Mom in NC Lives alone, limited mobility, some in home services, turning 91. Fell (again) hospitalized. Can afford assisted living, refuses.

I wouldn't want to go back either. Unfortunately, mom has the right to make her own bad decisions on where she lives. Often there has to be a major health related event to be able to force a move. What will help is if you stop rescuing her. Put your foot down, tell her you will not make these trips to help. There are other resources that she can find the social worker at the hospital may be able to help her. Or get her a geriatric care manager to help so you don't have to. Boundaries!

I agree.

"I can't possibly do that, Mom", is a good way to put it.

Sometimes I call this "enabling the illusion of independence".

Your mother is clearly failing at living independently if she has recurring bedbug problems. Her home is no longer a safe place for her to live. Let the discharge folks do their work.

If she leaves rehab AMA, they will probably call APS. But as stated above, if she is of sound mind, she is allowed to make bad decisions.

But that doesn't mean you have to support them.

Completely understand covid19 precautions. Neither one of you want to be exposed. Have you spoken with the hospital social worker? Is mom's nurse willing to tell them mom is no longer safe at home too and should really be in assisted living? This may be what balances the scales in favor of placement. Has she been evaluated for cognitive decline? Show time annie may have you all fooled. Make them aware mom is not safe in her own home any longer and you have no intention of moving her to your home. Being that she is a major fall risk and has physical problems concerning mobility it puts her at even greater risk. What happens if she needs to exit her home quickly and falls again, it could be a deadly situation. Ask the nurses to inform doc that you would appreciate it if they could give her a cognitive decline assessment may solve your problem and answer a few questions about how she makes decisions 🤷‍♀️ she could be show timing, my MIL was one of the best around and had her hospice nurse and social worker fooled for a little while, they can not keep it up very long tho and it will begin to shine thru. IE, oh they were gone for a week while xyz were here, my reply was it probably seemed like a week to her, ya, it was only 4 or 5 days, in all actuality it was overnight, we were home by 830 am. Time has a way of being exaggerated. I just did this exercise, um yesterday not today, need to do them today too. She may not like pt because she needs to do it and has no control over when, interrupts her favorite tv show, reading an article, insert excuse. Also challenges her to remember how to do the exercise, maybe she doesn't want them to know she can't remember everything and it'll blow her cover. Or she's just stubborn and digs her heals in. Good luck, I hope you can get her into a safe facility for her wellbeing and yours.

Would your mom be open-minded about getting her house cleaned up and hiring a live-in home/health companion? This would give her the satisfaction of still being somewhat independent and living in her own home while making it a far safer place to live in.

Don't go back. There is nothing you can do there. If you are not there they will see her placed. If you have to ask for them to apply for Adult Protective and Guardianship of the State. This is no time to risk your own health with this nonsense. If they send her home unsafely then she will again have to call EMS if she is lucky to survive to do so. I am sorry, but there is a limit. What really can you do when she refuses to do what she knows she must for her own safety. If Mom has no dementia then she is welcome to make her own decisions, even if WRONG decisions. Don't let them have anything to do with your OWN life. If there is cognitive decline THIS is the time to have that assessed, but do you even have medical POA? So honestly, I would step away because stepping into this is hopeless and is at least one of the circles of hades.

To find a geriatric care manager:

https://www.aginglifecare.org/ALCA/About_Aging_Life_Care/What_you_need_to_know/ALCA/About_Aging_Life_Care/What_you_need_to_know.aspx

https://www.aginglifecare.org/ALCA/About_Aging_Life_Care/Find_an_Aging_Life_Care_Expert/ALCA/About_Aging_Life_Care/Search/Find_an_Expert.aspx?hkey=78a6cb03-e912-4993-9b68-df1573e9d8af

I don't know if this will help you... But my relative was told by Doctor, PT, OT & Social Worker that Assisted Living was required.

It took time & a lot of mental effort to position myself better. Into what I call 'a caring advocate role' - instead of the 'on call helper' position I was in. By 'helping' I was encouraging the 'facade of independance'. By not rushing in to help, the needs were more clearly seen by medical professionals.

The Doctor conformed Anosognosia (lack of ability to perceive the realities of one's own condition). This also helped me to see it wasn't just stubbornness.

I do not visit at all. I am not willing to increase my Covid risk.

It's very wise to be be considering your Covid risk seriously. Adding to your DH's Covid risk is the last thing you want. Take care.

SAFETY. However cognitively clear she may appear to be, her present condition clearly defines her own inability to function within the falls, fractures, bugs, and previous injuries to care appropriately for herself.

Will it be easier for you if she’s geographically nearer to you? Do your research now, and find a place that YOU feel comfortable as a potential residence for her.

Do you have POA? Will you have finances available to manage her residential care near you (if you will be more comfortable being near her?).

Will you be comfortable using a “carrot on a stick” to manage her care when she refuses to cooperate?

Your mantra MUST be “Safety before all other concerns”. That means safety for her AND ALSO safety for people who love her and have run out of other caregiving options.

The fear (for the responsible caregiver!) is REAL (Mom will be mad, Mom will react in a way that may make her condition worse, Mom won’t love me any more), but part of you new caregiving job is to work through all this new, brutally hard stuff, (whoever imagined a year ago that we’d be adding PANDEMIC to all this?), and make the terrible, unpleasant, not what you OR Mom want decisions that will result in the safest, most objective, most humane decisions you can think of going forward, FOR ALL OF YOU.

You’re not alone. We all got to this site because the things that are happening to you and your LOs have happened to us, and we’ve worried through them and wept through them. We’ve tried to keep love and respect and concern in the equation, and sought the often painful compromise.

Take good care of yourself, do the best you can. That’s all you can do, and that’s enough.