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What should I say so she doesn't get upset?

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I would tell her, "Hey, let's get out of the house and go for a ride!" Drive around for a while, talking cheerfully about anything BUT... When you get to the nursing home, you might say, "Let's go in and look around." Go to the office and ask if they'll give you a tour. Take her to the dining room first, then activities area. And so on. Take her back home, and talk about it for a few days.
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Does her doctor have her respect and trust? How persuasive and firm is he able to be?

One would have sworn that mom's neurologist had gone through some clinical training as smooth, calm and firm he could be with my mom.

If he or she is, it might be best to hear if from her doctor first for they have to write the order for her to go to the nursing home in the first place. That way she can freak out to him without you having to play the bad guy.
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Barbara, I hope you get your deep breath. It was sooooo much easier to deal with dad today--major doctor visit and a trip to Target--knowing that at the end I would be leaving him with the kind ladies at AL and going home to my own space.

Dad and I also visited 3 places before choosing his AL. It was actually a very easy choice--this one was clearly superior in facilities and services, plus it's the closest to my house by many miles. He strongly preferred one floorplan of their apartments to the others, so SO and I gritted our teeth and let him stay here until one of that model came open.

Time will tell if he's able and/or willing to make the best of this, but it was the right choice either way.
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I appreciate the way sandwich42plus expanded my answer.
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Let me add on to what Oldfriend2me has said. It's really easy to infantilize an adult with degenerative brain disease. You don't even know you're doing it!
Other people will do it to, by only talking to you, or using a very slow baby voice with the person.

Carefully assessing what your loved one is still capable of handling on a daily basis. This will inform what choices you can still offer, or how to go about getting decisions made and action taken. On a good day, they might be able to make decisions that are a little harder than on a bad day, where they can't handle any.

You really have to know the person very well and be willing to make mistakes, but also be willing to learn from them. Trust me, I did it the hard way with my mom and it added years to the process that are now lost years. Who knows what things would be like now if I had been more assertive earlier. We'll never know.

If you've shown mom all 3 possible locations and she doesn't like anything, that can't stop you or delay a decision. You're going to have to pick a place, and see if you can offer her a choice of room. If not that, maybe you can let her decide where things go in her room. Or what drawer pajamas will be in. And don't expect her to remember any of it!

You may have had to decide what can go and what can't, but always try to find at least one thing the elder person can have some control over. And make sure there are no bad choices in the bunch! :-D

Expect to take a lot of blame when they can't find something anymore. Just apologize and tune it out as much as you can. I would just say "Mom, we're all doing our best here. I'm sorry it's not perfect."

My mom would have tried to shoehorn every single cotton-picking thing from her 4 bedroom house into a one bedroom apartment. I had to intervene and make choices. When she wanted to know where the XYZ vase was, I would tell her it was in storage. "Not everything can fit in here mom! No, I'm not going to go by the storage unit today. Maybe another day."
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I remember when Mom went to a nursing home.
Her doctor initiated the conversation by speaking of his concerns for her safety and well being. Mom and I continued to talk about it. I went to several homes in our area. I picked out 3 that I thought were mostly suitable. I told her that I had 3 nursing homes for us to visit. I said to her that she could choose the one she liked the best. She did.it's very helpful if you can involve a loved one in the
decision.
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I an looking forward to that first deep breath, feelinglost. We will move my mom in 3 days. I feel like I haven't been able to breathe in months either.
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Just got home from moving dad into AL. He's still the drama king, and when I left was holding court with two staff members over his medications. He is most unhappy that the doctor marked the form instructing them to manage meds for him, but was entertaining assurances that he could page them any time if he felt he needed to take something "right now". Watching the staff with him, I knew without doubt that we had made the right choice.

At the suggestion of a social worker, we set him up for his initial session with the staff PT today, which kept him busy for an hour--long enough for me and SO to get his apartment mostly set up. She was right--it made things much easier than it would have been with him "supervising".

SO and I stopped to eat on the way home, and both just sat in the restaurant taking deep breaths, letting go of the stress that we've held for the last many months.
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Thank you, grieflistener! You confirmed our decision. We were definitely going to tell my Mom it would be permanent, but couldn't decide to tell her just before the move, or many days in advance. My husband said, if it was him, he would not want to be hit with it, then whisked out the door the next day. We decided to tell her, give her the time to be upset, then become resigned to it, then hopefully she will become curious about it. All the while, we will stress how nice it is, how happy all the other people are, and how many friends she will make. The truth is, if I thought she would not be happier there, I wouldn't move her.
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Ashlynne - I would request a care conference with the doctor and talk to him about this. It could be treatable depression and anxiety. What you describe sounds like pretty typical symptoms.

As our parents age, it seems like they can turn into somebody we don't know at all. An awful lot of people on this site have same/similar stories to tell.

When my mom was doing things like that, I told her she had to sit tight and stay put until the doctor said she was well enough to go home. I knew that was not ever going to happen, but she didn't. It calmed her down to think it was temporary and that somebody had taken her side. This stage was helped enormously with medication.
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After a particularly bad fall it was clear that my mother needed 24/7 care. She spent a month in hospital and was transferred to a lovely NH by ambulance. She has screamed, ranted, raved and plotted her escape for over two and a half years, would not associate with other residents or join in any activities, just hid in her room. It's been two years and nine months now and the past two or three weeks she has deteriorated to the point that she's unable to speak and sleeps almost all of the time.
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I've been involved in a 15 year ordeal with my mother as she hid her dementia and made one horrific decision after another in her life.

All but two people in the family were dead square against me moving mom out, but they were nowhere to be seen to help her stay. I crossed their opinions off the list of things to pay attention to. Help with tasks, errands, and bills, or kindly "halt dein maul!" (stop your mouth). These critical people couldn't even show up in the days before her move to say goodbye. All their claims of closeness were total horse manure.

On my end, I found a continuum care campus. It had senior apartments to end of life care and everything in between. I am so incredibly lucky to have a facility like that a mile away from me. And they take Medicaid.

Mom started in the independent apartment unit and has graduated to different units as her care needs increased. Because of the way the buildings are built & connect to each other, I can see the unit where her first apartment was from her current hospice room now.

This place is not high end, but it looks like a 2 or 3 star hotel inside. It is the nicest place she's ever lived. She is getting the best mental and medical care she's ever had in her life. The food was definitely a world better than what she had been feeding herself on her own. The burden is not 100% on my shoulders. I have other burdens that did not evaporate when mom needed care. I still have to hold up my obligations in life.

The people "against" residential care options were the same people preaching at me when I had babies, that if I put them in daycare my kids would turn into criminals and be damaged human beings somehow. Preaching that I had to quit my job and abandon everything in the name of staying home and doing it all myself. Let's just say I've never put a lot of stock in martyrs, so I did the best I could and everything has turned out fine even though the kids were in daycare. Nobody is a criminal.

We have options and choices, and a lot of people just aren't aware of what their options are. They make a lot of assumptions based on old information, or based in ignorance & fear. You really have to get out there and take tours to find a place you can feel good about. Just like finding a daycare for your kids you can trust and feel good about.

Educate yourself on your loved one's disease so you can understand what you see in the care facilities. If you don't understand dementia, you will not interpret that screaming old lady correctly. She isn't being tortured - her brain is unwell and she can't control it anymore. That man slapping & clawing at the care worker isn't defending himself from an attacker. He can't understand it's time to check his blood sugar or wipe his nose.

Overriding what your parent is verbalizing, and doing differently to preserve their safety and well being feels wrong, and we do nothing to prepare ourselves for that day. It's a real disservice that the "soon to be old" and "soon to be caretakers" are not prepared in advance for the change in family dynamics, finances, decisions, and legal aspects. Ignoring it doesn't delay any of it.
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sandwich42plus--I so appreciate everything you said. Well put! And to quote others, not ALL nursing homes smell. There are some good choices out there that accept Medicaid. christine1970, I don't envy the task in front of you. I myself have one just around the corner. If it takes therapy, don't feel guilty about the choices you make if they are in the best interest of your Mom. Good luck.
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I've been talking to dad about a move to assisted living for several months now. Last week they called to say they had an apartment available for him. We did the application paperwork on the weekend, delivered it in person together on Monday. I've talked all week about getting everything in place for a move on Friday. This evening I told him the doctor submitted her form today, we are all set to move you tomorrow. He looked and acted like he'd never heard of the idea! Not sure what we'll have tomorrow, but he IS moving. He has a date with their staff PT, which will hopefully keep him busy while we set up his stuff.
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All of these suggestions have been very helpful. I am facing the same delima with my own mother. She is only 78yrs. old but in the moderate to severe stages of Alzheimers. When she was younger she always begged us not to EVER put her in a nursing home, so this has been the most difficult decision of my life. I do not know if your mother has any memory issues but it has made this decision easier to make. I know some have suggested that you not tell your mother that it is only temporary, but this seems to be a good approach for my mother, as she simply cannot handle any big upsets in her routine. I also am letting her pick the things she wants to have with her. It is so strange the things she wants and what makes her feel secure, but it makes her feel that she is an active part of this decision and not something that is being thrown at her. I am also very careful not to call it a NH. We are calling it an assisted living and care unit. Treat it like she is going away to summer camp. My mom has many happy memories of both when she and when us kids went away to camp and we can talk about the anxieties and things we all felt. This helps to ease the fear and helps her to realize we all understand how scary this can be. My prayers go out to you. Hang in there and I agree, DO NOT FEEL QUILTY. It is a wasted emotion that will only cause you unnecessary anquish. Easier said than done I realize, as I am still struggling with the guilt myself, but talking about it and reasoning with others helps me to reason with myself. This is a wonderful website and a life saver for me. I hope all of the suggestions do the same for you.
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Sandwich, I feel the same way. With Dementia Mom will get to the point she can do nothing for herself. She may not even know me. My daughter has said that when that point comes and before I won't be able to care for her. I agree that my duty is to make sure Mom is safe, fed and clean. If that means a NH eventually, I can keep check regularly.
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I would just like to share that I am not a fan of the term "nursing home". I know we all use that term, and in reality, these new facilities are modern and can actually be called senior communities with lots of activities and places to make new friends. Of course, it depends on the amount of needs we are all approaching. But, many times the term nursing for many of these facilities is not appropriate in my humble opinion. Just a thought.
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I managed to find a private home assisted living home for my mother. There are only 4 residents each with there own bedroom. We were allowed to bring whatever we wanted for the room. Since it is an "age in place" home mom will be there until the Lord calls her home. Since my mother has dementia but does know who her doctor is we tell her that this is where Dr G wants get to live because of the stairs in her house. For the most part she accepts this now. Not at first though. Mom is on a medication that helps her from working herself up when she does want to go home. I do not know if she will ever totally accept being there but she is losing more and more memories of her life so she may forget all of her past, I dont know.....
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In many parts of the world, people have large families for the express reason of having someone who will take care of them when they are old.
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Oh, I forgot to add. The facility can also help you. During the intake, the representative can be very pleasant with her and ask her questions that allow her to have input. For example, they asked my cousin, if there was any reason that she couldn't come to the dining room for breakfast in the mornings? My cousin said, no, she was able. So, the intake asked her what she liked for breakfast, eggs, bacon, oatmeal, cereal, etc. She said that she could choose her meals. And what about her hair? Did she want to make an appt. to have her hair done there on site? And what games did she enjoy? They had a social calendar for her to look over.

The intake person really gave her a lot of control and it caused her to want to stay and take advantage of the amenities. Make sure you have at least a small bag packed so you can leave her right then. You can return with her other things later that day.
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First of all, I would make sure you are taking your mom to a facility that can really meet her needs. You say in your profile that she has dementia. I would make sure that the staff knows what she is like and are trained to handle that kind of thing. A good fit is ideal. Is this in a Memory Care unit? Some Nursing Homes have them.

One option that I used was to talk about how the doctor wanted her to get some help for a while. Her doctor had told her she really needed to go for assistance. I never said how long. I said until the doctor thought she had made enough progress. I built up the place as helping with her medications, meals, physical therapy and helping with her memory. They did provide all of those things, except not helping with her memory. She was not real happy at first, but she went along with it. I think she was scared at that point and deep down knew she needed assistance on a daily basis.

Over time the memory fades and eventually she doesn't ask about leaving anymore. She no longer remembers that she has a house. So, in some cases, if you can get past the initial entry to the place, it may not be as bad dealing with it down the road.
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The term "nursing home" can cover a wide variety of facilities. Be careful in evaluating the level and type of care she needs, and check out other residents to see it they are at a similar disability level. Look around and see what goes on; a place that my MIL was in briefly tied everyone into wheelchairs and they milled around all day. What she really hated was that they wouldn't let her wear her panties, to make easier toileting.
Don't even use the words "nursing home"; look into assisted living, board and care, post-acute rehab, residential care, etc.
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It is going to be difficult .. Be at peace with your decision and know that it is the best and safest for all involved . My mother was in a nursing home for a year and a half before she passed away two weeks ago. She asked to go home every day and her last word was home before they started her on morphine . I use to tell her that the Drs wanted her to get stronger then she could go home. She suffered a stroke in 2013 and it was very difficult and unsafe for her to be at home with me. She never really accepted the fact that she was in a nursing home but she adjusted . She made friends and loved the staff and they loved her back. I visited her every day and it became my second home as well. It was a great facilitie and she got amazing care. All in all it's not what I wanted or what she would of wanted but it worked for us and I will never regret my decision to put her in the nursing home. Best of luck to you!!!!
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Not all nursing homes are restrictive and sterile. Place her in a home that has a private room and care assistant that is dedicated to your mother. The assistant becomes a companion and may do things with her. Don't send her to a nursing prison situation, let her enjoy life.
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Tell her that you love her, & you want her to be safe.Just go ahead beforehand and make sure you feel comfortable about the place. Do not be afraid to speak up if the facility does not meet you expectations.
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I would like to add one more point to the discussion about child care versus elder care. When my parents were raising me they were in their twenties and thirties. Now, when I am caring for my mother, who is in AL, I am in my sixties, and certainly don't have the strength or energy that I had thirty years ago. It is unfair to expect people nearing, or in retirement to provide 24 hour care.
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I stayed overnight WITH my mom when I placed my mom in a great facility. That was good for the initial move. She never did like it despite my many efforts. This place even had a KILN and painting classes; I thought it'd be perfect for her. Instead, she kept going outside without a coat and was considered a flight risk, so in lovely February (Michigan freezing temps) they "kicked her out" of this place (you should have heard the initial sales pitch; they could take care of EVERYTHING). So, I moved her back home, after almost going bald over stress, decided to ditch the job I loved, move from a community where I had many friends, and care for her an hour away (from my friends/job). Turns out she is much more balanced and happy. I'm not thrilled with these changes, but am making the best of things. She is doing quite well, and I found a daycare program that is amazing! You never know what is BEST until you put your toes in the water.
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I didn't tell mom she was going to a nursing home. That's too blunt and a really unsophisticated approach. Did you tell your kids they're going to the doctor to get shots? No - not if you wanted them to get in the car.

I talked with mom about her fears, anxieties and problems living alone. There were many. This was a conversation that happened over time.
At one point I asked if she wanted a solution to the problems.
Then I had my husband tell her we were going to make changes to take care of her and keep her safe. She didn't fight it from him, which is why I did it that way.

We didn't give her a choice other than which apartment she wanted - this one or that one. In a nursing home situation, you won't have that kind of choice like you might in a senior apartment unit or assisted living.

If *YOU* stay calm and reasonable, you are helping them. If you go to pieces, they will too. They might anyway and you have to have enough spine and acting ability to get through it while maintaining boundaries and postivitiy. You can break down at home or in the car, but not in front of your loved one. You have to be positive and strong long enough to get through. It's hard.

But when they need 24/7 care, skilled nursing, a secure environment, and all the benefits of residential care you can't do at home, the pros outweigh the cons. It's about safety and wellbeing.

Saying that I need to take care of mom at home because she took care of me at home is a false argument. My mom also put me in daycare so she could work to feed me. She put me in school so I could learn. She was never doing full time hands on care for 18 years, like is possible for dementia. Her time to do my home-care was always limited duration and as I got older, I could help out by taking over some of the work. This is not ever going to be true for people with debilitating conditions & diseases. The guilt argument goes nowhere with me because it's manipulative. I will make decisions based on what keeps her safe, not what seems tit-for-tat based on my childhood care needs.
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as much as I hate to be the bearer of bad news, I must be honest and upfront with you that there is no easy way to tell her that you're taking her to a nursing home. That's because nursing home placement removes a personal freedom to come and go as they please as well as other freedoms that we all take for granted. One elderly friend of mine who needed round-the-clock care that he could not get outside of a facility was also taken to a nursing home, although I'm not sure how this was accomplished. When you're removing someone's freedom, there is really no easy way to do it, knowing your your self will continue enjoying your own freedom while your loved one has no more freedom. This is why nursing home placement is very hard since being in one of those places is definitely no fun. No matter how easy workers try to make it for the residents, there will never be any easy way to tell someone they're going to a nursing home and actually do it. You may lie to them when you yourself know the real truth, but when they find out you're lying about how long will be there, then you're going to have a real mess on your hands, so you may just as well be honest and upfront with them to start with. Again, I know this is going to be hard, an elderly friend of mine was very recently placed in such a facility. About the only good thing about it is the fact that he's in a veterans home and will get to keep all of his money. He was actually very much against ever going into a nursing home until he started realizing is upcoming mortality and the realization that he just won't live forever on this earth and that he was declining to the point of needing round the clock care. He was actually wanting to stay home for as long as he possibly could, and even die at home with dignity. In fact, I think to some point he was in denial about his true condition since he was actually wanting to do some stuff that I later learned it was beyond his capabilities to perform. At first I didn't realize what was really going on when he wanted to get and run and ice cream trailer as well as travel with it. It wasn't until later that the truth all came out that there was no ice cream trailer on its way and that he was far from capable of running one. I seriously doubt he would've gotten far with it had he gotten it and started what he set out to do with all of the squad rides to the ER nearly every night, and sometimes twice a day toward the end before he was taken to the vets home. Whether the squad took him or they were there for something else to help him with, it still took away from the rest of our town who needed availability since we only have a very small limited number of squads in our town. What if the last squad would've gone out to him, only for them to get a call about a real bad accident just outside of town? This just wasn't fair to our community to let abusing resources to continue when someone else could've been in far worse shape and possibly die from my friend's selfishness. Those who don't know about this specific type of situation won't possibly be able to understand if they themselves have never dealt with this specific type of situation before. Therefore, I would greatly appreciate that those who have never dealt with this kind of situation would please not leave nasty remarks because you never know what someone else is really going through. That person has since been put into a nursing home, which was all done by the professionals who handle very stubborn individuals elders every day. Getting someone who needs nursing home care into an actual facility may sometimes have to be initiated by the adult protective services who can actually get the ball rolling into getting the person an emergency court appointed guardian who can actually make the person go into a nursing home. I've actually seen this happen with another case since the person had no family around to help with the process. Getting someone into a nursing home can be the hardest when there's no family and the person is all alone without any other help whatsoever, I know I have seen this for myself. Just from what I experienced with others who need to be a nursing homes but wouldn't go, I know what it is to know someone needs to go but no one will help for quite a while. Therefore, all the situation can keep continuing even indefinitely until the right people come along at the right time and do whatever needs to be done to get someone into a nursing home where they need to be. Many elderly people just don't want to lose their freedom, which is why so many of them just don't want to go. Another reason why so many of them don't want to go is because I don't want the nursing home snatching all of their money. When the nursing home snatches all of your money, that leaves little to nothing for yourself, which is why it's even harder to get someone to go, especially when they have assets. The more money and assets someone has, the harder it may actually be to get that person into a nursing home. That's because that person is not willing to give up everything and settle for nothing. Combine that with that person not having any family or anyone else close to them who's able to sacrifice their own life to spend all of their time with that one person who needs round-the-clock care. This is what was experienced in the neighborhood for quite a while. This specific person has an RV, lots of money in the bank, and no family around to help him. There were only three of us who could come in and check on this elderly friend at night when he really didn't want to be alone. What really seemed odd is that he always got sick or other bad things always seem to happen to him when he was alone. Something was obviously going on behind the scenes when no one else could be there. We all knew better than to mention a nursing home to him, or he'd totally freak out, so I absolutely and completely know what you mean. My experience and what all I've been through is exactly why I can honestly say that there is never going to be any easy way to tell someone that they're going to a nursing home. I know that with some people, you can't even mention the word nursing home to them without them freaking out. I can't tell you how long I've actually faced prolonged situations very much like this, but I can tell you that it went on for quite a while.

My first situation was an elderly person with no family living in a house that was falling down, and renting from a really bad slumlord. The elderly man had absolutely no family whatsoever, and I was the closest to family that he even had. I was able to help him to a point, and we actually had some very nice situation set up to help each other by pulling together as we could. We helped each other in anyway we could despite the situation. In the end we had frequent problems with his residence where utilities went off at some point or another because of the slumlord pocketing the rent and not paying the bills that were included in the rent according to the lease. There came a time when adult protective services was alerted, only to find out they could not do anything without enough information. There came a time when two others finally came forward with their own abilities to be able to share what they knew. The information was all connected and the elderly man was taken by surprise one Friday morning and moved to an assisted living facility, only for him to be hospitalized twice within a short amount of time before suddenly getting taken to a nearby nursing home. This was not easy to take this poor guy to a nursing home, but it was definitely needed.

My next situation which ended recently after a little more than a year. There was an awful lot going on for the past year or so that actually started draining not only me but who knows how many other people. This person was actually abusive in some other way than I was able to recognize. Because of everything that was going on for so long, no wonder his family and other people could not be around him. This is because of how he was toward other people, especially those closest to him. It would take me a very long time to go back through everything that was going on, which I won't do. Everyone who knew this other person know that he needed a nursing home, but no one was in a position to put him there. This is why things went on for so long, and he was so stubborn against going into a nursing home. However, he wanted to go look at a house somewhere across town. He kept saying he was going to move away from here, but I don't know what really went on when I was not around. All I had was one sided the story. He started complaining about our hospital and paramedics. With all of the frequent flying he's done, it's no wonder that the staff were finally burning out and becoming aggravated with having to see him so frequently. Again, we all know that he really needed a nursing home. The hospital finally started working toward getting him to accept the idea when they sent social services to speak with him. I don't know how that went over, but I'm sure it wasn't good because it would not have gone well with him. I know that we have no veteran home here in our town, but I know that he was most likely taken out of town very recently. Being taken out of town will eliminate chance of them running away and coming back home, so not having a vet home in our town is actually a good thing. I can't even begin to say how much this man has put us all through for what all we've endured. However, all I can do when I look over at that empty apartment is to say good riddance to the bad memories that haunted us all.

Again, the nursing home placement is never easy. Even the mention of "nursing home" Will make many elders freak out, this is a harsh reality like it or not. There's no easy way of bringing it up, never was, nor will there ever be. This is why you need your support network to be there with you to back you up at the time this very difficult discussion is started. This needs to be a private family meeting where everyone is on the same page by being in agreement but this one person needs nursing home placement. Everyone needs to come into one agreement of what's going to be done and what everyone else's part will be in the situation, and everyone needs to work as a team and stick to their part. Some binderies will need to be set and enforced in order to force this person into having no other choice but to go ahead and let you take them to the nursing home. One of those boundaries will have to be to stop enabling the person and any bad or undesirable behavior that may be going on. This is a situation anything like the person living alone and not being able to be alone all the time, this will take away from the life of whoever is checking on this person. In my specific case with my most recent situation, the person has ways of getting you to stay longer than intended. In some cases such as mine was, there may be times when the person just doesn't feel like going out, and the elder will have ways of getting that person to go out anyway even by luring them by any means possible. The person being lured into going over there may find themselves in some situation that could even put their health in jeopardy, as what happened to me when this elderly man kept his place too hot. Some people just can't be where it's too hot, and in the case of my elderly friend, He would crank the heat then call me over saying it was cool in his place. Many times I had to turn tail and leave or turn the thermostat back down when it was in the 80s, 90s, or even right about 100, even on a hot day. This was only one telltale sign that my elderly friend needed far more help than what we could give him, besides other obvious telltale signs. Combine that with being unwilling for nursing home placement and him wanting to tough it out alone. This was part for us to let certain things go on for so long, but it was harder when he started getting careless with his VA own power chair when he almost hit people with it. He almost hit several people, and was almost hit in traffic for going against red lights. When someone needing nursing home placement is overly dependent on others around them to the point it takes away from the lives of others, or that person is a danger to themselves or others, then something must be done. If no one else is going to do it, then someone needs to alert the adult protective services about the most serious matters. If the family won't step in and help in some cases, then the adult protective services will at some point step in with enough information.
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Don't take her to a nursing home, take her to an apartment that has personal care. If your Mom has stay at a first class hotel that caters to you, this is the feeling she will get.
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