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Newbie here. 93 year old mom recently in need of 24/7 care due to becoming a fall risk and mild cognitive decline/dementia. I still have a full house at home with 4 adult kids and husband. 2 oldest have been dealing with their decade long debilitating and untreatable medical conditions, which prevented them from going to high school and/or college, hence them also dealing with anxiety, depression, suicidal thoughts. Mom can no longer understand/realize the effect this has on our family. She has absolutely has no qualms about me taking care of her every need, what effect it might have on me, as if it is totally natural and expected, while my brother gets a free pass on any obligation to help.


Hired a 24/7 care giver in her own home. She has been through 5 now since Thanksgiving, they can’t deal with her bossiness and abuse. She constantly berates me and the caregiver, screams at us, tells us how horrible we are, to the point that I just no longer care what she says and minimize my time with her just to survive (been told I’m going to hell and called a pig, physically shoved and told to shut up many times) but the caregiver wants to leave. However, she can be sweet as pie to everyone else, so it seems she can control her behavior, but she chooses to rip into to me, her caregiver, her sister and my godmother, who avoid talking to her now for their own piece of mind.


Mom refuses a nursing facility, and how could I dare throw her into the street like that, how shameful and embarrassing for me to even consider it. What a horrible person I’ve become.... I am touring a facility and want to take my mom to show her how nice these places can be. I also want to be brutally honest with her and explain the situation, that if she keeps treating the caregiver this way, she will have to move into a facility of her choosing. My question is, is it right to give her this ultimatum, and to point out that she is able to choose how she treats certain people, or is this how dementia works? Is she truly unable to control these angry outbursts ? Are we victims of her abuse also her triggers? It’s embarrassing to say, but I cannot stand being around her, and I have to take her into my home every other weekend to give the caregiver time off. My husband resents her now because of how she treats me, but refusing to let her steal my joy has made me callous towards her.


Should I lay it all out to her? If not, how to I get her to change her behavior?

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Why do you think that your mother will be any more pleasant in a facility?

Have you talked to her doctor about her behavior? Has she been evaluated for depression and anxiety? Have any meds been trialed?

I'd start there. I would also stop taking her into your home. The caregiver is getting paid ( by mom, right?) and should understand that in dementia, this is sometimes expected behavior.

The next time she ends up admitted to the hospital, work with the discharge planners on getting her into a facility.
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To whom is your mother as sweet as pie? She rips into the caregivers, you, your aunt, your godmother... it doesn't sound as if there can be many left on the Safe List.

Your brother says he can't help with mother's care. What stops you saying you can't help with her care? He may be further away, but you're the one with the pre-existing commitments. How come you got left holding the (big) baby?

My MIL - Lord love her and bless her 'cos not many others are going to - also got "fired" by quite a few agencies before my SIL and her husband found one whose caregivers were made of sufficiently stern stuff; so I wouldn't despair. Are you working with an agency? - have you discussed the issues with their senior staff?

You are not responsible for your mother's behaviour. You are therefore not responsible for changing it, either; and you are right to put boundaries in place so that her behaviour does not impact more on you than can be helped. But the main argument against giving her an ultimatum is that it won't work: she won't think "gee, I'd better behave myself and hold my tongue or they'll put me in a home." She will just use it as one more grievance to batter you with. And that's even assuming that her dementia is not busily destroying her social filters, which is - yes - a distinct possibility.

Why should you be embarrassed to admit that you are not inclined to spend more time than is essential with someone who is consistently abusive and unpleasant to you?

Crikey - I've just realised that with the weekend visits your situation is almost identical to my SIL's, and this post is almost a reprise of the conversation I had with her on Monday. And similarly, I'm still exploring the issues with her. What SIL *should* do is make herself scarce - but that is never going to happen.

What was your mother like before?
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Do just what your brother is doing and refuse to help. Why does he get to refuse and you don't? Time for your "free pass"!
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Countrymouse: My mom is sweet to everyone else she meets; nurses, doctors, therapists, and especially my brother and sister in law who refuse to help. He, BTW, has been an empty nester for 15 years and retired for over 20 years. He has zero obligations. But he does have severe arthritis, so my mom gives him a free pass, and always points out how heartless I am about asking him to help with her care.

My mom was kind and helpful in the past, always helped with my kids, but also critical and controlling. She sabotaged my relationship with my in-laws with vile gossip. I was young and thought mom knows best. 10 years ago or so, I stopped asking her for advice, because I realized her advice almost broke up my marriage more than once. Always has an opinion about my hair , clothes, furniture, kids hair, beards, clothes, girlfriends... always cared about what others thought. So what will people think if I put her in assisted living. Everyone lives with their daughters, she tells me. While the reality is that only 3 friends live with their kids. The rest, dozen or so, are still on their own or in some type of housing. She is very jealous of her sister who lives with her daughter. My aunt does not have dementia, but my cousin has told her that if it comes to the point that she cannot take care of her, my aunt will need to go to a facility. My aunt said she is ready to go now if needed.

My my mom has been on Xanax for 20 years. Doctor mentioned antidepressant but she is so sensitive to meds that I’m afraid to start with her. She will blame all her symptoms on the new pill and refuse to take it. But I’m will rethink that one.
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BarnBrooklyn: I take my mom with me to give the caregiver time off. She is not paid for her time off. At my house she seems better, because there is no power struggle. She senses the caregiver is in charge and feels she has no rights in her own home. For example, I bought a pack of paper towels yesterday and brought it over. My mom sneakily asks if she can use those paper towels too. I told her of course, they are her paper towels.
However yesterday I had a few moments alone with the caregiver and it seems mom is not happy and gets agitated about coming to my house. She complains about packing her pajamas and hairbrush, she gets the day confused and is ready two days early. I thought she enjoyed being in my home with her grandkids. Apparently I was wrong.

Caregiver has has asked me to tell her to stop attacking her for every little thing. Caregiver doesn’t think she can take it anymore. Just yesterday mom needed a battery for a clock. She called and asked me to buy one. I asked what kind. She ranted and raved because the caregiver put the battery somewhere and mom couldn’t find it. Mom put it in her purse. I heard the whole thing on the phone and I couldn’t live like that myself. The caregivers health is suffering too.
Sorry. I know I’m just venting here, but unless you live it, you just don’t get it.
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You're not by any chance resident in Golders Green in North London are you???

It's the "everyone lives with their daughters" comment. That's exactly what my MIL tells my SIL. Funny, because when it was my SIL's MIL who needed looking after, my MIL was adamant that no woman should EVER move in and be a burden to her children...

Not that I didn't agree in that particular case.

I'm glad you are touring facilities - have you seen any you'd like to shortlist? Do not set yourself up to fail by hoping she will agree that they're lovely and she can't wait to move in. She is not going to agree, because she does not have a rational agenda; she wants what she wants, and she won't budge, it's a point of principle. So you develop a plan that will in fact take care of her wellbeing no matter how rude she wishes to be about it. Complaining can be recreational too, after all.

An antidepressant is not going to do anything to a person's personality; but if the doctor has recommended this change because your mother's behaviour is badly affecting *her* quality of life then I wouldn't second-guess the prescription. Talk it through again with the doctor if you still have concerns.

Brother who's too busy with his sore knees and his art class to have her to stay... What, then, is his idea about how best to manage mother's care? Has either of you got power of attorney, by the way?

Um. There is nothing callous, you know, in rejecting a hurtful and inaccurate accusation. Your mother's saying you're throwing her onto the street, you're a terrible daughter, you're horrible, etc. - she is angry, that's true, but the accusations are nonsense and you are only right to let them bounce off you. It's no more callous than it would be to move out of the way when someone tries to punch you because he's drunk or upset.

And you don't have to be brutally honest. What about just, honest? What about the - I'd have thought - uncontroversial statement that you wouldn't take insults or shoving from anyone else and you're not going to take them from her, either? What about telling your mother that domestic employees are not paid to tolerate abuse and the contract will be terminated?

But if confrontation or criticism aggravates her tantrums, then don't bother with them. Do what needs doing without discussion.
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Caregiver needs some training in how to handle early stages of dementia. In particular, caregiver needs to understand that you, on the other end of the phone, are not nearly as well placed as *she* is to calm and reassure her agitated client.

Where are you getting these people?
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Thank you all for listening and for your input. Just being validated for my feelings is so therapeutic. As a mom of 4 kids, I am still involved their issues. They’ve been dealt some bad hands, and I need to be strong for them as well. It’s not easy to have their depression and anxiety all around me, with the occasional “mom, I’m looking at guns online” lurking over my shoulder. Yes, they are in therapy, but no one is prepared to launch. I didn’t expect to be in this position at this point in my life. I was supposed to be an empty nester a few years ago, allowing be to focus on my mom. But life did not turn out that way.
So I contacted my brother and therapist SIL, that they need to mediate between mom and caregiver, and teach caregiver how to handle mom’s behavior. He will also need to introduce her to the idea of assisted living and if needed move her there. Since I will be the one in daily contact with her if she is in an ALF and not him, (she never complains to him about anything) I also don’t want to be the bad guy for putting her there and have to constantly hear about it.
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Your Mother is not in her right mind and therefore cannot reason any more. She is not intentionally trying to hurt you or your family. So, you must protect yourself and your direct family from her abuse. I know it's a hard choice.

You are only a victim if you allow yourself and those you love to be abused by your Mother.

Hugs to you.
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If the dementia is mild such that you can reason with her then yes give her an ultimatum - IF you intend to keep to it. You have to be willing to carry it through. In many ways getting her to go into a facility whilst she is at mild dementia stage gives her some chance to get to know people rather than waiting until she hasn't a clue what is going on round her.
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She has dementia.
There is no reasoning with her
There is no use arguing with her
She does not "choose" who to be nice to or "choose" to be mean to

These are YOUR decisions that now matter, how to keep her safe, how to keep you "sane"

I do not understand how she has gone through so many caregivers. Does she "fire" them or do they quit. The caregivers or the agency works for you. Trained caregivers understand dementia and how to "work around things" Unless your mom is a physical threat to them they should be able to deal with her verbal outbursts. You just need to find one that is the "right fit"
If you find that an agency does not work out or private hire caregivers don't work out the only choice you have is a Memory Care Facility. Much different than a "Nursing Home" A nursing home is for skilled nursing care and it does not sound like your mom needs skilled nursing care.
If you can not find a caregiver or agency that will be able to deal with her you have only 1 option. Continue your tours, find a facility that you like, that has a bed, that will fit her needs and set up a move in date.
She will not understand your ultimatums.
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I don’t blame you for not wanting to be around her. No one wants to be abused like that! I will say that 24/7 care is very expensive compared to ALF costs.
With her dementia the personality changes come and the belligerence etc. This is common. It’s sad that some dementia inflicted are mean and some are sweet. Your mom may calm down if she gets in the right facility. I hope you are aware that you absolutely can not reason with dementia!! And you don’t give choices because they can’t make good ones. But your question on how you get her to change is answered simply.."you can’t " because you are dealing with the disease and how it affects her brain. Try to remind yourself of that when you see her, it will help. Threats will not work.
Do you have DPOA? Has her state been diagnosed by a physician? Then you might be able to make the decision to move her. There are some ALFs that have respite rooms where you could drop her off to stay for a couple of weeks while you are out of town (use a therapeutic fib here if you stay in town). Tell her while you are between caregivers this is necessary. You don’t ask her if she would like to, you tell her this is what is happening. Remember, no choices! Then she may find out it isn’t that bad and you can move her there if there is an opening. Better to move early in the dementia for better adaptation. With mild cognitive decline she should be accepted. Then be sure the facility also has MC if that is needed later on. And be prepared that it can take 3-9 months for most to adapt to a move. They will often hate it and want to move out. Don’t capitulate. Stand your ground.

Watch Teepa Snow videos on handling their dementia and read the book by Paul Chafetz called Loving Hard-to-Love Parents: A Handbook for Adult Children of Difficult Older Parents. It’s a quick read but full of valuable tips. He is a psychologist who counsels people like us.

this is not an easy road but learn how to handle this disease and read all you can. You have enough on your plate. Good luck!
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allieb4, it sounds like you took a tremendous step on 6/5! Did they accept this enlistment? Stay firm, this is exactly where they can be leveraged. Please add a post again soon!
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Since you say she has mild dementia, I assume her basic personality has always been as averbal abuser. That’s not going to get better. My narcissist mother is the same. Part of being narcissist is abuse to family, sweet as pie to onlookers. It’s all about the outward appearance to them( hence why it’s an “ embarrassment “ for you to put her in a facility to her that might show the reality of her abuse although she’d spin it to show how awful you are)
Move away from the train wreck. If you are in charge of her finances, an ALF is the way to go. She’s safe and you keep your sanity.
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100% agree with what’s been said here, living it as we speak. The AL has been a Godsend. Six months and so many confirmations of what I only thought was me. No, these folks are completely non compliant about meds, structure, food you name it. I’ve spent over a year cleaning up financial disasters as well. They can not make sound decisions. Bad judgement can have serious consequences.
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You were right it when you said that she has lost the ability to understand the effect it has on you and your family. Alzheimers/dementia destroys the personality and the cognitive mind. They live in the moment. My mother was less mean to myself and others. Luckily the illness didn't affect that part of her. But still, it nearly did me in. I ended up placing her in a facility. If I were you I'd do the same. Don't let your mom's guilt-throwing keep you from doing what's best for you, your family or even your mom. Give yourself a deserved break. Know it's the best thing. If your mom were in her right mind, she would agree.
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I think you have enough on your hands with your own family. Offer Mom the opportunity to visit care facilities with her or explain you will make the decision the best you can in her interest, but that she will go to assisted living now. Tell her that you wish you were more a Saint than you are, but that you are human, and have more than you can handle. She will not understand ultimatums. Those with dementia do not respond to ultimatums with any consistency. You truly do have enough on your hands with your own family. Your mother will grieve her move, but the truth is that she may actually be happier in assisted living.
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Speaking from total experience ...... take her to a physician who specializes in geriatric care . Many will have different opinions ... my mom was the EXACT SAME WAY .... key word... WAS!

Environment is everything
Approach and delivery in your conversations is everything
Empowering her is everything
I am a mental health professional and I suggested to the dr . A dose of seroquel
im the Am and and in the PM as it is a mood stabilizer . She is also on a small dose of Prozac which is an antidepressant . Miracles came ! My mom is the most pleasant and cooperative at peace individual . Not groggy and stoned from medication . LIFE IS GOOD !
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One of my friends told me dealing w dementia is like dealing w a toddler and she is right. As someone else said, your mom is not in her right mind anymore and cannot be reasoned with.
It’s time for a family meeting w the focus being on putting your mom in assisted living if she cannot take care of herself.
My mil has been w us 7 years. All of her children wanted her in assisted living so we ended up taking care of her. I think my husband is finally beginning to see the light. I realize he was stuck w her cause that’s what he chose.
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For starters she prolly does not really realize how hurtful she is being. My sister who is only 67 has moderate to severe dementia with other underlying mental issues.
She tells people in her mobile home park that I’ve killed 9 people with cars, yes she says cars. and the government is looking for me, and then says I’m in jail and they cut my legs off, and there gonna take her to see me. She claims I’m trying to kill her or poison her. The other day she told my husband I’m drinking heroin.
its some pretty ugly seedy stuff, and even though I know she’s out of her
mind it’s pretty difficult to deal with.
My sister is going on 7 weeks of refusing to take her medication.
ive not been able to get into her house or be around, because in her broken brain I’m the evil one.
i could go on & on but I realize your here for answers to solve your immediate problems.
Just know it’s not you, your the caregiver who is getting disrespected by someone who more then likely has anosognosia.
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Allie 84. What An absolute complete nightmare for you. You did not say whether you were her only family. Believe me she probably does not even realize what she is saying , but it certainly does not make it any less hurtful . She should be grateful that she is able to afford 24 hour care . And I hope your family is not paying for that. But as I said she does not even realize it . You are going to burn out this is entirely too much for you. Your primary care at this time should be your own welfare and that of your husband and children even though they are adults . You also did not mention if you have POA . If you do you might have to enforce it soon . I think you should check out the facilities and just present it to her . She is not going to go along with it. If she ends up losing this caregiver and you cannot replace that person, I would suggest having her take into the emergency room for whatever issue, And then speak with the social worker and tell her of your and that you have done the best that you can and you can no longer take care of this. They will be forced to find placement for her. I am sending my thoughts and prayers to you because this will be a nightmare. You have done all you can for her you need to take care of yourself and your family .
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My friend is giving care to her 83 year old mother with dementia. I have been shocked at the names and defiant behavior the mother exhibits. My friend said that prior to dementia her mother did not use profanity. She and I figured out, we think, the reason the mother singles her out for name calling. My friend tells her mother to put on her pajamas, take a bath, eat, to sit down when mom decides to dance in a restaurant. There is no doubt that my friend loves her mother; I hear it every time she says, "Mommy." Much of the time, my friend laughs at the name calling, and has a very positive attitude about caring for her mother. She takes her mother to medical appointments, hair dressers, out to breakfast, etc. I suppose I have described assisted living but even so I am in awe,
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You answered your own question when you said, "Mom can no longer understand/realize...." This is typical of Alzheimer patients and there is little you can do to help them behave differently. Alzheimer's disease is different for each person and always gets worse rather than better. In my opinion, changing the place of residence will not automatically change her behavior. I would suggest that you take your mother to see a geriatric Psychiatrist. The doctor may be able prescribe medication that would help modify her behavior on an ongoing basis.
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Dementia....Anyone who is Familiar, Knows how it Goes...learn to Live with her like This, She won't be Around for a Frown, Forever.
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I'm not one for a long drawn out responses because each situation shared that I read, uniquely different. This one is a difficult one. What you said at the first, "mom recently in need of 24/7 care due to becoming a fall risk and mild cognitive decline/dementia."
Mother at 93 is having difficulties. Possibly behavorial situation.
Don't explain to her what you are doing. Get her a new gereatric doctor with dementia specialty, to evaluate her. Her incapacity to care for herself mentally and physically warrants professional care 24/7, as you said. An ALF with memory care sounds good. Your husband & family are first, then mother. Your guardianship may be needed. So, an elder attorney will help with this.
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Thank you so much for sharing. I cannot tell you anything as I am in the same dilemma. But it was great reading what people had to say. Its not reassuring but it is nice to know we are not going crazy and we are not the only one going through this tough time 👋
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It is what it is, its dementia, they don't remember 2 minutes in past what they said.
We have the same problem and she was always like this in past years.  The dementia patient was always like this even in younger years.  Get some professional help, your family doctor and he can say she can't stay at home and
suggest that she moves into care home.  They know how to deal with this type of behaviour,  Why are you bringing her home? You don't have to do this!
Go and discuss with doctor and let him do his job, they have medication to calm
her down and not be so hurtful.  They can get violent and you do not have to be pushed, shouted at, do something now, get support asap, cause its only going to get worse.  Been there done that.
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unfortunetly you cannot change her behavior and it won't get better, so you have to decide what is best for you and the rest of your family. She is never going to be nice about it, it is how the dementia works, you never know what will set them off. You may be able to speak to her doctor about a mood stabilizer, it helped a lot with my mother for almost 2 years, now we are going down hill again. Sorry the news isn't good but there is no reason to sugar coat it when you have to live with the reality.
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I am living w/ the same mess, but just me at home. My mom can be so verbally abusive, but sweet as sugar when she wants to. I'm so tired. Here's my answer for you. My mom fell AGAIN, was in rehab where she was put at the end of the hall and had minimal attention except for a fine PT team. I also took her by wheel chair to visit a substandard nsg home. I found a live in who didn't charge an arm and leg as she needed a place, but she's not PERFECT poor girl and mom berates her day and night. So we had " the talk". I told he-, "listen these are your options. Melissa or to a nsg home, not an ultimatum,we just don't have the $ for anything else and you will have to go on Medicaid and a Medicaid facility. She is trying now to hold her tongue more. It's hard, but there's nothing else to do. She lived w/ me for 8 mos and I was her servent 6 am-9pm daily. Never again. So that's that, I have no siblings. Hope you can work it out. I don't know your adult children, but perhaps each can spend 6 hrs a day w/ mom once a week to relieve the caregiver. She needs a rest from mom's tongue and that might help. They will also learn to care for others. Kids need that
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Setting limits and boundaries is important.
Equally important is knowing when a person inflicted with dementia can make their own decisions/when to honor those decisions or step in and make the best decisions for them and family.

For 3-1/2 years, I worked with a woman who expressed all her decades (7) of anger at me. I was her care provider. No other family in this state, which really was one sister and they did not get alone well.

I had to learn to give her choices, such as (and this may not be appropriate for your situation):

* Saying "this behavior is unacceptable and inappropriate."

* I will give you xxx (from 10 minutes to the rest of the day and leave for the day) to cool down.

* If (and when and I did need) reinforcements to do something that was in her best interest (when she refused, stomping her feet like a child), I had to call in the social worker. This was in a multi-level senor housing development so I did have ongoing access to professional support there. This client insisted on using a plastic garden chair at her kitchen area / table. She'd 'jump' the chair back to get in or out of it. Some times the chair would get caught in the carpet and she almost fell backwards. I had to get her a new (furniture consignment store) chair. Before I could do that, the social had to come in and assess [after I explained the situation] and tell her that the chair she wants to use/keep is not safe. Client felt 'defeated' with two of us agreeing, and from client's point of view, somewhat ganging up/attacking her position. She fought to the end even with the Hospice social worker and nurse (not wanting overnight care. They convinced her to 'try it out for a week.' I took the first overnight shift; she died the next morning. Before that, she awoke at around 3am and I got up and she said "I'm so glad you're here." She died at 10:30am.

* For other situations that would come up regularly (involving rage and ranting at me), another social worker with decades of experience said I needed to write a contract. I said I did this initially. She said "Oh no, you have to do it for each infraction, each time it occurs. Write it up and explain that it is inappropriate / unacceptable behavior, etc., and state my position and what I will do in the future, should that behavior happen again, and have her sign it. I did this twice in one year (I did not want to write up every little thing). This actually worked - often for 2-4 months to avert the specific unacceptable behavior.

* One needs to get their 'troops' in line / support. Have a clear plan and stick to it. If one wobbles, the person with dementia [may be able to and/or] will see this
I realize it is different working with a family member. However, I do believe all family members need to be considered and the overall needs of the unit when making a decision. Gena.
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