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I don't blame you for needing a break. You definitely need one. But before you take one you must line up in-home care for your mom or arrange for her to go to a facility while you take respite care.
Rarely do dementia patients admit they are not able to take care of themselves and insist on round the clock supervision. In their mind, they're fine. That's when they have to be taken care of as you would a child who isn't capable of looking out for themselves.
Getting her to accept the care is the key. There are many ways to do that, ranging from insistence to persuasion. I would certainly halt her cooking ability, even if I had to disable the stove or pull the circuit breaker.
If you can access it you can usually - and it is usually not a given force your Mum into respite care for one reason and one reason alone. If you don't have a break then you are going to have a breakdown...at this point it will all be taken out of your hands and your Mum would be put into care possibly permanently.
So to put her into care for a week or two while you have a much needed break is realistic and you must have agencies or possibly grant agencies/charities that would enable this.
If you rang APS and said you were on holiday for a week they WOULD step in and then there is a risk that you would be prosecuted for neglect. However if you consult in advance to arrange the care and are insistent on it then you won't be leaving her alone. She might be stroppy as hell initially but she will forget soon enough - My mum hates going into care for a week but she goes because I HAVE to have a break - all my family know when I need one - I cry a lot at stupid things.
If not, in-home care agencies offer varying hours. I'd start with having someone come a few hours a day while you are there before you take your trip. Then take your break and keep the help if you/she can afford it. You shouldn't be on duty 24/7 for years at a time.
Good luck,
Carol
Next I suggest you call your local Alzheimer's Association and ask to speak with a counselor. They are available 24/7. They can help you decide what to do.
In my opinion, the reason things are so difficult, is in fact because there is a need for a care manager. If you wish to take on that role then there needs to be what we call a care plan.
Decisions will need to be made as to how yor mother's care is handled from the most basic of tasks to how are the bills going to be handled, who is going to be the Durable Power of Attorney f(DPOA) for finances and most importantly who will be DPOA for Healthcare.
You can seek answers on the internet but also locate an elder law attorney in your area. Ask for a one hour consultation so that you understand what is necessary and what is required. Don't just speak to the first person you find. Look into all of the elder law attorneys, ask around, then when you have identified someone you like go ahead and make an appointment.
Hope this helps. Good Luck.
https://www.agingcare.com/News/The-Hidden-Dangers-of-Elder-Self-Neglect-146760.htm
Your question about legal responsibility is important. Can a family member simply walk away from someone whom they have cared for? There may be many theories of liability. Rather than write about all the bad things that could be imagined, I'd like to mention some of the resources and approaches that you could look to, for help with these difficult and frustrating circumstances.
Have you called on the Area Agency on Aging, ASAP (Aging Services Access Point) or town senior center? There may be many resources for care and assistance available to you. These agencies should provide you with approaches that can work.
Alzheimer's Association offers support groups and training for caregivers.
If you need legal authority to protect your mother's finances and health, a Conservatorship and/or Guardianship petition can bring the needs into focus and provide you, or an objective professional Guardian, with the authority to manage care and finances. There may be a charitable organization that provides guardianship services in your area.
The ASAP and/or an elder law attorney can help you identify home care reimbursement and payment programs that may be available through Medicaid, state agencies or the VA if you mother or father are veterans.
There's no denying the difficulty of the situation, but finding help to serve your mother's best interests is an accomplishment that is worth the effort.
First, yes, of course, if any of us relinquish responsibility that we have taken on and that results in harm to another, then we are responsible. You and your mom could be sued for all sorts of things. Just as if our child causes harm or damage.
Second, there is a rule of the sea: you don't make long passages alone. It is forbidden (though stupid people do it) because it is so dangerous. The boat and radio need to be tended 24/7, meaning you cannot sleep. And you must sleep!
For me, this analogy is clear. Caregivers need plenty of back-up!!!!!!!!!!!!!!!!!
Third, I would like to point out that one's family member need not be in the worst possible condition for us to suddenly be placed into the "responsibility harness." My husband has a number of medical issues and he is doing quite well with all of them. We have lots of labs and appointments and all, you know the drill. He is a brilliant man. BUT he has just slipped in his own abilities that teeny, tiny little bit that put him over the edge--to where I have to take over, literally, every day something new.
It started in November 2014 with his not being able to drive. He would kill someone, believe me. But here is the kicker: he himself has not decided not to drive. This means that for the last ten months I have had to pretend that, heck, that's just where I wanted to go, too.
OK, so this means that I am so doing all of the driving no matter what, no matter how trivial and unnecessary I find the trip. But also in the last ten months, he has, with diplomatic grace, passively transferred ALL responsibilities to me. I now do EVERYTHING from the garden to the car to the computer to the house to the paperwork, insurance, blah, blah, blah. And, on top of that, he has just begun to: leave drawers open, leave the fridge open, leave the water running full blast (and can't hear that), leave lights on...
And as I was saying, this is someone who is doing pretty well. He can feed, bathe, and dress himself. He can so some small workouts at the gym, he can do a tiny bit in the garden. He reads a lot and writes to friends. And yet at the same time, he has abdicated all responsibility.
I guess what I am saying is this: the responsibility net is wide and deep. It can scoop us up long before our loved one is in a really bad state.
The thing that helps me the most in this period of limbo, don't laugh, is to remember that God doesn't give us more that we can handle. When I remember that, I perk up.
I don' know if this is helpful to others but it certainly has been cathartic for me.
Anyway, if you are in NY, there is something called the Nursing Home Diversion Program. Your Mom will need to qualify for Medicaid (there are ways to handle the spend down - like pooled trusts - and there's no 'look back'). Then, if the care she needs can be provided in her own home cheaper than going to a nursing home, Medicaid will pay for it.
Alternatively, If you have private pay funds then use them! But I'm guessing you would already be doing so if you could. Churches often have folks who will visit seniors, you can use this time for respite.
If you do end up having to find a nursing home for her, make sure they specialize in dementia care. I've found that the 'average' nursing home is a terrible place for someone with dementia who also has emotional/behavioral issues. They cannot provide the one-on-one staff these patients need for their own safety.
A couple years ago, I met a man who cared for his wife while she was dying of cancer. He said, and this is verbatim, "The caregiver goes down with the ship". This is not true if the caregiver gets support and time off.
I agree with previous posts suggesting starting out a few hours here and there while you are present to get her used to the idea of someone else caring for her in the home. I would not leave her alone without another caregiver present - many things can happen the least of which being sued or brought up on charges. I have had home care aides show up at a person with dementia's house and have them locked out or the person forgets they said yes to the care. We've always found a way around it and never left her alone.
Caregivers with experience in dementia and Alzheimer's care should be able to work around your mom's resistance - if they cannot then they are not the right person. Come right out and ask when interviewing candidates - "how would you get around resisting care?".
Lastly - yes get an elder law attorney and geriatric care manager to consult on these issues of competency and guardianship. You may have more options than you think with the right support!
I have no idea what your responsibility would be in case your mom started a stove fire and unplugging the stove and microwave when not in use is a great idea! But otherwise you are providing round the clock live-in care for your mom and that is not neglect. Your mom has access to medication, food, shelter, companionship, etc. I was just discussing this issue with my husband (a doctor) and was asking what he does if a frail elderly person is injured when they were at home alone. Could the family caregiver be charged with abuse or neglect? He said that it is highly unlikely. Most likely, he would refer the patient to a social worker to make sure that arrangements are made for discharge -- will the person have adequate supervision when they return home, or will they need to find another living arrangement for the person? (And by the way, that is a lot of work and most social workers will not pursue that unless there is no nearby family and/or patient’s family is adamant they can’t provide care at home.)
Here is a description of what is considered elder abuse and neglect:
helpguide/articles/abuse/elder-abuse-and-neglect.htm
And from National Center on Elder Abuse:
http://www.ncea.aoa.gov/faq/index.aspx
If you need to run an errand and have to leave mom for 30 minutes -- if she is not a wanderer, stove is unplugged, etc. -- that does not sound like neglect. I have never heard of paid caregivers who will run to your house at a moment’s notice to babysit for half an hour. These things need to be scheduled in advance and sometimes the necessity of the errand outweighs the risk of leaving the elderly person home for a short time. If she has a “button” (for Life Alert or similar) and is capable of using it, it seems reasonable to occasionally leave her unattended for short periods of time. Sometimes the comfort of the person being able to stay at home balances out the risk of leaving them alone, and that is something the caregiver must decide.
Area Agency on Aging, the VA (if your dad was a veteran), Catholic Social Services, and Jewish Community Centers often have some help available, and some states offer PACE programs (which provide senior day care free of charge to most people who enroll.) None of these agencies, as far as I know, offer nighttime help or “last minute” requests (unless you enroll her in an adult day care) and they are all stretched thin. AAA (and CSS which work with them in our town) and the VA have been a huge help to us, but it only alleviates a small part of the burden. You sound like a very loving daughter and I hope you find support!
For the people offering “have to’s” and “musts”, it seems like Moms2nddaughter is weighing her options and risks, something that family caregivers do all the time. It is not an easy decision to place someone in a nursing home. Unless her mom is wealthy, hiring visiting help is going to be a challenge financially, outside of the above agencies which will probably get you 12-16 hrs a week total, if you are lucky. Finding a facility for her mom is going to be a challenge in a lot of ways. I am pretty sure she is asking about liability because she is trying to weigh her risks/costs/benefits of keeping her mom at home versus those of trying to place her somewhere. Real information will help her make that decision. Offering your judgement telling her what she “has to do” with worst case scenarios of all the harm she might hypothetically be doing when she is already caring for her mom round the clock is only going to increase anxiety, when she obviously has enough to deal with already!
And also it is a little bit different dealing with a spouse than it is with a parent or grandparent. Your husband probably sees you as his peer and equal. No matter how demented a parent is, they still seem to see their adult children as children and do like to acknowledge the child "knows better." If Moms2nddaughter's mom is at risk, the daughter knows she needs to do something. Convincing the mother that things are changing and she will have to go along with that is another matter.