Our mother is 86, lives alone, has numerous health issues. The big issues r diabetes, she takes five insulin shots a day, won't eat properly, she has severe back and shoulder pain, so she sits all day, she has neuropathy causing her right hand to go completely numb at times, her memory is slipping, she has low blood sugars more frequently, when her hand gets numb she can't draw up her insulin. This am she put the needle in the vial, held the vial in her left hand and used her teeth to pull the plunger back. These r just some issues. She goes to FL. With me Dec through March but refuses to move in with me or my sister full-time. I live an hour away, my sister lives five minutes from her and provides meals three time a week and takes her to store and appointments but my sister now has a medical issue she needs to address, I get physical therapy twice a week and I can't just drive to moms often. Now mom needs IV iron every other week x 5, there is no transport in her town and the hospital is 30 minutes away. It would be easier for her to live between us but she refuses and doesn't have money to hire help.

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I agree that having your mother in a care center where she can get help 24/7 would probably be best. I'm not so sure that living with one of you would be ideal, but it might be a transition period between independence and full care.

These things might be best, but she doesn't want them.

Are there things that would make her safer where she is, at least until the dementia gets worse? For my mother those things were arranging a cleaning service, laundry, meals on wheels, a visiting nurse, and working on pain management. For your mother the obvious first thing is to switch from syringes to insulin pens. A needs assessment may uncover several things that could be put in place to help Mom where she is.

Managing medications was the hurdle we couldn't get over, and as our mother's dementia increased, she moved in with one of my sisters who had just retired. This was her "assisted living" experience, and it lasted a little over a year. Then as her needs increased she moved to SNF. This graduated path to increased care may be more acceptable to people who resist care.

But here is another perspective altogether: Life expectancy the year your mother was born was 63 years for women. Now for women in the US who have reached the age of 65 their live expectancy is 20 more years. Type 2 diabetes reduces (on average) life spans by 8.5 to 10 years.

In other words, you mother has already surpassed her statistical life expectancy. Good for her! She sure must have been doing a lot of things right in managing diabetes for 55 years, and her health in general. Congratulations are in order.

At this point, maybe her goal for herself is comfort. (That is what mine will be if I make it that far.) Living a lot longer may not have the same appeal to her that it would for a younger, healthier person. That could be especially true if dementia is starting to show. As you say, she knows what to do for her diabetes -- and she just doesn't want to do it anymore. Shouldn't that be her choice? This isn't just a rhetorical question; it is serious. How much self-determination should we allow/encourage/support for our elderly loved ones? How much should we try to force them to do what we feel is good for them?
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Mom has access to food. She has lost interest in pretty much all good that is good for her. My sister provides dinner for her about five times a week and alot of the times mom doesn't eat it. She wants to eat carbs and sweets. She has been a diabetic for 55 years and knows what she needs to do but won't anymore.
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Your mother may refuse. Mine did, which left me no choice to leave my home and move 400 miles away to live with her till we could figure out what we were going to do and believe me, we ran the gamut of ideas. She did suffer a stroke and died, though.
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I took a screen shot of black hole's response. It is spot on and needs to be heard. Your mom is not safe if she cannot take her insulin (try an insulin pen instead of a syringe) and definitely not safe if she is getting frequent low blood sugars. Many assisted living facilities will not administer insulin or test blood glucose. She may need a NH. If you don't do anything now, you will have your crisis soon and that may solve your problem of where mom goes
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It sounds to me like the very reason why she's not eating right is probably because her access to food may be limited due to no transportation if she doesn't drive. From your description, it sounds to me like she's probably trying to conserve the food she already has to make it go further, and I don't blame her. It sounds like she probably does need to be moved closer to where there's a grocery store. Around here, there's a dedicated senior apartment complex within walking distance of the store, it's just two doors down. You may have to move her within walking distance of a major grocery store where she can have access to food. It sounds like the reason why she's got no transportation where she is, she may likely live out of town like out in the country, which would explain why there's no transportation in some areas and the nearest hospital would be 30 minutes away. I'm not sure if there's an ambulance service near there, but in some towns or villages around here, it's usually in a neighboring town that's well-developed. Anytime an ambulance or other emergency service is called to one of our neighboring villages, it comes usually from our well-developed town. Our town usually serves our nearby neighboring villages and even out in the country where in the hospital wouldn't be anywhere near some residents who live out in the country. Yes, it sounds like your mom definitely needs to be brought into town and out of the country or if she lives in a village, she definitely needs to be moved out away from there and close to where there's a grocery store and a hospital. She should also be given some kind of mobility scooter with good fat solid tires if she no longer drives and can't stand or walk long at a time. If she has multiple health issues, she probably needs a mobility scooter. I recommend a mobility scooter for the floorboard, the floorboard can hold her groceries and she can go right into the store with her scooter. If you live in the US, all businesses are required by law to be handicapped friendly and accommodate scooters and wheelchairs. If your mom is competent, it will probably be much harder to force her out of her home as you put it because some people will fight tooth and nail when it comes to their home. I don't know if you know someone else who can come in and help her so she can stay home longer, but if so, it may be a good idea to line up multiple people in case someone's car breaks down. If you know someone from church, I would first try that avenue. I don't think I would go as far as forcing her out of her home but yes, on the other hand she does need to be where there are grocery stores and a hospital and other services. If she's not willing to go then I'm not sure there's going to be much you can really do if she's not willing to go and she happens to be competent. It sounds like she definitely needs a nurse and some other services to come in and help her and hopefully she can stay home longer if she can only get the help she needs. Someone needs to help her with her diabetic insulin needles, and it sounds like someone may need to help her with other basic needs.

It also sounds to me like she probably doesn't cook either, another possible reason why she won't eat right. Something people will only eat easy prep stuff or if someone brings it in and makes it available, so some people will only eat what's available as it's available.

Another thing to consider is your mom may actually be in the dying stage as her body slowly shuts down. During this stage, less food is needed because the body no longer needs much energy as the change progresses, winding the body down toward the grave until the person eventually takes their last breath and dies. Some people die suddenly whereas others will just go to sleep as they usually do but for the last time. These deaths are usually peaceful and have been known to be painless. I don't know if your mom is in the dying stage, but it sounds like she very well may be. Definitely have her evaluated by a doctor to know for sure.

If she's not in the dying stage and her body it's just conserving energy due to malnutrition, then she'll probably need some emergency feeding, because somethings can actually mimic the dying stage and can actually become it if we're not careful. I would definitely get her medically evaluated and see what the doctor says but go into the appointment with her and even into the exam room so you can hear everything the doctor says
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With ur Mom's health issues, she needs to have more care than u can give her. Her mind maybe slipping because she isn't getting the insulin she needs. I thought I'd never place Mom in long are but I had to now there's no money. I became a nasty person caring for Mom 24/7. Daycare then an AL helped. I am, so far, happy with the LT she is in. The staff is friendly and caring. There is still some problems with her laundry, I wash her clothes, they forget I do. How is Mom financially? Does she have the money to start her in a LT and switch to Medicaid? Diabetes needs to be taken care of.
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You need to find out if she has the capacity to make the decision to continue living independently. This means having her thinking assessed, to make sure it's still good enough for her to appreciate the risks of continuing as she is.

If she is found to have capacity, it will be hard to make her move. People have the right to make decisions that put them at risk or that others might not agree with. However, they should be able to explain pros/cons of the various options before them, they should be able to explain why they are choosing a certain option, and they should show insight into the risk of their choice.

A fair number of people in your mother's situation may not have capacity to make the decision to remain home. Unfortunately those are the ones who often resist having their capacity assessed, so it can be a lot of work to get this all sorted out.

Your options for getting help include calling Adult Protective Services and also notifying her physician to see if that person can help get her assessed.

Moving a person also depends on whether you have a durable power of attorney (and can show she's incapacitated). If not, you may need to seek guardianship.

This is all assuming she lacks capacity, but she might not. Some older adults would rather take substantial risks living at home, and some do have the capacity to make that decision, when we carefully assess them. If this is your situation, you will have to figure out how to set limits regarding how much help and effort you can offer her.

Good luck!
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Mom is not a candidate for in-home care. Too many concomitant medical issues. Way too many.

Not to mention, having mom in your home (or sis') will damage the host's physical health, mental health and family life. Might not be obvious at first -- like that old chestnut about the frog in a pot of water and the heat is slowly increased. Then surprise-not-surprise: boiling point. 

There is a (sick) cultural imperative that adult daughters (and D-I-Ls) should annihilate themselves caring for an elderly parent. People who don't give two sh*ts about your sanity will drop smug hints about how "great" it is that Mom is not in a nursing home. 

Well, where does that leave the caregiver? What's "great" about you or sis not getting a full night's sleep for the rest of Mom's life? What's "great" about spending hours each day cleaning adult poo with the same hands you use to cook dinner? What's "great" about being too preoccupied to have a relationship with your grandchildren? 

And p.s., Mom won't live forever, no matter who is minding her myriad medical needs. Mom needs -- and deserves -- specialized care for the time she has left. Is there a M.D. and a staff of RNs, LPNs and CNAs in your (or sis') home 24-7? Nope.

If $ is an issue, explore Medicaid. Tons of advice about it on this forum.

Work toward a solution where you and sis can do what you do best: be daughters. You and sis are human beings, not life support machines. Your visits can enrich mom's experience and brighten her day.....while you maintain a close relationship with the professionals and advocate for Mom. THAT is caregiving, too. Don't let anyone tell you otherwise.

And definitely don't listen to anyone who's championing Mom's "independence." That ship sailed. A realistic decision can also be a loving decision. It's not one or the other.

Skim around this forum for ideas and support. Good luck to you. And big hugs. This stuff is rough. Make a serious effort not to get lost in it. You matter, too.
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I did it with my dad the day I went over and he was sitting in the dark, staring at the TV which was not on.

I asked him what he ate and he said he couldn't decide so he just didn't eat. I asked what he ate the night before and he had no recollection. I told him that it was time.

He cried but realized something had to be done. We have 7 acres and went out together and found him a mobile home to put in our front yard so he still had his independence but was no longer alone. He thrived for several more years this way. His small pension paid the mortgage and it was cheaper than a nursing home. Afterwards, we just sold the mobile home.
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karbar, you've gotten good advice here. It sounds to me, too, like she should be in a care facility, that she is not giving herself a very nice life at all and would benefit from nurse assistance. What do we say is 'independence'..? Maybe being mobile and not feeling awful, maybe she is not so independent now but could be in a facility that provides the care she needs. Good luck. I'm glad you and your sister have each other!
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How does someone go about forcing an adult to do something? Do you pick her up, throw her over your shoulder, and physically put her down in your home? Wouldn't things be easier if we could do this!

Based on your description I'd have to agree that she needs help in her daily living. She just wants to hang onto her independence but by clinging to her independence it sounds like she's causing a lot of stress. And if you think it's stressful now just move her in with you.

Moving her somewhere in between you and your sister sounds like it would be very temporary. She probably has her place all set up the way she needs it, to accommodate her disabilities. And a move at her age is very difficult. She'll hate it, she'll hate wherever she lives, and she'll ask to move back everyday. Her health will likely decline a bit. And she'll still be living alone and more dependent upon help because a move will discombobulate her and she may not bounce all the way back.

If you and your sister want to get your mom into a better situation I agree with the suggestion of looking for an assisted living facility. Maybe an independent living facility. But if your mom doesn't want to move to another location between you and your sister I don't think she'll want to move to a facility. So what do you do? Wait for an emergency. Many people have found themselves in your situation, myself included. Eventually your mom is going to need to go to the ER and that's when you begin making necessary changes. This sounds horrible but at the ER or in the hospital our loved ones are vulnerable. As adult children we can find support in the hospital (nurses, social workers, Dr.'s) that can talk to our parent about their living situation. If they're sick and in the hospital or ER we can form a supportive team to convince the parent that changes have to be made.

And you don't have to wait until your mom is deathly ill or seriously injured to get her to the ER. If you want to facilitate this process just begin looking for an opportunity to get her to the ER. With my mom it was falling. She was so weak and she needed to be in the hospital (in my opinion). She would crumple to the ground occasionally and my dad would call me to come over and scoop her up off the floor. I tried to convince them both that she needed to go to the ER but they both refused. The next time she crumpled to the ground my dad called me and I went over there. I feigned illness, said I was too sick to pick her up so we had to call 911. Competent adults can refuse to go to the ER and my mom was right on the line of being incompetent so they took her. And that's how I got my mom into the hospital. Manipulation.

If your mom is fairly competent and refuses to budge you may need an emergency to lay the groundwork for a change.
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In my opinion, your mom needs to be in a facility with round-the-clock care. She has major needs already and those will only escalate over time. Unless you want to be bound to her 24/7 with NO respite, you need another solution than her living with your or continuing to live alone.
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Wow very tough. It is kind of you both to want mom to move in but sounds like she has a lot of heath issues to which will only escalate with age.

Can u visit a local senior center and make appt with director and they can listen to your story and concerns and then provide some insights and options for you to consider.

Have you talked to her doctor? Maybe document your observations and concerns and mail to her dr to have him aware of what's going on ahead of moms next visit. He and his office social worker might be able to have a non biased conversation with mom and plant the seed about her continuing to live independently.

Think hard before you have mom move in. What seems doable and easier for u now might not be so easy a year from now.

Maybe there are support systems or visiting nurse that can come in a few hrs a week or aid a few hrs a week to help mom with everyday living and errands. Or church volunteers that come by and visit elders, meals on wheels to supplement your meals.

Good luck.
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Does your mom qualify for Medicaid? Was she or her husband a vet? She might be able to get help from one of these. It sounds like she needs to be in ALF or maybe even a NH as you and sister have issues of your own. Your profile mentions dementia but you didn't list it in your post? It's doubtful that she will understand that her children can no longer care for her. Do either of you have DPOA?
You might get help from area on aging. Call and ask if they will do a home visit to evaluate her condition and let you know of any local assistance. If she is competent, ask her what she plans to do as you and sister are limited with what you are able to do. Realistically living between you probably wouldn't last too long. Since she had lived with you for several months you realize what that entails but for how long would you be able to manage it? If you put her and yourself through a big move, maybe it would be better long term to try to get her in ALF that has connecting MC or NH? If you think she won't qualify for Medicaid in your state, seek the advice of a qualified elder attorney.
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