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My mom went into AL about 3 weeks ago after having in home care for about a year. She is NOT liking it!! A year ago she was walking with a walker and fairly independent. Now she uses a wheelchair and needs assistance to get around. She cannot propel it herself. We got her an electric wheelchair so she would feel like she had more freedom but she is reluctant to use it. She won’t socialize, go to meals and has no interest in changing her attitude. She is in a nice place (apartment style) and the staff for the most part are good to her. They are usually pleasant when they come but often take longer than I think they should to answer her call button. (30 minutes plus…is that normal?) She is in constant pain with her many ailments. When she went into AL she was a 1 person (caregiver or myself) assist. Since being in AL she has gotten worse and now requires 2 people to go to bed, get out of bed or use the bathroom. Since she is a 2 person assist they require her to do PT and OT to get stronger. This makes her hurt more! If she doesn’t do therapy she can’t stay at this AL. (They are only licensed for 1 person assist.) I personally think a lot of her problems are due to depression. If she was happier I think she would go back to being a one person assist. My mom has no desire to live because she is in such pain. We have tried pain management to no avail. We are hoping to get another appointment with a different doctor hoping he/she will have more ideas/options. She doesn’t want to take depression medication since she took it a few years ago and it made her a zombie. She also doesn’t think she is depressed. On top of all of this she smokes and is able to smoke on her patio just outside her door however winter is coming and she will hate going outside!! Now that she is in AL I am only 15 minutes away. If she goes back home with 24 hour care she is 45 minutes away. She also lives in a remote area where as now she is in a city that has bus transportation to dr appointments, shopping or even going out to lunch. It is next to impossible to get her in and out if a car.
Bottom line…I want her to be happy and ideally pain free. The pain may not go away but she can be happy again. Do I bring her home with caregivers or “force” her to stay in AL or a nursing home? Caregivers at home are quite a bit of $$$$ and no guarantee she will be happy and most likely she will still be in pain. Bringing her to my house is out of the question due to her smoking!

It's only 3 weeks. Give it more time
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Reply to Dawn88
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You want Mom to be happy . But Mom has no desire to live because she’s in so much pain .

Your Mom may not be capable of being happy again , and that’s ok . She doesn’t have a lot to be happy about due to age , pain , immobility .

If Mom can’t afford homecare then that’s out of the question .

Unfortunately it sounds as if Mom may need SNF nursing home if she can not do PT OT .

See what the new pain doctor says . And does Mom know she needs to improve to stay in AL , rather than go to a nursing home where she would most likely share a small room ? Perhaps it would motivate her . Or perhaps she will say she’s in too much pain for PT .

Some more time will tell .
You don’t say what her medical conditions are or if she may qualify for hospice .
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Reply to waytomisery
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MiaMoor Oct 11, 2024
If she has to share a room, the company might do her good. However, she wouldn't be able to go smoke on her balcony - that would be the real kicker!
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If you can, try to impress on her trying to get better so she can go home.
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LoopyLoo Oct 2, 2024
If she refuses to take the meds and therapies to help her, what chance is there of her getting better?

A friend of mine had to put her mother in MC because they couldn’t afford $16k a month for sitters. People don’t realize how much this costs.
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You are not responsible for your mother's happiness.
You cannot control her happiness. You are correct. Bringing her home is no guarantee of happiness. She is elderly and things are not going to get better. In fact they will get worse and there will be more losses, more pain and more unhappiness. I am 82. I can assure you that aging is not about h-a-p-p-i-n-e-s-s. That isn't how aging is spelled. It is spelled in capitals: L-O-S-S.

You tell your mother you are very sad that she isn't happier. That you understand her losses, her grief, her mourning. That she should perhaps see a doctor to see if a mild anti-depressant might help a bit. You tell her that you mourn all this and it is hard to stand witness to her unhappiness, but that this is now the best, in fact the ONLY option. Let her know that running out of money in a home care situation would mean a nursing home, and that would be devastating.
Ultimately, and if she argues with you, you will tell her again that you are sorry, and that this is the best that can be done now.

That's it.
No happiness, no cheering, no banners, no parties. This is about TRYING to pull SOME contentment out for the time we must remain. And I stress the "must" because some of us long for an option. Your mother is burdening with the yoke that is too heavy because she believes you may have an answer. You DO NOT have the answer. THERE IS NO ANSWER.

I am so sorry. But your mom has had her life. Do not let her ruin yours. Do not throw your own life and contentment on her burning funeral pyre. She has no right to that. I say that as an 82 year old mom. Mom's generally come in two types. One will burden you with their own burden and one will lie and tell you "Yeah. Things are good!". You happen to have drawn the former. I am sorry for that because it causes children to feel things they should NOT have to carry.
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ElizabethAR37 Oct 6, 2024
Totally agree. I've essentially had my life. Chirpy bungee-jumping super-agers aside, at approaching 88 that's the/my truth--which doesn't mean that I'm entitled to be a total grouch and raise havoc for everyone else. I try to be the mom who tells our kids that "Yeah. Things are good." I intend be that for as long as I possibly can, hopefully right up until I make my Final Exit one way or another. I only hope that effective pain and anxiety relief will help that along! Chronic pain is miserable; I'll give it that.
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Do. Not. Take. Her. Home.
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Reply to LoopyLoo
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DO NOT TAKE HER HOME.
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Reply to Dawn88
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If you bring her home, you will be at her beck and call and you will wear yourself out physically and emotionally. I know it's hard, but she's better where she is. I envy you that you got her in there.
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Reply to Tiredniece23
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I think you have answered your own question. Somehow, you need to make the AL work. It doesn’t sound like letting her go home with care coming in would be a sustainable solution- you would be making more work for yourself and you will likely need to find AL or SNF care again.
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Reply to jemfleming
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Hi Lisa, I’m so sorry for what you’re dealing with. I have a similar situation. My parents have now been in assisted living for one year and absolutely hate it. But someone on this forum shared with me that often it is not necessarily that they want to go home, but they want to go back to who they used to be. They want the life they used to have back. Unfortunately, their minds and. their bodies are not capable of that. Hearing this just kind of helped me understand. Hope this helps a little. It’s a difficult situation I know!
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JuliaH Oct 6, 2024
Very insightful, you learned quickly!
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How about give your mom at least two months to adjust? It's a good idea to send a social worker to her for assistance.
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MiaMoor Oct 11, 2024
And then another 2 months, and so on.
Going home isn't really feasible.
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This isn't a matter of what can you do, you already made the decision and it's the best one. You can't expect someone who needs that much assistance to go home. It's a big guilt trip that you want to go away but only you can do that. Stop punishing yourself, you've done all you could do. Worrying about making her happy isn't as important as what you've already done...she's safe and cared for! You can't accommodate any living arrangements, any better, than what she has. Just think what would happen if she dropped a lit cigarette and was unable to pick it up? You think she's just going to be able to jump out of a wheelchair and get water to put out a fire? See? You're good!
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As far as winter and smoking outside, good gift ideas; nice space heater and a full length down coat. That should keep her toasty on the balcony.

Therapies can only help her and it is a proven fact that activity helps decrease pain. I would encourage you to take her out of her room for activities and learning that new wheelchair. You could make it fun and hopefully, she will start adjusting, it is still early days, don't be hasty in making any changes. Quite frankly, i don't think she would be happier at home, she might say she would but, happiness is in our hearts not our location.

Step back, breathe and give this some time to work out.
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Reply to Isthisrealyreal
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I think that nicotine which is one of THE most addictive substances may have a lot to do with all of this. She is not buying into the place and showing you this by remaining anti social and not trying to help herself. If she has dementia, she may be doing this all unconsciously, if not she may be doing it on purpose. If she has dementia, I would not ask if she wants antidepressants and there are many, many and you have to work with dr. To get the right one and get the right dosage. She may just be declining mentally and physically. It happens. You have not only her to consider but her finances and your own health. If you do not stay healthy you are not supporting her at your best. Some older people are never happy and don’t understand why their pains cannot just be fixed. Her smoking is the worst possible thing she can do for good health. If she goes home and has dementia there is a fire risk.
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Reply to RetiredBrain
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LisaMGM: A reversion may not be a great idea. Speak to the facilities' social worker and go forward, not backward.
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Reply to Llamalover47
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Do not take her back home. Sadly the AL is best for her now but I’m thinking she will need skilled nursing home soon. I was in this same dilemma with my aunt. She was in AL and refused to do anything, no PT, OT and she refused to socialize or even go to the dining hall. It became too much for the AL staff. She just wanted to lay in bed all day. A nurse there pulled me aside and told me a SNH would be better for her. (She wasn’t supposed to suggest that of course because the AL would lose that paying resident). I moved her two weeks ago and feel much relieved. Her level of care is well suited to her now.
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Reply to JColl7
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How old is she? Has she always been like this? Antisocial .. unwilling to see herself as any part of a problem?

What kind of pain is she in? The kind that countless doctors and tests and specialists haven’t been about to diagnose or treat?

So she gets cold when she smokes … (let’s not mention the link between smoking and chronic pain). Everybody knows smoking improves your health and happiness, right?). Maybe if she’s uncomfortable, she’ll do it less. If she has to figure out the bus or AL transport system to get herself cigarettes in the winter … she has 2 choices. Quit or learn.

We can’t expect our mothers to choose being happy if they’ve spent their lives choosing the opposite. My mother is who is in my minds eye as I type this. There are so many positives to AL if you choose to engage in them. I hope to afford AL myself eventually .. and will choose to participate in the community of AL. My mother chooses very differently and is miserable and complaining on a couch in her Al Apartment. But thinking back, that’s how she was in her home too. I shouldn’t have expected any different.

What is your mother pressing the call button for? If it’s not an emergency they should be running down the hall for - 30 is pretty good! Imagine that all the residents are pressing that call button for non emergency items all day and night long … and then there’s an occasional emergency in there .. and then think about how fast is reasonable for somebody to get to her place. I don’t know what’s reasonable, but I can imagine the variety of calls that come in; the ones that are like my Mom would be complaining nonstop while thinking they deserve the care the queen of England received.

I’d leave her where she is and adjust your expectations of her. If this is who she is - you’re only going to make yourself miserably hoping for a change. Put a little more time between your visits. When you visit can you get lunch with her at the cafeteria so she experiences it with you next to her?
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Reply to Lmkcbz
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Since my mom has been in AL (1 year), she has decided to use her wheelchair more and more, instead of the walker. This has caused her to get weaker. We have tried to do PT and she will send them away and tell them that she doesn't need them. The only time she actually uses the walker to go to the dining room, is when one of her daughters is there to make sure she uses it. I suspect she won't be happy until she's completely dependent on the wheelchair. My point here is that it's ultimately up to her to stay as active as possible. She knows once she gets to needing two people to transfer her, then she will no longer qualify to stay in the AL, but will need nursing home care. There is nothing I can do about that. If I were you, I would NOT bring her home. There is no guarantee that she would be better off there.
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Reply to darts1975
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It is no longer about what she wants but what she needs.
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Reply to lkdrymom
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Same thing with my mom. Your mom will adapt. She is better in AL than home. Your mom shouldn't go back home since her health has declined. If anything, maybe you may have to look for a different home that is more hands on. Keep your eyes on your mom. Sometimes health issues are overlooked. Don't feel guilty or have regrets. You are still your mother's caretaker.
My mom became miserable when she found out she was not going back home. She decided that she didn't want to cooperate with wheelchair transfers. My mom has Dementia and suffered with anxiety and depression. She is antisocial and does not participate in activities. I had to put my mom on anti-anxiety medication. It has calmed her down. My mom's health has declined because she refused to go to doctors while she was young. Now my mom is 85 and is in Hospice Care for severe heart issues. She is wheelchair bound as well. She has nothing to look forward to because she decided not to pursue any enjoyment. My mom has given up on her life because she became a widow during this process. I visit my mom everyday to keep an eye on her. My mom has me wrapped around her finger, but I have control over her care and my sanity.
It is frustrating with using the call button and waiting on Aides. Your mom may have UTIs occasionally. Staffing is not great in any of these facilities.
Just keep in touch with your mom and the administration. Follow your instincts.
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Reply to Onlychild2024
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Noooooooo don’t take her out of AL. If she would be compliant with PT, the activity and conditioning will make the pain less bothersome. Perhaps set some boundaries to help herself make the best of her situation.
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Reply to JeanLouise
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I hate to even say this because smoking is awful, but she needs a smoking buddy. I used to live in an area with no indoor smoking and the patios built by bars for the smokers were sometimes more fun than the inside! Smokers love smoking and it’s an instant thing to have in common with someone. It might help her warm up to the place.
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MiaMoor Oct 11, 2024
I agree.
My mum's illnesses were caused by smoking, but I know how hard it is for an older person to give up. If that, at least, gives her a way of making friends, it's turning a bad thing into a good.
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You can not make her happy, that is her decision - always. If she does not move enough, she loses muscle and eventually the ability to move.
Pain is best addressed by a doctor that specializes in pan management, not the "house doctor".
Depression should be evaluated and treated by a psychiatrist, preferably one that specializes in geriatrics.
Since finances are limited, you need to talk to her insurance company to find out what she is entitled to. Then you can talk with hubby about how much your family can/wants to supplement for her needs.
Ask doctor for nicotine patches and help your mom to stop smoking.
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MiaMoor Oct 11, 2024
I wouldn't advise anyone to supplement from their own money, unless they're wealthy. They have to think of their own family's needs, as well as their own old age.
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My Mom knew she was not safe to live alone in her home, even with some modifications made. She made the choice to go into Assisted Living, she toured communities, and chose the one she wanted. She had no cognitive issues. Just unsteady and would trip and fall often. Since she was such an active participant in this decision, we never expected that on the first week she moved in that she would cry as much as she did and say she wanted to go home. Change is extremely difficult for older folks. They have a routine and moving is very scary. Their entire routine is upended. My Mom took a few months to settle into her new routine, and made a few new friends. She also had a couple of friends from home come and visit weekly, which was very helpful. I agree that a smoking buddy for your Mom might help her adjust now. Does she have a hobby she loves? If so, see if the activities director can get a group going for her hobby. Also, if any of her friends from home can get rides to visit her, she might not feel that she lost all her social connections when she entered Assisted Living. Please do not move her back home now. There was a reason she needed to make this move. Three weeks is not enough time for an emotional adjustment.
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Reply to JanPeck123
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To be blunt, Lisa, I think that your expectations are too high.

Your mum may never be happy again, and there's nothing you can do about that.
You didn't put your mum in a position where she lacks mobility and is in chronic pain. Unfortunately, you cannot fix that.

Taking your mum back home would put your mum in a position where she is alone, save for the carers, and has no opportunities to do anything else because she would be trapped in her home. In AL (or a care home where they are insured for 2 carers assisting with transfers, if that becomes necessary) there are opportunities for your mum to make friends and find ways to deal with the pain.

Boredom and unhappiness make pain worse. I know from experience that being content and having distractions make pain more bearable. When someone forgets pain because they are doing something, it isn't that the pain is imagined, it's because the brain is fabulous at helping us ignore pain when it's being occupied with something else.

Unfortunately, waiting 30 minutes for carers to respond is normal. It shouldn't be, but that's how it is now. When my mum managed a sheltered housing court, she was out within a few minutes of someone pulling a cord, even in the middle of the night (coat on over her pyjamas). But, places are managed very differently now.

I hope that your mum settles where she is - it really is early days - and that she can start doing more for herself and only need one person to assist with transfers. Otherwise, she will have to get used to another place that can accommodate your mum's needs.

Take the pressure off yourself by not striving for perfection, but settling for good enough. The first is impossible and the second will be making the best of a bad situation. There really isn't much more you can do.
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Reply to MiaMoor
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I would maybe hire someone privately in her home .. you can go onto a site called Nextdoor or put out an ad for help needed and interview some people and do a background check though and you can pay a lot less than going through an agency . I am a private caregiver if you’re lucky to get someone like me the care will be even better for her . I do errands and clean the house while caring for my patients . I would also set up cameras in her home so you can monitor the caregiver make sure they are doing their job appropriately .
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