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My mother is 89 years old and lives in independent living in a nice senior living center. About five years ago, I moved mom from the Northwest to the Midwest. She was alone and friend started to call me telling me she should not be alone or drive anymore. It was obvious that her sight was failing, and she had some mild memory issues. In the last year or two her memory issues have been worsening where she can't learn anything new like people's names, how to use a new dishwasher, her new address and phone number etc. She is also struggling writing checks, forgetting where she puts her stuff, and forgetting some words permanently. She has refused to see a psychiatrist or a neurologist and constantly battled me, saying that this is simply "old age stuff". However lately she has had more hallucinations and she is very depressed, so she agreed to see a psychiatrist who diagnosed her with moderate dementia. The primary concern of the psychiatrist was the dispensing of her medication and recommended to hire a nursing service (she will not go to assisted living) to at least handle her medications. Although I prepared her medications in pill boxes, she either forgets to take them or purposely removes the pills because she feels she doesn't need them. (She has high blood pressure and heart disease). I now am going twice every day to give her pills. However, she is still able to dress and bath herself, participate in some social activities and has a housekeeper that comes once a week that also helps her. I have been mom assisted living for many years and it is simply exhausting. I do have full POA but it's difficult to use it. Part of it is that I am having trouble accepting her situation and forcing "my will" on her. Now, it's a safety issue. There are also cultural aspects because we are Latinos and moms' expectations of the eldest (me) is taking care of her. Like many, I am balancing my relationship with my husband, my calling as minister, her care and making time for my first grandchild who lives in Atlanta. I am retiring the end of this month from my professional job, but I'm actually more concerned that she will expect much more from me and I am exhausted. Mom has the means to pay for any care she needs.
I have been reading the posts for over a year which I find very helpful. Thank you for your consideration.

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Yours is a very common scenario. Many on this forum have gone through it or currently are experiencing it. The good news is that she has the funds to cover any care she needs.

Stubbornness is a signature characteristic of dementia. In my experience with my 3 elders (93, 100 and 103) it only gets worse. Caregiving requires some creativity and the use of "therapeutic fibs" to deliver needed care. Going forward you do not need to convince her of things that benefit her. With dementia, she'll likely forget she ever agreed to it, anyway. Then you're back to square one.

Have you contacted the management at her IL community to see if they are familiar with local services? Or, can recommend a resident who is reliable and willing to give her the meds (for a fee, of course)? This is because it's 2x per day. Have you checked with the pharmacist to see if there's an alternative form of her meds so that she only needs to take them 1x per day? Like a patch or time-released version?

Your responsibility as PoA is to act on her behalf for her own best interests. You are not "forcing your will" on her. You are doing your duty. You don't have to meet the expectations of someone who has dementia -- she can no longer work from inner reason, logic or empathy -- so old rules no longer apply.

Since you mentioned she is having delusions... you can call 911 and have her checked for a UTI (which can cause delusions). Once she is in the hospital, you can have her transferred directly into AL or MC that you have chosen prior to this strategy.

Please understand that almost no one at that age likes change or the thought of losing independence. With her moderate dementia, she won't like anything you do unless she moves in with you and you serve her hand and foot. Which is the care that my 100-yr old Aunt gets yet she is still resistant, combative, vulgar, exhausting. In a facility she will get all the care and attention she needs, plus the benefit of socialization, activities, etc. which she will not get cloistered in her IL apartment. This is what my MIL gets at the very nice facility close to our house.

Others will make more suggestions. I wish you all the best on this journey!
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You’re a wonderful daughter. I understand that the cultural issues are huge. The way I know this is that for two years I provided a home for a married couple from a culture far different from mine because they had nowhere else to go. She became very ill and since she was living in my home (free of charge) I became her caregiver for more than 6 months. For one thing, she distrusted American doctors, and for another, everyone in her country knew that frozen foods give you cancer, so I was at fault for making her sick. There was no reasoning with this nonsense. So if your mom expects you to take care of her, I doubt you’ll change her mind. But still, you should try. Have the talk about how living in the US is different from wherever she’s from and that one of the things that goes along with living here is that women have careers and responsibilities and are unable to take such a big role in caregiving. She wanted you to have greater opportunity, right? Then she doesn’t understand and starts crying, and she has dementia so can’t fully understand anyway, then you go on to say that help is available for both of you. You tell her someone that you’ve already arranged for will be coming by to meet her and help her with her medicines, etc. Mom still won’t like it, but if it’s someone from her culture who can brighten her day, she might start enjoying it, especially if you take care to find someone with a compatible personality. If this doesn’t work, she may need to go to memory care sooner rather than later. By no means do you want to let her cultural issues control you because she’ll feel entitled and it will never stop. You deserve a life of your own and seem to have one, plus that new grandchild. You already know that you can no longer meet mom’s needs. I wish you luck with this difficult task.
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We wound up having to do “Either….or”.

It was by no means a happy or pleasant solution, but LO was living in a house with one bathroom, up three steep steps, down eight steep steps, a landing in between.

She would admit that she was afraid to stay by herself, but reject every solution we could come up with.

Finally we coaxed her into “..a week trial” in an AL near me, knowing that if the setting proved suitable, she’d be staying.

Although it didn’t turn out as we’d hoped (it probably never does), she ultimately adjusted fairly comfortably, but in Memory Care, not Assisted Living. Be ready for some changes, whatever you decide.

Also remember, when SAFETY enters the discussion, “forcing your will” becomes the ultimate kindness.

Enjoy that grandchild!
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" I have been mom assisted living for many years and it is simply exhausting."

And now you are going twice a day to dispense meds, and there will be further mission creep.

Can your own doctor tell you that all the stress is not good for you? And then you can truthfully tell your mother that your doctor said you must stop doing so much for your own health?

We read often of outdated cultural expectations on this forum.
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Merci4712, check with the senior facility to see if they have what is called Med-Tech service where a certified Staff member brings in the meds [said pills are locked in the nurses office] either once a day or twice a day, and makes sure your Mom takes her meds.

This worked great for my own Dad as he kept ignoring notes I had around his apartment as reminders. It was well worth the extra fee, as it is so important to take blood pressure pills the same time frame each day. Missing a day or two can really reek havoc on one's system.

As for forgetting names of people she just met, heck I have had that problem since I was a kid.

My Dad had trouble remembering his new phone number [now I know where I inherited that type of forgetfulness] and new address when he moved into senior living. I typed said info in large font and taped it to Dad's landline. He said that was a great help.

Who is your Mom's financial Power of Attorney? It is now time for that person to take over the check writing, etc.
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I would say that your Mom is more than moderate in her Dementia. She should not be left alone. She is no longer a candidate for Independent living. If you want her to go to an AL, then you may want to say something to management about her diagnosis. Someone there maybe able to evaluate her and if they find she is ready for the next level of care, tell her she can no longer remain in Independent living.

My SILs mother was in Independent living and they did manage her mothers medication. But there will probably be a charge. I really don't see any Nursing service that would come out certain times of the day to make sure she gets her meds. I worked for a Visiting Nurse Assoc. The Nurses would fill the med planners weekly, maybe even give the client their meds during the visit, but never went back a second time in the same day. The client had to be able to take their own medication on time or a family member had to give it to them.

You can't even hire a CNA to dispense her medications unless she is Medtech certified.

Everything you describe about Moms behaviour is more like Mid Stage, IMO. Its becoming, its not want Mom wants, its what Mom needs and Mom needs to be in an AL/MC facility. She will only worsen.
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