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First let me say that yes, my 84 year-old mother is ill. I realize that. She has, for 18 months or so, become extremely manipulative, attention-seeking, faking illnesses and disabilities for attention. The first time occurred during a short-term skilled nursing facility stay after a hospital admission for an illness. Of course she received a lot of attention when she first arrived because of assessments and so forth. She has put on an act to get back to facilities ever since and stay until Medicare coverage runs out. Once she was even discharged basically for refusing to comply with therapy or any part of her treatment, claiming she can't do anything on her own even though staff knew better.


After a few days, she started soiling herself. She refused to get out of bed to go to the dining room so that staff would bring meals to her. She refused to walk or make any progress whatsoever in physical therapy, even though she was told by staff that she was not putting forth the effort needed to improve. Of course she became angry, claiming "They're mean to me!" She claimed an in-home caregiver, a family friend is "Mean." It is because the caregiver will not wait on her all day. She actually laid in bed one day until 1 p.m., expecting the caregiver to come on her day off, clean mom's soiled bed and butt and feed her. Mom said, "That's her job."


The next facility visit occurred after an alleged fall. She had several falls, all of which occurred when no one else saw her. In one incident my sister rushed over after a call from mom, claiming she fell getting something out of the closet. Yet she had her cell in-hand and the closet door was closed. She refused to answer how she fell if the closet wasn't even opened.


At the same facility she again refused to go to the bathroom. I was there when a nurse asked, "Do you not feel when you have to go?" Mom replied, after the 2nd time pooping on herself, "Well, I just thought it would be better on you all if I just went in the bed." She also stated to me that "I am about the worst one here," meaning the sickest.


She is at a different skilled nursing facility, this time after being in the hospital for UTI, likely secondary to her diabetes. She falsely stated that she has not been able to walk for 2 years, after refusing to comply with physical therapy again. She has on the same shirt she had on 2 days ago because she lied, saying she has no clothes. Why staff did not look in the dresser where she has many clothes, I have no idea. No, mom did not forget they are there.


She has her mind made up she is staying there. Dad has survived 3 heart attacks. You cannot get him to realize that he will lose everything due to Mom's manipulation if Medicaid steps in. They do not have nursing home money. Mom refuses to listen to anything, says very nonchalantly, "Oh well, Medicare will pay for it," even though we told her Medicare does Not pay for nursing home care and that dad pays a lot just for the skilled nursing!


She is not depressed. She is manipulative and lazy, refusing to do anything but lay in bed and have people wait on her ever since that 1st facility stay. While that sounds harsh, it is the truth. Last visit, she refused to walk in physical therapy but an aide walked in the room, discovered that Mom got out of bed, walked all the way across the room and back to bed on her own, to where one of her enablers left candy and cookies, knowing she is diabetic. She had a cookie in one hand, candy in the other. There were no visitors, so no other possible way she got it.


I am a former adult protective service worker, so have lots experience dealing with sick, disabled, manipulative, neglected, abused seniors. Yet, I am at a loss for how to stop her from ruining my dad financially just so she can get attention, even though she was never lacking for attention.


What are your experiences with this? Thanks!

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Have they checked your mom for stroke or brain bleeds? My grandma had a clogged artery in her neck and it literally changed her overnight, it remains the scariest memory I have. When it plugged completely she had a series of mini strokes and brain bleeds that changed her to an entirely different person.

You can't trust the hospital to look, you need to say her behavior indicates she has had a brain incident, we took a 96 year old woman to the ER and they were clueless, my husband said, ya know it looks like she's had a stroke. This got them checking that out and sure enough, that's exactly what it was, but not one medical person had that thought. Scary.

You say you are a professional in this field but leaving that aside because it's family, I would think now is the time to implement all of your professional know how and to even call in some favors to get her head checked. This may be a woman who is done with the hard work of being a housewife or it may be something else. I'm afraid we are all a little less gracious towards our own parents and their issues. Doesn't insulin abuse cause some pretty nasty complications? Could this have caused an issue?
Im not saying you don't know what you know, but sometimes we don't want to see. I think by the time I'm 84 I will be done scrubbing toilets and fixing 3 meals a day. I bet your mom has always done all the housework and cooking, maybe she's just done. None of us know what is happening but you can't get upset because people are responding to what you wrote. I don't think any offense was meant.

I would have her head checked for any brain issues and then I would have her understand that the psych ward is her next stop if she doesn't have any real issues. Soiling yourself is mental illness if you can do something other than that. Sorry, it's not just reserved for the young.

I hope you find out what is behind all of this.
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Reply to Isthisrealyreal
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Thanks for the additional info.

But just to be sure im undestanding- when you say this all started after her first rehab stay - you’re saying that no, prior to then she was not one who sought attention and did not run on the self-centered side. Correct?

I ask because it’s two different ball games between someone who is acting completely opposite of how they’ve always been - perhaps indicating a physical cause as in a stroke, an infection, genuine brain atrophy, etc and someone who has been highly self absorbed most or all of their lives.

My mom. She was always self absorbed- just skilled at hiding and disguising - most of the time - until dementia made it impossible for her to keep the mask and filters going.

I had to smile a sad smile when you mentioned a resort vacation. You should have seen my mom during her last hospital stay - even before the dementia really escalated. You would have thought she was at a Four Seasons Hotel the way she used her call button for “room service”. “Could I get more coffee”, “Could you take this coffee and heat it more - it should be hotter...”.

Sigh.
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Reply to Rainmom
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DMarie, I dont know who is telling you about what Medicaid spend down looks like when there is a community spouse involved, but they are wrong. There are specific rules in place to prevent spousal impoverishment. See a qualified Medicaid attorney with dad, asap.
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Dmarie5 Jan 2, 2019
Medicaid is different in every state. It is a federal program but each state administers its own Medicaid program and are free to set their own eligibility rules and other guidelines as long as those guidelines do not conflict with federal Medicaid rules.

I am not talking about regular Medicaid spend down. I do realize now that I said "Medicaid spend down," and I am sorry for doing that. I did not mean the regular "Medicaid spend down program," only that you cannot have any assets.

Rules are different for Medicaid when it comes to nursing home eligibility. I do have a certificate in "Medicaid in a managed care environment." That and the fact that I looked it up on both Medicare and Medicaid sites, and used to network with Medicare, Medicaid, VA, nursing homes, hospitals and so forth when an APS case manager, is why I have the knowledge that I do have regarding nursing home coverage. I had to take myself out of the professional thinking on this one, since it is personally affecting me, which is why I turned here for guidance.
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I forgot to mention about Medicaid since someone brought it up. Medicaid here requires complete spend-down of all assets before they pay anything, including bank accounts, stocks, everything. They even require selling your life insurance policy! Mom's social security check will go straight to the nursing home, so my dad will have no home, no money in the bank, no life insurance and 50 percent less income if Mom was reclassified as nursing home patient from skilled nursing patient.
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Reply to Dmarie5
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I will try to provide additional information. First, there is not any animosity between me and my mother, as someone suggested. I do not think asking for advice in handling a manipulative, attention-seeking elder at the expense of a home and money in my father's pocket and family not having to run every time she claims she falls is "animosity." Sorry if I portrayed that. I am genuinely seeking advice.

Those of you that stated she is manipulating to gain attention are correct. When it started, Rainmom, was right after her first rehab visit, when she got a lot of attention from people she did not know. She started pretending she had difficulty walking so they would come running and so home care agencies would come to the house after she went home. She found this a way to get out of doing any housework or take care of herself. It is not mental depression. It is strictly manipulation. Home health care staff did not want to be around someone where they cannot go beyond their allowed level of assistance, that refused to do anything independently.

She was perfectly able to care for herself until that first rehab stay, which sent her into an attention-seeking frenzy with medical providers. Of all her alleged falls, no one was ever present, except one genuine fall on the wet bathroom floor. She was checked out. Her doctor said she had a leg bruise but was fine.

She goes into facilities after deliberately not taking her insulin (You can't put the insulin in a pill box so harder to monitor), a 'fall' or some other reason where she can get to the emergency department. Of course they keep her because of her high blood sugar. That is where her dramatic Oscar-worthy performances start. She refuses to go to the bathroom, says she cannot walk, and needs someone to feed her. So of course the hospital sends her to a skilled nursing facility for 'rehab.'

So far this stay, besides what I already mentioned, my younger sister was taken aback when asked by an aide about other family not visiting, that mom is "Missing your dad since he nor anyone else has been here." My father was there on 1st shift; mom lied to the second shift staff because they were not present and therefore did not know that my father, my sister and uncle all visited that very day. No, she did not forget. She wants pity and attention from staff, poor me, nobody comes to see me.

I should mention that I am in my 60s, live 100 miles away, do not have transportation. I have severe spinal stenosis per MRI and 2 auto-immune diseases. I am going to have to get more involved though.

I think hospitals look at the fact that her sugar is high, she is in her 80s claiming she cannot go to the bathroom or walk on her own so naturally they send her to rehab, right where she wants. She acts like she is on a permanent vacation with resort wait staff catering to her every need.

JoAnn29, you provided some great ideas, as did others. I like your idea, "I told the billing department when Mom was in rehab to get her strength back, that there was no money for therapy past the 20 days. They better do what she needed in that time."

My dad is minister of a small church and mom used to go to church every Sunday morning and sometimes mid-week. It was ok if Sunday night was too much for her. After the first rehab stay, she decided she was too sick to go to church most church days. She told me, "Wwelll, I'll have to ask my doctor if I can go." She only wants to be around people she can manipulate, who do not know her history since that first rehab stay. Why they have not caught on by now is beyond me. Of course, we want her to be there if she needs to be, but this is getting to the point where it is pure absurd.

I admit that I was offended by her statement, "I am about the worst one here" that I mentioned in the first post, given the fact that while she is attention-seeking, some other people there have serious, life-ending illnesses.
I hope this provides more info. Thx!
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Reply to Dmarie5
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Dmarie-
This subject- this type of behavior- manipulation to gain attention is something I have way more knowledge and experience with than I care to. Understatement.

You state that this has been going on for the past 18 months. What was your mother like prior? Is this behavior and attitude a complete 180 from the mom you use to know - or is this just a new level of self centered attention seeking?

A little background info would be helpful towards more specific advice.

But - hmmm... 18 months. My mom passed several months before this time frame of your mothers. I suspose it’s possible - if this attention seeking is new for your mom - that my mothers “spirit” moved into your mother body...
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Reply to Rainmom
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Therapy can be given at home.
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Reply to JoAnn29
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I agree. She needs a Psychic evaluation. Something wrong when you can't explain how Medicare works. Why would anyone in their right mind want someone to clean them up when they can use the toilet. And, if she is so uncompliant, why do they keep her past the 20 days Medicare covers 100%. I told the billing department when Mom was in rehab to get her strength back, that there was no money for therapy past the 20 days. They better do what she needed in that time. She was released in 18 days. I was told by the RN at the AL that for every day in the hospital, its 3 days of rehab to get your strength back.

I am surprised the Hospital keeps recommending rehab. My Mom had 4 falls in 4 months. She was taken to the hospital, checked out and sent back to the AL. The only time she went to rehab was after a serious UTI. That was the visit to get her strength back. You can refuse rehab. You have enough info to say that Mom is using the system and Dad can't afford it.
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Reply to JoAnn29
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I'm sorry, but I don't think anyone who is acting the way you describe your mother is firing on all cylinders, from the way you write it sounds as though the animosity between you is long standing. I think the best way to protect your father is to grant him the freedom from having to become her caregiver if she returns home. Eventually one or both of them will likely need skilled care and their assets will need to be used up to pay for it, as the others have pointed out there are ways to get your mother into a facility and still provide your father.
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Reply to cwillie
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Check in with an elder law attorney. Your dad is community spouse and will be protected from financial ruin. But, it takes planning.
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Reply to gladimhere
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Can you research what the rules are in your state for her to qualify for Medicaid. Your dad will not become impoverished for this to happen but he may not have as much.

Something is very wrong with her head to think pooping her pants is easier on anyone. She should see a geriatric psychologist or psychiatrist maybe they can help her. My heart goes out to you, how do you deal with this kind of aberrant thinking. Hopefully the professionals will know. Maybe a trip to the psych ward will get her attention.
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Reply to Isthisrealyreal
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OMG - I feel for you. What a nightmare your mother is. I really don't know what to tell you. Maybe, the only way is to not play her game. Record proofs showing her lying about her disabilities. Perhaps, you could connect with your old APS office and ask if there's anything that can be done.
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