My mom lives alone at 95 in a 2-story. Of course the range of needs is increasing, toenails way overgrown, needs help bathing I’m sure. We are calling and checking to see if she’s eating- she says she can’t remember. Sister brings groceries and I visit a few times a week with food, but that’s distanced and masked. She’s always refused living in with anyone or allowing any help. She has a medical alert system, sometimes she wears it. Has always been an extremely private and proud person, but very nice.
My sister and I are frustrated with her declining all our efforts. We are watching her just wear away. She has a bad memory but not dementia. “Just say no” is her motto.
Thanks for listening.
The big unfortunate thing is often these catastrophic events do not end well.
If you can begin a conversation with mom in that way. If she is willing to agree that if she fell there would be larger problems, that might be helpful. But I can tell you my Husband was stubborn and there is no way that he would have agreed to have help come in, he would not have agreed to move out of his house. If he had not developed dementia he / we would have remained in an OLD 2 story house that was not in any way set up for "aging in place". If either one of us had fallen and or needed help it would have been a nightmare!
If she insists and you want to make this work then if possible eliminate her having to go upstairs. Move a bed down stairs, convert a room on the first floor into a bedroom. If you can make a bathroom easier for her to use. Rip out the bathtub and put in a zero threshold shower. If the toilet is a standard height put in one that is ADA compliant (if your mom is short maybe the regular one is fine)
I would place a door at the base of the stairs so she does not have to go upstairs and I would lock it so she can't go up stairs. (maybe a little excessive but it would be safer. It would also save a bit on heating you still need air circulation but you can close off some registers)
If this can't be done then the only thing to do is ... wait...
(short of having her declared incompetent and forcing her into Assisted Living and that may kill her just as quickly as a fall would)
If she even has one ounce of competency in her, APS will do nothing unless she is deemed incompetent. The law is very clear. You can’t force any elderly person to do anything!! I mean anything!! I’ve cried to everyone who will listen. They all say the same thing. “I’m sorry there is nothing we can do Elaine since your mother is competent. If your mother doesn’t want to bathe she doesn’t have to, if she doesn’t want her hair washed she doesn’t have to, if she doesn’t want to change her clothes, she doesn’t have to. There is no law saying she has to.
Someone once told me they can’t make an elderly person bathe in a nursing home either. I just keep thinking if my mother did go into a nursing home that possibly the trained staff could talk her into it.
It is a horrible situation to be in. You can’t help someone who doesn’t want to be helped.
Yes, part of it is stubbornness but another part is fear. It’s true that we can’t make them do what they don’t want to do.
Welcome.
The good news is your elder is living her way & probably will do until the 11+ a half hour. A life well lived.
The bad news, as you read from many others who tread this path, there is not a lot you can do. It can be heartbreaking to watch.
Decide with your sister what's reasonable as to what you will both do regarding visits - maybe a daily phone call each - am & pm?
Look out for these flags;
Weight loss.
Forgetting to eat/drink, not eating/drinking enough.
Unkempt hygiene/hair/clothing.
Unable to remember when last washed. The steps of the process becomes too long/hard. Unable to make appointment for podiatrist etc.
Unexplained bruises or burns.
Are falls or kitchen accidents happening?
If so, speak to Mom's Doctor about a needs assessment. You still may be powerless but there are ways to sneak home heath aides in.
My mother wasn't losing weight (though it would have been beneficial to lose a little!) What I found was after taking the car away, I had to take her shopping. When I would come back the next time, I was finding the fresh stuff in the fridge (mostly veggies) all shriveled up, unused. Even the chicken she froze was just piling up. That's when I realized she was mainly eating frozen dinners and boxed crap. She wasn't buying enough dinners to last between trips, so I tried making extra and freezing items for her.
Definitely monitor the food, to see if it's being used/eaten.
They don’t want to be a bother to anyone. They are modest so it’s embarrassing to have help bathing, toileting, etc.
If they previously fell in the shower like my mom has it is frightening for them.
They wish to remain independent and many people are extremely set in their ways.
It isn’t always easy caring for parents. It can be challenging. Best of luck to you.
You stated that your Mom has a bad memory, but not dementia.
I am curious to know if she has been tested by a Geriatrician?
My Aunt was misdiagnosed by her PCP.
What he called mild cognitive impairment was later diagnosed as Alzheimer's by a Geriatrician.
This may be important for you to know.
This is a very tough situation!
Sometimes doing what is safest and best for our LO'S is the hardest thing!!
Keeping her safe is paramount!
Don't lose sight of that!
God bless!!
Do what makes your mom happy, don't worry that her home isn't that clean. Ckean the bathroom and kitchen when you go there to visit.
Install Cameras in the home so you can keep an eye out. Unless she is smelling, don't be concerned how often she bathes as she can clean herself with a face cloth as in spit baths.
Make sure a couple handrails are installed in the bathrooms where most Falls occur.
Better to let your mom stay in her own home in comfortable and familiar surroundings and be happy then to make her miserable by trying to make her move.
Let your visits be fun not have her dreading that everytine you come all she hears is complaints, even if you think it's only because you care about her.
Juse make things easy for her. If she doesn't have a bed downstairs, bring one down from upstairs.
Most seniors don't live very long moving them, especially in to a Senior Home, they get depressed and have to be told what to do and when to do it and sometimes are treated bad.
My 96 yr old Dad is living in his own home but he has dementia so he has Caregivers.
I have Nest Cameras set up so I can check on him any time 24 7 and make sure he is being treated right.
Do the best you can, offer help and let your mom have a peaceful last days, months, years she has left.
Maybe you could find a Live In if your mom agrees.
Put yourself in your mom's shoes and think about what you would want because your time will come.
People think placing a loved one in a home is best for them but in reality, it's really done more of what's best for them so they don't have to worry about the loved one.
But when caregivers are turned away... it becomes a Dignity of Risk vs Duty of Care situation : choice vs safety.
Does she have problems with balance or movement that would indicate that 2nd story isn't safe for her any more?
Does she remember have expired food in her refrigerator that she eats?
Does she medications she needs to take regularly and a pill box to organize/remind her when to take them?
Does she forget about the stove or oven when it is on?
Is the home clean and garbage taken out regulary?
Is she healthy?
Does she bathe every day - smells fresh and hair isn't greasy?
Are her clothes clean and in good repair?
Are her nails clean and groomed?
Does she have access to nutritious food and eat enough to sustain her weight?
Does she have daily interactions with others who help to monitor her health?
If your answers to these questions and others that come to mind are mostly negative, then it is time for mom to live with somebody or have people come into her home. Consider that she needs day time "help" who will help with her personal needs and the needs of the home. Ask family, friends, folks from your community of faith, and "paid help" to come by every day of the week. You can have each person fill in a journal of what they did when they visited. You might also want to consider a few overnight visits to make sure she doesn't wander off the property at night.
Since your LO is independent-minded, it might be best if folks came to her as "visitors" to help or give her "gifts" of housecleaning services which are in reality home health care aides. Please remember that home health care aides can not dispense medications and only "remind" folks to take them.
My dad was the same way stubborn. She might start falling in areas where the cameras aren't, she could get Urinary Track infections. She might try to drive or walk outside then loose her train if thought.
I would ask her state Elder options for resources on helping her and give you advice. If your a Veterans family ask them for help. It will stress you out not being able to help bc she probably won't use the medical alert.
The best thing for me was to get a little ving surrogate will, doable Power of Attorney and see about a DNR - do not resesitste form. That way you'll know what she wants and you won't feel guilty about making that judgement call.
It took my dad awhile to get used to having someone else help but I couldn't do it by myself.
Also, check with In home Hospice, not every client they work with passes away.
You may also want to take a Caregivers course, through Elder Options it's free.
Elder Options might be under a different name it depends on where you live.
My dad passed a month ago at 95. I'm satisfied for the most part I did everything I could do and he passed peacefully and painlessly.
See if some one like the police or Fire Station can do a wellness check once a week. Go to your fire station for a sticker to place on her door and get a list of medication s she takes and leave it in her refrigerator so who ever comes has that. A wellness check from a friend or what I just mentioned is good. She will get over not wanting help if my dad did anyone can!!!!!
You maybe able to get those forms online but we went to a lawyers office. Make sure it's done with your sister.
There is a lot to think about. Feel free to leave me a message.
It will work out.
I got a caretaker for 4 hours at first. (10-2) I told my dad that she was a “cook”. She made sure he had a good lunch. As time went on she came earlier and stayed later
(9-6). One morning we could not find him. He had fallen in the bathroom. Now he required around the clock care. I put a wireless bed monitor on his bed so the caretakers would know when he got up. They would help him to the bathroom and then back to bed.
One day he was going “home to Texas” and someone had better take him or he was walking there. Because of COVID I could not move him to a memory care facility. His dementia had finally gotten to the point that safety was a issue. I moved him just a week ago to a private pay memory care. Very hard to do but I took his chair and bed etc and he thinks he is at his house.
I took my dad to a podiatrist. They take care of those toenails in 5 minutes.
After that I just kept them filed or clipped. I bought a nail grinder which is easier than clippers. Bathing. I bought adult wash gloves that are heated in the microwave. One day we did arms another day legs. I have a lady clean every other week. Let her be home as long as she is safe and nourished. It’s a hard road.
Visit the private pay facilities ahead of time. You will know if and when it is time for her to move. I have a POA to sell my dad’s house for funds to pay for private pay care.
He is now clean, safe, well fed and has social interactions. I can visit anytime I want. I had WiFi installed in his room and put up a camera. I can still see him in his bed at the facility
God Bless You
My mother's condo was mostly 1 floor, but there was a finished basement area. Granted she didn't use it much by this time, but those stairs were awful! I hated using them and was concerned about falls. She denied using them or going down there, but the cameras YB put in told a different story. Not much usage, but it only takes once! I did have to get WiFi installed, but it was very helpful being able to keep "eyes" on her. There were 3, one outside the door to monitor anyone coming or her going, one inside the door, that could view the table where she would eat and/or spent a lot of time and one in the basement.
For the most part, she was okay to be there alone. We did try hiring aides, mainly for a sanity check as none of us could check daily, and to check she took her meds. The agency sent a nurse to eval mom, and this included a better cognitive test than the one they use in a regular doc office. Medicare DID pay for this test. She recommended a timed/locked dispenser and the aides (only the 1 hr minimum) would check and remind her to take any she missed (they can't dispense, but can remind.) The plan was to increase the time/days as needed, but less than 2 months later she refused to let them in.
The cameras WERE useful in that they can be enlightening. She developed a kind of OCD behavior before bed, ramping up to 1-1.5 hours of checking several places before she would go to bed. Probably some form of sun-downing, but she wasn't aware she was doing this.
After refusing the aides, I searched for a place closer to me for her. Thankfully they just opened the MC unit in time. Had we not been planning to move her at that time, she might have died from cellulitis, as she "bruised" her leg and didn't have enough sense to tell one of us or seek treatment. That is bad enough for anyone, but can be a quick killer in the elder! It delayed her move a few days, to get initial treatment started and required TWO rounds of anti-biotics, elastic stockings and wound care for quite some time.
The things you don't see when not living there would probably make your hair stand on end!!! Cameras are the next best thing, if you can't arrange for one of you to stay for several days or a week. Early dementia has the capability, in many cases, to hide itself from us. When we don't see someone for anything other than brief visits (includes doctors, they don't spend enough time with the patient to see through the charade!), we can miss the early signs.
Mom used to have YB clip her nails now and then, but rather than haul her to a podiatrist, the MC unit brings in a home health nurse who can clip and trim nails. Perhaps you can find one who can come help her with that. I understand she doesn't want anyone in, but if you go that day, be there with the person and see what can be done, at the very least she would get one trim! If not, she could end up with infections and/or need more invasive treatments at a podiatrists! Coax as best you and the nurse can, offer a reward of something she especially likes.
I would definitely either find a way for one of you to stay with her for extended time, or install cameras. She is likely a disaster waiting to happen.
With the medical alert, for a long time my mom hung hers on the walker. I asked over and over for her to wear it. Tried to tell her that if she fell, the walker could be too far away to get to. One day I kicked the walker away from her and said, what if you fell and the walker rolled that far away from you - how would you get the alert button to call for help. She eyeballed the situation for quite some time and I could tell it finally clicked. She has worn it ever since. She recharges it at night on her bedside table and puts it on each morning.
With covid it may be hard to see a podiatrist, but that's a dr visit that should be made at least 2 times a year. If out of the question, ask some beauty shops in the area about home visit and have them come while one of you are with her.
Ask her doctor to request bathing help and a nurse to come by. She will probably have to see the doctor in person (or online) because of Medicare rules, but it can be done. If she needs help with bathing, either you or the sister are already doing this for her - explain that the service can be paid for with her insurance. Her hygiene and nails are important, falls in the bathroom are a huge problems and you want to keep her moving as long as you can. One slip in the bath could mean lying in a bed the rest of her days. Clearly that's not what she wants for herself. If you get inhome health care to help with bathing, maybe adding a housekeeper would be accepted later on.
Agreed that these are not the droids... oops, the signs you should be looking for. My mother's early dementia started at least about age 91 - mainly repetition of questions or statements, all within a very short time. There were other subtle signs that I didn't catch until after the fact (accusing others of stealing items, incl OB taking her tweezers. Note, he didn't, she had SO many tweezers that I found when clearing out the place!)
As far as recognizing me, it's been SIX years now, almost 4 in MC, and she still knows who I am (haven't been able to visit since mid-March, but when a staff member asked about us, she made sure she said Oh her and those CATS! When I was able to visit, she always knew me and could see and recognize me across the room. This is a woman who is more or less living her life from about 40+ years ago (based on asking about her mother, gone over 40 years ago, and referencing a cousin's baby who would be just over 40 now.) She can carry on a bit of conversation, but sometimes gets stuck on something, like a pair of shoes in a sale flyer, and keeps coming back to that. Her words are still intelligible, she just loses that train of thought!
As I noted in one comment I made, she was no longer cooking meals, just eating frozen dinners, forgetting she put supplies I brought into a spare BR closet, then asking for more, etc. There is more that was apparent, but the point is you can't always tell unless you spend enough time with a person what their cognitive start REALLY is! She also got that skin sore - cellulitis - and didn't have enough sense to tell one of us or seek treatment. She told her neighbor she bruised her leg and the neighbor reported it to me, thankfully! If the move to MC hadn't been around that time, that infection could have killed her before I was able to get there again.
Honestly, there is little you can do. Some of these stubborn folks want to stay home and do it their way. I had a MIL like that. There is nothing you can do but offer help and safety and you have done that. Yu know where this will go; likely Mom does as well, and still prefers to do it her way.
I started crying today because the nurses were able to clean her but she wouldn’t let me!!! But she is out of it now so that’s why.
Therr is nothing you can do if a loved one refused help. My 96 year old mother who lived in her 2 story house alone had a stroke and I found her on the floor. She had a stroke and pneumonia. She is now on comfort care at the hospital.
But, that's the way she wanted it and they determined she was "competent", so don't beat yourself up. Between her and them, there really isn't anything you could do. You tried VERY hard to make them see, but no one agreed with you.
Hopefully she will do okay - not great but okay. My mother had a stroke earlier this month. She refused to go to the hospital with the EMT, so they called me. I finally said if YOU can convince her to go, then take her and do what testing you might be able to get done, but no hospitalization. She refused. Not sure what they would do anyway - tests might confirm the stroke, but given what they saw/reported and the after-effects, it's pretty clear it was a stroke. Not much to be done really.
After the EMT left, she asked the nurse who called them. Silly nurse admitted it was her, so mom got mad at her and tried to kick her!!! From a wheelchair no less (she was already in that, from refusing to stand/walk months before the stroke.) Although she still has right side weakness (must be fun at meal time, she's right handed!), some slurring, she's back to her usual self... She didn't have pneumonia and wasn't alone, so that was a help for her. So sorry that your mom couldn't have been moved, at least to AL. Stroke may happen anyway, but the pneumonia and being alone could have been avoided. Again, NOT your fault!
I just hope those caring for her aren't looking at you when they question her dirty feet or any other condition. I would loudly proclaim everything - She wouldn't let me help and no one here would help me!!! Then give them the old chestnut: "I TOLD you so..."
I called 911 and they took her to the hospital. She had pneumonia and a stroke.
I have all the phone calls on my phone of her calling me and telling me not to come over. She will wash her feet herself. Don’t come over. She told me that on the Friday before October 23rd.
I wish I had talked her into life alert. My mother n law had it. My mother refused it!!! She said she didn’t need it.
I saw her Sunday and then Tuesday. She fell somewhere in between.
Sometimes I do believe fate is already written - life alert of not 😞.
I pushed my sister to get one. She does use it regularly. But she has also lain on the floor all night, been stuck in a chair, on the bathroom floor & NOT pressed it. Reasons include: I didn't fall (I slid, or I was stuck) so I didn't press it.
Friends have reported their relatives have not pressed the button because: Didn't wear it. Was wearing it but didn't remember I was. Didn't remember what it was for. Didn't even know where I was.
The reason for the fall may include TIA or any reason for lapse of reasoning.
And this gem! Family visit & ask FIL where MIL is.
'In the garden'. What? She can't get out there, or do any gardening anymore? She had fallen out there was found in the garden bed. How long ago did this happen?
'Just now'.
The woman was very sunburnt & dehydrated - EMS called & transported to hospital. Her life alert was in the house where she left it.
It sounds like you are assuming she doesn't have dementia, but the comments made sounds like she may be in the early stages:
"...calling and checking to see if she’s eating- she says she can’t remember."
"She has a bad memory..."
Dementia can mean many things and have many symptoms (or lack thereof.) Forgetting things happens as we age, but not recalling whether one ate or not, I would be concerned. In the early stages, it can just seem like bad memory (which does happen with dementia), but they can seem normal too. It isn't like she's going to be stark raving mad, and it doesn't happen suddenly, it is a progression. Many people and doctors miss it, because they can seem so "normal", just perhaps a little slower or a little forgetful.
Misconceptions about dementia abound. I wouldn't even mention the "D" word around my mother, because to her it DID mean you were "off your rocker", aka crazy, but it couldn't be further from the truth!
Assessment first. Plans from there may change.
(refusing help, live in or not, or refusing to move can be part of the condition too.)