My mother has a difficult personality. She has dependent personality disorder, narcissistic tendencies, self medicates, sleeps all day and night. She has lived with us for the past 5 years and continues to decline due to not getting out of bed. She wants everything done for her and I’ve held boundaries and did the least possible so that she could maintain as much independence as possible. But now she has reached a point where she no longer has the strength to leave the basement. She can’t make it up the stairs or the side yard without help and a LOT of effort. So she avoids it. She falls quite often due to weakness and over medicating and cannot get herself up. I cannot lift her because she is twice my size and she is usually not dressed so she resists me getting help from my husband and son. She takes too much medication or skips medication. Partly due to confusion but mostly due to dependency. She doesn’t bathe, she is less and less capable of handling her finances. She is an online shopper and a hoarder and has so many auto ship orders that she swears she didn’t order and doesn’t know why they keep coming. I’ve arranged meals on wheels, got her a walker, a respite nurse bathe her once a week. She will not make any effort the doctor requests. She is on constant painkillers among many other medications and her memory suffers because of this. I’m having to handle all of her medications but she is resistant to me taking complete control. Due to my own limitations I can’t be her caregiver. I’ve made this clear to her multiple times but she doesn’t want to hear it. Tomorrow I will be on a call with her and her doctor to document all of these things and they will recommend her to a care center. My mother will be furious and will refuse to go. I have zero legal guardianship. I’m so emotionally and mentally exhausted. I’ve been her punching bag for the past five years. What steps do I need to take? There have been times in the past when she was hospitalized, either from sepsis or an overdose and I realize now that I shouldn’t have let them keep sending her home. I have children at home and a full time job and she’s very demanding but refuses to do anything she should do for her health. 🤷🏻‍♀️

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Bebbaloo, you have a huge heart to be providing the help that you are. It's not that you can't continue to provide her care, you are no longer the appropriate person to provide her care, as you have realized. She needs medical attention and counseling. You can try to "reason" her out of the basement but sounds like that hasn't worked, so don't even go down that bunny trail anymore. Are you her durable PoA? If you are, then you can legally make decisions on her behalf. If you aren't I strongly suggest you get this in place (in fact, you can inform her this now a condition of you continuing to help her), if she refuses to give you or anyone durable PoA you can have a discussion about what happens to people like that: they become wards of the county and then the county will make all her care decisions, not family. For immediate help and support, you could contact your county's social services for guidance. I realize she has you in a bind and it is emotionally distressing. I encourage you to find the energy to deal with it a little every day. Your attitude should be that she *will* be moving out. She will put up all sorts of roadblocks but you must ignore this. Also it is very important that you inform your siblings that you can no longer provide her care and that she will be leaving, voluntarily or not. Transparency with them will help. If any sibling doesn't like that plan, tell them they can come and get her immediately. I wish you peace in your heart that moving her out is in her best interest and that you have success in doing so! (Your hubby and family come first).
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Bebbaloo74 May 2020
This was SO helpful. I appreciate your response so much. I do not have power of attorney and she has no intention of giving it. Her doctor today was very clear on the call with her that she is steps away from a care center and making it impossible for her family to care for her. I will continue to repeat that I cannot be her caregiver. It’s an uncomfortable conversation every time. She gets upset. I will take it a day at a time! Thank you!
If you have zero guardianship I suggest you call 911 due to FAILURE TO THRIVE, hospitalize her, and refuse to take her back. Simple as that.
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If your mom can comprehend and retain conversations then your conversation with her should be like this.
"Mom, I love you but I can no longer care for you the way you need to be cared for. If changes are not made I am afraid something bad is going to happen and you will not be able to recover. I do not have an option but to look for a facility that can care for you better than I can."
I am guessing that she says she will change but if you know her history change will not happen. So the best thing is to find a facility that can care for her. Assisted Living if she has no cognitive problems, Memory Care if she does, or a facility that has both so when the time ever comes she can transition from one to the other more easily.
You are doing the right thing for her as well as yourself.
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Unfortunately the point of your being willing to negotiate may have come and gone.
And really the situation you describe is awful for all of you.

I’m sure you would hate to resort to this but Utah does have a “long term guest” removal process. This if there was no formal tenant type agreement. Details can be found here.

Otherwise you may need to go a more traditional eviction.

I would not pick her up if she falls. Call 911. How do you know that she has fallen? Does she call you or do you discover her when checking on her? Think of your own health. Don’t even get started with your husband and son.

If she won’t let you manage the pills, don’t pick them up from the drugstore. Go over with the doctor how the pills are to be given and if it’s worse to take too many rather than not enough. Build up a tolerance to her outburst and stick to your guns. It sounds like she bullies you into doing what she wants.

If you can regulate the pills then she might become more reasonable as a result.

Good luck on the phone call. I hope the doctor is direct and your mom is able to absorb the information. So many caregivers step off into these land mines with the best of intentions. Do look for a therapist to help you stay focused on making this happen.
Your local Area Agency on Aging may be able to advise you on facilities and programs and give you an assessment on which she would be best served in. It looks like they are closed now but I will include this link.

Let us know how the call goes.

edit. I didn’t mention POA because unless she is deemed incompetent you still wouldn’t have the legal authority to make her do anything. For that you would need to be her guardian. You do have a right to choose how you live your own life and who lives in your home.
You might ask the doctor if he feels she could be deemed incompetent.
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Because she doesn't manage her medication correctly, there will be an emergency. So, she is taken to the hospital. Pray she is kept over 3 days because then rehab maybe suggested. While in rehab, have her evaluated for Long term care. If she meets the criteria, then have her transferred upon completion of her therapy. Stand firm that you are not able to care for her so she cannot be released to your home. For one thing, its not safe with her living in the basement. Now if she does not go to therapy, you make it clear that she cannot be released to your care. You can no longer do it and again, the basement is not safe now.

I just have a question...does the basement have a door to the outside? If not, you may want to check with your Township's regulations to see if a basement used as a living area needs two ways in or out. If it does and you can't provide another way out, maybe your excuse to get Mom out. It is a Fire hazard.
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disgustedtoo May 2020
Typically basements have access to the outside, unless it was just a "crawl" space, but that wouldn't be appropriate for anyone to live in!

I took this " She can’t make it up the stairs or the side yard without help and a LOT of effort." to imply access to the yard in addition to stairs going to first floor.
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I would ignore her refusal to allow you to handle her meds.

Mom, you have a choice to make: I handle your medications 100% or you move to a care facility. Those are the options, period.

If getting her stabilized on her medications doesn't improve things then you have no choice but to get her the care she requires and that means a facility.

She can refuse, but so can you. When you stop jumping every time she yells she will not be nearly as comfortable and you will not be so worn out. She doesn't get to decide for you, so she has no decision that impacts you and your family, unless you continue to allow it.

I know it is so very hard to get to the end of your rope with your mom. It feels like you should be able to do something, but the something is getting her into a facility that can meet her needs, any other something just props up an unsustainable situation and destroys your wellbeing in the process.

It is the kindest thing that you can do, even though it is the hardest thing that I have ever had to do.
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So many come here racked with guilt, continuing options that no longer work but stuck & unable to look for other solutions.

You certainly have a hard situation alright but what comes through is you have a clear view of the reality, what is in your ability & what is not. You are willing to look at options & sound like you are ok with care centre direction.

So now it is about the paperwork to arrange & the physical moving in. I would get advice from the Doctor on these. It may be guardianship is needed, but the Doctor may have experience (like other's on the forum) who have bypassed this with success.

I think I would plan for the next fall & push for transport to hospital. 'Falls - for investigation' is usually what it gets labelled here, to get into ER. It is sometimes the coded version of 'ER dump' but the reality is, if there are frequent falls - meds, mobility, chronic health all should be reviewed for her own safety.
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I admit, reading your first sentence gave me a laugh. Because so many of us, myself included could say the same and it is too often the understatement of the year. The decade. I do not know how you have survived. Your own health and well-being and that of your family is at stake. I'm not expert enough in this area, but I would think, hang tight, the next time she falls call 911 to get her up and justify a reason for her to be taken to the hospital where they can check her out, review/stabilize her on meds and buy you some time and respite. You can't have her come back and do this again. It sounds like her mental illness has impacted her physical health to the point of non-function. And I suspect her mental illness, particularly a personality disorder that is deep seated will be hard to resolve. If a good psychiatrist is not involved you need one. You also need an elder law attorney to outline your options, but probably that would be more helpful once there is an evaluation to get a sense of her competence and determine if guardianship is necessary or not and she can make decisions on her own. You might get some info from the National Alliance for the Mentally Ill (they might have revamped their name). And of course there is always Adult Protective Services because she is a risk to herself. I don't know how you've lasted and had kids to worry about plus a job. Your job must provide some respite from it all. My heart goes out to you.
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I also live in Utah and one thing that our atty told us as we prepared our trust was that if all 5 of our KIDS agreed that we required a higher level of care--whether we liked it or not, we could be put into some kind of facility.

I was a little aghast at that, but he said in his whole career, he'd seen this happen ONCE. I did tell my kids about this--and they understand that this is a possibility---in the end, most of us will have to rely on family for support of some kind. I DO NOT want to live with ANY of my kids.

I do not know what this particular 'law' is called, but for people like me and my DH, it is kind of self protecting, ONE kid cannot have all the say. They have to concur.

Do you have sibs? If mom will not go willingly into LTC, you make need to enact this situation. (And I have a feeling she's NOT going willingly).

As far as the medication mix ups--it HURTS to get old and I hate when drs refuse pain meds for elderly patients. I have to take something everyday for my 'whole body' arthritis and I can tell you it's not fun and I don't appreciate my kids' hassling me about it. However--I don't OD and I sure don't sleep all day.

Your mom is probably very depressed along with just getting old. I hope you can find a place for her and get her settled. Plan on the worst, hope for the best :)
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Frances73 May 2020
Meds are a big issues with the elderly. I was appalled to find out how my mother was timing her meds to suit her schedule, instead of taking them as prescribed. And if multiple drs are involved there may be overlaps and duplications.
What happened five years ago that was solved by your mother moving in with you?

I'm not going to comment on what's taken place over the last five years: it would be the equivalent of saying "I wouldn't start from here" which is about the least helpful and most irritating piece of advice on the market (hardly less unforgivable than "I told you so.").

The question is, as you've already put to yourself, what now; and you're already gearing up to have the key conversations. But to give yourself a chance: go back to the root cause. What was it? Why did she move in?

You also mention doing the least possible to encourage independence: very correct, quite right, only as you've discovered not so easy to put into practice. But your mother is now only 72! There is on the face of it no reason why she couldn't look forward to independent, productive and very much happier years to come. Let *that* be your main incentive to make changes, and it will become a lot easier to stick to new boundaries.
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