My Mom refuses to leave the home to do anything. She hasn’t had her hair or nails done in over 2 months. She used to get her hair washed and styled once a week. She also refuses to go to family functions or visit friends.

We have portable oxygen so that is not the problem.

She is experiencing short term memory loss & is on medication to help with that.

Her doctor increased her anti depressant to double the dose. I was hoping this would help but it hasn’t.

She is also refusing to follow her COPD treatments, including nebulizer treatments 4 times a day, wearing a vibrating vest & wearing a CPAP a few hours a day, to help with her collapsing trachea.

I’ve gone round & round with her on trying to explain the benefits from the treatments & how it will help her breathing, but she still refuses.

I’ve also had heart to heart talks with her letting her know this is her decision & if she is tired of all the treatments, she can choose to give up and go on Hospice, as this was an option giving by her doctor. She gets upset with me when I discuss Hospice with her.

She has a physical therapist that comes over 2-3 times a week, which my mom despises! The physical therapist also has no luck getting my Mom to wear her vibrating vest.

Her breathing is so labored, she can’t take more than 10 steps without being out of breath & coughing. She also completely abuses her nebulizer inhaler. It’s like her pacifier she has in her hand 24 hours a day!

She does eat well & sleep well and is completely independent as far as taking care of her personal hygiene, showering & dressing.

I’m at a loss on what to do 😢

Any advice would be greatly appreciated. Thank you

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AnnReid & Isthisrealyreal, thank you so much for the responses! I agree with getting her on hospice care. I was told a person can go on and off hospice care depending on how they are doing.
I will discuss this with her doctor this week.
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That is correct Beatty, mom can go off and on hospice care.
sending you both positive thoughts. My mom has COPD too and I find myself wanting her to get up and be more active but I have to remind myself that she can’t breath and lugging around portable oxygen can be a real PITA. She uses inogen so we have to bring extra batteries and make sure to plug the machine in to the car charger and it’s just a real pain sometimes!
She is cherry picking which self care tasks she wishes to perform and which she doesn’t.

It is stressful and discouraging to you to watch this.

She is demonstrating short term memory loss, depression, and disrupted sleep.

She is refusing social conduct.

It seems overall that she is not benefiting from her present arrangements, and you aren’t either.

Are there funds that could support a caregiver/companion for a period of time each day? She might (or might not) respond to someone cheerful an matter of fact more readily than she responds to you.

I’m not sure how you’re thinking that medications at her age should “help” her depression or forgetfulness? Has the doctor kept in touch about the prescriptions she’s taking?

It doesn’t sound as though she wants you to direct her health management or lifestyle. Depending on her cognitive status, you may not have any more leverage with her. That’s why I’d try a neutral, objective assistant.
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I would just get hospice in and explain it is for you. That you are okay with her choices to not use her meds, but you need someone that can help you navigate the process. Make sure she can keep her inhaler though, that is what she wants and she should have it.

I can't imagine how difficult life must be for her and I can imagine that she is feeling like what is the point and purpose. You can't even laugh when you can't breathe.

We all take breathing for granted and when you can't breathe it is a terrifying demoralizing situation. You say 10 steps and she is completely winded, oy vey, that is not much. I don't know that I would want to take all my meds so I could continue to exist in that condition.

Prepare yourself for the end, she has made her choice and her actions tell you what that is. Love her and let her do as she pleases at this point, nothing is going to give her the ability to breathe freely again, she doesn't want to prolong her misery with meds and therapy, that's okay. Find ways to enjoy her while you can and maybe she will find pleasure as well. Letting go of expectations can help you feel better about her letting go.

Hugs! It is a difficult journey for all of you.
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MACinCT, I keep all her medications and dispense morning and evening, with the exception of her inhaler & her trazadone (sleeping pill).
We tried to take control of both of these things and she went ballistic!!
I agree, the inhaler is doing her more harm than good!
She uses it on average 13 times a day!!
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Countrymouse, thanks for the response. Right now, any advice on how to help motivate my mom is greatly appreciated 😊
She is still asleep so not sure how’s she’s doing today.
I love your advice on finding out how much effort she is willing to give.
I’ll try that today.
Thanks again
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To clarify, she overuses her Albuterol inhaler! Sorry I accidentally wrote nebulizer.
Thank you, MACinCT, that is a very good question. Im not sure if she actually has short term memory loss or hyoercarbia. We’ve tried to get a MRI of her brain, to figure out what the memory issues are, but she’s unable to lay flat so it was unsuccessful. We also tried an upright MRI but she was too fidgety. The next step is to do a sedated MRI. It’s just been put on the back burner as she refuses to leave the house.
I have discussed this with her pulmonologist and he recommends going on Hospice care.
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Goodness, I do feel for your frustration.

This is I'm afraid going to sound like a really idiotic question. But, you did say "any" advice, so in for a penny...

How is she feeling today?

Ask her, and then really listen to what she says. The idea is to take a step back, and then try again with what will help her, only this time aligned with how much effort she's willing to make.

Kind of a compromise between all of the many therapies that would in theory help her condition, and what is actually possible because she might just join in.

Don't waste another breath on reasoning with her. Cruel - to you! - and probably just makes her feel even more worn out and antsy.

Out of pure curiosity, not meaning any criticism by it, have you tried on that vest? I would!
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I am a respiratory therapist and even I am baffled what to say. It may be time for hospice cause she is giving up. There is no enjoyment here. Does she realize that she will use up her nebulizer meds and will not be able to get more repules until the next cycle? Try to control them and supervise dispensing them. You know she cannot chase you around.The drug is supposed to last 4 hours so she is not getting benefit. Inhaler abuse can be hard on the heart. COPDers should be educated that using those meds more frequently than prescribed means that they need to see a doctor immediately or go to the hospital. When she whines about withholding meds, offer her oxygen or CPAP. Call her pulmonologist for suggestions although it sounds like she will not leave the house.
I understand she might get anxious if you withold her meds, but this is an opportunity to get her back in hospital. Get her tuned up or discussing palliative.
One other comment is are you sure it is short term memory or hypercarbia from the disease? ( high CO2 in the blood that cannot wash out due to shallow breathing and not wearing CPAP)
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So it's not that she's NOT using the nebulizer, it's that she's using it too much?

I'd get her back to the pulmonologist for a re-evaluation.
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