OP here: Thank you for the advice everyone. PP, I do think a group home may be ideal one day, I am just not sure it is going to be an option in their current town. It is certainly something I will look into though. Thank you.

We do plan on being there to support the niece. I just wish they lived closer. It is hard being so far away.

OP what about a group home? My birth mother is a paranoid schizophrenic who started hearing voices in college. I don't know her whole story, but she has been in some sort of group home for at least 20 years now. There are medical folks who visit and ensure she takes her medications. She was still independent, not under guardianship, until recently when hospitalized for a separate issue and went under financial guarsianship because she wouldn't leave the apartment to fo to the bank for money for food and other items. Now someone sends her groceries with her own money. I don't know how the group home is funded, however... She does pay rent, she perhaps is on Medicaid and may have money from her mother who was well off, but estranged from her...not sure

The group home is not perfect, she has dealt with roommate issues and bed bugs. But it does mean she is not on the street and has someone checking in on her.

NP. Thank you for taking care of the niece and seeing more in her than her circumstances. Bless you, bless you.

Continually invest in the niece. You are kind to pay for college. Offer her a stable home when she’s in college during breaks. Once she’s 18 you can be more active. You sound like a very good person, OP.

And as niece and her mom get older, do what you can to shield niece. As she launches into adulthood, she doesn’t need her mother dragging her down. She won’t see it this way as kids always love their mothers. But help niece.

Agree that talking to an attorney about a special needs trust would be helpful. But the worst part about mental illness is that if someone doesn’t want to get help, you can’t force them. Temporary orders only last for a few days and they are only granted in extreme circumstances. There basically has to be a likelihood of near-immediate physical harm to the mentally I’ll person or to others. And now just verbal threats. It is a high bar. And our country is awful at taking care of our sick citizens.

Our name is Legion, for we are many.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My aunt lives in a LMC condo complex. Out of 100 or so units, there seem to currently be 5 or 6 residents who were "dumped" by family members who bought the units for their mentally ill relatives. They create such havoc with the neighbors, the management, the HOA, everyone.

There's just no easy answer. The state of mental health care in our country is terrible. You're a good person to care, OP, and the daughter will likely have to take on more and more care as she ages.

OP here: It is rough. I understand why the laws were changed. I mean the way mental illness used to be handled in this country was atrocious. But now it is still horrible in different ways. I don't want SIL to have no autonomy and I think "wow it would be horrible if someone had to force me to take meds each day" but I also just want her to see a doctor regularly. Just wish she had the ability/will/desire to do so. I really worry because she seems to be getting worse and worse and I worry about the safety of MIL and my niece but she hasn't threatened them or anything. It just feels like a ball rolling down the hill headed for disaster.

OP, reading your thread it sounds like MIL could outlive SIL which would be a blessing.

I was thinking the same thing. I hope they all have their legal affairs in order as there is a young girl in this mix who is going to get lost in the shuffle no matter who goes first!

Anonymous wrote:

Anonymous wrote:pp the potential for home care through the state would be through a Medicaid waiver, just to help you get started. Each state has different types of medicaid waivers so it's complex (and therefore some states have more services than others). I don't know Texas but given the politics of the state, usually those states will unfortunately have the least services available (and the most poverty!) and you are right finding services in the small town is another barrier. Thinking creatively - when the time comes, maybe you all pay out of pocket to someone in the town to do some of the general upkeep. If you could find someone trustworthy who needs extra income since it sounds like many there struggle.

But like we said first steps are Medicaid, food stamps, and disability so she has some income coming in.

She does already have Medicaid, food stamps, and disability. She used to have TANF (But I think they cut off after a few years). MIL has access to the food stamps so she is able to use those for groceries. She gets disability, but obviously only SSI so that income is minimal. Thank you for the advice on waivers. I will look into it.

I think her doctor would have to order the aids through Medicaid.

Mom lives in one of the poorest counties in Maryland and we have direct pay and also some agency caregivers for Mom. One of Mom's direct pay caregivers told me her mother (in her 40's) gets free caregivers through Medicaid due to morbid obesity and a stroke.

My other experience with this is that we get some caregivers through Bright Star and Comfort Keepers. Some of the caregivers that we've had over the years also did work the same week for Medicaid clients through an agency that specialized in the Medicaid clients and supplement their income with side work through Comfort Keepers and/or Bright Star. I guess what I'm trying to say is even though the Medicaid workers are paid through Medicaid the same caregivers generally are doing outside work for other pay direct agencies if that makes sense. i.e. You are not getting lesser care through the Medicaid workers.

Anonymous wrote:

Anonymous wrote:My aunt lives in a LMC condo complex. Out of 100 or so units, there seem to currently be 5 or 6 residents who were "dumped" by family members who bought the units for their mentally ill relatives. They create such havoc with the neighbors, the management, the HOA, everyone.

There's just no easy answer. The state of mental health care in our country is terrible. You're a good person to care, OP, and the daughter will likely have to take on more and more care as she ages.

OP here: It is rough. I understand why the laws were changed. I mean the way mental illness used to be handled in this country was atrocious. But now it is still horrible in different ways. I don't want SIL to have no autonomy and I think "wow it would be horrible if someone had to force me to take meds each day" but I also just want her to see a doctor regularly. Just wish she had the ability/will/desire to do so. I really worry because she seems to be getting worse and worse and I worry about the safety of MIL and my niece but she hasn't threatened them or anything. It just feels like a ball rolling down the hill headed for disaster.

OP, reading your thread it sounds like MIL could outlive SIL which would be a blessing.

Please do all you can to help your niece. It appears she lost in the gene pool with her parents so please do everything you can to have nurture overtake nature with her.

Someone mentioned it a few pages ago but if getting her a house is too much, how about a trailer?

PP again but I would proactively see how you can start helping her daughter now- start a college fund, fly down to take her to tour some colleges, look up scholarship programs like POSSE and Questbridge, see if Texas still has the top 10% go to A and M, etc. Help her get involved in extracurriculars, encourage her to find a trusted teacher so she has another adult to interact with in a more positive way, etc.

I would buy her a very small house or apartment, look into any nonprofits or social service options in that area (although I’m sure there are very few) or move her somewhere there are more social service options. These would need to include: meal delivery services, check ins, etc.

Otherwise pay for meal delivery, a cleaning service once a month and see if she can get a wellness check once in a while by a social worker or whatever services the area has. Not showering or having teeth and lying bed all day, while horribly sad and not a way I would want to live are not reasons she can live alone.

Anonymous wrote:

Anonymous wrote:With how you described her in the second, more detailed comment, I wonder why you haven't gained custody of her daughter? I'm sure it's hard to worry about her, but I would pull more focus there. If her dad won't take her full time, you need to step in if you have the means to do so.

While I'm sure your suggestion is well meaning, it is out of touch with what is realistic here. First of all, children don't get taken away from their mother's because they are poor and unmedicated. Judges routinely send kids back to much worse situations than what OP has described in this country. In rural Texas, the DC aunt/uncle aren't rolling in and getting custody when she is living in a "stable" home with grandma and the mother, has food/clothes and goes to school. Second, OP would blow up her DH's family trying to do this. The best approach is to keep doing what she's been doing for her niece and offer to pay for boarding school if that is something the mother/grandmother would consider and hope like she said that the niece is over 18 when grandma passes.

OP here. Correct. IF grandma wasn't in the picture it may be a different story. SIL just never really leaves her room but grandma takes care of niece. She is well taken care of, just not by her mom.

OP you should consult an attorney with expertise in special needs trusts. They will help you set up a situation where you can pay her living expenses without jeopardizing her benefits.

Anonymous wrote:With how you described her in the second, more detailed comment, I wonder why you haven't gained custody of her daughter? I'm sure it's hard to worry about her, but I would pull more focus there. If her dad won't take her full time, you need to step in if you have the means to do so.

While I'm sure your suggestion is well meaning, it is out of touch with what is realistic here. First of all, children don't get taken away from their mother's because they are poor and unmedicated. Judges routinely send kids back to much worse situations than what OP has described in this country. In rural Texas, the DC aunt/uncle aren't rolling in and getting custody when she is living in a "stable" home with grandma and the mother, has food/clothes and goes to school. Second, OP would blow up her DH's family trying to do this. The best approach is to keep doing what she's been doing for her niece and offer to pay for boarding school if that is something the mother/grandmother would consider and hope like she said that the niece is over 18 when grandma passes.

With how you described her in the second, more detailed comment, I wonder why you haven't gained custody of her daughter? I'm sure it's hard to worry about her, but I would pull more focus there. If her dad won't take her full time, you need to step in if you have the means to do so.