What to do when mother with dementia insists she can live alone and I want to get a job but can't due to her needing constant supervision?

You start by saying no and putting yourself first. Move out as soon as you can. The longer you stay in this situation, the harder it will be to get out and more you will ruin your own life.

Contact APS and report her as a vulnerable adult. Let them come in and assess the situation. You can’t help your mother if she won’t help herself. Good luck! You can do it!

First, get the job.

Then, tell your mother and your sisters that you will be starting work on [date] and they will need to arrange support for your mother.

You're right: your getting a job and an income will change their attitude beyond measure. Yours too. That's definitely where to start. Do you have any employment ideas in the pipeline?

NutMeg, just because she wants to stay in her home doesn't mean she should, or gets to. You are orbiting around her to prop up her delusion that she is "independent". If the sisters are dead set against her going into a nursing home, then they can deal with her care. You are not responsible for her happiness. You are not obligated to participate in her care, physically or financially. Find another place to live, a new job and give them your resignation notice (about 1 month). Everyone ages, everyone declines, everyone dies. Everyone needs to be realistic about this and as adults, plan for this eventuality for themselves. Your mom didn't do this. That's on her. No one asked for your consent in being her indentured caregiver. Please do not feel guilty for leaving. I wish you all the best as you start a new life.

As a rule, don’t rely on someone with dementia to determine whether they can or cannot live on their own. If they had that sense of judgment, they wouldn’t be dementia patients.

Do YOU have the funds saved up to move out? You have no power or standing if you don’t have the ability to be free of her home. You can’t say you’re done and leaving if you can’t actually go somewhere and get a place to call your own.

So get the job you want. Start building savings quietly. If in your absence while you’re working, your mother has an accident — well, that proves that point. If not — when you’re able, get a place and get out, and then negotiate what is to happen next.

No one needs to acknowledge that your mother needs a different living situation because you’re there maintaining her living situation. So the first step is getting yourself out.

Then, if what they all want is for you to care for her — that will have to be your JOB if you’ll be giving up your own to do that. If they can’t afford that, or are otherwise unwilling, then they’ll all have to step up to do their part or find a nursing home that will.

This doesn’t all fall on you. So work on yourself and building yourself up to where you can properly negotiate what needs to be done.

My two cents.

It’s time for a family meeting where you tell mom and sisters that you will no longer serve as a full-time caregiver. You are done. With that assertion firmly in place, tell them you are willing to help make plans for next steps for mom with help of sisters. Sisters must contribute.
Make goals and plans for yourself with a timeline for moving out and on with your life. Don’t back down. Don’t let them FOG you. Fear-Obligation-Guilt.

*Where do I start?* It's a very good question - it can be overwhelming!

I think start with more knowledge about Mom's whole health situation. That may show the way forward.

Has she had a thorough medical checkup lately? Book it & take her. Discuss your concerns with the Doctor - just a short version will do. "Mom needs a lot of help these days. I'll be returning to work & possibly moving in the near/medium future. What do you suggest?"

Don't dismiss any suggestions the Doctor makes - warning: talk of NH or even hospice may even come up. But get the FACTS. Start there.

Thank you all for the input. You are right, maybe a part time job at first, to start a savings plan and go from there. If I line up a job and then inform the sisters they need to help find care for when I am absent, they might step up. They might not though, considering they don'tseem to grasp how bad her memory really has gotten. She has almost started a fire a couple times on the stove before, when I was gone for an hour running errands. They tried to give excuses saying anyone could have made the mistake. She also goes right to the baking cabinet when I am not around to eat sugar. Yes. Sugar. With diabetes. I have to lock the fridge when I am not present because she helps herself to sweets and dairy. Which makes her have horrible accidents on the floor, which I need to clean and if left unattended she will forget and track right through it and walk all over the house, it has happened twice.. So yes, I have to have peace of mind or a job will not work out. I have no support network with her. I am adrift at sea. I already went though caregiving for my Dad for 6 years, until he passed. My life is not my own. Thank you for helping me find my first step.

Nutmeg, I understand the pros and cons of getting the job first. While you look for one, here is something else to think about doing. You are ‘enabling’ your mother and your sisters to believe that your mother is ‘independent’. What can you stop doing, that would be fairly safe but very inconvenient for your mother? Picking things up off the floor is an obvious start. No appointment deliveries, she can organise a taxi and take herself. Eat out yourself, let her make her own dinner. What else? The issue is to stop the thinking that mother can live on her own, you are doing nothing important for her, and you are in fact a bludger. Tell your sisters what you are doing – you are stopping unnecessary ‘help’ because you are looking for a job and a new place to live, and it needs to be clear how your mother will manage when you are not there 24/7. And keep notes of anything you did decide to ‘help’ with for safety reasons, so that is clear too. You can do all this immediately. It may help you to feel that you are taking positive steps, and it may also push things to a head.

This extra option may sound a bit harsh, but at least consider just accepting her poor food choices. If she makes herself very ill, it will also bring things to a head.

Beatty, you have to have the job first for the people who need to do something - mother, sister - to have the reality dawn on them that the something needs to be done. Otherwise it's always over the rainbow for them and they sit on their hands forever.

It is also possible that you may have to call their bluff. That requires nose-hardening, I agree, but it is temporary.

If she is low income, there might be funds available for in-home care through Medicaid. You should explore this option while looking for employment, so that she will have someone there to watch over her.

"...how can she think she can function alone?" This is dementia lying to her. My mother was the same way - her mantra was that she was "fine, independent and can cook." She was not and could not! Despite AL being in her plans before dementia, once it kicked in, even in the earlier stages, this was NOT an option for her anymore. It was even more distasteful than offers from my brothers for her to move in with them (but was still adamant that she was fine and wanted to stay in her place!) We did try bringing in aides, just for 1 hr/day to check on her and make sure she took her meds. That didn't last 2 months - she refused to let them in, so we had to figure out a way to move her to MC.

Given your mom's various ailments, she could likely also qualify for NH. Many people immediately say NH, but that is mainly for those who need specialized nursing care. Medicaid can be used for NHs, but not so much for MC (there are some exceptions.)

While looking for employment and exploring what help might be available (you can try push back on sisters, but I wouldn't hold my breath on them changing!), you should also look at dementia-proofing the home, like child-proofing. You mention locking the fridge, which is a start. If you are going out, even for short trips, you should disable the stove. The cabinets can have child-proof locks installed to prevent her getting into sugar, etc. These will not only help her, but you as well, since you have to deal with the aftermath!

Does anyone have POAs? These will be useful for managing her finances and medical care, but will NOT give anyone authority to move her. If no POAs are in place yet, it may be too late. Some attorneys will question the person, to determine if they are capable, but given what you've said about her, I don't see that happening.

Just finding a job and moving out shouldn't be the only steps taken. They are important for you, to provide you with a life and future, and should be part of the plan, but she should not be left to her own devices, as she is not capable of self care. EC attys are not cheap, but often will at least offer a short first consult for free. You can find local ones using zip code at naela.org. Have all questions and concerns ready before any consult. Be sure to highlight lack of funding for atty and care options. They can also help with processing Medicaid care. APS may have suggestions, but generally they are not your best option for help.

Your sisters are at this point very selfish. They have relied on you all these years and expect it to continue, but offer no help. Although my brothers did contribute SOME to input for plans and a little help in dealing with things, certainly not enough or their "share." At some point I found it best to just do what needed to be done and forget consulting with them. I don't and won't provide the hands-on care, but I do manage and take care of everything else for her care. One brother I haven't spoken to or seen in over 2 years now (related to his abuse of me) and the other is becoming more difficult to deal with. Once mom passes, I plan to consider myself an only child! We share parents and genes, but that's about it. I often have said, and still believe, that I received most of the brains in our family!

Best of luck - work on finding the right solution for mom and yourself. Don't count on their help too much.