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My mother went into assisted living a year ago and since then has steadily declined. She wasn’t in good health before that, in a wheelchair, stage 4 metastatic NSCLC, pancreatitis, diabetic, and obese. She now goes between acute diarrhea, vomiting, and she’s incontinent. She sounds like she still has her facilities and is now talking about leaving the facility due to the cost, and getting an apartment with a caregiver as needed. I feel this is the worst thing she could do at this point. She’s in denial of her declining health. Not sure what to do.

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Is your mother capable of moving out of the AL herself, finding an apartment, hiring movers, setting up the new place, finding caregivers, paying the bills, ordering supplies, food, arranging treatments, etc etc etc? If not, this is just talk, plain and simple. Because you will make it clear you'll do nothing to help her undertake such an endeavour as she's too ill and too weak to make such a move, not to mention too financially unstable to pay caregivers for 24/7 care AND to coordinate it and find replacements when they don't show.

Your mother is likely suffering from cognitive decline now in addition to her other dire health issues, which is clouding her judgment and causing delusional thinking.

I'm sorry for the situation you're both dealing with. Have you spoken to her doctor about hospice coming in?

Best of luck to you.
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Do you have any legal power to direct her care in her best interests?

Are you her DPoA or guardian?

If not, and your Mom doesn't have a medical diagnosis of cognitive and memory impairment, then you will need to stand by and watch the train wreck. Just don't help the train wreck. At all. Do not lift a finger.

Don't provide any help with her moving out. None. 0. If you do and she moves out and then you become entangled in the train wreckage, that will be on you. It will feel very hard at first, but then when she stays where she's at it will get better. Just don't listen to her complaining.
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I think that you may be wrong about your mom having all her faculties and about her being able to make this decision.

I would discuss this with her facility's administration, and ask for their advice if you intend to interfer in any of this at all in any way.

It is time for an MD to LEVEL with your mother about her diagnosis and prognosis. Her stage four non-small cell lung cancer is a terminal diagnosis in and of itself, let alone the underlying dire chronic conditions, and she should be now in hospice care if she understands her condition and wishes to avail herself of a peaceful ending.
This is not a time to leave care, but rather to add care on!

Your mother will not be able to afford the 24/7 care that she will require soon at home, even WITH hospice on board. My friend died in hospice at home almost exactly a year ago. Paying two caregivers (hard to find) 20.00 an hour for 12 hour shifts? You do the math: comes close to 500.00 a day with meals. Minimally.

I think the one thing you can now do is sit with administration, or MD, or Social Worker, and level with Mom about her condition and about the foolhardiness of thinking she can return home.

MOST IMPORTANTLY!!
You must make it clear that you will not participate in planning, in hiring, in care of any kind if this is her choice, as enabling such a wrong-headed poor decision-making process would be negligence on anyone's part. I understand how tough this is. I don't see that there is any choice in the matter.

I am so sorry. My heart goes out to you and to your Mom for this dire diagnosis, and for all the suffering she is going through. And for your own grief standing witness. Try to protect yourself from letting the appropriate G-word, GRIEF, become guilt. Because you didn't cause this and can't fix it.
I am so very sorry and wish you luck. I am hoping you will update us.
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I am surprised the AL has said Mom is beyond their care. Sounds to me Mom may end up needing Long-term care. She will spend down her assets and then apply for Medicaid.
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waytomisery Nov 2023
I agree. I was even thinking hospice .
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