How to have that talk with your very “independent” elderly parent that they are starting to do things that need to be monitored.

She is not independent. She lives with you, you do everything for her. Does she pay rent or help with household expenses. How did she come to live with you? What about a senior center or assisted living. You are her only stimulation. Try calling the Area Agency on Aging and ask for a visit and needs assessment.

Yes, she should be seen by a doctor, no question. The decline you are seeing could be many things only a doctor can evaluate that. How to get her there? Everyone needs to see a doctor, at least once in awhile. Doc can identify problems that she doesnt even know are there. Then treat them.

I read your profile and previous posts. You wrote of much of this back at the end of July, yet it seems nothing has changed.

You didn't answer any questions back then about her going to live in a facility. What about it? Your H is retiring sometime this year, and what is life going to be like at your home with your mother once that happens?

She's been living with you since last February. What happened to where she used to be living. Was it a house that was sold/needs to be sold? Or did she rent. What is her financial situation?

What is the plan for when her dementia gets worse?

Does she still have capacity for logical thinking or is she completely in the emotional reactive realm? If logical thinking is gone then there is no capacity for a discussion. You will just have to make decisions for her care as you see fit for her health and safety (and yours). You say she doesn't have dementia symptoms but then go on to mention symptoms that are very much part of early stage dementia - social isolation, resistance to care, anger and upset, repeating things from the past. You say she doesn't need help with ADLs, but she doesn't cook or clean. She is hardly independent. How safe can you keep her and how much more abuse are you willing to take? Because it doesn't sound to me like you are going to be able to talk to her about making changes. You are going to have to make changes.

I suggest looking for a senior center program or an adult day care. You can run your errands while she is at day care and she gets socialization with others her age. You can re-evaluate her mental status after she has more stimulation and/or you can start looking for affordable AL.

I have the same problem with no real answers, but wanted you to know you are not alone in your frustration.

My mom blew up at me a few days before Christmas over this very topic and then refused to speak to me. I imagine on their end it's fear and denial. I get that. But at the same time I do NOT get how our parents feel entitled to dismiss our very valid concerns. I mean it's not like we aren't affected. Your mother lives with you. Mine is next door to me in my condo. We are affected daily! We are OWED some cooperation, and I am to the point of really feeling resentful about it.

After the last blow up before Christmas I decided I'm not going to try and force conversations with my mom, but at the same time I'm not going to sugarcoat things for her benefit either. That's all I know to do for now.

Have you considered getting a nanny cam or two set up in your home? That way you could watch her remotely from your phone (if you have a smart phone like an iPhone). Lots of people use these and they work well. You could tell your mom you are doing it because you are concerned. If she pouts, she pouts. The bottom line is you need to leave sometimes and you are tired of worrying about her being home alone. Tell her the cameras are necessary for YOU. For your mental peace of mind. That may get her to realize some things, or maybe not, but at least you can leave the house and still check on things so your not worried. BTW many of the cams also have audio. I know this because I have one I got for my dogs a few years ago. I could actually talk to them from my phone and they would hear it coming from the camera. In that instance the whole things was pretty funny, but in the sense of watching a senior it could be very useful.

I haven't done camera's with my mom because she would have a fit and disable it. My goals might also be different than yours because when my mom can no longer live alone safely I'm not going to try and keep her there. Nope. That's when she goes to assisted living, or in her case it will likely be memory care.

Good luck.

I think by "independent" you mean she thinks she is. Or is the word really stubborn.

There are so many reasons why Mom is like this. Depression could be one. Elderly don't deal with change well. A good physical could answer a lot of questions. Her potassium levels could be low. Her Thyroid could be the problem. Diabetes, anything. Or, she can be showing signs of Dementia. Tell her Medicare requires a physical. But you can't solve anything until you find out what is wrong.

How about: (Act like you don't know how it will go. It will just get you even more tense) Deep breath, "mom we need to plan now on how we are going to adjust to the changes that are coming. Let's do it now, while you are still in good health and I am in a position to make the right decisions and not all stressed and worried about your safety"

When she brings up bad memories, step in and quickly change the subject. Find a way to get her to some degree of socialization. Paid home companion twice a week for four hours got my mom started in the right direction and gave her a reason to get out of bed in the morning. We also did drop off adult day care for 1/2 day once a week. At the time the other clients were at different stages, but I explained that to her and said that she should enjoy what ever events they had (little bus rides in the countryside, music, crafts, whatever).

It's like you go 100% and nothing seems to work, but later you realize it is a process and the 2% that works has the effect of socializing for her and respite for you.

The day I told my mom that we were placing her in memory care I felt the words were going to catch in my throat and choke me, but she actually listened and shook her head in agreement(!) The next day, of course, when we came to pick her up she had no memory of our earlier conversation. But I held on to that brief moment when she shook her head in agreement and it gave me the strength to move forward.

I am very concerned about the safety of all of you at home. She's going to set the place on fire!

I don't know if she is up for a convo about this stuff. It might be a little beyond this point where you can have a rational discussion about her decline. I would skip it, cuz I'm totally into avoidance at this point with my mom. Probably bad advice because of my bias.

Anyhow, protect yourselves however you need to. Dementia proof your house - take the knobs off the stove, put the toaster away, etc.

I like the camera idea so you can monitor things but what if she's doing something dangerous and you're across town doing errands? I think she needs a babysitter. Senior center of adult day care might be worthwhile. Or someone to sit with her so you can go out with more peace of mind.

Tough situation, this elder care. Ugh. Not easy. Or fun.

I don't know if I am really adding much new. I would get your mother in to see a geriatric specialist. Hopefully, the doctor will have good rapport with your mom and build trust. He will be able to talk to her about her mental decline. You can explore avenues in the meantime, but I would secure a sitter to come into your home when needed for sure, and try to get your mom involved with some engaging activities. My mother refused to go to the geriatric specialist at first because she didn't like the sound of the man's name. Eventually, I got her to go and she loved the doctor so much that she did whatever he said. He told me NOT to have my mother think the decision to go to memory care was mine but his, and to always put the ownership on him. Believe it or not, this worked! My mother loved her memory care facility (think clean, safe, small, lots of activities). I also interviewed and arranged a professional, licensed sitter to come to my house if my husband and I had to be gone as I did not want my mother unattended (prior to re-locating her to a memory care facility). You may think that this might not happen to you, but my mother wandered off one day and it was the scariest thing that has ever happened. After that, she needed to go to a facility (she wandered off when she still lived with my family). They say you don't know that will happen until it does. How true! Also, my mother loved the activities at the memory care facility. She was very engaged. She got more out of that than staying at our home as I could not be with her all the time and doing things. Maybe you can brainstorm ideas of what your mother could constructively do with her time. And maybe she will gravitate and accept some of the ideas. At the beginning stages of my mother's dementia, she was still able to read 2 newspapers a day (which I ordered for her). I had a list of her favorite TV shows (Antique Roadshow, Jeopardy, and golf/other sports) and she watched those. I checked out lots of movies from the library that featured her favorite actors/actresses. I would buy her magazines with pictures to enjoy. She was an interior decorator and gardener so she loved those times of magazines. Sometimes, I set out simple tasks of folding clothes, sorting silverware, sewing buttons, etc. for her to do around our house. She loved puzzles and did one each day. I gradually got puzzles with fewer, and larger pieces. The puzzles occupied at least 1-2 hours of her time/day. She also liked music so she would listen to music. I had 4 brothers and sisters so we set up a rotational calling tree whereby my mother received a phone call a day from one of her children. We also brainstormed holiday gifts that would enhance my mother's mental/physical skills. I do think your mother needs (as we all do) mental and social stimulation. Good luck trying to add those to her day. I also agree with the others to get some future plans in order because the time will come when you won't be able to handle your mother at home any longer. You will need to find a quality place for her. Do that now so you are ready to go when the time comes. Good luck!

Is there an Adult Day Care near you?
Is there an active Senior Center?
Both might do her a world of good just by getting out and socializing with others.
I would also disconnect any appliance she might tend to leave on. Any that shut off would be fine. Like a toaster instead of a toaster oven. An electric water kettle rather than one you use on the stove top.
I would be very concerned about space heaters and heat lamps. Is there another way to adjust the temperature in her room?
Your other option is to have someone come in. And it sounds like it is getting to the point where she should not be left alone anyway. This would have to be a deal breaker point. Either she allows someone to come in when necessary or you will find an Assisted Living facility to move her into. I think given the choice of the two she may relent and "allow" someone in if she knows you are serious.

A point on your last question...
You minimize all the hazards in the home AND you have someone come in AND you get prepared for the fact that your home might not be the safest, easiest place for her.

Your Mother is past the point of safely being left alone when you are out doing errands, so for now, you need a parent minder to stay with her, no if and or buts, or else you are going to come home to your house being burned to the ground with her in it, or you may find her seriously injured while you are away.

You need to think ahead about how you want your home to be run if she continues to live with you, so be prepared put your foot down or else be miserable, as things are only going to get worse from here on out.

If you can make sufficient changes to your your home environment that is comfortable for you in the short term, do that now and reinforce as time goes on, but begin to prepare yourself for the eventuality that your Mom is going need more assistance in the future, beyond that you can do for her, so begin researching Assisted Living places, preferably ones that have step up facilities as her symptoms worsen, think memory care.

You can do a lot of research right here on this site by reading how others have managed, and then begin touring Assisted living places to get a feel for the best possible place for her. If you think that adult daycare might work to give her the safety and stimulation, plus give you the opportunity for some space, you may be able to prolong the inevitable, but don't be caught unaware, do your homework.

These are difficult decisions that need to be made, and it's Easy for me to say, as we did everything wrong from the start (13 years in our home), lol! But we did learn eventually and did finally get my FIL into Assisted living, unfortunately he became gravely ill after only 12 weeks and he ended up in hospital with pneumonia and lung cancer, so we brought him back home on Hospice care where he died 9 weeks later. Please don't wait like we did, your family, your marriage and retirement are worth so much more than trying to appease someone who doesn't appreciate what you are doing for them, and of course their safety should also come first. Good Luck!

Thank You everyone for you thoughtful and thought-provoking answers. I will definitely be trying them out. A bit of advice I was recently told was “to wait for the next thing to happen,” but while I’m waiting, I also want to be planning. I was thinking about previewing assisted living facilities to be ready for when the situation becomes worse. Thank you all so much for reaffirming that idea. 

I have also talked with my DH about having a sitter come in while I get out. This would be two-fold as mentioned in the responses. Safety and more socialization for her.

I do like the suggestions on getting her involved in planning for the changes that will be coming. Thank you for the advice. Is she logical? Hmm...sometimes she can be, but other triggers put her in an emotional reactive realm. So talking to her is iffy. She can also hit the reactive emotions when anything comes up that she doesn’t want to deal with. 

A day socialization program would be great for her, and I have suggested this several times, but she is NOT interested. Thank you for all the suggestions of things she may be interested in doing. We will try it out. She does walk as much as she can for exercise and gets mental stimulation through crossword puzzles, library books (need to look into movies - good idea), educational dvds, and she loves to watch Jeopardy, Wheel of Fortune and some sports. 

When she first moved here, I got her to go (literally kicking and screaming) to the doctor to set up a meet and greet new patient visit. They asked her about setting up a Medicare physical and she said she wanted no part of that. But to tell her that is is required by Medicare may work!

The camera idea is interesting, although she wouldn’t like anyone watching anything she did, she would take her walking stick and knock them down. I guess they would be good to see what she is doing that could be changed for more of her safety. 

I have been eliminating or changing her access to most of the safety concerns, as these are serious concerns. She doesn’t use the stove or oven at all. 

I feel like we’re stuck right now, she’s not quite able to live independently, but not ready for assisted living. I realize I am in control if any changes are to me made to the current situation. I will be checking out assisted living places for when the time comes or it is no longer doable at home.

You haven't mentioned finances (or if you did I missed it). What are your mother's finances? Could she afford AL? Is she contributing towards your household now? SHE should be the one paying for any sitter who comes in. (That is, unless you are wealthy and don't mind paying for all of her expenses.)

Many people are shocked at the cost of facilities. Are you aware of what they cost (now)?

If your mother could be Medicaid-eligible, it would be a good idea to consult an elder care attorney now to see what to do now to ensure Medicaid eligibility when the time comes to place her in LTC.

Why do you say that she is independent? She is relying on you. So therefore she needs assistance. You are concerned which is natural. I am quite sure it’s taking its toll on you. No judgment from anyone on this forum so please be honest in how you feel. Everyone here has had their own frustrations.

I don’t feel doctor appointments are negotiable. You need to know her medical situation since you are her caregiver. Make the appointment for her. Tell her that you expect her to keep the appointment. Don’t give her a choice in postponing or a cancellation of the appointment. Tell her it is a mandatory requirement.

She is living with you, not the other way around. Ask for her to sign a medical release to get information because if you don’t HIPPA laws will prevent your attainment of any medical information. She needs a complete physical.

If she blatantly refuses to cooperate then start looking at assisted living facilities or nursing homes. Life is too short to live in misery.

I am sorry you have this difficult and stressful situation. Best wishes to you and your family.

Taz You need to be very tactful and careful here as upsetting your Mom will serve no advantage to you or your Mother as it will cause anger and create I'll feeling. I am not a Medical Person and I have no qualifications in this area but I have seen Alzheimers once before and I found as I read your Post that it is very similar to Alzheimers. Since your Mom refuses to go to the Doctor, why not as a Doctor to come and examine your Mother. Don't even tell your Mom the Dr is calling as you can ask the Dr to say that She, or He is calling to all the Elderly People living in the area and that this is a curtous visit. Have the Doctor spend a good twenty minutes talking to your Mother and pay the Dr as She or He leaves. If there is any bad news let the Doctor give it to your Mom, but please avoid putting your self in the firing line.

You are the fulltime caregiver. Your mom is living in assisted care because you provide it. She is not independent because you provide meals, housekeeping, a home, and always check behind her for safety hazards that she neglects. Thankfully, she can complete toileting, bathing, dressing and ambulation without your support.

Seems your mom is wedded to her routines and gets upset when her routine is changed. Research shows that social isolation tends to lead to more decline, but socialization for a person with dementia needs to be part of their routine.

Seems your mom probably has some dementia, but you need to have her evaluated by a doctor so together you can map out "best care" plans for her. Alzheimer's can be treated by medications for a time. Depression and anxiety can also be treated. You also neglect to mention whether your mom has any chronic medical problems... other than needing a cane to walk. A doctor should check her for those types of illnesses as well.

First, there should be no space heaters or heat lamps in her room at all!! That's #1 safety issue. She could burn your house down!
When she becomes argumentative and trys to get you to leave, you can( very nicely) remind her that this is YOUR home! When she starts her independence speed, remind her
( very nicely) that you are the one that cooks her meals etc. At that age stubbornness comes into play because they don't want to give up their independence but aren't realizing they are dependent. Good luck and stand your ground. YOU are the caregiver

When you try to tell "them" that they are starting to mentally decline - you open up Pandora's Box.

Either continue to minimize all the hazards you can or consider some form of assisted living for her.

Trying to tell someone about mental decline will not be received well at all.

Character limit is vexing me, so let me start with this little bit:

"I realize I am in control if any changes are to me made to the current situation."

Are all the medical directives and POAs in place? Even with POA, moving her could still be a problem. Many think this gives you complete power, but it doesn't (been there, done that - EC atty said we could NOT force her to move. it required some trickery to get her to move as she was refusing any move.) Medical POA gives you ability to discuss her medical treatments and have access and make some decisions. Durable POA gives you the ability to manage finances, sign paperwork and make some decisions (based on what she would have done if capable.) It does not give you power over her life in general. That has to be worked out as best you can.

If no POAs, etc, consult with EC atty is advised! Typically many will give you an initial consult (~30-60m) free. They are not cheap, but often well worth the cost! Have all questions/concerns written down and take notes. Ask about costs, visit several who offer the free consult and compare cost as well as how their "plans" meet your concerns.

Some of her behaviors/reactions suggest cognitive issues. If it's dementia or not will be determined by testing and observing how it progresses. Early stages include memory lapses, difficulty making decisions or understanding why something should/shouldn't be done, etc. You should explore - there are many sites which have stages/symptoms listed. Example:

"Although the early signs vary, common early symptoms of dementia include:
*memory problems, particularly remembering recent events.
*increasing confusion.
*reduced concentration.
*personality or behavior changes.
*apathy and withdrawal or depression.
*loss of ability to do everyday tasks."

'A bit of advice I was recently told was “to wait for the next thing to happen,” but while I’m waiting, I also want to be planning.'

Unfortunately waiting for the next "thing" to happen could be very bad! Checking out ALs now is great, but meanwhile... Cameras and aides to monitor when you are not there or when she goes for a walk should be seriously considered. You have removed some safety issues (space heaters, etc.) - consider others that might be needed.

If/when you hire someone to watch over her/walk with her, pass it off as help for YOU not her. When our mother was still in her condo, but in early dementia stages, we brought in aides, for checking on her and that she took her meds from a locked dispenser. Initially she was told it was doctor ordered and paid by Medicare (she refused any personal help, so no Medicare coverage, but she didn't need to know she was paying!) We were lucky that the company minimum was only 1 hour - check her and meds, didn't care what else they do, but it only lasted a few months and she refused to let them in. In your case, it is your house, so you can hire someone and ask them to do some random simple "busy" tasks for you, but primarily to have eyes on mom!

Does she go for walks on a regular basis, such as same time of day? If so, the aide could be hired for that time and just say 'Oh, a walk sounds like a great idea, mind if I join you for some fresh air?' Use that time to tackle outside errands.

"They asked her about setting up a Medicare physical and she said she wanted no part of that."
FYI - Medicare covers an annual "Wellness" but does not pay for a "real" physical. To understand the differences, see:
https://www.alz.org/media/documents/factsheet-medicare-annual-wellness-visit-2017.pdf
IF she also has a supplemental plan (such as a Medicare Advantage plan) a physical may be covered w/wout copy. My plan includes a "free" home health visit, but I don't need it and had to ask them to stop calling/mailing me about it! If she has such a plan, someone can come to the home to do the Wellness exam. Suggesting Medicare requires it might help get her to the doc. It can't hurt to try.

Cameras: there are Nanny Cams that can be set up and not really be visible - I would install these when she isn't there to see them and not tell her. Common areas are best and can enlighten you about things you don't see! Our mother lived alone, and at some point began a nightly OCD routine checking the door lock, sidelights, dishwasher and LR. This started with a few iterations and became a nightly marathon, 1-1.5 hours over and over! The early stages can include "show-timing", so many can appear to be somewhat normal, but given enough time this falls apart. She stays in her room a lot, so might be good to have one there too.

It is good that you have been limiting access to safety issues. Although she doesn't use oven/stove now, could she? If it's a newer model, there should be a control lock. My washer, dryer and stove have these control locks. Removing knobs works too. Microwaves have LONG had these controls - if you hold the Stop/Cancel button about 3 seconds, you can lock/unlock the control panel. These are useful!

As with growing babies, you have to stay one step ahead! Plan/learn now!

If she is spending a lot of time alone, her brain is thinking about all kinds of things - past, present, future and some can be upsetting. Since she can get around good with her cane, try to get her out of the house. Maybe to beauty shop for hair cut. A short shopping trip. Lunch. Insist that she go with you to get some fresh air and change of scenery.
If she clutters around a space heater, it's just not safe. You might need a window unit ac w/heater so you can get rid of all the heating elements. Anyone can forget to close a refrig or turn a toaster oven off - I've done it several times myself - however it could also be an indicator of mental decline. Remove the toaster oven and tell her it broke. Get a regular toaster than turns off when the toast pops up. Minimize any hazards you can for everyone's safety.
Even if she doesn't really like to socialize, you said she will do it if someone is there. See if you can get others to visit more often to keep her engaged. If she has no friends or family to visit, then take her to a doctor (just tell her that Medicare requires an annual check up) and ask the doctor to order some in home physical therapy to help her keep moving and limbs strong. It will get a person in the home a few times a week that she can talk with.
It's possible both of you have gotten in a routine that became comfortable - you are out in main area of house doing your thing with her not really in your way and her up in her room living out each day. More interaction may help her.

Have you thought about having a cognitive evaluation performed by a neuropsychiatrist or geriatric psychiatrist? How about taking her to a senior group to increase her socialization and reduce her isolation? You could get your errands done while she is out too. Did she have any hobbies in the past? Maybe reintroducing them would be helpful. Contacting your area agency on Aging for resources and supports may be hel0ful as well.

I have similar problem with my dad..We live in the same building, so i am near...He was also leaving the water running, one day he left the stove on (he said for heat) but he left a pot in the oven so the smoke detectors went off and my neighbor called me...I walked into a house full of smoke and he didn't even notice that or hear the smoke alarm going off. I also tried to tell him he is declining in his memory and stuff but he tell me I am crazy and that I just want him to die. (nice huh?) I finally install cameras in the house..one in the living room/ kitchen and one in his bedroom..Now if he doesn't answer the phone I can check to see if he fell or god forbid worse. A nursing home is not gonna happen unless he completely loses his mental facilities. so until then the cameras do help when i go out for the little time I do... Good luck..its not easy ...god knows...BTW he is 102 years old , a blessing and a curse all at the same time if you know what i mean....

We (me and mom) sorta had that problem with my father and driving. He wanted to keep on driving, we told him no, because of Parkinson's disease. We also had that the same problem when he wanted to go upstairs to clean out his room (We were moving him downstairs because he fell down the steps twice-One time he broke his arm while doing so.) He wouldn't stop trying to find a way to convince us that he needed to drive or go up the stairs. We stuck to our guns and said no every time he asked. He finally gave up, got the hint and stopped asking. After a while, he started insisting that he was fine enough to stay by himself when my mother went out with her friends. My mother decided to ask a nearby neighbor to keep an eye on him while she was out. Their neighbor agreed to do this and It proved to be very helpful for us in the end.

I would suggest that you state your reasons why the person (that you are caregiving for) needs some supervision, especially when you are out running errands. I would stick with your guns and not cave in to her. It's hard but I know that you can do it. (You may want to take her into the doctor and have him or her tell what is going with her and why she needs supervision)

You may want to ask someone that you are close to maybe, come over for a visit when you are going to run errands or something like that. That person will also need to be firm with her when she tells them to go away or something like that. But hopefully, she won't notice and won't be a problem to the person visiting or to you.

I am sorry that you are going through, I do hope that things get better for you and for her.

Since your mom doesn’t want to go to the doctor you can call Area Agency on Aging and ask them to come do an assessment and let her get a bit of a talk this way. They can come to you and perhaps advise you of medical staff that would do so as well.
They can also let you know what services are available to you and your mom. Whether or not you choose to use any of these services, you will know they exist and under what circumstances you will have the ability to request them.
I would tell your mom that the Agency on Aging is coming to assess her. When she objects, let her know that you need the information to make good decisions for you and your husband, that you need to look ahead for your own futures. Just have a few non confrontational replies ready and move ahead with your plans.
Also I would suggest you check out Teepa Snow on YouTube. She is a master at dealing with dementia patients. Watch her interaction and see if some of the things she discusses reminds you of your mom.
Also look her up on this site. She will teach you how to redirect your mom’s resistance to your prompts.
If you serve her meals in her room, I would stop that so that she interfaces with others during meal time. If that’s too much to bear for you and husband then make it once a day instead of three meals a day.
And yes, she will probably use her cane on any cameras that blink at her. So place them where she isn’t looking at them when she’s seated or lying in bed. She’ll probably forget about them if she isn’t looking at them.
Let us know how things go. We learn from one another’s experience.

You'll have to trick her to go to the doctor's, e.g. "Mom, let's go to lunch and then I have a doctor appointment" - which happens to be her doctor's office as well.