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Mom and Dad live at home. Mom is 82, Dad is 87. She has always badgered him but it has become severe. She rages for hours at a time, then acts like it did not happen. No remorse. She will NOT see any doctors - they do not know anything. Her decision making is poor but she still drives. She recently announced she needs to move back to the area she lived until about age 50, 500 miles from where they are now. She says she won't go unless Dad does, or until he passes. She fantasizes about how her old friends want to be with her. We want to move her back there to an IL with memory care. Planning it now and want to send her off within 24 hours of telling her. Are going to approach it in a positive spin, that we are honoring her wishes and getting her there while she is still able. Dad wants to stay home and is perfectly able now.

Dad is very fearful of her and that she will go into a rage at him if we drop it on her.

Reading a lot on this site about her rights, but what about his to live the rest of his life without the abuse? Should we file a complaint with Adult Protective against her first? We just want to peacefully separate them and think we can convince her to go. We just don't think giving her a lot of time is wise - we would have to remove him from the home temporarily if we do.

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I know a couple that was married for at least 40 yrs...they couldn't stand each other. In their early 70's the wife moved out...and...about 4 or 5 months later...they moved back in with each other because they were sooo afraid to be alone!!! Now they are much nicer together and living just fine. Like I said...you never know...a temp moving apart is a good start. Please keep us posted.
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"She says she won't go unless Dad does, or passes." There is the entire story right there. Give them some temporary time apart, keep assessing the situation, separate them if they are going to hurt each other. Increase visits, make them unannounced. Find out what Mom really wants. Since we all don't get what we want all the time, make some adjustments so each has a little of what they want. This can be changed if we don't panic. What do you think, about now? Would like to hear back if you have a solution so I can help someone else. This is harder on you when it is your own parents. Take people with you to their house.
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The frail father: Is there a chance he could be partly causing the mom to get upset? Of course, her raging is abuse, but if it is dementia and cannot be helped, isn't it important to get her the medication to cope?

What about a closer look at the father's needs. Some couples are negatively bonded and would suffer if apart from each other for too long. Maybe he needs to go to a temporary home apart from her, see if she gets better. I do agree, something needs to be done. The couple we know are still together after 4 years, since knowing about this. No one acted on the nuclear option when the wife wanted to return to her homeland. I was amazed this could go on, and they really did not need rescuing. Just something to consider. Has anyone asked the mother what she is upset about? Trying not to take sides here.
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Yes, lifeexperiences, that is it. Once she gets to IL, she won't know she is there anyway. Make it easy on the rest of the family.
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I just thought of something...why don't you move her out somewhere near you as a temporary thing? You never know how people will adapt until you do something about it. Sometimes living in the future is just that...you never know. Please let us know what you do. Goooood luck/1
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Your mom will find when she gets "back home" nothing is the same, most or all her friends are gone or in a home themselves. I agree she needs anti-depressants, and soon. I would tell my mom we are going to the store and I would take her to a doctor. I took mom to a neurologist who ordered a CT scan and he confirmed the ALZ. Had to explain to her over and over why I took her to a new doctor, but the diagnoses was a confirmation of my fears for her.
I agree that you dont want her and/or your dad 500 miles away. Their need for assistance will get worse, not better. Hope everything works out for you.
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Experienced staff in dementia AL would say: TELL her she is going to IL, TAKE her close by. This was VERY hard for me to accept but I have come to rely on the fact that my mother is good with the present moment only. If it sounds like what she wants, that is fine with her. (That is the meds helping her to be calm) Then she forgets. For example, she told me she wanted a phone (long story) and I said, "shall I look into that?' "yes," she said and was perfectly content. I never did, never had any intention of doing so. She never mentioned it again. Laura Butler is right. Sometimes this kind of "trickery" is actually the most humane--and safest for everyone.
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I'm glad that there is a brother living near the IL near where you plan to move mom. Is he on board with her being his responsibility once she gets there? As her dementia progresses (and she probably does have dementia/mental illness) she will needs more hands on care, even if she's in a facility.

If my memory serves, my mother had to have a complete workup before going to IzL, including TB test. Something to plan for.
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Wow...this is a h*ll of a problem...and god bless you father that he has to live in that h*ll house!! Yes, move her out...or move him out...just move them away from each other. Move them closer to home until you observe them both apart...you really don't know for sure until that happens. He deserves to die in peace...one piece!

Please let us know the outcome!!!
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It sounds as though your mother is an abuser and you are grasping a straws. I support you in separating them. Your dad deserves to live out the rest of his life in peace. Moving her 500 miles is a bit radical. Is there anyone there who would take responsibility for her? Can she go into AL rather than nursing home care? I would guess that your mother will be ready to come back home soon, when she realizes that nobody there cares a whit about her. What then? Are you relegating her to her end days with no loved ones present? How will you and your dad feel about that in the long run? Some assisted living facilities have a trial period. My aunt and uncle took an apartment for 6 months. could you do that?
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UTI's if not treated can lead to sepsis, very very serious. Very difficult to treat.
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I would not use an OTC drug for a UTI. These are very serious in the elderly and need antibiotics. She really needs to be evaluated in a hospital. It was said she raged before its worse. People like this seem to have more strength and could seriously hurt her husband. Next time she rages and can't be controlled call the police. They will take her to a hospital to be evaluated. This will be the easiest way to get her in home. The man my be afraid of her. Give him a break.
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CFCRochester is quite right.....My husband's Mom has always had an attitude personality most her life, as no one is more important than her, regardless of who crossed her path.....A personality that surmounted, with an added diagnosis of early stage demensia.....additionally progressive upon falling from drinking, and breaking her neck...twice....with also history of 4 mini-strokes, 2 mild heartattacks, and April 2014, having to have a smaller stent put inside an existing stent. Yes, all be it a miracle she is alive and 80th B-Day celebrated this past Saturday. I add all this to say, while being independent at her own home, until May of 2014....she would go into rages so harsh, she would growl like a wild animal and literal horror in her eyes....I kid you not. My husband called he Dr. and told him he had to do something....we could not handle her, and home aid nurses witness these fits. He gave us samples of Cymbalta 30Mg. to try as one a day. This worked some seemingly, yet she still would go into either angry fits hitting her tight fist on her own leg....or....hard crying fits. Then he increased the Cymbalta to 60Mg. once a day.....this got MUCH more balance to her overall. We had no choice, for her safety, after the stent implant to get her into a long term care facility. The first doctor there that was seeing her, after a few months, for no known reason, took her off the Cymbalta....it was two months before we became aware that Mom was again having fits and rages. I was moved within, to ask the head nurse if she was still getting her Cymbalta 60 Mg. daily? Mom had been on the Cymbalta for over a year and a half....the Dr. took her off cold turkey...a big no no medically. My husband contacted her Social Worker, who nicely informed us we could switch her doctor if we wanted to, and she went further in taking quick measures to get Mom back on the daily Cymbalta. Mom showed restored balance within the first week being back on it. So much so, that she has begun to help put nail polishing on some of the other residents for them. So consider asking her physician to atleast try this, in the same process as was done with Mom. It's worth a try, including, for your Dad's comfort in possibly having some late good moments around her, with her. DO consider NOT having her driving anymore. Mom drove until one day, because of the demensia, she did not know where she was, and how to get back home....it scaared her, and she never drove again....that was about 2 years before she broke her neck.....Ihope this helps you, and others too. God Bless....Carlena/FL
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I feel sorry for your father because I go through the same abuse. I took my husband to the doctor and a visiting nurse came. He was found, they said, early stages of alzheimiers or it could be depression. Either way he refused medication and I found his doctor totally patronizing. He said this is only here say. He does not live with him. Sometimes you have to put a white like out there to get them to the doctor's like if you don't go to the doctor's you will lose your hospitalization. I told my husband it was a follow up visit and the doctor called me. He has been trying to be decent but it is not working. Good Luck I certainly feel for all of you involved. Someone that is stubborn is hard to deal with.
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Tell her that the facility in IL requires a physical checkup before they can admit her!
But it's pretty common that she doesn't want to go "back home" as it is now, but what it was when she was younger. It's going to be very disappointing (and she may not believe it's the same place.). That might make her even worse, as she's lost the "roots".
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Wow---Ship her 500 miles away, to elder care there?
Despite the rationale used, which sounds good....She's /not/ in her right mind; she is a frail elder.
It might seem like a good idea to ship her where she /thinks/ she wants to go; but it won't look like what she remembers. She'd be in a strange elder care facility, in a strange place that appears different from what she remembers, with few people she knows.
She's been in her current location for the years.
Would she settle for an alternate solution to the grave-site visit, and burial? What if she has photos of the graves? What about helping her Skype with the few at the old place whip can? What about promising to bury her with family at the old place?
Elders often go through episodes where old memories are so VERY vivid to them; compared with more recent ones, those old memories seem real and, they want to return to that reality, because they understand they were 'more of themselves' then and there.
--- Except, no one can go back in that way.
Thinking she can go back to some place/people she liked when she was younger, is delusional. It's a form of trying to escape current conditions. Demented persons, at some level, understand things are going haywire; they don't like it, but can't stop it. The mental/emotional 'solution', they think, is to try to return to a time/place when these mental problems weren't happening.

If you call APS first, it could move things along faster maybe, but maybe not in ways that are best for her and family.
They might do one of a few things, including removing Mom from her home to a facility [if there's a bed open]; might remove Dad to elsewhere; might accuse the wrong person of elder abuse instead of Mom [especially if she's great at "show-timing"].
Bottom line: Mom needs a Doc to check for physical ills, determine her mental state, and see how far has dementia progressed.
IF nothing else works to trick her to see Docs, or if the Docs are not listening to your descriptions of her behaviors, you might have to call the hospital to ask what the procedure is, to get her brought to hospital on a "51-50" [72-hour mental health evaluation/watch]
KEY WORDS: "Mom has become a danger to herself or my Dad". Be prepared to describe how she is a danger to herself and your Dad. If she is potentially a danger to anyone else, say so.

Moving her to a proper level of care facility /nearby/ is more appropriate.
But, must have Doc evaluation to do that, too.

If a UTI that's causing this behavior, could she have had a history or them all along, that never got treated? You say she has not been nice to Dad, for years...was she disagreeable to others? Just within family or to anyone else?
Does Mom even have a Doc she has seen, even years ago?
Or does she need to re-establish with a new one? [[If so, need to choose one that's good at Elder Care!]]

Several suggestions others listed, seem safer, saner, more realistic, despite her wanting to go 500 miles away, and despite there being seemingly good connections there.

====== Call your her local Area Agency on Aging--some of these offices have various names, but Agencies that help family caregivers and elders, get helps they need.
NOTE: Please give the worker a printed/written list of behaviors and cues--some of these people are not that observant, and, they really wait far too long into dementia, to start documenting that something's wrong--if you give them a concise list of her behaviors, it might help the worker do their job better.
They should be able to send a social worker or RN to come to the house, to do a longer-than normal observation---/more than 2 hours/, for some elders....
.......My Mom could maintain a "nice" personality for almost 2 hours, then took a breather-break to her room in order to collect herself, then returned in about 15 or 20 minutes, again able to fool people into thinking she's fine.

====== IF you have not done so already, start making "well-check" call requests to 911 for a well-check on Dad, because of Mom's behaviors.
OR, You and/or your Dad can call 911 to report Mom is raging, help is needed;
.....police MUST write a report for all 911 calls--this is a paper trail which could help getting a Doc to make a determination; often, they are unwilling to pronounce dementia on someone who can still drive a car and make it back home.

====== Should Mom still be driving a car?
======Having trouble figuring how to prevent her driving?
======Does she have others who can give her rides where she needs to run errands?
----Uncle finally told G'ma, her driver's license had to be renewed, and that she had to take a drivers test. ---THEN, he called their local Licensing department, gave them a heads-up on G'ma, that she was unfit to drive, been getting lost/confused, and that they needed to make absolutely sure she Flunked her driver's tests! They were great. Of course, she flunked! ----That way, instead of barking at Uncle for preventing her driving, she barked at the licensing bureau. Worked much nicer that way.
Of course, she was compliant with not driving, because an authority figure had taken that away from her.
---- SOME elders insist on keeping driving until they catastrophically stop...those are harder to stop, without taking the car, the keys, and blocking any access to a vehicle they might try to drive. Similar with weapons/guns some have.

====== Tell Mom: "It's required for you to get a Doctor check-up every year; you haven't had one in a very long time; you have a Doc appointment scheduled for [date/time]".
Also tell her:
"Insurance refuses to cover medical treatment unless you have a Primary Care Doctor; it's just a check-up, so the Doc[s] can meet you, so you are familiar with them IF you need to see them, later".
----IMPORTANT: Write up a concise list of one-liner's, of Mom's behaviors and the impact on Dad. Docs /depend/ on other witnesses to the patient's behaviors, unless the patient is so 'over-the-top-they-can't-miss-it'. List her behaviors, your concerns, Dad's concerns. Give the list to the Doc's nurse/staff, "to enter it in Mom'd file so the Doc is aware; we don't want to forget to inform him of things".
======Do you think she might not go to the Doc's office, if she has advanced notice? You will need to use subterfuge!
-----Tell her you are taking her [[somewhere she likes]]; give enough time ahead for stalling, yet still be on time.
Tell her you need to make one or two stops along the way. I have gone so far as to tell my Mom that I needed to stop at the clinic or Doc's office, to check on something for myself, or pick up something for someone else I was helping...it seemed to work, at least once.
------IF she gets there, then refuses to get out of car?
You call Doc's office on your cell phone; tell them "the patient refuses to get out of the car; she's been having rage episodes that might be due to a UTI; she must get to this appointment; could they please send someone to help you bring her in for the Doc to see her?" --- Often, the elder will hear that, and suddenly choose to go ahead in, to save embarrassment!

=== If that doesn't work to get her to a Doc, call 911; ask them to "help get Mom to see the Doc"; that you "do not know what to do to get Mom the help she needs"; that you are "very concerned for your Dad's safety".
They might have other suggestions or referrals...but...
They might send an ambulance and haul her to the E.R.
IF they do that, encourage them keep her there!
IF Mom somehow ends up in the Hospital for anything, encourage them to keep her there!
Do /NOT/ let the hospital, or E.R., push you into taking her home.
Mom sounds like she's unsafe on her own, and Dad is unsafe with her there. You Likely cannot have her in your home, because [pick some]....there is no room; or, there are kids; or, you are too sick yourself to properly care for her.
----IF you take her in, you are stuck with her and her behaviors, which will get worse--can you really handle it?
Once in your home, facilities can and /DO/, refuse admittance...you are stuck.
Most facilities and many professionals, do anything they can, to prevent having to get stuck caring for patients who act-out badly......I've seen what gets done from the facility's side, and from the caregiver side, to avoid taking in more patients with behavior issues.
You are in a position to advocate strongly for the health and welfare of your Mom and Dad. Part of that, is sometimes having to get-in-their-faces about doing their jobs in taking proper safe care of an elder, instead of foisting it back on those who no longer can do it.
If you prevent the Hospital sending her home, they must find her a facility--even if it's for longer observation.
IF they give you too much trouble about it, call APS on the hospital; report them trying to abandon a frail elder who is no longer safe on their own, or may be a danger to her frail elderly spouse because of her behaviors.

IF your plans to move Mom 500 miles away do work out, and things go as planned, that would be a nice thing for Mom...but imho, it will not guarantee her behavior would be any better. She would likely still rage, still act-out.
IS your Brother good at dealing with her?
Or, is he likely to stop visiting because of the stress of dealing with her?
Does she have at least several friends who really will visit her?
Or, will she end up mostly spending every day in the facility, alone?
If she was in a Facility nearer you, would you be visiting her more often?
If she was in facility nearer you, would Dad visit her at all? Would he want to?
If she's in a facility near you, and Dad starts feeling better for it on his own, might he want to visit her sometimes? He can't do that if she's 500 miles away.
IF she's placed in a closer facility, she's away from Dad, keeping him safer, sooner maybe...and IF Dad wants no part of her after a few months alone, Mom could always be moved from one facility to one 500 miles away, later.

Sure hope you can get her to the Doctor.
IF not, please try some of the alternatives one can use at home, to help her body be healthier, and maybe fight off a UTI.
But please, still call people for help dealing with this. It sounds like Dad needs respite, sooner than later.
Keep us posted!
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Thank you all for your helpful comments, suggestions and support. To clarify - our Brother does live in the location where Mom has said she wants to end up. It is the area she grew up and lived for over 50 years, and where all of her family is buried. She has been talking alot about her Dad, and wants to be able to visit his grave. She also has some old friends in the area, that she thinks she will see. One is younger, Mom calls her "her other daughter". She would live very close by. Mom spoke to her on the phone about moving there when Dad is gone. We just want to move up the timeline to protect Dad. One reason for the distance is so she cannot just move back in with Dad to continue the abuse.

Dad will be living in his home, with help from one daughter and a grandaughter who will move in if he needs more help.

We will try very hard to get her to a doctor.
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You have gotten some very good advice, comments from others. Do what you think is best, knowing what you know about your mother and your father. I just wanted to write to let you know what you are experiencing is not uncommon and I think some separation between the two of them wouldn't be a bad idea. I know of people whom were separated by living location, due to temper tantrums of one of the people, and it worked for them. Their lives were probably better for it.

I have also seen, with my own parents, that if they are not separated or given some time away from one another at the least, it can lead to abuse...both verbal and physical.

So, in your case, I agree the two need to have space between them. Whether it is 500 miles...I don't know. Sounds extreme and problematic. Perhaps you should consult with an elder care organization or expert, if available locally.

I wish you and your family...peace.
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Oh, how I wish it were so simple to get raging parents away from each other. Mine both rage at each other almost constantly. Being around them is H*ll. Shipping one of them off to a far away place, however, is not an option, although I would definitely separate them locally if I could. Unfortunately, they both refuse to leave their house, and apparently they are allowed to make their own decisions, no matter how unwise and unsafe they are. POA... pffftt.. means nothing until they're drooling and can't feed or bathe themselves...
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Your mother must be evaluated by a DR. For her own good.I think filming her on action is a good idea.if her Dr. Does not respond to this find another Dr.!
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Seek professional help~call adult protective services in your area.
I did not read anything but your question. Call ADPS ASAP.
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Somebody in the family's got to be willing and able to stand up to this octogenerian. Helloooo? Anyone?? Oh, and by the way, that'd be standing up to BOTH of them.

As a perquisite to moving where she'd like to move, she goes to the doctor for a complete and thorough check up. Someone in the family takes dad into their home to get him away from any acting out mom may do -- they BOTH get to see what living apart is going to mean.

Forget honoring her wishes to move her 500 miles away to a memory care unit. Move her into a memory care unit wherever it is most convenient for the rest of the family. You say she has dementia and you're letting her tell YOU where she's going to live? You need to rethink your plan.
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I hope you have a POA. I have heard that the family chooses an assisted living situation, moves some of Demenia patient's furniture and pictures in beforehand and says, "let's look at some apartments." As soon as the staff member arrives to meet them she engages them and starts down the hall, the family member leaves quietly for a vague reason like the bathroom. This not the way you woul hope it happens, but may be the only way.
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I agree with Countrymouse. I am always amazed that people seem more willing to pick the extreme option rather than tackle the smaller things that may offer a solution.

1/ How can you plan to get her unannounced into a car and drive? 500 miles while she rages against you, yet you won't force her to the ER or a doctor?
2/ If you plan to offer care to both parents, but they are now separated by a vast distance... how is that going to work, or are you planning to wash your hands of Mom altogether?
3/ Your Dad is being a little passive aggressive himself... it is always so much easier to fix the other person than make changes ourselves. While I sympathize with his desire to be free of her rages, Dad will probably need to move into assisted living himself after she is gone. Why not make the move now, even just for a respite stay? His options would be seem much clearer once they are apart.

As for the idea you are honouring her wishes, it is "eyewash" indeed! Giving into irrational behavior and delusions is not honouring anything, it is running away from the responsibility to get things under control.
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You may want to think twice about moving your mother 500 miles away from her family members. Most people I know and read about move their parents to facilities closer to them. It's much easier to help provide care, support, talk one-on-one to the facility staff and doctors and see for yourself the needs of your elderly parent.
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Um. You're moving your mother permanently 500 miles away from her 87 year old husband? Gosh.

Do any other family members live near this ILF?

It isn't the moving her to a facility, or the extracting her from your poor father's daily life, that I'm querying. It's just that unless he really wants never to see her again, or not much anyway, that sounds like an awfully long way. Absence does make the heart grow fonder, after all, and should he begin to miss her you could end up with the ghastly outcome that over time he forgets all the abuse and moves there to be with her. Is there no suitable facility within reasonable, regular visiting distance?

The "spin" - your word, not mine - that you're honouring her wishes in the choice of area is actually total eyewash, isn't it. As you say, you're relying on the sudden recent announcement of a person whom you know is a) indulging in fantasy and b) completely losing the plot, what with her lengthening rages and verbal assaults on your father.

In any case, to move your mother without her fully informed consent the family will have to establish that she has lost capacity and then either exercise power of attorney, assuming you have it, or apply for guardianship. If you really can't get her to her doctor, then you could try recording episodes and showing them to her doctor with a request that he come and evaluate her.

I understand and am sorry for your father's fear of your mother's reaction to being separated from him; but she is eventually going to find out! So, again, unless he plans never to cross her path in the future he will at some point have to hear her view of the matter. His degree of fearfulness seems quite extreme: is he afraid for his personal safety, or just worn down with being yelled at?
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I am concerned about the fact that your Mom always badgered your Dad and that it now has gotten worse.
I think they both need a physical and perhaps a neuro-psychological evaluation. I wouldn't take your Dad's word for Mom's behavior from 500 miles away.When my husband became rageful it was so against his normal personality, but as his wife, I was not able to see his behavior as illness. I was first so angry and hurt. I detailed the progress of my changes in a book called Put That Knife Away. It may be helpful for you to read it.
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Somehow you need to get her to the doctor for a diagnosis. Rages are common with urinary tract infections and frontal temporal lobe dementia. Perhaps she has had mini strokes? To move her to assisted living she will need to provide doctor's orders partially to determine level of care that she will need. Moving her 500 miles away from dad sounds extreme. How often will he want to see her if she is moved? Then what?

If moved the rages may very well continue. Is there family nearby to assist when mom has an emergency? Assisted living in my area is not permitted by their license to administer meds that are prescribed as needed, all meds need a regular schedule.

I understand that you need to protect your dad and I am sure her rages frighten him. She needs to be checked out by a doctor to determine if there is a medical reason for them. If moved she is to assisted living you need to have her examined. You will find out very quickly how badly she really wants to move if she has to see a doctor first.
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If the reason is not a UTI or other physical reason, know that psychotropic drugs have side effects such as much higher risk for falling. What I found to help control my mother's behavior is take her for DAILY walks in the park. Even just a few minutes a day. It effectively helps reduce the amounts of falling. She uses her walker, but we do it daily like clockwork weather permitting. If it rains when it stops we go! I also give her a cup of cocoa every single day. For some reason I noticed she's better. It takes about two weeks but it does help her a lot.
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Yes, dementia is a very strange world. And sounds like your family physician is a real good place to start. She needs some good drugs. The problem is, she probably knows all this, and the anxiety this is causing is pushing her to do things she would not normally do. Anti anxiety meds will calm her down. But as people with dementia age, many times its never their best qualities that are enhanced :-) Good Luck!
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