How to handle a difficult mother who refuses to go to assisted living?

If an elder refuses to move to Assisted Living there really isn't much we can do unless to take them kicking and screaming.... the Assisted Living facilities are very familiar with this and they do what they can to make the new resident feel welcomed, it's not easy.

One thing positive, your Mom does allow Home Aides to come into the house. So many elders even refuse that type of help. Maybe you need to hire professional Caregivers from an Agency, if it is within Mom's budget, and the Agency usually have Caregivers who can over-ride the resident to do what actually does need to be done. Like going through Mom's closet and washing the soiled clothing.... going through the refrigerator to remove expired food [when the client is napping is usually the best time to do this].

Depending on your Mom's age, many elders remember back when "nursing homes" were actually asylums, thus the reason they will refuse to move. Trick Mom into visiting one, saying you are helping a friend look for a senior living complex and you can get a free lunch [if you call ahead]. Mom might be pleasantly surprised, and may even see someone there that she knows from the past.

Otherwise, you will need to wait for a medical crises to happen. My Mom was very stubborn, wouldn't move nor have caregivers nor have cleaning crews, and here she and my Dad were in their 90's. Yep, we have a crises, a very serious life threatening fall, and Mom lived her final 3 months in long-term-care. Dad happily went into Assisted Living and loved it there.

You do not note whether your mother has granted you authority under a Medical Power of Attorney and a Durable [Financial] Power of Attorney. Could you carry out the doctor's orders using these? At a minimum, the "Home Aides" should be replaced by people who actually do their job, Have you considered an "anonymous" report to Adult Protective Service?

Based on my experiences with my mother who had dementia, I would do whatever it takes to get your mother into a nursing home rather than try to find the right home health aides. I say this because your mother has put inedible food back in the refrigerator and may do something more dangerous in the future.

It sounds as if your mother needs to be in a memory unit unless you can hire 24-hour aids through an agency who, as was suggested, "actually do their jobs."

If you have a Durable Power of Attorney you can do this. If not you may need guardianship. Your doctor can back you up. If she never speaks to you - well, that will last about a day - but just roll with it.

Most elders have no idea how nice most modern assisted living facilities are. Yes, there are bad ones, but, in most states, they have improved immensely.Many are lovely and offer compassionate care. The same is true for many nursing homes. Both types of facilities often offer memory care.

I feel that this is a case where you have to override your mother's wishes because her brain will not allow her to think clearly. She needs your help. It's very hard, I know. We hate having our parents so upset with us. You'll need to be prepared for her to be nasty to you even after you move her. Just let it go. Eventually, she will likely get so that she enjoys herself, especially since you indicate that she is social. This could be the best thing that every happened to her, yet she may not admit it to you. Bite the bullet anyway and do what must be done.

Good luck to you with this. It's tough. Many of us know this.
Carol

I am getting ready to take my mom to court for guardianship and what I have found out since my mom has lived with me is that my mother is never happy and has continuously stated she was going to find some place else to live but never does. My mom needs 24 hour care and will not allow home health aids to come into the home, so we are moving forward so I can make the decisions for her safety. I figure if she is unhappy she'll just be this way no matter what I do so she can be unhappy here or in assisted living facility. Guardianship is the way to go. Safety first. She'll talk to you it's her way of controlling. My mom has said that to but she still talks and has the lovely mood swings. Never changes. Bring peace to yourself and move forward.

As has been said, this is very hard but...

What choice is there?

You have to bit the bullet and do what is necessary.

I was in a similar situation. I did force my mother into the AL, it was awful, and then she began to receive the correct medications in the correct dosages. And life was good. That was 2.5 years ago.

Today it is all just a bad memory. I visit my mom and she knows who I am and we play cards.

Even if your mom won't speak to you, is that worse than what is happening now??? Are you having great conversations with your mom?

Do what is the best for her and let the chips fall where they may.

You have to think of her more like your child now than your mother. As with our kids who puff up scream holler and cry say I hate you & all that. Well they get over it. She will to. It may seem harsh for a bit but you have to do what is best for your mother bottom line.

To me, it's pretty easy. What's more important? Her well being or the threat of never speaking to you? How involved is your sister in all of this? Maybe she needs help as well.

As mentioned here, it also sounds to me like she just needs to be in a different facility like memory care. If she needs round-the-clock care then assisted living won't cut it, not by a long shot. I wouldn't worry about her feelings when going for guardianship, you must do what you must do, you don't really have much of a choice in this matter if she needs a guardian. If you can't do it, someone else will believe it or not, like it or not someone will take guardianship of her even if it happens to be the state it's going to happen one way or the other whether she likes it or not. Not taking guardianship of someone in mental decline will result in serious consequences later when something happens like her wandering out into the street and maybe even getting hit by a car by someone who can't stop in time because she just ran right out there without looking. She could end up in some other very dangerous situation and maybe with someone out there with a criminal history. Another scenario is if someone doesn't have guardianship of her, she could very well end up getting scammed out of all of her money or maybe even forgetting to pay the bills and she gets evicted. Assisted-living is for people who can still take care of themselves and are ambulatory, not for someone needing nursing home care. You would hate to walk in one day and find her on the floor because if she falls and maybe breaks a hip, there may not be anyone around to help her back up. Another thing to consider is if she has a medical emergency, she may or may not be able to get to the help box to get help. There are so many things to consider before enabling potentially dangerous situations to happen by someone somewhere not getting guardianship. Not getting guardianship of someone who obviously needs it is very shady business, no guardian means bad things can happen anytime to that person obviously needing guardianship. It's the same thing with letting a child running loose and something happening to that child sooner or later, you just don't let children run loose no more than you would let a demented person run loose. My foster dad was a perfect example of why they guardian was needed because dad badly neglected himself and he didn't realize when the dump he was renting was actually falling down around him due to severe deterioration all because the slumlord let it get that bad. The multi apartment house clearly could've fallen down on him and I would've walked in one day to find him in the rubble. What actually happened though is wild animals were getting into the building. Yes, we had raccoons and stray cats even getting inside the walls. On multiple occasions though, raccoons would actually show up in dad's apartment, so this was a dangerous scenario and he had no guardian at the time and I was far from able to do that kind of thing. He had no blood relatives left and when you have a demented person in a dangerous situation with no one able to take guardianship and definitely no family, this is a very dangerous mix because dad could've easily gotten bit by what could've turned out to be a rabid coon. The wildlife authorities didn't want to seem to do nothing and neither did the city cops, or even the fire department. When the cops finally came, all they did was just take the raccoon out in the front lawn and turn it loose, only for it to find its way back in days later. I personally think we had a bunch of incompetent people working for our town and whoever was working in a position where a lot of wildlife was concerned and refusing to help was also in competent! Not one of those people should've ever been in those job positions just because they either don't want to do it or they don't handle these matters. If they don't help in the situations then what the heck are they even doing in those jobs? Public servants are just that, they're supposed to help even in situations like this where you have an elderly person who is declining and they happen to get a wild raccoon in their apartment and can't get it out. Yes, at the time I suspect my dad had dementia even at time, but I was at the point where I didn't recognize it until it further developed later. Dad should have had a guardian much sooner but hindsight is a very good teacher. Someone out there can hopefully learn from my experience because someone out there is most likely a first timer who doesn't even recognize warning signs of mental decline, and this can go on for years until one day you wake up and it's unmistakable and very obvious that you're loved one desperately needs the help you're not able to give them. Guardianship arrangements should actually be made very early as soon as the person is diagnosed with mental decline. Don't wait for something to happen before someone goes for guardianship whether it be you or someone else, even the state. Don't wait until the person is badly sick, hurt or broke due to scams before guardianship is in place.

Well if her doctor deems her mental state is such she cannot be left alone, then just take her to the facility (with the doctor signing all necessary papers) and let professionals care for her. What difference does it make what she says? She has dementia! Pretty soon she will lose the ability to speak and you won't have to listen to her. What makes you think people with dementia are rational? You don't say if you have Medical Power of Attorney. If your sister says she thinks your mother is "happy", then she is in denial. Dementia is NOT a "happy" disease. It only gets worse and your mother is in a terminal illness, so put your adult, rational thinking in gear and help her because she cannot help herself!

I've said this before relative to my own situation with my mom, but there is a point, as other posters have said, that the parent-child roles reverse. I'm getting there with my husband too. You should also realize that if someone comes into her home and sees the state in which she is living, they could very well file a report with Adult Protective Services. It's time to use whatever means you need to in order to get Mom the care she needs.

I agree with others that you need to move ahead with whatever will get your mother into a safer situation. It is unlikely that AL is the best choice so consider memory care. I understand how it feels when your mother says she will not speak to you. That might happen, but likely once she is getting the care and medicine she needs, she will come around. With my mother i had to wait for a crisis. After a hospital stay, she was transferred to a nursing home for rehab. I refused to take her home and eventually i moved her to another facility. I did have POA.She accused me of every nasty thing such as stealing, lying, etc. It was deeply painful. Now 8 months later, she has settled in, and has forgotten how much she hated me. Of course you have the complication of a sister who wont back you up. One thing I did was restrict my visits with her for while. I did not see her alone and came only twice a week. One visit was a treat going out. The other was a bit more social and taking care of practical matters. You are not alone going through this. I got terrific support and practical advice here. Good luck to you.

My husband and his siblings had a simular situation. At some point you become responsible for her safety. If you are aware she is in danger and don't do something you could be held liable. They had the doctor make the order and they took her to the home. You have to get your siblings on board. If they refuse speak to an elder care lawyer and let them know you have told your siblings your concerns and they refuse to help. This way you have documented proof.

Sometimes people are just not in a position to be able to do anything like others are. At very least they would ask around if they don't know the ropes like I had to with my foster dad until I finally found out there was such a place as the APS and where it was. If you're not able to intervene, they can't hold you reliable for that if you just don't have the knowledge or resources. However, as mentioned here, they can hold you accountable if you flat out refuse when you know someone's in danger, but I tend to think that only if you've voluntarily taken responsibility for them as a or guardian or medical POA. I know when my foster dad was declining and had no guardian, I was definitely not held responsible since I was not in a position to be able to help him. At very least I could do is start calling around and asking to see where I may turn after telling about the situation. Most of the time no one could help, which made it much harder for me because I lacked the help needed to get him out of a house that could've fallen down on top of him anytime, and I definitely didn't have the help needed to get other stuff done for him that clearly needed done. This was one of those situations where a friend finally told me that I've done all I can do at that point and all I can do is let whatever happens happen because there's nothing more I personally could've done in my situation. I was by no means held responsible for him, I was already doing everything I possibly could with what little knowledge and resources I already had. I was glad the APS finally stepped in but I was definitely not happy with the guardian who had to end up taking over everything. Sometimes when guardians take over, things don't always turn out desirable or favorable to the family or other loved ones, but I guess that's just how the cookie crumbles sometimes and there's really nothing much you can do about it when I big shot lawyer happens to be your loved one's guardian. I hope I never get that bad and need a guardian, because I could at very least sense when somethings wrong and throw a fit about it and become very combative and uncooperative like my foster dad currently is. I think something is definitely going on in that nursing home that shouldn't be going on because I can see it in dad's reactions

If your mother needs 24/7 care, AL might not take her unless they have a memory care unit. Unfortunately, neither home care aides or AL aides can force a patient to do anything. You need to get a doctor's documentation that she needs guardianship. I would guess a memory care unit aide has much more authority to get a patient to do things? (not sure, if a legal guardianship, changes things and you could give caregivers more authority, like with caring for a child too young to make decisons?) I just know in AL, my mother still refused to bathe and they could not, by law, force her. They only succeeded twice in a 9 month period to convince her to take a shower with help. AL doesn't watch residents 24/7, just assists physically, monitors to make sure they are safe, healthy and go to meals, keep their apt clean, etc.

Yes, you feel guilty, but the truth is, your mother is not your mom any more - you need to be her mom now - as hard as that is, it is for her own safety. She is incompetent and doesn't know it. Wouldn't a memory care unit be a lot less expensive than 24/7 aides? - and the upkeep and expense of her home, bills, etc (the stress of which is on you, not her) would be eliminated. Eventually you will end up cleaning out the house and selling it anyway. And you can use the money from the home sale to pay for her progressive needs for more and more care.
Our mother had many of the same behaviors, rotten food, filthy clothes, not bathing, forgetting to eat, stubborn, mean etc. Physically she was healthy, but unable to function in independent living. She couldn't be trusted to take medication, she wrote little notes all over the apt, then wrote notes directly on the refrigerator. My sister fought me on moving her for three years from IL (for 5 years previous to IL, getting her out of her house - where she refused to let anyone in except us - so we had it all). as she went further and further downhill mentally. Finally, the doctor agreed to document she couldn't live in IL with her level of dementia. IL then said we had to move her (which removed some of our guilt as it was a "higher authority" decision). The good thing is - you already have that from your mother's doctor, you just need to make it legal with the courts.

Of course Mom didn't want to move so we never told her the plans. Sis took her home for 3 days while the rest of us moved her to her new home. We gave her a tranquilizer, sat her down and informed her she no longer lived in IL. Then took her to AL and left her with the people who have dealt with these situations many times. Yes, we felt guilty, but at this point Mom could not make rational decisions and we knew she would be safer there. A plus over caregivers (some are good, others just babysitters) is AL has company of others her age, people to eat with and entertainment and professional staff there 24/7.

Even in AL, Mom struggled and 9 months later ended up in NH where she lived 5 months before passing in March. When the downhill mental slide begins, it is pretty fast but at least she had good care by people better able to deal with her problems than me (70 & sis 78)
Its been 9 months since Mom passed and I am still sad but know she is in a better place, and we did the best we could for her, as long as we could. Sad of the way things went for her because we waited too long to move her. We were so often frustrated and angry with her for not cooperating when we should have known it was not her fault, it was ours for trying to reason with a person who was no longer rational and not able to be there all the time.

I wish you luck. Try not to feel guilty, just tell yourself that you are doing what is best for her, and the situation is just like a child who resents a parent telling them what to do, realize this is the point in life when roles switch.

It's good to hear stories about elderly people who are careful who comes into their homes, it seems like someone was smarter than others may have given her credit for. Kudos to her! I'm glad she was smart enough not to let anyone in except close family she trusted. Only let those who trust in your home because you're sitting duck if you're too trusting and let the wrong person in. I'm not up there yet, but definitely smart enough to not even answer the door unless I'm expecting someone and not answer the phone unless it's someone I know or I'm expecting a call from. These days that's the way to be for safety and prevention of scammers. Always protect yourself and your home. Again, kudos to that woman who was smart enough to protect herself in her own home by not letting anyone in except trusted people, good for her! If she's still living, tell her congratulations, I'm very proud of people that smart especially when they're most vulnerable, I'm just amazed and I think that story just made my day! 👏😃👍

Hang in there! I was in a similar situation with my mom not wanting any help. She left lights on continuously, left the water running, and she left the stove on almost burning the house down. There was also strange behavior which almost tore my family apart. I tried to hire aides but she wouldn't let them in the house unless I was home (I work all day). She was diagnosed with dementia a couple of months ago explaining the mental issues. Now she is in a assisted living facility with memory care with the help of many people( Doctors, Assisted living workers, and my wife), due to her refusing to go. She is doing good now and I'm able to take care of my family knowing my mom has the care she needs. Make sure you have the POA documents since you will have to make all of the decision on her behalf. Do what is best for You and your mom. Take care!

The only thing I can add, besides agreeing with most of what was already said (are you my long lost sibling?) is this:
Our elder care attorney told us we cannot "drag her out of the house" if she refuses to go. We were ready to take that next step and get guardianship to get her into a memory care place, but THEY will not accept committals (I posted a question on this forum about this).
That said, I can also relate to the sibling issue. My younger brother refuses to listen to the information I looked up and provided, but doesn't research on his own (he is VERY computer saavy, so that is not the reason). He is ADAMANT that she would want assisted living, not memory care. Despite the facilities (the first he found and we went to, and the place we decided on) telling him this, he still is being a pain in the butt, and will likely continue. He doesn't/won't accept that assisted living is mainly for people with physical limitations. Memory Care assisted living provides the physical help, when needed, but is more secure and safe - the better choice for our mother.
It was finally worked out (hopefully, she was just taken there at about noon today) by seeing a new doctor local to the place (her other long-time doctor office has been ignoring me and all my requests) - between durable power and doctor saying she should be moved, we got over that hump.
We also tried the aides, but after a few months, only an hour/day to "check" on her, she refused to let them in.
At 93, with limited hearing, macular degeneration (legally blind in one eye) and dementia, the woman needed to move months ago, but without the doctor helping, we could not do it. She has been living alone, and refused to go to brother's, I cannot physically take care of her. She was supposed to move in Tuesday, but developed cellulitis (dangerous for anyone, even more so for someone her age and mental status!) and the move was delayed.
If YOU have durable power and doctor says needs to be done, then it comes down to little white lies to mom. Take her "to lunch" at the place and let them take over. If sibling also has power, I would just not discuss it with him/her and move forward. My next step if brothers, doctor and facility wouldn't work with us was to call social services and let them take her out. She'd go to a nursing home, which I believe is covered for 60 or 90 days by medicare, but we didn't want her there. IF we had to go that route, then we could maybe get her to agree to another place nicer as she still has some mental function - mainly short term memory and being adamant that she is independent, can get out, people come in and can take care of herself (none of it true except in her mind).
I hope the best for you. The stress getting to this point has been tremendous for me (younger brother fights everything we try to say or do, older brother lives in NC so he can only help when he comes up. Everything falls on me, all the calls, paperwork, etc, fighting to get what she NEEDS! BTW, if your dad was in the service, you might be able to get veteran's benefits to help pay. We did the whole trust thing for all her money and condo to protect her assets last year. VA requires minimal funds or they won't help. Despite all the physical help needed for moms and dads who are suffering from this, there is a ton of paperwork to do....

Boy does this sound familiar. Do you have POA? Do you have her on the waiting list for AL or memory care? If you have the dementia diagnosis, and have POA - you should be able to place her in memory care. The facilities where you have a deposit - have they assessed her yet? That is key and that needs to be done.

I took my mom "out to lunch" at the ALF where she now lives and staff assessed her then. I just said we going out to lunch and meeting a friend of mine. She was mad when we got there, but then forgot all about it because she had a wonderful time.

I would not place your mom in a ALF that does not have a memory care unit. Also, if she has not been assessed - the facility that has your deposit may not accept her. My mom can be very argumentative and a risk for wandering - so when assessed - they said she needed to be in a locked memory care unit.

I could not take her kicking and screaming - to emotional for me. So I hired a geriatric care manager to move my mom into the ALF. Once again, she was taken "out to lunch" and then told she would be staying there for awhile. That way, she did not associate me with the move.

Its never going to be easy, but there are people who are not emotionally involved and can help you with the move. To this day, my mom doesn't think she needs any help and she thinks her mind is fine. There is no rationalizing here. If you have to trick her, you have to trick her.

I found that with my Mother I had to become the adult as she became the child. With the dementia they do not think things through clearly. They do not remember doing some things. They do not understand timeline dimensions. If you have POA, I would check further in the document to see what further powers you have in order to make sure she is taken care of. Work with her doctor. We had her move in with us after she broke a hip but it was a mentally impossible environment and she wanted to go home. My brother and his family moved in to take care of my Mother but it was physically and mentally an impossible environment. My brother dumped her into a terrible nursing home and left. After visiting a few times, (45min drive 1 way), I knew we had to get her out. We found a nice Assisted Living place that gave her an apartment, meals, laundry, etc. and was affordable. Got her VA benefits applied for, set up and sold her home and put that into an account to pay for her care. As she slowly declined from Parkingson and LBD and then a broken back from a fall, I was so happy that we pushed to get her into a nice care place.

Well, 'middledaughter', you will just have to shut your ears to all the outcry and arrange to do what is best for your mother, and get her into assisted living, or memory care, for her own good. So WHAT if she objects and laughs in your face? What's she going to do? Call the police and have you arrested? Sue you? Let her vent and throw a fit. Her time for living on her own is OVER, she can't maintain a safe, healthy life on her own if she won't let the hired help give her medication or whatever. Your mother is not who she used to be, her brain is deteriorating..... If my 5 year old ran out in the yard and poooped in the kiddy pool, slept under a bush, and wouldn't eat anything but cheese doodles, would I just stand there wringing my hands and asking for advice? No! Measures must be taken for that kid's own good, medical attention or a special program if needed, in spite of the certain battle of wills that is sure to come. So must you 'man up' and do the right thing. So, you have everyone's permission and encouragement her to do it.

I'm nearly at that stage in my mom's case. She's one step behind in that she won't even accept the doctor's diagnosis of dementia or take Aricept because she is convinced she doesn't need it. I'm grappling with the same issue, i.e. home care or moving her into an assisted living place that has a memory wing that she can be moved into. I appreciate the information on this string.

I thought of an idea for those who refuse to take dementia meds. The caregivers can actually see if there's a liquid version they can just mix with the persons drink, or a type of pill that will allow for crushing and mixing with the person's food so they'll never know they're actually taking their meds. The caregiver can actually pick up the meds for the patient and just don't let the patient know they have it so that way there are no fights over meds. The person will never know they're actually taking their meds if it's blended well enough with food or even smoothies. Your blender is your friend, perhaps consider using it to make healthy smoothies and just slip the medicine in there with the ingredients. Approaching it this way sure beats fighting the person to swallow a pill when they don't want to because that way they'll never know the meds are actually in what they're consuming

I think you may just have to involve APS but start with the people at Eldercare to see if they have any ideas. you said she has long term care insurance which is good. Do you know how long this will last?
As far as meds are concerned discuss with her Dr what is really necessary for her to continue to take or what can be added to make her more compliant. the fewer the better is usually the best choice. Time to act before things happen by themselves.

There are worse things than having your mother not speak to you.

Please take care of her instead of worrying about a relationship now.

Sorry for your loss.

If she does stay at home, you need someone that is going to do what should be done not just listen to what she says. They need to do the cloths washing while they are there (all the clothes). They need to police the refrigerator and not just put bad stuff in the garbage but in the outside tub so it is unassessable. Some pills can be acquired in liquid form so it is easy to add to the food or drink. Also bathing doesn't have to be every day, but a warm towel in the morning can be refreshing. As for your sister: Ask her to be there 24/7 for one week and she will realize her mother needs help. Each kid wants to think their parent is ok, so there is some denial that sets in. If she doesn't notice food on her clothes then her eyesight might be going bad. My mother washed the dishes. I dryed so I could spot unwashed dishes and put them aside to wash again. Your mother mostly needs more asertive home health care people.

Your mother needs a 24/7 in home person as it looks like you can afford this. A nursing home will not be able to cope with her at this stage. Do you have a POA?

You start the petition for Guardian, it is long overdue. The court can decide whether she can stay at home. Your sister can have her say in court.

Oskigirl -- I recommend your concept of moving her into an assisted living place that has a memory wing that she can be moved into. In retrospect, I realize how much damage I did to my health and peace of mind by delaying placing my husband in a nursing home.

Update on my mother. I have filed for a guardianship. I felt such a sense of relief after doing it. While my sister decided not to be a co-petitioner, she is not fighting me on this. She will not testify on my behalf, but neither will she testify for my mother. I appreciate all the advice from everyone. (By the way, I do have a durable POA, but lawyer decided to go the guardianship route.)