My 92 year old mom is very independent and believes she is completely taking care of herself. She doesn’t need help with ADLs. She lives in my house with my DH and me. She does have all her meals made for her and housekeeping done for her (all by me). She is quite frequently upset about something and yells or is upset toward me, no one else. I am an only child.

I check up on her during the day to make sure she didn’t leave the water running, the refrigerator open, items a safe distance around the space heater, heat lamps left on, the toaster left on, etc. These things don’t happen all the time, but enough to make me concerned. She can carry on a normal conversation with someone if required, but prefers not to socially interact with anyone. She stays in her room most of the time. She does walk, mostly with a walking stick.

I believe all this time in her room is contributing to her mental decline. She doesn’t have dementia symptoms, but will bring up things from the past that are upsetting and then bring them up again and again. Other things she is forgetful about, and I’m not sure about her mental state. I think she is trying as hard as possible, but probably very confused and frustrated about what is going on with her.

She will not go to the doctors for anything.

I need to go out and do errands, but am concerned about her in my home. I need to have a discussion with her about her decline and how I am concerned. But know how this will go...she will become very upset with me and not talk to me, tell me to leave, get away from me as much as possible, be very disappointed in me, tell me how can I treat her that way, and blame this on me somehow.

So, do you tell them that they are starting to mentally decline and you are concerned? If so, how is this best approached?

Or do you just continue to minimize all the hazards in the home and go from there?

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Why do you say that she is independent? She is relying on you. So therefore she needs assistance. You are concerned which is natural. I am quite sure it’s taking its toll on you. No judgment from anyone on this forum so please be honest in how you feel. Everyone here has had their own frustrations.

I don’t feel doctor appointments are negotiable. You need to know her medical situation since you are her caregiver. Make the appointment for her. Tell her that you expect her to keep the appointment. Don’t give her a choice in postponing or a cancellation of the appointment. Tell her it is a mandatory requirement.

She is living with you, not the other way around. Ask for her to sign a medical release to get information because if you don’t HIPPA laws will prevent your attainment of any medical information. She needs a complete physical.

If she blatantly refuses to cooperate then start looking at assisted living facilities or nursing homes. Life is too short to live in misery.

I am sorry you have this difficult and stressful situation. Best wishes to you and your family.
Helpful Answer (14)

Does she still have capacity for logical thinking or is she completely in the emotional reactive realm? If logical thinking is gone then there is no capacity for a discussion. You will just have to make decisions for her care as you see fit for her health and safety (and yours). You say she doesn't have dementia symptoms but then go on to mention symptoms that are very much part of early stage dementia - social isolation, resistance to care, anger and upset, repeating things from the past. You say she doesn't need help with ADLs, but she doesn't cook or clean. She is hardly independent. How safe can you keep her and how much more abuse are you willing to take? Because it doesn't sound to me like you are going to be able to talk to her about making changes. You are going to have to make changes.
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PowerOf3 Jan 2020
I read into it the same. Knowing they can showboat was a big lesson. I’m not there but sounds as if she IS in early stages. Depending on where her decline falls and what her dr says, you will have to establish your discussion or lack thereof on your own (and the decisions going forward).
You must get her to a dr! You must! Until you get an idea of her decline you’ll spin wheels.
How about: (Act like you don't know how it will go. It will just get you even more tense) Deep breath, "mom we need to plan now on how we are going to adjust to the changes that are coming. Let's do it now, while you are still in good health and I am in a position to make the right decisions and not all stressed and worried about your safety"

When she brings up bad memories, step in and quickly change the subject. Find a way to get her to some degree of socialization. Paid home companion twice a week for four hours got my mom started in the right direction and gave her a reason to get out of bed in the morning. We also did drop off adult day care for 1/2 day once a week. At the time the other clients were at different stages, but I explained that to her and said that she should enjoy what ever events they had (little bus rides in the countryside, music, crafts, whatever).

It's like you go 100% and nothing seems to work, but later you realize it is a process and the 2% that works has the effect of socializing for her and respite for you.

The day I told my mom that we were placing her in memory care I felt the words were going to catch in my throat and choke me, but she actually listened and shook her head in agreement(!) The next day, of course, when we came to pick her up she had no memory of our earlier conversation. But I held on to that brief moment when she shook her head in agreement and it gave me the strength to move forward.
Helpful Answer (11)

I read your profile and previous posts. You wrote of much of this back at the end of July, yet it seems nothing has changed.

You didn't answer any questions back then about her going to live in a facility. What about it? Your H is retiring sometime this year, and what is life going to be like at your home with your mother once that happens?

She's been living with you since last February. What happened to where she used to be living. Was it a house that was sold/needs to be sold? Or did she rent. What is her financial situation?

What is the plan for when her dementia gets worse?
Helpful Answer (10)

I am very concerned about the safety of all of you at home. She's going to set the place on fire!

I don't know if she is up for a convo about this stuff. It might be a little beyond this point where you can have a rational discussion about her decline. I would skip it, cuz I'm totally into avoidance at this point with my mom. Probably bad advice because of my bias.

Anyhow, protect yourselves however you need to. Dementia proof your house - take the knobs off the stove, put the toaster away, etc.

I like the camera idea so you can monitor things but what if she's doing something dangerous and you're across town doing errands? I think she needs a babysitter. Senior center of adult day care might be worthwhile. Or someone to sit with her so you can go out with more peace of mind.

Tough situation, this elder care. Ugh. Not easy. Or fun.
Helpful Answer (9)

Your Mother is past the point of safely being left alone when you are out doing errands, so for now, you need a parent minder to stay with her, no if and or buts, or else you are going to come home to your house being burned to the ground with her in it, or you may find her seriously injured while you are away.

You need to think ahead about how you want your home to be run if she continues to live with you, so be prepared put your foot down or else be miserable, as things are only going to get worse from here on out.

If you can make sufficient changes to your your home environment that is comfortable for you in the short term, do that now and reinforce as time goes on, but begin to prepare yourself for the eventuality that your Mom is going need more assistance in the future, beyond that you can do for her, so begin researching Assisted Living places, preferably ones that have step up facilities as her symptoms worsen, think memory care.

You can do a lot of research right here on this site by reading how others have managed, and then begin touring Assisted living places to get a feel for the best possible place for her. If you think that adult daycare might work to give her the safety and stimulation, plus give you the opportunity for some space, you may be able to prolong the inevitable, but don't be caught unaware, do your homework.

These are difficult decisions that need to be made, and it's Easy for me to say, as we did everything wrong from the start (13 years in our home), lol! But we did learn eventually and did finally get my FIL into Assisted living, unfortunately he became gravely ill after only 12 weeks and he ended up in hospital with pneumonia and lung cancer, so we brought him back home on Hospice care where he died 9 weeks later. Please don't wait like we did, your family, your marriage and retirement are worth so much more than trying to appease someone who doesn't appreciate what you are doing for them, and of course their safety should also come first. Good Luck!
Helpful Answer (8)
rovana Jan 2020
Excellent advice - the safety issues are paramount and they are real!  You really cannot afford to "hope for the best." Get rid of heat lamps, space heaters, etc. Disable stove, oven, whatever. If in doubt, consult the fire department. This is to serious to worry about anyone feelings.
I have the same problem with no real answers, but wanted you to know you are not alone in your frustration.

My mom blew up at me a few days before Christmas over this very topic and then refused to speak to me. I imagine on their end it's fear and denial. I get that. But at the same time I do NOT get how our parents feel entitled to dismiss our very valid concerns. I mean it's not like we aren't affected. Your mother lives with you. Mine is next door to me in my condo. We are affected daily! We are OWED some cooperation, and I am to the point of really feeling resentful about it.

After the last blow up before Christmas I decided I'm not going to try and force conversations with my mom, but at the same time I'm not going to sugarcoat things for her benefit either. That's all I know to do for now.

Have you considered getting a nanny cam or two set up in your home? That way you could watch her remotely from your phone (if you have a smart phone like an iPhone). Lots of people use these and they work well. You could tell your mom you are doing it because you are concerned. If she pouts, she pouts. The bottom line is you need to leave sometimes and you are tired of worrying about her being home alone. Tell her the cameras are necessary for YOU. For your mental peace of mind. That may get her to realize some things, or maybe not, but at least you can leave the house and still check on things so your not worried. BTW many of the cams also have audio. I know this because I have one I got for my dogs a few years ago. I could actually talk to them from my phone and they would hear it coming from the camera. In that instance the whole things was pretty funny, but in the sense of watching a senior it could be very useful.

I haven't done camera's with my mom because she would have a fit and disable it. My goals might also be different than yours because when my mom can no longer live alone safely I'm not going to try and keep her there. Nope. That's when she goes to assisted living, or in her case it will likely be memory care.

Good luck.
Helpful Answer (7)
dogparkmomma Jan 2020
This self-centered behavior is part of the dementia. Even people who weren’t selfish before can get like this. It is not rational. So explaining that you have rights and needs too does not change the behavior. I would suggest that you be ready with plan B and know where she will go and how it will be paid for because sometimes when you need to make a move, you need to do so quickly.
I think by "independent" you mean she thinks she is. Or is the word really stubborn.

There are so many reasons why Mom is like this. Depression could be one. Elderly don't deal with change well. A good physical could answer a lot of questions. Her potassium levels could be low. Her Thyroid could be the problem. Diabetes, anything. Or, she can be showing signs of Dementia. Tell her Medicare requires a physical. But you can't solve anything until you find out what is wrong.
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Happyplace Jan 2020
This is excellent advise. Tell her Medicare requires a physical in order to get her to the doctor. Then, the doctor can set you with with a social worker consultation. She's probably getting more symptoms of dementia because she is isolating herself. If she's not moving much, she will get more frail and at an increase risk of falling. Also, get rid of the space heaters because likely her safety awareness isn't going to get much better that what it already is.
I don't know if I am really adding much new. I would get your mother in to see a geriatric specialist. Hopefully, the doctor will have good rapport with your mom and build trust. He will be able to talk to her about her mental decline. You can explore avenues in the meantime, but I would secure a sitter to come into your home when needed for sure, and try to get your mom involved with some engaging activities. My mother refused to go to the geriatric specialist at first because she didn't like the sound of the man's name. Eventually, I got her to go and she loved the doctor so much that she did whatever he said. He told me NOT to have my mother think the decision to go to memory care was mine but his, and to always put the ownership on him. Believe it or not, this worked! My mother loved her memory care facility (think clean, safe, small, lots of activities). I also interviewed and arranged a professional, licensed sitter to come to my house if my husband and I had to be gone as I did not want my mother unattended (prior to re-locating her to a memory care facility). You may think that this might not happen to you, but my mother wandered off one day and it was the scariest thing that has ever happened. After that, she needed to go to a facility (she wandered off when she still lived with my family). They say you don't know that will happen until it does. How true! Also, my mother loved the activities at the memory care facility. She was very engaged. She got more out of that than staying at our home as I could not be with her all the time and doing things. Maybe you can brainstorm ideas of what your mother could constructively do with her time. And maybe she will gravitate and accept some of the ideas. At the beginning stages of my mother's dementia, she was still able to read 2 newspapers a day (which I ordered for her). I had a list of her favorite TV shows (Antique Roadshow, Jeopardy, and golf/other sports) and she watched those. I checked out lots of movies from the library that featured her favorite actors/actresses. I would buy her magazines with pictures to enjoy. She was an interior decorator and gardener so she loved those times of magazines. Sometimes, I set out simple tasks of folding clothes, sorting silverware, sewing buttons, etc. for her to do around our house. She loved puzzles and did one each day. I gradually got puzzles with fewer, and larger pieces. The puzzles occupied at least 1-2 hours of her time/day. She also liked music so she would listen to music. I had 4 brothers and sisters so we set up a rotational calling tree whereby my mother received a phone call a day from one of her children. We also brainstormed holiday gifts that would enhance my mother's mental/physical skills. I do think your mother needs (as we all do) mental and social stimulation. Good luck trying to add those to her day. I also agree with the others to get some future plans in order because the time will come when you won't be able to handle your mother at home any longer. You will need to find a quality place for her. Do that now so you are ready to go when the time comes. Good luck!
Helpful Answer (7)

She is not independent. She lives with you, you do everything for her. Does she pay rent or help with household expenses. How did she come to live with you? What about a senior center or assisted living. You are her only stimulation. Try calling the Area Agency on Aging and ask for a visit and needs assessment.

Yes, she should be seen by a doctor, no question. The decline you are seeing could be many things only a doctor can evaluate that. How to get her there? Everyone needs to see a doctor, at least once in awhile. Doc can identify problems that she doesnt even know are there. Then treat them.
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