Mom is 99. We live 2000 miles apart. The assisted living is not very helpful. There's always an argument about taking out the garbage or washing her hair or her clothes...every week it's something new. Mom's quality of life is zero. She is in constant pain, deaf, and doesn't see well. Her legs are useless so she drags herself every where. It's really horrifying to be part of this. I am the only child.

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I agree with AnnReid that your mom seems to need a higher level of care. I too am an only child. I manage care for 4 people, ages 85, 91, 98 and 101. Two are local to me and 2 are in FL while I'm in MN. My point in telling you this is that you will need to make some decisions based on what you want the outcome to be. It is not easy to manage care when thousands of miles away, especially when the care is not enough. If I were in your situation I'd work to move my mom into LTC very near where I live. Yes, easier said than done, but once done, it will be easier to manage. You won't have to provide more hands-on care but you will be better able to work in her best interests when she's near you. It won't be less emotionally challenging, but I don't see the downside of moving her. Not sure if you are durable PoA for your mom and what her cognitive levels really are at this point. She may be totally resistant, in which case you can employ a "therapeutic fib" to get her moved. If finances are an issue you can apply for Medicaid for her. If she doesn't have a lot of assets, the app isn't that hard to complete but you will access to basic info like her bank account and what assets she does have. Being an only child in this situation is hard in many ways but at least you get to call all the shots, unlike people who are constantly at battle with siblings over control. All you can do is the best you can. May you gain peace in your heart as you make decisions and work towards the outcome you think best.
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God is the one to pray to for this journey to end for your mother who's in chronic pain and misery. I pray daily, to both my deceased dad, mom's deceased siblings, and God himself to please come take my mother out of her misery to be reunited with them again. She will be 94 this month, with bad leg pain from neuropathy, wheelchair bound, moderate to advanced dementia, mostly deaf, super confused, etc. etc. Her quality of life is pretty non-existent as well, and she's in Memory Care with a very high level of care round the clock. It's not how much care she's getting, as much as how much quality of life she's NOT getting. I too am an only child, but I live 4 miles away from her MC. Complaining is part of the routine for ALL of them, I believe, so I wouldn't get too worked up about that aspect of things.

As far as hospice goes, my mother does NOT qualify for their services, even WITH all of her issues. Your mother may not either, but she may. Have you looked into it? My mother takes Tramadol 4x a day for her chronic pain, and says it doesn't help at all. For hospice, she doesn't meet the criteria (even WITH dementia advancing) because she hasn't lost 20% of her body weight, believe it or not!!!!!!!! She eats like a trucker and weighs 190 lbs. So...........that's where we stand on the hospice matter.

Anyway, I hope God decides to take your mom sooner rather than later because being 99 and in the shape she's in is too much. Sending you a big hug of empathy and understanding. I get it.
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Just to repeat what others have said -- she's WAY beyond assisted living-level needs. She should be in a skilled nursing facility.

Knowing the terminology of different levels of care is vital, and this is a good example. She needs daily nursing care for pain management, mobility issues, and basic living needs such as bathing. That's skilled nursing.
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Well first I must say(being a Christian), that God is the only one to pray to, not only in our times of need, but every day. Secondly I will suggest putting mom under Hospice care, where she will have more eyes on her, and they can help get her out of the pain she's in. At her age, I'm sure she won't have any problems qualifying for their care. A nurse will come out at least once a week to check her vitals, and an aide will come at least twice a week, to bathe her and wash her hair.(you have to request her hair to be washed) They will report to you, any neglect they might see while there, and if they feel a higher level of care is needed. And it might just give you more peace of mind. Wishing you the best.
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What constitutes “Assisted Living” in your mom’s state? It sounds as though she really requires a higher level of care than her present residence provides.

My LO is in the memory care area of a very good LA, and there is a tiered set up providing progressively increasing levels of care as needs emerge.

Do you have any possible connections in her area whom you could employ to provide surveillance over her circumstances and loop mom’s needs to you, especially concerning her day to day care?

Prayer? I pray. What I forget sometimes, is “Let go, and Let God”. If YOU are doing the VERY BEST YOU CAN, whether from a distance or next door, in Covid World, that may be all you can do.

I deeply appreciate your intention of doing the best for her that you can. I’m linked in a situation in which my LO has 2 POAs, one of whom lives over 1,000 miles away.

Until Covid I was able to provide companionship and oversight, and of course for the time being, that’s not presently possible.

The other POA writes a check once a month and calls and complains about what I do (“due diligence”-LOL).

I think it would be helpful for you to pursue to possibility of a “visitor”, ideally one who could “drop by” at different times during the day to see what’s happening in your mom’s residence.

I’m assuming that you’ve gone over your mom’s contract with her residence, to be sure that she receives ALL the services she’s paying for. Times are unquestionably strained, and things that WERE done and should be done are lost in the Covid struggles, but there should be some parts of her contract (laundry for example) that should be absolute baselines.

I know my few ideas aren’t much help. Hoping some others can do better for you.
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I have to agree, your Mom needs LTC. The AL is no help because they can't help. They have less aides. As said, they assist. I am surprised they haven't told you they can no longer give the care she needs.

I would find a nice LTC facility and use the money Mom has left for her care then apply for Medicaid when it runs out.

As said, you may want to see if she qualifies for Hospice.
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I think it is sad but I think it is true. We, the families and they the elders DO come to praying for it all to just end. I just finished Elizabeth Berg's book about her parents last years, in their 90s, supportive children trying to move them out of their home in Minnisota into assisted living, the misery of the Mom and of the Dad and of all the kids. Just truly awful, especially since I, at 78, am between Ms. Berg's age of 70 and her parent's ages of 90s. 10 years on either side and there am I am so much misery for all involved. I am sorry, as a Nurse I have concluded that we live too long, and that it is for the most part loss upon loss upon loss upon loss, finally our mental faculties and our physical abilities, our dignity, our memories. I am truly so sorry. There seems no answer.
But if you want company, the Elizabeth Berg's WONDERFUL BOOK called "I'll Be Seeing You". You will, at the least, know that you are not alone.
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Pray to God for help and guidance. I feel for you. I feel for your mom.

My mom is 95 and would never have wanted to live this long!

My dad died in 2002. She’d much rather be with him in heaven.

So sorry that you are struggling with this situation.

Hoping that your mom will have an easy transition and that you will find peace and joy.
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I repeat the Lords Prayer a few times a day in the car, when I am walking, when I feel the need to, every day, I feel the need to say the Lords Prayer. And when its a beautiful day: I say: This is the Day the Lord has made, so rejoice and be happy in it. It makes me feel good for a few minutes.
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Assisted Livings (ALs) offer just that..... an "assist" to residents with the activities of daily living (ADLs). If she can't walk, not sure why a wheelchair has not been prescribed for her but that you can discuss with her MD. Als are simply not staffed to deliver a higher level of care which, by your description, your Mom definitely needs. Please look into getting her hospice which will provide extra "eyes" and care for her as has been suggested. If that for some reason doesn't work and funds are not an issue and she doesn't not need skilled nursing care, perhaps consider hiring outside help to help with the hair care, bathing, whatever.
Wishing you and your Mom peace on this difficult journey.
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