Mom's behavior and attitudes in ALF with Hospice services is beyond understanding. Any ideas?

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My mother is in Assisted Living and has hospice services because of a "Failure to Thrive" diagnosis last September. She began improving in December at least to a point where she would read, do crosswords, smile, and walk the halls with an aide. She is 100 lbs, has no muscle to speak of and doesn't eat enough
She has always been negative and self centered. It has always been difficult to get her to do what doctors order such as exercise, drink enough water, and other common sense behaviors to battle depression.
She has been falling and hitting her head for years but still takes no safety precautions on her own.

So,,,,, ,,,,, two weeks ago she fell and ended up with 15 stitches inside of her mouth, 4 stitches outside, a black & swollen eye and bruises beyond measure. A few days later, bleeding in her brain was deemed the reason for speech problems.
We have worked closely with the AL facility staff, hospice, doctors, social workers, etc. and re-worked her space with safety in mind, made pretty reminders/posters to call for staff help when getting up, bent rules so she can eat in bed and arranged more frequent checks by staff. We brought a small refrigerator to keep yogurt, Ensure, pudding, applesauce etc. so she could eat well even with the mouth injury. We've had Hospice order a bed alarm but it has not come yet.

Yesterday she (? proudly !?) told me she had gotten out of bed to go to the bathroom by herself and .... yes, she fell and hit her head again. This had happened 14 hours prior and SHE NEVER TOLD anyone. As I was leaving she told me that she intended to get up without help any time she needed to.

A little info: I am only child, POA, live close by and am recovering poorly from hip replacement surgery. The ALF staff,~~ well some are good and others are lazy so thank God for the extra attention from Hospice. It's really an above average facility and I don't see myself getting ugly because a few staff are a little lax.

Family and professional staff tell me to stop trying so hard and accept that she will never listen or even grasp her situation . Mom's dementia is pretty mild but the numerous falls with head trauma effect her behavior. Any by the way she and I never had a super close relationship and she is not a believer. That she may not have an afterlife really hurts me.

Thanks for any help or thoughts...

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DK, I think this is one of the hardest things to deal with, accepting that there's only so much you can do and you can't fix the situation.
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My mthr was a hoarder, so I had to come to terms with the face that she lived by her own set of rules many years prior to us putting her in a facility. That does not make it easier to see her suffer the consequences of her poor decisions and stubbornness. With responsibility comes consequences, both in physical health and spiritual health. Sowing and reaping.

Respecting her decisions also means accepting her self inflicted injuries. You don't have to drop everything to rescue her from herself. You have done the best you can and you have provided a safe environment. If she chooses to refuse your help, that is her right. You don't have to enable her bad behavior.
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Thanks to both of you. I know a bit about TBI but could definitely learn more. I I can ask them to look at her medicines again, too. It's always comforting to know you guys are out there.
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DKOBrown, her ability to think stuff through is pretty much gone. We are going through similar problems with mom. You ask her angels to guide her and maybe send your own too. Her afterlife is in the hands of a much higher power, none of us can know what that will be. You know God will believe in her even if she cannot see the light.
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Traumatic brain injury. Numerous falls hitting her head one serious enough for a brain bleed. Please read about this condition. Mayo clinic has articles and lots available on web. Loss of cognitive function is a hallmark of TBI and dementia. She cannot connect consequences, and I am sorry you have this on top of all. She may need different placement or Meds change. Some Meds could be adding to fall risk. Ask pharmacist filling her prescriptions for side effects.
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