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My mom fell and broke her hip in July. She refused to do any type of therapy while she was in the hospital for that two-week duration. She then was transferred to a rehabilitation nursing facility. That was also a nursing home and has been there now. Just shy of four months, my mother currently still requires assistance sometimes two people sometimes only one person to get up out of bed to use a walker and she needs assistance holding her up. She needs assistance bathing she needs assistance with all her daily activities. Some of this could be just refusal to do them just like she refused or only participated in her physical and occupational therapy in a very limited way. I had this point at four months after the surgery of hip repair, not replacement but repair she has only walked 100 feet using a walker with 1 to 2 aids, holding her up she is still requiring the assistance in showering. There’s no reason for that she Hast to have help getting out of bed. She cannot do it by herself. She refuses to except that she has not healed. Her hip has not healed at all. There is 0% healing because she has done nothing or very little in regards to physical and occupational therapy I live 900 miles away from her with my own medical issues, as well as my own family to take care of and it’s only me my father and my brother both have passed away , she has burn bridges and has push people away and will not allow certain people in our house who are willing to help her. I have asked her to move closer to us or in with us and she has declined and today her orthopedic doctor said that she will not heal in a timely manner without putting in the work that she’s required to, and it is possible for her to heal part not in the way that her body needs to, but it will take years in during that time she will weaken further. Currently she requires 24-hour seven day a week care she cannot afford a private nurse. I cannot move away from my family, and I am not capable of providing that care for her currently out of state. If she were to move here, I have the help of my four adult daughters and my son when he’s home from college as well as my husband, she is currently angry with me because she is arguing that her hip is healed which it is not and that she can go home by herself. She’s claiming she only needs supervision even if she needs supervision to get up and move around that is not 100% independent. It is not safe for her to go home. She doesn’t shower when she’s home she does not clean her house. Her bed is full of dead skin Scales, it’s gross. It’s disgusting she’s living with mice. I swear they are her roommates. She tried to deny having any knowledge of them, but I have the proof I don’t wanna take away anything from her, but she is not safe living alone. She is not safe living in that home anymore and she’s not taking care of herself. She’s not capable of doing simple household chores. I don’t know what to do. I’m afraid she’s going to try to force her way out of the nursing home and I’m not sure what direction to go to if it comes to that point. She can’t even cook for herself. Her meals are provided to her buy meals on wheels. She doesn’t eat those meals she only eats the sandwiches so she’s not nutritionally feeding her body either my mother lost 90 pounds in a year and every doctor kind of kept pushing it off to the other doctor because they were stating that I had something to do with that illness. The only doctor she has not seen has been the pulmonologist and that’s because she canceled those appointments several times and then most recent appointment she was sick with Covid in the nursing facility, I do have a power of attorney and I am her medical proxy. She does have some issues with short term memory loss. I don’t think that her long-term memory has been affected yet, but she can’t remember a conversation. We had two weeks ago and a conversation that was had with a group of people a few weeks ago. Cognitively she is OK.

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DO NOT have Mom move in with you.
If she is not listening to you now , she never will. DO NOT enlist your children to be caregivers either. They have their own lives to live .
Your mother will not do more if she was home with you , and probably would do even less. These elderly woman seem to make servants out of their daughters.
I beg to differ where you say cognitively she’s ok. Does not sound like it if she is not bathing , and has mice for pets. And can’t remember recent conversations .
My mother had vascular dementia , her memory was not that terrible but she thought she was bathing and eating and changing her clothes and she was not . She also was messing up her bills , pills etc. Her executive function was not working . But to talk to her people thought she was fine . She could still carry on a normal conversation . She was belligerent and would not do what anyone asked of her either . The doctor told me that she could no longer be taken care of by family because she will not do “ what her daughters want her to do “ . Mom had to go to a facility .
It is also very possible that your mother has dementia and can not follow directions properly to be successful in PT. She may find it overwhelming and can’t or won’t try . I’m sorry but your Mom belongs in the nursing home. You say you have POA . Speak to the nursing home about how she lives at home and she’s not safe . They can do cognitive testing at the nursing home . Tell them she can not go home , that it’s an “ unsafe discharge “.
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Easy lists the positives, aides and nurses waiting on her hand and foot, probably daily room cleaning, ( even trash that misses the basket and is on the floor)aides to change and clean her,


Food brought to her room and placed where she can easily get it even in bed ( no cooking, on a schedule)no worry about meds, utilities and food, bed sheets and covers changed often, clothes washed and dried, bought back to her room hung in closet and/or placed in drawer, no worry about undergarments and personal items, all provided, can leave lights and TV on when she wants, could be all day if she desires, she's not paying the bill ,(esp if she is on Medicare and/or Medicaid). Free assistive devices ( wheelchair, walker, cane, etc) for her use. Landline phone for her convenience could be offered as well, drawers that can be locked with a key. Not really a curfew ( she can stay up all night with the TV on and at a somewhat loud volume if she wants, finally aides to wash her, even keeping track of her "shower days"

There you have it🙂
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lealonnie1 Nov 2023
Really? So moms too lazy to do anything for herself bc she's waited on hand and foot at THIS SNF you've made out to be like a luxury resort after badmouthing EVERY OTHER SNF on the planet?? 😑
So nice you've figured it all out for the op.
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Your mother is NOT "cognitively OK" if she's suffering from short term memory loss, isn't cooking or properly feeding herself to the tune of a 90 lb weight loss, isn't bathing, has mice in her home and all the rest of what you say! She's obviously suffering from dementia if she thinks she's capable of living at home, in THOSE conditions, alone when she's a 2 person assist!

I'd get on a plane and see what's going on myself, as her POA. She needs help and you need to lay eyes on her and insist she get tested for dementia. Then agree to keep her in the Skilled Nursing facility because she's in no condition to live alone, regardless of what she wants. Her needs must prevail.

Elders with dementia are not "refusing" PT and OT in rehab....they are mentally incapable of completing the exercises. Perhaps even physically. In many cases, breaking a hip is the beginning of the end for an elder, especially with dementia. My father was 90 when he broke his hip and he NEVER walked again. It was not due to laziness, refusal OR dementia, but because he had a brain tumor contributing to his mobility issues. Plus he was old and tired of fighting tooth and nail to make progress he couldn't physically make.

We had hospice come in and he passed shortly afterward. My mother had dementia and was unable to do physical therapy either, so she stayed wheelchair bound for 3 years and lived in Memory Care Assisted Living.

Go see mom and chat with the docs. As POA, you can have her stay in the SNF and remain safe and fed and bathed there. She needs that. Good luck.
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AndSoItGoes Nov 2023
100% agree that the doctor's comment about "putting in the work" is not helpful. Refusal is different from inability. Acknowledging that she really cannot do the rehab exercises will clarify the situation, it seems.
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Your mother is not capable and probably will never be capable of living on her own. Her mental issues are keeping her from doing the therapy.

You should not attempt to take care of her in your home no matter how many sisters are there to help. What almost always happens is that they promise and mean it, but when it comes down to the work required, they disappear into the sunset leaving you with a very sick person to care for and no one to help.

She's in a nursing home now. She needs to stay there where she can get the help she needs. They will have to find a place for her. You cannot help. Repeat: You cannot help. It's way beyond what a family caregiver can do.
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Don't make the mistake so many do, under no circumstances should you take her into your home. It will be one big mess and destroy your family unit.

Leave her where she is in the nursing home.

Sorry to say, she is not cognitively ok or able to care for herself.

Keep posting it will help!
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Does mom have the funds to private pay the NH for long term care or will she require Medicaid?

Has she had a formal cognitive assessment? She's NOT cognitively okay.
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“Cognitively she is (NOT) OK”.
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My mom had a roommate in the nursing home that she did rehab in. She was a very sweet lady who would talk about going back to her home. This woman did end up moving to the ‘permanent’ residence part of the facility.

I don’t know how long this woman participated in rehab. I know that it was longer than my mom. The woman had a fairly bad fall while trying to do yard work. She wasn’t able to recover from her injuries.

What have you discussed with the nursing home social worker and therapists at your mom’s rehab care meeting?
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No, you don't bring her to your home and expect ur adult children and you DH to help you care for her. Your Mom can't go home and legally the facility cannot discharge her if her needs cannot be met at home 24/7. You will not find an in home aide to take on a client who is a 2 person assist.

You don't say how old Mom is. Dementia could be the problem. If not, she is in the position she is because she did not do what she is suppose to do. So the consequences are, if she had done what she was suppose to, she would not now need an Assisted Living, if she can afford it, or NH if she can't.

You tell the facility that Mom is an unsafe discharge. That you cannot care for her in her home and not yours. Your Mom just has too much going on and needs more care than u can give. You could bring her closer to you but u should not care for her. You will end up being her slave. If like where I live Rehab is in the same building as LTC it will be an easy transfer.
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I wouldn't bring her to your home. And if you do, please don't involve your young family in her care. She clearly is not cooperative and you will be taking on 24/7 care for her.

I would leave ALL OF THIS in the hands of the facility she is currently in, and tell them that as well as being uncooperative with THEM, she is uncooperative with YOU. I would tell them you live far from her and there is no one to oversee her care.

I would not take on POA nor would I take on guardianship and I would not move her. I would allow the facility to do discharge planning. They cannot discharge her unsafely. They will get a court appointed Fiduciary to plan her care with guardianship of the state.

Throwing yourself onto the funeral pyre of your mother is one thing, but I sincerely beg you not to do that to your children.

This of course is in YOUR hands. You are the one who has to make the decisions and when you do you will have to take the responsibility for having made those decisions. I can only tell you what I would do. I never ran for Sainthood; it's a bad job description.
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I have gone through something very similar with my 94-year old Mom earlier this year. She was living alone, but in a house right next door to my family and I. Over the years her ability to care for herself had declined but I refused to see it and kept expecting her to snap out of it and get better. In May she fell several times, fortunately did not break any bones, but ended up in the hospital, then a local nursing home who insisted she was okay to come back to her home, she then fell again and couldn’t do anything. She needs 24/7 care in getting up and down, bathrooming, bathing, dressing, cooking, cleaning-all of which the local NH expected me to do. I have a family and full time job outside the home so this will never happen. I was able to get her into another NH an hour and a half away in another town and she stayed there until her insurance ran out. Now she is in a nice AL center in our town and is self-paying (fortunately she has the resources for that). She still thinks she can come home someday but I can see her circumstances more clearly now that I have not had the burden of caring for her in awhile and she will never be able to come home. She is in the best place for her safety, plus she has interaction with others all day and night, something she certainly did not have enough of living alone. Please look into whatever it takes to keep your mom in a safe environment. Either self pay, or get her on Medicaid. I’ve applied for Aid and Assistance for my mom since my late dad was a veteran. It takes a long time to get but if your mom is either a veteran herself or your father was, you may want to look into that as well. Hang in there. You are on the right track in having your mom in a safe place with staff trained to give her the care she needs.
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Aaaaaahhh! I know this! My mama was the worst at accepting physical therapy. The only thing I can think of is food, treats, drinks use as an incentive. Place them out of reach and if she wants them she needs to get up and move or she needs to do exercise to get them. I saw a video years ago with a child who did not want to walk and the therapists found that the child would do anything for ice cream. They set up two chairs and one therapist in each chair had ice cream and when the child would take a step (while holding on to the chair) the child would get a bite of ice cream. At first the chairs were close together then the chairs were moved farther and farther apart. Then the therapist would only give the child a bite of ice cream when he completed a touch of the chair and walk back. Soon the child was walking. Yes she will fuss and say you are hurting her but if she wants the treat bad enough she'll do it. Blessings
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anonymous1732518 Nov 16, 2023
Lol I was the exact opposite; was sad PT and OT ended, especially OT which I loved.
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She is not cognitively ok or she would do more. She sounds depressed but also out of touch with the reality of her health. She must stay in a fascility for basic care even if she refuses rehab. Don’t hesitate to do the legal action required here..
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Okay - do not move her into your house. DO NOT!! You don’t want this … nor do you want to do this to your children and husband. If she can convince a doctor to release her to her own independence she may have a career in acting! This is really hard for most of us to grasp … but it’s actually not our job to make sure she’s got a safety net in place. It was her job. And she didn’t do it. Call social services. You aren’t going to convince her of anything so pull back. Whether or not her hip is healed seems irrelevant, really. She can think whatever she wants. The doctor is the judge and jury.
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Dear LASpruck,
So sorry you're going thru this, I'm going thru similar. My guess is there's some cognitive decline or dementia going on. One sign is they become lumps and don't function. Consider getting her a full physical and perhaps for some antidepressants to help function better, evaluate cognition.
Call in social services to help you, this is the stage where you need lots of outside help(maybe legal-elder attorney). Don't take it all on by yourself!
Best of luck, you're not alone!
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She is most likely depressed and if you FORCE her to stay there you are going to facilitate her depression! She will most likely give up entirely and just wait to die!

You can look into home care for her. There are programs available in every state that have them. We have one here called IRIS that is wonderful. She can choose whoever she wants as a caregiver including family and friends. They also help to provide for things that she may need in the home ...like a lift chair, or a new entry to the home if there are stairs. They also provide for activities and therapy when not covered by insurance. This program is one through Medicaid, but there are others.

If you knew how horrible some of these nursing homes are, you would not want her in there for any length of time. Certainly not for the rest of her life. Do not take away everything your mom ever worked for. She will have nothing ...and will NOT be happy in a nursing home.
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waytomisery Nov 16, 2023
I think this woman is past the point of building a ramp to get in the house and some homecare . She needs 24/7 care and the family can not do it . Those programs you talk about do not give 24/7 care. If going home wasn’t enough incentive to do PT , nothing will work . Maybe the woman is unable to get better , maybe it’s too difficult physically or cognitively to do PT. She will not improve at home .

FamilyNeeded , If you have children , I pity them for the guilt trips you will be putting on them should you need care.
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Under no circumstances should you be her primary caregiver or expect your family to be caregivers. This is a recipe for disaster. You say you have "a power of attorney " but you don't say what kind. A Power of Attorney gives you the legal right to take over your mother's finances and her health care. However if you have a Durable Power of Attorney you will need to have your mother declared incompetent. If she does not have the finances to cover expenses out of pocket for the nursing home she will need to be placed on Medicaid. You will need to research your State for those guidelines. My Mother is 88 and my sister and are starting to have the same problems you are having. This is a difficult journey for all families in these situations.
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LASpruck: Cognitively your mother is definitely not okay. She needs to remain in the SNF
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Interesting, she sounds like the DON calling lady at this facility. Today, the aide actually asked her why she acts the way she did (cry, complain, etc), she actually said she didn't know.

She also needs help with her ADLs and does very little in therapy ( though she will have a meltdown if she thinks she's going to miss it)
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LAspruck,

If you check in for replies, I hope you will see that the majority of people are in favor of your mother residing in a facility for the remainder of her life.

Your mom is not going to improve enough to live at her home or your home. I would not ask your children to help you with this situation. It isn’t their responsibility to help in any way. Your mom would become a burden for them.

Anyone who advises against your mother entering a facility is clueless to the reality of your mom’s situation.

There are some people who are vehemently against nursing homes and facilities and judge them rather harshly. I would like to ask these people if they have been in every single facility in the country and are informed on how they are run?

Of course, no one has toured every single facility in this country to know which ones are suitable or not suitable for your mom, so please take arguments against facility care with a grain of salt.

Best wishes to you and your family.
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anonymous1732518 Nov 18, 2023
Here's a true story of the facility. A resident recently passed. She probably took part in activities. There are 2 doors to activities one across from the down elevator, ( which gets a lot of eye traffic) the other around the corner across from the Housekeeping closet ( which gets very limited eye traffic) a door or two from the stairs (only can be opened if the code is known).

You can probably guess which door has a photo of her and which one has Holiday decorations.

It would have been better to not put a photo up of her at all.
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Ask her medical doctor to evaluate her mental capacity. If she is deemed mentally incompetent, then whoever has the right to make decisions for her (ask doctor, social worker or case manager for details) may make decisions about where she will live. If she is deemed mentally competent, she is allowed to make decisions for herself - and live with the consequences.
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😆 moment "Girls Just Wanna Have Fun" playing while 2 female roommates having loud argument.
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As you say: "Her orthopedic doctor said that she will not heal in a timely manner without putting in the work that she’s required to, and it is possible for her to heal part not in the way that her body needs to, but it will take years in during that time she will weaken further."

"She refuses to except that she has not healed. Her hip has not healed at all. There is 0% healing because she has done nothing or very little in regards to physical and occupational therapy."

You are wanting to pull a rabbit out of the hat.

Clearly, you are (understandably) scared, grieving, sad/upset and want her to 'take care of herself.' You need to realize that you are in denial
Sshe will not. Is not. Cannot. You need to face the reality of her situation, as hard as this is.

COGNITIVELY ABILITY / BRAIN CHANGES_______________

If she was 'okay' cognitively, she would be making decisions in her best interest. She is not. How do you know she is 'Cognitively she is OK" - as you write here, and how do you believe that she is cognitively okay saying :

"She doesn’t shower when she’s home she does not clean her house. Her bed is full of dead skin Scales, it’s gross."

She can and is making her own decisions AS BEST SHE CAN WHICH IS VERY LIMITED.

You cannot do anything for her that she doesn't want to do for herself, whether she is 900 miles away or 5 minutes away. She has to want to care about her well being enough to change.

The bottom line is that 'we' - the family and those who care and want to help keep someone safe, well cared for, alive is limited due to what the person needs to do for their self. Often elders do not do what is needed for a variety of reasons. I would say the top 'reason' is due to cognitive abilities / the brain changes and the person unable/unwilling to make decisions in their best interest. Depression, fear, loss of independence, being overwhelmed are huge contributors to a person 'giving up.' When was the last time she had a medical assessment for cognitive abilities, needing medication for depression, anxiety, etc. ?

You can only do what you can and then you need to release this 'burden' you place on yourself. Even if you are a believer in Christ, he couldn't make her do anything she doesn't want to do.

If you feel it would help, move your mom closer to you or you move closer to her. I presume neither is a possibility at this time. If you are willing, make these decisions.

Yes, it is awful that there are mice around. No one wants to live like this nor see / know their aging parent is living under these conditions.

The bottom line: it sounds like to me that she needs to be in a nursing home - near you or where she is with 24/7 care. Then, you do the best you can, reailzing your limitations. Often the best we can do is provide active reflective listening, smiling, telling a loved one they are loved, holding their hand, giving gentle massage. Go see her if you can. Perhaps then you will realize you need to let go of how you want things to be and accept the reality of how things are.
Cry.
Get support.
This is hard stuff to deal with.
Certainly a grief filled time.

Gena / Touch Matters
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