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She does not eat much any more and has no interest in doing anything. My husband and I spend a lot of time with her (she lives very close to us) but we both work and feel like we are not doing everything for her that she needs. The problem is we don't know what to do or where to turn. She doesn't want to live with us, and would never consider assisted living. Yet I feel like we should be doing more for her to make sure she is safe and well cared for.

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My mother-in-law 97 years old lives across the street from us.....she is very independent...does not want to live with us and we realize would be too stressful for all. We went with Home Instead Senior Care(there are other great agencies out there too) almost a year ago when my husband (an only child) and I could not meet all her demands, needs and depression she deals with was increasing. We started out easy 3 days a week 4 hours a day( she too was very reluctant and not to thrilled initially).......we told her this was something she needed to do to continue to live in her home. She developed a great relationship with her first aide over time and now she is with a second aide just in the last few weeks(in addition to her 1st aide....they can cover for each other too which I'm very happy about) for another two days a week and my MIL not thrilled about the additional aide but doing better, she is now saying she is at least very nice....definitely takes awhile to develop a relationship. We are now up to 5 days of 4 hours each day with good results. I have my MIL to our house the other 2 days for dinner and the evening and do the MD appointments and some outtings when time allows...much more managable for me. She is constantly worried about money so my husband needs to reassure her all the time she has the money.....something this generation is known for(my Mom too)...maybe your Mom too....children of the depression. The aides help with grocery shopping, laundry, light housekeeping but primarily provide companionship...a ride in the car, playing cards, conversation. It took alot off me her daughter-in-law (I'm retired) my husband still works and I have my own mother who lives out of town in a nursing home with severe Alzheimers....who I try to see fairly regularly and I also work on myself that I won't feel guilty and need to have time for myself....if I don't take care of me I'm not to good for anyone else:-) My mother-in-law does take an antidepressant which helps her......unfortunately she stops it at times without her telling us(hides it from us!!!!!).....does not want to admit she needs that kind of help. The aides are keeping an eye on her meds as well which has been very helpful and presently taking her prescribed antidepressants with good results.....our summer was rough but much better with her on her meds and additional help. We are taking it one day at a time. Our next step is to check out some Assisted Living places and Nursing Homes just incase we need to go in that direction.....having some idea where to go next if necessary. Good luck...just wanted to tell you my experience......know every situation is different......." to you hugs"
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I agree with perseverance no one in their 90's wants to live totally alone.
Age has generally made their world smaller due to deaths of spouses, friends, siblings and even children. Companions, or home health aides with friendly dispositions can make their final days on this earth so much more meaningful.
Being in familiar surrounds is ideal as well.

Good luck I do agree that much of depression in the elderly comes directly from be lonely and left alone.
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She needs caregivers! Please, do the right thing and hire caregivers through Home Instead or the like. Of course she's depressed! She's been left alone!!
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Jinx, Meds are always an option, but if I can change my diet/lifestyle/etc. to accomplish the same thing, I opt for the latter. Hope I did not come across as against medicine. One of my daughter's sunk into a depressive state, and the cure was as simple as changing her room décor...color has amazing healing properties. And, her doctor told me to try that along with a diet adjustment. Not all doctors have a prescription pad attached to their hip. I have the highest regard for all doctors; but those who offer patients an alternative to meds when possible, are a more valuable resource in the long run.
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I understand your caution, ayagaba, especially with the frail elderly, but have you ever had suicidal thoughts that didn't go away?

If you run everything past a doctor who is an expert with the elderly, and a pharmacist, a TINY dose of the right medication can make her life worth living.

If God didn't want us to use medicine, then why did he create it? LOL, but I'm also a little serious. Penicillin! Epi-pens! Ether! WHY do you think we live so much longer these days? Clean drinking water, yes, but also modern medicine. I always try to take the smallest dose of the safest medicine that works, but if I have a problem, and IF a pill can fix it, I take the pill.

I have enough problems that a pill WON'T fix!
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Lots of good responses here...just a note--please make the psychiatric eval and prescribed meds for "depression" your last, last, last option. Too often prescription meds do more harm than good, i.e. lift one's spirits and demolish their liver/kidney/stomach lining, etc. She is 93! WOW :)
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Does she belong to a church where maybe someone there would be willing to come and visit? There are organizations that will come and just visit or ask if there is anything they can do to help.

The thing is a lot of people do not want to be a "bother" to their children and their families so even if you ask them to move in with you they will say "No" even if they would really like to say "yes." Then again there are people who will continue to say "No" because they really do not want to live somewhere else. They are use to their homes and their routine and they do not want to be uprooted and have to get use to someone elses routine.

As people age they do lose interest in many or most things going on around them. My Mom was a crafty lady and she sewed and decorated our house when I was younger but after my Dad died, my Mom's world stopped, she felt that she was no longer needed even though my sister and I and my daughter were living here with her and assured her that was not so. But my Mom no longer has interests in anything, she verbalizes that she is just waiting to die. She will only leave the house to go to the cemetery or if she has a doctor appointment.

Good Luck and Best Wishes to You All!
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If the agency has other caregivers to offer, you could find one she would enjoy. Or look for someone from church, a single mom or an early retiree (maybe male?) that has a personality she likes. Hire them, or tell the agency to hire the person for your mother only.

I was a "companion" for a while, and I could cheer one client up by gossiping about my (historical) sex life. Maybe she would like someone funny, or someone who would sit and knit, or work in the garden or cook favorite recipes from her youth, or someone who would bring their dog for a visit.

Maybe tell her that the companion needs the job! She may feel awkward having someone in her home, but might get used to it with a compatible person if she gets over her initial shyness. Tell her to let the person come in 5 times before she decides to keep or fire them.
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I had the exact same problem. Mother is 94. After a fall sent her to the hospital, she was deemed unable to live alone. She is currently in a NH and is thriving. I never would have believed it. So, don't rule out AL. My mother wouldn't be alive now, if she wasn't at the NH. She is clean, fed, with people her own age (that she knows) and is being made to walk around. Her family is pleasantly surprised.
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I would have he checked for depression but at 93 the elderly can lose interest in food especially when they have to prepare it and eat it alone. However, a balanced diet is needed especially if she is on some meds for heart etc.

I would consider adult day care or some senior meetings during the week to have her out with people during the day. Problem: her age, by 93 my father didn't want to sit up all day. The stamina is lacking by this point.

Everything takes lots more time at this stage, eating, bathing, toileting etc. So thinking they need to keep a certain schedule as they did at 80 generally isn't possible.

I would try to have someone there as a companion or home health aide during the mid day- to late afternoon hours (10am to 4pm) might work. Someone to help get them dress, feed lunch and someone to chat with during the day. This could eliminate the need to transport her to a day care center each day. Mobility normally becomes an issue. I would keep a PT coming for some armchair exercise if possible. If she still walks that would be something to try to maintain.

Good luck but just like the 80's aren't the 70's, so too the 90's aren't the 80's. Elder care gets progressively difficult, there is no quick fix---much of it is trial and error. Most of the experts never cared directly for a 90 something so much of their advice is useless. You face largely unchartered waters, just try to keep the elder safe, healthy and happy. You are doing your best. That's all you can do.
So I would hire a private pay home health aide or companion to be with your mother. If you get a good mix (elder to companion) they can assist them as they live their lives. Perhaps look into meals on wheels for lunch time. The elders get used to seeing the delivery person, we had a friendly guy who would
chat a couple of minutes with my dad (he liked seeing him each day).
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I have 6 sisters and two brothers besides me. My mom is 92 years. I had to take family leave from work, without pay, since 11-16-2012. I just recently started working again. My wife and I had to lliterly put our lives on hold, because all my siblings dogpiled on my mom and put her in a nursing home without her consent. She begged me to take her out of there! I took her out, despite all the arguement from my sisters, when I found out there was no Medical Power of Attorney. She came home with us on 11-21-2012. One day before Thanksgiving Day! My wife and I have been working 24/7 round the clock taking care of her without any support from any of my siblings, except my brother Marty. It created a hardship for us and it's still going. I had to rent out my home in Corpus Christi, TX and move to her home in Robstown, TX. My wife Hilda had to resigned from her job and is curently her caregiver without pay (income wise anyway), but the joy and the comfort that it brings to our souls, just knowing that my mom is in great care is "Priceless"! Not withstanding that we have always been known as "The Black Sheep of the Family" God really does work in Mysterious Ways! Save your mother-in-law! We need to respect and love them. They're our roots! Whatever it takes, "Just Do It"!
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It was seven years ago that my sister in Indiana began noticing that, living by herself like your mom, she was beginning to turn inward. Mom didn't want to give up her home either, so I invited her to "visit" with us in Texas for a few months. What a change! She'd go home for month and then move on to the next sibling's house. She rotated from Indiana to Texas to Illinois and New Jersey. We were all working, and she was by herself much of the day, but what a difference it made for her to become part of family life again. We took her with us to the grocery store, church, shopping, parties and family gatherings. While in Texas, she was my sous chef, and especially liked to stir the pan or chop veggies. She also liked to fold laundry and deliver the piles to everyone's rooms. She kept her own home until last fall. Mom is now past that stage of life and lives here in Texas permanently, but those were wonderful years ... for her, her children, grandchildren and great-grandchildren!
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If there is a senior center nearby enroll her in their daily programs. They feed the seniors a lunch, she will have others to talk to, and since you didn't mention her mental status, I wonder if it is intact. At 93 yrs. she is either sharp or with depression comes some dementia (or slower thinking). She needs some companion during the day and you could hire someone to come over for 4 hours and do home health care (cleaning, taking her out, talking, etc.) and find someone she enjoys. Then when the two of you get home from working, you will find a more enthused mother-in-law and you can enjoy a meal together! Just find things for her to do as she is dwelling on the end of her life. She is a survivor having lived this long, so give her a hug from me!
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Can you arrange for someone to spend time with her each day? If there are no medical issues, that may be all she needs at this time. It will keep her on track in terms of eating and having someone to do things with her. It could be going for a walk, playing cards or looking though photo albums. Find someone through word of mouth or a house of worship. When my Mom needed company, I had my unemployed friend visit. ( I was there the first time and showed her the ropes.) I told my Mom that "Ann" wanted to go into working with seniors and wanted to be able to say she had experience. Mom never knew I paid for it (with her resources) and said they had a lot of fun. Ann made sure they both ate, went for walks, asked if she could help with laundry, etc. I was always more comfortable on the days Ann was there. When she found a job, I called a nearby church and the staff there knew someone in their congregation that did that type of work. Again, I spent the first day showing her around. She e-mailed me each evening that she was with my Mom and gave a 'report'. This worked for a while but ultimately, we moved to assisted living. Never regretted this as an interim step though. Also, agree with above, get her to a geriatrician for depression assessment.
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Is there a senior center nearby? Can you get her to geriatric psychiatrist? Depression is NOT a normal part of aging, a can often be treated with an antidepresent
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This is the same situation our family had! My sister lives in the same town, the rest of us 200 or more miles away. It became impossible for my sister and yet, without quitting our jobs and moving 200 miles away, I could do nothing to help other than go down there as many weekends as I could and giving Kathy a break. She tried to hire people in for 4 or 5 hours every day but mom would tell them not to come back.
We got lucky when one of my brothers got off of active duty and was unemployed. We moved him in with mom. It is far from a perfect solution and I tell mom it is the only choice.
You and your husband need to look at all the options with as much knowledge as you can find. The price of assisted living, the amount of money she has, the cost of preparing your home to move her in, the ability of you moving in with her, the ability to find good help. Make your decision with your husband and than do it. If she is suffering any dementia, for her own safety you have to take the reins and do what is best. If she is becoming unhealthy, the same thing.
My 93 year old mother, a nurse until she was 81! and a very independent woman had to give up her checkbook. It wasn't even a choice and she believes that we had her declared incompetent. But we had to do it, for her own good. My sister pays her bills now and gives her money to spend. It has been the most difficult thing we ever did! Believe me, we have had some difficult decisions, that was the hardest! We did it out of love and concern
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