What do we do if mom is refusing all of our efforts to help?

If one of you can't stay and monitor for a few days (or even if you can), I would highly recommend getting her assessed. It can be done in the home with one or both of you there (before they assigned aides, the agency sent a nurse to do this, covered by Medicare.)

It sounds like you are assuming she doesn't have dementia, but the comments made sounds like she may be in the early stages:

"...calling and checking to see if she’s eating- she says she can’t remember."
"She has a bad memory..."

Dementia can mean many things and have many symptoms (or lack thereof.) Forgetting things happens as we age, but not recalling whether one ate or not, I would be concerned. In the early stages, it can just seem like bad memory (which does happen with dementia), but they can seem normal too. It isn't like she's going to be stark raving mad, and it doesn't happen suddenly, it is a progression. Many people and doctors miss it, because they can seem so "normal", just perhaps a little slower or a little forgetful.

Misconceptions about dementia abound. I wouldn't even mention the "D" word around my mother, because to her it DID mean you were "off your rocker", aka crazy, but it couldn't be further from the truth!

Assessment first. Plans from there may change.

(refusing help, live in or not, or refusing to move can be part of the condition too.)

To cont the life alert topic...

I pushed my sister to get one. She does use it regularly. But she has also lain on the floor all night, been stuck in a chair, on the bathroom floor & NOT pressed it. Reasons include: I didn't fall (I slid, or I was stuck) so I didn't press it.

Friends have reported their relatives have not pressed the button because: Didn't wear it. Was wearing it but didn't remember I was. Didn't remember what it was for. Didn't even know where I was.

The reason for the fall may include TIA or any reason for lapse of reasoning.

And this gem! Family visit & ask FIL where MIL is.

'In the garden'. What? She can't get out there, or do any gardening anymore? She had fallen out there was found in the garden bed. How long ago did this happen?

'Just now'.

The woman was very sunburnt & dehydrated - EMS called & transported to hospital. Her life alert was in the house where she left it.

Elaine, I am so sorry.

Sometimes I do believe fate is already written - life alert of not 😞.

Rosadelima I wrote to you on October 26. Then I went to my mothers on October 27th 48 hours after I had last seen her laying on the floor on her stomach.

I called 911 and they took her to the hospital. She had pneumonia and a stroke.



I have all the phone calls on my phone of her calling me and telling me not to come over. She will wash her feet herself. Don’t come over. She told me that on the Friday before October 23rd.

I wish I had talked her into life alert. My mother n law had it. My mother refused it!!! She said she didn’t need it.

I saw her Sunday and then Tuesday. She fell somewhere in between.

No, no Alva deer it was me elaine1962 with the mother with the dirty feet. They washed her body today and tomorrow will be a shampoo cap.

I started crying today because the nurses were able to clean her but she wouldn’t let me!!! But she is out of it now so that’s why.

Therr is nothing you can do if a loved one refused help. My 96 year old mother who lived in her 2 story house alone had a stroke and I found her on the floor. She had a stroke and pneumonia. She is now on comfort care at the hospital.

Imho, this was my mother. She demanded to live alone in her own home 7 states away from mine. I had tried to amend her living situation. She never spoke up even when her blood pressure ran 60 over 40 and she was at "passing out" stage. I said to her - "Here's what MUST happen - you will call your LPN friend to come and stay with you or you will call for the ambulance until I can get there to live with you." Prayers sent.

Lealonnie1, one of our most frequent and loved posters on Forum, can tell you exactly what you have to look forward to, as her Mom is just the same, and now she is in hospital with a stroke and the people caring for her Mom looking at her like "How come her feet are dirty". Her post today is in Discussions. Well, basically because Mom refused help and care. She did it her way. Likely the stroke would have happened no matter where she was, but her daughter has the added sadness of knowing that some little time passed before she was found.
Honestly, there is little you can do. Some of these stubborn folks want to stay home and do it their way. I had a MIL like that. There is nothing you can do but offer help and safety and you have done that. Yu know where this will go; likely Mom does as well, and still prefers to do it her way.

I can relate to this in some ways and have some suggestions which may or may not work. I will be 87 years old with not living soul and only a couple of long distance friends left. I am disabled and can't walk but I FORCE myself to do the impossible (it nearly kills me with pain but I refuse to give in - I just want to be NORMAL and do what normal people do). I almost never, except in the most extreme circumstances ask for help. I drive and have a walker and use it but when the pain is severe, it is h*ll lifting it up into the car and I am forced to ask for help and feel so ashamed and hate myself for not being able to do something so simple. Perhaps your mother is very independent and insists on doing things herself so she has some self-respect and self-esteem. She does not want to feel she can't - that would kill her emotionally, like me. She may not want to feel obligated and ask anything of others. Why not tell her you love her and it would make YOU feel so good if YOU could do something for HER even if she feels she can do it. Sometimes that works. Or you can take the tough stand and lay the law down that from now on, this is the way it is - end of discussion. Be prepared for a no response. Or, you may just simply have to accept what is is the case and let her be even it is dangerous or harmful to her. Leave her be happy in her little remaining time.

How do you know she doesn't have dementia? Has she been evaluated by a neurologist and clinical psychologist? She can recognize you and converse coherently, while still having a level of dementia that makes her very vulnerable to scammers and exploiters, as well as vulnerable to accidents like leaving the stove on, not eating, not taking meds. She made be incontinent and hiding the soiled bedding, meanwhile developing hard-to-treat skin sores from contact of waste on skin and not bathing. Someone should go by every day. If not, she could fall and lie on the floor for days--then if she survives, she has kidney and organ damage from not moving for so long, damage from almost starving.

Can you and the sister arrange visits that will happen every day? At least you could take inventory of food to see if she is eating or prepare meals for the frig to see if those are gone.

With the medical alert, for a long time my mom hung hers on the walker. I asked over and over for her to wear it. Tried to tell her that if she fell, the walker could be too far away to get to. One day I kicked the walker away from her and said, what if you fell and the walker rolled that far away from you - how would you get the alert button to call for help. She eyeballed the situation for quite some time and I could tell it finally clicked. She has worn it ever since. She recharges it at night on her bedside table and puts it on each morning.

With covid it may be hard to see a podiatrist, but that's a dr visit that should be made at least 2 times a year. If out of the question, ask some beauty shops in the area about home visit and have them come while one of you are with her.

Ask her doctor to request bathing help and a nurse to come by. She will probably have to see the doctor in person (or online) because of Medicare rules, but it can be done. If she needs help with bathing, either you or the sister are already doing this for her - explain that the service can be paid for with her insurance. Her hygiene and nails are important, falls in the bathroom are a huge problems and you want to keep her moving as long as you can. One slip in the bath could mean lying in a bed the rest of her days. Clearly that's not what she wants for herself. If you get inhome health care to help with bathing, maybe adding a housekeeper would be accepted later on.

As the daughter whose mother just passed away in a facility, I can't agree more with those who are telling you to let your mother be. Let her live her last days as she wishes and no matter what happens, be proud of yourself for allowing that. I know it is hard and not guilt free for you, but I can tell you that any option you force upon her will also not be guilt free or easy. Imho, telling her that you will do as she wishes is the best gift you can give her. If you can quarantine yourself for 14 days and visit her, that would also be awesome. Isolation for the elderly is worse than death.

As the daughter whose mother just passed away in a facility, I can't agree more with those who are telling you to let your mother be. Let her live her last days as she wishes and no matter what happens, be proud of yourself for allowing that. I know it is hard and not guilt free for you, but I can tell you that any option you force upon her will also not be guilt free or easy. Imho, telling her that you will do as she wishes is the best gift you can give her. If you can quarantine yourself for 14 days and visit her, that would also be awesome. Isolation for the elderly is worse than death.

Let her live what's left of her life the way she wants. The long toenails aren't pretty but, it won't kill her. Drop by as much as you can with her favorite foods but, please let her be where she wants.... at home in the peace and quiet.

Installing some cameras would be a very good idea at this point. My mother was still mobile, still able to do most self care and "seemed" okay. The forgetfulness itself isn't always a sign, however if there tends to be repetition of current issues, it could be a red flag. Repeating old stories from the past might be okay, but when they ask or say the same things within a short period of time, this is likely early dementia.

My mother's condo was mostly 1 floor, but there was a finished basement area. Granted she didn't use it much by this time, but those stairs were awful! I hated using them and was concerned about falls. She denied using them or going down there, but the cameras YB put in told a different story. Not much usage, but it only takes once! I did have to get WiFi installed, but it was very helpful being able to keep "eyes" on her. There were 3, one outside the door to monitor anyone coming or her going, one inside the door, that could view the table where she would eat and/or spent a lot of time and one in the basement.

For the most part, she was okay to be there alone. We did try hiring aides, mainly for a sanity check as none of us could check daily, and to check she took her meds. The agency sent a nurse to eval mom, and this included a better cognitive test than the one they use in a regular doc office. Medicare DID pay for this test. She recommended a timed/locked dispenser and the aides (only the 1 hr minimum) would check and remind her to take any she missed (they can't dispense, but can remind.) The plan was to increase the time/days as needed, but less than 2 months later she refused to let them in.

The cameras WERE useful in that they can be enlightening. She developed a kind of OCD behavior before bed, ramping up to 1-1.5 hours of checking several places before she would go to bed. Probably some form of sun-downing, but she wasn't aware she was doing this.

After refusing the aides, I searched for a place closer to me for her. Thankfully they just opened the MC unit in time. Had we not been planning to move her at that time, she might have died from cellulitis, as she "bruised" her leg and didn't have enough sense to tell one of us or seek treatment. That is bad enough for anyone, but can be a quick killer in the elder! It delayed her move a few days, to get initial treatment started and required TWO rounds of anti-biotics, elastic stockings and wound care for quite some time.

The things you don't see when not living there would probably make your hair stand on end!!! Cameras are the next best thing, if you can't arrange for one of you to stay for several days or a week. Early dementia has the capability, in many cases, to hide itself from us. When we don't see someone for anything other than brief visits (includes doctors, they don't spend enough time with the patient to see through the charade!), we can miss the early signs.

Mom used to have YB clip her nails now and then, but rather than haul her to a podiatrist, the MC unit brings in a home health nurse who can clip and trim nails. Perhaps you can find one who can come help her with that. I understand she doesn't want anyone in, but if you go that day, be there with the person and see what can be done, at the very least she would get one trim! If not, she could end up with infections and/or need more invasive treatments at a podiatrists! Coax as best you and the nurse can, offer a reward of something she especially likes.

I would definitely either find a way for one of you to stay with her for extended time, or install cameras. She is likely a disaster waiting to happen.

My dad is 95. We installed BLINK cameras. They use WiFi. We put up four that show different rooms. On one camera I could make sure that he was in bed. I can watch him on my phone.
I got a caretaker for 4 hours at first. (10-2) I told my dad that she was a “cook”. She made sure he had a good lunch. As time went on she came earlier and stayed later
(9-6). One morning we could not find him. He had fallen in the bathroom. Now he required around the clock care. I put a wireless bed monitor on his bed so the caretakers would know when he got up. They would help him to the bathroom and then back to bed.
One day he was going “home to Texas” and someone had better take him or he was walking there. Because of COVID I could not move him to a memory care facility. His dementia had finally gotten to the point that safety was a issue. I moved him just a week ago to a private pay memory care. Very hard to do but I took his chair and bed etc and he thinks he is at his house.
I took my dad to a podiatrist. They take care of those toenails in 5 minutes.
After that I just kept them filed or clipped. I bought a nail grinder which is easier than clippers. Bathing. I bought adult wash gloves that are heated in the microwave. One day we did arms another day legs. I have a lady clean every other week. Let her be home as long as she is safe and nourished. It’s a hard road.
Visit the private pay facilities ahead of time. You will know if and when it is time for her to move. I have a POA to sell my dad’s house for funds to pay for private pay care.
He is now clean, safe, well fed and has social interactions. I can visit anytime I want. I had WiFi installed in his room and put up a camera. I can still see him in his bed at the facility
God Bless You

our mother lives alone also (I am two houses away from her), she is 93.  now......I take her food every day and she has a "reserve" of tv dinners which she only eats once in a blue moon (haha).  she is diabetic, takes meds.....I noticed the other day she was not taking the one correctly that is to be taken 2 times a day.....she apparently only been taking 1 time a day.  So I reminded her about that.  Then she has an issue with her ankles/feet (and sometimes legs)swelling.  I told her she needs to drink more water (that's like talking to a wall), needs to make sure she moves around a little more (not sit all day) and to keep her legs propped up when she is sitting (she don't do that either).  I know she is starting to have some little changes in memory.......but I think once they (and we will too) reach a certain age, they gets the craps of "having" to do stuff they don't want to.  So they(we) get stubborn and all we can do is remind (nag) or whatever you want to call it and hope they listen.  Once a fall has taken place then it will be up to others to decide whether she can be alone or not.  I don't know if maybe you can ask her to do it "just for you" this one time.....then she might like the extra help even if for just 1 or 2 hours a day 3 times a week.  It would give her someone else to take to also especially if she doesn't get out much.  Wishing you luck in this.

I had a very similar situation with my dad. I stayed with him. The issue is they don't see what we see. I don't feel she sb there totally by herself.
My dad was the same way stubborn. She might start falling in areas where the cameras aren't, she could get Urinary Track infections. She might try to drive or walk outside then loose her train if thought.
I would ask her state Elder options for resources on helping her and give you advice. If your a Veterans family ask them for help. It will stress you out not being able to help bc she probably won't use the medical alert.
The best thing for me was to get a little ving surrogate will, doable Power of Attorney and see about a DNR - do not resesitste form. That way you'll know what she wants and you won't feel guilty about making that judgement call.
It took my dad awhile to get used to having someone else help but I couldn't do it by myself.
Also, check with In home Hospice, not every client they work with passes away.
You may also want to take a Caregivers course, through Elder Options it's free.
Elder Options might be under a different name it depends on where you live.
My dad passed a month ago at 95. I'm satisfied for the most part I did everything I could do and he passed peacefully and painlessly.
See if some one like the police or Fire Station can do a wellness check once a week. Go to your fire station for a sticker to place on her door and get a list of medication s she takes and leave it in her refrigerator so who ever comes has that. A wellness check from a friend or what I just mentioned is good. She will get over not wanting help if my dad did anyone can!!!!!
You maybe able to get those forms online but we went to a lawyers office. Make sure it's done with your sister.
There is a lot to think about. Feel free to leave me a message.
It will work out.

Is she safe?
Does she have problems with balance or movement that would indicate that 2nd story isn't safe for her any more?
Does she remember have expired food in her refrigerator that she eats?
Does she medications she needs to take regularly and a pill box to organize/remind her when to take them?
Does she forget about the stove or oven when it is on?
Is the home clean and garbage taken out regulary?

Is she healthy?
Does she bathe every day - smells fresh and hair isn't greasy?
Are her clothes clean and in good repair?
Are her nails clean and groomed?
Does she have access to nutritious food and eat enough to sustain her weight?
Does she have daily interactions with others who help to monitor her health?

If your answers to these questions and others that come to mind are mostly negative, then it is time for mom to live with somebody or have people come into her home. Consider that she needs day time "help" who will help with her personal needs and the needs of the home. Ask family, friends, folks from your community of faith, and "paid help" to come by every day of the week. You can have each person fill in a journal of what they did when they visited. You might also want to consider a few overnight visits to make sure she doesn't wander off the property at night.

Since your LO is independent-minded, it might be best if folks came to her as "visitors" to help or give her "gifts" of housecleaning services which are in reality home health care aides. Please remember that home health care aides can not dispense medications and only "remind" folks to take them.

Home IS sweet home.
But when caregivers are turned away... it becomes a Dignity of Risk vs Duty of Care situation : choice vs safety.

Install cameras in the home and buy food that is easily fixed like microwaveable and instant and ready made like yogurt, breakfast bars, applesause, milk and juice.
Do what makes your mom happy, don't worry that her home isn't that clean. Ckean the bathroom and kitchen when you go there to visit.
Install Cameras in the home so you can keep an eye out. Unless she is smelling, don't be concerned how often she bathes as she can clean herself with a face cloth as in spit baths.
Make sure a couple handrails are installed in the bathrooms where most Falls occur.
Better to let your mom stay in her own home in comfortable and familiar surroundings and be happy then to make her miserable by trying to make her move.
Let your visits be fun not have her dreading that everytine you come all she hears is complaints, even if you think it's only because you care about her.
Juse make things easy for her. If she doesn't have a bed downstairs, bring one down from upstairs.
Most seniors don't live very long moving them, especially in to a Senior Home, they get depressed and have to be told what to do and when to do it and sometimes are treated bad.

My 96 yr old Dad is living in his own home but he has dementia so he has Caregivers.
I have Nest Cameras set up so I can check on him any time 24 7 and make sure he is being treated right.
Do the best you can, offer help and let your mom have a peaceful last days, months, years she has left.

Maybe you could find a Live In if your mom agrees.

Put yourself in your mom's shoes and think about what you would want because your time will come.
People think placing a loved one in a home is best for them but in reality, it's really done more of what's best for them so they don't have to worry about the loved one.

From what you write it sounds as if she is doing remarkably well, even for someone 75 or 85,... and she’s 95! I don’t see much that needs fixing here, I would consider this a huge blessing and invest time more into the relational aspects with her. Western society tends to automatically associate anyone over a certain age as most certainly needing a lot of extra help. A friend of mine pointed out she had known and also heard of a couple seniors in their nineties who participated in a walkathon and have zero dementia, happily it sounds as if she is cognitively ok, you said sometimes she has a bad memory but no dementia, and has overgrown toenails, and her independence is important to her, and that you stop by every week. Unless there’s other things you didn’t mention that are really serious and I wouldn’t imagine that’s the case this seems to be a case of not much needs fixing. you check in regular, she doesn’t have dementia, she has food — since you see here you’d notice if she wasn’t eating much at all you would be able to tell by her appearance, since you didn’t include weight loss she must be eating adequately. You say your frustrated she won’t accept more efforts of help, i think in a indirect way she’s trying to express one of the things you can do to help is allow her that freedom and independence she needs it’s actually an important part of her self esteem and overall health is to retain the level of independence she’s been able to maintain, I would focus more on relationship, talking with her having a cup of tea, talking about things that interest the both of you, your really fortunate she’s definitely in the small percent of seniors who do really well into very advanced age.

I'm not sure this is a good solution to anything. But if she is like my mother was, she can't be talked into anything much. However, my mother always loved a good soaking bubble bath. ( As a younger woman, she and my father would sometimes visit a "hot springs" for "mineral water baths") At 88, no way could she use a bathtub...even showered infrequently. Most of the time, I think she considered even that too much effort since she was no longer very mobile. But she did allow herself to be talked into a "spa-like" treatment with a warm bath, fragrant bath salts, soaking as long as she wanted and a gentle message afterward... Could you find enough help to get her in and out of a bathtub and provide her something similar as a special "treat"? Maybe followed by, as an added surprise, a pedicure from someone who knows how to safely do overgrown toenails). Just an idea.

Rosadelima,
You stated that your Mom has a bad memory, but not dementia.
I am curious to know if she has been tested by a Geriatrician?
My Aunt was misdiagnosed by her PCP.
What he called mild cognitive impairment was later diagnosed as Alzheimer's by a Geriatrician.
This may be important for you to know.
This is a very tough situation!
Sometimes doing what is safest and best for our LO'S is the hardest thing!!
Keeping her safe is paramount!
Don't lose sight of that!
God bless!!

It is heartbreaking to see the elderly deteriorate. There are several emotions that they feel too.

They don’t want to be a bother to anyone. They are modest so it’s embarrassing to have help bathing, toileting, etc.

If they previously fell in the shower like my mom has it is frightening for them.

They wish to remain independent and many people are extremely set in their ways.

It isn’t always easy caring for parents. It can be challenging. Best of luck to you.

PS 'Just say no' or 'I'll manage' 'don't fuss about me' etc can be cover up answers. They can hide vascular dementia in my opinion. Seen this many times.

Look out for these flags;

Weight loss.
Forgetting to eat/drink, not eating/drinking enough.

Unkempt hygiene/hair/clothing.
Unable to remember when last washed. The steps of the process becomes too long/hard. Unable to make appointment for podiatrist etc.

Unexplained bruises or burns.
Are falls or kitchen accidents happening?

If so, speak to Mom's Doctor about a needs assessment. You still may be powerless but there are ways to sneak home heath aides in.

You've joined the club : Awaiting the Crises.

Welcome.

The good news is your elder is living her way & probably will do until the 11+ a half hour. A life well lived.

The bad news, as you read from many others who tread this path, there is not a lot you can do. It can be heartbreaking to watch.

Decide with your sister what's reasonable as to what you will both do regarding visits - maybe a daily phone call each - am & pm?

Rosadelima.i am going through it with my mother at age 96 living alone in her 2 story house. She stays downstairs now since she can’t go up the stairs.

If she even has one ounce of competency in her, APS will do nothing unless she is deemed incompetent. The law is very clear. You can’t force any elderly person to do anything!! I mean anything!! I’ve cried to everyone who will listen. They all say the same thing. “I’m sorry there is nothing we can do Elaine since your mother is competent. If your mother doesn’t want to bathe she doesn’t have to, if she doesn’t want her hair washed she doesn’t have to, if she doesn’t want to change her clothes, she doesn’t have to. There is no law saying she has to.

Someone once told me they can’t make an elderly person bathe in a nursing home either. I just keep thinking if my mother did go into a nursing home that possibly the trained staff could talk her into it.

It is a horrible situation to be in. You can’t help someone who doesn’t want to be helped.

See if Office of Aging will go in and evaluate the situation. Hope someone has POA. Medicare will pay for her toenails to be done by a podiatrist ever 10 weeks.

Unfortunately and this is often the case you can not "do" anything or "force her" to do anything. So it is a waiting game. you wait until she either agrees that she needs help and permits it OR, and this is the kicker, you wait for some catastrophic even to occur. A fall, her getting ill that will force a hospitalization then hopefully rehab and you can, at that point say, "mom, you can not stay at home alone. That means either having someone move in with her, caregivers taking shifts or moving her to Assisted Living or Memory Care.
The big unfortunate thing is often these catastrophic events do not end well.
If you can begin a conversation with mom in that way. If she is willing to agree that if she fell there would be larger problems, that might be helpful. But I can tell you my Husband was stubborn and there is no way that he would have agreed to have help come in, he would not have agreed to move out of his house. If he had not developed dementia he / we would have remained in an OLD 2 story house that was not in any way set up for "aging in place". If either one of us had fallen and or needed help it would have been a nightmare!

If she insists and you want to make this work then if possible eliminate her having to go upstairs. Move a bed down stairs, convert a room on the first floor into a bedroom. If you can make a bathroom easier for her to use. Rip out the bathtub and put in a zero threshold shower. If the toilet is a standard height put in one that is ADA compliant (if your mom is short maybe the regular one is fine)
I would place a door at the base of the stairs so she does not have to go upstairs and I would lock it so she can't go up stairs. (maybe a little excessive but it would be safer. It would also save a bit on heating you still need air circulation but you can close off some registers)

If this can't be done then the only thing to do is ... wait...
(short of having her declared incompetent and forcing her into Assisted Living and that may kill her just as quickly as a fall would)

The bad memory at some point can be serious enough. You mention your sister. I think your posting here does tell us that you are worried, and I think rightly so. Whether there is a future of visits needed for care giving in terms of cooking, cleaning both herself and her place, Covid-19 or no (so yes, ALWAYS carefully masked)--there is already now a need, as I see it, for twice daily safety checks. Even that is a risk where fires and falls are concerned. I wish you luck. Really tough at this point. A fall at this age can be deadly and very quickly.