My mother lives in my basement and her level of care has gone beyond my capabilities. She refuses to go to a care center. What next?

This may sound drastic but I would suggest contacting the Adult Protective Services in your area if there are no other viable solutions. It sounds like your mother could be at risk for injury due to falling and over medication. They may be able to give you some directions on what steps to take next to ensure your mother remains safe. You won't need your mother's cooperation or permission to relocate her if this agency's assessment determines that she's at risk for imminent danger. They are able to get a court order to move her somewhere safe and this can happen pretty quickly.

I am so sorry to hear about your mother. Have you considered bringing in a home care aide/attendant to assist your mom. That sounds like a plausible solution especially if she doesn't want to go to a care center.

For her medication give her 3 options 1) a medication dispensing machine that is filled by you or an RN and dispenses her medications on a timer 2) her pharmacy can pre-package for Medication on Time or look into Pill Pack 3) you control her medication and bring her what she needs to take when she needs to take it.

Ask her physician to order PT for her. They can come to the home and work to help strengthen her and improve her ability to walk. Mom has the choice to accept this or go to a rehab facility. Tell her either one or the other. She will need to do whatever exercises are ordered. How old are your children? Can they help make sure she does her exercises? Make sure these include that she can manage the stairs. Make it a requirement of her staying in the home.

Bathing is a MUST – does she have access to a full bath in the basement? Have an Aide come in 2x a week for Personal Care including bathing and a hair wash. She will need to be assessed by an RN for safety and they may recommend a sponge bath to start until she gets stronger.

If she falls do not help her up. You could hurt her or hurt yourself. Call the EMT or Fire Department for an assist. This will also help document the frequency of her falls. If they transport her to the ER let them know you do not feel she is a safe discharge and needs rehab.

It’s not going to be easy but you need to stick to your guns and let her know these are the rules for continuing to live in your house, she can choose to stay or leave.

I would look into hospice care. They come into the home and help. It has been a God send for both my parents.

I am sorry you are going through so much. I know it is difficult. Please know that so many of us are feeling your pain and discomfort. It is called empathy. 97yroldmom had a great answer for you. Keep safe and try not to get so discouraged. Help is there - just find your choices and then move forward. God bless you.

Since you'll be part of the conversation with doctor - tell it just like you did here. Her lack of wanting to be mobile and keep up her strength has taken her to a level that you aren't able to physically handle. -- Maybe tell them both if she gets to a facility and participates with exercise and mobility, she can come back - but as it stands right now, beyond your ability.

You do not have the ability to meet what your mother requires. She needs skilled nursing facility. I do not think a board and care would accept her. You are heading for a break down and your mind is already telling you of changes in your caregiving abilities. You are "wearing out".

You should go to get her dr.doctor ask if ,to state that ahe need to go in an home. Also try to get guardianship of her. Go to to your probate department in your city. Have her right take from her. You can be over her. Look for an paralegal lawyer. You can use her money to pay for it. I had to do this for mom. Fran

Bebaloo You have my empathy for your impossible situation but that said I'd like to suggest you look at things another way. Your Mum "gets upset" okay, understandable and it upsets you. You have a Husband and Son, are they not also
`upset' by MIL/Grandma's situation? By what it's doing to you, their Wife/Mum?
That makes 3 of you unhappy because your being railroaded by 1 persons being unhappy.
I hope this helps you to review your situation speedily for all of you.
By the way she can recover (and will) from being upset, she can't recover from killing herself by a fatal overdose/fall. Good luck

She's "nesting" and content.

Imho, changes must be made for your mother's living situation. I do not know why she moved in with you 5 years ago and won't go down that road as it's counterproductive to moving forward. Your mother is young. Prayers sent to you.

Oh my dear, I’m exhausted for you!

you need to do something about this situation and quick before she really hurts herself or you.

she needs to be in an Assisted living or maybe not...a nursing home if she can’t really do much herself. You definitely need to obtain a durable power of attorney if she can still understand documents and sign it or you need to file for guardianship so that you can complete documents on her behalf.

First of all, you make it a fact to the medical people you cannot and will not be able to continue. Second, you seek (free consultation) advice of an eldercare attorney and somehow get a Power or Attorney or find out what happens if she won't give it to you. Also contact all of the aging organizations you can find, the hospitals can often help you, or contact your state senators and assemblymen for help. Somehow there must be a way to possibly get her into a hospital for some reason and then from there, they can move her somewhere. I agree - you cannot and you must NOT allow this to continue. How to get her out, I am not sure but there are ways and you need professional help to get it done. With her bad behavior and personality, pay no attention to how mad she is - she gets what she deserves. Please seek help now.

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.

First of all, let's get to the basics, what I mean is your mom is so independent ( at least she think she is) sounds like she is scared and doesn't know or what is happening to her.
Five years of tormenting you isn't a good thing. Mom thinks she has it all together; what I feel that the more you try, you resist caring and loving her the way you were ment to do or maybe you never felt love or cared because of the type of person she is;
For God sakes, you are not helping the problem,
Yes! I said it, it's become a problem to both of you
Lamins term, get your family back, get your self respect back because this is unhealthy, only thing I can see for you to do, is stop beating yourself up and definatly stop the poor me, we both know dementia has arrived for the past years and it is worse despite her personality of me, me, me syndrome; Power of Attorney is number one!
Find a loving assisted home, nursing home etc.
You can't continue loving her like the way you are now. Trust yourself in making the right decision.

If her doctor decides she is no longer mentally competent to handle her own affairs. then it paves the way for someone else to. It would be better for you to have POAs for financial and medical drawn up and signed before that appointment. Otherwise, you may need to talk to her doctor about next steps for her admittance to "a unit" since she is a not safe and not in a healthy situation on her own. Then, social work will place her in a residential facility and a "legal authority" will be authorized to act on her behalf. It won't be ideal, but it takes the burden off you to provide for her care... and she will be getting the care she needs.

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.

Before getting anyone else involved I would tell you to first try standing up to her and forcefully telling her she has no choice because you will have her removed if she doesn't consent to choosing an assisted living facility to go to. There are also income care options available to you that you can call for her, but I would want her out of my home for your own good as well as for hers. I am very familiar with Narcissist Personality Disorder and they back down when you are unflinching in your boundaries AND ,as in this case, you have all the power and control. certainly I would point out the good aspects of assisted living to her and tell her not to knock it before she's tried it, but if she gives you grief I would revert to either you choose the place or I will choose it for you. If that doesn't work- you should call your local area on aging to find out what services are available to you. You could be charged with elderly abuse if she is found to be neglected, but only if she is not of sound mind unable to care for herself. You can report her for not taking care of herself, which in this case will likely put you in the drivers seat if they find her to be incompetent or incapable of caring for herself. If she is showing any signs of dementia for example , then she might be put in your care and then she would have no choice but to go to assisted living.

What happened on the call with her doctor? Did he/she have suggestions for you on changing her living situation? At the least, when she falls there should be no attempts to pick her up, call 911 for that, my dad knows that’s what’s required for him. Encourage going to the hospital at anytime you can, it’s a good step toward moving her out, though not always foolproof. I’d get ahold of her credit cards when she’s asleep and stop all the auto deliveries, and then act like you have no idea what happened. And make it a condition of her staying that you hand out the meds, she may well need them but not to the point of zoning out, they can be given on a schedule as intended

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.

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.

So sorry that you are having this issue especially during these Covid 19 times.
First, take care of you- self care!


It sounds like your mom lacks the capacity to make decisions. The MD can determine this and document so you can move forward with planning. If she falls again call 911. She can be assessed in the ED. You can request that she go to a nursing home for SAR sub acute rehab or straight to long tem care. It is possible she can transition to long term care from there or be transfered to another facility. Everything is based on insurance; does she have your states version of Medicaid?

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.

Bebbaloo my heart goes out to you. Your mother has a difficult personality disorder. Does she have her mind? Is she competent? My mother is turning 96 in August and is competent. My mother has some kind of personality disorder too. I don’t live with her. She lives in her big 2 story house all by herself. She refuses to leave her house and I can’t make her. She doesn’t want any help. She’s a hoarder, refuses to bathe or wash her hair. I had to step away from it all. I see her once a week. My son goes over to take out the garbage and bring in her mail. My mother microwaves her food, pays her own bills, manages her own meds, changes her own depends. I would talk to your moms doctor because there has to be a way to get her out of YOUR house. Key word is YOUR house, not her house. You have to have a plan to get her out of your house and into a facility. Talk to her doctor and how to make this happen. Take care and stay safe.

"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."

Will be curious to hear what her doctor says. Might you consider having aides come in to provide the care? If so, does she have assets/means to pay for aides? If not, Medicaid can often provide limited help in the home, if the person qualifies. If you feel she would be better off in LTC, she does sound like she would qualify for NH vs AL. Again, if she doesn't have assets, but qualifies medically and financially, Medicaid would be in order (you'll want help with filing that!) You also may not need guardianship, but if you do, you could let the state take guardianship if you don't feel you can take that on. Doing that would mean you have no choice where she is placed or access to any assets she might still have. Our case (below) shows you *could* achieve getting her placed without that - Note also, POAs do not give one authority to force someone to move either, even those with dementia!

Our mother was still living in her own condo, but given her failing memory (she was still ambulatory until recently) and inability to understand she needed help, we were faced with ADAMANT refusal to consider moving anywhere, ESP AL - even though her plans before dementia were to move to AL when the time was right. I started my research and looking for places, then bringing brothers into the "decision making process." Meanwhile, we had to make some legal updates to take care of her assets, including the condo.

The EC attorney told me we could NOT force her to move, even with the dementia, and he recommended guardianship. That takes time and money (it would come from her assets), but the facility we chose would not accept a committal. We had to resort to other means (fibbing - YB wrote a phony letter from 'Elder Services' which stated she either go where we decide or they would place her. This worked because she had injured her leg and didn't have enough sense to have it checked or even tell us, and it developed into cellulitis! She was lucky it was just before the planned move or it could have quickly killed her!) She was madder than a wet hen, but she went with my brothers (I stayed out of the actual move.)

In your case, I would recommend you start looking for a place that might take her in, and get some legal advice. The doctor might be able to recommend a social worker who can work with you to help facilitate the move. Does she have assets/means to pay for LTC? If not, you will have to start filing for Medicaid too. Legal/SW help will likely be needed for that too. It may take some time to find an opening in a facility that will take in new clients, given the virus situation - meanwhile, work on getting everything in order.

IGNORE anyone who says ER dump or eviction. Those are NOT valid suggestions.

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 :)

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.

Sounds like she either needs a care center or more paid home health aide hours at home. She has no choice as it is now a safety issue. Those are her only two options. This recommendation needs to come from her MD. Even just managing her medicine seems like a full time job. Would she have an option of going to short term rehab for med management and strengthening? Might be worth discussing although I'm not sure what the availability is now with the COVID crisis. If she got stronger during a short rehab stay and cleared her head from the pain meds, maybe she'd be more motivated to help herself? I wish you good luck. Let us know how the meeting goes.

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.

https://www.utcourts.gov/howto/landlord/criminal_trespass.html

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.

https://mountainland.org/resource_categories/view/33/utah

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.

ER dump her, or just evict her.