How do you convince an unruly parent to go to a facility? Can I make her go? I’m mentally exhausted from dealing with her.

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How do you convince an unruly parent to go to a facility? Can I make her go? I’m mentally exhausted from dealing with her.

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My mother is 83 with multiple health problems. After a hospitalization, she went to a NH/rehab. Ended up having to stay due to poor progress in therapy. She spent 4 years in this facility located in my home town. She was so angry and complained CONSTANTLY about wanting to go home. When COVID hit the facility, I made the decision to move her back to her home about 2 hours from me. Staying in my home was not an option. Been there, done that. She’s a difficult person. At the time, I was working from home and able to travel there to help with her care along with part time sitters. Here we are 4 years later. I have cut back to part time work. I spend every other week (2 weeks of every month) caring for her while paying private sitters the rest of the time. She does not have the funds to cover this and is on Medicaid. I have a family of my own that I need to be with. This whole situation is out of control and I’m exhausted and becoming financially drained. She refuses to go to a nursing home and I’m not sure if she’d qualify for AL. Nevertheless, I have got to get back to my life. She is very selfish and narcissistic and has been her entire life. I have provided care due to feeling like this was the right thing to do, but at this point, I feel like I have gone over and beyond. I need to be at home and stop living out of a suitcase and return full time to my family and career. How do I get out of this situation? And how do I convince her to go to a facility? Can I make her go? I have DPOA.

Burnout Care Decisions Durable POA Parents

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You’ve got this the wrong way round. You don’t ‘convince’ mother to go to a facility so that you can then get your life back. You get your life back, and let reality convince mother that going to a facility is her best option. Tell her that’s what you are going to do and why, then do it.

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Thank you for your reply. I have told her that she is going somewhere after the holiday. I guess I feel guilty, but no idea why. She comes from a long line of children taking care of parents at home. I have explained I can’t do that. Just hard.

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Your words won't make her go but your actions might.

How to formulate a workable, safe plan & action it may be determined by many factors - how dependant Mom is, how stubborn, her health requirements etc.

Happy to be part of a board to bounce ideas off.

I found the hardest part of withdrawing hands-on care was my own brain. True. Changing my thoughts was the key that unlocked my cage.

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You are SO right about our brains causing most of this! Sometimes I do things just because it's easier than dealing with the pushback. She's VERY stubborn. I don't know how to describe her cognition other than mild-moderate. She forgets things sometimes, repeats things, has no money management skills, and sometimes makes bad decisions. She uses a walker and can get out of bed and wheelchair on her on and walks pretty much everywhere, but is very high risk for falls and requires help with dressing, bathing, toileting and cooking. I also have the guilty thoughts that she will likely decline once moved to a facility. I saw this happen at the 1st facility she was in and observed how much she improved once back at home. However, I realize HER life is what SHE makes it, and that's up to her.

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Margaret and Beatty are correct. You need to say "Mother, I. can't do this any more. You are going to have to make other arrangements. I will help with those arrangements if you like, but the current plan is unsustainable and doesn't work for me."

Try to remember that YOUR needs count as much as her wants.

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Thank you for the reply and encouragement. I wish I was better at doing this. I have a plan to get her somewhere after the holidays. I hate it has taken me this long, because my family has suffered, but I'm way at past burned out and it's a necessity at this point. I'm still dreading the process because she is going to fight it. She's the type that would call a cab to come get her.

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You HAVE gone “over and beyond “. I could not “ convince “ my unruly narcissist mother that she could not live alone in her home either . The advice I was given by a social worker from the local County Area of Aging was “ STOP helping your mother, let her fail , sometimes it’s the only way “. You should not be spending your own money on your mother either . Tell her you can’t afford it anymore , and you can’t do this anymore .
Call your mother’s County Area of Aging , get a social worker involved. They helped get my mother placed in care . If that doesn’t work , step back , call APS .

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Thanks for replying. Sounds like you've been through a similar situation. I have told her about the money situation and my needs. She has no concept of money, says "I have money" which is barely enough to pay for her home expenses and everyday living, much less full time home care. She has a social worker through the Medicaid, but so far they have not been very helpful about changing care situations. I'm not sure how to "let her fail" since she needs 24 hour assistance/care. When I'm with her, I definitely let her see that she can't manage on her own and she knows this. She just lives in a fantasy world and has ridiculous solutions that are not feasible. She puts a guilt trip on me as well, says "I know you wouldn't put me in a NH" She's always been a manipulator without much success, BUT obviously it's working on me in her old age.

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Why are you paying for her care? With Medicaid she should be in a NH.

You have done way too much already. Sit her down tell her that you cannot continue to financially or emotionally support her, and that she will have to be placed in a nursing home.

It is no longer about her "Wants" it is about her "Needs".

Start the process now.

Good Luck!

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I want to know how the mother had a home to go back to after four years paid care in a nursing home.

Unless that asset was put into someone else's name. If so, then that person can borrow on it and pay for homecare.

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Is she cognitively impaired? If so and since you are her DPoA and she's already qualified for Medicaid, you don't need to have her accept facility care. The caregiving arrangement only works if it works for both parties. It's not working for you therefore there needs to be a different care plan: one that protects her and meets her needs and also protects and preserves your life.

You may need to formulate a therapeutic fib to get her to go: her house has a gas leak, the furnace is leaking CO2, there's an infestation...and she needs to go to a temporary apartment until the work is completed. The facility admins can go along with any narrative since they've seen it all.

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I love the statement about the arrangement only works if it works for both parties. I'm going to use this with her! However, she knows it doesn't work for me, she just doesn't care. Her cognitive impairment is mild-moderate. She definitely understands when I'm making decisions she doesn't like..lol. The AL facility near her offers respite care where she could go for a trial visit but I really feel like she needs NH care. That's part of our battle. I'm going to check with a NH and see if they offer some type of respite care to ease her in there. One of her caregivers has been diagnosed with a serious illness and likely won't be able to work much longer, so it's a good time to make a move. Thanks for your comments and encouragement. I needed it!

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First of all, there is no reason on earth why you should be paying for her care. She is the one who needs care and she should be the one paying for it.

How was the four years in the nursing home paid for? How was she able to return to her home after that much time and it didn't have to be sold and the proceeds spent-down for Medicaid?

You can have your mother paced. She was placed for four years. Stop paying the homecare bill. The aides will stop showing up there will be no choice but NH placement.

I was a homecare worker for 25 years and operate my own homecare now. I have never known an elderly person that willingly went into a "home". Not one.
Their families just did what they had to do. Have her taken by ambulance if necessary.

There is another possibility though. A live-in caregiver. Depending on what her care needs are, this may work for both of you.
Look for a private-pay one on a site like care.com then start interviewing. It will cost far less than hiring hourly caregivers.

I'm assuming that your mother does not live in an apartment. So her house somehow escaped the greedy clutches of the nursing home. If the place is in your name a loan out on it to pay for live-in caregivers if that would be enough for her care needs.

There are options here none of which involve you paying for anything or being her caregiver yourself.

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Live in caregivers are such because they don’t want to accede to rules that agencies and especially facilities are bound to enforce. The caregiver for neighbors dad tried to stop neighbor from visiting him in the hospital. My uncle’s caregiver/girlfriend is still refusing to leave a month after he died. My in laws are now paying over 122k for their evening weekend sleep aide, which was a bargain at a 20/hour base for two people three years ago, but is now 90 percent her taking care of her cousin’s child by having her do performative child labor around them.

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You will have to be as honest with your Mom as you are here with us.
You will have to tell her that this cannot go on.
She is not incompetent, so you cannot force this issue, but you CAN stop enabling her to stay in her home.
Your DPOA will not work at present because your mother is not incompetent and you cannot tell her what to do or where to move unless she is.

Tell your mother what you told us, and tell her that at the beginning of the year you are no longer free to help her other than ______________(here list the ways you can help, perhaps a visit every weekend or a weekly shopping trip). Tell her all other help she must hire on her own.
Tell her that you will help her with applications to Medicaid if needed, or with arranging finances and checking nursing homes, Board and Care facilities, ALFs. But that you will no longer be available to her otherwise.
Let her know the truth, that she is doing poor decision making and you are enabling that by coming to help her. Honesty can be delivered gently but firmly, and it must happen.

There is honestly no way around the truth, and the amount of time we spend avoiding it is quite tragic. I wish you good luck and am so relieved you have not moved her in with you. I hope you'll update us.

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Thank you for your words. I have told her the truth multiple times. I'm brutally honest. I have done this nicely and we've had heated arguments over it. I just need to act and place her somewhere. My goal is to get her somewhere in January. The part I struggle with is pulling away. She requires 24 hour assistance with ADLs. I could elect not to hire the sitters when I go back home, but I would consider that neglect. She needs help with toileting, getting meals, etc. She knows she needs help but doesn't like to admit it. She'll cry and act like she's so sorry for keeping me away from my home, yet she refuses to budge. She's just a selfish individual. She already qualifies for Medicaid and has a daily 5 hour caregiver, however that's a drop in the bucket considering she needs round the clock assistance. I pay the additional caregivers to give myself a mental break and to spend time with my family. I hate missing out on time with my grandkids. I posted in this forum in search of ideas on how to go about actually convincing her to go and making this happen, preferably peacefully. I realize that's not likely..lol. It's up to me and I appreciate your suggestions.

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Has it been documented that she cannot make decisions for herself? If so I believe you can place her in a facility without her consent. If not, maybe a Dr's appointment is in order. I know several times when I worked LTC, family would take their LO to the Dr and explain the situation to the Dr and the Dr would write orders for the LO to be admitted for evaluation. Sometimes the LO stayed in our facility, sometimes they went to a different type facility. Another idea is tour various facilities and talk to the social workers to find a place that might work out well for both of you.

You are absolutely correct that the current arrangement isn't sustainable. My heart goes out to you and hope for your sake that you can get something done soon. Do you have any other family might be able to help you? By that I mean to find a facility for your Mom and those type things. Just someone close to discuss things with, bounce ideas off of, or just vent to might help loads.

Good luck and don't forget your a wonderful child for being willing to do so much for your Mom.

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Thanks for your compassion. I'm not 100% about the documentation on her mental status in current medical records with her primary doc. I doubt it, but I have a great relationship with her doctor and it would be no problem getting him to document that. Plus it was documented for her last admission.
I have taken multiple tours of homes at various levels of care. It's just a one sided tour. She refuses to go and look for herself. She has to be evaluated for AL, but what I've gathered is that she's borderline between AL and NH. Some facilities say that based on what I've told them, she'd need NH care. I've had several say she would likely qualify for AL, but I know she'd be at risk for falling there. So many NH are short on staff and funds, and the care is less than ideal. Just something I'm going to have to accept. I am the only one making decisions on her care. I have friends that I vent to often and that definitely helps. I recently joined this site and love getting responses from people who have experience dealing with elderly issues. Thank you again for your input.😊

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Go home and stop paying for her. She will then see she has no money.

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Lol! Easier said than done. I guess I'm soft hearted

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If she has not been declared incompetent you can not "force" her.
Is your DPOA in effect at this time? (legally)
The next time she is in the hospital ask to talk to a Social Worker. Explain that she can not be discharged to home as it is unsafe at this time. You can not care for her and the caregivers she has are not there long enough to make it safe for her to be home.
STOP doing what you do for her.
You do not say what other medical conditions mom has that require you to go stay with her for half the month.
You might want to begin the application process for Medicaid.
You can talk to the local Senior Services Center or the Area Agency on Aging to see what services she may qualify for. (they can also assess her needs)
You say she can not afford AL but if the house is sold the money from the sale would be used for her care. And since there would be no property taxes, homeowners insurance, food expenses, gas bills, electric bills it might end up being less expensive or about the same in AL.

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Thanks for replying! Yes, my DPOA is in effect. What would cause that to change? She was hospitalized in 2015, 2016 and 2019 and all times rehab/NH was recommended. In 2015 I pushed for short term rehab but ended up with her at my house afterwards because she wasn't strong enough. Never again will that happen! Terrible experience. The other times she went straight to a rehab facility and ended up being recommended for LTC. She is already on Medicaid and is enrolled in the Elderly Waiver Program that does provide some assistance but not near enough. She qualifies for the AL waiver and could transfer to that program but very few AL facilities in my area accept Medicaid. All NHs do and that is really the level of care she probably needs. She came home 4 years ago with a recently broken hip, bed ridden. Therapy worked wonders and she gets around with a walker fairly well once she gets up. She's diabetic (no meds at this time), has kidney disease, some GI issues, vision problems, but her biggest problems are severe arthritis in her hands which limits her ability to do a lot of things and limited mobility in general due to poor strength. She's at very high risk for falls. She has dizziness and balance issues in addition to the above. And yes, she could probably sell her home to be able to pay for AL, if she'd qualify for that level of care. Thank you again for all of the information

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You aren’t going to convince your mom to go into a facility.

You have to convince yourself that this situation isn’t feasible for you to continue.

It isn’t going to be easy because your stomach is probably in knots thinking about the backlash that you will receive from your mom for telling her that her free ride is over.

Your current solution isn’t working out well. So, you may as well be miserable for a short time during the transitional period and get what you want in the end,

Please don’t make the same mistakes that I made. I allowed myself to be the primary caregiver for far too long. It only became harder as the years went by.

This situation is never going to get easier for you to manage on your own. Accept that your mom needs to be in a facility to receive proper care.

Do whatever it takes for you to become self aware of the fact that you deserve to live your best life.

I had outsiders telling me that I would regret it if I wasn’t my mother’s primary caregiver.

Trust me when I tell you that my biggest regret was that I was my mother’s primary caregiver for so long. I can never get that time back in my life.

I wish you well.

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Great point! I so appreciate the encouragement. It helps to hear confirmation of what I already know. I'm psyching myself up for January. She must go somewhere!

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FlowerGirl, you may well be "soft-hearted". But you've also been groomed by a selfish parent to put HER needs above your despite the fact that you will have no one to care for you in your old age if you don't take care of your family and career now

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So true!

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You need to have her evaluated for 24/7 care. Then get a doctor to back you up that she needs to be in care. You need to talk to her Medicaid SW and tell her/him this "in home" care no longer works. That you pay for xtra help. That you have had to go p/t to be there for her. That you can no longer pay for her xtra help. Five hours are not enough hrs. You have a family who needs you. She needs 24/7 care in a facility.

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OP, your recent post says “I feel guilty, but no idea why”. We all spent our childhoods doing what we were told. That’s why you feel guilty about not doing what you are told. You and M are both acting like you are still a child and she is still in charge.

You also say that M “comes from a long line of children taking care of parents at home”. Perhaps 2 generations, but if the line is any longer it’s because there was no alternative. Have a closer look at that ‘long line’. It’s probably not a genuine reason for feeling caught yourself in this age.

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Thanks for responding. I have tried sorting through this guilty feeling for the last 2 years. I've been the "parent" in this relationship since I was a kid. I'm aware of all her antics and I'm quite used to it and usually have pretty good coping skills but this move has thrown me a loop! I have always kept her best interest at heart, but maintained my distance as an adult. We chatted on the phone weekly, only getting together on special occasions or if she truly needed assistance. I'm just saying we were not that close as many mother/daughters are. When she became ill, I was her best advocate for getting the best care, but the NH she was living in (supposedly the best in my county) declined while she was there. New DONs, lots of staff quit and went elsewhere. I saw my mother decline over these years and I attributed that partly to her health issues and age. However, when she came home, she thrived. Learned to walk after not getting proper therapy at the previous place, mainly due to COVID rule changes and limited staff. She started getting out in the community, her cognition improved, and her overall health improved. Although she would not be going back to that particular facility, I somehow believe I'd be contributing to her demise, thus the guilt. Now granted, she picks and chooses what she puts her efforts into, and if she chooses to do nothing for herself once she moves, I know that has nothing to do with me. The 2 facilities I have narrowed to are good and I know people at both places as it's a small town...her hometown. I don't have any places near my home that are decent so I'd be most comfortable with her there although it's farther away. Thanks for letting me explain and vent! Regardless of my unfounded feelings, she's got to go! And very good point about the generations of caregivers. You are right!

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My narc mother insisted that I leave my husband and school-age kids to be with her 24/7. When I refused she tried to kill herself. I used that to get her in care.

You can help keep her safe but you cannot make her happy. We were raised to fulfill their needs. You must accept the conflicting fact that you cannot do both.

My mother became angry while in the hospital and refused to move a muscle ever again. At her age, you move it or lose it VERY quickly. Sure enough, she has lost so much muscle mass that she can no longer walk nor stand. The PTs tried so hard to get her back on her feet but she sure showed them how nobody was going to tell her what to do!

I placed her (with help from the hospital) in care and became Mommy to my kids and my husband’s wife again. The guilt is easing, now that I’ve had a chance to reflect.

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Thanks for sharing your story and so happy you got your life back. It all hits very close to home. I remind her daily to do her exercises and she has very little interest, especially since we've been having some serious talks about moving. I try to tell her she's just hurting herself. My husband has been very supportive and thank God, my kids are grown, but I have grandkids I'm missing out on. I have just lost myself in this whole process. I CANNOT wait to get back to a normal life. It's unfortunate that it has taken me this long to put my foot down. I love this supportive forum and appreciate your comments. I am making a move with her one way or another in January. I would rather it be a positive experience but it's clearly not going to be. I have friends who's parents are so agreeable to make that next life decision as they age. I can only wish...lol. We will all likely have to make those decisions if we live long enough. If I've learned nothing else, I know I will never burden my own children with what to do with me. We've already had that talk..lol! Thanks again for the advice. You are 100% spot on!

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I wish I had an answer, myself. My aunt needs desperately to be in one. She can't walk without a walker, incontinence issues, sleeping all of the time. If you mention AL or NH, she goes ballistic and you can't calm her down. I was her springing POA at that time. I assisted getting her home care. She tried to get me to pay it, since I suggested it. She paid for it, used them for a while, then got rid of home care. Fussed at me that I will no longer tell her what to do and she'll decide what's best. I gave up my poa and she's home alone with no home care and back in her filth, angry at me for no longer visiting and giving up poa.
Like grandma said, you can't force them to go, unless they're declared incapacitated. I'm just waiting for something to happen. I did send her a Christmas gift.
Best of luck to you. I know it's harder, since it's your mom.🙏🏽

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Sorry you're going through this. It's a tough situation, that's for sure. She either doesn't understand the burden or refuses to acknowledge it-probably a little of both. I'm trying to avoid arguments with my mother, but shes going in January. I'm going to tell her she can make the best of it and I can visit regularly and she can come and visit me on special occasions/doctor's appointments-OR- if she chooses to throw a fit, I'll do it the hard way and find the necessary resources to get her there and keep my distance afterwards. I'm exhausted and over it.

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How do you convince an unruly parent to go to a facility? Can I make her go? I’m mentally exhausted from dealing with her.

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