Aging neighbor and caregiver boundaries question: What boundaries might be good, and how do I implement them?

Your neighbor has complained that she is doing too much and that your Mother needs better care and that she "just can't do it".
She has told you all you need to know.
Your Mom's neighbor is doing too much and has told you so.
Your Mom's neighbor has told you that she needs more care, and has told you so.
Your Mom's neighbor has told you she can't do it, and has told you so.
May I ask what the question is here, really, because you have admitted that without this neighbor this cannot go on as it is, and that you are not close to the area, and are currently dependent on the care of this 81 year old woman. Who has TOLD YOU all the facts you need.
So I guess I would just like to repeat, Your Mom's neighbor is doing too much; she has said your Mom needs more care; she has told you that she cannot go on doing this. I am afraid the ball is now in your court. I am sorry. It will be sad for your Mom to have to leave her home and she will mourn that, as will you. I am afraid there is, however, no other answer I can think of. I wish you the best in finding a facility where she will be happy.

You are living in the land of denial. You mother's neighbour, elderly herself, has flat out told you that she can't keep doing this and yet you have somehow convinced yourself that you are doing HER a favour, give me a break! The fact is you are taking advantage of the empathy that causes her to step in when she sees a need and clearly makes it difficult for her to set boundaries, that's not cool. If you don't want to burn through all the friendship and good will offered by this kind woman then get your mother the care you admit she needs.

One thing that you are doing by sending checks to a senior in HUD housing is jeopardizing her housing. That is probably why she is tearing some of them up. She knows what could cause her to lose her benefits.

Maybe, find another way to compensate her. Gift cards, grocery cards, cash. Besides, checks mean a trip to the bank.

"Sometimes she does too much and complains that my Mom needs better care and that she just can't do it."

What, it's the caregiver's fault because she should be standing back more?

Nope. Be told. Your mother needs more support than the neighbour can give. Get a proper assessment done, and hire care.

Honestly, the "I would just like to encourage her to do more for herself and maybe require my Mom to do more things independently" ALWAYS comes from the person who isn't right there with boots on the ground seeing and truly understanding what the loved one can and can't do for themselves. The fact is, at this age and after a crisis such as a broken hip, your mother likely will not be able to do more things independently. Every crisis leads to a minor recovery and perhaps a plateau, but it's never one that takes them back to their pre-crisis level of health and independence. That's just how it is.

I think the neighbor is doing you a huge favor by speaking up as she has. No doubt she will indeed miss your mom and it may lead to a bit of a decline on her part as they have been mutually dependent on one another, but you need to do what's best for Mom, and living independently in her own house may no longer be viable. Look into in-home help, or an assisted living situation. Maybe the neighbor would like to come along, and they can continue living near one another.

My suggestion would be to take the pressure off of the neighbor by getting enough professional or compensated help in to do the “ work” so the neighbor can really just be a companion. This way the neighbor still has responsibility without as much work? My guess is she will still do hair, check on her etc but there should be less pressure and they can simply enjoy each other’s company. In the meantime it would probably be a good idea to start your research, get mom on a list or two for the facilities you prefer (it can always be delayed once she moves to the top) so your plan is ready to go when the time comes that your mom can no longer stay at home.

You said " But I really think it's best for my neighbor's mental wellness to have my Mom there." I find that very presumptuous. And this is after she's told you she "just can't do it". I understand we all want to think we can find the perfect situation, and that our loved one's decline won't continue, you won't have to maker harder and harder decisions. But it sounds like it's time.

Why are the only 2 options a) the neighbor provides any help needed or b) mother goes into a nursing home on Medicaid?

Why can't you hire her some in-home support?

When my MIL and her husband both started having health and cognitive issues, I too was blessed by willing neighbors who checked in on them, shopped for them, etc. I also am PoA for 2 very elderly aunts in FL (and I live in MN). Again, blessed by a neighbor couple who were my eyes and ears until things changed.

Eventually your mom will need more care than can be given by an untrained person who is 81 years old. You have stated that right now your mom cannot afford AL. Have you checked into something called an Elder Waiver?

"The Elderly Waiver (EW) program is a federal Medicaid waiver program that funds home and community-based services for people 65 years old and older who are eligible for Medical Assistance (MA), require the level of care provided in a nursing home, and choose to live in the community."

source: https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=id_056766#:~:text=The%20Elderly%20Waiver%20(EW)%20program,to%20live%20in%20the%20community.

Also, contact her local area's Agency on Aging for other resources. Medicaid is run by each state and I have heard that some state's MA program will pay for AL.

I have read your prior response that you are concerned that facility care is suboptimal. My MIL is in one 3 miles from my home. She's on Medicaid in LTC in a private room. She gets awesome care and lots of social exposure and options for activities, events and outings -- something your mom won't get cloistered in her home with only her 1 friend feeling the pressure to be her entertainment committee. Not to mention the friend is only 1 sudden health crisis away from putting your mom and you into crisis mode. That's what can happen at 81, no matter how healthy she seems right now. Loneliness is crushing to the elderly.

If I were in your situation I'd start having the conversation with your mom that, base on lots of research you've been doing, it would be best to *eventually* move her to a care community near you. Are you her PoA? Hopefully so. Research and visit facilities local to you. Talk to an elder law attorney and Medicaid Planner for your state. For Medicaid She needs to medically and financially qualify, and some states have a 5-year financial look-back period on the app. There are many ways one can easily screw this up.

I would call up the friend and let her know that it's ok if she's feeling like your mom's care is overwhelming her, that you are looking into options and how can you help her in the interim? I totally understand that you wish to help your mom stay in her home but eventually she won't be able to so better to work on the solution for this now rather than in a crisis. I wish you much wisdom as you ponder her future care, and bless you for doing what you're doing for the both of them right now.

You seem to feel entitled to have this neighbor help your mother by cleaning, vacuuming, doing her hair, fixing her food and the rest of it, then wanting to enforce 'boundaries' on her in the process! Never mind the woman is 81 years old herself & telling you your mother needs more help than she's willing or able to give her! Then you come back with a sarcastic remark saying, "But according to everyone here, having the neighbor do anything is presumptuous and apparently "evil" on my part. I'll start looking into nursing homes and try to do better. Thanks for all the help."

Really? You already have 'all the answers' so what kind of help are you looking for from US?

Your mother is fully functional yet has no short term memory, THE most dangerous kind of memory loss to have, even though you are watching her via video cameras and alert systems. Being sent off to rehab in a SNF, she is furiously calling 911 and others to get her out of there and tried to escape twice. Yet she can do a 300 piece puzzle, so all's well! Denial is not just a river in Egypt, you know.

You can be as sarcastic as you'd like, but the truth of the matter is, your mother is suffering from at LEAST moderate dementia and should not be living alone. That does not mean you should "put" her in a horrible nursing home where she'll "get care from people she doesn't know, doesn't have a personal connection/friendship with, and the neighbor is left in her apartment being bored and feeling lonely. Ok, noted. " You can hire in home help from someone who's not 81 years old and doesn't need 'boundaries', but who can provide the sort of care you'd like her to get. Or, you can find her a suitable SNF that may not be perfect, but would keep her safe and cared for.

Dementia is a losing situation for EVERYONE, you, your mother, the neighbor, all involved. It worsens with time and causes all sorts of potential dangerous situations your mother can DIE from while alone in the house. That's the truth. Take it or leave it. "Put" your mother in a nursing home or leave her alone in her home with you watching her over a device & her 81 y/o neighbor helping her out while she still can. There's no great answer or easy solution here, in all honesty.

But change your attitude b/c you came to a forum to ask for help but then choose not to listen. To people who have either traveled this horrible road before or who are traveling it now. It sucks, no matter what you do or how you do it. We lose our mothers to a very ugly disease that wipes out who they once were entirely, leaving a husk of a person in their place. So we all know what it feels like and how much money, time, head space & worry it truly causes. Don't shoot the messengers you came to for help.

I hope you can find a solution that works for you, and that keeps your mother SAFE, above all, b/c that should be your only real goal here. Not to find & implement boundaries with a neighbor who's going above & beyond the call of duty to care for your mother out of the goodness of her heart!

I suggest you read this 33 page booklet which is a download and very informative. It's called Understanding the Dementia Experience by Jennifer Ghent-Fuller. It may offer you some enlightenment on what your mother is going through, and what lies ahead. Knowledge is power.

https://www.smashwords.com/books/view/210580

Best of luck, whatever you choose to do.