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Mother is 91 living in a very nice assisted living facility. She will not cooperate with staff refusing am and pm cares, twice weekly showers and refuses dining room meals wanting her meals delivered at an additonal 20$ per day.
She sits in her nightie and robe all day rummaging through old cards and letters.
The staff is frustrated with her since she stalls and takes up a great deal of their time. She has gotten obstinate and tries to convince us she is taking showers and going along with the program. She was just released from the hospital on Sunday with cellulitis and leg swelling. We had a stern talking to with her and advised her the next step will be a nursing home. She promised to allow ADL's, get dressed and at a minimum go to lunch in the dining room. Well, she cooperated on Monday and today she refused. Mom does have mild/moderate memory/dementia issues but has it together enough to know what need to happen. Really, we can hardly handle the calls from AL and have guilt and sadness that she is letting her hygiene go. Please advise us. We are at a loss.

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Makes me wonder how the staff is approaching her. I've had a very obstinate client who "refused" to shower, dress, etc. I just joked, teased, and "gentled" her into compliance. Maybe the staff doesn't have that luxury. I believe the loss of self is very depressing. Going through old letters and other memories takes her away from the unacceptable. It's a sad thing, but you must not feel guilt in her behalf. This is apart from your control.
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If your mom is non-compliant in an assisted living facility you may have no other recourse other than to move her to a nursing home. If left to her own devices she won't do the minimal tasks AL requires and the AL staff can't get her to be compliant and you can't get her to be compliant what other option is there?

If someone told me, "You have to do x, y, and z or else you will need a nursing home" you can bet that I would do x, y, and z. That your mom doesn't seem to care that there are consequences to her non-compliance tells me that she may not be able to completely reason on her own.

As I'm sure you've discovered, it's nearly impossible to get an elderly person to do something they don't want to do. You've talked to your mom, professionals have spoken to her, I'm sure the AL has thrown in their two cents....still she is unwilling (or maybe unable) to care for her most basic needs.

It might be the right time to start touring some nursing homes.
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I know exactly what you are going through, because my mother is doing the same. I offer my prayers and hope things get better. I don't know what to do with my mother either.
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Assisted Living won't keep her much longer. Hopefully you have her in a facility with a nursing home wing. If not, start looking around, because it is time, so sorry you are going through this.
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I dont think you can say MILD dementia i dont get this word? my mum will not cooperate with carers coming in its a nightmare this is sadly a part of dementia and as pam says how much are AL willing to put up with? If a home dosnt scare the pants off her then shes not reacting normally and her dementia is far from mild? i would prefer my in a home with pros who deal with dementia patients than her lose her dignity in AL. My mum wont even take her meds properly OR let me do it??? if this continues something bad will happen and ill have no choice but to place her in a home for her own safety! So sorry for you its so stressful and sad to see them like this but my mum will not do what shes asked and ive let her be now and wait until something happens ive exhausted all avenues! Is she there long? maybe give her time to adjust? OR maybe the dementia is progressing fast?
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You might want to calmly have a talk with mom and say what eyelash suggests "it's xyzzy or nursing home mom, is that what you want?". Let CNA-Kathy and I help you get showered this morning and then you and I will have a nice lunch together in dining room". Then do it.

If she continues to refuse, stay away for awhile and maybe she will be acquiesce. Tell the AL that you no longer want them to call you regarding mom unless it is an emergency. If they have a visiting nurse or house dr, see if he will visit your mom and make it drs orders that she bath, etc. maybe convince her taking care of herself will keep her out of a nursing home.

Good luck.
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