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She is 88 years old and lives alone. My sister and I have been taking care of her basic needs but things are becoming labor intensive. I found an Assisted Living facility near me only 15 minutes away but she refuses to go.

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If she has money to pay assisted living, would that same amount hire some help to keep her in her own home a while longer AND help you/sis out? If so, go for it. She may be ready to go later, but appears not willing today.
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As everyone says, she won't agree. Taking care of her is labor intensive and will become more so. Does she say she can do everything herself? If so, let her. Make a list of daily and weekly chores that must be done. Go over it with her and ask what she can do herself. If she insists she can, then "see you next week" and review how it went. Go over the list and see what she was actually able to do. At some point she may say she needs help. If she doesn't see it even though it is becoming obvious (unwashed dishes, laundry, food not put away, etc.) you are dealing with more than stubbornness and it is time to take control. That is your decision to make.
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You do not ask or require her agreement.
You tell her there is no other option.
She goes.

You can do this as compassionately as you can.
The key is to be clear at the onset - and strong in yourself.

As long as you and your sister continue to do what she needs, she will not agree to any changes, esp moving into an unfamiliar area. Even if you stop helping her, she still may refuse to go.

It too depends on her level of dementia / assessment of it / medical documentation, and what legal authority you have in order.

It is certainly 100% guaranteed that if you ask any elder 88 years old if they want to move out of their home, they will say no. Did you expect that she'd say yes ? Leave what she knows, her roots (I presume). No older person wants this kind of change. It is hard, emotinally and all other ways.

Be compassionate in your decision making.
Be clear on what you and your sister decide.
Do not argue (provide reflective listening i.e. "I hear you saying ..." "I understand how you feel."

She may likely not listen to 'reasons' or what is reasonable and necessary.
She is scared and wants to stay where she is. Expect her to react and be upset.
Then do what you need to do.
She may / will be angry with you and your sister for a while, while adjusting (it could take months), although she will come around 'if she wants to' - and once she is in there.

The alternative is 24/7 care and that is very expensive.
Yet, this may be the answer if she can afford it.

And, then the final decision is up to her if you / your sister do not have legal documents to make decisions (and you need medical documentation of her ability to care for herself / dementia / brain changes). While sad to know, often changes cannot / are not made until something serious happens, ie she falls and ends up in the hospital, then rehab, then it is straight to a facility. Try to do what you can before the option isn't an option and you are 'rushed' to find a place for her.

Gena / Touch Matters
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Hothouseflower Oct 2023
Thank you. This was very helpful. I will be having this conversation on Wednesday with mine.
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Before you insist she move consider ways to relieve yourselves of excess burden. Are there technologies (e.g. Amazon Echo or Show devices; personal alarm/alert system) and services (e.g. food delivery; ride services; local senior centers with transportation; companion or home health aide) you could set and use for your other?

Moving at the age of 88 is often traumatic.

Keep in mind, a move to an assisted living facility is more than a change of scenery. It is a change in a way of life. Meals are scheduled and have limited menus. Exposure to "germs" is greatly increased. Help is limited, and depending on where she lives, staff may not speak English clearly. You and she lose the ability to manage her care providers. The ownership and or management can change overnight. Care levels, providers, and services can change overnight. The monthly fee can increase significantly.

It is my opinion that most people are better off and more content staying in their homes and/or familiar surroundings if at all possible. I have seen and spent extensive time in numerous facilities (just the term makes me cringe :-\ ) and I have spoken with many residents.
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waytomisery Oct 2023
It’s quite possible that this woman with dementia is needing more than the big brother routine from cameras . If she can’t be left alone anymore and can’t afford 24 hour staff in her home then a facility is needed . Living alone at home unsafe at 88 “ is often traumatic “.
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My brother and I hooked up with a senior advisor who knows the facilities and helped us choose 4 ALF to view. Somehow my brother got my mom to come and see the 2 we had chosen. The first didn't seem as good and was a horrible drive but the sales staff was genius. She engaged my mom and by the end got mom to agree to a weeklong visit. The 2nd place, the staff was not so savvy, I pulled her aside to tell her to schmooze mom. Then we went out front and mom met the patio ladies who all oozed praise for the place. Mom wanted to hang out with them. So we signed her up for a short term respite stay that she never came home from.
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cmilly123: As your mother unfortunately suffers from Alzheimer's, her malfunctioning brain has lost the capacity for logical thought processes.
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Mentally, there are all kinds of fears associated with Assisted Living. Some are valid and some are not. If you had the opportunity to stay in a dorm room while you were young, going to Assisted Living is not much different than that, except that you are older, a little more set in your ways, and much more fearful of the future and what others could do to you.

You need to market the move to AL to her. First, visit the AL that is only 15 minutes away. If you think your Mom would like it, sk them how to pitch the move to your Mom. If you think your Mom would not like it, then start looking at another AL. Also do your research. What do other people say about the AL? Have they been in the news?

One of the ALs that looked good to me, was pitched as a senior spa. They had choice of entrees every day plus a backup menu for people who didn't like the choices. All meals were served on a white tablecloth with ceramic dishes and nice looking silverware. Once a week, there was a van ride to various places. Each day, they had their choice of activity. My Mom didn't watch TV, however, if one did, the cable service provided included premium channels. They had a 24 hour "bar" that served coffee, tea and hot chocolate and cookies. Nail salon, hair salon, PT had services on-site (for extra fee). She was swayed by the fact that she would like in a "fancy" place.

Basically, you need to make the AL look better to her than staying at your place.
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waytomisery Oct 2023
I’m jealous. I couldn’t even get Mom to look . She was paranoid we were tricking her and would dump her and run.

The dorm room made me chuckle. My son described it as college life for seniors too .
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You are two more daughters among many other daughters and daughter in laws stuck in servitude . If your mother has dementia she may never agree to leave her home . Mine didn’t . Maybe a social worker can talk her into it , maybe not.

Call your County Agency for Aging . That’s how I got my mother out of her house. They said to stop helping my mother so much . They sent a social worker out to the house , the social worker interviewed my mother and determined she was not safe to be alone. The social worker gave my mother various scenarios and asked my mother what she would do. My mother either could not come up with a plan or finally said she would figure it out .
The social worker said mother needed 24/7 supervision . At least in my mothers case they had the power to remove her from her home . Maybe other states are different . I had an AL picked out already . Do not move in with your mother or let her move in with you .

The social worker was scheduled to return to my mothers house in 2 weeks with a strong person to remove mom . However , one of my stupid sisters told my aunt . My aunt called my mother and told her that her children were dumping her in a nursing home . My mother went off the deep end saying she had chest pain . EMS took her to the ER . She was admitted for observation . I asked to speak with the social worker there . I told her the situation . She called and spoke with the social worker who had come to the house . My mother left the hospital a few days later and went directly to the AL , luckily her room was available early .
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Beatty Oct 2023
From way-to-misery to way to commonsense 👏👏

Tough Love is still Love ❤️
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I had to contact APS when my sibling with DPOA wouldn’t do anything to keep my mom with dementia safe in her home.

She had fallen multiple times & could not get up & he only went there every week or so to check on her.

APS found she was not safe living alone & either had to go in a nursing home or have a 24/7 caregiver
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You take her, admit her, see she is sort of settled in, let the aids get her settled, you walk out. The memory care I put my husband in told me to stay away for 3 weeks. Then come to visit. I did this. Not a problem, He asked me where I was, but didn't know we had been separated. You can't let a demented person call the shots, they don't know any better. Don't tell her you are putting her in a home. Period. Just do it, "she's getting a check up" you leave and let the home take care of her settling in. Period. I did this with my husband, Believe me, demented persons don't know what is happening. Just get it done, leave, let the facility finish settling in, Amen. Don't baby the patient. Don't feel sorry for them. They lived their life, but can't finish it by themselves. Let the NH handle it. Stay away for a few weeks. Best wishes.
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Explain to her that you can’t keep up with it anymore and even though she doesn’t need to go it would be really helpful for you. If she scoffs at that then follow through and start doing less. Maybe she will be fine in which case good for you. If she starts to have issues you have ammunition for your case. You can’t make her go unless she proves to be a danger to herself or others.

Another angle would be to play up the amenities like opportunities to socialize. My aunt moved into a senior community and she has made so many friends. She says she should have done it much sooner. She is dealing with a cancer diagnosis now and it is nice to not have to struggle with that alone.
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Look into homecare for her, don't force her into a home if she's not ready. It's best to live in your own home with help for as long as you can. Life expectancy drops when you enter a care home.
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Hothouseflower Oct 2023
In my case is being 95 years old old enough not to have worry about life expectancy anymore? What about everyone else's life expectancy who is navigating one crisis after another to keep a loved one at home? The stress of it is beyond the pale. It just gets to a point when there is nothing left to give anymore.
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Why not look for additional in home care instead?

STOP trying to force her into a one of these facilities. If you truly care about your mother you will NOT put her in there. The neglect and abuse in many of these places is horrible. You are asking her to give up all she owns and move into a place that will bleed her dry of everything she has remaining. Then throw her out in the end. Don't do it!
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Southernwaver Oct 2023
How much is 24/7 home care? What do you do when people don’t show up? Is this care covered by Medicaid? Thanks.
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"She's been there three months and has now settled in nicely."

Mission accomplished, now, what about you?
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In my case, I visited several on my own when she broke her back and started showing memory issues. Once I narrowed it down to two, we would go to open house events and just have lunch a couple of times. I still couldn't get her to go, even though there was one that she liked best. It took her breaking her hip and physically seeing that she couldn't be by herself before I got her in one. Even then it was a struggle, she just couldn't accept that it wasn't just the physical limitations but her memory issues as well. She's been there three months and has now settled in nicely. It's an active community and I think that makes a difference.
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If mom has a documented diagnosis of dementia then she may be unable to make the decision to remain in her home.
If it is not safe the person that is POA makes that decision as to her living arrangements.
If no one is POA then someone may have to petition for Guardianship.
Mom probably figures she is doing well and does not have to move.
Stop doing for her what you are doing. Your sister should also stop. this may get her to realize that she does need help.
Unfortunately in some cases it takes a catastrophic event for things to be put into motion to make a change like this.
If mom falls, or is otherwise taken to the hospital you and or your sister need to make it VERY clear that mom is not safe at home and she can not be discharged back to her home, you also need to make it clear that neither of you can safely care for her at this point.
With the diagnosis of dementia if the AL is not a locked facility then Memory Care would be a better and safer option.

Oh, to answer the base question ... you will never get her to agree to move into AL. The person with POA is the one that makes that decision.
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Sarah3 Oct 2023
Her mother doesn’t have dementia, there’s no mention of it in her post. I understand a number of folks here have parents or spouses w dementia but it doesn’t automatically apply to all seniors. There was also no mention of falls or other issues other than the op and her sister needing to have more free time of their own so they don’t have to check in or help her w basics. A caregiver for a window of time x times a week would allow the mother to remain at home at this point
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Be sure your paperwork is in order. If you haven't consulted with an Elder Care attorney, the time is now. This will free up your time and mind to visit facilities and find one you deem appropriate. Plus, when the time comes for a facility, your ducks will be lined up.

You can't force your mom to go to a facility. Oftentimes something happens....a fall, a stroke, etc., and that makes the transition easier from hospital to either rehab or a facility.

At this juncture, there isn't much you can do except put cameras in your mom's house that she doesn't know about so you can check on her, call her frequently and check in on her.
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In your profile, you wrote that your mom has Alzheimer’s disease, along with several other serious health problems. The Alz means that she very likely cannot make informed decisions for herself anymore. The part of her brain that is responsible for logic and reason is broken and is unavailable to her.

”Letting her fail until she figures it out” simply will not work for a person with Alzheimer’s disease. She will NEVER figure it out, because she CAN’T.

You said you and your sister are her POAs. Is the financial POA in effect already, or do you have to get doctors to write that your mom is no longer competent to make her own decisions?

if you need the doctor sign-offs, then get going on those. Have Mom evaluated by a neurologist or geriatric psychiatrist, and ask for referral to a neuropsychologist to have her cognitive function thoroughly tested.

if the financial POA is already active, then now is the time to use it. If you and your sister are unable to arrange to move mom to Assisted Living (by taking her there for a “temporary” stay that then becomes permanent, for example), then you may need to petition for guardianship so that you can make all decisions for your mom from now on.

My sister and I had to move my mom’s things into her new AL apartment while she visited a friend for a few days. Then, when I went to pick Mom up, I drove her to her new place, where Sis and other family and friends were there to welcome her to her new home.

it was the hardest thing I have ever done.

My mom is still angry at me about it, two years later, but she goes on and on with everyone else, telling them how much she loves living there with the friends she has made.

i wish my mom could have made the decision to go into AL for herself, and I wish she wasn’t angry at me, but she is safe and has friends, gets her meds and her meals on time, and I can breathe again.

I wish you great courage and creativity. This is HARD.
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Pyrite Oct 2023
It may be HARD but your solution seems the most intelligent.

Move completed and subject installed. Bravo!
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You and your sister help with her basic needs, as she lives in her home. There was no mention of falls, dementia etc or any safety issue so from what you write she’s safe to remain in her home at this point w the basics of assistance. It sounds like it’s something you and your sister need to free up more of your personal time which is understandable.Having a caregiver seems like from what you describe would be quite appropriate, for example 2-3 x a week (adjust up or down as preferred) for a block of time to assist with taking her to appointment, going on a walk or outing w her, getting groceries maybe some light meal prep etc whatever her basic needs are so- then the both of you will have more of your time freed up and could enjoy occasional or semi regular visits with your mom as your able to
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lealonnie1 Oct 2023
AL is some horrible house of horrors or something? My parents lived in luxury in AL and had great care at the same time. Passing judgement on the OP is an ugly thing, don't you think? From her profile:

I am caring for my mother Minerva, who is 88 years old, living at home with age-related decline, alzheimer's / dementia, anxiety, arthritis, diabetes, hearing loss, heart disease, incontinence, mobility problems, and osteoporosis.
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Been there, done that. After a fall, sepsis, severe malnutrition, and a hospitalization, we got Mom (with “mild” dementia - could no longer understand bills, etc.) into an ALF. She HATED it, and everyone in it. Called it a prison, refused to participate in anything, wouldn’t eat the food, said all the staff were stupid, fat, incompetent, ugly, you name it. Had snide nicknames for everyone. We kids all live thousands of miles away (she was the one who moved). After a year of fielding her rants and complaints and insistence that she was “perfectly FINE,” we gave up and moved her back into her house, with home assistance two or three days a week. And guess what: she calls to complain every week about the caregivers, that she doesn’t want or need them, but if they have to reschedule, she complains about that. All suggestions or attempts to help are refused or criticized. Her dementia is worsening and her attitude is vile. We are simply in waiting mode for another crisis, at which point we will let adult protective services take over. Some things you just can’t fix. Our ALF experience was an epic fail: she was safe and supervised, got regular medical attention, etc., but she made everyone around her miserable (which, TBH, is how she likes things), and fielding the endless calls and e-mails from her and the ALF staff was exhausting. All to say: ALF may not end up being a solution. So there needs to be a Plan B…and C… and D…
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WastedEffort Oct 2023
I'm a private caregiver for a lady that is in an ALF. She complains non- stop. She, too, has mean nicknames for the staff, hates the food, her VERY nice apartment like lodging. She's miserable and makes everyone around her miserable.

I'm the 3rd party that doesn't care what she says. I'm making sure she gets her showers and other personal care. She goes to activities, but bores easily.

Some people are never contented and that's just that. She'll never change.

Live your life.... don't give it to your mom.
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I recently placed Mom in AL. She also suffers from dementia- this will not improve; it will progress and become more dangerous for her to be on her own.
You can't reason with someone who suffers from it. Their long term memory (of their younger years when they were capable) flood their minds; not the short term memory where they forget and can't accomplish daily living tasks without assistance. No one wants to admit to this and your Mom will fight you all the way. Just know that this decision will keep her safe and will keep you sane.

Dementia is a cruel progressive disease and it will never get better.
Her living alone is a bad circumstance waiting to happen. Think stove/fires, falling etc.

I was a full time 24/7 caregiver for 7 years ; was worn out and my health was/is suffering. DO NOT let yourself get to that point. Visit as many AL facilities in your area that you can and choose one that works financially and is clean and well run.

Meet with and hire a reputable elder care attorney and have them help with applications for the Medicaid waiver if finances are an issue. Are you POA/Health Care POA? If not and you plan to assist, you will need this to make all future decisions- banking, healthcare, AL facility etc. Make sure to get the legal documents in order NOW as once she doesn't have cognitive abilities you may not be able to get them.

As others have stated, most AL facilities have tons of activities and offsite excursions with shopping. There will be an adjustment, but eventually all will even out. Change is hard at any time in life. It will be hard for her and for you, but it the best decision- I wish I made this move years ago. Don't let guilt or grief get in the way! I did that- it cost me my health, career and all relationships.

One person (you) can not do all of the work all of the time. It is not sustainable long term and your life and health will suffer.

I wish you the best in the coming months and hope that you find a great AL facility.
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Daisycat Oct 2023
Daisycat here Peekie1928 thank you for posting this. Had to put my mom in nursing home 4months ago. I have done it all for her forever and she is ninty one with dementia.It helps when I read post like this.I am trying to get straightened out now from taking care of my mom.It takes a toll mentally and physically.So when I start to feel a little guilty I come to the website and get good information and advice like your post thank you
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Sorry! It posted twice.
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Are you really considering what's best for your mother or what is best for you so you don't have to do as much for her? If she is really incapable of being safe at home alone, you help arrange for more outside help. If yu and your sister have reached your limits of time and enrgy to take care of her needs, her choice may be between Assisted Living and Home Care.
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Your profile says Mom suffers from a Dementia. She can no longer make informed decisions. Its now what she needs not what she wants. I so hope you have POA and its immediate. You now make decisions for her. If the POA is Springing, then you will need to have a doctor or more say Mom is incompetent.
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I had a talk with my aunt who is still in rehab after knee surgery. She's in a rush to go home and sit in her house by herself. She basically laid down the law with me and told me that SHE will decide IF she needs a caregiver. and IF she needs a caregiver there, they will ONLY come two days a week for light housekeeping only. I basically knew she was out of her mind and being delusional. I told her well, you know I cannot move down to where you are to take care of you, and I cannot visit with you and stay with you for a week or more to care for you, as I work, and live far. She just pretty much whatever at me, and told me I was out of her will and for other reasons than that. I haven't spoken to her since.
I agree with the others to pull back. If they want to be that delusional to think they're independent, and can do for themselves, and make decisions for themselves, let them. I'm not going to let her or anyone else run my life.
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An honest conversation with mom is in order. Tell her the reason she can live on her own is because you and your sister do so much for her but it is getting to be too much for you two. She will take offence at this then say she will be fine on her own if you find her to be too much work. It is ok that she gets mad. You may even have to let her fail for a bit. Just enough to get your point across.
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Has she ever seen an assisted living place? Does she know there are birthday parties, outings, entertainments, transportation? Find an inviting one, check it out, and have them give her the grand tour. Maybe lunch. I do not know why any elder would prefer to sit home and vegetate while declining when they could have some fun in their last years.
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anonymous1732518 Oct 2023
..and gossip.
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So you are speaking with your Mother. I wonder if you are speaking HONESTLY in that I wonder if you are telling her that YOU and SISTER cannot go on in this manner. Often people approach it as "What's best for YOU, Mom. That isn't really honest, because Mom thinks she knows what's best for her and thinks she has it all wrapped up with you and Sis helping; she is hoping to beat this thing by "going" before she has to go into care. My partner is 83; I am 81. I can identify with her EXCEPT that I have no daughter living near me and I thank heaven for that--and my partner's girls are both in no condition physically to be of help (that is to say more off their feet than WE are). So we KNOW we must make "plans". And we do not WANT our kids responsible for our lives (or deathes) when they are in their last quality years, kids raised, able to enjoy some freedom from work, etc.

You will need to be honest. You will need to tell Mom that you cannot go on. That she needs to be safe so you can ALL relax. My brother in ALF said "You know; this is like when I was young and in the Army; I didn't much like it but I make the best of it". You are going to have to tell Mom she is going to have to make the best of it.

By this I mean you are going to have to tell Mom that this is the year you all three get this move done. And if she refuses to consider this you will withdraw your care. That she is on her own. You will provide her the number of a good Elder Law Attorney, a good Fiduciary to handle bills and accounts, and you will provide her some numbers to call such as "Visiting Angels" etc for shopping, cleaning, cooking, appointment.

I understand how tough and anxiety provoking this time is. Approach it with hard honesty. Consider seeing a Licensed Social Worker with Sis who does private practice to work on a path forward. Be honest with your Mother. Tell her that you CANNOT and you WILL NOT go on with this.

Good luck. Please update us. Your journey will help others.
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Then you and your sister stop being her crutch. You are giving her a false sense of being independent. Pull away, she will get the message.

If she doesn't tell her that you can no longer meet her demands and she can hire a caretaker to come in and take care of her.

Set your boundaries and stick to them.

Good Luck!
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AlvaDeer Sep 2023
Yes, I fear they have to stop enabling what won't work long term.
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