My 81-year-old mom talks a great game with the doctors and physical therapists, but won't do anything they tell her to do. What do I do?


She has been with me for 3 months and has declined severely; she is almost an invalid, choosing to sit in her lift chair all day, even for sleeping. She has lost weight ( about 10 pounds) from not eating, and has had 2 UTIs from not drinking enough. She has become incontinent, mostly from not being able to make it to the toilet on time, so we have added a bedside commode. Unfortunately, walking to the bathroom was her only movement all day. She has no hobbies, no interests, and no friends. She doesn't want any of them. The news is on all day (you'd better not change the channel!) but she sleeps most of the time. The doctors have checked everything possible. All her blood levels (vitamins, thyroid, et cetera) have come back fine. She had her depression medicine adjusted, but it has not helped in any way. When we go to an appointment, they tell her there is no medicine to help her, she just needs to eat drink, and move. She agrees to everything and promptly comes home and won't do a thing. She tells me she is too tired, she will do it later, she just needs to rest a bit first. We now have home health coming....everything from therapies to nursing to bathing. She does pretty well with them and promises the moon and stars, but then does nothing between visits. We found a bad spot on her backside, and they have determined it is a bedsore developing. She seems worried and eager to help herself, until it is time to actually do anything. What do I do? Let her languish? I can't "make" her do anything! It is frustrating seeing her decline, almost by choice. Is it failure to thrive? A stage in her dementia? Do I need to stop worrying about it and leave her alone? All of the professionals involved in her care seem to be looking to me to ensure her compliance. In the meantime, every day is a fight to get her to even get up to go the commode. I am not able to sit with her all day to force her through all the therapies. Her new thing is that I am not reminding her to do everything she needs to do. Frustrated is not the right word. Please advise.

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I think you were quite clear in your question, I suppose I was less clear in my reply because I was afraid of projecting my current situation on to yours. I allowed my mom to make her own choices because I was convinced she was dying soon and it wouldn't matter in the long run (meanwhile she is still going nearly 5 years later), and realistically I'm not sure what I could have done to motivate her anyway without making the kind of drastic changes that are only clearly visible in hindsight. I guess I am cautioning you not to invest too much of yourself into battles that you can not win but to look ahead to what your ultimate goals are. If you are determined to keep your mom home with you until she dies you need to make realistic plans for coping with her continued decline. If you feel that there will come a time when you will need to place her in a facility then perhaps preparing that option sooner rather than later might be the best course of action.
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I would tell her that she must comply with doctors orders or you will move her to residential care. Start taking her to care facilities for a visit, because likely that is where she is headed.

Hold tough and start an activity calendar on the fridge just like children. Set a goal. Remind her if she doesn't get 70% compliance within 90 days she will go into residential care.

Don't depend on paid caregivers or aides. They don't care whether patient complies or not, they get paid either way and as long as family is around it gets pushed back on you.

Sorry, but this was my experience for 9 frustrating yrs with my mom. I'm long distance so it was even worse to get mom engaged or help herself. Finally I gave up and let her hit bottom and turned her over to APS and their patience lasted less than a year before they placed mom. Now she loves memory care, eats, exercises, takes care of herself and developed new friends.

I wish the same for you.
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cwillie, I guess I didn't ask the question correctly. I agree with you on helping mom, but I don't know how. I can't physically make her do anything....I can provide food and liquids, but can't make her eat and drink. Same with all the medical care and therapies. I can provide them to her, but can't make her participate. She only takes her meds because I stand over her and watch her take them. I understand that dementia has an apathy component, but I don't know how to overcome that. She does not understand the gravity of her situation, nor do I expect her to, so she is not motivated to help herself, or let me help her either.
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hi dj you have described my father 90 exactly. he sits all day eyes closed doesnt even have on the tv shuffles to the kitchen for his milk and dr pepper may or may not make it to the bathroom sometimes gets sore from
sitting in the chair so shuffles to thr bed. isnt interested in anything may do some laundry but will chat up a storm when the nurse comes to examine or a
caregiver is in bit i think it takes so much out of him to do that he will sleep the whole next day. says he can shower himself but is lying. wont take his meds and like you the caregivers and nurse are looking to us to get dad to do the things hes supposed to even though we live 90 minutes away and work full time i feel your pain
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How invested are you in having her remain living with you? The apathy the comes with dementia can seem impossible to overcome but if you are determined to keep her in your home you need to ensure she gets out of that chair and moves or she will lose the ability to walk, stand and transfer. I recently placed my mom in the NH after caring for her several years not only because she reached that point physically but because the stress of managing her care was destroying any love I felt for her.
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