How to deal with an angry, verbally abusive parent in a nursing home?

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My mother was previously at home. I have 2 homes on 1 property, very close together, and she lived there by herself with us checking on her several times a day.

Her health began to deteriorate shortly after my father died 10 years ago. She would go to the doctor but then refuse to follow directions, take medications, have recommended procedures, etc. She was finally forced into having at least one medical procedure last year because her health became so bad, it was either have the procedure or be in tremendous pain.

She was placed on home health at that time, and they would have re-certified her, but she she started refusing to comply with their treatments/recommendations, so she was discharged for noncompliance.

She then began to fall frequently. She would just sit in her recliner all day long, only getting up to feed herself or go to the bathroom. She became deconditioned. Again, she was placed on home health with home PT, an aide for bathing, and nursing to help with meds. She made it through the first period, and they recertified her for a second, but again she began to refuse to comply and was discharged.

In November 2013, she had a major stroke and fell, injuring her right arm. She was sent to rehab and then sent to skilled nursing in a nursing home. She should have received skilled services until mid March, but because she refused (again) to comply with therapy or rehab, she was discharged from skilled and placed on long-term care.

She cannot walk. She cannot feed herself very well because of the injury to her arm. Her trunk muscles cannot hold up her body, and she is somewhat like a rag doll. She is an extreme fall risk and has fallen several times, even with all the precautions. She is incontinent of both stool and urine and frequently soils herself, requiring very strict cleanliness precautions because since she refuses to move, she is at huge risk for bed sores. She has an advanced directive/living will and has explicitly stated that she does not want a feeding tube or any heroic measures.

I am giving all this background to get to the topic.

I try to stop by and see her every day after work. She is extremely angry and verbally abusive to not only me but the staff. She does not want to get out of bed, especially to shower or sit up in her wheelchair. She has hit, kicked, and pulled the hair of at least one aide.

She has refused meds. They brought in a psych to see her, and she was offered antidepressants, which she refused.

She curses me when I see her. She at first demands and then pleads to go home. It is just me. I am her only child. She has siblings, but not only are they worthless, their health is almost as bad as hers. There is absolutely no way I could care for her at home because she requires 24/7 care. She has told me that I am "going to pay" for what I have done to her and that she hopes I die in a nursing home.

My 16-year-old son often goes with me to visit but lately has refused to see her because she is so verbally abusive.

The facility is now in the process of documenting her behavior to determine if anything can be done. Their staff doctor requires specific documentation before something can be done.

Me and several others have tried to gently explain things to her, and she is just convinced that someone is keeping her there and that if we sold just let her go home, she would be better.

What do you say? What do you do? It is to the point that I don't want to see her, but on the other hand if it were me in a nursing home, I would at least want some company. What have others done in this situation?

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aj6044, can you explain a little more? Your profile says your dad is in Assisted Living. Where is you mother? What are her impairments? What aspect of this would you like to discuss with us?
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I'm 20 years old and I'm dealing with the exact same thing. My mother threatens me all the time. It's exhausting and it makes me sick. I don't know what to do. My mom is only 60 and may live for another 20 years. I refuse to deal with her before I've even had a chance to have a life.
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dsa5868….OK, so you are now your Mom's Mom, because your Mom took care of you when you were born and for 18 yrs. Well, so tell me…….are you able to lift your Mommy out of a wheelchair(baby buggy) and gently lay her on a changing table, pick up her little bottom, clean, wipe, put on destine and talcum powder, and place a nice neat little diaper on her bum? When you take her everywhere with you, do you have a carriage that is easy to take out of the car and if there is an accident in her diaper, find a nice changing table in a public restroom?
When your Mommy child decides to have a temper tantrum in the store, are you able to pick her up and wisk her outside before she disrupts everything in sight?
Oh what happened when you turned 5? Did you not start the journey to going to school? I bet those teachers were mean, weren't they? Did your Mommy take you out of school and just let you have your way? From the age of 5 to 18 you were in school and frankly, I hated school! But my Mommy said I was safe there and needed to learn so I could function in the real world.
Honey, if you want to take care of your Mother at home, I think that is great! But please don't compare it to having a baby. Not even close. Having a baby at age 20 or so, don't even come close to taking care of an elderly parent when you are in your sixties.
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Just like everybody else, same deal here. My mom's actually pretty good with the staff, though, and now that she's been documented to need Ativan and Haldol (she's already in the lockdown unit), her moods with them are much better.

I've learned to show up about an hour before lunch, with a raft of things to do/discuss/show her (newspaper, I bring my cat sometimes, I have neighborhood stories, new "skies" for her walker that I have to fit, new clothing, whatever) to keep her occupied until she starts to get anxious about getting her favorite seat for lunch. Diversion, diversion, diversion. When she asks if I'm staying for lunch, I alternate between "no, I didn't sign up for lunch today" and "I don't see any extra room for me here, I'll just go home and eat."

I also don't go every day, I go maybe 2-3 times a week. I had been going once a week, which was too infrequent as she kept thinking I'd just abandoned her, then I went to every other day but that was too frequent as not enough had happened since our last visit. Every third day or so seems to be just about right.

Good luck. You ARE doing the right thing, just as I'm doing the right thing, as badly as I may feel about it...
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One more thing u can get state to help u have someone to come into ur home while u work to care for her don't use that as an excuse not to bring her home there is help out there do care for her in ur home just like the state helps with babies there is help for the elderly
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Look I have worked with the elderly its very hard to do even more so when they are ur parent nursing homes do not have the staff to provide the care each one needs I always have said they need more staff but that's not possible like I said for the money they make its very hard work and u need to remember ur mom brought u in changed ur diapers til u were taught to walk talk learn everything was done for u til u were old enough to do for ur self when our parents get older they become our babies kind they need feed they need changed they are in there exit stage and I feel its my job as my moms child to care for her and make her comfy til god calls her to go home we weren't stuck in a home with out good care when we were raised were u no u were giving great care and lots of love y shouldn't they receive the same from u as they leave this world give her love do the best u can for her its not easy but raisen u wasn't easy either remember u probley had a few fits growing up to and was angry ur mom didn't drug u up did she why would u allow that to be done to her its not right make her as comfy as u can if she's in pain try to ease. Best as u can til gods ready for her take her home with u and love her don't leave her in a home where there's. Neglect and she's lonely care for her like she did for u til gods ready for her no worries he will come for her soon promise u'll be glad u did when she's gone because u will miss her very much u only have one mom enjoy her while u can love her while u can it will be hard but it will be a relief when its over but u'll feel better inside and shell feel better and loved did u understand what I'm saying trust me I've worked in those places I know what go's on there take ur mom home and love and care for her u'll be fine the state can help u with money to do it if u need it but that the best thing to do don't give up ur mom depends on u to help her change her feed her just like u did as a baby u needed ur mom now ur mom needs u. GO GET HER .DON'T LEAVE HER ALONE NOT CARED FOR LIKE U CAN DO OH ONE MORE THING DON'T LOOK AT IT AS U HAVE ALIFE TO BECAUSE UR MOM ALSO HAD A LIFE AND SHE DIDN'T LIVE IT FOR AT LEAST 18 Yrs IT WAS ALL ABOUT U WHAT'S A FEW YRS OF YR LIFE ON A TEMP HOLD TO HELP HER TIL SHE GO'S HOME ITS NOTHING AND U WONT HAVE THE GUILT WHEN SHE GO'S THAT U LEFT HER WHERE SHE WASN'T CARE FOR OR LOVE LIKE H COULD HAVE DONE JUST BY TAKEN HER HOME OK any thing else I feel is wrong to do
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Ashlynne, you have described my mother, too. I have encouraged her to use her wheelchair and "scoot" out into the common areas, but she refuses. She argues with her roommate, and her roommate has learned to take out her hearing aid (ha!). They have tried to get Mom to engage in activities like crafts, etc., and she refuses.

In the past, when I had therapy, I was told that she likely had a borderline personality disorder and was highly narcissistic, so much of what you have said is right on the nose.
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mjapril123, a narcissist, my mother was never happy with anything, nothing was ever quite good enough life long. A few weeks ago I, along with the NH admin, sat down with my mother to try to persuade her to try to make a friend or two and take part in some activities but it was all met with excuses and refusal. She will not try, just stays in her room with the door closed, b***hes and complains and dreams up all sorts of crazy stuff.

Some people will never be happy with anything. Someone else's happiness is not your responsibility it is theirs.
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mjapril123-Your mom is where she need to be-I hear so much guilt, which is fear, which is so understandable. I walk with you. I now live in the guest house on our property. I had to move out of the home my husband & I shared over a year ago. I could no longer take the abuse & I have worked as an R.N. for 40+ years. I mostly work with the dying or the Psychiatric clients in the home. I also travel ,as I can & lecture.
My husband suffers from Solvent Dementia. Your mom always remembers who you are?? So many questions I have....is your mom suffering from Alzheimer's, Dementia?? We could talk privately if you wish....
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Thank you all so much. Several of you have hit the feelings and questions I have right on the head. There was a part of me that felt guilty because I wondered if she possibly could come home. It does sort of ruin my day when I go by there and she says the things she does. Then I see that it takes 4 people to get her up from a wheelchair and onto the toilet, and that is even using a "sit-to-stand" lift, and I know there would be no way that we could do that at home.

I also remember the things she said before she had the stroke such as, "I hate this house and have half a mind to just burn it down, " even though it was my house and the things she considered catastrophic were minor, like a light being out in a closet. She would also continuously say, "Just check me into a nursing home! Just check me into a nursing home!" She said this to anyone who would listen, so thankfully I have those people to back me up that she did indeed say it. I would tell her repeatedly that the best thing would be for her to stay in her home as long as possible with home health, etc., but she would not listen. In her mind, it was as if a nursing home was Club Med. I also told her that likely if she ever was in a nursing home that she would not be able to come home because of her physical condition. All of that has come true. Every. Single. Thing. That I have told her would happen has happened.

This past summer (2013), a social worker from home health came out, and we applied for a provider for Mom through DHS to help her with cooking and cleaning, groceries, etc. We wrote all over the application to NOT call Mom but to call me. Instead, they ignored it, called Mom and said they would need to go over her financial information. She told them it was none of their d**n business, hung up on them, and so it was, of course, denied. Back to square one. That was when home health ended and she started falling again soon after that. Home health even wrote a "carefully worded" letter to her doctor because they were concerned about her difficulty with ADLs and refusal of help.

If I even thought there was a remote chance that she would allow caregivers in her home and not tell them to leave, I would maybe consider bringing her home. However, I have no doubt in my mind that she would tell them to leave, accuse them of stealing or whatever, and then we would be stuck.

I work 3 jobs (2 of which are home based, which I did so that I could be near her), and there would be absolutely no way I could take care of her and still pay bills if she were to come home.

However, telling her this means nothing. I know that she thinks the last place she was (home) she felt well, so if she went back she would also feel well, which we all know is not true, BUT I also know without a doubt that she would tell them to leave, even though she promises and swears now that she wouldn't. She would tell them to leave, and we would be screwed.

I am just voicing that in writing because it has been circling in my head. I appreciate all the reinforcement, advice, and common sense that have been in response. Thank you all so much for reinforcing what I already knew in my heart. I appreciate you all. Thank you.
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