Is it too late to stop enabling?

Tell your mother that you are unable to keep providing the assistance that she needs . Tell her you can not do this anymore and that she needs to join her sibling in assisted living .

If that doesn’t work , back off and let her fail . I was told to stop helping by a social worker when I called the County Agency of Aging for help to get my mother out of her house to assisted living .
The social worker came out and assessed my mother , interviewed her with questions about emergency and non emergency scenarios
“ What would you do if …….?”
Mom could not answer or “ come up with a plan “ , for scenarios. The social worker deemed her unsafe to live alone .
The social worker was willing to return in 2 weeks with “ strong help” to physically remove my mother from her home and bring her to assisted living on an agreed date between the social worker and the facility .
This was 2017 though . Things may have changed as resources are stretched thin as well as the bar seems to be lower these days for elders to stay at home . Something we have seen the last few years with other family members .
Good luck .

Doctors are afraid to absolutely tell someone they have to go to a facility . Makes it hard on the families .

What Way says is the way to do this.

Tell mom that you can no longer manage both households and that she needs to make a plan for her care that doesn't involve you.

Do this kindly and with compassion, but stick to your plan and allow mom to sink or swim on her own.

If your mom says "I'll just sit here and wait to die" Call her bluff and say "OK if that is what you want" and do what you need to do to remove yourself from the situation. My grandmother would threaten to kill herself if she didn't get her way. Telling her to do what she felt best really took the wind out of her sails. She says this because she knows it works, stop making it work.

Hand that guilt trip right back!

"If that's what you wish to do mom, that's your right."

"I love you, mom, but my family comes first."

"Mom, I can't do this anymore. You'll have to make other arrangements or let me help you make them."

Repeat as necessary. Trying to reason with someone with dementia is useless, so don't do it. Make your statement and take your leave.

I really don't call what you have been doing enabling. Your Mom has Dementia and needs help. You are doing things for her she can no longer do. I so hope you have POA. Its now what she needs not what she wants. Its what you need because your burning out. You don't ask her cause it will always be no. You just do it. The rolls have changed. You are now the parent and she is the child. For my Mom, the evaluation was just questions and observing. This is how they determine what level of care she needs. Like its said on this forum for Caregiving to work it has to work for both people.

Just take her for a ride to visit brother and tell her this nice person is going to talk to her. When its time to place her, again she is visiting with brother. When you get there, with help of staff, you tell her this is where she needs to stay a while so you can go on vacation. Then allow the staff to take over from that point and stay away for a few days so she can acclimate. Then it maybe white lies after that when she asks to go home. "The doctor thinks its good that you stay a little longer" "I am still vacationing but thought I drop in to see you".

You might be able to slip in the evaluation for the AL/MC by having the evaluator come to her house and passing her off as a friend. Ask the facility what they do in cases such as mom's. They deal with this all the time.

The AL progressing to MC is a great idea, and once you get her in there, you'll heave a huge sigh of relief. So keep working toward that. Also, the neurologist could write a stronger note, since she's hung up on "recommends." It could be handled more like an order for care, such as they write to get patients into rehab or something like that.

Add more visits to brother that include her in activities with him, such as outings or musical events held on the premises where he is. You and mom could be there with him for meals. (Arrange all this with the facility beforehand.) Once she's going there a couple of times a week for a while, one day she gets taken to her room there by a friendly aide, and you are nowhere in sight. She stays there until "doctor says you're strong enough to leave" (which is never).

If she refuses to visit brother and won't participate, I suggest that you suspend or decrease your visits to her. Your explanation is that you've tried the best you can, you are not available anymore due to family responsibilities, and you hope she has a nice day. As others have pointed out, you cannot reason with a person who has dementia, so try no longer. Let it be what it is.

Eventually something will happen. She'll fall and end up in the hospital and rehab, or she'll start running up and down the street naked as my neighbor did, or, as my husband did, she'll wander and end up as a Jane Doe in a hospital ER after being picked up by Good Samaritans. That's when she will have NO choice in the matter.

I'm so sorry you're dealing with this. You are a kind and caring daughter, and I wish you luck. (Also, footnote: You won't be able to keep mom happy no matter what you do. She has entered the dementia zone of NO MORE HAPPY and she's playing it for all it's worth. Accept that because you might as well not fight it.)

Is there any way that "something" in the house needs fixing that will take a while?
A roof, plumbing, painting...make it something that is actually needed for when the house is sold. (I presume it will be sold to pay for her care)
That way you can tell mom that due to the repairs she has to move out. She can stay in the same place her brother is. Call it Respite stay"
During the stay she can be evaluated.
The repairs can take a bit longer than anticipated until you simply tell her that she is safer remaining where she is.
I would have the doctor on the next visit remove the "recommend" wording if that is what she is focusing on.

It is never too late. Be honest with Mom and tell her you are unable to do it.
Burnout is serious and effects could be staggering so you need to put yourself first.
I am experiencing mental exhaustion call it burnout or whatever.
I have therapy as although I have no guilt and help with physical aspects of care I tend to overthink everything and worry constantly.
One told me this week when I started with disease or some issues: No, stop!
It is about you!
Actually, I am getting another therapist this week, idea is to work on how to grieve parts of my life lost, this is not the same as grief of person lost.
It is what deep down we all know how we are loosing parts of life or certain aspects of life. It is about rebuilding life.
Caregiving certainly makes us disappear in some ways.
You need to find your own way and put yourself first.
As POA you are not responsible for her care, you have fiduciary duty of care, but you are able to assign other responsibilities.

LBlondie12, I sent you a PM. Hopefully it is helpful.

I'm responding to your additional note:
"I have said this exact thing to her and her answer is ok, I'll just sit and wait to die here. I responded that it doesn't work that way.

Is it cruel to then stop food shopping, dispensing meds and fire the aide? This is my moral dilemma."

Yes, actually, it does work that way. Many stubborn elders wait and die in their own homes. Maybe they would rather die in their home alone than to move to a care home.

And, as POA, you do have some obligation to try and keep her safe, but YOU do not have to be the caregiver. You can hire an aide to do the shopping, dispense meds, and you do not need to fire the aide to make your point to your mother. But, it is not too late for you to Stop Enabling!
Stop going there twice weekly.
As her health declines, it may be an emergency visit to the hospital which gets her out of her house. Or she may come to the decision herself that she is ready to join her brother in a nice assisted living.
From what you say, it sounds like the holdup is that she refuses the evaluation for AL. I don't know how you make her do that, even though you have POA and have the power to make that decision on her behalf.
You may have to wait, and then employ tougher love, and ask her doctor to write an order referring her to a skilled nursing facility.

If her attempt to live on her own does eventually land her in the hospital, you can refuse to take her home. Tell the doctor she is unsafe to be discharged to her home, and they can transfer her to a suitable care facility.

I know you care for her and want the best for her. But you can't make her submit to the evaluation for AL if she refuses. Unless someone else in this forum has a good suggestion for making that happen. You have POA, so legally, you can. I just don't know how you get her there.

I don't think that you've been enabling in the negative sense of the word. You've been managing your mum's health and daily living issues because of her declining condition. However, it is getting too much for you and will only get worse.

This is the usual pattern with caring for a loved one with a degenerative disease. The trick is knowing when to stop the hands-on caregiving and juggling of "sticking plaster" solutions and switching to some form of residential care.

You have POA, so make sure you know the conditions for when that comes into effect and what you need to do. It won't be easy, but you will be able to make decisions for your mum, such as her undergoing whatever necessary evaluation and moving into residential care. You can ask the facility about how to put this into effect when your mum is resistant.

I would never stop essential assistance. The shopping and help from aides are essential and should be paid for from her own money. I would limit your visits to once a week, though, if you're struggling. At the first sign of crisis, you evoke the POA/call emergency services/social services and get mum moved to a suitable facility.

I think most caregivers struggle with this stage - when to stop enabling someone to continue living at home and to take full control of where and how they live. It's rarely easy and it's often messy, even with POA.

My advice regarding the clutter, once Mum is out of her house, is to pay a professional company to sort it (out of your mum's own finances). You will be exhausted and in need of a break when you have finally managed to move your mum somewhere suitable; sorting out her clutter could prove way too much for you. It's the least important thing, so don't stress yourself over it. Also, you don't want it taking a whole year before you can sell the property to pay for your mum's care.

Speak to her doctor say another letter needed the wording is ambiguous and causing a lot of problems- your mother can’t look after herself and needs help and can he support something so that your mother understands that
You shd get health assessment done for home and it should show mother incapable and that sort matters out
Be prepared that an assessment may seem your mother fit
And you need to be prepared for that
re the dog
if your mother can’t look after the poor thing then maybe - only you know your mother say dog has to go to xxx as you cannot look after it - the law will come in
that can go two ways work or send her into depression
Only you know your mother to try that
maybe speak to care facility and arrange a visit
ask them if they can make tea and make her feel welcome
the stigma of going into a home is still around
maybe seeing it she will have a different view
are there any centres that allow dogs?
maybe your mother needs a budgie
Altho even that needs daily water change etc

Stop trying to speak to her with an impaired mind. Speak to the marketer, to schedule a luncheon at the same time you hire movers for just the essentials of her bedroom for now. Tell her you are taking her out for a special lunch, 90 min to 2 hours is a good amount of time, and before she is done make an excuse to the restroom or drop her to visit her brother. Give her 2 weeks to adjust on her own..
The marketers are familiar with this ploy. If she needs MC, all this including brother visit can occur in the facility.With incontinence she might be better in MC and staff can bring her there at the end of the visit. If she accuses you, let her know that the doctor will decide for her safety.

Take your mother to visit her brother. Pre-arrange an evaluation by "dropping by" the office to do some "business" or have lunch there. The person who will evaluate her should present herself while your mother is waiting for you or when you two are finished with the meal. Neither you nor she should use the word "evaluate"; the person should casually "visit" your mother while she is waiting or the meal is finished. The person could open the visit by stopping at a couple of tables within hearing distance to ask "How was your meal?" and therefore stop by your table next. The professionals are definitely familiar with your problem and can direct this approach properly or have better suggestions. Do NOT "help" your mother with answers during the visit. The employee needs to hear your mother's answers, not yours.

It's never too later to stop enabling. There are some very good answers here.

The very first answer stated "The social worker was willing to return in 2 weeks with “strong help” to physically remove my mother from her home and bring her to assisted living on an agreed date between the social worker and the facility."

You cannot "kidnap" an elderly person from their home and place them in a facility. As far as I know, we still live in a free United States of America. The elderly (even with cognitive issues) have the right to stay in their own home.

You stated "I have said this exact thing to her and her answer is ok, I'll just sit and wait to die here. I responded that it doesn't work that way."

Well, yes, it DOES work that way. You cannot force her out of her home. If, however, you get "the call" that she has fallen and was taken to the ER, THAT is a different story. At that point, you tell the discharge staff at the ER that she cannot safely be discharged to her home as she lives alone and you are an hour away from her. They will most definitely try high pressure tactics to get you to take her home with you, but you must be firm that she is unsafe at her home and you cannot take care of her.

This will then have the Social Worker (discharge coordinator) begin looking for a place to place her. AND JUST SO YOU KNOW - it may NOT be the same place where her brother resides. Nursing facilities have you fill out a "pre-qualification" questionnaire which requires you to disclose your mother's financials, whether she has a reverse mortgage or a reversible trust, etc. The nursing homes "decide" if your mother is a suitable financial candidate for them to accept her. If she can private pay for a couple of years before going on Medicaid, the "nicer" facilities may accept her. Otherwise she may be sent to a "not nice" facility. The nursing homes hold the power.

Social Workers do not discharge elderly patients to assisted living facilities. Only to nursing homes. And there are really no "nice" nursing homes. They are for profit facilities who are notoriously understaffed. If you think you can just put Mom in a nursing home and forget about her because you think she's in good hands and getting great care, you would be sorely mistaken. You still have to visit frequently to keep an eye on her care. Trust me on that fact.

Your only option at this point is waiting for "the call" - meaning some incident happened where an ER visit is warranted. Then go from there. You have determined your mother is not safe to live alone at home. You've done the right thing and gotten her an aide 2x a week. You say you do her grocery shopping and "do her meds". Does she safely cook for herself? Take her meds correctly? Is she showering? Can she dress herself? These are all ADLs (activities of daily living). You may have to hire a live-in caregiver as her dementia/Alzheimers gets worse (and it will). Her incapacity may take YEARS to develop into full blown Alzheimers, IF she even develops Alzheimer's. The neurologist should have explained to you that all Alzheimers patients have dementia BUT not all dementia patients will develop Alzheimers.

You're not "enabling" your Mom; you are arranging the care that she needs going forward. Every elderly person I know (including myself) wants to stay in their own home as long as possible. And that's their right. Wouldn't you? It's a conundrum to say the least. Start by telling your Mom that YOU need more help because you're an hour away and the traveling is getting too much for you. Tell her you will be hiring an aide to come more frequently (and use HER funds for this) to help her with her cooking and meds. Tell her if she insists on staying in her home, you will do everything possible (including using HER money) to make that happen. Many times, this pushes the elderly to "rethink" their living situation if they have to spend more of their $$ to stay at home.

Good luck and keep us posted.

This is in Canada. When my mother, who had early Vascular Dementia but was still very capable of living in an AL, threatened suicide I was told by the psychiatrist that she could be forcibly removed to a geriatric psychiatric hospital, as she was a danger to herself. As it happened mother agreed to go voluntarily. If she hadn't they would have taken her against her will.
I was totally in agreement with this. She had refused to take the meds that would have helped her and needed more care.

It took 9 months in this facility for her to start taking her meds, at which point she was placed in an AL which was specialized for patients with mental health issues as well as dementias. It worked very well for her, I was greatly relieved to see the difference in her once she started taking the meds.

There may be something similar in the US.

I know of posters here who have essentially kidnapped their parent with dementia to get them into a safe environment as the parent did not want to move, but was not safe at home. I would not want it on my conscience to leave a demented parent at home because that was where they wanted to be, and then have them injured or die from a fire or other accident they caused. It's a matter of wants vs needs. No one always gets what they want in life.

I’m afraid if you back off completely and something happens to Mom you will suffer regret terribly. My Mom always says have no regrets. But then i think if you stop completely but still keep an eye on her- maybe she will realize she needs help since you’ve been doing everything for her. Not very solid advice I know. Maybe cut back a little at a time ? Not much help. God bless

This whole thing about killing themselves really triggered me and not in a good way.
My father is 95, has mid-dementia and lives on his own with my help. He started talking about suicide whenever I asked him about going into AL, and I knew this was a tactic, so I raised my voice slightly and said
"Are you listening to me? I need you to listen to me really carefully. Do you remember how you felt when you heard [Grandson 1] killed himself? Do you remember how sick you felt? How you cried? Just imagine how it makes ME feel when you TALK about doing it to yourself. You DO NOT have the right to put me through this."
And next time I took him to the doctors I told the doctor what my father had said. Dad said "I didn't". I said, "You did. Don't lie"
Haven't heard it since.

Withdraw vs support.
This is tricky.

Step back with love aka *Tough Love*?

But, importantly, *First, do no harm*.

🤔 I would love to sit & discuss this over coffee with you. Explore just what can be done - to change this - but in a safe way.

LBlondie12: Cease enabling.

Ok. Some initial thoughts..

Work behind the scenes.

"I have found a place that I like and her brother is already there."

Good. Visit, get the brochures, meet the Manager. Ask if they have short-term Respite Care.

*Respite Care can be very useful! *
Find out if this is an available option. If YES, we can come back to that with a plan 😀

Next, seek independant financial advice. If funds allow & happy with the place, contract etc, complete the paperwork for as pending or waitlist.

Is this AL near you? Would be easy to take Mom for a visit to see her brother? Have a nice visit, lunch, coffee...? But then again, I dunno.. that could backfire.. She may look for faults, not like the coffee, the furniture, meet a less than smiley staff member..

I think you need to take the reins and tell her what she will be doing now. You wouldn't let a toddler dictate what they will and won't be doing. This situation is pretty much the same. You have POA. It is time to use it.

If she isn't already she will become a danger to herself and to others. What happens if she sets her house on fire?

It's hard but you need to do what is best for her. She needs to be kept safe and probably should no longer be living alone already now.

It sounds like a great idea to place her in her brother's facility.

I might add you already have a doctors' note confirming that she has dementia and he recommended that she go into AL. So you have all the ammunition you need to act.

Start moving forward with a plan now. Good luck!

The reality is that your M is coping just fine with all the support you are giving, and she has no need or incentive to change. ‘Backing off entirely’ will change things, but it’s a bit cruel. What you can do is to work out a few things that she likes but that are not essential, and stop them. Tell her it’s all become too much for you to cope with, and if she wants all the extras that she enjoys, she will need to follow a different course. EG Arrange her own grocery deliveries, get uba to take her to doctors appointments, and send the dog off to a shelter. That will be a big shock. If you can do this (even for a couple of weeks) it may change the conversation that you really need to have.

The reality is that your M is coping just fine with all the support you are giving, and she has no need or incentive to change. ‘Backing off entirely’ will change things, but it’s a bit cruel. What you can do is to work out a few things that she likes but that are not essential, and stop them, perhaps one by one. Tell her it’s all become too much for you to cope with, and if she wants all the extras that she enjoys, she will need to follow a different course. EG Arrange her own grocery deliveries, get uba to take her to doctors appointments, and send the dog off to a shelter. That will be a big shock. If you can do this (even for a couple of weeks) it may change the conversation that you really need to have.