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She already was at a nursing home. She won't go to assisted living. She has one leg. She only wants to go home. What do I do? I am at mt wits end!

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Even though this is an old thread, I just read it because my 90 yr old mother fell at 3 am and broke her hip trying to go to the bathroom (she was, of course 1/2 asleep, and she doesn't listen to safety instructions, like using her walker... properly... especially from me... her 'daughter'... I am the last person she wants to listen to, but this is what gets her in trouble). When she got out of a 3 week rehab. facility, they said she had 60% cognitive lisistening abilitiy... Her mind is way ahead of whoever is trying to talk with her... including the therapists). My mother lives with me (13 years now)... and, my heart always breaks for her as I watch her make terrible, decisions... I try to come to terms (like you) that we can't be 'them', so what are the consequences?... (they are just like some of you caregiver's have said on this thread)... Many times I just feel paralyzed like this morning when she fought me to help her take a shower... (I see her floundering all over and not thinking of what she should be doing for her safety...).  Then, I sometimes see her crying in her room and it makes me feel badly... no wonder caregiver's get sick, especially when you can't win).  I only wish I could be so Blessed to have someone be my advocate when/if that day comes.
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Carol is right. My own experience was we moved mom at her insistence into a nearby ALF. She got homesick and flew home on her own. About 18 months later, after a broken wrist, broken hip and uncounted number of falls, food poisoning events and God knows what else, she caught Cdiff in a nursing home, went home on her own from there, fired 3 sets of home care teams and was 9/10ths dead by the time I flew in and found her. Four months in a nursing home. We tried relocating her to be close to us in an ALF (again). This time she decided to stay, but every evening she tries to escape. Exit seeking they call it. You just can't win, or get your way, or ensure their safety, or get anything accomplished except making yourself miserable. Sometimes you just need to let them do as they wish until they die. Depends on their level of mental competence. I'm sorry to be so negative, so down on the process, but there it is. Many elders don't kick up such a fuss, but the few that do make up for the rest of them ten-fold.
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How far away from you does she live?

My mom planned on going home too. She lost her independence due to a bad fall or so we thought - but it was really the cognitive problems (lack of safety awareness, failure to read and follow instruction on her meds) that led to the bad fall that kept her from ever being independent again. She thought if she could walk she should go home. She even agreed to a LifeLine and would plan on not climibing the stairs anymore. But, she had advanced vascular dementia and could not toilet herself, fix meals, transfer to bed or shower, and walking was the least of the problems. Still she got mad when I said I'd rearranged her furniture to make sure she would be OK in a wheelchair, which I did before I realized how bad her thinking skills were, and that she could decompensate completely with any infection. It took that and a formal geriatric eval to totally convince me that she would not be able to do what she wanted. I had also wondered if she just wanted to go home to die there, but that was not it at all; she really could not judge what it took to be safe living alone. She, like your mom, wanted no in-home help except maybe a chore service and threw out three different agencies I asked to assess her situation.

Get a doctor to meet with you both and be the bad guy to tell her she if is not OK to live alone, and they will probably also do incapacity letters to activate a POA or help with guardianship if you end up needing that. If she is not that far away and really is still competent and wants to take the risks, its possible to have food delivered and laundry done by someone else. In PA the Ursulines were a recommended resource. AND - given those fractures, has anyone measured her bone density and started treatment for it?
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You need to look into a guardianship for your mother so that you can legally make the decisions for her to have home care or whatever care she needs. She may be competent, however, there are provisions for elderly people who are not able to make the decisions needed for their own health care in order to keep them safe. Please contact your state agency on aging for more help.
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If your mother has not been deemed incompetent, she still may make her own decisions. This is not an easy thing for any of us to accept. Despite my experience as an eldercare professional, my own mother makes many decision I believe not to be in her own best interest but she has the right to make them. My experience counts for nothing in my discussions with her if her mind is made up. We have to accept that which we can't control and look for ways to fill the safety gaps as best we can. Remember to take care of yourself with some focused stress relief strategies during this difficult time.
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My mom will not agree to wear an alarm, she also will not agree to help in the home. We just had this conversation yesterday with her. My hands are tired. I cannot let her go home unattended when she cannot wash her clothes, buy her own food etc.
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It's understandable she doesn't want to lose control over her own life, and if she is mentally sound - that's the main issue - the best you can do may be to let her go home and hire some in-home help and make sure she wears an alarm. There's a point, frustrating as it is, where we have to realize that they have a right, if mentally sound, to make their own decisions. These decisions may, in the end, make a nursing home necessary rather than a move to assisted living. or in your case, living with you. But if she insists and she is mentally sound, she does have rights, painful as it is for you to watch.

My mother fell many, many times before she finally got afraid enough to move. She had an alarm, and I was at her apartment at least once a week (besides my daily time I spent with her) for emergency calls when she fell. Finally, she made the decision to move, but it was then to a nursing home. It's hard to watch.
Carol
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Thank you, I will look into your book suggestion. I told my mom that if she falls at home she will be unable to enjoy assisted living. She will have too many needs. She is depressed and just does not want to hear it. She is on depression med already. She is sharp, just stubborn. I do not think she has Alzheimer's Disease symptoms. Today she asked again if she could go home for a week?? She has no fear, she just wants to die in her home. How much longer can I keep her in my home against her will? I am her POA. Ohh she can care for her basic needs at my home, laundry, small meals, potty,dressing & putting on her leg. She stays all day in a wheelchair and needs a spotter if she is going to walk with a walker.
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You should be able to purchase No Ordinary Move through Amazon.com. It is a book. I know the author and she has assisted many elders and their families through the emotional and practical challenges of moves.
As the executive director of an assisted living residence, I all too often see elders waiting too long and before making the decision for change and then they are much too fragile for us to be able to meet their needs. Assisted living is really intended to be a residential setting with supports for grooming, dressing, bathing, meal preparation, medication reminders, socialization, etc. It is a wonderful bridge between home and a nursing home. Complicated medical fragility is not always well served in an assisted living setting.
Tough love is difficult with our children and even tougher with our parents. Sometimes we have to honestly say that we can't do what we have been doing any longer. So much goes into that decision but caregivers must consider their health in the mix. Did you know that the primary caregiver to an individual in the home with Alzheimer's Disease is more likely to experience stress related illness and even death than the person with the Alz. Disease at the same age. Care at home is possible but the primary caregiver must be firm about having support whether it be paid professional support or the support of other family members.
Alzheimer's Disease is classified as a terminal illness and at a certain point can qualify for hospice benefits.
Just a few hints this time. Hope it helps.
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With this last arm break my mom went to a rehab in a nursing home. 2 weeks. I pulled her out and took her home with me so I could care for her. Well, 8 months later she is still here. She cannot shop or make meals for herself at her home. She sure does have spunk I tell you! The doctor said she should not go home alone and got pretty stearn with her. She has had 3 docs and a therapist tell her that they do not think she should be alone. She still insists she is going home. I take it day by day trying to keep her here. She refuses home care and a call button and assited living. ARGHHH!
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I know you're concerned about her. Is she able to care for herself? Sometimes a fall makes them more willing to move. A fall would be awful, of coarse, but it may take her to some place for rehab, then she may be placed somewhere whether she wants to be or not. You are thoughtful to care for her. Gotta admire her spunk, though! Sometimes the judgement goes along with physical decline. Sorry to hear about your struggle. Will pray that her best interests are cared for, and that you can find peace with whatever happens from here.
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We visited a wonderful assited living! She refuses to even try it. She will NOT allow anyone in her home to help and WILL NOT wear an alarm. All I hear everyday is how she has a house and needs to get back to it. Even though it is not safe and the next fall can make her bedridden. Any more suggestions? She is VERY VERY stubborn.
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Carol said it well. Also, where do we find, "No Ordinary Move"? Is that a book?
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Lois has a good suggestion. One thing we frustrated caregivers have to remember is that a move is so emotional to the elder that they can't be "reasonable." This is especially true if they are moving from a longtime home. The memories are there. Their "things" are reminders (sometimes literally) of who they are. Leaving this is hard, even though they may be frightened to be alone.

Third party help is nearly always helpful. A good friend, pastor or Rabbi who knows your elder can sometimes spend time reminiscing and help the person sort through emotions and even sort thorough the "things." It's a process, and for them, a highly emotional one.

My mother considered assisted living for quite some time but couldn't make up her mind to leave some of her belongings behind. She would have been able to take a lot of furniture and belongings, but she couldn't make the decisions. Finally, she had to move to a nursing home instead, and so she "lost" even more, though we moved as much of her personal life into her room as possible (bedspread, chair, pictures, etc


This is a hard thing to do. Our hearts are with you.
Carol
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Options exist. Read No Ordinary Move by Barbara Perman. Some really great info and insight into what a move means to an elder person and some ideas for mutual decision making.
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This may not be all bad (see “Don’t want Mom to live with me anymore”).

She's independent and wants to stay that way. Maybe she would be more receptive to wearing a personal alarm and having in-home help, or moving to assisted living. Many elders say they don't want assisted living, but once they move and are around peers, they love the company. Then, in a good center (check them out) they have someone check on them, plus they have alarms for help. You can hire extra help if needed. Could you tour some AL centers with your mother and tell her that if she doesn't want to move in with you, maybe assisted living with peers would be better?

Assisted living is quite different from nursing homes. But if she absolutely won't consider it, in-home help may be your temporary answer.

Carol
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