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Mom is not grooming, eating or taking her meds. My sis goes over daily and insists on her eating. mom wants to die at home. We have made arrangements to move her to assisted living. How do we tell her when she is so bull-headed and refuses. My sis wants to take her to lunch then say her house has something wrong and we can't go back for 4 weeks till fixed. Drive her to assisted living and her things will all be there. Is this a good idea, nurse said they do this a lot. Any other suggestions?

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When we realized it was time for my mother in law to go to assisted living we first made a appointment to speak with her Doctor.His advice was to tell she was in need of some physical therapy and she would be more comfortable getting it in that setting instead of at home.She has a little Apartment there ,we had her pick out what furniture she wanted to bring telling her we wanted he to be comfortable while she was there.She settled in quite well at first every month or so she would say she felt better and would be home soon .Then there came the day she announced she liked it there and wanted to stay,so go ahead and sell her house.When house sold took her over to see if there was anything else she wanted,she looked around and seemed quite happy with her decision.
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Taking residents back to there home after placing them in Assisted Living can sometimes turn into a real mess. I have heard of times when they will get to their old home and refuse to go back to Assisted Living. I would perhaps just ask them if there is anything they want from the old home as opposed to taking them there.
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You are correct in many cases I'm sure, before taking her there I discussed it with her Dr and also the staff at assisted living.I just felt in her case she might need a sense of closure since she decided on her own it was to be a permanent thing.This is a very difficult step (moving into assisted living) I would advise talking all steps taken over with professionals and also people who know her the best.
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I agree with Mary12 involve her doctor and try to come up with a transition plan. Take a few weeks to ask her questions about how she is able to care for herself. Ask her questions about preparing her meals and Activities of Daily living (ADL's) and Independent Activities of Daily Living (IADL's) Sometimes bringing a third party to do an assessment of ADL's and IADL's can push someone out of Denial and help the recognize the need help. Also taking her to lunch and to do a tour with no pressure at theAssisted Living can show her it is not a house of horrors. When doung a transition I always try to make it become their idea on a couple levels before I tell them that it is my opinion that they need to move. I try to work with then over 4-8 weeks slowly nudging the to come to their own conclusions. Giving them time to process things so they do not feel controlled. I try to give them as much control as possible. I know this is hard. Sometimes having a third party involved with the doctor Helps her to come to terms with where she is.
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what is wrong with her wanting to die at home?
Why cant you get someone to come in and help her with the things she needs help with? Nursing homes and assisted living, they are NOT home.... you know the saying, Theres no place like home..,,, good luck, I do not think lying to her is a good Idea, would you want that to happen to you?
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I agree with many of the suggestions. Is there any congntiive issues? If so, you need to pursue the move. I would tell her once and approach in a positive manner and focus on the benefits of the move. We were ill before we moved my parents but they quickly adapted and were happy with the smaller and simpler environment.

If mom does not have any issues, could you make her part of the decision process? The need for control and value are strong and if she is with it, moving her and telling her something is wrong with her house may cause distrust and she will be sure to try to NOT like the new place.

We did family interventions and had the conversation with our parents (there are 4 kids who had to fly across the country). We wanted to show a united front, tell them how we wanted to help and wanted to ensure their safety and well-being. It's not easy. Best of luck.
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I am in similar situation with my 87 yo mom. She has been steadily declining the last 6 months, she has "mild" cognitive issues, she has major OCD and Paranoia. Her bullheadedness would win Olympic medals. On Thanksgiving evening, after six weeks of a damaged Achilles, she did something very silly and tore the Achilles completely off. My husband and I have been struggling with keeping her home, she wants, we want. However, the impulsive behavior and lack of care for consequences for herself or others, since July make it unbearably hard to manage her. Chances are good, depending on the circumstances, the next "event" on the horizon means we will have to explore Assisted Living. Siblings are non-involved, not helpful. We can not stay home with her 24/7. She's started throwing terrible tantrums that would have caused 2 year olds to blush. This is one of the toughest situations you will encounter. Good luck...if you find the right answer, please share. Sending positive thoughts for a happy outcome.
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I think there are so many factors that come in to play here. If your mother has the financial means to have full time care and someone to clean and cook, then personally by all means, I would allow her to 'die at home'. At 91 why not? But she may have a huge or difficult house to navigate (steps, bathroom upstairs, disrepair or something else). She may not have the means to cover the 'nut' to do this.
My MIL wanted the same thing. She lived in a very small home, one level so not too much to take care of, could afford to have someone there all the time and had lived there for 48 years. Her other child, my husband's only sibling, was a bully with her and forced her - really with him total control freak - to go into a place that she was not happy in and then lived another five years. It was sad and really unnecessary. She could have afforded to stay at home. There are definitely risks at home, that's for sure. And it is definitely costly and not every one can afford it. In her case, the worst part was living in a very small town, with not a lot of qualified home care specialists. Still wasn't a deal breaker, because she had a neighbor she liked who was willing to do it and insurance would have covered it. But son #1 got his way and immediately sold all her things, home, car,all of it, in an estate sale. I think the surprise for him was that it didn't net all that much. A lifetime of memories and things went pretty cheaply and she did have nice things. Unless you own a priceless art collection or rare jewels that is the way it is, I think.
In the end though, only you know your mother's 'whole picture' and I would just urge you to do what you would want done for you some day. Put yourself in her shoes and then decide what is best for her. At 91 she probably doesn't have a lot of time left and if she is talking about wanting to die at home, she may know something you don't. If it is possible to give her that, perhaps you should consider it.
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I am sorry, I forgot to mention that Mom's dementia has gotten pretty serious. She forgets to eat, we've turned off stove so she only uses microwave and she is having both urinary and fecal incontinence. She will only shower about every 10 days and only after being 'forced' to. She is mostly living in cookies and milk.
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My 94-yr old mom with dementia can afford to stay at home, with 24/7 care. And we kept her in her own home as long as possible...possibly even longer than we should have. We just moved her into an ALF and wished we had done it sooner. The socialization alone makes it worthwhile. And it is actually less expensive than 24/7 in-home care. If/when it is time for a NH, well.....we will cross that bridge when we come to it.
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Realized I didn't comment on your very initial question. We had Mom involved in the decision making the entire process. Yes, even with her dementia. She was agreeable about it up until the actual move-in time. Then she did a 180.

The only suggestion I can give is if she has a favorite aide right now, have that aide do a few hours a day for a while at the ALF. We are on day #4, and the aide is with her today for a few hours. Less anxiety for Mom right now and well worth the extra money. Good luck
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Great tip
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There you go again caregiving is always about the parent it's much more difficult when it's the spouse with Alzheimer's that has to be moved
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Same problem here. Mom is 100 and refuses to go. She has Alzheimers and the doctor and IL notified us she HAS to go. We have been advised to take her to one of our houses for a few days while the others move her. Then we are going to give her a tranquilizer and simply sit her down and tell her that the doctor and IL say because of her age she can't stay in IL. She will be upset, but, like your mother, Mom has dementia, her hygiene and cleanliness is poor, she doesn't eat right and she gets confused. She can't take meds by herself and she refuses to let any aide in the door. Sad thing, but I'd advise trying what we are going to do. We don't dare tell her ahead of time, she will absolutely freak out and be so upset she will make herself sick if she has time to think about it. I wish you luck. It seems that many many elderly parents do this, and we children bear the brunt of having to be the bad guy. I wish we had done it years ago because the socialization will be so much better for her than sitting alone in her apartment.
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imsunny: I just read your second post. Your mom's behavior must be typical of dementia sufferers, as my mom is the same, except she hasn't showered in 2 years, and barely washes, has urinary and fecal incontinence also, and lives on sweets and ensure. Yes, we will feel guilty doing it this way, and no we won't let her go back to IL to say goodbye as it would just upset her, and at her stage in dementia, she doesn't really care about anyone else. You might try telling your mother if she doesn't like where she is in 6 months you will find another place for her. By then her house will be sold and she will be adjusted, but it might satisfy her in the short term. That's what we plan to tell Mom.
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gosh I can understand the appeal of making up the story about "something wrong with the house" and just check her into AL, but I don't know if I could live with myself if I told such a lie.
if the parents wants to die at home then exhaust every possibility to make that happen. and for those who say home care costs more than ALF, I have to wonder, it seems cheaper in our area to hire home care. AL around $5,000 a month and memory care for Alzheimer's care is around $8,000. Per month.
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We priced it out when we realized 24-hr care would be needed. $20/hr off the books, $25/hr thru an agency for home care. 24 hours a day, and is is $7200-$18,000 a month. That is before food, utilities, etc. And those prices are for CNAs, not skilled nursing (LPNs). Even then, we were willing to do it if it were best for Mom to stay in her own home. Sadly, when Mom stopped realizing she was in her own home, we knew that wasn't of importance anymore. The socialization, or lack of it, was a huge concern. She wouldn't go out of the house. In fact, it was a chore to even get her out onto the deck for some fresh air.

We tried her in one of our homes...the home with the most people coming and going. Even that wasn't enough for her. We all had our own lives, and she was looking for entertainment every waking moment. Because she was bored, she would cat nap day and night, thus keeping the rest of the house up all night long. In addition to being fed, bathed, meds management, dressing assistance, hygiene assistance, etc. As she says about the ALF, "there is always something going on here to keep me busy".

Iamsunny, good luck & pls keep us posted.
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IKORWPA is correct is correct taking her ahead of time is great.At the AL my Mother in law is living,they sent a nurse out to have a visit and get a feel of what stage she was at.When a room was available they arranged a luncheon for her with my husband and myself also.Several of the key personal had lunch with us ,others came in to visit after then we had a tour with her,it made it very warm and welcoming. Remember most AL's have a waiting list anywhere from 6 to 9 months or longer and you really need that time to plan everything.
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Sounds about right,,, rip off that bandaid fast. 91 years old should not be alone. See her a few times a week, then just once a week for her to adjust, and then take her outtings, etc. make it fun,, nail day, hair day, snack day, lunch day, etc.....
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I'm sure the dementia part of the equation is a very important one. This is a difficult thing for each of us to know how to handle.
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I so appreciate your responses. The problem with keeping Mom at home right now is that I live in MN, Mom and sis live in SC. My sis has lost 30 lbs and is beat up from taking care off Mom and watching grandkids. It's not fair to her. She retired early to care for Mom. Hard for her to do alone. Mom won't let 'people' into her home to help. I come as often as I can, but I still work and my family is in MN. My sis and I are not dealing well with this; guilt, fear of unknown, sad for Mom. We hope a month from now, we will have all settled down
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Best of luck to you imsunny this is the hardest time for you everything is so up in the air and unsettled.unsettled. Trust me it does get better and yes there will be times no matter happy she that you will question if your doing the right thing,that's normal and you are doing the right thing.At times you feel like you have young children again,and at times it's more difficult to be always be patient with the oldsters than with the children.
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We took my mother to an assisted living facility and have turned the matter over to the county to file a public guardianship. She has been totally resistant to medical care, accused my sister (who was residing with her to help) of being a trespasser, would not cooperate with medical workers sent to the home by her doctor. A neighbor became concerned about her and called the police. She weighed less than 80 lbs and was covered from head to toe in grime and filth. They took her to the hospital. The hospital sent her to a rehab center which refused to allow her to return home unless she had 24 hour medical care. She refused, so we took her to an assisted living facility.
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Dementia is tough because you can't reason with them any more. They are not unintelligent and until the Alzheimers becomes stage 6 or so and they are mostly unaware, you still have to deal with THEIR sense of what is real. (even though you know it isn't real) So, sometimes you just have to deceive them for their own safety, especially if what they want isn't affordable. Funny thing, my mother goes from "I hate being with all these other people" to "I just went downstairs to find someone to talk to because I can't stand sitting in my room" (and its IL and not a room, its an apt) When we move her to AL, it will be a room. But, I have a feeling once she gets adjusted, she is going to like being paid attention to, flattered and having people around her who are more like herself rather than feeling as she does now - left out because of her deafness, social ineptness and short term memory. I have to tell myself Mom will be happier eventually.
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Revisiting the cost of in-home care, for those who want to pursue that option: No, you do not pay $25/hour for an LPN to basically sit there doing nothing while your parent sleeps. I know some people in my major metro area/suburbs, are hiring caregivers (not LPN) at 10 or 15 an hour, overnight and asleep (but with an alarm if needed) then it is cheaper pay for the overnite time. For example, if they work 4-12 pm "awake" then they can sleep until 8am (unless bed alarm goes off). If the bed alarm goes off, it is documented on the system, and the caregiver gets paid extra for being wakened and assisting as needed.
My point is, you do have options to keep an elder at home, safely, and it does not have to not cost $18,000 per month (who would do that?). Even my own neighbor has a 96 mother with Alzheimer's, they have 3 different caregivers and a weekend crew. The overnite person basically sleeps there (she is a middle-age widow and this income helps her greatly), hardly ever has to wake to help the elderly mother. It can be done, and it does not have to be THAT expensive.
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@DebJames - you did the right thing. Good for you.
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Pretty good, Mom won't let anyone but us in her house so this would not be an option. We tried and she refused to answer door multiple times. She is not trusting
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My mother told me one time "I'd rather DIE AT HOME than go to a nursing home"...well, that's not going to happen. Turns out when she was with me, she was always asking for whatever, clogging the toilet, etc., etc., Now, I understand that, but a 'normal' person can't take this day in day out. Why? Because it's NOT normal. They're requests, they're insistence, etc., etc., their wandering, their constant whining, complaining, etc., etc. Whatever.

My mom fell six weeks ago which landed her in the hospital, then in rehab. She had no choice. Rehab happened to be part of nursing home facility. It's nice. I trust the people there, who KNOW how to handle her. They KNOW she's stubborn (today, she was getting out of the wheelchair without the walker. When I asked her, Where's the walker, she told me she didn't want it. You can NOT reason with a person who has this disease. Repeat: You can NOT reason with a person who has this disease.

She was playing BINGO today and darned if she wasn't having a good time with her new 'friend'. Now my mother never has had a friend. But she has one now! She was watching the same shows on tv she watched here. The difference is when I visit, I'm not angry with her. I can play Bingo with her in the Dining Room (which is nice). Today, she was complaining they serve the same food every week (common complaint with her)...I told her I've had the same supper three days this week!

Don't feel bad about this. Just do it. Then you leave for a few days and let her acclimate. Guaranteed, while she may tell you she's not happy, she'll adjust.

I'm thinking about you.
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@Im sunny - if she's not allowing anyone in the house the next option is you call her doctor and tell the doctor this. The police will come and take her to a facility.

She has no options if she's not thinking clearly.

It's tough. Yes. But you have to do it and just understand she's not thinking properly.
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Litldogtoo, can you get the police involved without a guardianship?
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