Mother rejecting all attempts to provide assistance. Any advice?

So so many of us on this forum can relate to what you're going through. First, do you or anyone have PoA for your Mom? Know this will give you best suggestions from other posters.

You do not have to wait for her to agree or like it. Few elders ever like the thought of change, no less a profound change like moving into a care facility. Often people resort to telling "therapeutic fibs" to get them into the facility. Like, "The apartment is having the furnace replaced and tenents have to move out temporarily while repairs are in process" or "the building has an infestation and for safety, people will be housed in a temporary apartment", etc.

Based on what she can afford, and what works for you in terms of quality, location, services provided -- you should be choosing the place. Do not bring her until the day she moves in. Stop discussing it -- it will go nowhere and just make everyone anxious and angry.

Move her in on private pay and when she is close to runniing out of funds you apply for her Medicaid (takes 3 months to process normally).

You would be surprised at how many resistant seniors come to love the facility because it helps solve the loneliness problem. Best wishes to you in working out the details!

Have you spoken with caregivers? Do they feel she is safe? Are you her POA? Is she competent to make you POA and are you willing and able to serve as same? If she is not competent are you willing to go for guardianship? Is there a social worker involved. If they agree she is not safe they may be willing to help you get emergency guardianship for placement if your Mom is no longer safe alone, and it sounds as tho she is not. She has, at the least, the caregivers. And eventually there will be a fall and a need for ER help. At that time reach out to social services. Sure wish you luck.

She will never be ready. This is the time she depends on others to make good decisions for her, not decisions she’ll be happy with per se, but decisions in her best interests. Consider that as issues have piled on with age, that “happy” in whatever form that looked like for your mom is likely over with, sad but a reality. She’s no longer safe on her own. Time for a new plan, either a new place with around the clock help or around the clock help in her home. And know that her condition will worsen so plan with that in mind

She is like my mother was, thought she was self sufficient, she was not. She refused to go into AL for 10 years, lived alone in the mountains of NC. Don't need to bore you with all her episodes, she finally had a slight stroke and was afraid to stay along at night, the EMS started charging her $600 every time she called, like 3 times a week, that ended that, we swooped her up, moved her near us in AL.

Crazy time, the ridiculous part is that she LOVES living in AL, new friends, activities, no cleaning, no cooking, just fun!

She is 98, my brother & I wasted alot of our time and effort on trying to convince her to do the right thing, we were all stressed and she was only concerned with herself, selfish is as selfish does. No concern for us what so ever.

Your mother has dementia and is not safe to live alone, period. You either get her placed in a Memory Care Assisted Living facility now, or wait until she has a crisis and is forced into care. She doesn't have to feel 'ready' for care for you to KNOW she is beyond 'ready' for care, since she's refusing to bathe, cannot cook, is suffering from incontinence issues and God knows what else! If your brother is her POA, then get him on board to place her, and get her to the AL under some pretense of going there for lunch, then situate her in her new apartment which you've set up like her current place. Let her know that her old place is being exterminated or repainted or some such thing, and that's that.

It's not easy to make such a move, but it's easIER than it will be when she's hurt herself and is forced by the hospital into managed care. I'd rather be The Bad Guy NOW than wait for such a crisis to occur. I had my own mother in AL and then had to segue her into Memory Care, against her wishes, when her dementia became moderate and she could no longer properly function in regular AL. Their world is greatly shrunken down in Memory Care, which was exactly what she needed. That and one-to-one caregivers to change her Depends and toilet her every 2 hours, and help her with everything she needed help with, and provide her with 3 hot meals a day, etc. Not to mention the wonderful activities they provided and the companionship of other elders in the same position she was in. It turned out to be a win-win situation, and I was fine being The Bad Guy b/c mom was safe and secure, and well cared for in the process. She died in Feb at 95 years old from dementia combined with heart failure.

Best of luck keeping your mother's safety as your #1 priority now.

PS: I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia. The reviews for her books are phenomenal b/c they are written in plain English & very easy to read/understand. Her writings have been VERY helpful for me.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2

She also has published a workbook entitled, “It Isn’t Common Sense: Interacting with People Who Have Memory Loss Due to Dementia.”

https://www.amazon.com/Isnt-Common-Sense-Interacting-Dementia/dp/1481995995/ref=sr_1_4?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468655&sprefix=jennifer+ghent%2Caps%2C631&sr=8-4
 
Here is a list of useful tips from her e-book I found to be excellent:

The “Dont's”

· Do not reason and argue
· Do not demand that they reason or problem-solve
· Do not demand that they remember
· Do not demand that they get their facts straight
· Do not correct their ideas or scold them
· Do not reorient them
· Do not think that they are being uncooperative on purpose
· Do not think that they really do remember, but are pretending not to
· Do not use a “bossy” dictatorial attitude in care
· Do not act with impatience

The Do's

· Enter into their frame of reality, or their 'world'
· Be aware of their mood or state of mind
· Use few words and simple phrases
· OR use no words, just friendly gestures and simple motions
· Do everything slowly
· Approach from the front
· Wait for a slow response
· Constantly reassure them that everything is 'OK'
· Keep people with dementia comfortable 'in the moment' - every moment
· Maximize use of remaining abilities
· Limit TV or radio programs which they may feel are frighteningly real
· Maintain privacy
· Provide a safe physical environment

Language Needs
· Use short words
· Use clear and simple sentences
· Speak slowly and calmly
· Questions should ask for a “yes” or “no” answer
· Talk about one thing at a time
· Talk about concrete things; not abstract ideas
· Use common phrases
· Always say what you are doing
· If they repeat their question, repeat your answer as you did the first time · Give them a longer time to process information
· Wait patiently for a response
· Be accepting of inappropriate answers and nonsense words
· Speak softly, soothingly and gently

Care Needs
· Recognize that receiving personal care feels intrusive
· Reassure with your tone and manner
· Do one thing at a time
· Talk through the care “play-by- play”
· Be aware of your body language and use it to communicate relaxation and reassurance
· Be sincere
· Use a soft, soothing touch
· Be aware of the individual’s unique triggers
· Be aware that a person with dementia may not accurately judge whether a situation is threatening to them
· They may respond to fear, pain or anxiety by defending themselves with what we call “aggression”
· If they become distressed, stop immediately and allow them time to calm down – don’t try to restart the activity right away
You need to change your behaviour to adapt to the dementia because the person with the disease cannot.

The fibs were the only way we were able to get mom in MC. She was in AL and declining due to her vascular dementia and UTI’s. We were faced with MC or getting her 24 hour sitting services in her AL apartment. That was cost prohibitive. So, we prayed and the Lord presented the one and only one out of the several that we looked at. We signed the papers, my husband set up her apartment (we were able to put a frig in it and a removable room divider. On the day of the move, I took mom for a dental appointment followed by a mani-pedi and then got her hair done. We were going to meet my husband for a late lunch at her new place (AL and MC). While we were gone for the appointment's, my husband and friends moved mom’s things and the 1/2 day caregiver was there to put away her personal items and was there to greet her. We walked from the dining hall to her new apartment/room. My husband told mom that he got a call from her place and that he had to move her stuff out because of a broken water pipe. The place had flooded in the wall but he was able to get everything out before it was ruined. Because the new place was set up, and she was very very tired, she was grateful and happy that she had a bed to crawl into immediately. I kept the 1/2 day caregivers for 7 days because mom is mobile and needs direct guidance. Her short term memory is gone most of the time and she sleeps a lot so the 4 hours a day is guaranteed socializing, showering, lotions, walking, drinking water (Propel). She has been there 14 days and has acclimated well. We are grateful. One night she was telling the caregiver this was not her place. We have pictures on the wall to show her, We have alexa playing BBN.org radio which is a no commercial Christian station. The caregiver called me and I talked to mom (not asking her what was wrong) telling her I called to pray with her and that I wanted to say good night. Mom told me that this wasn’t her place and I reassured her that she was safe and that she was tired -asking her to please lay down and let me pray for God’s protections and peace. She agreed and went right to sleep. Turns out the “flood” story is used to move people into MC and is a normal “fib”. We didn’t know that but since mom is allergic to mold, she was grateful for a safe, dry place. :)

Can you take her to neurologist for testing? You might get some unbiased support and she will hear it from a non-family member.

in the long run, you do it anyway because you love her.I vote to keep her in her home as long as possible over assisted-living. She’ll get used to the caregiver in a home and come to depend on them.

you do need to lock away or move out of the house, all valuables and sentimental things, and get nanny cams at a minimum as well. I’m sorry but you can’t trust blindly; there are too many that are unworthy.

good luck and God bless.

Is more in home care an option? AL does not sound like enough care if she is not even fixing jer own meals? She may not like having someone in the apt to help her, but her choice may be between care takers at home and Memory Care.

While she is still able to sign legal papers, make sure that all of her paperwork is in order. She needs to set up powers of attorney for medical and financial matters, a living will with her advance medical directives, a will if she has assets. I am assuming that you would be her POAs. You may need an attorney to assist, and if she has not done this already, mention that it is something that every adult should do. She needs to plan for a time when she may not be able to care for herself. This is a good time to talk to her about her options if this unfortunate time happens. Would she prefer staying in her apartment with caregivers (and at some point she may need 24/7 caregivers)? Or would she prefer being in an assisted living/memory care facility where they have professional staff who can care for her and will have people her own age around, activities, handle meals, bathing, housekeeping, laundry, etc.? You also have to let her know what your own capabilties are to help her. My mother was living a difficult 5 hours away when my father passed away, and I told her that I wouldn't be able to visit often unless she moved closer to me. When I was my mother's POA I was thankful that she made things easy for me (I was her only child). She made me joint owner of her bank accounts and I got a credit card on her account with my name on it so that I could purchase things for her. She let me take over her financial affairs when she was about 91 years old (I noticed at that time that she was missing bill payments and not filling out checks correctly and offered to do it). I set up her accounts online and paperless. Regarding your mother's situation, there comes a point with memory loss/dementia when a person is no longer able to make good decisions for themselves. Some people with dementia don't know that they have dementia. Sadly, her condition is likely to decline. She clearly needs assistance, but is resisting it and unrealistically thinking that she doesn't need care. Does her primary care physician note anything about cognitive abilities on her chart? You also have to think of what you are able to do. Can her caregivers take over meal preparation and help her bathe, or give her sponge baths? You'll need caregivers that know how to handle people with dementia. At some point, her doctor may declare her unable to care for herself and this will invoke the POA. One thing to realize with dementia is that people lose their ability to think and plan ahead, and can no longer learn new things. You'll have to help her with the move and downsizing, if she moves to assisted living. Only take practical things that she actually uses, clothing should be able to withstand hot water and hot dryer, and be easy to get on and off (elastic waists, no little buttons, etc.). Towels, bedding, blankets and linens that are used, and extras while some are at the laundry. Only pack a few personal mementos, no valuables and no personal papers, especially papers with financial information. Pictures can be hung on the walls, TV, phone, computer if she uses it, etc. Only a few kitchen items, or use disposable. She won't be cooking.

God bless you and, your mother .
She realistically will most likely never think she " is ready" for some form of placement. She grieves her loss of independence, probably feels like she is a burden, ( tho I realize you do not view as such). Emphasize safety with her and, move forward with appropriate placement; be sure her Physician is a part of assessment placement needs, she may need more than ALF if memory issues are already present, again for safety reasons.

Practice good self care! You and your health are important too !

* She is unable to make decisions for herself.
* Does she have an MD dementia diagnosis, indicating she cannot handle her financial and healthcare ? that she is incompetent to manage / make decisions for herself?
* Whoever is the POA must make these decisions.
* You do not 'get her ready to agree.' This is not possible. You make the decisions that are necessary. First, you need to have medical documentation of her competency.
- You tell her it is temporary or whatever will appease her.
- You do not argue. You say "I understand [how you feel]" - listen and let her know she is being heard (this is important). Then you do what needs to be done.

This is urgent.

Gena / Touch Matters.

Mom thinks she isn’t ready yet because she is not understanding that your helping is what keeps her’ independent’.

A Geriatric Psychiatrist can educate, medicate and recommend an appropriate placement. I'm sure there's some medication to help with tantrums, something I will be looking for in the future, I'm sure.

LloydS: Perhaps your mother needs to see a neurologist, who can provide her with an M.R.I., which is typically the gold standard to detect for dementia.

You are now in the parental role. Time to be loving but firm. Should she really be living alone? Tell her she needs rest and company, you are going to see that she gets it. If necessary, you will ask her doctor to order it. She is scared. She is losing it, knows it, and a new situation and lack of control is terrifying. Reassure her, stay close during the change. She needs care. Your job is to provide it, not get her approval, just reluctant acceptance. A friend stayed the first day and night in her Mom’s AL apartment which was helpful if possible.