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How does she want to die? Laying on the floor with a broken hip alone? Slipping outside and freezing to death? I ask this because we lived by an elderly woman, her family lived nearby but we were pretty much constantly attending to her needs, falls, fears, water dripping in the middle of the night that she was sure was a burst pipe. My point is someone is going to get those emergency calls for help. And it could be you don’t make it in time for the last one.
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Judysai422 Jun 2019
If your mom is of sound mind, these are good points to discuss. Make it about you not wanting to let her down when she needs you.
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My LO is the last survivor of a lovely large family. She was caregiver to many of them, and having seen them through numerous debilitating illnesses and conditions. She was of totally sound mind when she TOLD ME that I was to be her POA and ASKED another relative to serve in the same capacity.

The family home was a haven for well over 100 years, very poorly suited to the needs of a 90+ yo woman with a recorded fall history. When she began showing signs of failing memory and increasingly poor judgement, we placed her in a very pleasant, well run, expensive ALF, where she was soon moved to the locked MU.

SHE had spoken of that choice as one of her alternatives before we decided to move forward on it. There was NO GOOD CHOICE available to her OR TO US, when we moved her.

DH and I visit often and the other POA shows up once in a while and complains about what we do. Our goal is always that she be safe, we’ll cared for, and as content as we can manage.

I admit to having had constant fears of her being unable to reach out for help if she were left alone to continue living in the home in which she was born, and it was always part of my decision making on her behalf.

There is NEVER a good decision available when the goal is altering the life of someone who elderly, failing, and dependent. There is only the hope that with careful and thoughtful considerations, the best choice can be made from the “less than good” choices available.
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busymom Jun 2019
And Ann, you don’t have to feel guilt about making your loved one safe. Hard decisions require some gut-wrenching moments, but they are the right thing to do.

Not everyone can move their loved ones into their home or move in to live and care for their loved ones. My mom ended up in a lovely assisted living facility after fracturing her hip (she also had Parkinson’s disease). She went there, because my dad could no longer handle her daily needs. He lived at home alone for several years until he could no longer drive and became a fall risk himself.

I was the POA for both of my parents. While I often communicated with my siblings regarding the care of our parents, the majority of the decisions were left up to me. I prayed a lot and I was very often given “wisdom from above.” Moving my mom to assisted living was easier to do because of her fractured hip. Moving my dad was a much more difficult decision, but it was the right one. Getting meals to my dad when an ice storm hit our area and his power was out, made it crystal clear to me that something different had to occur.

Moving my dad meant for him that he had lost his independence, had lost living in his own home, and shortly after moving to nursing care—he lost his wife (my mom). Yes, he struggled for many months and still “argued” (almost up to his last moment on earth) about being able to drive his car. For both of my parents, I would encourage them to look on the more positive side of things. What do they have right now? A warm bed, new friends, good food, safe environment, loving care-givers, visits with kids and grandkids? When we shared laughter, singing, favorite foods, etc., it made a big difference for each of us.

When I went to bed at night, I could sleep knowing Mom was being well-cared for and the same with Dad. Knowing your loved ones are safe is a huge bonus.
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I am hoping to be able to live independently until the end but I live in a retirement place that has some support. Change is hard but even harder the older we get. At least someone should check up on her by phone or visit. Is she not bathing or forgetting to eat? This can be hard as we have less energy. Standards seem to drop as some things seem less important. The question of safety is different. You could give her one of those devices where you push a button for help. While many people do not want to leave home, places are so much nicer today are they have other people for company and help is available and there are activities.
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It seems that we are all concerned for our elders safety - which is a given. However, many of us want to place the person in a facility that will take care of them and relieve us of that responsibility. Are we being selfish? I asked myself that constantly when I had to make the decision for my brother. He had moderate dementia with major medical issues. I just was not capable of taking care of him even with day help.. I still have guilt about it, but I know it was the best place/choice for him. Now his dementia is very advanced and I am glad he is there and I don't have to do it now because believe he would have adjust as easily as he did.
It sounds like your situation is different. There is some good advice for you in this forum - Can you talk to her heart to heart and list your concerns and goals. Maybe you both can come up with a plan of care that will accommodate her needs at home. If she won't talk about it reach out for support help. There are a lot of support and volunteers that are trained and will day sit. I would check with Elder Services. Have all your ducks lined up before talking to your Mom so there won't be any confusion for her. These are extremely hard decisions to make. Btw, who has POA? Good luck with your Mom. Non of this is easy.
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She's a grownup and it's her choice how she wants to live and die. Support her wishes any way you can.
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What is there in life other than freedom of choice?

You should not be asking US what your mom wants. You should only be asking her.

As long as she is “okay” (nothing in life is perfect) and somewhat happy (that would make her better off than most people in this world) let her be.

Call her everyday to make sure she is fine and her needs are being met. Devise a list of people who can take her to lunch occasionally or check in on her in case you can’t get through - neighbors, family members, congregants of her church.

Let her live the life she wants.
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I would advise leave Your Mother be where She is happiest and wants to remain, but to call every day to check in on Her to make sure She's ok and has enough fresh food and heating, etc. Moving Your Mom elsewhere against Her wishes would only set Her back and She would only go down hill very fast. At 96 years Your Mom has lived a full and happy Life independently so leave Her remain in Her own home.

Blessings to You Memax and Your Mom.
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disgustedtoo Jun 2019
While suggestions like this sound great, OP does indicate mom has dementia/Alz... there are so many ways this woman can injure herself or put herself in extremely unsafe/deadly situations. Our mother was in early stages, but also lived alone. One neighbor did check in now and then, but it wasn't her job (I let her know how much I appreciated the help/extra set of eyes.) If OP's mom forgets the stove/oven and starts a fire, wanders off, injures herself and there is no one there to help, could you live with the results (burns to death, suffers from injury, lost and dies outside somewhere?) Set backs will happen no matter what, with dementia. However she could still live more years safely in a safe environment with oversight.

Our mother was resistant (understatement) to moving, whether in with one of us or AL, but clearly was beyond being safe home alone. She DID manage to injure her leg and develop cellulitis just before the move to MC, and she didn't have enough sense to get it looked at or tell one of us. If we had not been about to move her, it could have killed her! It is a serious infection and delayed the move a few days while treatment was started. She was early 90's then and also refused to have help come in (we tried and after a few months of only 1hr/day sanity/med check, she refused to let them in.)
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How did she end up back home after the last hospital stay?

You previously said she was near the end and hospice was recommended by many posters, has that been implemented?

Would the social worker at the hospital not help you at least get her in rehab.

If you are only going to worry about her and not utilize the services available to help her, can you see a therapist to help you stop worrying so much about something that nothing is going to change until she passes.
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How bad is her dementia? Can she still understand things and make decisions? Is she safe? If so, then just the fact that's she's 96 is not enough to push too hard on getting her into a different living situation.

If, on the other hand, she if not capable, perhaps she should be moved somewhere safe, whether she likes it or not.
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I question this often if dad were to pass before my mother. Although she wants to remain in her home there is no way I could sleep at night knowing she was on her own. My situation is a bit different as she has minor mobility issues, but her mind is not capable of dealing with the complexities of daily living. Obviously she feels otherwise and this is why she continually does things that put her in harms way. There is no reasoning with someone with dementia.....add this to the stubborn mentality it's a no win situation. Do have DPOA? If so, and she has been clinically diagnosed, you can claim her to be incompetent to make rational and thoughtful decisions for her well being. That would give you a clear path to do what is best for both of you.
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disgustedtoo Jun 2019
I replied to a comment you made to someone else's comment - basically DPOA does not give authority to move someone. It gives you the "power" to act on fiduciary matters. Medical POA allows you to make medical decisions, but unless it is specified in the document (most often it is not), it does not give you the authority to make the person move. Dementia or not, they still have the "right" to make decisions. It is good to have both POAs setup beforehand, but making someone move against their will is not going to fall under these documents (as someone else said and we had happen to us, the EC attorney said we could not force her to move - he suggested guardianship, but the MC facility said no committals.)

The best one can do is either convince the person to move OR come up with a plausible reason the person needs to move, temporarily (in their mind), to a safe place and let the staff work with the person. We were told by staff that even in MC the residents can refuse treatment, meds, etc and they have to get creative in getting them to comply.
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Of course you feel bad about her living alone, but if you make her move, you'll likely feel bad anyway. (She may be very mad at you, or simply unable to adjust to new facility's rigid schedules for meals, showers). Mom's social worker even said that every time mom went: to "E.R.> to rehab>to her ALF again", she lost cognitive function & strength. I think its cuz their adaptive skills are diminished (due to age). Their sense of stability & comfort is lost once they leave their home (against their will), but it may become medically necessary anyway. So follow your own conscience, cuz your gut knows what decision you can live with peacefully, after she's gone.
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When a person breaks a hip or has a stroke, say, there's a nice clear Before & After line and it's easy.

I see that your mother has heart disease and dementia; and I remember very well that with these progressive illnesses it's impossible to pinpoint exactly when it stops being okay to leave her to it. You get increasingly uneasy, while your mother becomes increasingly unable to assess and plan her own living arrangements.

What are the main risks you're concerned about if you do, as you say, just let it happen? On a scale of 1 to 10, where 1 is fine and 10 is can't bear to think about it, how would you feel if they were to come to pass?

These are more questions to discuss with your mother. They won't give you the answers that make it definitely okay to decide one way or the other.

Or, rather than wait for the game-changing fall or incident, could you think up some crucial piece of building work or redecoration that her house needs, and persuade her to stay temporarily in a nice facility? At least that way she would get to try it out, and she might take to it, or she might decide she can't face the kerfuffle of moving back home again.
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Normally, I would say that if she's able to do it, then, it's her choice, but, your profile says that your mother has dementia, in addition to other health issues. So, I would look at what level of progression she has of dementia. For most people, it's too risky to live alone, past the early stages of dementia. Judgment becomes impaired and the person is not able to perform many daily activities unassisted. Past the early stage, there are all kinds of risks, such as starting fire by leaving on stove, eating spoiled food, letting strangers into the home, mistaking medication, wandering, etc. And, no matter how much the LO may protests, if they are not competent to live alone, their contention is not suitable. Do you have her DPOA or Healthcare POA? Her doctor may be of assistance too.
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The thought of our loved one lying alone, suffering and unable to summon help if needed can cause a lot of anxiety. It may help to insist on an alert pendent and to devise a method to check in daily - for years my aunt and mother checked on each other with a morning phone call, another lady I knew used to grumble that she could never sleep in because her neighbour called for help if she didn't get up and open the drapes (lol).
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A lot of people on this forum would probably say, lucky you! Let her live the way she wants. If something happens to her, she will be one of the lucky ones to die at home. My dad has lived in a memory care facility for over two years, having moved in at only age 78. I can tell you after visiting the place often and interacting with residents that have been there upwards of a decade, that is NOT the way to go. I hope you leave her alone.
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My dad is living alone and it’s also as you say “not good” We all know it, he’s physically beyond frail. But as he’s mentally competent there’s nothing we can do to change his living arrangement, simply put he’s free to live as he chooses. So we’ve made his environment as safe as it can be, removed tripping hazards, have his mail come to the door, have him wear a life alert button, and perform many household tasks for him. He knows the help we give is what makes it possible for him to live “independently” Same with your mom, all you can do is make her home as safe as possible, she’s free to choose living alone
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Remarkable your mom has lived on her own for 96 years. I can understand you must be worried about her. But if she is happy with her living situation and does not want to move, you cannot make her. You say she doesn't do anything she's supposed to. What does her doctor say about her health? Does she have dementia or Alzheimer's? My mother has moderate dementia and is living alone. She absolutely refuses to go to a memory care facility and our attorney says we can't force her. Right now the only thing my brother and I can do is visit often and take her to see dad who is in a nursing home 4 times a week (not easy for me as I live 3 hours away). She refuses to have aides come into her home. Can you visit your mom frequently or will she accept in home care? There are things you can do to make her home as safe as possible. If she is in relatively good health for her age, you will have to go along with her wishes.
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Abby2018 Jun 2019
This is why people put DPOA in place when parents are still of relatively sound mind. I'm surprised your attorney has not mentioned this.....is she still competent enough to sign this document? Two years ago I insisted my parents see an elder attorney to put everything in place before either became seriously ill. This was the only thing they would agree to signing (trusts, etc. they refused) for both medical and financial. Mom has been diagnosed with dementia, but not in an official capacity. She will be tested at the end of July by a specialist. Rest assured when the time comes her dementia causes us to question her ability to live alone (right now she lives with dad), I will most certainly place her in the appropriate facility. Dementia only gets worse and quite frankly even though they appear lucid they are not capable of making decisions that are best for them.
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I agree, she has been doing something right. Let her live the way she wants. If she isn't doing what the doctor says, oh well, she has lived this long. As my RN daughter says, she is passed her exasperation date, GBH.
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oyadancing Jul 2019
Your daughter is brilliant. I'm stealing that one, past her exasperation date - although I may be past mine! 😁
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You posted back in May that Mom has COPD and you felt she was “very close” to passing. You asked if we thought you should just let her pass at home. Since it’s almost July, I have to say Mom must be a very strong-willed woman who will do things on her own terms and in her own way. She’s seen a lot in her almost a hundred years on this earth. No one lives to be that old without good old fashioned grit and determination.

Do you live close to her so that you can offer help without interfering and making her feel helpless? Make sure she’s safe, ok and has what she needs and let her live on her own terms. She’s made it this far and God bless her for it.
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At 96 what exactly is she supposed to do?

I think that you will just have to decide that she has done something right to be 96 living alone and well enough to let you know this is how she wants it so bugger off.

We can't live forever, but we can be unhappy enough to make it feel that way.
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My mother is 94, lives by herself in the mtn area of NC, 700 miles from me and my brother. She refuses to move by us, go into independent living and anything else we suggest. So we just wait and will do what we have to do at that point. There is nothing else we can do. She is a vile person, has not friends and the other family members have not spoken to her in 30 years.
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Presumably she was fine living alone at 94 and 94, what has changed that has you concerned now?
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