Mom's not really trying -and I feel guilty. How do I cope?

Was your mother taken to the ER after that last fall? And they released her into her own care after?

You say your mother "isnt trying". Has anyone evaluated her in more than a cursory way for dementia? Like a full neuropsych workup?

Is she on meds for her depression? Do you have poa for health and finances?

I'm sorry to ask so many questions, but knowing this information will give us a better picture of the situation.

Unless she is losing cognitive ability she is fully aware of what happened and was scared out of her wits, but she chose to endure the discomfort rather than call for help. I imagine she is pleased as punch with herself for managing to overcome her ordeal help and looks at all those bumps and scrapes as her "war wounds". She seems to be attempting to assert her independence and possibly resents your constant remonstration. Pick your battles carefully, perhaps a promise to keep the phone with her at all times or to investigate an alert pendent system is the best you can hope for at this time.

I'm also careing for parents long distance. Like you I call every day and have neighbors I can call in emergencies. You mentioned neighbors and caregivers. Do you talk to these folks? Does anyone stop in daily?

I make the long drive to see my folks 4 or 5 times a year to deal with crisis and sometimes just to get an eyeball on things. How far away are you from mom?

Foster, she would be a LOT safer in Assisted Living, plus they manage meds and there are lots of activities and good company.

Wow - such helpful responses! I will take time later this pm to answer the questions. Thank you all for taking an interest!

One quick thing: Pamstegma -- I would LOVE to have her move to assisted living. Thing is, we were on a waiting list for four years to get her into the subsidized senior apartment that she moved into about six months ago. We were hoping that this apartment would be a place where she could heal and regain strength after too much isolation and too many accidents. I don't even know how to think about her moving again. She found this last move so overwhelming and traumatic...

I wouldn't chalk her poor ability up to not trying. It sounds like she's really struggling. I would try to have her assessed. Once the falls start, it's often a series of them and if they suffer a fracture. Well....it's downhill.

I wonder if the reason she keeps mentioning her previous fall is that she has forgotten that she has already told you, so she thinks it's new news.

We have noticed that when seniors fall and delay calling anyone, even though they got up, it seems that they either forget to are not able to call. It's like they lose track of time.

Since you say that she is not able to care for herself is she falls, I'd take measures to get her some place where she can be taken care of, like AL. Even though she moved, it may still make sense to explore it. I hope it works out.

In answer to Windyridge's very sensible questions:
I live in Texas; my mom lives in Arizona. Because I work full-time and am the main source of income for my family, I can't visit very often.
There is a young woman who takes care of my mom out of the goodness of her heart, bless her. She sees my mom every couple of days, from what I can tell. And my mom has physical therapist visits every few days. She has a small dog that needs taking out, so she has to open her front door at least a couple of times a day -- and because the apartment units are close to each other, it's easy for neighbors to see her and say hello.
Mom also has a few friends from church who give her rides, and her pastor visited her a couple of days ago. I don't have the friends' numbers, but I have talked with the pastor and given him my contact info -- and asked him to please do what he can to help his church care for her.

And to Babalou's questions:
Mom didn't go to the ER after her most recent fall. She called the young lady who takes care of her (when she can, working around her night-shift full-time job). The young lady called the EMTs. All of these people arrived at the same time to get mom up, and I was on the phone with them. Mom was making light of the situation, saying she was OK, etc.. The EMTs checked her over and left. THEN my mom complained about how beat-up she was. The young lady got her into bed, and my mom slept for a long time.

It is unclear whether my mom was unconscious for some of the time she was on the floor. She says she was awake and afraid that she was going to die, but ... for more than 24 hours?!

She is on meds for depression. She just told me that her Dr is reducing her dosage of Depakote (medication for bipolar disorder). She also said that her Dr 'will refer her to psych as follow-up.' I don't know if that means that a proper, full eval will be done.

Re the powers of attorney - That's tricky. My brother was being very pushy about getting power of attorney over her before he died a year ago. I find myself avoiding the issue because it raises all sorts of issues about control. This is really where I find myself unable to think clearly.

By coincidence (or providence!) I just stumbled across a Grief Group that meets in my area. I am thinking of going to that for a while. My brother's death was a suicide, and I think that I need to sort some of that out so I can take care of my mom properly.

(Please forgive me for going into so much detail -- as you can probably tell, I'm a bit pent-up about all this.)

MB, at the young age of 73, there has to be a reason why she is so totters as you call it. That is not very usual in someone so young. Perhaps it's the medications. I do agree that she needs an assessment of her balance and if she were in assisted living she could partake in exercise classes they offer. If all she does is sit all day, that is one reason for no leg strength. However, I agree with a precious person that you have to pick your battles. No need to feel any guilt as you've done nothing wrong. I would have to wonder if your mom is compensating for some cognitive deficits and trying to appear like she has everything handled. Her bravado and refusal of help indicates that. But you know her personality and I do not. She needs a cognitive evaluation for certain. It sounds to me if she needs this many people checking up on her she's not safe alone. You do need POA if you are the only child left. Also health care POA. Does she have an advanced directive. None of us want to ask these questions of our parents (believe me I know as I had to discuss a DNR with my dad) probably need to set up an appt. with an attorney and get these in place. I think you're attendance of a grief group is excellent and I'm sorry about your brother's death.

From your description, it sounds to me like she really needs to have either in the home health care coming in to help her or maybe a live-in caregiver. If all else fails's, definitely gain custody of her and put her into a facility. It sounds to me like she may not want to be a burden to anyone, so she tries to still do things for herself even if she shouldn't. I used to have an elderly friend who was always calling the EMT. It was already pretty frequent, but when it eventually became once and then twice daily, somehow the right people were able to gain control of the situation and get him into a nursing home. It wasn't fair to the rest of the public that he was taking help away from where it was really needed when most of the time he didn't need any help. Abuse of resources is exactly why I think something should be done to stop it. I'm glad that our local EMTs were able to finally get something done and crack down on the ongoing problem that one of the only worsened. Again, it's not fair to the rest of the public if one person is abusing the system and our resources, especially when someone else who really needs it must face delays in help arriving when is most needed.

Oh, MB, my heart goes out to you, trying to do this from afar!

About POA, it's about having the power to act in your mom's best interest, doesn't give you the ability to dictate where she lives--only guardianship would do that.

Suppose the next time she falls, she unconscious for a day or two in the hospital; bills have to be paid, decisions made about health care, etc. That's where you need financial and medical POA. something to mull over.

Mom certainly needs a cognitive evaluation and perhaps some fine tuning of her current psych meds.

Several years ago, an elderly friend who lived alone in an apartment building, well connected in the community, fell in her apartment. It was summer time, so lots of folks were away. She lay there for three days, until a neighbor noticed her newspapers piling up. the doorman CLAIMED that he'd seen her leave on a trip with a family member, but the neighbor persisted and called 911. She was alive, but spent several week in the hospital and then in rehab, eventually returning home with 24/7 aides.

My point is, please get as many local phone numbers as you can and give yours to the neighbors and friends. Encourage them to contact you.

And I hate to be suspicious, but please get POA before that nice young lady who is taking care of your mom out of the goodness of her heat does.

You mention she is in a senior housing. Is there anyway that she could set up a way that one of the other residents would stop by her apartment to check on her. She could do the same for someone else. So your Mom could have "Sally" stop by on Tues and Thursday and your Mom could stop at "Sally's" apartment on Mon, Wed and Fri. That way they check up on each other.
I am impressed that your Mom watched a video on her phone, many would not know how to do that. (and I won't have a phone smarter than I am)
There are medic alert systems that will respond if there is no movement within a certain period of time, that might be an option.
Or a remote camera for you to monitor her. Place the camera in the kitchen or living room so you can monitor if she has been in the area. If you see no evidence that she has been around you could follow up with a well being check.
And the reason for her instability should be evaluated.

MB, lots of very good advice in this thread. A couple points that are important I think:

The POA needs to be done. If mom can use a smart phone I would think she would be able to discuss this with you and agree to a POA. I am long distance and I was able to get a very broad POA about 4 years ago. As my parents declined I've had to take over all the bills and finances, oversee medical care and deal with many other issues. Without the POA this would all have been impossible. You need to lay this track soon.

I'm fortunate to be retired so I can jump in the car and go deal with whatever comes up. I know it's much harder for folks who are still working but sometimes it just has to be done. You can only do so much over the phone.

Whether you're long distance or living with elders stuff is still going to happen. Your mom can have a fall with you in the next room. I've tried hard through the years to get the house set up, grab bars, bed rail, potty seat, fix this and that etc.

I used to constantly worry that I wasn't doing enough, shoulda-coulda done this or that. I've now come to realize things for my folks are as good as I can make it. We won't prevent everything. People continue to age, have falls, dementia progresses, they need more care and looking after.

I'm more at peace with it all now. No guilt. I still worry but I don't obsess any longer like I used to.

Good answer, Windyridge. I would just add that at some point, you are going to have to get involved, short distance. It sounds like there are some great neighbors and the girl who helps out "out of the goodness of her heart." But neighbors, a nice person, and the church cannot be asked to assume responsibility for your mom's well-being. It's great that they are helpful and involved, but please just keep that in mind as you continue to evaluate your mom's care and situation. My mom lives in a retirement community. People were helpful to some extent. But they go on vacation, are out and about, and have responsibilities of their own.

I can't stress how important getting the Durable Power of Attorney and Healthcare POA as well. There will never be a better time to get it, since your mom could suffer from mental decline and then not be able to appoint you. Then, it's much more complicated. You can make up a story about someone you know and how horrible it was that they didn't have the paperwork signed. And it's true. You can read about that all the time around here.

Since you are long distance from your mom, you might explore getting what I have read about called a case manager. I hope that's the right term. They can assess your mom's needs and even keep check on her to determine how she's doing. It would be ideal to have someone go into the apt regularly to ensure that your mom doesn't have spoiled food in the fridge, plumbing is working, that she is clean and nourished, etc.

Will you be in contact with the doctor she will see for an evaluation? It might be a good idea to provide him input, since, you can't be sure what your mom might tell him. She could suddenly say that she never fell. So, I'd try to confirm that the info that she reports to an evaluator is correct.

All good advice from many people who have been there, or are still there. I'm wondering if your mother is just starting into dementia because she is exhibiting many of the signs. If showing bad judgment is not part of her behavior in the past, I'd have her evaluated. (but keep in mind that elders can often fool a doctor into thinking they are "normal" - my mother did for years also lying to the doctor.)
You mom may be beginning to feel her limitations and is fighting them, and part of that fight for continued independence is denial (and doing things they know they shouldn't - like standing on a chair to hang curtains, etc).
By all means, get a POA before it is too late and see if you can get your name on her accounts so, in case of emergency you can pay her bills, etc.

We feel the same way with 90 Y/O Dad and we are right here! He lives semi-independently next door to us and we have monitors in place so that we can keep an eye on him when we are not there or he is not here. There have been a few falls recently - fortunately with no apparent or expressed injury, but mostly due to the fact that he "forgets" to utilize his walker.
He is tall and heavy making it difficult for even both of us to pick him up, so husband and I have literally gotten down on hands and knees and shown him how to get himself up. Unfortunately his retentive abilities are not what they used to be and he is unable to recall this info - especially at the time of distress and disorientation.
This is very difficult for us and of course our primary focus is prevention, but we tend to think more logically than Dad can given his current physical and mental conditions.
And his PCP so wisely reminds us at every check-up, "It's not going to get any better"!
BTW -where can we find the video showing the elderly man about how to get up from a fall?

MB--I feel for you, caregiving is hard enough when you can actually get to your mom and see her and watch her "in person".

Maybe time for you to visit and address everything at once? At 73, being "tottery" suggests to me, anyway, that she is not getting much physical exercise and there could be some serious muscle atrophy. My mother is 86 and since her hip replacement, she is VERY tottery. She needs a walked but refuses to use on in her own house. That battle was lost....but prior to her surgery, she was falling all the time, 3-4 times a week, and would also kind of "play up" her injuries. That's just the sympathy vote, in her case.

Maybe if you came to visit you could assess the situation, get in place the POA, check her living environment and make it safer, get her to the dr., etc. Oh, this sounds like a joyous vacation, doesn't it? But I think trying to do all this long distance would be harder.

It IS hard to talk about end of life things with our parents. Some just refuse, but hopefully your mom will be compliant. Fuss her a lot when you visit (sounds like she asking for attention)...and let her know that you come from a place of love, not anger. My mother doesn't do well with the criticism that sometimes comes, and now I am older and get some from MY kids, I get it.
I wish you well. I am sorry about your brother. Please try to come to terms with that too. You have a lot on your plate, but you can always come here to talk.

Hey, cands!, can I make a suggestion regarding picking up dad? The home agency we use gave us one of these belts - like a seatbelt - to use with my mom. If you've ever seen anyone do physical therapy after surgery, maybe you've seen it in use. Anyway it is like a safety belt so the patient doesn't fall. I have used this at least 3 times when my mom just went down. I don't understand the physics of it, but just putting it around her waist and grabbing on has allowed me to pull her up with ease. Without it, she is like dead weight and I just can't do it. I wouldn't have believed it until I tried it myself. Good luck!

Thanks tornadojan! That's a great idea. Although we've heard about these items, it just didn't occur to us at the time that there might be a need for one. We'll be on the look out - maybe at thrift shops in area.

Cands, Jan is talking about a gait belt, while it does give you something to hold on to if you are helping someone I myself have not found it to be very helpful in helping mom off the floor. You can see many helpful videos on using gait belts and getting up from a fall by searching YouTube, it is a great resource for lots of caregiving info.

Thanks for the input, cwillie. We will take a look.

Is Power of Attorney simply a form she - or I - fill out?
I imagine that it needs to be witnessed. Or certified somehow... Or do I need an elder-care lawyer for it to be legal?
Is it state-specific?

Please ignore previous flurry of questions - I googled around and found the form for Arizona. Now I just need to figure out how to present it to my mom in a way that doesn't make her upset.

There are different types of Powers of Attorney. I'd contact an attorney to make sure it's done properly. Getting things online can be problematic to a lay person. It's not that expensive to go with a legal professional. I've seen people do them by themselves and then it turns out that something is not right and they are worthless.

I strongly agree with Sunny, use a lawyer. It's not that expensive.

Also, if the language of the poa is written correctly you can use it to take care of her affairs and finances now as long as she agrees. Don't get a limited POA that gives you no power until she is declared legally incompetent.

Plus, there are technical things that may need addressing that only a lawyer may know about. New laws can change requirements. I wouldn't take the chance.

The Health care power of attorney also allows HIPPA access so you can handle her medical affairs later should that be necessary. I agree on using an attorney for both types of POA.

MBFoster: I am very SHOCKED that your 73 year old mother is acting very much older than her physical age. Is she on medication for her "lifelong depressive?" You should get her checked out by a psychiatrist. My goodness, I'm 69 and 1/2 years of age and I would immediately get myself to the doctor if I "tottered" and also if I had lost that much of skill set to know that if I've fallen, I call 911 stat and don't scooch, crawl, et al.

To all those who urged me to use an attorney, I am heeding your advice. I assume that I will want one who practices in Arizona. And I assume that there is some way that this can be handled largely by phone and e-mail. Thanks for your guidance. I know that things will seem better when I work through this -- if only because it will force me to think about the inevitable. When I know what to expect, I can cope a lot better.