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My mother is 89 years old. She can no longer take care of herself. She is blind in one eye and can't see very well with the other. My brother and I and a friend spends hours a day ensuring that she gets at least one nutritional meal a day and make sure that she has food for other meals. We occasionally find her on the floor. My brother and I both work full time jobs and it's very hard to go over and take care of her. She won't let us help bathe her. She won't let anybody else in her house to help her. I'm afraid that if she won't let us help her that her hygiene will be impacted. She has a very good appetite when we are there. We just cannot help her the amount of hours that are needed. If we were able to get support, how do we pay the people that come in? I heard it's very expensive. She refuses to go to a facility also.

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Who has POA for mom? That person can make decisions for mom now that she's no longer able to. If nobody has POA, next time you find her on the floor, call 911 and have her taken to the hospital for a psych evaluation. She's likely suffering from dementia and needs to be tested and then placed directly from the hospital.

If you can hire aides to come in to help mom, she'd pay them from her funds directly. If she's low income, apply for Medicaid on her behalf.

Mom should obviously not be living alone anymore. You can also call APS to report a vulnerable and mostly blind senior living alone who's prone to falls. They can evaluate the situation and place her as well.

Best of luck to you.
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RunningOnFumes Dec 14, 2025
POA still may have limits as to what can be done without the principal’s consent. In Arizona, even if the POA says the agent can make decisions about where the principal lives, the elder law attorney we consulted said that state law generally will NOT allow a POA to force the principal to move if she doesn’t want to… that requires a legal determination of incompetence and guardianship. Get legal advice to be sure of your ground.
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She doesn’t get a choice. It’s facility time.
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My mom isn't the type to want a stranger in her home either. In 2023, Mom was 87 yo, completely blind in 1 eye, and low vision in the other. Stage 3-4 dementia.
We introduced a personal care aide in stages.
Step 1. 3 days a week, 1/2 day mornings. The first day, I stayed the entire session. The 2nd day, I left after 2 hours. The 3rd day I didn't come at all. 6 weeks after we started this arrangement, Mom fainted at the breakfast table. THANK GOD the aide was there.
We are now up to 7 days a week 1/2 mornings. (Mom is now legally blind, stage 5 dementia). Mom has 3 regularly scheduled aides to help her. They take good care of them, and she is unfailingly polite to them, and overall, much more cooperative (on a regular basis) than with us, her adult children!. At first the personal care aide was paid for out of a senior program funded by our city.
This year I was finally able to get her qualified for Medicaid, which allow us to go from 5 days a week to 7 days a week.
I am currently working to get 20 more additional hours per week so that Mon-Fri Mom will have care 8:30-4:30pm, and 1/2 days on the weekends.
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Hrmgrandcna Dec 18, 2025
Yes!! You were very very smart in the way that you introduced CNAs into the home gradually so that she could become accustomed to the idea and build a rapport with her caregivers. Now your mom's care keeps getting better and better. Good for you.
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She thinks she’s doing fine because she’s still living alone in her home. Although you, the friend, and your brother have loving intentions, you actually aren’t helping! You’re propping up the facade that she is capable of living how she is. Why would she consider leaving if you’re doing it all for her?

I’m sure she doesn’t want to move into assisted living, but she can’t call the shots anymore. She is not able to care for herself and not able to make good decisions anymore.
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Reply to LoopyLoo
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IMO , When an elder refuses hired help in the home , they go to assisted living , period .
Sell her house and use that money to pay for it .
Do not use your own money to pay for a care aide at home either.
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TrishaAlvis Dec 18, 2025
If I needed help, I would ABSOLUTELY allow it! I work for a Home Care Aide Seniorcare Agency, HCAs do not do this work for the money, they do it because their hearts are in it and still receive a decent wage for the "job". It is a calling for me to want to help, so I do. As a lead Supervisor first, a family HCA for my mom and bonus Dad, now as a Community Liaison. I am the person who presents who the company is and what we do. We are non-medical and all of the Aides are certified by the State. We have a contract with the State through The Department on Aging and with local County Senior Services. Medicare and Medicaid pay for the services if the Senior(s) are under assets (probably differs by State) so the Senior (over 60, under a certain income, needs help with ADLS) receives services at no cost--they never get a bill! They should start with Senior Services/DoA now!!! The sale of her home hopefully will com after she leaves the house and is probably left for her and her brother. They will need the proceeds to pay off any remaining bills. PLEASE, ask for help.
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Your mother will now need to have APS called to do a wellness check on her. If they find that she seems without capacity to make her own decisions they can enter her into the hospital system for assessment. If that happens you or your brother must decide if she requires someone to manage for her due to an inability to do her own care or due to lack of competency, if you would like to assume temporary guardianship of her. I will warn you that acting as guardian for an uncooperative senior with or without dementia is something I would never agree to do.

If your mother will not go into care, and if APS says she has a right to her own decisions regarding this I would tell her you will not be helping her any more. I would give her the phone number to ambulance to admit herself if she is unable to act for herself and I would agree to install a safety system to assess daily for falls. But I would do nothing else until she recognizes she cannot act on her own, and you will not help.

I am sorry to seem so brutal, but as long as you do everything she will not change her mind. You may decide to leave her be. At that point you will get the call from coroner or ambulance company of hospital ER and you can have Social Workers act for her and in her behalf. There are many seniors across the country without children. You will have to let your Mom know if she isn't cooperative with safe placement, she will be in their same position.

At some point in life, our unrealistic choices are no longer our own choice; and if they ARE, they may kill us. Some would prefer to leave the house feet first than have another year or two in a nursing home. I am not certain but that I don't agree with that thinking myself.
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Suzy23 Dec 14, 2025
I’m curious Alva. If you were to need help with ADL or IADL, would you allow a person to come into your home to help? Either for short term (say you were recovering from a broken bone) or for longer term?
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My mother is in a similar situation though not quite as extreme — yet. She can still bathe and dress herself and prepare simple meals and she gets groceries delivered. I also work full time and already visit my mom 3x per week and sometimes bring her meals but I know I can’t ramp up at all. I’m at my limit. My mom also doesn’t want anyone else coming to the house or to go to assisted living. (Sometimes there is a gulf between want and need. A lot of why I’m on this site is about telling the difference) she has fallen a few times but she calls 911 for “lift assist”

You have received a good range of advice. The only things I can add are as follows. Consider working with a geriatric care manager, but check what they offer and how payment works first in a consultation call.

If you find her on the floor and call 911, hopefully from there you could get a dementia diagnosis and have her transferred to a Medicaid accepting facility, if she has no funds to pay. Whether you or your brother have POA or not— my question is, is she in a fit state to call a lawyer about it? What would a lawyer say? I wonder whether she would be considered a danger to herself.

Even if you don’t get a dementia diagnosis, is anyone else (doctor, social worker, geriatric care manager) going to tell you she is fit to be sent alone back to her own home?

Who is paying her bills and filing her taxes and such? Assuming you or your brother, you should have access to her bank account and therefore knowledge of her monthly income and assets.

Is she in danger or setting fire to the house, leaving the water on and starting a flood, leaving the door wide open all night, giving all her money to a scammer?

as I’m sure you realize, her condition is going to get worse. More falls for example, and therefore ongoing risk or broken bones, gashes, concussions, etc.

You could also maybe put cameras in her house so you can monitor if she falls or has some other accident. Obviously you can’t be monitoring it and running over there at every hour of the day or night. So it’s not really a fix.

I feel for you and wish you the best!
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As a daughter of a mom with dementia and a former CNA and caregiver... I want to say that your mom is not alone in not wanting people in her house that are not related to her. This is in no way unusual. But the fact is she needs help and it can either be in her house or she can go to a facility. You would feel terrible if she had a fall that was very very serious. There are caregivers out there that you can find that aren't really really expensive but that are skilled. And actually want to help people. And perhaps your mom may need a walker as well. But the most important thing to do first is to get her checked out and diagnosed... Does she have dementia or not, etc.... But she definitely has vision problems which are going to exacerbate the fall risk. You need help and so does your mom. I was often given the more "difficult to please" patients who were dead set against having any type of help. The majority of the time I was able to convince them to let me help them. The key is treating our elders with respect and being adaptable.
You may find someone that she really likes. You never know until you try.
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Reply to Hrmgrandcna
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I know if I ended up lying on the floor, I would be scared. How long am I going to lay here before someone finds me? 😭 At this stage, life alert won't be of any help and there's usually a contract that you have to fulfill before you can cancel. She needs a safe place and whomever is POA has the responsibility to make sure she is! Wether she likes it or not, it's not up to her. An injury at this age,takes so much time to heal,if they heal at all! You don't want to see her bedridden and in pain. The house has to be sold and the money is for her care, when that runs out Medicaid should take over. It's a big job ahead but the relief of her being cared for is going to help you get through it. Some people feel guilty at first but come to realize "I should have done this sooner!"
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Reply to JuliaH
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Contact your local, county or regional agency for the blind. They’ll have suggestions, contacts and maybe equipment to help mom. It may be called Lighthouse For The Blind or similar.

BUT do not think mom can stay at home even with help from them! She needs full-time care way beyond what family can provide.
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Reply to Fawnby
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Homecare is very expensive and if she cannot afford it really the only other options are her assets get spent-down on her care so she qualifies for Medicaid and she is moved into a care facility. Or she is moved in with family, or family moves in with her to provide care. I did homecare for a long time and have seen situations like yours play out many times. You're not alone.

You don't mention her having dementia, so I'm going to assume that the three of you (yourself, your brother, and your mother) can sit down together and speak like reasonable adults. Let her know that she needs a lot of help and you and your brother can't provide all of it. Tell her that nothing will get an elder a one-way ticket to a nursing home faster than being stubborn. So if she's going to persist witht the stubbornness of not allowing anyone into the home to help and fighting you and your brother every step of the way, then it's just a matter of time before she has another fall and gets placed by the state. It will not be her choice then and will get done against her will. So the stubbornness has to go.

If she doesn't have dementia, she can be left alone for periods of time if she's willing to stay put and watch tv. Or take a nap. I've had clients who were fall risks but did not have dementia. They would be set up in a downstairs room with the phone, tv, laptop, snacks, drinks, and a portable commode next to their chair. They would not get up and walk around until their aide arrived or a family member. Some although still able to walk but a fall risk, would get around their homes in a wheelchair if no one was there.

If your mother doesn't have dementia her remaining home can be possible.
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Reply to BurntCaregiver
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Make sure your mother wears a fall alert pendant. If she refuses to do so, obviously she can no longer live alone. You and your siblings have to either take her in, move in with her, get expensive in-home caregivers, or file for Medicaid (with the help of an elder care attorney) and place her in a nursing home. No one likes being in a nursing home but sometimes it is the only option.

Unfortunately it sounds like your mother is no longer physically capable of living alone because of her vision and because she is now a fall risk. It sounds like she has the beginnings of dementia, the hygiene thing is one sign. (My father refused to shower for over a year, it was nauseating.) You guys will need to step up to the plate to figure out what works for all concerned, not just your mother.

It's a sad situation. My heart goes out to you. Best of luck handling this.
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Reply to Hothouseflower
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I am so sorry. They would rather do nothing and then have really crappy options later. 😒 In almost all of these cases, if they would of selected somewhere sooner, the communities might work with them once their assets run out. It's super frustrating. I am watching my own family train wreck.
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Hothouseflower Dec 18, 2025
Yes, that's where my family is right now -- one big freaking train wreck. I really wish they did something sooner, but no. They were so smug about refusing to do anything.
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Your mother is in no position to make unreasonable demands and expect them to be met. At some point, you have to make the decisions for her, and if she doesn't like it, that's too bad.

If you don't have POA, and she is stubborn, she may continue to live alone, unaided, in her own home until she dies. She may just prefer it that way.
It almost made me laugh when I read your concern that her hygiene will be impacted. This is not your biggest concern right now!

You can find home care agencies to hire help for her. Ideally, her money should be used to pay for this. If she adamantly refuses, and you feel adamant that she should have in-home care, then you can pay for this if you are willing and able. I believe it's around $25/hr. Or at least is was 10 years ago. Probably closer to $35 now, as the caregiver receives roughly $17/hr, and the agency will charge double that to cover their overhead expenses, and payroll taxes.

You and your brother should stop going over to help her. You are enabling her to feel that she is able to live independently. Why should she let anyone else in her house or go to a care home if she has you to do everything?
If you back away, she may find those options more appealing.
You say she refuses to go to a facility. She doesn't have to. She has the right to live as she wishes in her own home, and to die at home on her own terms.
If she becomes mentally incapacitated, and unable to make decisions for her own care, then you, as next of kin, may be able to place her in a care home. If you don't have the authority to do that, then you can call APS, and let them get guardianship for her.
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Reply to CaringWifeAZ
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Suggest you Have a family meeting - with mom. Suggest Contacting an elder care attorney to figure out options.
Depending on your state, any planning mom has done and her short and long term needs, there may be options.
Our national healthcare insurance and service systems are geared to facility based care. Unless mom paid for LTC insurance, her assets (home?) will be needed to support her elder care. Catholic charities and other service groups may offer some support - 4hours for personal care or housekeeping - but once mom cannot be left alone, either family or out-of-pocket care payment is needed.
in NYS there is currently no look back period for spend down and thus people can become eligible for Medicaid (Medicare does not cover LTC).
Medicaid will confer some hours at home, both not 24h care.
Anyone who wants to remain in their home with 24h care needs LTC insurance-
Irrevocable trust can be used so that any planned will options for the home can be fulfilled - or the house can be reverse mortgaged to pay for care but then it will be owned by the bank and mom will end up with nothing and in a nursing facility on Medicaid.
contact elder care attorney.
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Reply to AliOJ58
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Adult protective services would remove her from her home since she cannot stay alone. We had to bring Mom to our house against her will and moved her into a personal care home when an opening came up. Maybe there is adult day care nearby to try. We live 320 miles away so could only call and she would lie or get mixed up about what she had eaten. She also refused to hire in home aide (thieves) and only had home health nurse when prescribed by doctor. Good luck.
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