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Mom is 86. 3 of us daughters help out, but two live far. She doesn’t like our help reminding her of meds, despite the fact she forgets them most days. She doesn’t like us putting our arm in hers so she doesn’t fall. She thinks things like the house being filled with smoke from leaving the electric stove on is no big deal!

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Our situations sound similiar, Snoopycharlie. My sister and I chose to take the calculated risk of letting Mom live at home, despite a diagnosis of Alzheimer's, but we were lucky in one regard because she had no interest in cooking (even when we were kids!).

We have been going to a caregiver support group for about a year because Mom is as stubborn as a mule. Won't give an inch or admit anything is wrong. Everyone in the group felt like we were taking too big a risk and one finally told us, it will be an injury that will spur action into an irreversible transition to another living situation. They were right.

This December, Mom called my sister at work to come get her mail (which she's paranoid about leaving in the street side box for more than 5 minutes) and to pour her a drink because Mom hurt too much to get it herself. We wondered what the heck happened, so - long story short - we cooked up a story to get her to a doctor (which she would NEVER do voluntarily, even if her arm were falling off) and she had a fractured tibia, just under the knee cap. From there, it was a whirlwind trip in an ambulance to the hospital, then to rehab, and now in the memory care facility, which she still doesn't realize she will never leave.

It took an injury to get things moving. Lucky for us, it wasn't too serious as in having life-threatening consequences. I feel for you, but if you reread your original post again, I think you - and your sisters - will see that something needs to happen. It's hard as hell. Every minute of the planning will feel like conspiring and doing something *to* your mother, but you are doing it *for* her. Sometimes the best care we can provide a loved one is letting the professionals handle it.

Meantime, do some research on area homes where she can live her life in an "aging in place" community. Start with your state agency that oversees SNFs, etc. See if you can find a senior housing specialist in your area (or wherever Mom will likely live) who would probably charge the facility where your Mom is placed, so no out-of-pocket for you.

Good luck to you and your sisters. It's also helpful if all three of you are in agreement about next steps and you each share in the load that is to come. It doesn't stop just because Mom is placed somewhere. Seek the support of a caregiver support group.
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Mom really should not be living alone at this point.
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Don't put your arm through your mother's to prevent her falling. You won't stop her falling, if she's going to, but you might well dislocate her shoulder.

This is apart from the obvious point that people grabbing hold of you in general is disagreeable, even if they are well-intentioned. Would you like it if someone did it to you, without your say-so?

A physical therapist can show you this technique - your mother takes hold of *your* arm, and you put your free arm around her, across her back, so that you're holding her hips up against yours.

E.g.
You on left, mother on right.
You hold up your left arm.
Mother grabs onto that and holds tight.
You place your right arm around her waist/hips and hold her close to you, firmly but comfortably.
You set off on a sort of three-legged race basis.

Filling the house with smoke is not necessarily a big deal - done it myself, regularly. But there are TWO points there which are a very big deal indeed. One: is there a smoke alarm? Is it working? And two: leaving the electric stove on. Especially if you might return to it and not realise it's hot, God forbid, shudder...

Anyway. All in all, you want an Agenda.

Falls. Will your mother's GP/PCP suggest a walker, rollator, or any other kind of anti-falls aid? Would she be more likely to use it on professional advice?

Medications management. What meds are these? Have you considered one of the many types of dispensing reminder box, or consulted her pharmacist about it?

Cognitive assessment. If these difficulties are all part of a pattern that has recently come to light, it would be sensible for your mother to have herself checked out by her doctor. I'm guessing she's not going to do that to please you, correct? I'm also guessing that you don't have HIPAA authorisation - she hasn't named you as someone to share confidential medical information with? But you can still write to her doctor and share your concerns with him/her, even if you don't get immediate feedback. You then do some nimble talking and get your mother along for an appointment, any old appointment, and leave it to the doctor to explain.

More generally, your mother seems to be feeling "got at" and criticised for these "little" niggles; whereas all you want is for her to take her own wellbeing seriously and accept help where it's wanted. For now, anyway [you don't say that to her!]. I know how frustrating it is, but every time you talk to her remember how sensitive she is about it, and try to reassure her that you're not about to have her bound and gagged and dragged off to a nursing home. This is all about her *staying* in charge.

And, of course, she may herself be petrified at the idea that she's "losing it" and doing all she can to ignore problems. You can't blame anyone for dreading the loss of their faculties; but the answer to that is always - better the devil you know. If she faces up to aging, which comes to us all, and finds out where she stands, and takes some basic precautions, then God willing she'll get to make choices she's happy with.
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Unfortunately her being able to care for most things is not good enough. If she's falling and forgetting meds and going to the mailbox, you know that she is at risk.
She's leaving the stove on too? Even if it is electric that's a huge red flag. (We had to take all of the knobs off of the stove. And my mom couldn't remember how to use the microwave. My sister was afraid she would burn the house down while they were sleeping. Luckily it didn't come to that.)
And yes, this is a big problem, the transition from being an able bodied person to a person who needs help, but you have already reached that stage.
Assisted Living would be ideal, as she would have her own apartment and she would have meals prepared, and possibly thrive with a community of other elderly, and could take part in activities.
It's time to take action.
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If she need to have an arm to steady her...she needs a walker. "Helping" her like that will just have 2 people down on the ground. And if she will not use a walker you need to learn how to guide her to the ground NOT stop her from going down.

If she forgets meds, falls and goes out to get the mail alone she really should not be living alone.

You have a few options.
1. Have someone come in to help out daily. Remind her to take her meds and makes sure she does. And in general monitor her for falls, helps her get the mail.
2. Assisted Living facility or Memory Care where she can be independent but can get help when she needs it. (If you opt for AL she will eventually be moved to MC so choose a place that she can transition and not have to move to another place.
3.Have Mom move in with one of the 3 (or one of the other siblings). Notice I put this last on the list of options.

You mention she has Dementia..This will not get better. It will get worse.
She may go to get the mail and wander off and if lucky will be found by a neighbor or police.
The falls will become more frequent chances are she will break a hip, arm, shoulder. At that point surgery, rehab and with dementia rehab is difficult. The result may be that she would be in a SNF if she does not gain function fully.
And it does not sound like she is safe where she is. I would disable the stove/oven have her use the microwave and if possible get Meals on Wheels to deliver. At least this way someone would be checking in on her at least daily.
And you might want to think about getting cameras in the house so you can monitor her until a decision is made on the next steps.
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If she falls, one fall too many is on its way.
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It’s time to move her. Our mother was the same. The catalyst for us was finding out she was being drained of large amounts of money by a “friend “. We were able to use the situation to get her out of her home before she fell and was hurt badly - or burned the house down.
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I think you already know the answer to this. Mom needs help. None of us Seniors want to accept the fact that we are aging. I hate the fact that at 65, I’m slowing down. When our kids tell us we need help, our first inclination is to disagree. We know we need help, but we sure aren’t going to admit it.

But, in your mom’s case, she’s putting herself in danger. When I came into my mom’s apartment once and she’d left her oven on, I knew then she needed help. Falls can be deadly. They happen in a split second. If we can right ourselves, we may get away with a pulled muscle or a few bruises. But, we might also hit our head or break a bone. In addition, your mom could start a fire and endanger the lives of others.

A kind and loving intervention might work. If you know a good friend of her’s, maybe ask them to start a conversation and mention how great it would be to live somewhere (like a senior apartment or Independent Living) where there is access to help and senior activities. You and your sibs can also speak with Mom and firmly but lovingly tell her you’re scared she will get hurt and you’d be devastated if something happened. But, you cannot force her to accept her aging. If her mind is sharp, she will continue to deny anything is wrong and you will have to be super vigilant until she, herself realizes she needs assistance.

At the least, maybe a Life Alert subscription?
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Snoopycharlie Apr 2019
This is extremely helpful info. To see where my mom is coming from, and empathize, to how to move forward in helping her. Thanks so much
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Sadly it does appear that your mother needs more supervision to help keep her safe.
It IS a big deal if mom leaves a pan on the stove on and the place gets filled with smoke.

Yes she will be stubborn about this but for her safety it’s time.

Options are AL or NH unless the family can hire private CG’s which is not in our budgets to pay those aides.

Good luck to you!
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She wants to remain independent so downplays the potential seriousness of these issues. But she's going to have to accept some tradeoffs. So if memory is an issue, for safety, she's not going to be able to access the oven. Definitely contact the local fire dept and ask about getting a knox/lock box where her house keys will be safely locked inside for emergency purposes. And get an emergency alert button, perhaps one of the new versions with fall detection. Maybe the MD can insist on a walker. Falls happen regardless of where one is; sometimes a bone breaks and THEN there is the fall. Consider meals on wheels; a microwave if she has the capacity to use that? But be aware of what the meal is delivered in...i.e locally, it's now in an aluminum pan which cannot be microwaved (and regrettably cannot be recycled here either). Med dispenser can be helpful. Camera to keep an eye out for you. Can the location of her mail being delivered be changed so she doesn't have to go out if it's cold or icy? Some people I know have carriers that know they are disabled and will place it in a bag hanging on their doorknob or a hook.
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shb1964 Apr 2019
Good advice about the fire department but unfortunately, not all county/city fire departments offered that service. I called to get that for my mother before we moved her and I got transferred from dept to dept to dept until someone finally told me my county doesn't offer that service. But now that her house is empty and squatters have taken up 3 doors down, we've asked the sheriff's dept for occasional drive-by watches. Not sure what good it will do except for increased law enforcement presence. They don't get out and walk around the house (which might be a tip off to anyone watching that it's empty anyway), but something to think about.
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