I am in a real pickle. My mom has been told by her doctor, and most recently by an emergency room doctor, that she needs to be living in a facility that provides some level of care or in a living situation that does not involve having to climb 2 flights of stairs. Since her hospitalization in June, Visiting Nurses has provided care in her home, and she has been considered homebound. In any case, my mom will NOT agree to do anything (set up care with someone else for when they leave) or make arrangements to have various things done (groceries, laundry, taking out trash, etc. Her nurse, her social worker, me ... we're all broken records and she won't listen. She hung up on me Monday because I was telling her something she didn't want to hear re: hiring help to get to one of her doctor's appointments or risk a fall (which could negatively impact her independence and land her in a nursing home--which she doesn't want).
The nurse told me today that they have never run into a situation like this where someone just absolutely refuses help or is this stubborn. My mom is of sound mind, but is making decisions (as I've pointed out to her) that don't support the independence she still wants. She keeps saying she won't go into a nursing home. I am an only child, not married, and there is no other family on her side to help. I'm it. And it is not an option for her to move in with me or near me. Her needs exceed my ability to meet them, and I know what my limits are. I am willing to help, provide information, facilitate care, etc. but I am unable and unwilling to take on full-time caregiving in this situation.
So my question is twofold:
1) How would you handle this situation? And if you have had to deal with it, did you have to do to get your stubborn parent to take the right action?
2) At what point would a situation be considered neglect (by an adult child) under the law if they are aware of the unsafe situation, but the senior refuses to do anything on their own behalf or spend their money to make needed changes.
I'm at my wit's end and at the end of my rope. I don't know what to do!!!!
It sounds like poor Grandmother is dealing with some paranoia. The idea of having strangers in her home is frightening to her. Would it help, do you think, if someone she knows and trusts were to introduce her to a helper? For example, is she goes to church, could her minister accompany the cleaning person on their first few visits, to help GM accept them? Would GM listen to her hairdresser about what a wonderful program meals on wheels is, and how carefully screened the delivery people are? I'm sure you get the idea, but orchestrating this kind of thing from a distance would be tricky! And if GM is severely paranoid she might not even trust people she has considered friends in the past.
Can you get in touch with the social services agency where she lives, explain the situation, and see what your options are?
Is is very good of you to be concerned about Grandmother. I hope you can find practical ways to help her.
Since I posted this original question, I had to move my mom into assisted living. She fell a week after I posted this question, and that was the wakeup call she needed.
A few months back, a retired nurse told me that if she was ever in the hospital to remember this fact: it is easier to get someone into a facility from a hospital. So when she ended up in the emergency room after the fall, it was determined that nothing was broken.
However, I pressed for more tests to determine the cause of the fall (e.g. stroke, etc). Fortunately, they ended up admitting her for further evaluation. And after that, I had access to a social worker and a discharge planner there at the hospital. I had some long, detailed conversations with the medical professionals handling her case as well. Long story short, they repeated the same thing to her that I had been telling her: she was no longer safe to return home without assistance. My understanding is that discharge planners/the hospital cannot release a patient into what they understand as a dangerous situation. So her time ran out at the hospital and they had to place her somewhere. She dug in her heels up until the last minute, but we finally convinced her that she had no real choice other than to go to the facility where she now is staying.
She now has admitted that she is relieved not to be in her old apartment, but it having problems adjusting to the assisted living facility. She wants a more independent living situation, but I do not necessarily agree with her assessment of her abilities. Even with her in assisted living, I still am overwhelmed with her needs. While I'm not doing laundry, grocery shopping, I am still having to go to the store for her quite often. And I am in the middle of moving/packing her apartment. She was a packrat and a collector, and the job seems never ending. A whole new set of issues as she doesn't want to get rid of anything and can't have all her belongings with her.
But at least she is now out of the dangerous situation she was in. My advice is to remember that fact about hospitalization: that it is easier to someone into a facility if they are already in the hospital. And it allows you to draw on the resources that exist there--discharge planners and social workers who can help convince an elderly person that they are no longer as independent as they think they are, and that they need to be in a facility.
She keeps saying she has always taken care of Gramps, which is not true. He has always taken care of her. Granny gets mad and refuses when any family member tries to talk with her. “Oh you don’t know what I go through with Him.” is her standard comment. We love her dearly, but know she is a “Drama Queen”. She makes herself the center of attention. She hates it that Gramps has taken the priority with the family and that she is not in the lime light. She refuses to do what her doctors recommend.
Gramps wanted to go home from HealthSouth Rehabilitation. The family and the doctor’s agreed his mental health would improve, and in turn he would regain his strength. A physical therapist would continue to come to his home and he would need a visiting nurse. We all felt a live in care taker would be best. Granny refuses to allow a care taker, even though Granny is incapable of getting him out of bed and wheelchair. In fact she told HealthSouth and the family she had called and arranged for a visiting nurse, which turned out to be not true.
He wasn’t home three hours and she had already lost patience with him, threatening him that she would have him placed in the hospital if he did not eat. He eats, he is just very slow. These types of comments upset him. She has the family at its wits end. Are there any suggestions to help us? We know it is Gramps’ house too, but he doesn’t have the strength to fight a battle of wills with her.
My Dad was a danger to himself and others, and unable to control himself, and could not be controlled. They literally hauled him away and locked him up. Still, he refused their recommended medications. So, a Judge imposed, by force, administration of said prescriptions to be given intermuscularly (by strong nurses and a needle-literally by force). Dad's Alzheimer's type illness has progressed to the point he sometimes takes his medications, and sometimes refuses them, but for the most part, his behavior is more controllable (on the meds). He is doing much better, and a much better facility, and only an occasional struggle ensues. Thankfully, the burden of responsibility is on them, and not me.
When Mom's Physician suggested I take Mom to the same facility, I resisted, because she "wasn't that bad." However, she is becoming an danger to herself, and we are looking at alternatives for her care. But the bottom line is this: they cannot be forced against their will to comply with anything, unless they threaten the rights of others, and are such a danger to themselves that a court must intervene. And even then, they can still resist control, to some extent. As we've been told by a Geriatric Specialist, Guardianship is no magic solution to get someone to comply. Unfortunately, we've had first had experience and understand the meaning of his caution. I understand the pickle situation, and not all pickles are sweet.
if your mom is competant and of 'sound mind', then you will have no luck with the conservator or guardian route. it will be a dead end and probably damage your relationship with her. The problem you described is that she is digging her heels in and asking you to do,do,do and you can't do forever without help and understanding from your mom. It sounds as if you like her and need the least restrictive, most productive way of handling the problem. From what I hear nobody wants to go into a nursing home; and your mom probably would do ok if she had help other than you to keep her in her place.
Probably the best thing to do depending on whether or not she has resources is to hire a geriatric counselor who has a track record of being able to create a relationship and dialoge with her / his clients. That person can also be your sounding board on which way to go. If you have no money, ask the hospital social worker for a referral to the right agency in your area that handles social services and aging issues for seniors Value your relationship with her, work on finding the right person to open the lnes of communication and whatever you do don't feel bad if you have to ask for help. Remember, only you know your own feelings and situation - eveyone is different. When you have reached your limit, summon up the same strong "NO" as your mom & you will be ok.
Its important to realize though, that when you sit down with someone to discuss it they are focused on you, and your problems, it might be more helpful to get that one to one help first and then do the reality check on aging sites.
Good luck to you & we are all amateurs here except for dear Carol B......you need a pro!
The only legal advice I can give is what I've done: obtain Guardianship through Probate Court. Then you have the authority to make decisions for them. The only problem with this is, it does nothing to facilitate compliance. Our loved one can still refuse care. But I cannot answer your question regarding neglect. It would be a good one to ask your County's Commission on Aging (Area on Aging in some counties). There are also free Senior Legal services available in some counties. And Senior Centers often have a Social Worker on staff, or an attorney who does free counsultations.
My mother is stubborn, and argumentative. Together, we have seen attorneys, Social Workers, Physicians, Specialists, Pharmacists, etc. She does not follow doctor's orders or recommendations. Her Primary Care Physician and Psychiatrist have both told me to "remind her you are her Guardian," when trying to get compliance. I am at a loss myself, because they should know that holds no weight with mom. Ha! If only it were that easy. Sometimes mom does what is necessary, else she'd really be in dire straights (or straits). But sometimes she doesn't. She takes her meds, but craves narcotics. And she finished her Chemotherapy treatments. She refuses to see certain Physicians at some times, though. I have called them for advice. They say, "try to be persuasive, and work with her." I don't know whether to laugh or cry, and want to ask, "Have you met my mother?" (when I know they have). But they see her for short office visits, and don't know what it's like to deal with her day in and day out. WOW! To whom can we go for help?
So I go to Support Groups, talk with Social Workers, Lawyers, State and Local Police and Sheriffs, etc. All acknowledge how tough it is to deal with someone like this. But none have magic answers.
Just today, I met with my county's Day Care & Respite expert, again. We touch base whenever possible. I've been talking with her for over a year. She told me that mom will just have to fall, or break something, and be hospitalized for three days, in order for Medicare to place her somewhere. At the rate my mom is going, she will do this to herself, or her health conditions will force her there. I just make sure she has the basics: food, shelter, clothing, medical care, a little spending money, and a social outlet. My mom's not lacking for any of these. In fact, I go way beyond...and actually pamper her, often. I know her likes and dislikes, and try to please her. But I can't make her do things against her will, even if they are in her best interest. Fortunately, she has lots of freedom, and can still get out and about and enjoy some limited activities with friends.
I don't know what more to tell you, other than make sure your mom is safe. Clear her home of tripping and fire hazards. Make sure she and her home are "clean" and dry, and reasonable maintained. If not, you could ask the Department of Human Services to do a "well being check" on her (evaluation of her situation). But things usually have to be really bad before they will step in. Call around, and ask your questions to different entities. And don't worry. You're probably doing a very good job of looking after your mom. The most important thing is to see that her basic needs are met. Take care of you, as well.