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I live 4 hours away. My sister is 45 minutes away and goes weekly to get her groceries and do other household chores. I go once a month now but my sister needs to be out of town for another family illness. My mother has fired any help we tried to get and is losing her memory and very difficult. She refuses to come to my house. She claims she needs no help but is losing weight and we suspect she doesn't eat well. She refuses meals on wheels. We clean and do errands and call daily. She can no longer balance her checkbook but won't accept help.

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Jane, the reason your Mom doesn't want any outside help is because she knows that you and your sister will be there to help her out. Thus, in her mind why spend money when she has the both of you. One thing to thing about, it's your Mom's choice to live alone, thus she needs to own up to her own responsibilities that come with that choice.

I understand what you are going through, both my parents [mid 90's] live alone in their single family house. In their mind they feel they can managed and have managed because I am just a phone call away and live literally around the corner..... I run them to doctor appts, hair cuts, banks, get their groceries, run down to their house if Dad falls, etc. Boy, they got me trained :0

Both you and your sister need to work out some plan where neither one of you are constantly running over to your Mom's home... and any time your Mom says she needs this or that, just remind her she made the choice to continue to live on her own. "You need to own up to your choice, Mom".
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VS's idea of an evaluation is the best first step if you and sister, presenting a united front, can make it happen. You need as far as possible to know where your mother stands cognitively.

If she's losing it, that's a whole can of worms that the two of you will need to discuss further; but then there will be the usual sources - mother's medical team, APS, neighbourhood and voluntary organisations - to call on for help in drawing up a long term care plan.

In a way, it's rougher on you and your sister if an evaluation establishes that your mother still retains full capacity, because then your hands are much more tightly tied: you can't interfere if she doesn't want you to. If that's the case then all the two of you can really, reasonably do is make sure that your mother knows who to call in case of emergency. A senior alert would perhaps help set your minds at rest; and if you tell your mother YOU need her to wear it because otherwise you won't sleep for worry she might, possibly, accept it. It's about as unobtrusive as help gets.

My great aunt lived independently and happily until she was 96, and she'd have carried on longer than that but for a small medical error compounded by failure to listen to her. So I'm all in favour of independent seniors, and don't agree that dottiness is inevitable. But the fact remains that it's we, the relatives, whose hair turns white unless they'll agree to some kind of safety net. How strong that net has to be for your mother in particular is what you need to find out first.

I agree with sunflo too that asking her how she expects to manage practical things while your sister's away is important. You're not bossing her around: you just want to know that she has made arrangements, you're not second-guessing her about what they are.
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You and sis should have discussion with mom about sis's upcoming abcence and the need for help for mom. Suggest to mom "Mom, sis can't be here for several weeks, I'm willing to come for a few days, but we are going to have to hire some help to come in. It's either that or you will have to go to respite care because sis and I don't want you to be alone". Offer to jointly interview some caregivers together and tell mom you'll stick around a few days while she and caregiver get acquainted. That's all you can do unless you want to move up there for the interim.

Enlist her doctors help in convincing her to accept help if you can.

I feel for you. My mom lives independently at 91 and refuses all help or assistance and I too live 5 hrs away and work in a travel job so I can't take care of her nor do I want to. No one looks in on her but this is how she wants it until there is a crisis.
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LOOK FOR: Rotten food in fridge, unpaid bills, scorched cookware and bruises indicating unreported falls. Count her Rx meds, for example if there are 30 pills and the Rx was filled 28 days ago, there should only be 2 in the bottle. At some point she needs assisted living if she can afford it. If she is still driving, get that car out of there. Take her on tours of assisted living places "just in case". A good facility will do a thorough eval and help sort the financials.
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Mom needs an evaluation to see where she is really at medically and cognitively, so you can decide in good faith and good conscience whether the right thing is to get guardianship (particularly if she will not let someone be POA and handle finances that she is currently not managing adequately, and is in danger of eviction, utility shutoff, debt collectors or sheriff knocking at the door) and start making decisions for her, versus finding whatever supports she will accept that can keep her reasonably safe. If someone is really severely lacking in judgement and memory, it may not be safe for them to be home alone even if someone could visit every single day. An objective assessment of the home situation would include looking for fire hazards, enough food to eat that is not spoiled, reasonable sanitation (a little clutter is OK, but trash not taken out, excrement, odors, and vermin are not.) This is rarely easy - if it is clearly on one side of the fence or the other, it is at best emotionally difficult; and there is often a real gray area in someone who is functioning marginally in a familiar environment who may be able to do so and wants to do so for as long as possible.
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Jane, this is a very hard issue. Are you contemplating moving closer to your mom temporarily? Can you cook ahead for a week, i.e., can she microwave meals safely? Will she accept your help with meds and finances?
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At that age their not able to live alone in their home.One fall is all it takes to stop that living at home care of thinking.The time will come if not here already.
To your question,I would say 3 times a day would be a fare visit frame.She will need someone to give her her morning meds.(Morning).Afternoon lunch(Afternoon) and evening dinner and help to bed.(Evening).What about depends and trips to the bathroom?At age 94 I'm sure she needs help with those issues too.
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