My mother had three subsequent health issues right after we lost our dad; she fell and broke two ribs, then had a small intestine infection, then had pleural infusion. All these conditions have resolved months ago. She had home health aides helping her while she recovered. She has no health issues now and doesn't even take any meds. She's very healthy. She uses a walker but probably doesn't need one. She continues to have the home health aides 10 hours a day. This is very expensive as you can imagine! She refuses to work on being more independent. She lives in a senior apartment complex where there are activities, one meal provided in a dining room 5 days a week, etc. She refuses to do any of these things. She does have some friends in the building but doesn't have any desire to see them apparently. She wont even go down stairs and get her mail. She has these aides do everything for her that she could mostly do for herself. She does dress herself and go to the bathroom by herself. These aides are often are just sitting around with her! We were with her at Christmas time and took her out to dinner three times, church and to my brothers home near by (I pretty much didn't give her a choice and told her this is what we were doing and she was going).
She did just fine. She admitted she felt stronger and didn't even need to use her walker the entire time. I had been a geriatric social worker for 30 years. I know very well that the less she does the less she will be able to do, the more dependent she will be. I also know that her not getting out into the community and socializing with others is not good for her cognition. She does have some cognitive decline. My brother and sister-in-law, who live near by have asked her to attend church with them, etc. and she refuses. I feel that these aides are actually doing more harm, to some extent, then help.
I'm about ready to say to her that if she just wants to sit in her den (she has a very large apartment that she pays $3,000.00 a month for) and be waited on she might as well move to the assisted living care level where she would just have a small room and be waited on. At least in assisted living she would be pretty much forced to be around others her age and be exposed to activities etc.
I know I can't control her but the choices she is making are driving me crazy!
Thoughts?
Frustration may be a manifestation of grief for you. She is no longer her former self and it’s sad to see and hard to accept. As a former geriatric social worker it has to be difficult being on the other side. Like working in hospice and then needing it for a loved one or yourself. It’s a whole other experience of emotions and decisions. Take care.
The walker, if the person is hunched over the walker is not being used correctly. It has to be adjusted to a comfortable height and the person taught how to properly use it. If you see someone walking with the walker out in front of them, thats incorrect. They are suppose to push the walker a few inches ahead and step into it. If done right there should be no hunching.
As to your comments concerning the walker, proper adjustment and training on how to use it is exactly what I said in my post. As to whether holding it far away from the body as opposed to close makes a difference, I agree that it likely does, but my mother did keep it close and it still encouraged her to hunch over. That is because she completely transferred her balance to it and leaned on it. The typical walker, even if the handles are adjusted higher, and even if held close, can lead to these issues. There is a walker made that is specifically made to encourage the user to stand up straighter, but none of us were aware of it at the time. Wish we had known.
My mother was always more of a couch potato. That is a recipe for dependency. But, I give her credit for making it to about 93 before she lost her ability to walk. Really outstanding in so many ways.
You have also expressed concerns about finances. That is also a very valid concern. Unless she is very wealthy and has endless resources, it makes sense not to waste $ paying for care that is not really needed now because if she lives long enough it will surely be needed for care later. Home care is more expensive than care in an AL facility. Especially if she has multiple aides for many hours. It really doesn’t make financial sense to pay caregiver rates for people to sit around and/or wait on someone who doesn’t need it. One could say that if it’s her $ that’s her business. That’s all fine until she runs out and it becomes the family’s problem to come up with a care plan. Both of my parents are in their mid-90s and living with home and family care. As POA, I have to manage resources for two. My mother would need SNF care and my Dad would need AL/memory care. That would cost them approximately $17,000 per month! Totally out if the question because one could impoverish the other. The care would be more expensive and less quality/one on one. My brother and I are making it work as best we can with the help of aides. You have to weigh the costs against many factors that are individual to your situation. But wasting resources is never a good idea.
If you have POA you may have options but even with that it is difficult without your LO’s cooperation. Good luck in coming up with a better plan.
Who is paying for her rent?
If mom is paying for the caregivers
If mom is paying her rent
If mom is happy where she is let her stay where she is.....for now.
If you look at a list of Major Life Events the top are
Death of a spouse
Divorce
Separation
Incarceration
Death of a close family member
Major health concern
Job loss
Moving
She has had a few of these and you now want to add Moving.
"They" say you should not make any drastic changes for at least 1 year after a major life event.
She has had major health concerns, the death of a spouse. Let her find herself, let her grieve, let her find out who she is.
I would be concerned about depression and anxiety at this point.
But that is for her to discuss with her doctor. (You could mention it to her doctor in a note in her Patient Portal)
But for now just support mom in doing what she is doing.
BTW...unless you are living with mom I can't see how she is "driving you crazy".
Now that I have said all that ..
If you and the rest of the family are paying for the extra care and can not afford it then the situation needs to be addressed and you need to be honest with mom that she is going to have to cut back expenses.
YOU see how Mom is not doing all she can do on her own.
Mom is 88. She may be finding seemingly simple, everyday living difficult . Some elderly will actually voice it and say “ I’m tired of living”. Although physically she is doing well , mentally she is tired.
Losing a spouse , having gone through some recent medical trauma’s, and having some cognitive problems can lead to the person not bouncing back totally .
It is frequently seen that each time an elderly ( with cognitive problems ) has to deal with a tragic event , including a hospitalization they do not return to baseline . In other words each event chips away .
It may take her more time , it may take an antidepressant , it may take gentle encouragement to see her become more motivated.
OR perhaps your Mom really is doing the best she can. Time will tell . She may also prefer to sit and be waited on . Assisted living may be the alternative to having this private aide.
And even though she may admit she enjoyed something ( an outing with you ) does not mean that she will be more active on her own at her facility.
I know how frustrating it is when our moms won't do things to stay active to help themselves be able to stay active. It was a common struggle between me and my mom when she lived with me for 7 years (now in AL). She would have LOVED to sit in her recliner all day with me waiting on her hand and foot. I did screw up and did way too much for her way too early but that darn hind sight is really good at showing us our mistakes a little bit too late.
Your mom is pretty old (mine is ONLY 80! LOL) and grieving. Give her some time. Bring up AL. She might like it but might also miss her paid friends. I'm sure they dote on her and she probably loves it.
My mom is in AL and mostly only leaves her room for meals and even then she dodges that sometimes (at the crazy price of $4.50 to have your meal delivered!). She sits in her room most of the other time because she forgets to go to activities or is just too tired to bother. Your mom would probably miss the one on one chit chat she gets with her paid helpers.
Good luck.
Exactly!!! This alone can be why some people live in assisted living who physically could do more. They would rather just sit and have things done for them, and can’t be bothered getting up even to do an activity .
It reminds me of the elderly on cruises who just sit around waiting for the next meal.
Family often have to accept the choices our elderly loved ones make and let them live their lives how they want . Many choose to sit in AL in their rooms. And others are always sitting out in the common areas and go to activities.
I’m a grief counselor. This opting out of things and saying no to a lot of things and depending on others to take care of her has been a long term pattern for her. It’s very hard to see her want to be waited on for about everything when she has no health problems and she doesn’t even take any medication.
I think she was so codependent on my Dad she just doesn’t no how to “be “ she doesn’t know how to have her own identity.
Why her choices are driving you crazy?
She can live however she chooses.
Has she been assessed for depression, recent cog tests ? Maybe an antidepressant would help .
Big events can cause a significant step down at this age . Perhaps she’s improved as much as she is going to . After big events many do not return to as much independence as before , they are too tired at this age and prefer to have things done for them .
If cognitive decline is happening , she may prefer to not go to activities , it’s not unusual . My experience is that there are joiners and non joiners . Activities can be encouraged but not forced .
She seems to like having a companion . Maybe leave it alone for now until you try to get Mom to agree to go to assisted living . Are you POA? IMO it’s time for assisted living.
If Mom is content being waited on that’s her choice, let her be content. Try not to let it drive you crazy .
Many of us wish we had a parent who would use their walker and seemed content in their facility .
she broke her ribs 5 months ago. All healed. The pleural effusion was months ago. My daughter who Is an OT doesn’t even feel she needs a walker anymore. She’s independent in all ADLs except for maybe help with bathing. At Christmas time she refused initially to go out to dinner but then went and did fine. Refused to go to church and then I suggested she should go and she did great. Didn’t even need her walker. Had been asked to go to church other Sundays and refuses. Refuses to go downstairs in her senior living independent complex to get her mail. Said to me “why would I do that ? “
She has always done this before. She just wants to sit in her den and be waited on. She may be depressed and cognitive changes of course can add to that. I worked as a geriatric social worker in mental health for 12 years. Paying $450.00 a day for someone to wait on her is a little hard to take when she is independent in ADLs and is even able to get her breakfast on her own ( she did this on her own when the aides weren’t able to be there.
They seem really good till they aren't. Your Mom lost her husband of probably 60+ years. Then she has a fall and breaks her ribs. Painful for one, shock to an elderly body for another. Then she has a pleural infusion which means fluid in the lungs, kind of hard to breath, and maybe a sign of CHF which both rob you of strength and the ability to breath. She is not just going to bounce back.
And thinking that an AL will force her to be social and join in activities...it does not work that way. By law, they cannot make a resident do what they don't want to. Its like having an apartment. Mom pays rent. She is not in jail, she can come and go as she pleases as long as there is no Dementia. If Mom wants to spend all day in her room, she can. Not even in LTC can a resident (not patients) be forced to do something they don't want to.
At 88 years old Mom should be allowed to do whatever she wants to. She has lived this long and deserves it.
she can do whatever she wants but not participating in her care is not good as she will lose the ability to do things on her own. Having people wait on her and it costing $450.00 a day is not good when she is able to do things for herself. There may not be enough money left when she needs assisted living care etc. of course she’s grieving but that shouldn’t mean stopping life. I’m hopefully going to be able to get her into see a geriatrician to address possible depression and some cognitive decline.
An 88 year old woman with cognitive decline and a pleural effusion ALONE is serious enough to warrant using a walker and getting the help she's getting now! Nevermind that she's a recent widow who suffered broken ribs and a "small" intestinal infection! My dh had a pleural effusion in 2020 and has never regained his full lung capacity to date. And he's 65.
What on earth is the difference if mom uses a walker if it makes her feel more stable? If you read these boards, you'll see how we struggle TO get our loved ones TO use walkers to cut down on their falls. And here you are insisting yours doesn't need one! Do you realize the absurdity of that statement? She's not depending on a wheelchair or lying in bed all day....shes using a walker to help her feel more secure. Good for her. In your quest to make her more "independent" you may wind up causing her to die from a fall because she "doesn't need" a walker at 88.
At her age, your mother has earned the right to live as she sees fit, using her own money to do so. AL is a great idea at her age but does not guarantee she'll socialize or take part in activities. Plenty of elders lead cloistered lives in AL too!
What's going on right now isn't broken, so why insist on fixing it?
first of all the broken ribs were 6 months ago. The pleural effusion was 5 months ago. All resolved. She has better oxygen saturation than me! The stomach infection was resolved 5 1/2 months ago.
she was evaluated by an OT who said she probably doesn’t need a walker and should have been weaned off of it as she is capable of walking short distances without it. We have no problem with her using the walker though. For Christmas I got her a tray for the walker so she could carry things on the tray. She is very capable of doing things on her own. She is independent in ADLs except for some help with bathing. She has no health conditions and takes no medication. Our concern is if she doesn’t do all she can for herself she will use the ability. Being waited on for everything when she is able to do most things on her own isn’t good. Also it’s concerning she is spending $450.00 a day for someone to be with her and do things for her she can do isn’t good. She could live another 10 years and she needs to be sure she has enough money to prepare for possible future care needs.
I know she is grieving and probably somewhat depressed.
I doubt you mean it to sound that way.
I realize you are simply trying to give us your version of "the truth".
But your mother is 88 years old.
Your mother has cared for, then lost her husband. Has endured illnesses and falls.
As a trained geriatric social worker I know your training gives you to understand that illnesses are common to the newly bereaved.
As to whether your mom was EVER outgoing socially, I cannot know. I myself am NOT, so I sympathize with her.
I do think you are right in one thing.
It is time for ALF for your mother.
This move may in fact be good for her, as she'll be with others for three meals, and--given that some ALFs (such as my brother's) are sort of cottages, with about 14 residents around a dining hall and a common room for socialization, more socialization occurs just naturally.
I would speak with your Mom about this possible move for her own safety and well being.
I know that, as a trained geriatric social worker you are aware that walkers aren't always about "muscle and blood and skin and bone" but about balance, and balance is poor in the elderly. Yes, they can become a sort of emotional "crutch", but at 88, why not?
Other than that, I don't know what to say to you.
You are a geriatric social worker.
I am a bit surprised at what seems to me (and I could well be wrong) your lack of empathy and sympathy.
I would encourage you to examine, if not your feelings, your presentation of them.
I wish your Mom well. I hope things will be better for her. I hope you will practice patience with her in these last years she spends bereft of the man she loved. I hope you will allow her to "do it her way" in so far as that is possible.
You might consider hiring companions, who are not for medical care but will encourage her to go out, drive her around, take her to lunch, and accompany her to activities in her facility. They won't toilet her, may help her get her medication when she starts taking some (though not administer it, just make sure it's on the table where she can take it) etc. Companion care is not as expensive as a CNA.
If I were you I'd consider not being as involved with mom as you are. Let her live as she likes. At 88, she certainly doesn't have the energy she did when she was younger, and if she's happy sitting and chatting with people in her apartment, so be it. When I'm 88, I hope I can take it easy, free of others' expectations of me.
Surely you know that at 88 becoming "more" independent is an uphill battle because she's not only not being able to maintain existing abilities, she's actively losing those, never mind trying to add or improve on things. Your expectations are the thing that needs to change.
When was the last time she has a cognitive/memory exam? Does she have a baseline?
You aren't responsible for your Mother's happiness. You can't/shouldn't project your expectations for her senior years onto her.
Expectation = premeditated disappointment
Maybe AL would financially be the better solution for her, but don't have any expectation that she will be "forced to be around others" because it's not the staff's job to force anything onto their residents. She may never leave her room and they can't make her. Not even to eat.
Are you her DPoA? If so, please check to see if you should now be making decisions for her in her own best interests, not decisions that only make you feel better about how her life should be and look. It's hard to separate our emotions to make wise, objective decisions for our parents. I wish you clarity and peace in your heart on this journey.