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Mother is in the beginning stages of dementia and we have chosen a very nice assisted living place that fits her. She refuses to go because "that is for old people" and she is not old- has nothing wrong with her. But her short term memory is fading and we don't have any other options. Can you force your parent to go? She will not want to give up her house full of furniture either.

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If your mother in law is only in the beginning stages of dementia, it is very unlikely that your husband or his sister can force her to move even if they do have a springing power of attorney for her - do they? - and it would be a mistake to try because they will lose her trust.

What are the main concerns about how she is managing day to day? What's happening?
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CM is spot on (as always 😁).. How is Mother coping with her day to day?

Can she shop for groceries, collect medicines, cook, clean, bathe, do laundry, pay bills?

Or can she arrange what help she needs for this ie order & arrange deliveries of groceries, meals, meds, engage a cleaner/laundry helper?

Does she need help in those areas? If so, does she admit she does?
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My brother & I wanted our mother to go into Independent Living 12 years ago, she was a young 85, living alone in the mountains of NC.

She refused, well 2 years ago she had a slight stroke, she was afraid to spend the nights alone, calling the EMT's over & over again, they started billing her $650 each time she did, well that ended that, we scooped her up, moved her near us in AL.

Guess what? She loves it, new friends, she teaches chair aerobics, plans event and so on.

Lot's more to the story, suffice to say, we had to sit and wait as the guidelines for invoking your POA and placing someone in AL are stringent. My mother would not have qualified for us to force her as she doesn't have dementia, bathes herself, feeds herself and with a walker gets around fine..she drove until she was 94!
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What we did for my BIL is put ring cameras up in the apartment where he lives one in the kitchen/living room and one in the bedroom. He lives alone and he has dementia too. His short term memory is completely gone. He knows the cameras are there and we use them to see what he is doing. Like yesterday he had 5 meals the ones that have the ring on their phones weren't watching him. I have the ring application on my desktop computer but I was down with a migraine and I am not POA of him. The POA's didn't watch their camera of him.

No you cannot force a person into any kind of living faculty they have a right to say no until the time when they are completely incompetent then you can place them in a place.

Prayers you find the right answer for her. You might want to visit some of these places with her to see if she would like them. This is what we want to do with my BIL but we have to wait until he is 65 to get help.
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People can still live in their own homes with early dementia, but she may need aides to assist her if she is having difficulties with day-to-day needs, taking her medications on schedule, getting to doctor appointments, etc. If she cannot afford aides, or they will not be appropriate for her, then assisted living/memory care may be her best option. People cannot be forced to move, unless they are declared incompetent by a doctor. You may want to consult with an attorney who specializes in elder law. Before you take that step, make sure all of her legal paperwork is in order while she is still able to sign legal documents: setting up powers of attorney for medical and financial matters, a living will with her advance medical directives, a will if she has assets, banks have their own POA forms, ask her to get you a credit card on her account (with your name on it) so that you can purchase things for her, and you need to be on file with Medicare and Social Security to be able to speak on her behalf. My mother made me joint owner of her bank accounts, etc., which made things much easier. I got copies of all of the statements so that I could monitor her accounts. If she's starting to mismanage her money and miss paying bills, speak to her about taking over her bills and financial matters. She may be relieved not to have to do it. You can also speak to staff at the AL facility you think will be good for her and ask their advice on how to convince her that this would be a good move.
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My mom was widowed back in 2009 and became super independent which was great that she tried to move forward but it actually turned into a nightmare because she would hear none of it when she started losing her memory around 2017. I live in NY, she in SC so it was easy for her to hide it but I started suggesting she consider help and still she dug her heels in. Fast forward thru the pandemic and she was telling me she was getting lost driving to the market, misplacing items, asked me to help pay her bills, etc. and STILL refused the notion that she needed help.

This past January she had a heart attack in the shower, face planted the tub and found by a neighbor when I couldn’t get in touch with her. Hospital for 2 weeks, rehab for 10 days… I’ve been down here since due to her diagnosis and inability to care for herself. Some days are better than others but she swears that I’m making it up to sell her house and I somehow got the doctors to sign off on it. I’ve managed to keep her safe, make sure she eats, takes her meds and gets back and forth to her doc visits but the emotional toll is heartbreaking for all involved. Thank god I’m her POA because she’s all set to go into AL this week and keeps trying to put it off.

Sorry for the lengthy response, but long story short, this disease doesn’t get better so try to get the legal stuff (Will, POA) in order and start gently suggesting help. I know it isn’t easy because no one wants to lose their autonomy but at the end of the days someone needs to be the adult in the room and keep her safe. Good Luck!
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HollyDolly Apr 2022
My mom had a bad seizure in 2014 that greatly affected her short term memory. She also swears we are making things up. It's sad and hurtful. She also believes things that are clearly not true, but there's no convincing her that what she believes is false.
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We had the same problem. For years we cared for her at home using hired caregivers, 10 hours a day. We had POA but we talked to a lawyer and in her province of Canada, you need a "mandate" (court order) that she is incapable to do more than financial transactions. So we got a mandate a year ago, just in case she got worse. A month ago, we had to stop as she was a danger to herself, we could not get reliable caregivers, and it was a huge stress for me and my brother. We told her she was going out for lunch, then told her the house needed repair and she could not stay in it, and took her to the best memory care retirement home in our city. We are selling the house. She says she hates it, but seems to participate in the activities, and attacks me and my brother verbally every visit, but she is safe and well cared for. I wish you all the best in dealing with your mother.
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Your mother is in the beginning stages of dementia. She may not be at the point yet where she has to move out of her house and into assisted living.
Would homecare be an option for her? You won't be able to force her to go unless she is legally found to be mentally incompetent or an at-risk vulnerable adult. Even if you have her POA, you can't force her to go.
Try homecare. Hire privately. If her house is big enough hire a live-in companion.
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HollyDolly Apr 2022
My mom has long-term care insurance, and my family is right now getting ready to move her to assisted living. Initially the plan was to have care in home, but it turns out it is a lot more expensive, and my mom needs to sell her home in order to have enough to live on, even with the the LTC insurance.
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A hospital can discharge her to such a place if they believe discharging her to her own care would be unsafe and if you do not tell them you will be taking care of her. Anyway that was my experience in NC. But there has to be first a reason she is taken to the hospital. For my mom she started wandering and knocking on neighbors doors and the neighbors called me. Finally after consulting my MD sister I called an ambulance to go get her.
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Most ALs and SNFs can make arrangements for respite - short term stays, Maybe suggest she have a visit to check it out for "when she is ready."
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My Nana is a bit further along in her progress (about stage 6) but still has some of those concerns. My cousin and I are doing our best to care for her at her home but recent occurrences have forced us to make a decision on her behalf. The whole process is taking an emotional, mental, financial and physical toll on all of us involved.
We scheduled a visit/ tour of one of the memory care facilities ( Cedarbrook in Ware, Ma - it is amazing facility with wonderful staff) and accompanied her to see all of the options they offer. Not only did my cousin and I go with her but my sister, my aunt and a close family friend went along. We had lunch and met the staff, took a lovely long tour, got alot of our questions and concerns addressed and my Nana was in awe of the facility and everything they have to offer. I do think taking the time to go with Nana, seeing everything offered, knowing that it’s not a place where they just dump you into a room and ignore you was a big hurdle we overcame.
Theres also the understanding that it’s not just because Nana is a bit forgetful that we are making her move, it’s that the facility will provide her with therapy to help combat the dementia- not cure it but to help her know how to live with it and not be afraid. We are constantly reinforcing these points in preparation. The other point is that this place doesn’t have to be permanent - setting a timeline for her - saying if in three months she hates it’s, and she’s not getting any help or better than we will reassess the living arrangements and figure out something else. Memory care facilities are so far from a nursing home/ rehab and I think it is something a lot of the older generation doesn’t realize. That you are just trying to dump them and get rid of them- you are looking for a place that will help them
live their best life from here in out, since you can’t be with them 24/7 to ensure that yourself. Assuring your loved one that they will still have independence (to a point depending on their level of care needed) and that they won’t be locked up and forgotten I think is a important step.
I believe in just laying it all out on the line. That everything you are doing or arranging for them is out of love and wanting them to have the best care and therapy possible.
We are moving forward with setting her up over there, getting her place ready and figuring out what she has to bring and what we will get her new. It’s still a long process that’s taking its toll- yet at least now we all have something to look forward to.
More than anything my Nana wants to help and be useful- and in discussing this with the facility - they have various tasks she can assist with and that will be her “job” while she is living there and can help “take care of the elderly” ( My nana will be 87 at the end of May)
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HollyDolly Apr 2022
My family went through the moving process once with my mom, she came back to her home for a few years, and now we're doing it all over. It's exhausting, and heartbreaking.
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She doesn't belong in assisted living if she has even the beginning stages of dementia unless assisted living also supplies a memory care facility. It will be a much harder move for her when her dementia advances. Not sure how old your mom is.... people are in memory care for a lot of reasons. In my mom's facility where she lives there are two gals who's ages are around 35-40 and the other one in her 50s. The rest are in their 70's+. Do what's best for her. I wish you luck!
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PeggySue2020 Apr 2022
35: 40, even 50? Are they there for dementia or a developmental disorder or clinical low iq?
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Is she diagnosed?
Does anyone have POA?
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My Mom was beyond the middle stage of Dementia. I did not discuss an AL with her. It was not even mentioned until we were on our way there. We had already moved her furniture to her room and arranged it as closely as we could to her room here. We told her we were taking her to her own apt where she would meet knew people. Took her to her room and then the common area where we sat for a little while. When we left, a staff member took over. I was lucky, Mom acclimated well.

You may just have to do it with no discussion with Mom. You are trying to reason with someone who has lost that ability. And, in her mind she maybe not be old. My MIL was in her 80s when BIL would show her booklets about ALs near them. She would say, they are old people. Believe me, she looked her age. At that point she was still with it. Her idea always was that my DH would move near her 16 hrs from where we live. Nope, I had my Mom and 2 grands I was not leaving. And DH chose me.
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Whether or not she can still live alone is dependent on a lot of variables. My stepdad passed away 2 1/2 years ago. We thought for sure mom, who has dementia, would have to go into memory care. My sister and I decided to see if the could live by herself for a few days while we looked for someplace to move her. She actually does quite well, but my sister and I alternate going over everyday. We bring her meals so she does not have to cook and does not try. I sold her car, so that is not an issue. I bought a seven-day automatic pill box so she will take her pills on-time 4 times a day. Installed a Ring camera so I can see if she goes outside. She remembers how to turn on the TV and can still do her own laundry and actually enjoys it. She has coloring books, lots to read, and she rifles through all her drawers and cupboards everyday. Oh well. We know that someday this will not continue to work, but for now it does, and we never imagined it could be a possibility. This only works because my sister and I can do this, but we usually only have to spend about 1-2 hours a day there.
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Artgirl11 Apr 2022
good for you ... the ring devices saved me to keep mom in her home ... thx for saying this ...we only go 2 days a week because we all live so far away but neighbors are at hand and the cameras are a godsend ...

karen ...
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A couple points. Has your mom been tested to determine her level? My mom did and still does believe she doesn't belong in AL. My brother was also sceptical at the beginning (1yr ago) even though she couldn't manage meds and was a diabetic surviving on cake and ice cream. Finally convinced him when geriatric doctor stated that sooner the better so she could get any benefit from the placement and adjust better.
When she was evaluated, and after move, it became apparent that she was much worse than we had known. Over the course of the year she went from regular AL to acute AL to memory care. So far she hasn't adjusted but her meds finally got changed and her behavior has evened out a bit. She thinks all the people there are old, the men don't even have cars! She wants to come home, go to the bar with my brother to find a man. Wants a gun to shoot my long deceased dad. Oftentimes it seems she is in the 1950s.
To get her there we got a agent/advisor to take us to 4 places. We narrowed to two. Took mom to see the two. Found that she was amenable to "trying it out" if the home really engaged with her and asked her to come try. Was especially helpful when some residents spoke to her said they loved it there. So she packed for a 2 week stay. Which we made permanent.
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My 64 yo sister has aphasia and some dementia from a brain tumor that has limited her ability to cook and clean a home; no driving. She can wash her clothes and take her meds as she has focus for those tasks, but that is about it. She was out of state and no family so I asked her to move back to my city/state and into independent living. I found a facility that did it all...independent, assisted & memory care, so she will be able to move to the next level when needed. I questioned the IL option but with my support for shopping and finances she has been doing very well. It was hard to downsize but I asked what items brought her joy and happiness. It seemed to work as most items moved found a place. While I know she doesn't need all of those things, she is happier having those items close. Before moving in she told me she was too young to move in. However, she has done well/better being around others and is participating more with activities. I don’t know if independent living would be an option but it could be a starting point.
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We just went through this. Even the POA didn't help so we got guardianship (expensive and time consuming) and forced her to move "to the old fogies home" (her words exactly.)

And we/anyone that listens hear daily how she was forced to live with old people and her house/possession are becoming "a hell hole" because "she isn't there to take care of them". 🤷lol
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Other than "beginning stages of dementia" is she unsafe living at home?
Would she do well with a caregiver/companion that would come in and be with her?
There are times when unfortunately you wait for some catastrophic event that will "force" the issue of the move to AL or even Memory Care. (And if the dementia is to the point where she is unsafe at home there is a good possibility that Memory Care would be better than AL for her.)
She is not going to like it no matter when the move happens.
She will decline once she moves as well. Any move most likely will cause a bit of a decline no matter when the move occurs.
"Forcing" a move is difficult. If she has not been declared incompetent then you probably legally can not force her to move. If you obtain Guardianship then you can force it.

Many of the AL facilities have activities, almost "resort" type living. Would she be willing to try out a community for a week to see if she might change her mind.
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I wished my parents listen to me to live in assisted living. Dad died and mom was left with memory loss and major anxiety. I truly believe had they done the right thing my mom would not of broken two wrists, two hips, and a elbow. The major reason parents of a certain age or medical issues should go to assisted living is they will be in familiar surroundings and will make friends. When it gets to the point they have to go to an assisted living community it’s a burden on them and the family. If I knew what I knew now I would not of allowed my parents to put me as POA. Parents are responsible for their decisions and their children should not have to pay the price for stupidity and stubbornness.
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Debstarr53 Apr 2022
What price did you pay for being POA? I'm just wondering because I am POA and so far it has been a good thing, but I have heard there can be problems involved.
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joodzjazz: Perhaps you should speak to your husband on this issue since it is HIS mother with fading short term memory. Best wishes with your mother in law.
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Davenport Apr 2022
Hi, LL; did I miss something the OPs dilemma concerned mother-in-law?
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I eased my mom into AL by taking her on tours of several in her area. We met the director, had lunch with residents, even sat in on some of the activities. I then arranged for a 2-week "Respite" stay for her so she could experience what it would be like.

I also reviewed her financials to show her how much money she was spending to stay in her big family home versus the fees for AL. Frankly she was spending more to live there than her income! (We sold the house and that funded her expenses until her death.)

When she decided it was a good idea and chose one of the facilities we went through her house and helped her pick out the furniture and accessories she wanted to take. I supervised the move and arranged the furniture, hung pictures, etc, so when she moved in her new home was all set. We rented a storage locker for seasonal stuff and anything else she couldn’t bear to part with. Most of it she eventually forgot all about.

The most important thing here is that I did nothing without her cooperation and input. Although the move was a HUGE benefit for me and my siblings it was her life after all.

One big thing that I think helped her was we went through the house and she chose pieces to give to family and neighbors. It seemed to give her peace to know that things she had cared for and cherished for 70 years were going to a good home. She had nothing of real value but the memories attached to them.
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My mother also refused assisted living. Her last days were wetting herself and falling.
Some people can't face health issues and will let themself suffer instead of being comfortable and safe.
My parent had heart issues so her legs finally gave out and she was falling so her last hospital trip, she realized she couldn't continue in her house( but died a few hours later)
The option is to get a power of attorney, discuss legal options and criteria for your state- usually have to have the person legally declared incompetent which is difficult.
So either your parent will have a health scare and then be more willing to go, or you will wait for her to be in her last days and pass on never going to asst living.
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I was in the same situation with my parents. It is possible. I had my mom sign a form that I could talk to the doctor. Then she was tested and talked to the nurse and let her know I couldn't do it all. Doctor completed the paperwork, and it was done. My father was dx in 2015 and passed from ALZ in Nov 17 and 3 weeks prior mom was dx with vascular dementia and still hanging on. My Narc mom tried to guilt trip me saying she wouldn't last 2 months at AL. After 4-5 times saying that, I finally said if the good Lord is ready for you so am I. She never said it again!

Mom was at AL for 3 1/2 years. She has been with me since Dec but will be going to a different AL soon. If you are unable to take care of her...She has to go. Don't let her think it is an option but get your ducks in a row first. You have to look at this as a marathon not a sprint. You may be dealing with 10-15 years. You have to conserve your energy. I am 7 years in and no end in sight. I am very weary as I have been both of my parents 24/7 at times and have to liquidate their estate. Even when a LO is place there are still a lot of things behind the scenes to handle. Pace yourself. Hope this helps! Hugs!
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Also, I highly recommend Boundaries by Cloud and Townsend. Best book I have ever read other than the bible. It has literally transformed my life.
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Anosognosia or lack of insight is common in dementia. You will never convince her. Don't waste your time. You have a tough task. You can discuss her refusal to go to an assisted living with her medical team and try to figure out a strategy. A nurse or social worker could help you in this regard. This type of situation is fairly common, very few old people move willingly to an assisted living facility, because they don't want to lose their independence. With dementia, the denial is much stronger. There are solutions, but they won't come easily.
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I had this issue with my mom. She was extremely against AL and refused to leave home, but home was terrible disgusting and she was not taking care of herself on top of her dementia. I tried to ease her into it with showing her how it's just like apartment living and she isn't locked in like a prisoner. She caused a huge scene and argument when she realized what it was.

I have POA and had a neurologist and dr letters saying she needed to be in AL so i set it up with the director. Got her room ready beforehand and ended up just having to tell her we were going to visit a doctor about her medications (prayed to god she didnt remember her previous visit.) it was the only way i could get her in the car and through their doors. I set up with the director to let them know what time we'd be arriving so they were aware. They also knew she was very against living there but needed to. Once I got her through the doors, I let them take over. I felt extreme guilt to have to lie to her about it and uproot her from her home where she was comfortable so suddenly. But it was the only option I had left.
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