My mother has a difficult personality. She has dependent personality disorder, narcissistic tendencies, self medicates, sleeps all day and night. She has lived with us for the past 5 years and continues to decline due to not getting out of bed. She wants everything done for her and I’ve held boundaries and did the least possible so that she could maintain as much independence as possible. But now she has reached a point where she no longer has the strength to leave the basement. She can’t make it up the stairs or the side yard without help and a LOT of effort. So she avoids it. She falls quite often due to weakness and over medicating and cannot get herself up. I cannot lift her because she is twice my size and she is usually not dressed so she resists me getting help from my husband and son. She takes too much medication or skips medication. Partly due to confusion but mostly due to dependency. She doesn’t bathe, she is less and less capable of handling her finances. She is an online shopper and a hoarder and has so many auto ship orders that she swears she didn’t order and doesn’t know why they keep coming. I’ve arranged meals on wheels, got her a walker, a respite nurse bathe her once a week. She will not make any effort the doctor requests. She is on constant painkillers among many other medications and her memory suffers because of this. I’m having to handle all of her medications but she is resistant to me taking complete control. Due to my own limitations I can’t be her caregiver. I’ve made this clear to her multiple times but she doesn’t want to hear it. Tomorrow I will be on a call with her and her doctor to document all of these things and they will recommend her to a care center. My mother will be furious and will refuse to go. I have zero legal guardianship. I’m so emotionally and mentally exhausted. I’ve been her punching bag for the past five years. What steps do I need to take? There have been times in the past when she was hospitalized, either from sepsis or an overdose and I realize now that I shouldn’t have let them keep sending her home. I have children at home and a full time job and she’s very demanding but refuses to do anything she should do for her health. 🤷🏻♀️
Ask her physician to order PT for her. They can come to the home and work to help strengthen her and improve her ability to walk. Mom has the choice to accept this or go to a rehab facility. Tell her either one or the other. She will need to do whatever exercises are ordered. How old are your children? Can they help make sure she does her exercises? Make sure these include that she can manage the stairs. Make it a requirement of her staying in the home.
Bathing is a MUST – does she have access to a full bath in the basement? Have an Aide come in 2x a week for Personal Care including bathing and a hair wash. She will need to be assessed by an RN for safety and they may recommend a sponge bath to start until she gets stronger.
If she falls do not help her up. You could hurt her or hurt yourself. Call the EMT or Fire Department for an assist. This will also help document the frequency of her falls. If they transport her to the ER let them know you do not feel she is a safe discharge and needs rehab.
It’s not going to be easy but you need to stick to your guns and let her know these are the rules for continuing to live in your house, she can choose to stay or leave.
I think this lady needs more supervision than home visits can provide now (falls/med supervision/hygiene/behavioral) so needs round the clock care.
The lady refuses care in home, refuses to move into a care centre & is living her way, which is currently in 'self-neglect'.
`upset' by MIL/Grandma's situation? By what it's doing to you, their Wife/Mum?
That makes 3 of you unhappy because your being railroaded by 1 persons being unhappy.
I hope this helps you to review your situation speedily for all of you.
By the way she can recover (and will) from being upset, she can't recover from killing herself by a fatal overdose/fall. Good luck
you need to do something about this situation and quick before she really hurts herself or you.
she needs to be in an Assisted living or maybe not...a nursing home if she can’t really do much herself. You definitely need to obtain a durable power of attorney if she can still understand documents and sign it or you need to file for guardianship so that you can complete documents on her behalf.
I'm not going to comment on what's taken place over the last five years: it would be the equivalent of saying "I wouldn't start from here" which is about the least helpful and most irritating piece of advice on the market (hardly less unforgivable than "I told you so.").
The question is, as you've already put to yourself, what now; and you're already gearing up to have the key conversations. But to give yourself a chance: go back to the root cause. What was it? Why did she move in?
You also mention doing the least possible to encourage independence: very correct, quite right, only as you've discovered not so easy to put into practice. But your mother is now only 72! There is on the face of it no reason why she couldn't look forward to independent, productive and very much happier years to come. Let *that* be your main incentive to make changes, and it will become a lot easier to stick to new boundaries.
Five years of tormenting you isn't a good thing. Mom thinks she has it all together; what I feel that the more you try, you resist caring and loving her the way you were ment to do or maybe you never felt love or cared because of the type of person she is;
For God sakes, you are not helping the problem,
Yes! I said it, it's become a problem to both of you
Lamins term, get your family back, get your self respect back because this is unhealthy, only thing I can see for you to do, is stop beating yourself up and definatly stop the poor me, we both know dementia has arrived for the past years and it is worse despite her personality of me, me, me syndrome; Power of Attorney is number one!
Find a loving assisted home, nursing home etc.
You can't continue loving her like the way you are now. Trust yourself in making the right decision.
Mom, you have a choice to make: I handle your medications 100% or you move to a care facility. Those are the options, period.
If getting her stabilized on her medications doesn't improve things then you have no choice but to get her the care she requires and that means a facility.
She can refuse, but so can you. When you stop jumping every time she yells she will not be nearly as comfortable and you will not be so worn out. She doesn't get to decide for you, so she has no decision that impacts you and your family, unless you continue to allow it.
I know it is so very hard to get to the end of your rope with your mom. It feels like you should be able to do something, but the something is getting her into a facility that can meet her needs, any other something just props up an unsustainable situation and destroys your wellbeing in the process.
It is the kindest thing that you can do, even though it is the hardest thing that I have ever had to do.
First, take care of you- self care!
It sounds like your mom lacks the capacity to make decisions. The MD can determine this and document so you can move forward with planning. If she falls again call 911. She can be assessed in the ED. You can request that she go to a nursing home for SAR sub acute rehab or straight to long tem care. It is possible she can transition to long term care from there or be transfered to another facility. Everything is based on insurance; does she have your states version of Medicaid?
You certainly have a hard situation alright but what comes through is you have a clear view of the reality, what is in your ability & what is not. You are willing to look at options & sound like you are ok with care centre direction.
So now it is about the paperwork to arrange & the physical moving in. I would get advice from the Doctor on these. It may be guardianship is needed, but the Doctor may have experience (like other's on the forum) who have bypassed this with success.
I think I would plan for the next fall & push for transport to hospital. 'Falls - for investigation' is usually what it gets labelled here, to get into ER. It is sometimes the coded version of 'ER dump' but the reality is, if there are frequent falls - meds, mobility, chronic health all should be reviewed for her own safety.
She now has accepted & likes the fleet of paid aide helpers that visit. She is cleaner, meds on time, food arranged now. She lives in her OWN apartment, not in MY house - that would be very different as you said.
Her Doctor said she may live as she chooses & make good or bad decisions as she chooses. How much I help is up to me. How much other people help is up to them.
She cannot arrange any of her own care & other relatives enable this to continue. It will change in a crisis situation one day.
Your Mother's situation will too. It's what they're chosen.
Signed, fellow WFTF member (waiting for the fall) 😔
Will be curious to hear what her doctor says. Might you consider having aides come in to provide the care? If so, does she have assets/means to pay for aides? If not, Medicaid can often provide limited help in the home, if the person qualifies. If you feel she would be better off in LTC, she does sound like she would qualify for NH vs AL. Again, if she doesn't have assets, but qualifies medically and financially, Medicaid would be in order (you'll want help with filing that!) You also may not need guardianship, but if you do, you could let the state take guardianship if you don't feel you can take that on. Doing that would mean you have no choice where she is placed or access to any assets she might still have. Our case (below) shows you *could* achieve getting her placed without that - Note also, POAs do not give one authority to force someone to move either, even those with dementia!
Our mother was still living in her own condo, but given her failing memory (she was still ambulatory until recently) and inability to understand she needed help, we were faced with ADAMANT refusal to consider moving anywhere, ESP AL - even though her plans before dementia were to move to AL when the time was right. I started my research and looking for places, then bringing brothers into the "decision making process." Meanwhile, we had to make some legal updates to take care of her assets, including the condo.
The EC attorney told me we could NOT force her to move, even with the dementia, and he recommended guardianship. That takes time and money (it would come from her assets), but the facility we chose would not accept a committal. We had to resort to other means (fibbing - YB wrote a phony letter from 'Elder Services' which stated she either go where we decide or they would place her. This worked because she had injured her leg and didn't have enough sense to have it checked or even tell us, and it developed into cellulitis! She was lucky it was just before the planned move or it could have quickly killed her!) She was madder than a wet hen, but she went with my brothers (I stayed out of the actual move.)
In your case, I would recommend you start looking for a place that might take her in, and get some legal advice. The doctor might be able to recommend a social worker who can work with you to help facilitate the move. Does she have assets/means to pay for LTC? If not, you will have to start filing for Medicaid too. Legal/SW help will likely be needed for that too. It may take some time to find an opening in a facility that will take in new clients, given the virus situation - meanwhile, work on getting everything in order.
IGNORE anyone who says ER dump or eviction. Those are NOT valid suggestions.
I was a little aghast at that, but he said in his whole career, he'd seen this happen ONCE. I did tell my kids about this--and they understand that this is a possibility---in the end, most of us will have to rely on family for support of some kind. I DO NOT want to live with ANY of my kids.
I do not know what this particular 'law' is called, but for people like me and my DH, it is kind of self protecting, ONE kid cannot have all the say. They have to concur.
Do you have sibs? If mom will not go willingly into LTC, you make need to enact this situation. (And I have a feeling she's NOT going willingly).
As far as the medication mix ups--it HURTS to get old and I hate when drs refuse pain meds for elderly patients. I have to take something everyday for my 'whole body' arthritis and I can tell you it's not fun and I don't appreciate my kids' hassling me about it. However--I don't OD and I sure don't sleep all day.
Your mom is probably very depressed along with just getting old. I hope you can find a place for her and get her settled. Plan on the worst, hope for the best :)
I just have a question...does the basement have a door to the outside? If not, you may want to check with your Township's regulations to see if a basement used as a living area needs two ways in or out. If it does and you can't provide another way out, maybe your excuse to get Mom out. It is a Fire hazard.
I took this " She can’t make it up the stairs or the side yard without help and a LOT of effort." to imply access to the yard in addition to stairs going to first floor.
And really the situation you describe is awful for all of you.
I’m sure you would hate to resort to this but Utah does have a “long term guest” removal process. This if there was no formal tenant type agreement. Details can be found here.
https://www.utcourts.gov/howto/landlord/criminal_trespass.html
Otherwise you may need to go a more traditional eviction.
I would not pick her up if she falls. Call 911. How do you know that she has fallen? Does she call you or do you discover her when checking on her? Think of your own health. Don’t even get started with your husband and son.
If she won’t let you manage the pills, don’t pick them up from the drugstore. Go over with the doctor how the pills are to be given and if it’s worse to take too many rather than not enough. Build up a tolerance to her outburst and stick to your guns. It sounds like she bullies you into doing what she wants.
If you can regulate the pills then she might become more reasonable as a result.
Good luck on the phone call. I hope the doctor is direct and your mom is able to absorb the information. So many caregivers step off into these land mines with the best of intentions. Do look for a therapist to help you stay focused on making this happen.
Your local Area Agency on Aging may be able to advise you on facilities and programs and give you an assessment on which she would be best served in. It looks like they are closed now but I will include this link.
https://mountainland.org/resource_categories/view/33/utah
Let us know how the call goes.
edit. I didn’t mention POA because unless she is deemed incompetent you still wouldn’t have the legal authority to make her do anything. For that you would need to be her guardian. You do have a right to choose how you live your own life and who lives in your home.
You might ask the doctor if he feels she could be deemed incompetent.