Alzheimer's is one form of dementia; there are also others. Proving incompetence is not necessary for obtaining a power of attorney. In order to grant someone power of attorney, though, I believe a person needs to be fairly rational. Proving incompetence is different and more complicated. If a person's decision-making ability is substantially impaired they may no longer be able to grant power of attorney to someone else. A doctor would need to testify to their impairment so a guardian could be appointed. Again, sadly, your cousins need a good elder-care attorney. They also need to start researching memory-care units, realizing that there may be waiting lists and not all can or will handle patients who are combative. This isn't an easy road, but educating themselves will help them make the best decisions possible. (((Hugs))) to them and you.

I'd suggest the daughters talk with their mom's primary care doctor and give specific examples of the problems they are seeing. The doctor may not be able to say much to them without their mom's permission, but should be aware of what's going on. Next step should be an appointment with the doctor for a complete physical, including a review of all medications, and possibly a referral to a specialist for a diagnosis. Hopefully there is someone she trusts who can be given permission to receive medical information. Then (or possibly concurrently with these steps) consultation with an attorney specializing in elder care. If she really doesn't trust anyone to act on her behalf, they can advise on how to proceed, and their advice will be valuable in any event. Someone will need to have durable power of attorney, etc. I agree that an apartment would only be a stopgap. Researching assisted living places or nursing homes which have memory care units would be more useful. Why make her move twice? The really difficult legal point (in my experience, I'm no lawyer) is if she isn't really capable of making good decisions, resists advice from others, and yet is not sufficiently clearly impaired that a judge would declare her incompetent. Her daughters really, truly need a very good attorney, for her sake, not just theirs.

Yes, it is so hard. I'm so sorry. :grouphug:

I wasn't aware of this, but it looks interesting. Thanks for bringing it to my attention!

Yes, if they can happily make that decision while they're young enough to adjust, that is obviously the best situation. I hope that happens for you all.

Well... this may not be what you want to hear, and of course ymmv. I have been where you are, and I'm not sure I would push it again if I could do it over. My mother had always said how much she wished she lived close to us and could see the kids every day. They did need to move away from their house with no bedrooms or bathrooms on the first floor. A house came on the market near us which was accessible and really completely suitable, my father wanted to buy it, and he and I jointly encouraged/pushed her to agree. They had been trying for years to agree on some retirement living situation in their own community and just couldn't agree, and the situation had become urgent, so we pushed, and she capitulated. She had been in her old home for fifty years and had deep roots in the community. She wasn't really able to get to various meetings any longer, but she had the security of feeling like that community was all around her and accessible if she wanted to make the effort. We took that away from her, with all the best intentions but not enough understanding. In her new community it quickly became obvious that she was more confused than we had realized. She had no well-trodden routes. She'd call, late at night, from some completely improbable and often unsafe location because she'd gotten lost driving. She had a couple of minor accidents. We had to take her keys away, and then she felt completely isolated and dependent, even though the kids and I were very close and with her frequently. I realized that when she'd said she wished she was closer to us, what she had really meant was that she wished we were closer to her. Our presence did not compensate for the loss of her community. She never did really adjust. Her pain at leaving her home was the constant theme of every conversation for years, until I'd stop by the house just long enough to drop off supplies and flee when the refrain began. It hurts to realize the commitment to be there for your parent and help them in old age has actually harmed them, and you cannot fix that harm. Dementia did stop that refrain in a few years, and it was easier for me to come over and comfort her in the middle of the night when she was having delusions, because I was so close. It was easier for me to keep an eye on the care she received, and accompany her to doctor's visits, and make sure she had food she liked and the right sort of tea. The practicalities were all easier, and maybe that makes up for the fact that she was so unhappy with the move, but I'm not sure. If I could have put her in a good assisted living place in her own community, maybe she would have been happier. I just won't ever know. All this is just to say that this stage of life isn't easy. With the very best intentions one can do the wrong thing, or never know what the right thing might have been. Old age, really old age, not young old age, is often cruel and really awful. And the decision to leave a known familiar life for a new community is so wrenching and has such deep repercussions that, knowing what I know now, I wouldn't push if there is time for your parents to make their own decision in their own time.

In our (still fairly short) experience, ABA has been positive, warm, and very enjoyable for our dd. We are seeing slow improvements, I think, but we've only been at this over the summer. The question of switching between different therapists may depend on staffing levels at your provider. I'm not sure what documentary you saw, and I wish I did have a book to recommend. I guess, for us, it came down to needing help. We weren't making progress on our own, and ordinary parenting techniques we grew up with were actively counterproductive. We were ready for anyone who could help. I'd be glad to try to answer any more specific questions you have, but I'm not sure if I'm understanding your concerns very clearly. Do you already have a diagnosis? Is the evaluation to diagnose, or merely to see how many hours of ABA are recommended? You may also get more responses on the Learning Challenges board.

Sometimes the behaviors which seem odd to the uninitiated are coping techniques which comfort the person with ASD. People on the spectrum are often under an enormous amount of stress dealing with sights, sounds, smells, and the simple presence of lots of new people. It sounds like you've got a big family, and this young man is in a new country, speaking a language which is not his first tongue. These would be somewhat stressful situations for many, perhaps most, 17 year olds, but he's got an unimaginably greater amount of stress to handle. I know you want the best for this young man, and I'm speaking gently.... What you see as getting too comfortable and behaving badly sounds very different to me. In our family, undesirable behaviors appear as a reaction to stress which has become overwhelming. Perhaps for the first few weeks he was able to keep things under control, but now it's all just too much. Generally, as hard as these behaviors are for bystanders, it's harder for the person with ASD. Again in our family, and I can't speak for others, the least helpful action is to draw attention to these behaviors in the moment. He is already too stressed to control them. Embarrassment can be acute and further overwhelm him. His parents can probably provide the best guidance. What did they suggest? I agree to focus on getting your son some space. His frustration may be compounding your guest's difficulties. Could you find things for him to do away from the guest? Some reading material from the library about the challenges faced by people on the spectrum might also be helpful. Probably the behaviors you're seeing are not just based on lack of social understanding, but spring from acute discomfort.

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I think/thought I encountered it in Green's book, but I'm not sure if it's originally his or someone else's idea. Anyway, the concept has been profoundly useful to me, in behavior around schoolwork as well as more generally.

We went through the process just this past fall, when our dd was nearly 10. I wish it had been earlier, but even though we were seeking help no one thought "autism." At first we were on the waiting list of a major hospital near us, but as the appointment drew near and we got concrete information about the visit, it didn't sound like a good fit. I found out that the whole process would take only one hour, with a yes-or-no diagnosis afterward. An older man was doing the testing, and dd tends to shut down around older men. I wanted the information we got to be as complete and accurate as possible, so I started scrambling, called private neuropsych practices within several hours' drive, and found a better fit for dd. The initial visit lasted two hours, we has a basic "yes" at the end of that time, and then there were several more visits to get a more complete picture. You might want to check out the thread in the Special Needs forum about the value of an aspergers diagnosis. My own experience is that the right diagnosis is enormously valuable, and trying to cope without it is not productive. If the concern is a false positive result, I don't know what the chances of that would be. We did get several diagnoses along the way which were superseded by the ASD diagnosis. They did let us start figuring out medications, and we already had some notion of what was and wasn't helpful when we got the ASD label. So the earlier misdiagnoses, while not allowing us to start therapies like ABA which would have been helpful, were not entirely useless.

Great article. Green's book has been very useful to us over the years, though I've always had a hard time with the part about identifying which skills are lagging. The fundamental idea that "kids do well when they can" (hope I'm correct in connecting this to this author) has been transformative for me.

This is helpful, thanks. I'm thinking this over.

Bump

Thank you! :lol: :001_smile:

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