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My husband asked me to post this for comments. His Mom is 88 and quite active. Has mild/moderate Alzheimer's. Insists on living along. Forgets that due to osteoporosis she is not supposed to climb on ladders, pick up large and heavy objects etc. Keeps hurting herself and breaking more vertabrae. Her doctor is of the opinion to let nature take its course since she fights tooth and nail with anyone (doctor, lawyer, her only son) who might suggest anything. Always a no.
And since you are not supposed to try to reason with a person with dementia, what do you do?
Her viewpoint is "leave me alone. I am not hurting anyone."

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I think you have to appoint (PCA) personal care assistance they give a proper care to your mom.
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Wyndie - gr8 answer, l agree it's about stepping up to the plate when someone is impaired. However, a couple of times you say " dementia is a form of Alzheimer's" but it is actually the other way around: Alzheimer's is a form of dementia... :-)
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Skinona: Your husband is hiding from reality. Most men do not like confrontation and his mother will give him confrontation....she is vocal...he doesn't want to hear it. He is not capable of making any decision and therefore is doing nothing. He may live 200 miles away from her for a reason, to "escape."

He cannot continue to live like an ostrich with his head buried in the sand. He is not helping his mother and his lack of doing anything will eventually cause problems between the two of you and honestly it isn't fair to the friends who are "looking in on her" to basically be her caregiver when that is her children's job.

My mother and I received a call from a relative that wanted us to come and help take care of her mother when she was ill on 3 different occasions. We drove over 350 miles each time and stayed to take care of my Mom's sister until she recovered. Now this relative was the daughter and she lived right next door to my aunt, and my aunt was married and her husband was fine, but we were called 3 times to come and care for her. My cousin said she could not quit her job and be at home to care for her mother, she needed the money. On the third trip my aunt finally died, the day after returning home from the hospital......my cousin retired from her job two weeks later.

My cousin did not want to be responsible for her mother, but she had no qualms about pulling my mother and I away from our homes, husband and children to care for her mother, who lived next door. I loved my aunt but I don't consider this fair.

If your MIL has only mild dementia then I might let her stay where she is for a while, but you both need to go and stay with her each month, so you can determine for yourself how she is doing. Just by calling you will not know if she is forgetting her medication, is she doing things dangerous to her health, is she in danger of burning her house down, how long is her memory, how is she handling her money, is she eating.....these things and more can only be determined by you while you spend a few days with her each month. You MUST see how they cope and handle their daily lives for longer than 10 minutes.

If you choose not to act on moving her now, begin to figure out what you are going to do down the road because her condition will worsen and she will need your help. Dementia is a form of Alzheimer's and sometimes it progresses slowly and sometimes it goes quickly, you will not know until it happens. My mother's began slowly and is building momentum with each passing day.

Your husband needs to go to an Alzheimer's Group in your area to gain insight into what we are all facing on a daily basis. He needs to face reality, but he needs the facts as to what this disease is and how it works. My mother can still argue up a blue streak but her memory lasts 5-15 minutes and is getting shorter by the day. Just because they can still make some sense in arguing does not mean they are okay, he is kidding himself. My mother believes the dog should be fed 25 times a day and will argue the reasons why, but is that normal behavior? Believe me there are days that I have wondered if my mother was just "putting on" or if I was the crazy one, everyone has felt this way at one time or another. I have an uncle that use to yell at his wife to "snap out of it!" The problem is they can't, it is part of the disease.

By the way you asked if dementia was catchy. Alzheimer's does run in families, it runs in mine. Dementia is a form of Alzheimer's. My grandmother had 2 sisters and the female children of these two sisters (6) all died of Alzheimer's and now my mother and her cousin presently have it, so your answer is kind of yes, it can run in families. Also it is known that some high blood pressure medications and some antacid pills (probably a ton of others) are known to cause Alzheimer's. My ex husband is currently taking one and I already notice a change, but his doctor has convinced him that the information is wrong, so he keeps taking it and he is 60.

I don't think your husband probably has dementia or Alzheimer's at this time but I do think he is overwhelmed and he probably does need you to step in and help him make a decision on what to do. He needs to be educated on the illness and he needs to see it in action with his mother.

You sound gentle and loving and it is wonderful that you tell her you love her and will do everything you can to make sure she is okay. Just make sure that she has a Trust and have her sign a Power of Attorney NOW. Let her know it is for future use only if it is needed. If you don't you will have MAJOR problems in the future and will have to seek to become her guardian or conservator which is long, difficult and very costly!!

Also you really need to find out about the broken vertebrae....a friend's mother has become bedridden due to these breaks and my sister currently has two that have had a cement embedded into them. This can cause paralysis and is nothing to mess with.

God Bless you all on this journey!
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Part of the issue is that my husband is behind on the progress of the disease. For instance her dr gave her directions for obtaining stool samples to make sure her anemia is not from a gi bleed. I told my husband no way can she do this. And he yells at me saying I am being unfair and not giving her a chance. Well, she's done it wrong twice now and we are on to the 3rd attempt. We live almost 200 miles away and make weekly trips to care for her. She has friends who look in on her when we are not there. We both have to work and are over 60. I have said I will not intervene in his decisions, but it seems the more time he spend with her the more out of it he gets. I sometimes wonder if dementia is catchy. It is not that we would not have her live with us, but that she refuses. I do not believe my husband would ever have her declared incompetent. I just keep reassuring her that I love her and that I will do my best to make sure she is ok. My husband still tries to "get her to understand." Lots of fighting. He thinks that because she can still argue, she has the ability to reason. I just stay home when I can't take any more.
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I live what you are going through....I however moved in with Mom along with my daughter and later my other sister as well. Since we were divorced there was no problem with this. The problem is with us the caregivers, we believe that we should let them continue to make decisions, when they are NO LONGER CAPABLE OF MAKING SOUND JUDGEMENTS. Depending on how bad your MIL's Alzheimer's is you may need to step in and take over for her own good or let her go for a while. In the beginning my mother was still able to do for herself and she worked in the garden and painted the house, etc. but as time has progressed and there is absolutely NO WAY she could or should live alone. She has left pots on the stove until the pans burned, she was giving away her money to everyone that called on the phone, she could not balance her checkbook, and she just makes bad judgement calls including feeding the dog 25 times a day (her obsession).

I have a problem with what the doctor said....To basically let it run it's course. Although that would be easy to just walk away and let her either live or die, I could not live with myself, knowing she is mentally deficient and I was going to just ignore it. If she falls and dies so be it.

My mother was/is very vocal, yelling at us that she is alright, she has no problem, she can live on her own and we all need to get out and leave her alone. We no longer listen, because we know the truth, we know her memory lasts from 5 to 15 minutes and she is basically in a new world again. She has heart arrhythmia and use to be able to feel it when it kicked up but she can no longer feel it so we have to take blood pressure and pulse daily.

The truth is when Alzheimer's kicks in, they still believe they are okay, they do not realize how bad their condition is becoming, because the condition leaves them without their memory to know what NORMAL was. This is when children have to step in and have the argument that will ensue but you have to be strong and know you are doing this for their benefit even though they don't see it that way.

You have essentially become the parent, now would you walk away and leave your child alone in this condition?

If you do not want her to live with you then see about a facility. You can sleep with a clear conscience that you have done everything you can to keep her safe.
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skinona, my Mom was the queen of stubborn. She was living alone with dementia in the early stages, putting freezer things in the fridge, vice versa, burning things in microwave, hanging paper towels to dry and putting ice cream under her bed so no one would take it. She refused to come live with me, refused to even open the door to anyone but me. She was happy alone, managed somewhat to live independently but talking to her about "my burden of worrying about her falling" didnt click. Nothing was going to happen in her in her mind. To pull her away from the home she loved and her routine would have been devastating so the burden became mine. Her doctor said if she is happy home, then so be it, if she falls she falls but at least she was happy. He felt if we pulled her out of her home, she would die of broken heart depression ailments anyway going right down hill. She would never want to burden anyone, but I knew she needed help. I was working fulltime 2 towns over, had 3 children and a husband, and would go into the bathroom at work and call her pretending I just wanted to say hello just to see if she took her pills. Long story short, I ended up calling her 5 times a day just to "say hello , joke joke." If she didnt answer her phone I called again and if she didnt answer a second time, I raced over there. I ended up going there every saturday and saying I hated to shop alone, and would she go with me. (lie lie). It became our day out to the stores and for groceries and a great way for her to walk and get her exercise in stores. Once home I would clean up, watch her sort her pills, take laundry home to do, etc. Each month I ended up doing more and more for her and then the dreaded day came. She fell. Her neighbor saw her outside and called me and the ambulance. (by the way, I previously gave all the neighbors a typed up paper explaining moms condition and my phone number, which came in handy!)
Mom had a broken hip and came to my house to recover because none of my siblings would commit to help at moms house. Within 7 weeks my Mom forgot she had a house and thought my house was hers, problem solved. I ran back and forth and called millions of times for over 5 years and shes been living with me now for over another 5 years, now in severe dementia.Near the end of her living at home I did talk her into getting "meals on wheels" delivered and it was just someone to drop by daily and bring a meal too.
If I had known what I know now about surveilence cameras, I would have had them set up in her house so I could watch her on my computer to check on her. Its a very long road but for what its worth, I rather have her here, safe and with the best of care under my roof, then to travel to her in a nursing home or her home, I love her here so much, despite the hard work. Best of luck to you.
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Tough situation and I've been thru, and still going thru same. Everyone has given you lots of options. My mom is 90 with dementia and chooses to live alone. We had 24/7 in home help (caregiver agency with CNAs) but it didn't last and she fought it at every turn. Her living alone with no help and no outside interaction is less than ideal, but she wants it this way. I've made decision to leave her be at this point and unfortunately, once there is a crisis, health, etc and she goes into hospital, we will force her to a dementia care facility near us. I didn't want to take her to court to force and she has been very vocal and resistant.

We have to remember, seniors have the right to make poor choices even if we don't agree unless they are in imminent harm...and that can be difficult to prove legally. I've neen there.

I would try to make her home as safe as possible, grab bars, extra lighting, stair tread safety, remove ladders, etc, rearrange cabinets so everyday items easy to reach and maybe life alert if she will have it...other than that, you will need to respect her decisions unless other health officials can convince her otherwise.

She's lived a long independent full life hopefully and she has a right to continue that as long her health isn't intErfering with your life ( she isn't calling you, or you don't have to take care of her when she breaks something).
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Can you shift the focus from "living alone" to "staying in your home?" With my dad I had to use the line "having someone live with you is how we're going to make sure you can stay in your home." You might need to say "if you break a leg, you will no longer be able to stay in your home." Now that my dad has 24-7 supervision in his home, he is gradually accepting help with all sorts of tasks he claimed he didn't need help with. Best of luck!
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Thank you Paulaeagerton- I did not know a system like this exists. I am testing my husband every day to see if he can manage 5 days while I travel to Mexico for dental work next month. Day 1 - went out to feed the geese (4), ducks (11), pigeons (too many), told him to fix breakfast like I was gone, came back inside, he was eating and the gas burner was still on! I immediately turned it off, told him about it and he said he didn't leave it on. Waited three hours, told him he left the burner on, and he said, "I won't do that again." Next day, we discussed leaving the burner on, and he said he didn't do that. I asked him if I bring someone in to cook dinner for him will he like that? No. The dog who is the Alpha dog wouldn't like it either. I have to get these implants finished so I can chew and taking the pets (3) & him with me is not an option. I will check out GrandCare and see if it would work for us. Thanks!
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Have you had a talk with her where you try to scare her?

If she's like my father, she might say that she's not afraid of death. Worse for her would be to fall and lie there for hours, unable to call help. Tell her if she accepts help now, she WON'T break a hip and will still be somewhat independent, but if she does break a hip, it will mean a wheelchair or bed for the rest of her life. Remind her she can't be guaranteed of dying, and can almost be guaranteed of greater disability WHEN she falls and hurts herself badly.

There's no reason to be tactful at this point.

It's a very tough situation. Good luck.
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It sounds like it may be possible that she might be able to stay at home a little longer, with some help (home health, etc.) Just because she goes to a nursing home doesn't mean she won't fall and break her bones. Home health agencies do fall assessments and try to remove or put things in other places that might cause a fall or an injury (such as the stepladder). Also you might want to consider removing or putting somewhere else the large and heavy objects she might try to lift. If it's gone or out of sight, she may not use it or she could ask an aide to get something for her that's she's wanting to use the stepstool to get. If you don't have power of attorney, it would be best to go ahead and get this so when and if she gets worse; you can make other arrangements. Also, you might want to consider a senior day care center, if one is in your area. They will transport them to and from the senior day care. Also a medical alert system device to put around her neck would be good. They are made to go off when she falls even if she doesn't push the button.
Also, you didn't say if there was anyone in your family living in the same town as her but if there is, you might want to consider helping her with morning and evening dosages and some home health agencies might be willing to help with this to some degree.
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I think there may be a window when moving to assisted living is easier on them. It is before the disease progresses to the point of not recognizing they are at home and think they should be in the childhood home, wondering where their parents are when they passed years ago, or where their young children are. I believe it is best for them to be able to remain in their homes, at least there is some sense of familiarity.

I took respite about a year ago for two weeks, which was very difficult for my mother. She became angry nearly nightly because she could not understand why she could not be in her home. If the disease progresses too far any move will be difficult for everyone involved and possibly lead to a decline in their general health.
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If Mom is adamant about staying in her own home, you might try the Grand Care System, which is a system of sensors set up throughout her home which report to a touch screen computer. You set up the allowable parameters and it will call, text or email you (or whom you choose) if something is amiss. It also allows her to listen to music, see family pictures, and Skype with family, all without knowing how to use a computer. Meanwhile if she gets up at night and doesn't return to bed, wanders aimlessly, doesn't access her meds or falls, you will be notified. These systems are much more affordable than assisted care and live-ins. Check it out
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I finally have moved mom in with me. She thought this would be temporary; she had cataract surgery and I wanted to be sure she'd wear the patch as told at night. Long story short, my sister-in-law and I decided we'd just move her into my place.. It's been 4 weeks and every evening we have drama. I just had no idea how much sundowning was going on with her. Our homes are very similarly laid out, and I made her new bedroom exactly like hers was, bathroom the same. I work from home and thought this would be easy for both of us. We have our usual routine during the day, get out and garage sale, usually eat lunch out, bingo, movie once a week. We get back home, everything still okay. I begin work at around 3:30 in my office/now bedroom. The sundowning begins sometime after that nightly - she will come back and ask me who I am or when I'm going to take her home, or where's my family (?) Very shocking at first but I can usually manage to calm her down quickly. I believe she nods off in the living room, then wakes up and doesn't know where she is. Or she will seem fine but will be banging around in my kitchen like she would at her home, only she's not really washing the dishes with soap but will use a paper towel, wipe things down and put them dirty into my cupboards. She dreams a bit at night but now usually sleeps the whole night. But she's angry with me and I don't know if she'll truly ever adjust to this. I have to "talk her down" constantly. I even have to get on her case about not taking a bath a few times a week, her sense of smell must be nearly gone. We've cleaned and repaired her home (she'd put holes somehow in every one of her closets (!!), nothing done outside since dad died 10 years ago other than my being sure the grass is cut by a neighbor, etc., lots of work just to sell the place. Anyway, I'm not sorry. I feel guilty at times but no, not sorry. She's where I can observe her. She has mostly forgotten about her house (usually talks about her childhood home). I realize she may never adjust and that things will probably worsen. But I KNOW I'm doing the right thing.
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My husband is almost 87 yrs. and he will make comments similar to your mother-in-law. This generation has been through the Great Depression, wars unlike the wars today, and were taught to just "get on with it". You and your husband have two choices as I see it from a caregiver who is also a nurse and social worker. First choice: let her be. Second choice: File for guardianship, get the courts involved and when her dementia continues to decline, then you will have everything in place. If she keeps breaking bones, then she is a danger to herself, and can be placed (legally) in a psychiatric hospital for observation and staff can complete an examination of her mental status. If you both do not feel you have the courage to battle this disease, then she will continue to have her way. I would suggest getting another doctor who will verify her diagnosis so you have more leverage in dealing with her legally. She reminds me of my female cat who doesn't want to come in at night, and due to the fighting male cat in the complex, I simply go out, pick her up and bring her in for her own safety. (My dogs already know they want to sleep inside in their soft beds). Let us know what decisions you make, and good luck!
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I think You have to apppoint a (PCA) personal care assistance. they will help your mother ,they also help people who need help and qualify for Medical Assistance.
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The question I'd ask myself is "how would I feel if I showed up at my Mom/MIL's house and found her lying on the floor in severe pain or worse dead....knowing that I had been brave enough to say, 'Mom, you can't stay alone. I love you and I don't want you to get hurt. We need to do something. Shall we try...?'" Then suggest a medical alert system, or a Granny cam, or a companion aide, or an adult day care center, or an assisted living facility. If she is as lucid as you say she is, let her have some input, but you can guide her into the right answer. Do it now before it is too late. This will take courage, something I lack, but I am trying to help my husband who has Lewy Body Dementia and grows weaker and more confused by the day. He doesn't like the aide coming in once a week for 4 hours, but I have to do something to save my sanity and to get him used to the idea because I HAVE to find a job...and soon. I have been looking for a year but the options where we live are limited, and I can't take just any job...I can't work irregular hours and expect the HHC agency to send someone any old time I need them. This is not easy for anyone. You have to do what is best for your loved one...even if it means she is angry with you...this, too, will pass. Her safety is of prime importance. Good luck and more importantly, God bless.
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i m a caregiver and with my expeirence i would get guardianship over her, my family went through this with my dad. and we had to place him in a facility for saftey, he always said no and did get angry with us not easy but saftey is important
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Like your Mother In Law, my Mom is very strong willed and independent. She also lives alone with Alzheimer's and Osteoporosis and is 87. She also refused help from any of her 6 children. While she has had a couple of falls and fractures in her arm and wrist she refused assistance of any kind, until recently. What worked for our family was to have an outsider, doctor, nurse, social worker, come and tell Mom that she can't be alone and that she needs help. For some reason she believed the 'professionals' more than her children. It took us about 6 months to go through the process of hiring someone to come into her home. None of us were prepared to move her to a health care facility. Nor was Mom willing to move in with any of us, which was what several of my siblings and I wanted. Mom still does not like the caregiver who comes every day for 8 hours but misses her when she's not there. She has maintained her independence by staying in her home and continuing her routine. For now this is working but we also know that its not a long term solution. In terms of the cost, here in Canada there is support for seniors living in their own home and the Government
encourages this option as its more cost effective.
I wish you and your husband well and if I were you I would try and get other people, as I mentioned previously, to encourage your Mother In Law that she needs help. While she may not admit it she knows that something is going on with her memory. It may take some time to convince her but be persistent.
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My mother's life got so crazy that we had no choice but to make the decision for her. She wasn't taking her meds, wasn't eating on a regular basis, and baracaded herself into her house to keep "Those People" from getting in. We applied for and received guardianship and moved her to an assisted living center. She wasn't happy about it, but she is safe, properly medicated and most of all ALIVE. Mother was angry with us for a while, but she never asks to go home - I don't think she remembers her house or where it is.
If you have a legal right i.e. guardianship, you can cart her off to an AL facility and you will know in your heart that she is safe and cared for.
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You're right, someone with Alzheimer's can't be reasoned with. Someone with Alzheimer's is unable to make decisions about their healthcare as well. She's breaking bones but keeps going. She could break a hip and be bed-bound for the rest of her life and she'd be unable to be left alone 24/7. The only other option for a broken hip would be surgery and at her age and with her Alzheimer's the anesthesia would ruin her. Either way it would be a painful and prolonged death. But what are you supposed to do? Your husband can't throw her over his shoulder like a sack of potatoes and take her somewhere safer. If she refuses to leave, and so many elderly do, there's not much you can do. Check on her when you can, call her, and hope she'll be spared a painful future. Can she afford in-home help?
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I sympathize with you and your husband as you're between a rock and a hard place. I understand why his mom wants to live alone - she doesn't want to lose her independence. But I also understand your husband's point of view because as long as his mom keeps doing certain things, she will keep injuring herself - and her statement of "I am not hurting anyone" isn't true anymore because if she injures herself doing these things - she is hurting her son and you also - because he has to worry about her more and probably wind up taking her to the doctor or hospital, etc. Has your husband tried talking to her about this? Maybe he should - and also tactfully tell her that if she continues to do these things, she could be backing him in a corner where he's going to be forced to make some changes she might not like. You can still "sometimes" reason with people with mild/moderate Dementia, but unless she's willing to change, there's not a whole lot that can be done. I think the doctor has the right idea though to let nature take it's course. She is 88, and has lived a long life and still active. So if she does injure herself, at least she did it on her own accord. Your husband shouldn't feel guilty if she does too because it isn't his fault. She's doing what she wants - which is what all of us would like. And if he doesn't want her to become too inactive, as that may be what keeps her going. Good luck!!
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