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Since then, Mom has fallen twice seriously...the last time two years ago and needing a total shoulder replacement at age 92. Since then, multiple UTIs, coming closer and closer together. She has been on various antibiotics which sometimes cause explosive diarrhea. When she has a UTI she gets very hostile and aggressive and accuses me and her aids of everything horrible. She has very advanced arthritis as well with bouts og painful Gout.


We have had hired help for her which at first was covered by her long term insurance. However that has a monthly cap and we have surpassed that and we had to deplete my mother's savings by about $50,000! There are only about 7 months left of that.


So now she has little savings left...but still too much to be on Medicaid or qualify for VA aid. We got a reverse mortgage to help keep her at home but now if we sell will not get anything much from that.


I have transformed my dining room at home into a bedroom and had a builder adapt the nearby bathroom for her shower chair with every intention of having her here.


However as the time nears when we need to move her out of the condo and sell it, I am realizing that I will not be able to handle all of her needs. At age 67 and hubby at age 72, we're hardly able to help her out of chairs and cannot prevent a fall if she loses her balance. Her aids tell me she needs 24 hour supervision. She is incontinent as well.


When I mentioned the possibility of assisted living, Mom freaked out. She wept for two days, called her aids all kinds of names refused to look at me and told everyone she knew that her family was throwing her out on the street and that I no longer wanted her. she said I broke my promise and she is seeing my true colors now. That really hurt!


All this in spite of my care for her needs in the last ten years. I cook for her, shop, cover all physical needs and juggle nurses schedules and doctors appointments. We bring her dinner each Sunday...call her at least twice a day and I usually see her during the week at least once. I am also needed to help with my daughter and her two very young children. Mom gets angry about my helping them...saying I need to rest more! It is so exhausting.


I am heartbroken about this and wish we had the money to cover at least 12 hours a day care in our home. But we do not have that money.


I am thinking of asking her doctor to let her know she needs more care than I can provide her at our home.


There is one sister who lives out of town and refuses to help. We hardly even see her more than once every two years for a few days when she expects to be entertained.


So any advice from anyone with similar problems? How do we get our elderly and stubborn parents to see the need for assisted living. How do we get them to realize the toll it is taking on their adult children? This is so very hard for both my mother and us.



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You made what I call “The Noble Promise” to your mother years ago when things were different, and better. At the risk of your own health and well-being, including using your own finances, you’re trying to make an impossible situation work because of the promise you made to her.

No one does cartwheels and handsprings down the middle of the street and celebrates having to place a loved one in a facility. But you and your hubby are now doing the work of 3 shifts of caregivers in a nursing home. You are bankrupting yourselves and putting your own health in danger. I know for a fact that chronic UTIs are extremely difficult to handle. I have a gouge-mark scar on my arm from my mother when she had them and became combative.

When we take our parents to live with us, on some level we believe things will go back to the way they were when we were younger and growing up with healthy parents. Unfortunately, that doesn’t turn out to be so. Our parents are now people we don’t even recognize. They are angry, mean, unhealthy, unreasonable and make unfair comments that cut us to the quick. Even so, it’s difficult to make ourselves understand what must be done and be ok with it.

Because there is property involved and also a sibling, you need to get an Elder Law Attorney on board. Hopefully you have POA. Write your sister a letter and send it registered so you’re sure she got it. Explain what you’ve decided to do. Express to her that if she disagrees, you are more than willing to turn over Mom’s care to her. Have the attorney help you navigate through what you need to do to file for Medicaid.

Good luck. Keep us posted.
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Good morning,

Unfortunately, I don’t think you can get them to realize the toll it takes on their adult children. I think most of them are like what you hear about drowning victims who can’t see that their rescuer is there to help them, so they latch on in desperation and endanger them both!

We never made a promise to our parents, we just rolled up our sleeves and became the Assisted Living Facility when they started to have problems in their early 70’s. Then as time passed, my siblings and I, along with paid professionals, became the nursing home. We fully intended to do this until they both passed away in their own home, but it became too difficult as their needs increased and we began to break down mentally and physically.

They are now both in a nursing home together. My father could somewhat see the toll this was taking on us, but my mother never did. My father was and still is very appreciative of the care he received from us and all the things we do now to advocate for him and when we come to visit. My mother, on the other hand, behaves as if it is her just due, as if she were royalty, and we her faithful minions. Every so often she will express anger toward us that we did not keep up the status quo of keeping her and my father in their home.

I do not know your mother’s limitations, but she may be past the stage of Assisted Living and may be eligible for a nursing home. Get a Needs Assessment done through her doctor.

It is hard, but you may have to reasses the “Promise”, as “Circumstances Alter Cases”. We never dreamed that there would come a time that we would not have the full time care of our parents. It was very hard to hand their care over to a facility, and over a year later, we are still getting used to it. We are still loving children who visit frequently and advocate for them.
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poetry21 Dec 13, 2018
I was also never dreamed that I will leave my mom in NH, saying other words I was terrified even of the thought about that, but with her dementia and swallow problems, when she got into the hospital because she stopped listening to me and eat all solid foods that she should not be eating, after that I realized that either next time I will not be able to find her in time when she will be chocking on her food and she ll die or I ll leave her in rehab where she went after the hospital. But because she always saying to me that she is dying there, the guilt is over me... yes, she lived 90 years of good life and in the last 13 i showed her the whole world...the worst thing that i was treated not long ago with breast cancer and i am afraid that she ll outlives me and then nobody will even come to see her in that NH
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My husband has made the same promise to his mother and now with his own health problems and advancing age, he is starting to see that even with the best of intentions this is a promise he should never have made. We are both RNs too. This makes it even more difficult since our careers have literally been made caring for others in the same situation.
The reality is we can only do what we can do. Her time at home being independent has come to an end. Of course she’s mad as hell about it! Who wouldn’t be? The only person she can be angry with is the two of you. It is a selfish~ self preservation time in her life, so she is being selfish. All she can see and handle is her own needs. It doesn’t matter that her care is putting your health and happiness at risk.
No one wants to accept that there care needs are a burden on others even when it clearly is.
You will both have to accept that she is going to give you both the biggest guilt trip of your lives. Accept it. It will most likely pass as she settles into her new surroundings.
I have a patient now that is as happy as anything until her daughter comes to visit her. Then she is crying and miserable, she tells her horrible things to guilt her. When I told her daughter I was surprised and how happy and involved she is here when there not here, she was shocked. Shocked and relieved to some degree. Her mother had convinced her she was a crying miserable mess 24/7 since she placed her with us which could not be further from the truth.
What to do about the anger and guilt? You’ll have to be very strong and resolute knowing you have made the only safe and sound choices for all involved. Let her vent her anger but don’t leave there with guilt over what you had no other choice about.
I have already lived with my MIL for two years and then could no longer deal with it and she is currently though temporarily living alone in her condo again. This nearly broke up my marriage. Yet she still says she was happiest living with me. To which I have nothing to say to her. My husband still feels guilty. She’ll be 86 soon and I know the time for her to live alone is drawing to a close. At that time we will have another huge decision to make. We are very divided on this.
Once the two of you say the pros and cons and make your decision you cannot waiver in it. I truly believe everything turns out the way it is supposed to in life.
She absolutely will be fine in AL or a nursing home so long as you stay involved and choose the best one. The prettiest places aren’t always the best. The one where you get to know her caregivers and visit her frequently is the best. She needs to know you still care and you’re doing what you feel is best for her.
Trying to explain your own health issues and concerns in giving her care is rarely effective. Though you can try to explain this to her don’t dwell on that aspect.
Shes only thinking of herself. Reassure her you are too and this what you both know is best for her.
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poetry21 Dec 13, 2018
I have a patient now that is as happy as anything until her daughter comes to visit her. Then she is crying and miserable, she tells her horrible things to guilt her.

I think that what my mom is doing for me, every time I come she is saying I am dying here without you....And enormous guilt overwhelming me....I promised not to her, but to my father that I will take care of her, when she died, by then he was 77, she was 75, and I did take care of her for 15 years, 13 of them living with me, last three were a hell with her dementia happened as a switch and my cancer diagnosis and treatment. Then she went to the hospital, the first time for those 13 years living with me being 90 and then to rehab and NH, where my doctor who knows me and her for 13 years said that it is no way I can deal with that at home, only if I have money to hire 24/7 nurse and I dont, those who have will not come to this site....
Still guilt and pressure every time I am there
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Enshope, your Mom's generation when they hear the words "nursing home" they immediately think of the County asylum where their older relatives sometimes had to go. Sadly the older relatives were placed with people of all ages who had serious mental issues so the facilities were hellish. No wonder elderly parents cry at the thought of moving.

I was a senior citizen myself, so I couldn't do everything my 90+ parents had thought I could do. I no longer was that 20 or 30 year old, even though in my parent's mind they thought I still was. That is why you rarely see any Staff at a senior facility who is in their 60's or 70's. It takes a huge toll on a senior caregiver [and many younger ones].

If you can, take your Mom to preview a couple of places that you know would take your Mom if she uses Medicaid later down the road, being self-pay first really helps. Use a "theraputic fib" to your Mom by saying a friend of yours is moving their parent to senior housing and what better way to get an honest opinion then to have your Mom preview the place :)
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when my mother had to go to AL after living with me, I found a facility that had IL, AL, MC, and SNF..she was in AL for almost a year when she had to move to SNF. She didn’t have to go to a new facility. So try and look for a facility that has more than AL.
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Harpcat Dec 13, 2018
Very true...it really helps to have the different levels of care!
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It is not unusual at all for a parent to see us as the horrible child and the enemy who "threw them away"...my dad's words...when the health declines so much they need nursing care. It sounds to me like an assisted living facility may not accept your mom in her current state of health. But you can contact and tour several and meet with the directors of each to see if they will. However even if they do eventually she may need to move to a NH for 24 hr skilled care.
I know I was like you, taken aback when my dad yelled at me for his placement without any consideration of all I’d done for him the previous 4 years. It hurts!
You made a promis in good faith not realizing what would then become impossible. It’s like promising to stay together when we marry but sometimes we break that and have to divorce. We often don’t know what is down the road. I’m sorry for you but you know it’s in her best interest to move her for both her and your safety. Hard as it is you must. I always have to tell myself that dad had a darn good life for 95 and his last few years in a NH doesn’t overshadow that. You deserve a life too
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This is one promise I wish people wouldn't make. We can't see into the future and know what kind of illnesses or disabilities await us. My brother made the same promise to my mother and he did not live up to it. I'm not blaming him because none of us had any idea she would have dementia, but I know he feels guilty that she's in assisted living and she feels he broke a promise to her. I will never ask this of my children for that reason.
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peggy40 Dec 15, 2018
Good point - I don't want my kids to have to deal with being my guardian. I'm learning from this experience that end of life issues need to be taken seriously in order to avoid greater hardships on my family.
My 82 year old mom had a near fatal, massive stroke 6 months ago and because she had no advance directives, our family has been confused about how to manage her life and affairs.
The stroke left her unable to speak, eat, walk and her entire right side is paralyzed.
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Thank you for asking this question as I, along with many others, are struggling with this issue. I never promised my Mom that she wouldn't go to a nursing home but all the other reactions she's had are very similar to your Mom's when we talk about AL. I've tried not to take it personally when I get the cold shoulder or hear that she tells people she wouldn't treat a dog the way she's being treated. I think you'd have to be heartless not to feel awful, especially when you've been the one taking care of most of her needs. What I've come to realize, though, is that we get the brunt of the anger because we are the ones who are there the most, therefore, are the face of what is happening to them. Like you, my brothers and I have tried to have in-home help for 12 hours a day but that is so expensive, she will be out of money soon. We've tried to explain the cost to her but she shuts down and doesn't seem to understand it - or she is convinced she will die before she runs out of money. I'm not sure about that but I am sure she's been adamant that she won't go to AL. Just recently, we had an assessment done in her home (and that was important) by an AL facility which has a continuum of care. This went much better than another time when we brought her to a facility for a tour and assessment. This time, they took the approach that her doctor felt it was necessary for her to be someplace where her new medications could be monitored because she was having some trouble with them. They approached it like it was going to be respite with the hope that she would like it after she got there and end up staying. The reality is that if she hates it, we'd need to come up with another solution anyway. Right now we are in the application phase and she hasn't moved in yet so I don't know what the ending will be to this story. But, she seemed to accept this approach and didn't just shut down.

What I've come to realize is that, after 8 years of care giving, I've done just about all I can do. I also have a husband and children who would like me to be around more and I need to stop cancelling plans because Mom needs something or doesn't feel well. Do I feel awful about that? Oh yeah! But, I've been feeling awful anyway so it's time to try something different.

I do wish you the best possible outcome - even if it's not a perfect one. Just know that any decisions you make are out of love for your Mom and what you feel is the best for her (and you). She probably won't see it that way, at least initially, but when you're at the point of saying "this just isn't working anymore", it's time for a different solution.
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Enshope Dec 14, 2018
Thanks so much for your response. It really helps to know I am not the only one in this position.
I have been in counseling and my advisor tells me that when we are the main caregivers/managers, our parents feel they can vent on us because they know nothing terrible will happen to them if they do. Not that it makes it easier for us though!
I asked my mother's doctor to call and explain how she needs more care than we can give her now. He told me that her illness and depression can cause these volcanic rages and that she has little control over them. He did call her and she was apologetic and more conciliatory after that. She agrees to at least tour the AL soon. I hope this new phase of hers lasts for a while.
I suggested we try the AL for three months to see if she can adapt to it. If not then we would have to find a different solution.
For the past ten years, I have managed more and more for her until it is just about everything now. It is so tiring and the nurses and their scheduling is so difficult.
Like you, our social life has decreased to be almost non existent. We need to cancel so often that friends get disgusted.
It is not what we both envisioned for her at this stage of life, but at least she would be safe there. Good luck to you!
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I really wish you had asked for advice before getting a reverse mortgage on your home. They are rarely a good solution to a financial problem.

You made a promise to Mum based on the Situation at the time. Now the situation has changed and your promise is void.

Your mother is being selfish. You have met her needs for 10 years and she does not want anything to change. But her needs have gotten far greater than your ability to meet them.

Enlist the help of her doctor, perhaps ask him to write an RX for 24/7 care in a facility. Once she spends down her $50,000 and the funds from selling her condo, she can apply for Medicare.

Good luck.
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I believe Tothill means that as the O.P.'s mother's funds become depleted, she can apply for Medicaid, not Medicare, which she should have now and which is not income-based--but does not pay for assisted living or for custodial nursing home care. Only rarely does Medicaid pay for assisted living; it will pay for nursing home care when the income requirements, which vary by state, are met. I'm concerned because assisted living is thus usually private-pay and often quite expensive. It sounds like your mother may not have enough money to cover it for long., in which case, she would need to qualify for Medicaid and get a Medicaid bed in a nursing home. That also means that ultimately you may have to break your promise not to put her in a nursing home.

As other readers on this forum have pointed out, many nursing homes now, including those with Medicaid beds, are much better places than when your mother was younger, with activities, attractive common areas, private baths, etc. Your mother might find the actuality to be much better than the anticipation.
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Tothill Dec 11, 2018
Thank you for correcting me Carol. I am in Canada and I tend to get the two programs mixed up.

I was thinking that if she has Long Term Care Insurance, that the coverage for Assisted Living may be greater than the coverage for home care. That combined with her cash could cover a facility until she is eligible for Medicaid.
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