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How to get her to accept other help. She's nice to me, but goes off the chain when I'm gone. Hateful, won't take meds.

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Emily, there is no way that you can convince your Mom to accept outside help.

My own Mom was that way. I tried the caregiving route per my Mom's doctor's request. No way, no how would my Mom allow anyone to be in her house, especially in her kitchen. The first night, the caregiver prepared a meal for my parents and when the caregiver served Dad his bowl, my Mom grabbed the bowl from my Dad and dumped it in the trash. Oh dear, we have a problem in the room.  The caregivers were fired on day 3.

What I had to do was what many grown children had to do, wait for an emergency. Like a serious fall or serious illness, call 911, Mom goes to the hospital, then to Rehab, then into Assisted Living if she can budget for the cost, or go into a skilled nursing home.

Because my Mom was so darn stubborn, she wound up in long-term-care after a fall that had a serious head trauma. No way could she now live at home. If only she would have accepted the caregivers. This was Mom's second serious fall, both times she was in the kitchen making lunch.
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By the time our parents reach (really) old age, they have a whole big history and lots and lots of baggage, medical and mental. Like ff, my mom sure did. She lived to be 95. She had so many delusions, phobias and just downright strange behaviors I gave up trying to figure them out. Some of them, like her abject fear of men, I didn’t WANT to know the reasons behind. I did, however, put my foot down on occasion with my Mom. Her subject du jour was usually sex. Once when I’d had enough, I looked straight at her and said, “Mom, be a lady! Ladies don’t say things like that!” She toned it down after that but it never completely went away.

Like frequentflyer says there is no way you’re going to change Mom now. What she is, she will stay. Unless she is in a facility, supervised by a medical staff, she won’t take her meds and will continue to be, as you say, “hateful”. I’m afraid anyone you hire will probably quit, and if there are family members who are charged with caregiving for her, she will alienate them. It might be time to rethink caring for her at home.
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