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My mother is very lonely. She refuses in-home help. She refuses assisted-living. Her friends are all dying. She has no hobbies. She doesn’t enjoy reading anymore she just stares at the television. She doesn’t initiate phone calls to anyone. People rarely call her. She has very few visitors. She expects me to be over there all the time, but my visits aren’t pleasant because I am the eating and medicine police. She doesn’t take her medicine without prompting. Now she has started telling me she’s taking it, when she has not. She doesn’t want to eat. I order delivery on a daily basis. She picks at it and that’s it. I don’t know what to do with her and I’m feeling very guilty because I know she’s lonely. I work part time and have a lot of activities. I don’t know how to cheer her up or get her in a positive mode. She is stage 4 dementia/Alzheimer’s and does not think anything is wrong. She’s just not as sharp as she used to be. She does not cook. She won’t even microwave. I’m afraid of doing anything that will make her even more dependent on me. I just don’t know what to do. As I’m reading some of the other comments, I’m guessing I have to let things fall apart before I can take any action. Otherwise it’s going to be a royal battle. What she really wants is for me to quit everything, move in with her and take care of all of her current needs. She refuses in-home assistance because she said she doesn’t need help. But she does.

If she is Stage 4 and you have POA, you need to place her immediately. What she WANTS is irrelevant. She needs to be someplace safe and looked after 24/7 and that is more than just one person can do. She requires more help than you can give so why do you feel guilty? You didn't do anything wrong.
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Reply to lkdrymom
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How was she diagnosed as having “Stage 4 Dementia”?

If that diagnosis is legitimate, it means that she does require “management” to be safe and live whatever should be her “best” life.

”Dementia” is comparable to “pregnant”. You either HAVE IT, or YOU DON’T.

Either way, as her “child”, you may all or partly responsible for her physical welfare. But you ARE NOT, and CANNOT BE responsible for how she FEELS about what you do or do not do on her behalf.

“Dementia” MEANS that neither her logical thinking brain NOR her emotional feeling brain are working correctly, and dementia, THE ILLNESS, is PROGRESSIVE and UNTREATABLE.

What she wants, what she expects, what she likes or doesn’t like, what she thinks about her own circumstances, ARE NOT YOUR RESPONSIBILITY OR BURDEN, and you cannot allow your guilt to be what motivates your decision making.

If, as you pursue safe, humane, and ESSENTIAL CARE for her, she has tantrums, cries, acts clingy or “more dependent” on you, HER behaviors will do nothing but make YOUR efforts harder.

I have had to place TWO women who had been the center of my life since my birth. The hardest part of that process FOR ME, was realizing that the people I had loved and been cared for and trusted WERE GONE, and that those two people needed ME to care for THEM.

Do your research. Find out what services, care settings and geriatric resources are available to you, then pick those that will work best for her and for you AND USE THEM.

AND THAT IS ALL YO CAN DO. If she acts in a way that is so distressing and disturbing to you that pushes you beyond YOUR TOLERANCE, GET HELP FOR YOURSELF, and stick with it until you are able to see yourself as being able to do the best you can, but NO MORE THAN YOUR BEST.

In geriatric management there are often NO GOOD CHOICES, and it becomes your job to choose “the best of the worst”. DO THAT.

Finally, use her financial resources, if you can access them, to do for her what she needs. Find out. Do NOT “quit everything”. You are an independent human and a caregiver, and her decisions about your life are clouded by dementia, and should NOT be accepted by you as doing a good thing for either of you.

Do the research and know how to get what she needs without sacrificing yourself. If you can do that, this situation CAN get better for you both.
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PennyBob Aug 22, 2022
Diagnosis came from neurologist and psychologist. Cognitive testing and MRI.
Thank you for your response
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No one can make anyone else happy. Your mother refuses help; doesn't initiate phone calls. She is responsible for her own happiness.
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eat-pray-love Aug 25, 2022
I am replying to your comment before I reply to posters. YES! to your comment. I have started to answer back to my Mom with "you have to be a friend, to have a friend." She makes fun of me on the phone when I say "hello" to neighbors when I am on with her. I say back "I think you handle me uttering a quick "hello?!" (NPD + Borderline) Complains re: the loneliness. Has the $ to allow me to hire on part time helper or her old housekeeper. Everything is a "NOOO!" So I release myself of the guilt & change the subject until her bad attitudes shift.. I will never live with her. It would destroy me. Her Doctor backs me. Some elderly are very manipulative. Boundaries!
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Your mother sounds like she is suffering from a treatable condition called depression.

Has she been seen by a geriatric psychiatrist for a workup? Has she been prescribed antidepressants and won't take them?

I would not be the food and med police. Visit with, tell her how much you love her and let her make her own decisions about what to treat with meds.

You are more valuable to her as a child than as an enforcer.
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PennyBob Aug 20, 2022
If I don’t enforce, it doesn’t get done. That would be disastrous. It’s a rotten position to be in. She has seen the psychiatrist. I’m soon going to have to schedule an appointment for me
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PennyBob, I'm moving this further information from the psychiatrist up here:

"Totally denies depression, but yes she is depressed. We are giving her medication for it, but I don’t think it’s working. We’ve had the work up done by geriatric psychiatrist. He pegged her as a controlling, manipulative little thing. We have gone over her results with her several times. She refuses to acknowledge. I feel sorry for her. She’s totally screwed if something happens to me. It’s a helpless feeling."

You don't get ant results by going over a psych report with a dementia patient.

She is not going to change her behavior. However, if YOU change YOUR behavior, something will change.

Your mother seems to have your cornered.

If you leave that corner, will she simply stop eating and drinking and taking meds?

Perhaps.

Thn she can be hospitalized for self-neglect, declared incompetent and placed.

That might be a good change.
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PennyBob Aug 22, 2022
The guilt makes me want to protect her from a train wreck. Tonight she was saying that she would pick up the phone and call the grocery store and order groceries and I didn’t have to do it anymore. I told her that’s not the way it works. She doesn’t understand. Maybe I should just give her the phone numbers and tell her to have at it. I hate to see her fail.
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If you have POA for your mother, you need to place her in a Memory Care Assisted Living Facility whether she 'wants' to go there or not, and she'll be safe and cared for 24/7 by qualified caregivers. She'll be fed, her meds will be administered to her, she'll be bathed, and she'll have no decisions to make. That's how it has to be for an elder with this level of dementia at play. It's not safe for her to be living alone, and she's not capable of following instructions you give her, or using the microwave, etc. Of course she's 'not as sharp as she used to be'..........she has stage 4 dementia! She's in denial, as most of the elders with dementia are, and will never admit there's a problem going on. What you need to do is to take the bull by the horns (if you have POA) and place her; sell her house to finance the costs, and let the chips fall where they may. If there's a 'royal battle', so be it. The staff at the Memory Care can guide you accordingly; this is not their first resident who's being sent their against their wishes. Trust me on that.

My mother did not want to live in Memory Care either, but she had no choice. I had to move her there from regular Assisted Living when her mobility issues along with moderate dementia became too much for the AL to handle. She insisted there was 'nothing wrong with her' but there was. She was not capable of managing her apartment any longer in AL, so there was no other choice BUT to move her to a shrunken down world where there'd be no decisions for her to make anymore. She wasn't best pleased about it, but that's life for an elder with dementia that's advancing. A no - win situation for ALL concerned.

Wishing you the best of luck getting your mother placed now, before an accident happens.
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Reply to lealonnie1
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Is there an Adult Day Care available locally? My mother was against AL or ADC but was finally talked into trying ADC. She liked it: riding on the bus to get there and seeing others for a few hours and riding the bus home again. I also think the experience of attending ADC as provided by a local AL/MC gave her a more open mind and relieved a lot of her fears about moving into the MC.
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PennyBob Oct 3, 2022
She’ll go to ADC if I go with her!
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Here's a quick way to stop the guilt. Are you the only family member? If you have siblings, what do they do? Are you the one who does all the caregiving? If there are others and they leave it all up to you, you have nothing to feel guilty about.

And even if you ARE the only family member left, you STILL have nothing to feel guilty about.
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Reply to CTTN55
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Can your Mother self-care without you? Preheat or order meals, order groceries? Take pre-packaged meds correctly? Maintain hygiene/dressing?

If not, she is no longer indepepdant. She is living alone, dependantly.

Therefore will need a different living arrangement sooner rather than later. Either adding in-home aides to supervise, prompt or assist ADLs or move into supported living.

The problem of lack of insight into her own needs (due to either cognitive changes, depression or both) is a common one. Also apathy (again, cognitive ie loss of planning skills or depression).

So much easier to stay sitting in your chair saying no, right?

Does Mom have a trusted Doctor to talk over her situation with? Sometimes a "It's time to move" chat from a professional helps.

At present you are holding her house of cards up.

Get your ducks in a row before you lower this house down & arrange the type she needs going forward.
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Kristen2037 Aug 25, 2022
I agree with this. Based on what you said, it seems like she needs to be in a memory care facility. It seems like her needs are greater than AL. And candidly, it seems like she needs more than your visits and is at high risk for hurting herself at any hour of the day whether with a fall, stove, wandering outside, etc.

I would consult an elder estate attorney and start looking into facilities in your area. I would brainstorm with MD about best next steps.

This is very difficult and a lot of work. Sending love your way!
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I can see what you are going through, I was in the same situation and the way I got out was to tell my husband this is it, I took care of you dad so now its up to your sister to take care of your mom. The sister is a nurse and she doesnt even know how to handle the situation, what a joke she is. I am just the daughter inlaw and I had to care for both of them until my father inlaw passed in Jan. I put my orders down and told my sister inlaw and mother inlaw, this is it no more. There is no way out of any alzheimers or diemensia persons. So, all you have to do is look the other way and know that you are all it counts right now. I know its hard but, you just have to care for you cause no one will.
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