to be taking Abilify but refuses to. She is in short impossible to manage as the disease has not yet affected her intelligence,short term memory or language. With a master's in Social Work she knows all the things to do to fight us.  She even called or had someone call the elder abuse hotline to report that we were abusing them.  They say that she is still able to "present well" so meeting her for the first time you would not realize all that is going on with her.  I can not drag my mother out of her home kicking and screaming so we have not had her placed even though all the medical experts tell us she should be in a structured environment.  I know as guardian I have the legal authority to do what needs to be done but how do you do that to your own mother while she curses at you? The decline has been most marked in the past 6 months and I keep thinking how much longer before the disease hits a part of her brain that will take away the abilities she still has to keep everyone agitated.  I worry also about my dad. I have searched the web alot lately to see if anyone else is dealing with this stressful a situation. It is unreal how much harder it is to deal with a person with this disease that still physically and mentally is functioning enough to make helping them impossible. I just do not know where to turn.  Noone seems to be able to help us. All my siblings are exhausted from trying to help them and fighting with them. They recently all told me that we have to stop helping them and let them fall on their faces.  I have a hard time doing that but is that what I need to do?  Should I let them go enough that they maybe find out that they can not care for themselves? Also as guardian can I be held responsible should I not do more than provide home healthcare and meds and manage mother's financial? I can not ever feel that I am not responsible but need to know where I stand legally as it is to the point where there is only so much that I can do for them without putting myself in jeopardy.

Answer
Hi Robin,

Oh my...i am so sorry you are in this situation!   Being a Guardian is tough enough....being a Guardian to one's parents....challenging at the least!  

First of all....as hard as it may seem....stand back and look at your mom & dad's medical and overall living condition subjectively.   Would you allow anyone else to be in that situation.  I'm guessing you say "no".  OK....so please call your local Office of Aging and let them know what is going on....that You are Guardian and that you want help for your parents.

Your local government will recognize your Guardianship....if they question, please have the lawyer or judge that was in attendence at the court proceeding to verify for you.   Your parents Doctor can and would be held Liable for Not recognizing your Guardianship...please remind him\her of that.  

As to what to do with your situation......i suggest a meeting amongst your brothers and sisters as to what their feelings and thoughts are.  If they are truly leaving everything to you...i'd call them and tell them that you are considering making nursing home placement and how do they feel about that?  If they are against it...are they willing to committ to 20 hrs. (per se) per week to not have that occur.

I think you are at a point Robin that you need to control your parents' safety.  They cannot drive, they cannot take care of their meds., and they probably have very limited day to day abilities for overall self care other than the visiting nurse.   

Think Safety and objectively....your family will make the right decision.

I wish you the best and peace of mind knowing you did the best for your parents in spite of the horrible diseases that have robbed them of "themselves".

Best Regards,

Michalene Peticca, MA