OP again. To be clear, she does not think she is fine. She thinks she is in hell but she sees it as the fault of everyone else and refuses care at the sane time. Objectiively she is fine medically but at constant risk from open wounds and other skin problems.

OP here.

PP - very helpful. That is much closer to our situation than anyone else may be familiar with. We have had 5 hospital admissions this past year, all because of refusal to care for wounds at home, at assisted living, at SNFs. Hygiene is related to this.

For those whi think you cannot be appointed as guardian when someone can oppose it, you are wrong She is in Pennsylvania and the standard is capacity to make medical and financial decisions. The nature of her combined mental illness and cognitive decline has taken her across the line into lack of capacity according to most recent psychiatrist who saw her who is from UPMC and a geriatric specialist. She has been kicked out of three assisted livings this year and two SNFs. We are on the third SNF in 13 months,

But it will likely be a contested hearing. I do not want to do it but there is no question that my brothers and I are in a better position to assess her true interests unfortunately and have saved her life several times now. But it sucks to take away the legal rights of someone who says everything is perfectly fine.

Also, those who say she can just be medicated and will be ok, undortunately not true, The paranoia and the blindness to risk are so great and cannot be medicated away. medical advice is not to medicate under her circumstances and that has been the position of multiple doctors at this point.

It is extremely difficult. I appreciate everyone’s comments and PP I really can both relate to and emphasize with your situation. I hope you have good support.

Anonymous wrote:

Anonymous wrote:If you do not intervene, the nursing home and the guardian will likely be in cahoots. I had this happen to my aunt who had no children. She was relatively young, was in a medicare facility because she had a trach and could not speak, but was mentally sounds. When she went into the ICU for pneumonia the nursing home petitioned to have her deemed mentally incompetent and requested a guardian be assigned, and suggested a particular guardian who then filed that his first request was to have the beneficiary of my aunt's life insurance to be changed (which he would have been able to do if he had been assigned as guardian). He wanted to change the beneficiary to the nursing home.

When I found out, I was able to get an elder care attorney involved to file an emergency injunction (or whatever it is called) to have me named as her guardian which I was.

This is a common scam. Netflix made a movie about a real one called" I Care A Lot"

I'm a PP from 1/4. The judge would have to be in on it too, because generally judges appoint independent guardians if family is unwilling or unable to be the guardian. At least in my state/ at every guardianship hearing at which I've testified, that happens. The facility is not able to request guardians, and the court always exhausts every family contact first. The NH resident is appointed an attorney by the court who represents them.
I'm not saying it never happens in other places, I've just never seen it, I guess. That sounds like a very corrupt state you live in.

In Montgomery County, MD it happens. Either the nursing home takes guardianship, an attorney is assigned by the courts, etc.

The facility we were at took financial guardianship through social security without telling us. It was a nightmare. They filed the paperwork and were approved despite my husband having POA. I went into social security and proved I was managing the money and the nursing home got paid and they gave the representative payee to me instead. We then went to court to get legal guardianship. We were told by the attorney we couldn't have joint but the court gave it to us no issue.

Anonymous wrote:I am in a very similar situation with my mother. I do have guardianship both financial and to make healthcare decisions. Even with both of these we can not force her to take medication or get medical care. She is in an assisted living which we were only able to get her in after an involuntary commitment. She refuses to take any medication or see medical professionals. We had a bad situation where she had a cut on her leg that got infected that she refused to take antibiotics for. We finally were able to treat when she got taken to the hospital in an ambulance. During this the als wanted to kick her out due to noncompliance with allowing open wound treatment. She is bipolar with paranoid delusions and is very difficult and has an angry disposition

It sounds like she needs a higher level of care in a nursing home.

Anonymous wrote:OP here. Thanks. My Mom has refused to shower or bathe for well over two years. It has been tough as she does not have a formal dx of a kind of dementia but was finally dxx with cognitive decline. All of it is on top of a serious personality disorder so it has been hard figuring out when we crossed the line and since she has opposed POA forever and may try to oppose the guardianship it has all been confusing. Also triggering for me is some of it resembles my childhood just enough so was like a slow boil. We had to threaten her to get her out of her house and to medical care 15 months ago and it has been a horror show since. I will def seek guardianship from the court and hope if she opposes counsel will be appointed and help her see that this is acceptable.

OP, I don't think you understand what you are asking.

Court guardianship is to make decisions and control the money. You could force her to move into a nursing home but you cannot force her to bathe, for example.

I got guardianship of a loved one with dementia. It was a very simple process. File with the courts, notify all interested parties, get two doctors to sign off on the dementia, and the court assigned an attorney for our loved one. We did not have an attorney. Attorney supported the decision and handled it in court for us.

However, if she refused to eat, bathe, cooperate with nursing home staff there was nothing to be done about it.

And, you have to show a medical or mental health issue that makes them incapable of decisions.

I am in a very similar situation with my mother. I do have guardianship both financial and to make healthcare decisions. Even with both of these we can not force her to take medication or get medical care. She is in an assisted living which we were only able to get her in after an involuntary commitment. She refuses to take any medication or see medical professionals. We had a bad situation where she had a cut on her leg that got infected that she refused to take antibiotics for. We finally were able to treat when she got taken to the hospital in an ambulance. During this the als wanted to kick her out due to noncompliance with allowing open wound treatment. She is bipolar with paranoid delusions and is very difficult and has an angry disposition

Also - the nursing home has to get paid. They can seek a court-appointed guardian to access the resident’s bank accounts so a LTC Medicaid application can be initiated.

I don’t think Montgomery County has a “county nursing home.” I don’t know if there is one in the DMV.

But two doctors have to deem her incompetent to make her own health care decisions. If she refuses your involvement, they will select a court-appointed guardian.

Anonymous wrote:

Anonymous wrote:Thanks but no scam here. This is a county nursing home and I need their help honestly. I am going to pursue guardian but I cannot make my mother conply with basic medical care

I'm not sure you understand what being a guardian means. You are not certifying that you can force them to do anything. You are the decision maker. Your mother will not be able to enter contracts, make legal decisions, etc., independent of you. It doesn't mean you are liable to get her to 100% comply with anything.

+1 The nursing home will continue to be her caregiver. You becoming guardian will not improve the odds that she will bathe, dress, etc; it has nothing to do with that. But if she becomes ill and refuses medical care, that’s where you can step in and approve treatments, etc. For example, if she is in the hospital and needs an MRI, they don’t go to her for consent but they will call *you*. If they need to sedate her for the procedure, again - they will call you tor permission. If she needs a feeding tube or any other complicated medical procedure, they won’t run it by her; you will be the point of contact. If they want to try to crush up a med in her applesauce and spoon feed it to her, they will reach out to you.

Anonymous wrote:OP here. Thanks. My Mom has refused to shower or bathe for well over two years. It has been tough as she does not have a formal dx of a kind of dementia but was finally dxx with cognitive decline. All of it is on top of a serious personality disorder so it has been hard figuring out when we crossed the line and since she has opposed POA forever and may try to oppose the guardianship it has all been confusing. Also triggering for me is some of it resembles my childhood just enough so was like a slow boil. We had to threaten her to get her out of her house and to medical care 15 months ago and it has been a horror show since. I will def seek guardianship from the court and hope if she opposes counsel will be appointed and help her see that this is acceptable.

I don’t understand. If she has capacity to refuse, that means she does not meet criteria for a guardian.

Anonymous wrote:Does anyone happen to know off hand how much scrutiny the guardian gets? I won’t be able to force my mother to bathe, wear clothes, trim her fingernails, consent to medical care. All I have is the ability to document that I have tried but I am not goong to tell her every day to bathe and have her refuse every day. I know this sounds crazy and it is. I think I have to do it but it is not as though it will change everything because she is refusing.

Well, you could authorize them to medicate/treat her psychiatric issues.

I probably should have mentioned it may be opposed by her so I am anticipating having to put on sufficient evidence.

OP here. Thanks. My Mom has refused to shower or bathe for well over two years. It has been tough as she does not have a formal dx of a kind of dementia but was finally dxx with cognitive decline. All of it is on top of a serious personality disorder so it has been hard figuring out when we crossed the line and since she has opposed POA forever and may try to oppose the guardianship it has all been confusing. Also triggering for me is some of it resembles my childhood just enough so was like a slow boil. We had to threaten her to get her out of her house and to medical care 15 months ago and it has been a horror show since. I will def seek guardianship from the court and hope if she opposes counsel will be appointed and help her see that this is acceptable.

Anonymous wrote:Does anyone happen to know off hand how much scrutiny the guardian gets? I won’t be able to force my mother to bathe, wear clothes, trim her fingernails, consent to medical care. All I have is the ability to document that I have tried but I am not goong to tell her every day to bathe and have her refuse every day. I know this sounds crazy and it is. I think I have to do it but it is not as though it will change everything because she is refusing.

I work in mental health, and my experience is that if you answer your phone when called for consent and get any paperwork filled out in a timely manner, you will be in the top 5% of legal guardians.

The main thing that you can do is sign her into the nursing home. If she signs herself in, then she can just sign herself right back out again.