My 87 year old mother-in-law is angry that we moved her into assisted living. How do we get her to understand that she needs 24/7 care?

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My mother-in-law always insisted that she never wanted to live in a nursing home. As her mental and physical health declined we encouraged her to either move into assisted living or allow social services to provide in-home help. She refused to discuss either option. When she fell and was hospitalized, doctors recommended 24/7 care. We moved her into a rehab facility and then to assisted living. She went on a hunger strike and was hospitalized again and has now been moved into the memory unit. She says that she doesn't belong there and now she is willing to let someone stay with her at home. We think that once she's home, she will refuse the in-home care and we'll be in the same situation as before. Family visits are limited because she becomes upset when we refuse to take her home. Is there anything we can do to make her understand that assisted living is the best place for her now?

Answers 1 to 8 of 8
Let her go home and try the in-home care. If she fires the person, or is mean to them, then tell her that the doctors said she is going to have to go to Assisted Living. Try blaming it on the doctors. Remind her that when she went on her hunger strike the doctors took over and she was moved. Tell her that you are sorry she has to have the in-home care but at least she can be in her home.
Can you sell her house? What you're going thru is almost the exact thing that happened to my mother-in-law. BUT even though she says she hates the asst. facility she's living in now, she says she knows that that's where she belongs. So we don't have the constant belligerence about going home that you're having. So I'd suggest selling her house if you can. In our case we haven't yet, mostly because the market is so bad, and my son and his wife are currently renting it which makes her happy that someone is getting use out of her little house.
From your previous post, I'm wondering if she had the psychiatric evaluation and is where she belongs. It does not sound like she was safe living at home alone and unless there is another facility that she would be happier in, you've done all you can. You can't make her happy, she has to choose to be, all you can do is make sure she's well cared for. I know it's hard, you want her to be safe, happy and well cared for, but just repeat the Serenity Prayer and hang in there.
God, grant me the serenity
To accept the things I cannot change;
Courage to change the things I can;
And wisdom to know the difference.
Thanks for the comments. Our main concern with letting her try in-home care is that if it doesn't work out, she'll lose her room at the assisted living center and be placed on a waiting list to get back in. I've known her for 20 years and she's never even let me into her kitchen so I'm having a hard time imagining her letting strangers come into her home. At this point, we are planning to sell her condo since it is costing $500 month and we would rather save the money for her long-term care. However, there is disagreement as to whether she should be told that they are planning to sell it. What do you think?
Top Answer
FairyLampLady, I have to be honest here and tell you that I think you would be wise to have your mother-in-law remain in the Assisted Living home where she currently is living. You have raised so many "red flags" , as far as her problematic behavior is concerned----not to mention her advanced age----that I think you would do well to "let sleeping dogs lie" and have her stay where she is. You could go from the frying pan into the fire if you allow your mother-in-law to return to her home. She has demonstrated so many stubborn, "blocking", uncooperative type behaviors that there's no telling what you'd be up against if she moved back home. As far as how you can convince her that she needs to stay in Assisted Living, you could have her doctor(s) explain the necessity of this.

Re your issue of whether to tell her if you are selling the condo----Depending on her cognitive condition, it could be argued either way. I have heard of some who do not tell their elder, and then it almost makes it easier on the elder because once the house is sold, it is sold. This is a difficult issue that I have heard about before.

I am a believer that the adult child has to take charge at a certain point; and if he/she feels that the parent cannot make a rational decision on his own behalf, then the adult child has to make the tough decision and do what is best for the safety and health of the elder. I had to do this with my father's driving , for example, and predictably he got mad at me. Eventually he stopped being mad at me and adjusted to not driving. Getting Dad off the road was important for the welfare of not only him, but for everyone else out on the road who could have encountered him. So I tell you this to encourage you to listen to your gut, heart, and mind and discuss with the others how they feel too and then do what you think is right. I also pray for guidance from God too and He has never failed me. He will help you and all of us know what to do.
It's always difficult to take over the roll as "The Decision Maker" with elderly parents who do not understand that they are not capable of "running the show" any longer. I know, because for the past year and 1/2 I have had to take control, and it has not been easy. I tried for several years to convince my parents that they needed some assistance or needed to move to assisted living, and they would not have any part of it. They would not allow anyone to come in and clean their home, would not give up driving, etc.

Our big "break" came when my dad did not feel well & told mom he wanted to go to the emergency room. We discovered later that she did not even remember how to call 911! Once he was at the ER, they discovered his kidneys were failing, and they admitted him to the hospital. My mother insisted each day that she was going to go bring him home because she needed him. We could not make her understand that there was anything wrong with him. She insisted he would be fine once he was home. Fortunately, the doctors agreed that he needed additional care & transferred him to a skilled nursing facility for physical therapy and additional care. We just kept repeating to my mom that the doctors would not let him come home until we "hired a staff to be there 24 hours a day to care for him". She could not understand that he would need care or that they would need any help. I asked questions like, "how will you bathe him?" "How will you pick him up if he falls?" She would respond with comments like "Don't be ridiculous! I don't bathe him; he takes showers." I kept blaming "the doctors" for not letting him return until "we hire 24 hour a day staff." She finally said, "We don't want people in our house, so maybe we should consider living at one of those places where they have people who will help." By handling it this way, she really felt she was the one who made the decision. When she made that statement, I responded by saying, "Well, that's another idea. We could take a look, if that's what you want." Fortunately, I had been doing a lot of research and visiting a lot of places in the area and knew exactly which place would be best for them. I had been keeping in touch with that place for over a year, letting them know that we were interested, that my parents were resisting, but that eventually we would want to move them there. Because of this, I only needed to make one phone call. Fortunately, they had an opening. My mom & I then went to look at the apartment, and she moved in 2 days later. I took her to a doctor's appointment and to do some errands while my sister worked with movers. We used a company that came out to my parents condo and photographed the way everything there was set up, including piles of papers on a desk. They also photographed my parents "wall of family photos" & rehung them in the same identical order in the new apartment at assisted living. The furniture that was taken was arranged as closely as possible to how it had been at the condo, and the piles of papers were reassembled on the desk. I did not bring my mom to the new place until I got a call from my sister that everything was done, including the bed being made & photos on the walls. This really made the transition easier for my mom.

My dad was finally well enough to join her there 4 months later. A few months ago I realized that they had reached the point where they really no longer belonged in the general population at their assisted living facility. Fortunately, a unit became available in the facility's memory care section shortly thereafter, and we took it. We did not tell them in advance that they were changing apartments. Instead, I took them to the dentist while my husband worked with the movers. By the time we returned from the dentist the move was complete, including pictures being rehung on the walls. Our only mistake was telling them when we returned from the dentist that we had moved them. We thought they would notice they were in a different location. They were very angry & said we should have consulted with them first because they would not have agreed to the move. (Duh!) Fortunately, it was nearly time for dinner, so we distracted them by saying it was time to go to the dining room. By the time we returned from dinner, they had completely forgotten that they were in a different apartment. It was the familiarity of their belongings and photos that made them think they had never moved.

Although it's difficult, your best ally is your own sense of humor. If you don't see anything funny about your situation or about the things your mom does or says, you are too close to the situation. Pull back a bit, develop a sense of humor and find someone with whom you can share your experiences. You will soon find yourself laughing about many things and will discover that you are not alone. At some point, you will realize that you must handle your mom the same way you would handle a small child. Be firm, but kind and loving and know that you are making the best decisions for the situation. It is your job to keep her safe, and to know that her caregivers are kind and attentive. Once you know that she is in a clean and caring environment, you should be able to recognize that none of us will be able to always live life exactly how we want to, & that includes your mom. If she continues to be angry and combative toward you, learn not to visit her so often. Let her adjust to her surroundings for a few weeks before you go back to see her. I live 1000 miles from my parents, so I can't be there everyday. I go about every 6 weeks and stay for anywhere from 5 days to 3 weeks, depending on what all needs to be done. (I have kept their condo, because it is much more affordable for me to stay in it than to have to stay in hotels, which means I can visit them more often & for longer periods of time.) When I visit them, I take them to doctors and dental appointments, purchase all their supplies, etc.) I have dinner or lunch with them a few times during my stay, but I do not eat every meal with them. You do need to recognize that sometimes less is more. The more frequently you visit your mom, the worse it will be. By going less frequently, she will always be happy to have you visit, plus she will adjust better to life in her new surroundings.

It is very likely you have friends who are experiencing similar situations with their parents. They are a great resource for you, because you already have a bond. Sharing experiences with each other is not only a great way to vent, it is also a great way to glean new ideas on how to handle your situation. I wish you the best of luck. You are not in an easy place, but you certainly are not alone!

I should also let you know, that I have discovered it's best not to try to get my parents to remember things they have forgotten and it's not a good idea to correct what they say. Try to either be non-committal or just agree with them, because it is very likely that they will completely forget whatever they have said in short order. In other words, if your mom says "I've decided to take a vacation to Rio and am leaving next week", instead of saying "Mom, that's crazy! You can't take a trip!", try saying, "Oh? That does sound like a lot of fun, doesn't it? Where will you stay? What all do you plan to do while you are there?" Let her share her story/dream and play along. Chances are the next time you see her she will have forgotten all about it. It's sort of like child's play or fantasy, and we do know that as dementia increases, people become more and more childlike.
Thank you all for your wonderful comments. We have just returned from our first visit to see my mother-in-law since she was moved into assisted living four months ago and into the memory unit one month ago. We live 400 miles away and are planning to visit more frequently now that she is adjusting to her new living arrangements.

I particularly appreciate the advice offered by parentcontrol. My mother-in-law did became visibly angry when my brother-in-law told her she couldn't go home but she became less angry when we visited later and talked about all the positive aspects of assisted living. Things also went more smoothly when we didn't try to correct her when she became confused. It was just so wonderful to be with her again that I didn't care if she thought I was someone else!

Our 13-year-old son (who understands her stubbornness all too well!) talked her into leaving her room to listen to him play the piano. She then wanted to walk and sit outside in the garden with us. We were delighted to see her playing bingo the next day when we arrived. It was the first time that she had participated in a group activity. She also responded well when we brought a few of her favorite items from home.

I wish that we had been able to do a better job helping her transition into assisted living but her refusal to discuss long-term care options before her hospitalization made things very difficult for everyone. Her health deteriorated so rapidly that we were not sure she would be able to stay in assisted living. Fortunately, her health has improved and it looks like she is responding well to the care she is receiving in the memory unit. We're looking forward to our next visit and we know that she is looking forward to seeing us again.
You are not alone. It was like climbing Mt. Everest to get my mom & dad to finally move into an assisted living facility. We had to get the family doctor to tell them that they had to do it. That was the only thing that worked. They will do whatever the doctor tells them to do. My mom was really mad at me & my sister long after the move. She said some hurtful things. But when I put myself in her shoes, I could understand her frustration & anger. I pretty much know that I am going to be just as stubborn & belligerent when it is time for my to move into a facility. My dad passed away 6 months after they moved. My mom has been in the facility for 4 years now & the road has been rocky. But I just have to keep reminding myself that no matter what, everything we did for my folks was what was best for them. You just have to always do what is best for you mother-in-law. Period. All the best.

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