How do I discuss AL with Mom, because I can't do this anymore?

Hi I just wanted to add that many AL places allow residents to have pets.

((((((((((I know exactly how you feel))))))))))

just sending sympathy

If she is in Skilled Nursing or rehab now?
If so simply tell her that the doctors say that she can not go back to living independently. you can even have the doctor or Physical Therapist tell her that.
Or the other option is to have caregivers come in and do ALL that you have been doing for her. (weighing the Pro's and Con's and prices I think you will find that AL will be less expensive in the long run if you factor in ALL expenses)

Tell her you made vows to your husband, not to her. You cannot be her "everything" (aka Caregiver/Slave) and not continue to work full time and save for your own old age. It is a huge second job and sacrifices all your time and your marriage.

It's not your fault Mom has gotten old and has health issues. It happens to everyone. She knows exactly what happens when you get old and sick, she saw her own husband go through it...and apparently made no plans about her own future?

You are burned out and cannot be her Caregiver (Slave) forever. What if something happens to your husband, or yourself? Mom would be in a facility, simple as that.

Lots of good advice here. Propping up Mom is not helping either of you.
I wish you strength to get this situation fixed.

"The doctors say you need to move to assisted living as I can't provide the care. We will be touring .......... next week. We will be touring ......
the following week." I have to go now. See you next week and walk out.

Keep it simple. Keep it brief.

Why do you have to see her today?

I'd plan a 3 week vacation or cruise with your husband. Tell her you need respite.

Or...don't visit for 3 weeks. Tell her you and your husband will be vacationing and do a staycation for 3 weeks.

Take a much needed break.

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You talk to her by speaking plainly and honestly. You will not be her caregiver. That is not an option. Tell her this. Let her know that her choices are go into a nice AL facility voluntarily where she will have a pretty good life, or be stubborn and return home and wait for another fall to happen and then it's placement a permanent nursing home, against her will. The state will do this.

Make your language very plain and tell her that if she insists on going home she will be completely on her own because you will not help her in any way. You will not even visit. Either it's AL or she is on her own. Then stick to it.

I know exactly how you feel when you just cannot bear one more moment of being responsible for them. I was where you are. Then I walked away. My mother was given a choice. That choice was mak it work with homecare or you're on your own.

CantBreathe, I can relate to parts of your story, especially your doing more and more for her over time (because it generally goes that way with an aging parent whose ‘independence’ is being propped up by a family caregiver at home) as well as the pressure you probably feel to go over there all the time as you are her only source of socialization. When you wake up in the morning hating your life, however, things have to change. Don’t underestimate the toll that this is taking on your mental health. I was a primary caregiver for my mother for 10 years. She moved to a retirement home in another city closer to my sister 6 months ago, and I’m still struggling to get my life back. Some days it feels as though I never will.

She needs to go into LTC, and you deserve to have your life back.

Her concern that she has "lost" you would be a great place to start the conversation. I would be honest with her and tell her that instead of being her daughter and enjoying your time together, you are now her caretaker and it has become more of a job. Additionally, you would love to return to your previous role of daughter and the only way that can happen is for her to have a different care taker. Like another person said, you need to address what her concerns are about assisted living. Years ago, when someone went to "the home", they were often forgotten and "the homes" were not very nice places. Today, the assisted living facilities can be extremely nice or a bit run down so you'll have to do some home work. When I was looking for a place for my DH's dad, I found a few that I would happily more into, though I cannot afford them at this time. Some had bars, movie theaters, ice cream shops, and many other things. The one with a bar allowed residents whose medications did not interfere to have 1-2 beers or glasses of wine on the days they were open without additional payment. It had a billiards table as well. The apartments were small but there was plenty of room all over the facility to spread out and enjoy.

Maybe ask Mom to list all the things that concern her about assisted living. Each one could be discussed, especially her concern for her dogs and for her own privacy since she's apparently not real social. While her falls, etc are concerning, I'm still not sure she's being fully heard and without resolution being forced to AL could be heartbreaking for her. Please have that talk with her, and give her truthful options re her pets and any other concerns that she's comfortable with before upheaving her safety zone. It takes preparation to change another's life so much on your part and theirs, much of that being emotional in context.

Something that I did not know until recently is that in 29 states children are required to take care of their elderly parents. Filial responsibility does not require you to do that job alone. There is assistive living, nursing home care, etc. If you are looking at your mother being released to her home, many of the issues you mentioned can be satisfied by services available to home-bound seniors. Large grocery stores will deliver groceries, there are medical companies that will provide doctors, nurses, assistants, caregivers, professionals for imaging, podiatry, phlebotomy services, meals on wheels, etc. Each of these services provide a chance for your mom to have additional people to socialize with and limits her alone time as well as helping her stay in her home. An in-home caregiver can bathe, assist with dental hygiene, do laundry, complete housework, etc. Your mom may benefit from grab bars, a walker, a cane, sit-to-stand devices and toileting devices (bidets are awesome and the toilet can be equipped with bars to help her stand), etc. Insurance should provide most of these services usually...i addition occupational and physical therapy may be helpful. smartwatches can provide fall detection and are available in waterproof versions.
A couple questions: Do you know why she is falling? That could be nothing more than an inner-ear issue, or over-medication (is she on multiple water pills, does she feel dizzy? Falling often should be investigated as to why it is happening doctors like to just write off everything because of age [my mother was MIS-diagnosed MULTIPLE times with Alzheimer's). Is her toilet the right height for her? That could be a possible fall hazard. What happens to her dogs if she goes into a facility? This may be a huge reason why she is against being put in a facility/AL. Could the pups be taken care of by someone else? Would they be willing to let them visit your mom at her new home? Home is comfort...we have our "things" all around us and we have so many memories at home. Nearly everything from home will need to be left behind when moving to assistive living or a nursing home...I can't imagine the feelings of loss a person feels when their life is reduced to just a couple boxes.
Now as far as being her caregiver: If you can't or you are just unwilling to do it, there is no shame in that.... Admitting that you cannot single-handedly fill every aspect of caregiving would eventually crush anyone, I believe. First, you have to be honest with yourself, then you have to be honest with her. Regardless of if she moves into assisted living, a nursing home or returns home....you are going to need people helping you.
I was my mom's sole caregiver for 7 1/2 years. Then she progressed to where she needed 24/7 skilled care. I couldn't risk trying to do it all any longer...I would have been playing with her well-being and I loved her to much to put her at risk. Her doctor had been demanding that I place her in a facility for years, but I had resisted. I had our clergy go to her bedside and talk to her (that really seemed to help!)...he told her how hard I had tried and that it was now kind of her motherly duty to take some of the burden off my shoulders. That helped her accept it. I told her that it wasn't that I would no longer be taking care of her....I just needed a lot more people to help, so I could continue making sure she was cared for as was needed.
Last year, I started caregiving for my deaf and largely immobile brother. He spent 8 months in hospitals and rehab centers because of his issues with his legs. He turned 70 years old this year. I'm 64. The items that I mentioned before are some of the things that I did at our home to help him to thrive here. However, he is fully aware that if it comes down to having him living at home and risking his health in doing so...he will go into a nursing home.
Anyhow....I hope that maybe some of this helps you.

The answer is going to depend on the stage of dementia. If the dementia has progressed far enough, you can tell her white lies like she is going for overnight testing, or just a two day vacation, or just a week while you take your own vacation or have to go help someone else. Once there, even if she asks about going home, you and the caretakers will be able to manage those discussions with more white lies like "tomorrow" and she won't remember what was previously said.

If the dementia hasn't progressed that far, the conversation is harder, but I agree with those who have said "tell" but fill it with the value to her of the community and lots of reassurance that you will visit often.

Whatever her stage, work with the AL team, too. They may have some ideas. They might even have someone who could come visit her to assess her level and give you an idea of what has worked for other similar cases. Some communities offer that.

We were lucky with my dad as he wanted to be with more people, make friends, take day trips (things offered my our local AL that I couldn't do because I was still working during the day. We took him to meet some of the people first, and attended some of the events there (hymn sing, New Years party). So the move was much easier than most, but it wasn't long before he was asking to come home, telling us the staff lied to him and the residents weren't friendly. And then Covid happened, so we weren't able to visit for awhile.

IMO, and I'm sorry to say, there is no easy transition. Take it one moment at a time; adjust each moment but always with the move as the end situation - don't waver from that. Expect tears but work really, really hard at not feeling guilty and giving grace to her and to yourself.

Bless you for the love and care you have provided so far, and for the love and care that goes into this decision. That love and care is always there; it just looks different now.

A lot of elders believe that Assisted Living is just a fancy name for a nursing home. When my Mom was needing more help and became basically house bound due to falls, my brother and I looked at a handful of AL communities. Then the top two were presented to Mom to tour. We were told that having her see too many would be confusing. She chose a nice one that was close enough from her home for friends to still visit.
My brother and I gently pointed out that she was making her world smaller and smaller by remaining at home and waiting for others to come visit. We wanted her to be in a community where she could enjoy herself. We worried that too many falls would put her in a situation where AL would no longer be appropriate and skilled nursing would be her only option.
It wasn't an easy process, and there were lots of tears, but she did agree. By 6 months into living there, she told me she liked the place and was actually having fun.
Good luck. It's a difficult transition.

Talk with her doctor and therapists. Enlist their support and ask them to be "the bad guys." In essence, have doctor - and other professionals - tell her she must go to assisted living because she can not live alone. Have them tell her that the amount of care she needs is too much for 1-2 people to manage. (This gets you out of the way as a solution.)

Once they break the "bad news", be "the good guys." Help her to see the benefits of assisted living: smaller place, cleaning crew, meals in a restaurant-like dining room, activities and opportunities to make friends... Help her to look at places that will allow her to keep her canine friends.

Until you decide what you want to do and realize that you must make changes, she will continue to expect you to continue what you've been doing.

She will NEVER accept an/other or different living situation - as long as you are there to do what you've been doing.

When you assert yourself and tell her "I can't do it anymore... you need more help than I can provide" she will get very upset / angry / mad. Realize that she is very frightened and used to how things have been - you there doing what needs to be done. She has felt an aspect of personal security w you - that is being taken away - and naturally, she'll be MAD and SCARED.

* She will continue to take out her fears on you.
* You need to learn how to not take it personally (while it feels that way).
- You let her rant and rave - ... for a few minutes. Then you leave and take a break for a few minutes or leave for the day. The point is: you DO NOT stay and listen to her ranting ... as this is extremely unhealthy, psychologically, emotionally and otherwise for you.

She won't be happy no matter what.
You need to focus on her well-being / her welfare and the best care she can get --- regardless of what she says or how upset she gets.

If you have legal authority to make these decisions on her behalf, that is half the battle. If you do not, see if you can get these things in order (she may say NO.) If she still has legal authority over her own life, she will make her decisions.

You've allowed this routine / life-style to go on for way too long and now you are at your breaking point.

Consider why you feel 'dread' visiting -
Are you afraid of her?
Do you take in what she says as 'if' she IS your responsibility.
Do you believe you need to 'stand there' and take the ranting (if yes, why?)

You can be both compassionate and set boundaries.
First you need to know that you HAVE TO SET BOUNDARIES.
Then, you say "I know this is hard for you ... its really hard for ME too...
And/but changes must be made as I can't help you out as I have been"

Think about how you need to proceed before you speak to her "This is what is going to happen ..." write it out so you can follow it without getting emotionally derailed.

These life changes are awful and awfully hard.
However, ALWAYS remember - you've done a lot over the years and you've shown her a lot of love and care. There comes a time when a person needs more care than a loved one/family member can provide.

Be prepared for her to not want to talk with you ... or however she may react to how things must change.

Do not take it personally. Remember, SHE IS FRIGHTENED of not knowing what is going to happen to her and you not there. This is natural. But, if you keep doing what you have been doing, you won't be able to function ... for yourself or to help her. You MUST take care of yourself.

Gena / Touch Matters

Can sure relate to being forced to be everything. Mom is impoverished and spouse and I are in what is rapidly becoming a HCOL area, so I'm really thinking about what to do. Probably we will have to eventually sell mom's condo and use the money for her care.

Hi,
Your situation sounds familiar to mine. Long story short, I was my dad's caregiver for over 20 years after my mom died. His health started to decline a few years ago and I was still trying but he was falling often. He had two stays in the swing bed and one in the nursing home for therapy. I told the social worker that I was unable to care for him full time and that I would not be moving in with him or him with me. He wanted to go home after the stay in the nursing home for therapy so we hired a couple people to help out.He did not like the night person so that did not work. His falls continued. I was struggling to take him to the doctor because he had gotten to the point where he could not walk.. It was even hard with a walker. He is now in a facility. He still says he wants to come home although he has been there a year. Please do not feel guilty. Taking care of an elderly person with many medical and physical issues is a full time job that requires professionals. As someone else said here, in home care can cost more than a facility. Have a long talk with your mom. It will be tough but it will be better for you and her. Also, as someone once said to me on this forum, placing them in facility is caring for them. Often people think that just because they are our parents, we are suppose to take care of them even if we are not able or qualified. Prayers to you. Keep us updated.

Can't breathe, you tell her straight out that you can no longer safely care for her and any choice she makes need to be made with the FACT that you will not be able to help her in mind.

Telling our parents "NO" is terribly hard the 1st time, then they lay guilt trips like old pros, saying it and sticking to it is terribly hard but, I promise it gets easier each and every time you say it and stick to it. Which sticking to it is vitally important because when we don't, we are teaching them that they can argue us out of our "NO".

You must be honest, you CAN NOT do it any longer. Sorry mom but, I CAN NOT do it. I will be there to advocate and be a regular visitor but I am holding on by the skin of my teeth and if I go down you will have nobody to be there for you.

Prayers that you can say no and mean it and she can see past her own wants to respect you and acknowledge that you are beyond the ability to care for her in her house.

Hi Can't Breathe.
I started thinking of myself while reading your post. I hope this helps. Your mom has to come to the realization that she is living through life's processes. Aging makes things happen and she has to deal with those things.
Like I mentioned I was thinking of myself. Driving is a good example. I have to deal with others for transportation and at first it was hard to deal with. I was able to feel better about it after thinking that It's part of life and aging. We can't undo it. We have to deal with it. I hope this helps. I think that when she comes to realize that. She will be easier to care for. Good aging care facilities can provide the information you both need and help reduce the burden. Be patient and do your best.

Get an assessor in the bell her the doctors say she needs full time care which you can’t provide so they’ve found a lovely centre fur her and we
are going to see it Saturday sort of thing
make a big day of it ask centre if a visit can be agreed and a welcome cup of tea / biscuit and reassure her you’ll visit often

If mom is decisional you tell her..
"Mom, I can't do this any more. We are going to have to find a solution. There are 2 I can think of.
1. You have a caregiver come in and help you do all the things that I have been doing.
2. We find an Assisted Living Community that can help you when you need help."
(Please see that the Community that you are looking at has a variety of care levels from Assisted to Memory Care to Skilled Nursing that way if she needs a higher level of care you do not have to move her or look for another place for her to move into.)

I think if you do the math on living at home with caregivers and living in Assisted Living it might actually be less expensive in AL.

If mom is not decisional then there is no discussion you place her in a facility that can manage her care safely.

I know burnout out can be difficult, but I wonder if your Mom ever said, “Now I have to grocery shop for my daughter!”
If your Mom was good to you, I think you should remember all the things she ever did for you. If you never wanted to be her caretaker, then maybe you should have dropped her off for strangers to care for her from the beginning. Life is give and take in all relationships. It is not ALL about nothing but fun for everyone. If you parent was terrible to you, then maybe you don’t really need to feel obligated, but if your parent was loving, giving, & caring, then maybe it would be good to give back. It was nice of you and your husband to take her in, but maybe you just were not cut out for this? But, aren’t you going to wonder if she is ok everyday? Best of luck to you all.

CantBreathe: Do not discuss, but inform, i.e. ' Mom, you are going tp xyz AL.'

I feel sorry for your mother’s situation, but she is no longer capable of caring for herself. You tell your mother that you cannot help her any more. Your mother is no longer safe living at home and requires an AL placement, whether she likes it or not. If necessary, get an ombudsman to talk with her to make sense that she is in an unsafe condition to continue at home. Then explain how she will live in safer arrangements.

The less said the better. It is crucial only to say that you now wish to live alone, and cannot continue in hands-on caregiving. That you will assist in finding a good placement and will enjoy visiting but that you will expect her now to have placement in care within and upon a certain date.

The more information the more argument. So don't discuss "reasons". They will just be argued down.

CantBreathe, I feel so bad for you. Parts of your story are very close to my experience so I can sympathize. First of all, take a breath and then just breathe. Just take a few minutes and do nothing but breathe.

Next, I'm a little unclear. Is your mom at a nursing home or rehab? If so, is she the one pushing for a release?

Is there a doctor onsite or one on-call? I suggest talking to a social worker or discharge planner there at the facility. Explain to them that mom lives unsafely at home, alone, and you cannot be responsible for her. See if the doc will write something up stating that she cannot go home alone because it's not safe. Then you can show her that and say "Sorry, Mom. Doctor's orders."

If she is adamant about going home against medical advice, and you do not have POA, then as others have suggested, you'll need to tell her it's not safe for her to go home and you can no longer give her the care she needs. It's time for you to protect your own health.

If she goes home against everyone's wishes, get her a Medical Guardian pendant or one from some other vendor that detects falls. That way if she falls, they'll know right away and call her. If she doesn't respond, they'll call 911 and have dispatch roll out EMS.

Don’t discuss, tell. There are times, even with people we care for and love, where talking doesn’t help. Mom will only want to persuade you, argue with you, convince you and you already know nothing will change. Tell her she returns him at her own peril as you not must guard your health and wellbeing. If she chooses to go home, leave her to it. An event will happen that forces change. I’m sorry it’s become so difficult and wish you peace in the storm

Whilst it is understandable, she has not been telling you the truth about her condition, especially the falls. You may consider this as the starting point, if she was to fall and break a hip in a lot of cases it is the beginning of the end for their mobility. Then if she fell how long would it be before she was found, hypothermia could set in.

Next you need to ask her who will help if you fall seriously ill. Keep pushing this point until you get an answer. Sometimes you have to be "economical with the truth" (lovely British way of saying telling a few lies). Tell her you have an illness which means you need bed rest (let's face it you are totally stressed out and heading for a breakdown). So can she pay for help in the short term ? See how that goes.

I have discussed what we call domiciliary care with my mother who is 88, still living on her own ok but like you I am the caregiver. At first my mother lashed out, saying I didn't want to be bothered, until I did the "little lie" and said I have a health condition. Then she began asking me how we could find someone reliable "to help out occasionally".

My mother is very capable still but there are times when she gets me down and I have wished in the past I could die in my sleep I have been there and my situation has only improved when she thought I have a serious condition ( I have high blood pressure). Like you I have a husband who helps out a lot but even his patience can be stretched to the limit. Always remember he is the priority over your mother.

Tell mom you can no longer care for her at home, PERIOD. Your health is suffering now and the doctor at rehab says she must go into Assisted Living instead of back home. If she starts carrying on, tell her you love her and leave.

This very thing happened to my father when he fell in Independent Senior Living and broke his hip. Rehab refused to release him back to IL even with my mother helping him, it was too much for one person to deal with. So I got them both into AL right away.

Its not your fault mom is no longer capable of living alone! Old age is about need not want, so her safety is the only important thing right now,

Best of luck to you.