I fear my Mom is slipping away and I feel.....I'm not sure what I feel.

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My mother is in her 90's and has fallen 3 times in the past 6 months; each time requiring a hospital stay. Each time, the doctors have recommended a rehab facility but mom absolutely refuses to go into one -- so, we have in home nursing and therapy 3 times a week, and someone come in each morning to make sure she gets up, bathed, fed, medicated, and gets her situated for the day. I come by after work to fix her dinner and sit with her until she is safely in bed.

Early on, mom would only agree to having the nurse's aid come in Mon-Sat, and every other Sunday because she wanted to have one day without any outsiders in the house. It turned out that on the off Sundays, she would end up calling me to get her out of bed, so we agreed the aid would come in 7 days a week. Last night I confirmed the aid was coming and I called this morning to make sure she was actually here. Mom said aid was probably at a neighbor's and she would be fine.

I called her around 4 to see what she did today and what she wanted for supper. It was then that I learned the aid had not come and mom had been unable to get out of bed the entire day. When I got to her house, I found her still in bed, laying in urine soaked pajamas! I asked her why she hadn't called me earlier and she said she figured she would be able to get up on her own eventually. When I questioned her about the incontinence, she said that she hadn't actually wet the bed, but that every time she moved, a little came out. (A lot came out apparently, because her mattress pad was soaked as well.)

I got her up out of bed and into the bathroom and she apparently had a lot of urine left inside. She finally finished using the bathroom and bathed herself, and I helped her dry off and get dressed. She's sitting up in the den now and still seems very sleepy and either not willing or not able to carry on a conversation. She's just reading the paper and dozing off. When I ask her if she was sleeping, she insists she was just resting her eyes.

I'm feeling very guilty for not following up to make SURE the aid was here, and also guilty that my mother was laying in her own urine soaked bedding for the entire day. I'm also frustrated that she didn't think it was necessary to call me, or one of her friends in the neighborhood who know her condition.

She steadfastly refuses to give anyone power of attorney and steadfastly refuses to go into assisted living. She's always been fiercely independent and I know she feels a lot of anger and resentment about needing a little help to get up and get through the day.

Having her declared incompetent would destroy her, but I'm not convinced she is capable of making logical decisions about her health and well being. n She's lucid enough to know the basics... day of the week, time of day, what meds she needs to take when, etc.... but when I ask her about her day.... what she did, who she talked to, what she saw on television or read in the paper, she gets annoyed with me.

Her aid, the nurse, and the physical therapist all think she is so witty and wonderful -- but she treats me and her close friends with increasing hostility and accuses us of being bossy.

I really don't know what to do now. Has anyone else experienced a similar progression?


You are allowing a person with dementia to make choices. You ignored the MD and let her have her way when she played the guilt card. Try to backtrack a little, work with the MD. She's not a candidate for Assisted Living if she can't get out of bed. She needs 24/7 care and that means a nursing home. Support the doctor's decisions and he will help you.
I bet you're angry and sad, both! Why is Mom insisting on making this so hard for you?

It may be time to have a worst case scenario discussion with her. Ask her how she liked being stuck in bed all day? What if you hadn't called her? Maybe you had plans for the evening, and didn't check in until noon the next day? What if she fell and broke her hip and lay there for over 24 hours before getting help? How would she feel about that? How does she think YOU would feel about that? Play up how unhappy you are at the idea of her getting hurt or lying there in pain for hours.

I think she may be off today just from the stress of the day's incident. I would expect her to bounce back after a night's sleep. If not, do get her to the doctor. She won't live forever, but there's no need for her to suffer from a UTI.
your mother could obtain a springing poa. its only in effect if shes incapacitated. i wouldnt want my kids to have poa without protective limitations. one would buy a monster truck and the other a monster bag of weed.
your mothers agitation likely comes from losing control of her life and surroundings. even if its not true let her believe that shes calling all the shots. you can lead while your following if that makes any sense.
she is slipping away and theres little you can do aside from keeping her comfortable and safe.
pstiegman - I don't know if she has dementia or if she is making intentional choices. She has always had to be in control- her way was the only way. This pattern hasn't changed -- only now her way isn't the best way (at least in my opinion). She is able to get out of bed on her own most of the time. In the past 30 days, there have been two instances of her being unable to get out of bed by herself. I think having her declared incompetent would destroy her and cause her to give up.

Jinx4740 - I've been told by others that she suffers from a narcissistic personality disorder and has been suffering from it for years. Her friends have admitted that she has always controlled me by using guilt. Being the only child (son), and having no siblings and no living relatives means that I have to step up. She didn't seem bothered by the urine -- I guess that since it only came out when she moved, her body heat kept it warm and she didn't sense the extent of the leakage.

As for wondering how *I* feel about things, that doesn't enter into her equation. She expects that as her son, it is my responsibility to help her. She said that if she really DID need help, she would ask for it. She went to an OB/GYN doctor on Friday and they found 2 masses in the vicinity of her ovaries. She has an appointment with the oncologist on Friday.

Tonight's challenge is just to get sustenance into her. She barely touched her supper (after not eating all day), and I'm having to PUSH her to drink some Ensure and some V8... every time I ask her to drink it, she says "nag, nag, nag.. I'll drink it when I'm good and ready"


Captain - thanks! A springing POA.. I've never heard of that. She is VERY, VERY secretive about her finances and doesn't want to give ANYONE that level of control. I'll see if I can get one of her friends to suggest it.
a social worker in a hospital was able to convince my mother a few years ago that she must get some kind of poa arranged because when it became necessary it would be too late. it was self fullfilling advice. mom was hospitalized with a heart attack 15 months ago and it indeed would have been impossible to conduct such business at that point.
Captain - it sounds like I am following the same path you've walked. Just coincidentally I reached out to an elder care agency which does independent evaluations, and coordinates the various services if the candidate/family agrees with them.
My mother has Borderline Personality Disorder, narcissism and now paranoia, which, apparently, is linked, at least in part, to a pretty significant loss of short term memory - a loss which is continuing. My mother is 101 and needs to be in control and always has. It is part of the personality disorder. It sounds to me like your mother is on the slide of short term memory loss and accompanying paranoia which is fairly common in the elderly.
My mother was diagnosed borderline competent after trying to fly across the country last summer without proper ID and without notifying anyone where she was going that she was coming. I don't call that competent. She is starting to lose or misplace money and other things, forget her PIN number and even gave her credit card number out on the phone, but thankfully realised it was a mistake and went to the bank and cancelled her card. It is the grey zone between competency and incompetency. It sounds like that is where your mother is, or perhaps she has crossed the line.
Thankfully, in my case, a few years ago, at the urging of her financial advisor and my honest reassurance that I had zero interest in taking over her life, but would be there to do what was needed when it was needed, mother appointed me EPA (enduring power of attorney to manage her finances which was active immediately) and agent for her personal directive regarding her medical treatment, where she lives etc. The personal directive comes into effect after she is declared incompetent by a physician. The scenario we used was what if she had a stroke, which affected her severely, and no one had been appointed to look after her affairs, she would be in a mess. I am in Canada so our terms/arrangements are a bit different. The springing POA sounds good. To activate it your mother must be declared incompetent. You need authority in both her finances and her care/treatment.
In my case, staff in mother's ALF and a few other professionals who deal with her, and I, are in agreement that mother has crossed the line and is no longer capable of making decisions in her best interests. That does not mean that every decision of hers is not in her best interests but that she has made enough bad decisions that could have caused her harm - or that is my way of describing it.
You are concerned about having your mother declared incompetent and her having a strong emotional reaction to it. My concern for your mother, and I think it should be yours, is whether or not your mother IS competent and still making decisions in her own best interests. To me she shows that she is not that capable. This will only get worse.
The ALF where my mother lives is in the process of watching her carefully in order to get the evidence needed to get her declared incompetent by their physician - for her own good. There is no way she would agree to go for an assessment. Will she have a strong emotional reaction to it? Yes, she will be furious. Should that stop me from pursuing the assessment? Clearly "No". As far as her finances as, I simply watch her accounts and so far they are in order. The time is coming when she will no longer manage her ATM debit card, and possibly her credit card, due to short term memory loss, so I will have to step in more. Will she be happy about it? No. Is it my responsibility to do it? Yes. When you are brought up by a person with a personality disorder you are more concerned about pleasing them than is healthy or good for them as they get older and more incapacitated. Do you get my drift?
You sound like you have a good head on you and have survived the narcissism pretty well. Your mother needs an evaluation and a care plan put in place. I understand that if she goes into hospital for some ailment, they do not have to return her home, but do have to place her in an appropriate facility. She does need you to take more control, as difficult as that is, and believe me I know as I am in that position, and also dealing with a sibling with similar mental problems who is, of course, siding with mother. You might ask her doctor, social services, the local agency on aging, an elder lawyer, whoever you think can help. I have made a lot of phone calls this week, learned a lot, and think we finally have a plan. Coming to this forum was a good idea –do keep coming as likely the road will not be smooth.
These stubborn old people are extremely difficult to deal with even when it concerns their health, safety and wellbeing. It is not your desire to take away her independence, but to see her properly looked after and situated. Unfortunately life - her age - is taking away her independence. Good luck to you and let us know how it goes.
Posted about the same time you did. Sounds like you are on the right track. :)
So, to recap:

Your mother has lived independently up until 6 months ago – without requiring any support from you, or actually with quite a lot of help?

Do we know what caused her to fall on the three occasions since then?

Why, specifically, did the doctors recommend a rehab facility? What treatment would she have received there that hasn't successfully been provided at home?

Can you manage your “evening shift” all right, or is it too burdensome mid- to long-term? I'm just asking, not criticising.

Because it seems to me that your guilt – I understand, you feel terrible – is centred on one isolated occasion when a plan fell through. But what's the big deal? So next time you'll know to check. An unpleasant experience for your mother, made you feel awful too, but a) really not your fault and b) no lasting harm done. I'd be more interested in finding out where the break in communications happened that meant the aide didn't turn up as arranged, and putting that right.

I also completely understand your frustration – with my mother, who however is in early dementia, the refusal to use her alert nearly drove me to drink. As I said to a care manager “My mother wouldn't ask for help if she was on fire.” It was at its most stressful for me when my mother kept telling me she “didn't want to bother me.” Magically, once I realised that the truth was she didn't want me bothering her, it all made a lot more sense.

It may be that your mother is slipping away. She's in her 90s. She's entitled. Why does she have to do it in a nursing home instead of in her own home, as she has always wished?

The thing is, if you were getting to the stage where you'd had enough and you wanted to be allowed to let go gently, in peace, how would you handle it? Give POA to someone whose natural concern would make her whisk you off to an institution? Stir up a fuss with the neighbours when you didn't feel any real need to do so? - and she was right, you know; there wasn't any real need. Different if she'd fallen or been taken seriously ill, but she just needed to go – it could wait.

I don't think your mother is showing signs of dementia. I think she's tired, and very, very old. Is it impossible, in the practical sense, for you to let her do things her way?

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