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My mom is 84 with end stage COPD and is getting ready to head back to AL after a hospital stay and 4 weeks of rehab. I’m cautiously optimistic that she will be able to stay but she has declined a lot on the past 6 months.


While she does not live with me, I am her primary/really only support and I’m just worn out as I have 3 children, 23, 13 + 10 and work full time at a demanding stressful job and have a million other things going on.


My FIL is up visiting and we had a long chat about my situation as he cared for my late MIL who suffered dementia and numerous health problems for over 10 years. He told me the best decision he ever made, and one he wished he had made sooner was to just stop pushing and controlling and to just love her. If she didn’t want to get up and walk he didn’t make her - If she wanted to sleep he let her sleep - if she didn't want to do her whole breathing treatment he suggested gently and then backed away.


It made me think a lot - I DO push my mom. I get upset with her when she doesn’t want to finish her nebulizer or do her PT or walk to the bathroom when I think she can and know she has to do that to get back to AL. I guess I think I’m helping her but when I really think about it, I get stressed out that she’s not listening and then she gets upset and defensive and upset with me because she’s tired and it makes for a miserable visit.


I guess I think if I don’t push her I’m not taking good care of her as she has cognitive decline and doesn’t remember or process things she needs to do.


While she is ‘end stage’, on O2 24/7 she says she’s not ready, so I feel like I should push her ... but maybe not? Maybe I’d back off and just focus on her being happy that is better? Does that make sense?

I have to ask what do you want to remember in her final weeks, months, years you pushing mom to do things or just being with mom whatever that is?

My mother has CHF, Afid, VaD and I let her eat what she wants and sleep as much as she wants because I know it is hard for her to do things. She is not a big woman but her heart can not pump O2 throughout her body which in turn makes her tried easily. However, she has told me that she was done with this life and her last wish is to go to Toledo Zoo so that is where I am taking her on my dad's birthday.

I think this is a very personal decision and only you know what is best for your mom & you.

To answer your question yes it makes perfect sense.
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Reply to Shell38314
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It's a tough balancing act. I don't know when to think it's "ok" to just let whatever happens, happen? Is she able to make decisions and really understand the impact of choosing not to do things to help herself to live a better life?

I feel like I'm very often giving my mom suggestions and pushing her to do what she can. I feel like the less you do, the less you can do. At some point, it certainly is time to give in and just let them be comfortable, when the end is near and there is no hope of improvement.

There are few easy choices for caregivers.
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Reply to againx100
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Can you have a conversation with your Mum and ask her, ‘Mum does it help when I remind you to complete your nebulizer treatment or Pat? Or would you rather let nature take its course?’
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Reply to Tothill
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I agree with Shell. She is 84 with a problem that tires her out. I wouldn't push her. Be there for her. Let the staff do their jobs.
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Reply to JoAnn29
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If you read the book “Being Mortal. Medicine and What Matters in the End” by Atul Gawande you learn that there reaches a point where we can get caught up in the treatments to no different end and miss out on living life ALL the Way To the End.
There are five questions we need to ask our loved ones to help them sort out what’s important to them to complete their lives.
Tte book is great but you can also google Atul Gawande and learn a lot.
Here is a link to one of his interviews. You’ll want to discover what Dr Gawande has to teach all of us.
https://www.nextavenue.org/atul-gawandes-5-questions-ask-lifes-end/
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Reply to 97yroldmom
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My MIL had lots of physical problems that made everyday tasks hard for her when she lived with us. My husband and I would push her to do what she could/when she could (mostly making her lunch while we were at work) but it was always a balancing act. Sometimes we got it wrong and pushed her too hard (asking her to walk 15 feet to the car instead of trying to get her oversized wheelchair through the door to get her the same distance).

After she died, a cardiac care nurse referred to people in her condition as "cardiac cripples." That term put it in perspective and I wish I had been more compassionate when she said she was tired.

Hygiene was an issue. She wouldn't let anyone help her take a shower but she would let me wash her hair in the sink. There were times when I would offer to wash it over multiple days and she would continuously refuse. I finally came to the "three strikes and I'm out" mindset. If I offered help three times and was met with "no" each time, then I stopped asking. When she was ready, she would ask me for the help.

Like everything in caregiving, there's isn't one answer to every situation. We are all doing the best we can on any given day.
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Reply to metoo111
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Tiger55 May 22, 2019
Wow, I learned something important here from 'meto111'. ["...a cardiac care nurse referred to people in her condition as "cardiac cripples." That term put it in perspective and I wish I had been more compassionate when she said she was tired.]  It's shocking that I had not thought of that, (cuz I blamed the anti anxiety med that my mother took, for her tiredness). It was finally revealed in a chest xray recently that she needed a diuretic for chf. So sad, & complex.
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You're doing a great job for your mom, & it's true we have to adjust our approach sometimes. Recently my mom had sudden change in strength (after a hospital stay), & I understand your dilemma. Can your mom discuss her desires with you? (I mean, about doing the 'work' to return to her ALF?) If your mom has lost some cognition, I don't think she can help you understand what's best anymore. The social worker at our ALF was wonderful at interviewing my mom to gain the insights I needed. (P.T. & O.T. helped me know how my mom struggled, & whether my hopes 4her were unrealistic). I hope those professionals at your mom's rehab can help you feel good about your goals.✌God bless you.
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Reply to Tiger55
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It makes a great deal of sense. It is hard, though. I was the second most often visitor to Mom in the SNF and between her first, my younger brother, we pushed her to try to stand again. At 87, we had hopes at first SNF admission that she'd be like others in her unit and gather strength to stand for transfers. Though there were three people surrounding her in her attempts, her fear of falling got the better of her and she quit trying. Poor lady, we even tried braces for her legs to straighten the curl so she could attempt standing. This went on for another six months or so and we accepted the inevitable. She just wanted to be left alone.

Best wishes to you.
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Reply to pronker
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I’ve definitely reached the point with my dad in the last year where I no longer push, and have asked relatives to do the same. In reality all the pushing, encouraging, cajoling, was getting dad nowhere. Finally accepted that he is who he is, and is where he is, there is no better. There was no reason not to enjoy the time with him, accept his choices, and rest in the knowledge that life will end for him at some point, as it will for us all, and it will have been a good one. I’d think if you decide to do the same your relationship with your mom will flourish, the stress will ease, and you’ll both be more peaceful
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Reply to Daughterof1930
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There is a difference between
pushing and encouraging
pushing and supporting
and
Backing off and giving up.
Let her call some of the shots. (If they are not "critical")
Let her decide when it is "time"
Support her.
Reassure her that you will be alright with any decision she makes.
It is difficult to realize that we are all going to die. But it is harder when someone is closer to the end of life. But the feelings we often have are more for ourselves than the person that is near the end of life. Often they have fought a long tough battle and are tired. And all we can think about is how much we are going to miss them, that we are "giving up" if we "let them die". This is selfish on our part.
So all you can do is support. And supporting is not giving up.
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Reply to Grandma1954
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