Hi so a few things have happened recently with my 91 year old lovely Mum. She has been getting confused with her medications and calls often to ask which ones she should take. We’ve sorted this out by arranging a pharmacist prepared pack to be delivered each week. She is also forgetting events that happened, like getting the results of her latest bone scan. Today, in hospital after a dizzy attack, she brushed her hair and then promptly pulled hair from the brush and just dropped the hair on the floor, she’s usually very fastidious about neatness. Her doctor wanted to do an aged care assessment to see if she should be still living alone. She got very angry, which for her is the cold shoulder and silent treatment. I was happy for this as she has been using her medi alert more often lately. After I went home, she told the nurses that she didn’t want that doctor anymore and requested another one, even though this doctor has been her cardiologist for many years and she always liked him before. We are scared that she will fall again when she is home alone and since she has severe osteoporosis the outcome would not be good. She is adamant that she will never go into care and tells everybody how wonderful her daughters are and that we will look after her. I have recently had brain surgery for an aneurysm and my sister is almost 70 and cares for her intellectually disabled son. We are both getting worn out and don’t know how much longer we can be running around after her, with all the appointments, shopping, bills and rushing over every time she uses the medi alert. We love her, she has been a wonderful, caring mother to all of us. I have another sister who is 71 and doesn’t drive, and two brothers who have their own health issues and really don’t do more than visit. I can see her demands increasing and am heart broken and at a loss as to the best way forward.
My father and my in-laws were all also wonderful in their twilights. It was good my wife and I were still strong enough to help them, even with two adult children who had their own serious issues.
My mother is the only parent left, and she is a true narcissist. Her cruelty is seemingly boundless now that she has lost many of her social skills.
Because of guilt, it was hard for us to place my father and in-laws, but it really was for the best. My wife still second guesses decisions we made for her parents when they were alive, probably because they were so kind, loving, and appreciative. My MIL actually loved the service at Assisted Living (AL), and we visited her daily.
I have my own health issues now, and I no longer have the stamina for my mother, even if I wanted to be her full time servant. She hates every place she lives, and I have moved her three times in two years. The last move was from independent living where we should never have placed her (she is not independent). She basically was kicked out for nasty and threatening behavior.
I can take care of her needs, but I cannot worry about her wants. It took five years of her cruelty to for me to finally drop the guilt and realize that my only duty is to make sure her needs are met. Happiness has to come from the person, it is not the responsibility of their children. Once I realized I am not the happiness fairy it was like a weight had been lifted.
However, consider this. Is Mom’s wrath (the “cold shoulder) worth your constant fear and worry that something tragic may happen to her? You could have her tested for a urinary tract infection, but it’s quite possible she is showing signs of dementia. Only evaluations can reveal what is truly going on. Don’t bombard her with ideas of what she needs to do. She will only shut down. Can you hire in-home care for her? I suspect she will not understand that you and your sister have other obligations and cannot care for her. As a last resort, if things escalate to the point she is truly in serious danger of harm, you can explain to her doctors that she is unsafe at home and have her placed in a facility. This is less than an ideal situation but unfortunately may be necessary.
The stats I have read said that 80% of elders get delirium when in the hospital, and 20% of very young people get it after having major surgery.
Having someone come in. And this will mean 24/7/365 as she will need "care" around the clock. This does not mean you will have to hire a nurse or even a CNA. If you hire through an agency they will not permit someone that is not a nurse to give medications. But if you hire privately you can instruct someone to give medications. There are drawbacks to hiring through an agency and there are pluses jut as there are pluses and minuses hiring privately.
Another option is Memory Care. There will be a locked facility so she can not leave or wander off. She will be cared for around the clock. Usually these are more "home like" and as long as she does not need Skilled Nursing care she does not need a "Nursing Home"
If you decide that you or another family member can care for her at home realize that modifications will probably have to be made. Larger bathroom, if possible roll in shower, higher toilets, no stairs, no carpet, wider doors to fit wheel chair these are just a few things.You should see a lawyer that is familiar with Elder Law make sure you or someone has POA for finances and Health. It is possible that they may suggest that your Mom needs a Guardian.
If you figure it our with modifications to her house, property taxes, insurance, upkeep, gas bill, electric, food, caregivers...it might be possible that moving her to Memory Care might be the same financially as keeping her at home.
Not an easy decision.
Also know that falls happen anywhere. They can not totally be prevented, they can be minimized. Decline will happen sometimes slowly sometimes rapidly.
Think now abut how you want to deal with emergencies, she most likely will not do well in rehab.
It might be the time to talk to the rest of the family about a POLST (Physicians Order for Life Sustaining Treatment) it is much more detailed than a DNR.
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