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My 94 year old mom has been living on the East Coast in the same house for 50 years. My brother lives two hours away and I live 800 miles away from her; we and our spouses all work full-time. Mom now needs round the clock care but refuses to move out of her home. We have hired people to help her, but it is hard to manage her finances, health care, etc... from such a distance. The cost of round the clock care is also enormous and she can't afford to do this for long. I've tried for years to get her to move to where we live, but no such luck. She also refuses to move to assisted living in her current location. Any suggestions? She is quite stubborn...

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You can contact the local Area agency on Aging for advice and for a "needs assessment".

You can call the local police for an occasional "wellness check".

You can call Adult Protective Services.

If your mother is competent and stubborn, usually the best you can hope for is for her to become ill or fall. When she is admitted to the hospital, make sure that you are immediately in touch with the social services department of the hospital to make sure she is sent to rehab. That can turn into a permanent long term placement, so think about scouting out rehabs/ltc facilities near you if you want to move her closer.
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losingitinmo Nov 2019
Thank you for the excellent advice -- she fell recently and was admitted to rehab, but we were unprepared. Next time, I'll have done my homework.
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Finally my mother had a slight stroke, now she thinks she is dying and we have moved her into AL in Florida. She is 94 and has lived by herself in NC, in a death trap for a senior, she refused to budge, so we just sat and waited, then it happened and we sprung.

There was nothing we could do but wait patiently, you might have to do the same thing, something will happen, it is just a matter of when. One thing I would recommend is that when it does move her closer to one of you, managing someone in a home from 800 miles away is not really doable.

Make sure all the legal documents are in place, Durable POA, Will, Living Will and so on. Prepare, do your homework, research homes in your area, as when it happens you will have to move quickly, within 2 weeks I had my mother an apartment in AL and next week I have the movers pick up her furniture and move it to Florida. In the meantime, I am renting furniture for her.

Plan now, something will happen soon, the odds are not in her favor.
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DILKimba Nov 2019
Great Advice DollyMe! This is the time to be doing homework. Visiting places, having a plan in place so that when her hand is forced, it's not a panic to find something.
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Your situation is probably the most common one we see on this board. The aging parent, their refusal to accept help and be independent, so we as family simply sit and wait for 'that fall' or something similar. sadly, they often wind up in a situation far worse than if they had gracefully accepted help and worked WITH us to find a workable solution.

My MIL lives near 2/3 of her kids. She really only accepts help from her daughter, but at what a cost! My SIL works, has her own daughter and kids living with her and has a sweet but very lazy husband. To have to run to MIL's house everyday is a 1 hour round trip or longer--then there's the shopping, cleaning and simply 'being there'---SIL leaves in time to go to HER house and start round 2 of the same thing.

All b/c MIL refused to even entertain the thought of assisted living. So, in the throes of a horrible UTI, she fell down and while she didn't break a hip--they told her 'next time' she will. She developed pneumonia and was in the hospital/rehab facility for 6 weeks. Back home, but now walking with a walker and trailing an oxygen tube. Just a mess and a scenario for worse...

All b/c she simply refuses to leave the home she's been in for 63 years. It's not like we don't GET IT--we do! But she is so stubborn and so difficult to please. She cannot see that she is wearing other people to nubs.

DH just hates the role of CG--he will go see her if I hand him a dinner all packed up and force him out the door. This gives him a reason to go-- as if the fact she'd 90 and alone isn't enough. He will go 2-3 weeks and not even call her.

I force him out the door with a container of soup and fresh rolls and said "GO! And don't come back for an hour!" It was late (7) and she goes to bed early, but he did go.

I asked him what the long term 'plan' is--this is going to kill his sister, she's doing 90% of the work--and he said "Oh, J is fine with all this!" And she actually IS! Or so she says. He said "we're just waiting for the next fall and then the broken hip and we can enact POA and get her in a home". Well, at least they have a plan.

I'd be happy to help, even though MIL really dislikes me, but I just finished chemo for cancer (cured it--yeah!) but I am still super fatigued and won't be 'better' for a couple of months at least.

I'm not really a part of this dynamic. MIL dislikes me and so I am not really allowed in her home. I could be of great help, but she will NOT accept it from me.

People can want what they want all day long, but in the end, the decision is often forced upon them. Then NOBODY is 'happy'.
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Davenport Nov 2019
Thank you, midkid58, for confirming my recent, totally unscientific 'share'.
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All I can say is that this sounds so very frustrating. You are trying to avert a really bad situation,and she is fighting your attempts to do so.
I can see this scenario in our future. MIL is 92 and is already letting us know that she will not be moving. Recently, she dropped her plans to move in with her daughter and is staying put.
I keep thinking that the solution when we get to the point that you are at, is to force the move even if it makes her unhappy. You do the right thing, regardless of whether she wants it.
It will eventually come to this at some point.
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Your profile says that she has dementia. People who have dementia often think they can live fine with no help, even though they are incapable of caring for themselves. Have you met with her and her doctor? I'd arrange a trip to her so you can meet with her and her doctor. The doctor may be able to intervene if he is apprised of the situation. Has he already diagnosed her with dementia? My LO's doctor told her she was not able to live alone due to her dementia.

Perhaps, an attorney as well, so you can see what legal options there are. People who are incompetent, aren't able to make sound decisions about their welfare. You might also check with neighbors, friends, fellow church members. Often things are going on that concern them, but, they don't feel comfortable contacting the family members to tell you to get her help. If you inquire, you might be surprised at how much help she needs. And, if that's not the case, you can put your mind at ease.
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disgustedtoo Nov 2019
"...doctor told her she was not able to live alone due to her dementia..." This might work for some people, but as your comment started, the issue is they often "...think they can live fine with no help.." This negates anything the doc might say! Mom's regular PCP promised to write the letter I needed for becoming rep for her pension, but after 9 months of begging them, nothing. So I took her to a new doc, prior to the planned move (due to location change when moving to MC we needed a new doc anyway) and she told mom "It isn't safe for you to live alone." No mention of dementia, nothing else, just that. Mom was already agitated by them trying to put headset on and also thinking we're going out to eat, but THAT statement sent her over the edge!!! In her mind she was fine, independent, could cook and take care of herself. Hardly...

If they will listen to someone else, esp a doctor, great, but sometimes that just puts more barriers up. It's worth a try, but doesn't always work as desired...
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One thing that helped us--we are the closest to my inlaws and my BIL is 1200 miles away--was to have HIM handle the finances. With the advent of online banking and bill pay, he can easily do that from there. It also helps with the appearance to my inlaws who don't care for me that I'm not near their money. ;-) Not that they have any, but that's another post. ;-) My DH does all the hands on care. We had a hard time getting them into a place too. It was a few steps at a time, which caused more work for us, but it worked out better overall. We were able to get them into an independent living apartment with "assists", like medication management, an emergency pull string, meals provided, etc. That lasted about 16 mos before it became obvious that they needed more. Fortunately we were able to play on their paranoia that "people there didn't like them" and got them moved to an AL that was a lot closer to us. After only 30 days there though, it because obvious that my MIL needed memory care. Their set us is small houses that house 12-16 people. The MC house is 2 doors down, so it wasn't a major move. It has allowed them both to get better rest, and have the care at the level they need it. The fact that we had done our due dilligence and already interviewed, visited, picked out places, allowed these transitions to go a LOT more smoothely and for us to "strike while the iron was hot."
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losingitinmo Nov 2019
Thanks for your reply, DILKimba -- good advice. I've been visiting AL/memory care places near me and have found one in particular that I think would be excellent. I'll contact them to see what their waiting list is like, so we can move quickly if my mom can be convinced.
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The ability to stay on her own has changed greatly since she now requires constant in home care. I completely understand what you are going through. When we moved MIL in with us for her care and wellbeing we went the route that her home could not take care of her any longer. We showed her a list of needed repairs and our estimate cost to replace expensive items. It was not easy to convince her because she had lived in this house for 91 years, actually the home she was born In. If you are looking into assisted living for her maybe you can take the approach of she will be able to choose her best fit now instead of having someone else decide at a later date, moving closer to one of her children so they can visit her more often and be able to take her on outings? It's hard for them to give up their independence and admit that they are in need of more help than they think is necessary. Stress the fact that the time may come when she won't be given a choice of where she lives and that the state will place her wherever they want regardless of her wishes.
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Given the age and condition of your mother, YOU take the bull by the reigns and make plans to move her someplace appropriate - no if's, and's or but's. YOU must be in control. Just find a way to place her and get professionals to help you. It is your choice, no longer hers. Do not let her control you or you will be destroyed by her stubborness and behaviors.
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losingitinmo Nov 2019
Hi Riley2166 -- thanks for the support. There's so much guilt involved... it is hard to tell her "no". But on a more practical note, while she has early stage dementia, I'm not sure she'd be declared incompetent yet. So even if I screw up the courage to put my foot down, I'm not sure I'd be clear legally. Maybe in six months or so...
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Despite her saying (prior to dementia) that she had to 'clear/clean up' in case she ever has to 'get outta here' (when asked what this meant, she said going to live in AL), when dementia started, mom, like others, maintained that she was 'fine, independent and could cook.' In their minds, yes, this is true. In reality, it is not even close! I tried once telling her that putting a box in the microwave and going beep boop boop beep hummmmmm BEEP is NOT cooking. That didn't go over well.

We couldn't even discuss AL at that point. Dementia was also a no-no word (to her it meant you were 'off your rocker', aka crazy, which isn't true.) Paugh, she wouldn't live in one of THOSE places... Again, it was HER plan to move to AL at some point! Better food? How do you know she asks. Mom, ANYTHING is better than the microwave dinners and boxed crap you eat now...

Brothers both offered to let her move in. Nope. I didn't, for many reasons. Tried bringing in aides (1 hr initially, sanity/med check only.) That lasted 4-6 weeks, then she refused to let them in. They sent their "expert" to talk to her - hahahahaha, she was lucky mom couldn't pick her up and throw her out!

Plan C - find a way to move her to MC. My suggestion was ignored. However, she provided the solution by getting cellulitis just before OB came up to prep for the move. YB drafted a phony letter from 'Elder Services' at the hospital where she was Dxed and treated. It stated she either moves to a place we choose, or they will place her. Reluctant and madder than a wet hen, but she went. I stayed out of the move (did all the pre-legwork, securing a place and furniture, etc.)

Although your profile indicates some dementia, it isn't clear how far along she is. With all the other issues, it sounds like 24/7 is needed, but unfortunately even those with cognitive issues have "rights." EC atty told us we couldn't drag her out of the house and suggested guardianship. Facility we chose said no to committals, but also said just get her here, we will take care of things. So, the fib had to be created to facilitate the move. I've since been told by staff that the residents can refuse care and medications - it is their "right", whether it is good or bad for them! They do work on coaxing the person to get the treatment/take the meds.

Perhaps you could come up with something? If she had any medical emergency (falls, broken bones, etc), you could blame the docs and keep repeating the move is temporary, until she gets "better" (knowing full well there will be no "better.") If you find a good place, perhaps send her phony mail that says she won a vacation at X place, free of charge! Entice her to go and then keep deferring the return. Maybe set it up so that you could tag along/stay for a day or two... make it seem "real." It stinks having to fib, but often this is the only way to move forward. True lies are those said to hurt others. Fibs, aka little white lies, are told to protect others, especially those with dementia. If you do get her there, defer the return too vague responses like "soon", "maybe next time", "when we get doctor approval" (if medical issues prompt the move), "oh the power is out at your home, we have to wait for them to fix it", or other plausible excuses.
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I've been there, am still here. 5 years in, no magic bullets, even on this wonderful forum. All I can offer you, losingitinmo, is my compassion.
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losingitinmo Nov 2019
Thank you -- the commeraderie and support on this forum is a lifesaver. Best wishes to you, too.
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