I lived with my grandma growing up. I no longer live there. Now she is in her late 80's and having difficulty with balance and strength. She is mentally all there (although she forgets things and has trouble "thinking outside the box"- she will only do things the way she has always done them, even if it doesn't make the most sense). QUESTION: is it bad to allow her to make decisions like going down the stairs alone to the basement (very dangerous for her) or doing other physical things on her own? I feel like she is a grown woman and knows the risks and should be allowed to take them if she wants. Is that bad? I feel very uneasy about taking away a person's freedom of choice. If she knows something is dangerous for her and does it anyway-how bad is that, really? What is the point of prolonging her life and taking away her free will just so everyone else can get a few more years of her company? (not that there is anything wrong with that if those are your choices) Am I the only one who feels this way? We have relatives going over on a weekly schedule to help with groceries, cleaning and laundry. So there is no NEED for her to take the risks she takes, besides the fact that she WANTS to.

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Your profile says your grandmother has diabetes and mobility problems. Do you know if her diabetes is controlled? Do you know what her overall health is? Do the people who go in to take food, help with chores, etc. know exactly what she is able to do inside her home? Do they or you really observe how she is functioning for more than a few minutes. Has anyone stayed with her for a day or two?

The reason I ask is that while you may think that she's an adult, experienced, competent woman, but there may be clues that indicate otherwise. It could be that it's not just her insistence on going down the stairs that is problematic. Things could be at work that you aren't aware of, as others upthread have stated.

I had a similar situation with my 62 year old cousin. She knew that she had terrible balance problem and weak bones. She was told by doctors to always use her cane when walking outside and to always walk on level ground. HOWEVER, she would constantly refuse to do that. No matter how often I cautioned her, she ignored me and others, even after falls and fractures. EVEN after the falls and fractures, she STILL refused to use her cane or walk on level ground. It resulted in much inconvenience for me, who had to care for her. (I did not live with her.) She didn't seem to care, which I thought was very odd.

Eventually, more symptoms surfaced and she was diagnosed with Vascular Dementia, possibly mixed with Alzheimers. So, it was not her normal brain placing herself in danger, it was a damaged brain. At that time, I was able to get her some help.

Sometimes, you have to get in the house, look at the mail, examine her handwriting, check the fridge and really discuss things to see what is going on. For short periods of time, she may be able to appear okay, but really pay attention to what she may not be saying. Sometimes, it's not just memory, but poor judgment that offers an early signal.
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Babalou wrote: "As far as freedom of choice goes, as long as her poor choices don't result in others being forced to give up their lives and livelihoods to care for her, sure. She falls down the stairs and ends up dead or in a nursing home. But if she hurts herself, is released back home and forbids outside care, demands that others give up their lives to tend her, that becomes problematic."

Yes, yes, and YES! Since relatives are already going over for groceries, cleaning and laundry, will the assumption be that they just up these visits for her caregiving if she falls and injures herself, requiring much more care? Will YOU be required to help out? Is this fair to her family? What are their thoughts about this? Will they be willing to step in as her (possible) around-the-clock caregiver?
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Your question Danyle is at the very center of my struggles with MIL. And I'm never certain that we are getting it right. MIL's behavior is much like Blackhole's description of her mom. Usually I'm on the side of - "its her life and her decisions, if she falls down the stairs doing something she shouldn't be doing and kills herself, at least she's happy in her home making her own (dumb) decisions." But what stops me in my tracks is knowing that if she falls down the stairs and DOESN'T kill herself .......then it will become a crisis for me, I'll become the (unwanted, resented, and abused) caregiver again.

So yes, on one hand, it is ok to allow gr'ma to make these decisions, let's face it - she's stubborn and going to do it anyway. But on the other hand, be aware, prepared, and realistic about the fallout.

Goodluck, its a tricky path to be stuck on.
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My mother's "all there" was just like your grandmother's. Knew who everyone was, what day it is, who the president is. Better at math than I am. But rigid thinking out the wazoo, unable to plan, not interested in any ideas other than her own.

Turns out she had 2 forms of dementia. This was discovered via autopsy. The last several years of her life, her physical and balance detriments were significant. She fell frequently. Toward the end, daily.

Because mom refused to see a doctor (refer to "rigid thinking" and "unable to plan"), she had no diagnosis while alive. So she was mentally competent by default. If I had tried to get guardianship -- or even challenge her less than ideal choice of POA and executor -- I wouldn't have had a leg to stand on.

My mother refused all home help, personal care and official outsourcing of home maintenance. Instead, she nearly dragged her 70-year-old sister and me into the grave with her. We were the only ones she allowed in. Basically grocery delivery, check-writing, paperwork. Only on mom's whim. (She couldn't plan, remember.) If I called on Wednesday to ask if she needed me that weekend, she didn't know. But she'd call on Friday or Saturday and need me the next morning, heck or high water.

Her home and investment properties fell into disrepair. All the while, she'd look everyone in the eye and say, "I know what I'm doing."

She died of complications from a bad fall. Could it have been prevented, if she had used her financial resources to make her home safer and employ specialized help? Probably.

Instead, mom championed her independence by hoarding, driving VERY unsafely, refusing productive help and pretending she had no money.

Mom could pull herself together for 30-60 minutes a week. Always for the benefit of church, the bank, the post office, etc. When they saw mom, they saw a dear, sweet woman who seemed to be getting more frail. Mom's neighbors saw the day-in and day-out reality crashing down. And they thought I was an a**hole for not cancelling my own life to co-live mom's life.

My aunt and I got the brunt of mom's inability to reason. Mom loved us. She had good days and good moment. Mom also reserved the depths of her irrational stubbornness for the two of us. Every common-sense suggestion we made was met with resentment, hostility and belligerent resistance.

Sorry for the filibuster. Just a long way of supporting Babalou's answer. Much as you love grandma, draw your boundaries now. Don't try to be the hero (despite the pressure you'll feel from yourself and others).

Hold fast to the memories from when you were young. And compartmentalize them. Your future with grandma will probably bear little resemblance to your past with grandma.

Make decisions based on what IS. Not what you wish for. And not based on expectations that others will dump on you.

Good luck. Keep coming back here for support. You'll get a variety of points of view. It will help you make sense of this sad and overwhelming time. Take care.
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If she is competent as you say she is all you can do is express your concerns directly to her.

Since she is continuing to do things that endanger her health like walking down the basement stairs when she has family who comes in weekly to assist her with things I might agree with Babalou in that perhaps your grandma doesn't have 100% of her good judgement but it could also be that she knows she is aging, she knows she's beginning to have limitations and she'll be damned (in her mind) if she's going to stop doing the things she's always done. Many elderly people become defiant about their independence and make reckless choices.

The title of your post was "Is it OK to allow grandmother to make her own dangerous choices?" The key word there is "allow". Your grandma may feel that she is allowed to do anything she darn well pleases and pity to anyone who says differently.

But your concerns are certainly valid. It probably isn't a good idea for her to be going up and down those stairs but what can you do about it? I'm sure she's been offered assistance by family and I would bet that she's turned it down. What else can you do? You can't force her to not use the stairs. You can't chain her to an arm chair so she doesn't injure herself doing something she shouldn't be doing at her age.

If a family member is there while your grandma is doing the laundry downstairs that person can hop up and say, "Grandma, let me get that for you." Or, "Why don't you sit down and have some iced tea I just made and I'll get that laundry basket for you." Be polite, be respectful, offer assistance but other than that what more can you do?
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I challenge your assumption that your grandmother is "all there" if she is exhibiting the rigid thinking patterns and lack of ability to see consequences that you describe. It sounds very much as though she's had a stroke which has led to vascular dementia.

As far as freedom of choice goes, as long as her poor choices don't result in others being forced to give up their lives and livelihoods to care for her, sure. She falls down the stairs and ends up dead or in a nursing home. But if she hurts herself, is released back home and forbids outside care, demands that others give up their lives to tend her, that becomes problematic.

Decide what you are willing to do. Just don't delude yourself about her mental capacity.
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