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I'm new to ALL of this. My mom hasn't been diagnosed yet, she's terrified of doctors (she's actually always been extremely anti-medicine, anti-doctors etc) and I'm scared of trying to get her into a doctor's office because of what she might do there. She has been in RAPID mental decline for the past 2 yrs, but we didn't really understand what we were seeing at first because frankly, she's always been wound really tight and she was just appearing to be a little more spazzy than usual. She lives with me and my 21 yr old son, who, thank God, has adjusted his work schedule to be home when I'm not here. He hates it, he's a little depressed about being trapped at home with her, but there's only one brother who lives here, and he pops in to see her once a month or so - too busy, blah blah blah. I don't know, I doubt I'd pop in to 'see her' more than that either, if I had that choice, lol. It's not like you can carry on a cogent conversation with her anymore. And now, her hallucinations are getting SO bad she's even telling the cat (she HATES the cat) that she loves her and please don't leave her. Eh? The cat looked as leery as ever (she normally yells at her) Her adorable little mini Aussie who was ALWAYS by her side, now hides under her bed all day, where she's safe from the craziness that comes with her hallucinations. Poor doggy, lol. She carries one shoe and a bundle of random stuff around off and on, all day. It's bizarre but we give up trying to stop it.


So my question is, in Texas - does she NEED a doctor's diagnosis to get into a care facility? She turned 65 last yr and threw away ALL paperwork concerning her new Medicaid that they force on them. (She's been on full SS since 2018) I tried to get her into a Medicare supplemental plan but they told me they can't look at her case until I can provide proof that she has med A and B or A OR B. What are these? I have no idea. I know she needs the supplemental plan tho, or everything will cost out the nose. I want to institutionalize her, I know that sounds cruel, but I'm gone 50-60 hrs a week just with work, and my son has been reduced to 20-25 hrs a week of work because of her and he needs to make money as well. We need her in a facility or we're not going to survive financially. She destroys/damages/throws away alot of things like food, her own brand new clothing, shoes, household items like blenders - all thinking she's being 'helpful.' I am currently missing some brand new work pants and now, her brand new box of coffee pods - I don't know WHERE she squirrels these things away but she's become a hoarder of EPIC proportion and it takes a full day off to get the house and her crazy room back into some kind of order. I'm starting to get REALLY depressed between home and work stuff.


It's good to vent. I'm currently starting to design a line of t shirts, mugs, etc for my online shops that give clues into what to look for with dementia, (ALOT of ppl think it's just memory loss - they have no idea what to look for, including myself when it first started happening) and some humor stuff that families will understand and get a much needed laugh out of. My son has taken to talking to my mom in a funny voice and calling her "graaaandma" instead of Nana. He will finish her bizarre sentences with something hilarious, and even she laughs alot, and I told him, always keep the humor bc it really helps. I get so frustrated with her, she's actually told me she's going to cut my throat in my sleep several times now (she can't even remember what a knife is, so I'm not worried LOL)


I'm designing the new shop and all proceeds will go to helping get this woman into care. I can't afford it on my own, my brother won't help, and my mom's SS will have to go towards it, but it's definitely not enough. The GOOD news is, after 18 yrs of smoking, she forgot that she smokes about 7 mths ago! LOL. I took away her keys about 5 mths ago so she doesn't try to kill ppl on the road anymore. :-)

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No, you can not get her into a nursing facility without a diagnosis from a doctor.

Medicaid does not force people to except it. So I think the paperwork she received was from Medicare. Medicare, if already receiving SS, is automatic at 65. I think A&B are also automatic. They were for me and DH and we needed B to keep his Union supplimental insurance. His Union also supplies Part D, our prescriptions. Our Medicare premium (for part B) is deducted from our SS checks. If Mom is receiving Social Security she should be receiving a statement every January showing what she will be receiving that year. That statement also shows the Medicare premium being deducted. You can probably go on-line to see it.

I suggest you call your County Office of Aging for an appt. They will help you sort things out. You may be able to go on line to Medicare and request another card. The card will show you if Mom has A & B. Then its trying to set her up with Part D. Depending on her income, she maybe able to get Medicaid for her supplimental/secondary insurance. In my state, Medicaid will pick up the balance that Medicaid does not cover. She will get prescriptions (part D) dental and vision. If she makes too much, she may still qualify for a State prescription plan, in my State its called PADD. Office of Aging should be able to help you understand all the ins and outs. While there, you may want to ask questions on how to place Mom on Medicaid for her care in a Nursing facility. Think your Mom is passed an Assisted Living.

If Mom has no money, then Medicaid will be needed to get her into a Nursing facility. Office of Aging should be able to help you with what criteria you will need to meet. Like assets. Does she own a home, this is an exempt asset. The income cap, assets she is allowed to keep, my state $2000. Her SS and any pension will need to be used for her care. She will have a Personal Needs Acct (PNA) where a small amount of her SS check will be deposited. (My state $50 a month). This is to help cover and personal things she may need.

You really need to understand how it all works at 65. Medicare is a good thing. You will be glad you have it when the time comes. But you need to have everything in order before you place Mom in a Nursing facility. In the meantime, if something happens and she lands in the hospital, take that opportunity to have her evaluated. This will be the time to say she needs more care than u can give. But, I would make that appt with Office of Aging ASAP because Mom needs proof of insurance if she ever needs a hospital.

If she becomes violent, call the police and tell them she needs to be Baker Acted. This will force her to seek help and be placed in a Psychic facility and get that diagnosis.
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In addition to the great advice you've been given, if you CAN get her into a doc office and she goes off, you and the medical staff call 911 and have her hospitalized.

It sounds like your mom may need to be in a psychiatric facility to get some calming meds at the correct dosages.

Once she is hospitalized, you are well within yourbrights to refuse to accept her back into your home.
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You ask, "Does she NEED a doctor's diagnosis to get into a care facility?"

A really important question we need you to answer is: are you your mother's PoA? If not, is anyone?

If you are, then you should review the document to see when your authority is activated. You can use a "therapeutic fib" to get her in to the doc's office ("Social Security now requires an annual exam in order to confirm your benefit") or whatever you think will motivate her to go. Once there have a pre-written note that you discretely hand to the staff telling them your relationship to her and ask them to test her for a UTI and give her a cognitive and memory exam. After that, you should be good to go. Then it's just a matter of what she can afford for a facility or filling out the Medicaid app for her.

If you are not her PoA and she has no diagnosis of dementia, cognitive impairment or memory loss then you have no real legal power to remove her from *her* home. Your home is her residence and you can't just make her leave. You'll need to evict her. Or until she requires a trip to the ER -- then this would be your chance to talk to the staff social worker and get her tested during that event.

She could have some other medical issue, like a thyroid problem or diabetes. She could have had a TIA. All those can cause behaviors that seem like dementia.
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If you're unfamiliar with Medicare A, B, and any other related plans, that should be your first step.  You can research online and get a lot of information about the basic plans.

There's also a private insurance agent who is very knowledgeable about the Medicare plans.  You could contact him and you can sign up for his newsletter:

David Hecker - Texas Medicare Supplement Specialist<dhecker@cablelynx.com>

I would highly recommend that you contact your local Alzheimer's Assn. and see if they're still offering the Creating Confident Caregivers' classes.  They're free, mine was small (6 or 8 people if I remember correctly) and you'll learn a lot, including on the issue of problem solving and interaction.  

Sensitivity training in our class arose b/c of the issues other attendees raised, but it helped all of us put ourselves in the position of someone battling dementia, and learning to be more sensitive to their needs.   There was one movie that was shown on the progression from initial dementia to more complicated dementia.   Everyone in the class was in tears by the end of the movie.   That experience was just as valuable as the problem solving and discussions.
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