Sister is unable to track meds and make sure Mom consistently takes them. As a result my Mom has had several COPD breakthrough episodes which have made her very sick.
My sister is doing her best but she has so many other things going on. I plan to offer for someone to come in and help but sister has already made it clear she doesn’t want us or anyone else coming into her home on a regular basis.
What steps should we take if my sister refuses help again? My Mom is deathly afraid of going into assisted living so I want to address this in a way that allows her to remain with my sister.
I have the POA but have tried to do things collaboratively to avoid major family drama. I know however that at the end of the day I have to make the decisions that are best for my Mom.
My plan now is to sit down with my sister and tell her we have to get some help for her and my Mom. I will let her know that I am prepared to move in the direction of AL if she will not cooperate with bringing in assistance.
That's how my mother's meds were dispensed by the pharmacy when she was in her nursing homes. You might have to find a different pharmacy than your usual CVS or Walgreens, but you can certainly start by asking if they do it there.
Help your sister set an alarm that goes off when Mom needs her meds.
There are ways to help without going all-in on assisted living or bringing in help quite yet, but if Mom misses more medications and it leads her to getting sick, then your sister doesn't get a say anymore.
MUCH easier on the caregiver. Especially if any controlling or nervousness (like my Mother, a "checker" triple checking everything).
I would also look at the meds Mom is on. If on Cholesterol I may see if the doctor would drop it. It effects the enzymes in the liver and can cause damage. If high she should be taken off. Probably on blood thinners. If for a long period of time, blood thinners can cause internal bleeding. I found when Mom was in the hospital, she would be put on meds she could go off of once her problem was cleared up. Like fast heart rate because of Thyroid. It was corrected with the Thyroid meds so didn't need the heart rate pill.
I would not say sister has Dementia. I would say she has too much on her plate and is stressed out. Stress can do all kinds of things to your body and mind. And Mom, its not what she wants, its what she needs. She needs to be getting her meds on time. She needs a daughter who is not stressed out. Why not start with some respite care in an AL. Maybe a month to give Sis a break.
If not, why would she be "deathly afraid" of living in an assisted living facility? I'd be more afraid of perhaps dying because of not getting my medications when I needed them.
In an assisted living facility she would be around other folks her age and get to socialize along with getting her needed medications on time.
Who is mom's POA? They need to be making the decisions for your mom and doing what is in her best interests, and it sounds to me that she needs a lot more help than what your sister is capable of providing right now. It's a shame that your sister doesn't see it that way.
Perhaps it's going to something really drastic(God forbid)to happen to your mom before sister will agree that things have to change. I just hope that your mom in the meantime won't suffer needlessly and be made worse because of your sisters stubbornness and lack of awareness.
I wonder what other important things your sister has going on? If she is not willing or able to dedicate the time needed to take care of mom properly, then she needs to be willing to accept that something has to change!
Does your mom have money to pay for an aide? You should not be paying for this. I can understand, sort of, your sister not wanting someone in her house regularly but these are not normal circumstances. If she can't keep up with mom's meds, then obviously something has to change. It will be better for both of them if she gets help.
Who has POA??
Can you and your siblings have a family meeting with her? Not to gang up on her because she will just be defensive but to kindly tell her that she's been doing so much for so long and you appreciate it but now it's time for some extra help. If she won't cooperate with help, then you'll have no choice but to pursue other options. It's becoming unsafe for your mom to live there.
Although mom may be very reluctant to go to assisted living, it may be the best choice for her safety.
Best of luck.
Your sister forbidding anyone coming into her home to help out reeks of dementia HERSELF, to be honest. What's going on with her that she's acting like this? Who has POA for mom who can perhaps step in and fix this mess?
Good luck
Fear, denial & stubbornness.
Sister's denial she needs help. Fear of family help, stubborn refusal to accept help offered family, fear of strangers or non-family help.
Mom's fear of assisted living, fear of strangers, fear of change. Also possible denial about her life stage & health needs. Stubbornness too.
I suppose you can sit down & discuss these fears, one by one. May take many many chats.. maybe involve a professional third party eg Doctor, Social Worker, Faith Leader.
Point out to both Sister & Mom they DO have choices. To stay the same - or change.
Change involves some letting go. This takes some bravery but can be OK! There are positive things to gain too. Many times people say Oh I wish I'd done this sooner!
The fearful & stubborn people who continue to resist change, well, a crises arises & change is FORCED upon them. The consequences are no time to plan & less choices.
These folk become members of the *awaiting the fall* club.
They risk being thrown into the nearest nursing home bed after a crises instead of an AL of their choice.
Also, why is mom afraid of assisted living? So many people enjoy it because they have a better quality of life, things to do and make friends. Living alone with your sister who can't even keep track of her meds seems like a really miserable life for your mom.
Why don't you take mom to see some assisted living facilities? When she sees the people enjoying themselves, the dining room where food magically appears on schedule, the in-house hair salon, the fountain in the courtyard, a nice room that gets cleaned by staff - what's to fear?
My mom is also in end stage COPD and has moved in with me, not due to fear of AL per se.. but it is mainly COVID scaring the absolute shinola out of COPD patients right now.
In her case at least the important things are-- the discus 2x a day, the budesonide to assist discus meds 2x a day, albuterol as needed (up to 4x a day), then her usual dailies for other reasons.
Breakthroughs/exascerbations won't necessarily be stopped by medication, though they hopefully prevent them from being as common as they could be.
But if sis is overwhelmed, and mom has cell and the ability to self-administer of her meds are in reach, just call, or even just send texts if mom is savvy enough with smart-tech. When my mom was alone my 3x a day calls helped her take her meds and these weren't 3x "how are you fine how are you"s, just "Hey mom calling to remind you to take your meds (daytime meds + discus and budesonide at noon-ish),. then before bed "Hey mom calling to remind you (night-time meds and PM discus/neb). So, a noon call, an 8pm call. A mid-day call was the normal "how are you whats up what are you watching" calls as she was very limited in moving around toward the end of her time in IL housing / sec 202.
IF mom can not self administer, then sister needs to set alarms to remind herself to care for mom. Or you call sister to remind her to give meds to mom.
I know ppl talk to their moms more than 2x a day anyway, two quick med-check calls can be quick, and also will help mom feel more connected to you even if it is only 2 three minute phone calls.
I'm slow and didn't read your "about" section re: moms mental status. But depending on how advanced it is, she might just need a time reminder daily for meds like my mom did. I do know that COPD itself leads to some dreamy-ness / disorientation just from lack of oxygen or CO2 trapping (which is a thing I know nothing about and my mom can't explain the sensation to me)
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