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Mom is in her 90's, living in independent living. She has progressive dementia and is becoming more and more confused, easily upset, paranoid not to mention more frail. We now have other serious medical issues with a family member and cannot continue to do everything for her. She is negative, difficult, stubborn, and has a 2 minute memory for most things. Deep down she knows she needs help, but keeps saying if we move her she will kill herself. For her own sake because she needs more than a couple visits a week now, she cannot be isolated as much as she is. But how do we deal with this? If we tell her, she will freak out, cry, carry on, have an anxiety attack, call us 15 times etc. Should one of us just have her overnight while the other moves her and just take her right there? We just don't know how to do this! Whatever we do, she will go to pieces. We are going to ask the doctor for a tranquilizer, but will that be enough. How do we tell her in the least traumatic way?

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If you tell her and then leave her living independently for a few days, you're asking for trouble, in my opinion. Yes, take her for a few nights' overnight and move all of her things . . . setting up her room "oh-so-pretty" for her with lots of personal memorabilia. Then "take her to lunch" at the new place, give her a comprehensive tour showing all the benefits -- really talk them up -- have staff ready to make a fuss over her -- introduce her (and yourselves) to some of the people, and tell her it's a trial run for a few weeks. Since you say she's very forgetful, in the moment, the trial run may alleviate her fears.

Be sure to alert staff that there's liable to be a scene. In fact? I'd probably ask them what they suggest. It's your first rodeo, but it's not theirs.

Good luck!
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Ditto to Maggie. But let me give you a word to the wise. I worked at an assisted for 10 years. If someone made a comment about killing one's self, they receive an immediate discharge. A family member would have to stay 24/7 with the resident until other arrangements could be made. A little dementia, a little forgetfulness, some memory lose would fly, but one comment of killing one's self, that's more than they are equipped to handle.
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Mom would never kill herself. she is a weak little girl acting in an adult body, always has been, and always manipulative and terrified to die, worrying about every little health issue, worrying about how she looks - God forbid she miss a hairdresser appointment, or not put on makeup! This is just a threat to control us and get her way. But thanks for the warning, because I would definitely have to tell the facility this so they would not expect her to be clever or brave enough to do anything. I know the doctor will put her on something for anxiety because she needs it bad, but since we can't trust her to take medications, she has been going without.
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Assisted would do med management. But they can't and won't force her to take her meds. She would be considered non compliant. Also, they don't care if she would never kill herself. They won't want to take on the liability
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Agreed, you can't force her to move and you can't force an ALF to keep her. Most ALF's do an evaluation of the patient prior to admission, so how will you accomplish that? So you wait for her to agree or end up in the hospital in a situation where the IL will not take her back. ALF's do not take screamers, wanderers, non-compliants or pants poopers. Those go to nursing homes.
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What you all are saying is very discouraging. Mom cannot/should not live alone much longer. She is deaf, doesn't hear the phone, doesn't understand what we say half the time (or remember), doesn't bathe, doesn't eat, is dehydrated, paranoid and confused. But she puts on a good act in front of people. She gets up, makes her bed, makes coffee, puts on her makeup, dresses herself, goes to dinner (but doesn't eat it). Do all of you mean that this is enough for a doctor to let her live on her own even though she just sits and stares all day long - when she isn't calling us 10 times a day about the same thing over and over? She isn't nursing home material yet.
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Hi. "She is deaf, doesn't hear the phone, doesn't understand what we say half the time (or remember), doesn't bathe, doesn't eat, is dehydrated, paranoid and confused."

You are describing my mother when she lived alone. We never thought that she would go to a NH. Long story short, she loves it. She is clean and healthy.

She fell and was in the hospital, so we told the doctor that she could no longer live alone. She tried AL, but she had bowel control problems. She prefers the NH. By the way, my mother is very cognitive, but has the same hearing problems that you describe. We have to scream to be heard.

So, it is my experience that your mother is nursing home material. I know my mom is safe and I have been very happy with their preparedness during storms, etc. Good luck. Your mom may go willingly, if preparations are made. I don't think that she is going to re-call, even if you tell her to expect a move.
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My mother is 91 years old and although deaf from one ear and limited hearing in the other. Her memory is ok at best. She walks with a walker, goes to the bathroom on her own, wears a pamper at night. She has a HHA that comes in and bathes her and prepares her meals, but in the evening she frequently forgets to take her medication. She is one those that says that if I put her in a "home" she will die of loneliness. She lives alone now, with here cat, except for a few of my visits per week. She has on occasion left the water running in the kitchen and a gas burner on the stove. This is my greatest fear. I have been looking at all the information regarding ALF's but have been told that the cost would be over $3,000 per month. For the service she needs, this is rediculous. I think they are talking more of these expensive highrise complexes, but living in Miami, I know that there are private homes that house a few residents and tend to be much cheaper. Since she is in a very low income category will the government not help? Any comments and/or ideas will be appreciated.
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When you say 'we are moving her to AL…' it sounded as if it was a done deal; and I was wondering, doing this against her will is one thing, but how did you arrange it without her knowledge?

But, so, it's not actually arranged, is that right? Are you still at the planning stage?

If so, have you considered seeking her MD's advice on what kind and level of care s/he would recommend for your mother?

The other thing I would be inclined to do, if your mother tends to turn in a command performance for her family members, is delegate as much as possible of the transfer arrangements to cool professionals who know what they're doing and won't get involved in (or inadvertently stir up) dramas.

So: seek advice, hand over to professionals; after that enjoy your visits. Best of luck, and best wishes for your other family member's recovery.
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Abuela - No one wants to leave their home, but if you judge the risks are too high, you might find that her income and a little more from you would cover a decent assisted living. She may be assuming you won't visit or something, it certainly does not sound like she would be lonelier there than she is now!! Did she by any chance ever get a long-term care insurance policy? Those will typically help some, but beware some of them are pretty scammy and manage to avoid paying by making paperwork confusing and difficult.

Nursing homes are more expensive than that but if she is closer to indigent and could qualify for Medicaid, that will cover them, but assisted living is usually private pay. If she currently owns her home, it is an exempt asset if she tells them she intends to return; there would be an option to sell and use funds to pay for care instead. Have you been to any eldercare attorney or estate planner about her situation ever?
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Chicago1954. How did you convince your mother to go to a NH? Mom simply refuses to accept she needs help. We are going to have to force her to go, which we don't want to do. We are hoping we can either convince the doctor to not approve her to continue in IL, or to convince the IL management she is in danger living there and maybe they can agree to say she has to move. She would be more accepting of it if she knows someone besides us says she has to go. We hate to lie to her, but an alternative is to take her home for a day or so, move her and then tell her the IL and doctor said she has to be in AL. Otherwise she will hate us and make us miserable for the next five years, just like she did when we made her move from her home to IL. And yeah, with her good health, she could live another five years - only thing is - being deaf with progressive dementia- her quality of life and enjoyment of life has been a lifetime negative for her, negative for us for the last 10 years.
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It sounds to me like she needs a memory care home which is outfitted with locked doors and alarms to keep the residents from wandering. This may not be her problem now, but it will be. We have been delighted with the MC that mthr is in, and they have done a great job keeping her busy with music, games, and other social activities. They were the ones to recognize that she was at the stage of dementia when hospice is appropriate, and hospice visits her there in her "home." The unknown is always scary, but if you leave mom there for a couple of weeks to settle into the routine, she will love it! It's like living in a dorm, and that is where mthr thinks she is!
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