Read my former post for more context. I have some caretaker duties for my disabled mother. She moved close to me recently, but her negative attitude continues and she has been treating me very badly.
Before she moved closer, I told her that moving closer did not mean I would see her more often, but that it would be easier to help her, and I would try to come and make dinner twice a month. I have kept my word.
Every time I see her, it seems she wants to make me upset by either ignoring things that need attention or by saying things that elicit a negative reaction.
1. She and her apartment are in a poor state. She won’t ask the PSWs to help her – I think it’s pride.
- floor has food and spills
- soiled bed underpads haven’t been replaced
- wears visibly dirty clothing and the same brief for multiple days
- sometimes refuses to shower for 5+ days (selective about PSW)
- having accidents on her lounger and denying it (I put a test sheet on and it got soiled, so now I have been putting disposable underpads on it)
- we hired someone to come every 2 weeks to do some cleaning and cooking
2. Will not address major health issues on her own.
- very bad swelling and redness in her legs
- said that a nurse told her to keep them up and soak in cold water (she is diabetic – foot soaking not recommended)
- went nearly 10 days in this state before I strongly encouraged her and took her to the hospital
- refused T3s and howled in pain for hours at emerg
- doctor said it’s cellulitis due to a small cut on her leg
- needs 2 weeks of IV antibiotics
- refused to stay overnight and was sent home with no guarantee for a nurse visit
- luckily did get a daily nurse visit for antibiotics
- legs are better but are still red and swollen - she doesn’t want to go back to the hospital
3. Zero critical thinking – forgot about 911.
- slipped off her bed with her phone and couldn’t get up
- has a medical device and tried and failed to get through to someone
- tried to message me very early then called me 2 hours later asking what she should do
- I asked why she hadn’t called 911 directly – she didn’t think of that
- she cancelled the medical device service
4. Forgetting the obvious – she cannot drive.
- she referenced driving in the near future
- I reminded her that her license was taken away after the stroke
- she said she still has it
- I reminded her that it was taken away because she has paralysis on one side
- she said she doesn’t need that side to drive
5. Inviting danger/risk – intentionally talking to online scammers.
- was contacted by and accepted social media scammers as friends
- I showed her how/why they are fake profiles
- she believes one is actually that person and asked if I would drive her to meet him for lunch, after she initially was going to invite him to her address!!
- keeps accepting more of them as friends, and now I am getting requests (and I’m sure her other friends are too – I hope they don’t fall victim)
7. Get her a cat because she said so.
- keeps demanding I get her a cat
- cannot care for it (feed it or scoop litter)
- I cannot take it if something happens to her
- demands that I care for it since I live close (not going to happen)
8. Being an entitled jerk – drop what you’re doing and help.
- demanded I come on NYE to fix her dvd player (disc was stuck)
- I told her I couldn’t and had been drinking
- called me the name of someone we know who is particularly rotten to their own mother
- next day I asked her if she was going to apologize and she said no, that I was the rude one for not helping her
- I hung up on her
Is she just mean, in denial or is she losing it? I cannot just cut her off since I feel obligated to help and she can’t function on her own, but now all I want to do is bare minimum to avoid being near her – it’s sad.
TLDR; My mom, a stroke survivor with paralysis, doesn’t care about her health or acknowledging that she needs help, and is being verbally and mentally abusive to me.
Have you thought about how to get to that point, preferably without danger to her and while protecting you too? Propping her up to 'just good enough' is not doing either of you any favors.
A lot of the issues stem from her behaviour. I would be much more inclined to help if she wasn't so rude and inconsiderate when I do. I have had to walk out of hang up min multiple instances because she loses her temper to a level that is not acceptable.
A smallish problem if client is fine to reschedule.
Much bigger problem if client cannot get out of bed, use toilet, feed self or take medications.
Seems either from the stroke or from just being herself, this is not related to memory issues, according to this test... I do not understand it at all based on her behaviour (unless she is specifically choosing to be this way, unclear why someone would do this/act this way).
She does have a home care assessment coming up, so we will see what comes of that.
Screening tests like MMSE are just one tool. Others like kidney function, bloods, infection delerium all can be screened out too.
By the way, the MMSE does have some limitations. From a MMSE website:
'A high MMSE score does not necessarily mean that you don’t have cognitive impairment. Similarly, a low score does not necessarily mean that you have dementia'.
In my (limited) experience, memory can still look ok but it is planning & reasoning that become 'tricky' with Vascular Dementia.
Family can notice subtle changes 2 years before a clinician does. (I did).
Please see my response to you below my original comment on this below.
Heart out to you! Alva
Report a vulnerable elder to APS.
Attempt to get Mom to her Doc for that 'check-up' (for discreet short cognitive screening tests). Attempt to gain enough trust & influence to get Mom to the next stage of neuro testing. Get knee deep in her finances, get financial advice & see what is adfordable in the world of Assisted Living.
Stage a takeover, either by discussing & gaining POA then running her life. Or full legal Guardianship through the courts.
My gut feeling here, since you mentioned twice a month dinners being your thing.. is get OTHER PEOPLE involved.
Basically, decide if you want to get other people to see the reality & help tow her little boat safely to the shoreline or row the boat yourself.
No judgement! (I jumped ship years ago).
From the net;
"Anosognosia is a self-awareness disorder which prevents brain-damaged patients from recognizing the presence or appreciate the severity of deficits in sensory, perceptual, motor, behavioural or cognitive functioning, which are evident to clinicians and caregivers."
It was dx in my LO post stroke, who has many of the symptoms you described.
For example, with dementia and with brain damage, when you bring up something, they very will often acknowledge it, but that is a social function of the brain and not a realization or agreement. They will still not understand.
Your mother needs to be diagnosed ASAP, and she needs a neurologist, not her PCP, to do it. She needs someone to be her guardian because from what you wrote, she is past deciding on a POA. And then the guardian (or State) will decide where she lives. Momma doesn't get to decide anymore because her decisions leave her at high risk.
Also, her finances need controlled, which would keep her from getting scammed.
I am POA of her bank account, so I went yesterday and removed her telebanking option from the account and took away her debit card and checkbook (she doesn't go out anyways due to mobility limitations, so hoping she won't miss these). The bank said this is the limit of what I can do as a POA because they can't remove her from her own account. They said even if someone comes in with dementia and wants to send a money transfer, so long as the person answers the reps questions to try to make them think twice (e.g. How long have you know this person? Are you sure you want to send this money?) and they still wish to proceed, there's nothing that the bank will do to stop them. I was pretty shocked to hear this.
Yes, stroke can cause brain injuries that worsen. She could be having ongoing silent strokes. She could have mixed dementia, meaning that it's more than one dementia affecting her brain. In other words, stroke injuries to the brain plus Alzheimer's or Lewy Body dementia. It's hard to sort all of that out, and you may not need to. They are progressive conditions and won't get better. You'll be treating her symptoms, not the diseases.
Mom needs 24/7 care and there's no point in thinking that can be accomplished in her home. She has to go to a facility where professionals take care of her. Start discussing this with her medical team and get her there somehow. What you and mom are doing isn't a viable solution.
Good luck.
I visit her for "social time" twice a month, with a focus just on making dinner and spending time together. I actually visit her 1-2 a week outside of this, as I have to deliver groceries, deal with medical appointments and calls from PSWs and nurses, do tasks the PSWs won't do, do laundry and help with cleaning. It's very draining, especially with this behaviour and attitude to try to manage at the same time. :'(
Waitlists for LTC and assisted living here are long, but I am trying to work with the doctor to get her assessed and figure out next steps.
This is a senior severely at risk and you can do nothing about that.
Let them know all the above. Ask them to visit and open a case.
If you are POA I would consider having APS help you resign that and would place Mom in the care of the State. If you are NOT POA, don't accept that duty, or guardianship or conservatorship.
Your Mom needs placement.
I doubt she will allow that.
All things given, your telling us all of this and with the addition of the infection, Mom may well pass of sepsis, which is a relatively fast death. You may be looking at end stage of life for her without treatment.
I do not think there is a lot you can do for your mother. I know that you know that putting a helpless cat into this is nothing short of animal cruelty. As Mom likely cannot get out to get a cat, hopefully that is the end of that portion of this tale of woe. If she DOES get one, please remove it to a shelter before it suffers.
I do not know if your mother has been diagnosed with mental illness, with dementia, or with both, but it does sound on the face of it all that this is what is going on here. Given her adamant nature I do not think you will be able to do anything about this other than report her to the authorities for care. Once a Fiduciary is put in place your Mom will be cared for and you will be free to simply visit her.
Sorry about all of this. Can't imagine it. Couldn't function in it and doubt anyone but the State will be able to. Sometimes things cannot be fixed. They can lead to death, but that is where all paths lead to in the end.
PS.............if there is a car it needs disabling.
I only have POA on her banking account, nothing else. Things will not end well if I enforce it for all other areas of her life. I would seriously worry about suicide if I did that (since she's brought it up before).
I have asked the family doctor how we can approach getting her tested - patients are made aware when they are doing a memory test, so I'm trying to work it in as a 'routine' check. We'll see if the doctor agrees (if she'll still see her).
There will be no cat - she can't get one on her own and I won't do it for her. She will nag until the cows come home, but I won't do it. She does not have access to a car directly, so should be ok there.
I do hope you realize(and if not reread your own post)that your mom should NOT be living on her own as she now appears to be suffering not only from her stroke, but also from some form of dementia(more than likely vascular).
Her brain is not only affected from her stroke but now also from the dementia, and things will only get worse.
She really needs to be placed in the appropriate facility where she will receive the 24/7 care she requires and will be safe. She is no longer safe to be living on her own. Period.
I wish you the very best in finding the appropriate facility for her .
This.
Stroke is a brain injury. It can cause damage to cognition, apathy, depression, lack of insight, lack of reasoning.
Some stroke survivors recover very well. Others are left with many deficits.
Vascular Dementia can cause strokes or alternatively stroke can cause Vascular Dementia.
No-one on a forum can diagnose - has there been any cognitive assessments after the stroke?
What does Mom's primary Doctor say about her living alone?
Her family doctor is new and I'm sure has reservations about it based on what she's seen. However, my mom will not willingly move into any kind of assisted living or nursing home. She was against it when her medical team suggested it after the stroke and still is to date, but even more stubborn...
She may not be able to realize things are in disarray or filthy. Her brain damage will cause her to be at higher risk for being scammed.
She may have areas of her brain that causes her to have a nasty personality because that might be the only part functioning.
Have you had her abilities tested? Have you arranged occupational and physical therapies?