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My 85 yr old mom lives alone in a small apartment. Over the past several years she does nothing but sit on the sofa watching TV. She refuses to make friends or socialize. I have noticed in the past years her hygiene is not good- not bathing, hair unwashed. She gets weaker by the day because she does not walk much or do anything at all, so it’s even hard for her to use her walker. She is extremely manipulative and stubborn. She fell the other night (we have a Life Alert system for her to wear around her neck, but she won’t wear it) and was on the floor until her grandson found her the next day. She had been there for over 12 hours. She crawled to the door and opened it for him, but did not try to reach the Life Alert because she said she just wanted to lay there and die. She has refused to let us come over for weeks and has cancelled dates with me, my brother and her 3 grandsons for various reasons. When she was found, she had 4 bags of garbage on the kitchen floor crawling with maggots and flies everywhere. She told my som not to tell anyone. I will spare you all the disgusting details, but the apartment was so filthy that the health department or social services would have condemned it as unhealthy and toxic.
She is currently in the hospital for evaluation and seems fine. When she said “you have no idea what I’ve been through”, I confronted her with the condition of her apartment and asked her how she could live like that??? She was always a clean person and kept a tidy house. We have tried for two years to get her to agree to a weekly cleaning service and she refuses, saying her place never gets very dirty. Every dish, every utensil was covered in dried food and piled all over the kitchen. She said that it was a little messy and it wasn’t a big deal.
She has lies to all of the doctors and nurse and because of Covid no one can go into the hospital to speak with her doctors. I have tried calling but each time I get a different nurse and never a doctor.
I don’t think that she can continue to live on her own. For the sake of my sanity and my marriage she cannot live with us.
She has no money and we cannot afford to pay for her care. She is 85 but in the shape of someone 100 and has the mental capacity and judgment of a toddler. She does not seem to have dementia and I do have a medical power of attorney and I am the agent.
She will hate me if I decide she needs to live in an assisted care environment, but she won’t do anything I say or suggest and expects everyone around her to deal with her bad choices. I am 65 and cannot physically or mentally deal with her manipulative ways (lying) and lack of thought to her actions or inactions any longer.
She has not made good life choices her entire life and I refuse to let her drag me down with her.
I honestly don’t know what to do. I am usually a take charge problem-solving, proactive person but I am just at my wits’ end this time.

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I feel like we must have the same mother! I’m going through the same thing except we moved her in with us and now don’t know what to do to get the help we need for her! She doesn’t think anything is wrong with her. It’s just me being controlling and bossy. I get you! Wits end here too! 🙏🏻
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Only a Doctor can determine if she has dementia. Sounds like putting her in a home is your only option under the circumstances. She may decide she likes it once shes there awhile.If she gets mad at you she will get over it. Dont stress just do what you need to do for her safety.
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Do you visit her regularly in her home? I have a stubborn brother like this but we ignore his protests and come into the house and attend to things anyway. Your mother may want to die because she realizes no one cares for her. Perhaps her grandson does, but you sound like you are at your wits end. Perhaps you have your reasons. Medicaid does not pay for assisted living which is very expensive. If she isn’t medically eligible for nursing home care and/or Medicaid, I suggest that you go over to her house at least three times a week and attend to things, get her a cell phone and have her check in with you twice a day. When she’s medically eligible for nursing home care, place her and spend down her resources until she is eligible for Medicaid.
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If you don't have POA and cannot pay for her financials, there's very little you can do besides be manipulated in this situation.

This sounds bad, but sometimes people have to face their own consequences.

We had a situation in 2020 that involved both the ILs getting sick and them attempting to guilt the whole family into providing 24/7 including us. No, that's not how it works.

24/7 home health is atrociously expensive. Like $170K/year for two people, which is the bare minimum.
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The best thing you can do for your mother is put her in an assistant living facility. Are you sure your mom does not have beginning stages of Alzheimer's /Dementia?
The reason I am asking is because I found my mom living in a similar situation. I finally had to take charge of the situation immediately. It was not easy, but my mother was no longer able to care for herself at all. Once I got her out of the condominium and took her to doctors describing how I found her she was diagnosed with dementia. After 3 years, my mom is at the severe stage per the neurologist. So, you might think your mom does not have dementia / Alzheimer but what you're describing is the classic symptoms and behavior of it. You should be thankful you have the power attorney on her because at this point it would be very difficult to get her to agree to it. It hard to put them in a facility but she will be safer and cared for much better than being alone.
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Consider hiring a Geriatric Care Manager. They are social workers who can truly help you and your mother. Your mom sounds ill. She needs caring compassionate assistance and so do you.
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I'm in the exact same shoes as you with my mom. She sits all day. Not interested in tv, music, puzzles, crafts, magazines...nothing but sit. I don't have power of attorney but I will on Friday. I will make the hard choice of putting them ( mom and dad) in assisted living. It's for their own good and safety. Both my parents live alone and have stairs up to their condo. Both refuse to wear a life alert system. As power of attorney you unfortunately have to make the decision to have her placed. You know she can't be alone anymore. My mom is super stubborn and is dragging myself and my dad down. I'm 62 and had a mental breakdown a little over a week ago. I'm just now starting to see a glimmer of hope. A tiny glimmer. It's so very hard I know. My mom will hate me for it but it has to be done. Do what you know is the right thing to do for her safety. You should feel better once you know she's safe. I know I will. 🙏🙏🙏
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Can you put it in the hands of the court to determine her needs and where she should be - if you cannot afford to sort her out and she will be impossible to get to make a sensible decision let the state decide.
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You say, "She is 85 but in the shape of someone 100 and has the mental capacity and judgment of a toddler." Then, "She does not seem to have dementia." Dementia means she has the mental capacity & judgment of a toddler!

Please realize that your mother is very ill and needs help. You are in the perfect position as her POA with her in the hospital now. Do not allow them to release her but insist she be placed in long term care by the social worker at the hospital. You'll get help applying for Medicaid on her behalf.

She is not safe to live alone, or equipped to handle life on her own.

Wishing you the best of luck with a difficult situation.
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domrocsmom: Imho, not wanting to use her Life Alert because "she wants to lay there and die" is a HUGE red flag that something is majorly amiss with her mental status, that in addition to the garbage with bugs and other things.
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Your mother may be beyond assisted living and ready for nursing home. Get in touch with social services and medicaide. Tell them everything. They will know what to do for/with her at this point in her life. She's not capable of taking care of herself.
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First, you are correct in not taking your mother in for sake of your own sanity and your marriage. Two words to the hospital social worker…”unsafe discharge” Inform the social worker from the hospital that you need help finding a placement for your mother. They can and should help you with an application to see if she qualifies for Medicare assisted home living. You said she lives in an apartment so I assume she doesn’t own a home, so that’s a great help when they evaluate her assets. Sounds like There’s a lot going on with your mom’s mental health…depression, confusion, daily living skills. Is she taking her medications correctly? Lots of things to consider. You are not alone in this. Many of us have been there. Only you can decide what works for you and please don’t let anyone guilt you into anything. Good luck and take care of yourself first so you can make healthy decisions. 🙏🏽🙏🏽
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BarbBrooklyn hit the nail on the head!!! Follow her directions but at the same time realize that your Mom's reality is no longer the same as yours. You can't "fix" her and neither can the medical profession. Hopefully, you got some pics or video of that apartment when you found her. As the medical power of attorney see if you can get a doctor to give you a mental evaluation while she is in hospital and can't escape on some pretext. If the dx is dementia, you have the power to decide where she will reside. Trust me ... if she is not in a facility, you will replay this last scenario over and over: and it it should never, not even for one hour be with you!!. So have the hospital place her (they will probably send her to a facility for STR); they will ask you to choose the facility but they won't give you a lot of time. I have a feeling she will not really participate in PT but they will try to cajole her into doing the exercises. Depending on the type of insurance (I'm assuming some type of Medicare - traditional or Advantage) she has she may get 5-20 days to participate with her insurance paying all or most of the care. After they finish paying, she will need to apply for Medicaid to stay there. The facility will assist you in the application but as someone said you need to stay on top of the application. Be prepared to supply them with birth , marriage and death certificates, divorce papers - if applicable, 3-5 years worth of bank statements if applicable, rent receipts, social security benefit awards papers ... you get the idea; start getting that together now while she is in hospital so you don't have to hear her complain. Now, if the hospital doctors (and let them see the photos of the apartment) say that she is competent...... there is not much you can do. They can not "force" her to go to rehab nor can they keep her against her will so she will be discharged (hospitals are not under the same type of "safe discharge" rulings that rehab facilities face) to her home. DO NOT go and pick her up. Let the facility figure out how to do that. I mean if she had no family, they would have to get her home on their own. Unfortunately, as this may happen again... you will need to start distancing yourself from the entire situation so that next time they will realize there is no safety net for this woman who needs to be in a facility.

Wishing you good luck on this difficult journey. Please keep us updated.
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My god - what a mess. This woman has totally screwed herself and is doing the same to you. I don't care what she thinks or feels - she is totally incapable of living by herself and you should NOT bear the burden of caring for her. It will pull you down and destroy you and she will be blind to that. You are NOT guilty, but completely sane if you place her into an appropriate facility at once. You have no choice - don't let her get away with her actions. She MUST be placed at once. You do not deserve to be tortured any longer by her and what she does in her daily life.
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Your story almost exactly like mine.

Mom would not keep things cleaned up and she wold not let hired help clean up.

I did not expect a perfectly clean home but just some general cleanliness. She insisted on keeping partially eaten food and dirty paper plates and plastic utensils.

she ended up with bacterial pneumonia. Also to make things even more worse she had a MASSIVE bed bug infestation. Had to bring her to my house with just the clothes on her back while my brothers and exterminator cleaned out the house. Exterminator said one of worst infestation he seen.

whatever you think you might want to do start planning now. Get out the trust and POA and see what they say. Start getting letters from the doctor confirming incapacity. My moms trust had a weird clause. Incapacity is to be determined by a committee of 2 doctors and a priest. Well we never went to church once so don’t know where that came from. The doctors really did not want to give that letter and it was an uphill battle. To make it worse she had become bedridden so how on earth was I going to get her to a doctor when she can’t walk or stand.

I even had to get a lawyer to fix some of the stupid stuff my parents did. What a mess. I’m surprised they didn’t have to lock me in an institute.

good luck.
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Your mother seems to be suffering from mental health issues. If need be, send a letter to her doctor at the hospital about what you have written here. Also contact the social services department at the hospital about what you have written. Social services can get your mother placed into a residential facility that will accept whatever her finances she has - even Medicaid.
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Email the social workers at the hospital, discharge planning, her MD and aging and protective services, with copies to yourself. State that it would be an unsafe discharge if she was to be discharged to home. Advise them that you are her medical power of attorney and do not support a discharge to home. Advise them that your mother is an unreliable reporter and may be providing inaccurate statements about her situation.

State that when asked why she didn't try to get help after falling she told family she wanted to lay on the floor and die.

Then briefly list what has happened that supports her inability to appropriately care for herself, starting with being unable mentally to get emergency care when she fell and lay on the floor for 12 hours even when there was a emergency alert device she refuses to use.

If you have photos of her unclean apartment include 1 or 2. List short descriptions of what you found, 4 bags of maggot cover garbage, all dishes and silverware caked with food.

Unable to bathe and maintain her healthy hygiene and refusing assistance.

Ask for her to be assessed for the appropriate level of care. Ask the hospital to begin the application for Medicare and/or Medicare. Ask them to begin the process for placement in that level of care.

At this point your mother is going to hate everyone, but you are doing the right thing.
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It is my understanding that Medical POA only kicks in if she is deemed "incapacitated". Clearly, she is not incapacitated.

Voice your concers to the medical staff, and ask to speak to the hospital social worker. Explain the situation to him/her and see if they are willing and/or able to help.

If not, while she is in the hospital, report the apartment to the landlord. Have them make a decision about terminating the lease or giving her a deadline for cleaning up the apartment. This will be her responsibility, not yours. Of she needs your help, she will have to ask for it. Then when/if you go in to help her clean, she won't be able to be angry at you, since she asked for the help.

As soon as you report her living conditions to her landlord, also contact adult protective services with your concerns. They can meet with you and inspect the living conditions. If things are as bad as you say, they may offer her the choice of being a ward of the state, or allowing her to give you full Power of Attorney, which would give you the ability to arrange placement and manage her finances.

From what I have read, it sounds like she is no longer capable of providing her own care. I disagree with another commenter, she does not need one more chance. She needs physical and emotional support, and a safe living environment.
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Hi - I'm sorry to hear that you're having this challenge with your mom...I plan to elaborate more on this site re: the hardships that my mom has caused me as a result of her behavior ...it's beyond. Until then, my thoughts are - if you want to start gradually and if you're uncomfortable implementing certain steps (such as a weekly cleaning service), you can tell her this directive is directly from the Hospital Staff and she MUST follow this - that's really the minimum and there are no other options - she doesn't really get choices and you should let her know that it's out of your hands. I would always strongly tell her that this is coming from other professionals, so the onus is off of you and it isn't personal. Otherwise, she'll need to understand that next steps will need to occur. You can say this firmly and seriously - and when you're just repeating the directive from the hospital, instead of coming from you, it may reduce her chance of manipulating. On top of all I am contending with, I have a single elderly aunt - that I'm also solely helping - and she's not easy to deal with - never was...and this is the way I had to help her - I'm not sure if your mom has insurance, but if she does (or even possibly medicare may cover), I was able to arrange weekly visits from a physical therapist and a cognitive therapist to my aunt's home for to improve her mind, body and spirit...and I made sure that she attended a senior social group (most towns have such)...and she's not a social person, but it got her out. I didn't suggest it...I didn't ask her if she wanted to go (or have these therapists come to her home)...I didn't give her any chance to voice her approval - when she tried, I nicely and firmly told her that there were NO options - it was to help her and the instruction came from other professionals to help her improve the quality of her life. It was the first time she didn't go into one of her usual tantrums and she finally just gave in - and after she got into a regular schedule, she started becoming more positive and receptive about it....I hope your mom will too!! Best wishes!
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As I often do, I am taking a different approach. Did you by any chance take pictures of her apartment? A picture is worth a thousand words. If not a narrative of what was seen, to share with the hospital, social worker and Mom herself!!
She may not actually be lying but just not living in reality since she was a neat person this reality may be hard to accept. Sounds like therapy may be needed.
Is it possible to hold a family meeting?? Mom may be eligible for a temporary placement, due to her mental state (depression) and physical condition
When she is well enough to return home, conditions should be set and met.
I am for....one more try. Best wishes.
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Call the president of the hospital, or better yet, have an attorney call him or her. Explain no one has discussed with you her living conditions and that she is not able to return home. Often, there is a social work department that would handle this. Be unpleasant if you need to be, better to let an attorney do it.
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Put her in assisted living. Listen, nothing can be worse then the conditions that she lives in. You will be doing her a favor. I have spoken to several families that have placed parent in assisted living and at first, the parents want to go home but later get used to it. What is the difference if she watches TV in assisted living or alone at home surrounded by filth. Good Luck and know that you are doing a great job just by caring.
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I bet if you let the apartment management know what condition the apartment is in, they would refuse to let her come back. While I agree people have the right to live as they choose, that doesn't mean they have the right to live in filth in an apartment or other multi-occupant dwelling. She needs to be in assisted living, or somewhere that will make sure she is not living in filth.
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Let her hate you, rather that than have something really bad and her lie in pain on the floor or heaven forbid she would cut herself and bleed to death and then someone find her. Sounds like she is depressed for whatever reason. Since you said you have medical power of attorney, stress to the doctor that she cannot go home due to the circumstances and that she is depressed and needs 24/7 care and should be placed. Tell them that she is not mentally capable of making decisions and she should be placed. Again.......let her hate you. at least you know IF she is placed that she will be taken care of (bathed, clothes washed, food given to her and no dishes to do, etc). She might even find some of the activities enjoyable after she has been there awhile. Do NOT let them send her home.........wishing you luck.
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Leave your mom alone and let her live the way she wants.
You said she doesn't have dementia so she is capable of living alone.
If she doesn't have money she can't afford a cleaning person.
You can buy paper plates for her to use to not have so many dirty dishes
You can invite her out to lunch, ect and if she doesn't want to go that's her choice.
Lother of people watch tv as what else does she have to do.
You might bring over a large print puzzle or a large print paint by number for both of ya'll to do.
play her favorite music.
Have a couple people over for a Bingo or card Game.
A Nursing Home is the Worst place you could put her and they are all understaffed.
There are many falls in Nursing Homes and they keep you too doped up.
As far as not bathing enough, she can't get that dirty watching TV and bathing or Showering once or twice a week is plenty.

Buy her frozen dinners to eat and she want very many dirty dishes.
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wolflover451 Aug 2021
not all nursing homes are bad, sure some are understaffed now because no one wants to get off their butts and work. my mom is in one, she is taken care of, has good meals.....does she have to wait sometimes to use the bathroom, yes,......but they get to her. she has not fallen and they have precautionary measures to put in place to keep them from getting hurt if they fall. my dad was there for 6 years and only fell one time out of bed onto a thick rubber mattress...........he was not doped up nor is my mother. so saying that they are all bad is not fair to the ones that are really good. and if this woman has no money, they can apply for medicaid. and if she uses paper plates........more garbage to be thrown on the floor.
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you are correct, go with your gut feelings. It is very clear she can not live alone and needs a care facility.
She sounds like my mother, (passive aggressive, )complains but does nothing to make her life worth anything. She does want others to care for her because she is just making no choice ( which is a choice)
You do what is best for her, best for you.
Best wishes.
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Since you do have POAs it is time you act on them. Your mom needs help and she needs it now. Since she nor you cannot afford Assisted Living/Nursing Home care, it is time you make an application for Medicaid. This process takes about 3 months, and you will need to procure bank statements, etc. which may make the process longer. Contact your State’s Dept Human Services ( DHS.) Also look for an elder care attorney.
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Do you have POA? Sounds like your Mom has given up and can no longer care for herself. Do not let her anger with you stand in the way of what must be done. She needs help! Contact her doctor and tell him what's going on. Doctor may be able to assist you in getting her proper placement for best care. Also, if your state has Dept. of Aging, contact them, too and ask for their help. There are State resources available that will assist you in getting appropriate and adequate care for her. Once all that sets in; your Mom just may turn around and be happier and healthier. Good luck!
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You need to call (again and again) the hospital and speak to the discharge planner and tell them the condition you found her in and calmly explain she can no longer live alone. You need to be firm that it’s an “unsafe discharge.” List the reasons. The hospital will try and move her out as quickly as possible and say they are putting in visiting nurse and other support services, all of which she will refuse. If you can’t get someone on the phone, then leave long messages, or type something up and fax it to the nursing station, social work office or doctors office - or all three. Just write an objective account of what you have been observing. And include she has no family able to provide the level of care that she needs. Say you can’t support a plan for her to be discharged back to her apartment. They might think you are a pain in the butt - so what. With her weakness and falls, she might be discharged to a rehab which would buy some time and allow you to work with the rehab for options. “Unsafe Discharge” should be your mantra when talking to staff.

Will she hate you if you try and find placement for her? Yes. I am a hated daughter, and there are probably thousands, maybe billions of hated daughters out there! You will not be alone! By making those decisions you are trying to keep your mother safe. Don’t argue with your mother or try and convince her that she will be better off. Just tell her “this isn’t working.” Tell her you can’t support her plan to go back home. She might say she doesn’t “need you anyway” but just don’t respond.

You say she doesn’t have dementia but her bad choices and failure to recognize her need for help is pointing in that direction. She could be great at covering things up. My own mother kept everyone at bay so that no one could see how bad things really were.

Start researching services for her and find out what needs to be done for Medicaid. In some states there are assisted living Medicaid Waivers but they have restrictions.

If she gets sent back home, call Adult Protective Services. Whatever you do, do not agree to take her home with you and do not agree to pay for services. That will be slow suicide and a path to divorce. Get some counseling to help deal with past and present trauma. Good luck! You are being a good daughter for trying to get your mother the help she needs despite her behavior. Remember that.
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Yes, sadly she will likely hate you…part of the deal when dealing with a parent who has dementia or personality disorder or depression. Sad to say…my dad's last actual words to me before he died were "I almost hate you"….because he blamed me for being in the NH. I knew his brain was broken and had to let that go even though it made me sad. Here is the issue…we so want them to shape up and be who they were before and we are convinced we can help that happen….until we can’t and realize that is nothing more than wishful thinking. You need to face reality and get your head not your heart involved in appropriate decision making for her care. Get her in a facility, where her last years will be with others, with a nurse and 24 hr. Staff, with meals, with cleanliness etc etc. Be prepared mentally for her anger, but at least you know she is living in clean safe environment. If this was you, what would you want for yourself? Filth and maggots, and a dangerous place where you fall and die?
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