How do I set boundaries with someone who is angry and resistant to medical advice? Takes it out on me, fell down 2x and is hospitalized.

Where's she going to go after rehab?

They'll have discharge people, social workers, or somebody else to work that out, and she's going to tell them she can go home. Then comes the question from mom to you: "You're going to take care of me, right?"

You and siblings must start rehearsing the answer, which is no. Then someone else, not you or sibs, will figure it out.

You must not take her into your homes because you'll never get her out. You must not agree to take care of her at her house because you'll never be able to get out from under that snowstorm. You must not manage her home care. She has dementia. She should go to a facility now.

You can't deal with someone who has made you her whipping boy. That never changes. A year down the road you'd be ready to ride a rocket ship to Mars in order to get out of this.

And you don't have to be physically present at the hospital or rehab. It opens the way for her to get mean and take out her anger on you. Why would you perpetuate that? Mom's shown you who she is - believe her.

Nobody is ever happy when they get older and are at their end of life. Many elders with dementia take it to the extreme, with tantrums and terrible behavior.

If you and siblings all have a "negative relationship" with her, you all need to meet and go over a game plan to ALL avoid becoming her caregivers. That means telling this clearly to the Rehab people, social workers, etc. "Mom is a fall risk, she has dementia and needs 24/7 care and YOU CANNOT DO IT." Repeat it 100 times. Do not cave or worry Mom will get mad, or you will "feel bad."
You need a reality check:

Can you tolerate changing Mom's adult diapers? Bathe her? Shop, cook, feed and clean up her mess? Listen to her tantrums, rants and screaming constantly? Become a 24 hr slave? Ready to give up your social life, job and future? Worry about her wandering off, or falling again?

How many years of medical experience do you have? Do you work? What if something happens to you, then what happens to Mom? You said she doesn't listen to doctors or anyone.

Now is the time to get your siblings on board, and have Mom placed. Then call and visit all you want. Mom will have 24 hour care done by experienced medical staff. She will be kept clean, fed and safe. They will know how to deal with her bitterness. She will have constant attention and medical help available.

With dementia, she's only going to get worse. Now will be the last chance to do this fairly easy. Don't cave in. Get your life back before it's too late.

Best to get her from rehab straight into a facility. Trust me, I didn't do that with my wife and I have paid the price. It is harder to get them out of the home and into a facility than to get them placed from a hospital where you have the physicians right there to recommend this.

My situation is a little different. My wife is dying of breast cancer and has schizophrenia (severe). It is somewhat similar to dementia at times but she does have lucid moments so when hospice evaluated her they said she was capable of making her own decision and I couldn't move her. I literally am stuck. Don't take her home. Place her now while you can

You cannot set boundaries with someone who won't honor them.

Look at it this way. There is a bull in the field who enjoys attacking you every time you enter the field. He has enormous horns and he wants to gut you.
You go to the center of the field, draw a line, turn to the bull and tell him "I don't want you crossing this".
Just how good do you think your chances are that the bull will honor your boundary as drawn?
Not great, right?

You say that you "found yourself physically present". Makes it sound like an accident. Like someone "beamed you up" and set you down in Mom's presence. That's not how it works. You WENT TO MOM. That's how you were present.

Words you tell yourself matter.

You had a mom so sadly limited that she was abusive to you.
I would stay out of it and out of her life.
I would CERTAINLY never assume responsibility.
Many people are out there living WITHOUT any children.
Pretend your Mom is one of them.
Supply mom with the number of 911 to call. Make the occ. friendly call. When she isn't pleasant hang up.

When Social Worker calls you from the rehab (and they WILL) refuse to participate, tell them your mother needs care she will not seek and you do not wish to assume responsibility for her.

She takes it out on you because you ALLOW THAT.
You are an adult, and responsible now to make your own decisions for your own life. Otherwise this sadness will play forward generationally.

I wish you the best, but the choice is ultimately your own.

Your mother has dementia and you are looking to set boundaries . I’m going to tell you what the geriatrician told me about my mother with dementia…..

She said I could not take care of my mother . My mother would not do what I asked of her , bathing, eating etc .
My mother did not understand and thought I was being mean to her telling her to bathe . She would not do anything I asked .

The doctor told me when it gets to this level , family can not take care of someone with dementia. They need to be in a facilty with 24/7 supervision . With staff trained to deal with the behaviors.
Parents with dementia don’t want to be told what to do by an adult child and they don’t understand boundaries . They think you should do what they want when they want as if you are still a child .

DO NOT TAKE MOM HOME . She can not live alone or with you . Talk to the social worker at rehab to see what the options are for placement . Tell them you can’t care for her . Don’t let them talk you into taking mom home . They may promise help to come in. It would be minimal amount . Tell social worker your Mom needs a facility . If Mom has funds or a house to sell to pay for assisted living / memory care , that’s the way to go . As POA you could do this . If you do not have POA , let the state take over .

From your profile:

I am caring for my mother, living at home with age-related decline, alzheimer's / dementia, and mobility problems.

With dementia at play, mom should not be living alone anymore. You can't be physically present for her 24/7 if you or your siblings want a life of your own, either. Elders with dementia get VERY argumentative and resistant to medical advice and following orders or taking medications. The same goes for boundaries.

The best place for mom is either Memory Care Assisted Living If she has funds to private pay or Skilled Nursing care with Medicaid if she does not.

The rehab center she's at now may suggest she stay in their long term care section permanently if she makes insufficient progress with physical therapy, which is often the case with dementia. It's very difficult for them to follow instructions or remember them, in reality. Medicare will only continue to pay for rehab if the patient makes progress.

Wishing you the best of luck with a difficult situation.

It's great to work on boundaries, even better to work on having peace in your heart that some problems only have "least bad" solutions.

If you think she won't get help if you don't step in, you're mistaken. Talk to social services at the rehab facility to see if she can be transitioned directly into a facility. Then step away and allow the county to acquire guardianship for her. The court-appointed guardian will take care of all her needs: shelter; food; medical and even social. The more you interject yourself, the longer her "best" solution will be delayed.

For yourself: BetterHelp.com is affordable, accessible online therapy.

You have her evaluated for 24/7 care while in rehab. If needed, you then tell them she needs to be transferred to a NH from Rehab. To send her home would be a unsafe discharge. There is no one willing to care for her. If no one who has POA you may ask that the State take over her care especially if she has no money.

You do not want to take on her care. The State can get her placed sooner. And as said, you can't set boundaries with anyone with Dementia. She needs to be declared incompetent.

THis has a steep learning curve but can be done. You probably have found yourself in a situation similar to mine, and I'm trying to learn how to improve it. It takes time...

From your brief description, this sounds like a parent who previously called all the shots, is very stubborn, wont listen to kids, or doctors. She has called the shots previously. What you and your siblings need to do now is to change the situation. It will take time but you want to turn the tables around. She needs to realize she is vulnerable, needs help, and is going to have to start listening to people and doing what they say, or else she will be in trouble. This is not easy, I'm still struggling with it. But a hospitalization, illness or injury is a good time to take steps, while they are vulnerable and perhaps willing to see a change of dynamics is needed and that they need you now.

As far as boundaries, I am assuming you feel the need to set boundaries. Yes, while in hospital, a child feels the need to be present regularly and be updated. Eventually, when she is placed in a long term situation (and a facility rather than back home sounds like it is the best thing as others have said), you are going to want to stop visiting so regularly and get your life back. So that is where boundaries are the right thing to do. It wont be easy, and she may push the boundaries to start with. You mentioned you don't want to feel bad in setting boundaries. I have struggled with this, but have recently realized that the boundaries are necessary for the well being of all, and so there is not a reason to feel bad about the boundaries, and saying no to some things. Slowly I am finding I dont feel bad when I have to say "no" to something. I still visit 2-3 times a week for about 2-3 hours. Maybe eventually I can reduce that time. I think its good to strike a balance between helping as you can, saying " yes" when its ok with you, and otherwise saying no to other things.

Consider reading one of the many good books or audiobooks on boundaries. Eg, "Boundaries" by Henry Cloud & John Townsend, or "Set Boundaries, Find Peace" by Nedra Glover Tawwab.

She will likely push at some boundaries to start, but if you are persistent, things can change in your favor. If she doesnt change, and happens to ignore or refuse to accept all boundaries from all the siblings, well then that is a different situation, which has been covered in other posts. In that sad situation its time to consider stepping partially or fully away, but hopefully it wont come to that for you. The boundary setting can work. I still struggle with it, but have found I'm making progress over the past couple of months. Hang in there! And yes, while you mention all siblings have a strained relationship with her, but hopefully you all get along among yourself. Its time for a talk with them, and see if you can all get on the same page and present a "united front". If you all have the same feeling about what Mom should now, and set similar boundaries, there is more chance of success.

Lfv , if your mom has dementia, you set the boundaries for YOUR sake--so that you don't spiral into burnout.

And so that she gets the help she NEEDS

As long as you and your siblings make it appear that mom will be "fine" at home because her "kids" are going to be there to care for her, they will keep sending her home.

However, if you talk to discharge planning and tell them that mom lives alone and won't accept assistance, you can get her evaluated for long term care.

Does that seem like the better choice?

Remind yourself that at some point in elder care, there are no "good" or "best" choices, only the least bad ones.