Mom signed the papers to leave AL at the end of March with my brother taking her home. I don't agree. Any advice?

Amy, I hope your Mom's foot surgery goes smoothly and that she can settle into a continuing care facility without fussing to much. I bet you wanted to tell your brother "I told you so", but it appears he now understands.

I have to say this was one of the most interesting and informative threads I have read and I read each and every one of the 80 postings above in one sitting this evening. Amy, thank you so much for coming back on to the threads and answering and giving updates, it helps everyone know if their suggestions were helpful. I wish others who post questions/discussions would do the same as these forums are such a good learning tool.

ALF may or may not take her back. They will re-evaluate her and if she cannot walk to the dining hall or is still cussin' and fussin' they will have to turn her down. If she can't do the rehab, she has limited options. That means a real Nursing Home or Memory Care facility. Don't feel guilty about this, she made poor choices and suckered bro into her delusions.

Brother may have meant well, probably did, but did not have a realistic picture. I'd avoid rescuing this situation. The AL is the safest place for mom. And brother will have plenty to do caring for her there, financial POA, etc.

Wow. Amy, this turned out at least as badly as you expected. She's clearly no happier at home than in assisted living, and she fell while brother was away (?) so was being left alone quite a bit (?) I know you mentioned she does not have dementia, but the almost delirious reaction to the pain medication and the fact that she is unhappy and nasty point to either that (probably vascular, non-Alzheimer's) or untreated depression. To top that off, she's getting repeated fractures - and has anyone addressed the probability that she has osteoporosis that usually can and should be treated? Big hugs, and prayers for much strength and patience... Brother may have only wanted her to be happy, you almost hate to fault him for trying (and denying) but if he can admit it was a mistake, that will be a huge and positive step towards getting the right things done.

I don't know if anyone else has suggested this, but perhaps hiring a geriatric care manager (with mom's funds, let me make that clear) might be the best route to go in managing mom's care from here on in. Your brother and you can both express your opinions about her care, but you'll be getting a professional unbiased opinion about what is in your mom's best interest, without the sibling issues getting in the way.

Amy, take care of the medical things only. tell your brother he's in charge of all financial issues--all the expenses, all the paperwork. If he does anything else that goes against your medical decisions for your mother, it's time to let him handle everything.

Don't know about compartment syndrome, but I'm going to re-emphasize the fact that she needs to be seen by a mental health professional whilst in the hospital. I feel bad for you being forced to pick up the pieces of your mom's poor planning and worse judgement. Is your brother returning soon? I'm hoping that when the geripsych or neurologist sits and explains that your mom has a personality disorder/vascular dementia/mental illness or all three, that he might have an "aha" moment and realize that she can't be left on her own. Especially because she's going to resist using the walker if she's alone and fall again.

Yes, another consult tomorrow AM. Dr who casted her foot is a surgeon I have worked with. Absolutely not my favorite, but not dangerous. I didn't intervene and make her wait for another surgeon because I didn't want her to develop compartment syndrome by waiting any longer. As it turned out she was immobilized and shipped out without surgery.

Okay Amy, this is the "nasty fall". You get mom back to the hospital tomorrow am, schedule a consult with a surgeon and geriatric psychiatrist to manage the psychiatric meds. She has surgery and you work with discharge to find the best continuing care facility you can that will accept her as private pay now and Medicaid in the future. If brother or mother says anything about going home, you point out to them that you've cleaned up this s**t this one time and never again. Yes, falls happen anywhere, but ALs have trained nurses on call. Make sure the community you sign her up for has a geripsych that comes in to consult

Thank you blannie! I needed that :)

I don't have great advice, just a big hug for you. Please keep us updated...

The social worker will see her tomorrow. Weekend admittance is such a pain. Mom is a tough one. I've advised the staff not to let the social worker use her real title. "Patient care advocate" always works for Mom. She HATES social workers for some reason. And yes, surgery is possible. Thank you

Wow, Amy. That's rough. Have you sat down with the social worker at the rehab facility to discuss the situation? That's usually a good place to start. If she has calmed down, is there any chance of getting her readmitted to the hospital for surgery, after which she could go back to rehab with Medicare paying for it? I assume she still needs surgery.

This is an update on Mom. For new readers here's a quick recap. Mom fell and fractured her ribs in Sept 2013. Went to rehab, went to assisted living, cried so much that brother took her back to her house against my better judgement. Said he would take care of all her needs. That has been hit or miss. Has become so frustrated with her that he said he won't clean, do laundry etc. Will only bring in food.
Fast forward to today. Brother is across the nation on vacation. Mom fell and fractured her ankle in 3 places. Strong narcotics given, she became severely belligerent (very frighteningly so) med doc wouldn't clear her for surgery. Temporary cast applied for stability. Hospital wouldn't consider her as an inpatient, called it "observation". Forced discharge on the second day. Transferred her to rehab and they really have no idea what to do with her, as she didn't have surgery. Medicare will not pay for rehab and her secondary insurance which had formerly been top of the line refuses also. She is now in her 3rd day of self pay. $460.00 a day is now coming out of her pocket.
Mom is not on Medicaid. She has a house and a little in the bank. Please help me if you know what to do from here. Even a smile or an "I'm here and listening" would be greatly appreciated.

Things seem to have reached a status quo for the time being. nothing you can do unless she starts her old games again but maybe she learned her lesson

She has no other help besides us. We both clean when we go over, but he is doing the brunt of it. I take care of her bedroom. I actually swing the door wide open and go right in while she's in the living room. My brother won't do that. Mom! you need new sheets. Last time she started to bark something at me, but I ignored it. He can't do that and will walk away before he's done. She says she's washing up and I believe her. She always appears to be fresh and clean.

Of course you are sad Amy.Finding out one's mother is such a nasty vicious woman is not something anyone can take in stride. You are doing the responsible thing by being there as support for your brother, idiot as he may be. You are right it may end badely but Mama dearest has made her own bed so take comfort in knowing you have done your part and need feel no guilt whatever happens. Who is cleaning her house and making sure she bathes etc. is hospice still going in?

Thank you, Countrymouse, it's OK, he knows he's an idiot. But he still has that warm heart that says, I'd have hated it there too. She wasn't happy. As far as my sanity, I'm still quite sane but sad much of the time. I cry easily and have far less interest in the enjoyable things I do. I keep telling myself that only you can control how a situation affects you. Only you can control your feelings, and that this can't go on forever. Then I think about how it may end... and then I tell myself to stop thinking and go out and play. So far it's working.

Amy, you're doing brilliantly. You're being supportive to your brother (and let's not go on about what an idiot he was… sorry, I said let's not go on about it, didn't I?), pleasant to your mother, and yet you still appear to be sane! Or at least you're typing - which is not nothing, because if it were me I'd be in a strait jacket in a corner, drooling, muttering and plotting to stab somebody with a fork. Your method for leaving the house without either delay or undue offence, in particular, is a master class. Thank you!

For all of you lovely people who took the time to respond, I'm posting an update. Mom is still home and as nasty as ever. My brother has been really good about seeing that she has food and is calling her every day. This morning he called me for her Dr's number. In the background she was chirping away. My heart was in my throat listening to her and I'm sure his was even worse. She told him that she had only one of a particular med left. He checked the bottle and she had 10. He asked why she would tell him that . After a pause she said, I lied, that's why.
Trust me, this is NOT dementia. This is how she controls. First, give us a reason to drop everything to go over and then have us in her hooks when we get there. 2 days ago I called in the morning, no answer, so I waited 10 minutes. Called again, no answer. With heart in throat I went over, unlocked the door, yelled for her and there she was, sitting on the couch. I was in the bathroom... It dawned on me that she could have called me before panic set in because my phone message was picked up. I ended up resentfully shopping for her and making fruit salad. Hey, you're there, what are you supposed to do when your Mom needs things? Yes, brother's job, but I was there.

Hair appointments are something I take her to. "11:30 ???? That's too early, I'm the patient. MOM, you're not a patient, you're the customer and I'm the driver.

I'm just venting. There are a plethora of stories to tell, but I won't ramble on ..... oh, just one more.... every time I'm on my way out she tries to pick a fight or tell me what nasty thing was said about me behind my back. Last one was yesterday. You should have seen the disgusted look on Mary's face when you said that......me----- gee, I missed that. Bye Mom.

Word to the wise. Physically fight your sibling if you have to, to prevent him/her from opening this can of worms. It's just AWFUL, and I'm staying as big a distance as I can.

Amy; I'm sure you would "do" for your mother in any situation where it was safe for you to do so...bringing food, taking her to the shower, etc. What needs to be maintained, I think, are the boundaries. You make hair and doc appointments at your convenience, you're got no obligation to be at her beck and call.

It sounds to me as though she's having difficulties getting back into the routine of living alone. She may come to realize that whatever she "hated" about AL, there were some good aspects to it. Are there any others nearby that might suit her better? We had a disatrous experience with my mother in one place (we relied on the fact that other family members had elders there and assumed it must be a good place, which it was not); another was a much better fit, in part, simply because it had "assigned seating" in the dining room, meaning that you always knew where you were going to sit and that it was less like a junior high school lunchroom, with all the pettiness and awfulness of being "the new kid". When some of the bad feelings have blown away, maybe she'll be inclined to go take a look at some other places and make a choice. Hugs!

That sounds harsher than I mean it to, but the point is made.

Wishing you the strength that, being the daughter of a narcissistic mother, I often struggle to find myself.

Nobody can volunteer you without your consent.

If you agree to any part of this crazy new scheme -- ANY LITTLE PART -- than you will get what you deserve.

You need tough love for your mother and brother, but first, and most important, you need tough love for YOURSELF,

Amy, at some point, talk to mom's doc about a neuropsych evaluation. It sure sounds like she's got some cognitive issues which often present as inability to plan and to see consequences of actions. I'm not like CM's sister but when our mom was insisting she she could live on her own with one of us kids (ha!) getting panic calls several times a day, I sat her down and said " mom, brother is gonna drop dead of a heart attack getting here to rescue you". She got that. Sounds like there needs at some point to be a discussion between you and brother about what is best for mom, not what she wants. Hope he gets there in one piece.

Amy, do what suits you, what you would normally have done before, and don't lift a finger more than that. But don't go to the other extreme of folding your arms and refusing to have anything to do with her at all, because your mother will gleefully attribute it to your sulking because you didn't get your own way.

Au contraire, she's got her own way. On her head be it. And when, God forbid, she falls flat on her face and winds up back in ER you must at all costs reject all temptation to say "told you so."

Look, she's happy at her home, yes? And you've done all you can to explain the risks. Well then. Anything that happens from here is not your responsibility. Rise above the intense irritation and frustration and be gracious.

Your brother sounds a sweetie-pie - can we swap??! x

One of the hardest transitions I've had to make with my mom is to go from daughter to "parent-like" in some situations. I'll go over to help my mom shower and she won't want to. Sometimes she'd cry. I'd be loving but firm, "Mom, I'm here to help you and you'll feel much better after we're done...I'll do all of the work, etc." I'd cajole her and finally get her into the tub. Afterwards she'd feel great and totally forget her earlier resistance. Same goes for taking her out to lunch. "No, I don't feel like it, I'm tired, etc." "Mom, let's go, I'll help you get dressed, you'll enjoy it." And she did. My mom is at the point where she just can't make good decisions about her own care. So I step in and help her out. Does she want my help in the moment? Heck no! Is she happy when we're done? Heck yes!

My point is that your mom may be at a point where her cognitive function doesn't allow her to make good decisions about her life and you and your brother need to step in to help her. And that help (from your side) may be letting her realize she's better off in AL where she has more care. Is it easy? NO! Becoming "the parent" is very tough. But I know in my situation I'm absolutely doing the right things for my mom.

For strength, I am reading and rereading everything you are all saying to me. The biggest problem I have is the human aspect of the whole situation. Mom was the mom that we'd all feel more than blessed to have yesterday. Husband keeps telling me that it's a ploy, that she wants something and that she hasn't changed one bit.
Yes, I went to her house with food. Couldn't help it, always did that. She looks terrible for a woman who always took pride in her knack for style. Maybe she will get back to her usual routine, but for now, no one is telling her when to get up and get dressed or when to eat. She has one big beautiful "I won!!!!" smile on her face.

I told her I'd call for a hair appointment and did. Rats, at AL the salon was right there. Why can't I stop doing things like this? I will be taking her to today's Dr. appt. because It was planned that way before I went out of town. It's just not right to back out on that one. The event this weekend is a shower that I would have taken her to anyway. When I asked her about going she said, "It depends on how I feel." My plan is to remind her of the time, call her 1/2 hour in advance and if she won't be ready I'm going alone. ... when she was in AL she was always ready for everything, and that included lipstick and eyeliner. Nothing there depended upon how she felt. I just don't get it, she's the same person on the same meds.

Being firm in a kind way is terribly difficult. And, I do have one heck of a good brother who I don't want to hurt. When he walked in yesterday the first thing he said was, "Mom, you better not be being mean to my sister."

Countrymouse, may I borrow your sister for a few hours?

Mom may heve won this battle but she is far from winning the war and her trusty steed (bro) will soon get battle weary as her demands increase

Amy, they are both about to learn a hard lesson. Stay away. Let them deal with the consequences. Ignore the phone calls. Any help you give now only enables a difficult patient and a brother in denial. Make them see the reality.

Amy hi I just found this page today and want to know how this arrangement worked out you can get ahold of me on facebook Rhonda S. go to message and you can tell me all I work in a nursing home took me longer to regester to send this off