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She only wants a family member there and no one can be there due to work and distance. Also no ability to pay for home health care.

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Tbw, my Mom was the same way, plus she thought my Dad could take care of her. HELLO, they were both in their mid to late 90's, still living on their own in their house.

After Mom had a major fall, I hired around the clock caregivers to which my Mom didn't want. Dad thought it was a great idea. After the 3rd day Mom shooed the caregiver out.

Ok, what do we do? Nothing. Unfortunately we all pretty much have to wait for an emergency to happen. For my Mom, it was a 2nd major fall with head trauma. She went from hospital to rehab to long-term-care. If only she wasn't so stubborn.

Thankfully, my Dad hired the caregivers back to help him as he was also a major fall risk. For him, it worked out beautifully.

When one can't budget for private home care, next stop is Medicaid [which is different from Medicare]. Check with your State Medicaid office to see what is available. It may be moot since your Mom refuses "strangers" in the house.
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Someone is being very stubborn.

Is she still competent?

What does she need help with? Is she safe alone? Sometimes what they want and what can actually happen are obviously not the same thing. She has no right to make family members provide her care. She can want it but that doesn't mean she will get it. Everyone has their own lives and responsibilities, etc. It's great if family is willing and able to help, but there are reasonable limits to that.

Is she still living alone in her own home?
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I thought I had already answered this question. Found it was asked twice

https://www.agingcare.com/questions/who-do-i-talk-to-when-mother-is-bedridden-but-refuses-outside-help-wants-a-family-member-to-take-car-457524.htm

There are also answers there.
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Your aunt needs to leave. You need to call Adult Protective Services and the Area Agency on Aging and report a mentally ill vulnerable adult living alone.
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If she’s of sound mind, the answer is that you can’t make her do anything. She’s an adult free to make her own choices, even bad ones. It also means you and your family don’t have to participate in the bad choices just because she demands it. May sound cold, but it means all of us have to face reality sometime, and giving it to demands only delays the inevitable
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Tbw777 Mar 2020
Thank you for your response. She for some reason doesn’t even think there is anything wrong with my aunt leaving her family to come live in and care for her 24/7. My aunt has not been home in 4 months. Me and my uncle are now trying to figure out what to do next. Can’t afford in home care. But Mom needs physical therapy to begin to walk again and she sent them away. We are feeling stuck because it’s hard to leave her laying there. She lies and tries to make us promise we won’t leave her. I don’t think her mental state is normal. But just don’t know what our next move should be.
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Health and Human Services is who can help you, also, contact your local area on aging aka counsel of aging.

If you all said no more, we get help or walk away completely, she will have no choice but to accept help, of one kind or another.

Don't ever make promises about what you will or won't do, none of us can single handedly care for a non compliant bed bound person, period. It is unfair to ask others to sacrifice their lives so you don't have to do something that you don't want to. I guarantee that nobody wants to give up their lives to prop up her imagined independence. It works for everyone involved or it doesn't work. No matter how much manipulation and guilt gets thrown out she isn't the only one that matters.

Call the Medicaid office or go online and start the process to get her into long term care, that's the choice she has made by sending PT away. She doesn't get to stay at home and not put as much effort as possible into getting better.
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