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Mom had a second TIA in 11/2013 after many falls and hitting her head. She lived with us for 5 months and was beyond difficult, demanding and clingy. In 11/2013 she went to hospital, then rehab in a nursing facility. They had her cycling 45 minutes daily, eating well, but not initiating anything on her own. When they "released" her from rehab, she began refusing to eat enough, drink enough, walk, socialize ... She would tell everyone FREQUENTLY that she was waiting for me to take her home (which was not an option due to my health). They finally "pushed" her out, saying that Assisted Living was the right place for her. She did not agree, and now after 47 days she won't dress, eat, leave her room. She's down to about 110 lbs. Now hospice is bringing services to her [as a "Failure to Thrive patient] and EVERYONE - family, hospice, assisted living - KNOWS she can do all of the basic things herself. And she's still telling people that I am the reason she can't come home. Mom is narcissistic and has driven everyone out of her life (except for me as POA and only child). I am just ranting ... Anyone in a similar circumstance?

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My mother in law did this post aortic aneurysm surgery. Refused to do rehab, refused meds, starved herself to death. Dementia does strange things to the brain. It's not your fault. If the docs can convince her to try antidepressants, there might be some increase in appetite and a better outlook, but it doesn't sound like she wants to live.
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Her behaviour sounds like a kind of self-harming, DKO, would that be possible? Anger turned in on herself.

Well! - I don't know what to suggest.

Trying to achieve some bathos, here: what would you do if she were holding her breath? Or screaming and screaming until she's sick, like Violet Elizabeth Bott? The one thing you wouldn't do would be to reward her destructive behaviour with attention, surely.

I'm seeing two questions here. One, how can your mother be persuaded to take up her bed and walk, so to speak? And two, how closely involved should you be in that process? I don't know the answers, of course, just hoping it might be helpful to break the issue down into more manageable sections.
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Thanks for the comments.
My mom has had different types of mental health care for the last two years. Her demeanor is a blend of early dementia, personality disorder, and basic personality. I never thought AL was right, Nursing facility wanted her out, and home was not a possibility. I KNEW something else was going on. The AL determined "Failure To Thrive" pretty quick and THAT explained the "something else going on". AL has been pretty nice about it, and her care level increased. I just can't understand having no interest in anything except laying there thinking about her problems,
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AL is not the place for her. She needs structured care. The aids in AL are used to dealing with mobile and self sufficient patients that only need help bathing or dressing. In a NH, the caregivers are more forceful and able to deal with your mother.
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Geriatric psychiatrist needs to see her, let him/her figure out the meds. What Pam says is the truth!
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pamstegman ~ thank you for solid advice. It sounds like you have some experience with this. (-:
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She is pixelated about being old. The MD can medicate her depression, he can even give her something for appetite. You limit your visits to once a week, for no more than an hour and be sure you are not interrupting an activity there.
Force her to satisfy her attention-seeking by interacting with the other residents. Deprive her of her audience (you) and she will find another. If you don't, she will continue to wear you down and play the guilt guard.
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