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My mother has been diagnosed with mild to moderate cognitive impairment ~ she is 78 years old and has been living with my husband and I for the past 7 months. She has a room off of our kitchen that is up 7 steps. Her room holds her bed, tv, sitting area, dressers, a desk and full bathroom. We have a small fridge in her room that holds yogurt, cottage cheese, fresh fruits, seltzer waters.
I prepare her main meals and at first she was coming down to eat dinner with us and I was bring up breakfast and/ or lunch for her.


Over the past few months she has stopped coming downstairs at all unless we are leaving the house for a doctors, hair appointment or visit with the grandchildren. When she does come down, it's with the full drama of moans and groans ~ she has a sore back and hip and she does suffer from COPD which she takes medication for.


She has become accustomed to being waited on for each meal. I have explained she needs to "move and get some sort of exercise" and it would help me a great deal if she would bring down her garbage and dirty dishes every day. She refuses.


We just had a doctors appointment and her doctor noticed she has gained some weight (13 pounds) in the past 12 months and has told her the same thing I have been saying ~ he also added that she is fast tracking her way to a nursing home with the lack of activity.


I want to make sure that I am doing the right thing for her and am considering preparing her meals and leaving them in the kitchen for her to come and get ~ this would have her coming down and up the stairs. I have tried this once and she slammed the door in my face ~ and she sent the dirty dishes she had down the stairs....
We also tried bringing her meals but not removing the dirty dishes and garbage from her room ~ this lasted 11 days before I couldn't take the mess up there and my husband felt the newspapers in her room were becoming a fire hazard. I just reverted back to bringing her all her meals, removing her dirty dishes and bringing down the garbage.


I know that I am dealing with someone with dementia so I don't want to make assumptions that she completely understands what she needs to do. I will say that she knows how to make her coffee in the morning and work the small microwave she has in her room ~ she also reads the paper and does her crossword puzzles. She has told me many times she just loves being waited on.


Suggestions please ~ my frustration levels are through the roof and my migranes are becoming much more frequent. I feel like I am dealing with a toddler.....


I would love input from anyone that has/is dealing with this type of issue and how to best handle.
Thanks very much.

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Sorry Chess due to my stress I wasn't comprehending, thought it was your MIL, either way what a loving, caring daughter you are. A true caregiver is a special person, it's not an easy job and not many, family or not take it on. As I mentioned I am a caregiver to my brother with ALZ, he's been in denial since diagnosed 6 years ago, the word has not been mentioned since. We did have a bonding moment at his consult, tears and hugs and letting him know we were there for him. Once home, alone without doctors, his "not having this," "don't need help," attitude appeared and has remained alive, especially with me, his sister and sole caregiver. This is what occurs to a primary caregiver, we seem to be the receiver of all their anger, negative emotions. I am sure it is partly the disease, but, my brother was tough when well, it just escalated. This is your mom and it sounds like you are up to the challenges but it will be a roller coaster ride for you and your family. I question decisions I made, I know I've helped my brother so much, but what a long strange trip it's been. Humor and prayers have helped. God Bless
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Sorry for you and what a blessing that she has you, a wonderful daughter in law, not many would take on this responsibility, it is not your mother and that's the reality of it. Due to her illness, a memory impairment, there will be behavior changes you will see as time passes. I know with my brother, afflicted with ALZ, his tough personality got worse. He has his own suite as well, a nice little setup created when he could no longer manage on his own. In the beginning we had meals together, did family nights, with tv watching, dessert. I felt more like a server, very left out, the gopher. In front of others my brother was kind to me, but alone, my husband off to work, his tyranny would begin with a vengeance. Demands unable to meet, name calling that could bring me to tears, physical abuse didn't happen but I was on guard 24/7. Not a big fan of meds, but on his doctor's advice had to start to keep everyone safe, they do and did help. 6 years have passed, he is still with us, but you learn to go with their changes, it is easier and ok. He prefers meals on his own, in front of his tv, he seems to relish solitude, I do sense it is easier for him as well. He has been in denial since day 1, his way of coping I presume, so I hear more no than yes, so less is better. I have learned to hold back somewhat to avoid any conflict. I know I cannot reason or win battles so I must ignore anything demeaning or hurtful. It is hard, and, sometimes I do respond, saying, "You do need me." I just feel I must, even though I know his response these days. It will not get easier if you take on this role, but, with your love and caring evident it can be done, but I don't think forever. Think all options thru, medical and legal advice helps, plan and follow thru. Stay strong and focused. God Bless
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Chess0727, I hear what you're saying. It can be frustrating when you suspect that the person can do things, only they refuse. It's difficult. There are a number of things to consider. One thing is if there is some actual reason that they are refusing to do what you ask. Sometimes, there is no easy answer, but, as someone said above, has she become unsteady on her feet or had loss of balance. My LO had terrible balance and grew scared to walk much. Also, is she depressed?

I might consider that with the cognitive decline, comes the LOSS OF INITIATIVE. It's not really laziness. It's brain damage. She may be good on some things and not good at others. I had to digest this when my LO insisted on lying in bed in soiled diapers, rather than going to the toilet. It made no sense to me at the time, but less than a year later she had severe dementia. Healthcare workers had labeled her lazy and spoiled.

She may need exercise, but, if she's resisting.....I'd try to figure out, how much benefit are you going to get by stressing over this? I'd just try to purchase healthy foods and keep smaller servings.

If you really want to increase her activity, you could say the fridge is broken and keep her things in your fridge, which means she has to come down to get them. I just wouldn't invest a lot of time in trying to get a person with cognitive decline to do chores or things around the house. I'd just treat it as a disability. If she will go to a senior day center, it might make her feel better.
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Similar problems with my 94 year old mother-in-law. I find that as the son-in-law, she is more likely to respond favorably when I get firm with her than she is to her daughter. I try not to do that except when necessary. She has been with us for 4 1/2 years.
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Back to the original poster - is there any way to move her downstairs? She may be scared to death she is going to fall on the stairs and just not be willing to say so.
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@Grandma1954 You're definitely correct. However, Dad told me that he's lazy. Even though my shower is accessible, Dad won't even let a male nor a woman CNA help to take a shower when his doctor requested the health care. As I mentioned earlier, Dad piles up so much dirty underwear (Depends) and Kleenex on the floor which makes his room stinks.

Believe me, I love him.  If he was not so stubborn about giving up his independence and he also wants to save money for my future, then he would get some help from an in-home health agency. I feel like I'm neglecting him because of my disability.
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To Madtoe: Your Dad is not to lazy to change his clothes. He is possibly any of the following:
Confused as to what other clothes to wear.
Confused as to where his clothes are.
Confused as to what to do with the clothes he has been wearing.

My husband would take off soiled clothes, fold them and place them by his chair so he would know where they were. Once he went to bed I would take the soiled ones and wash them and fold clean clothes and place them right were he left the soiled ones.

As for the shower he could be afraid he is going to fall. He may be cold, he may not know how to adjust the water. He may also not know what to do once he is in the shower. There are a lot of things to remember to do, turn the water on, wet the wash rag, soap it up, wash, wash hair, rinse, dry, get dressed. And if you toss in brushing teeth and shaving that is even more to remember.
It is not being lazy.
It must be exhausting to not know what to do!!!
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There is a special place in heaven for those who take care of elderly relatives! I have no advice beyond what others have said....but think of yourself, too. This is a very stressful situation. Call the Senior Services in your county to see what assistance is available. Even a few hours a week to yourself would help. Maybe your mom would cooperate more with an outsider? Start investigating what the next steps will be...better to apply for any available assistance way ahead of time.
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Maxtor, no money for a facility? I can't imagine u taking on these responsibilities.
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I have dealt the same thing with my mom until she passed 8/16/2016.

Now, I am dealing the same thing with my dad who is 90 years old. He has dementia and is extremely stubborn. He is losing weight and doesn't take showers even if I hired an aide to come in. He's too lazy to change clothes daily. 

What makes harder for me is that I disabled with cerebral palsy since birth. I can't walk and can't use my hands. I remind Dad to take his pills, eat or drink Boost every day, and set his appointment, etc. I beg him to clean up the mess after himself and he doesn't do it because of his backaches and dizziness. I feel guilty that my own assistants have to do the cleanup sometimes. Dad's bedroom is a mess with dirty underwear and Kleenex. No one cleans his bedroom yet because he doesn't want anyone else to see the mess.  

So, it's NOT easy and it's very frustrating for all of us taking care of our parents who became children again and some others are being "rebellious." 😩😰😰😢😢😢
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Chess0727, I fully understand what you are going through. My mom is almost 76, has had Parkinson's for about 16 years, has cognitive impairment as well, and, therefore, has developec a toddler mentality. Be creative. I know it's not easy. I went through a course on how to better handle stress, and my results from that is not to push the issues. That will only cause the "toddler" to want to push back. I had an issue about an appointmentt earlier this week and got as far as the car but could not get her in it. So, I rescheduled our appointment. It's not worth your health to stress about it. If she chooses to be stubborn, let her be. Maybe have a conversation with her about how you'd like the routine to be....meals downstairs...and that if she chooses to not come, she won't get to eat. But don't stress about not eating. One or two meals every now and then won't hurt her and she'll get hungry. Hope all this helps.
Susan
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I am in the same situation with my mother. The difference is she has most of the house and we have two rooms of our own. On her doctors order, I have backed off or "leave her alone". It's terribly hard to watch my mother do everything she can to hurt herself....back/hip issues, left foot withdrew major issues , heart failure, cops, kidney failure. She's refused all help and wants me to wait on her. I can't do it any longer for my sanity. If your mom would accept help, check local services who could come in. It's worth it. Also, your suggestion of keeping meals downstairs is worth a try. Wishing you Godspeed.
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You need to have a talk with yourself and then your Mom.
If you think it is frustrating now..and you have migraines now just wait.....
This is not going to get better.
Her attitude will not get better.
Your frustration as well as hers will grow.
If you do not think you can do this it will be easier to place her in Assisted Living facility now that it will be in 6 months, 12 month or longer.
She will not be able to do stairs for long so if you plan on keeping her at home you will have to either adapt a room on the first floor or resign yourself to the fact that shortly she will not be able to leave the house without the assistance from a medical transport.
If there is a bathroom near her room that will have to be made accessible, open shower, raised toilet and large enough so that a wheelchair can be used safely.

While neither of you probably want placement in Assisted Living then eventually Memory Care (and she may be past the point of Assisted Living now) this would be easier now rather than later if you do not think you can handle this for the next 4,5,8 years or how ever long she has. As I said this will not get easier.
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Thank you KatieKate....will do as you suggested.
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When my Mom refuses to get up and move...I just don't ask. I showup with her coat, tell her we need to get out...and the. Have her stand up..put on the coat..and we go. I do not ask her opinion, or permission. We go

Try going up stairs, saying to Mom..."dinner is on the table, let's get you up and down stairs" and proceed to help her do it. Don't ask.

This got me an argument the first couple times, but I knew it was dementia...so, I just ignored what she said and continued along as if she had said nothing. And it worked!

See that helps you
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Cttn55- the same thought has crossed our minds here as well.
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"she slammed the door in my face ~ and she sent the dirty dishes she had down the stairs...." Maybe just let her fast-track herself into a nursing home? Maybe that's what she wants? 
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Also, do watch out on those steps. They will actually give her useful exercise, so don't let her blame them for not wanting to join you; but mind she doesn't launch herself down them in some kind of passive-aggressive fit.
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I'm so sorry, must have been having a senior moment of my own - I have no idea why I thought it was your MIL! [head scratch]

All the same, mind you, many ladies do appreciate attention and support from younger gentlemen - I know my mother was always more apt to do as my exSO told her than if I tried it. Humph! But of course it does mean asking your husband to step up a bit above and beyond the call of duty... Any chance?

Either way, do give her plenty of time, and do be patient. She's not faking how creaky she must feel :(
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Thanks Churchmouse ~ it's my mom so Im going to deliver the news :) I am thinking that she will need to come down and get her dinner ~ she can eat with us or she can bring it upstairs...her choice. I imagine we will go through a few nights of "Im not hungry" I'm going to blame it on her doctor...haha. I guess I just need to get some confirmation that I'm not asking too much of her...I really dont think that I am
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Her joint pain will only become worse if she becomes more immobile and gains more weight.

Of course, I'm sure she knows that. And unfortunately it won't make moving around any less uncomfortable for her right now. What a depressing situation she is in; and how stressful for you.

Well, she's your husband's mother. Let him be the bad cop. Meals get taken where the family eats, and - assuming you do the cooking and the clearing away? - he goes to get her. He'll need to allow plenty of time at first for arguing and "I'm not hungry anyway" (and for the fact that she will need to take her time), but if he's sweet but firm with her it should work and it will do her good.

If your husband's not around for breakfast or lunchtimes, then just prepare a tray, take it up and fetch it - it's actually easier to work it into your schedule if you're expecting to do it anyway. But I don't see why you should be set up for twice or thrice daily confrontation with your MIL.
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