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Since my father passed away 8 months ago, my sisters and I have stepped into care for my 81 year old mother. We each take a extended weekend a month with my son's girlfriend picking up the middle. She has been inactive since her stroke 3 years ago, but has full mobility. She is a heavy smoker, drinks several glasses of wine a night and takes an extrodinary amount of ambien and advil pm's to sleep @ night. We are trying to make changes for her own good (like having her excercise by walking) and being more self-suffiecient. She can probably stay alone at times if she did and of course cut back on the Ambien so she isn't falling at night. She seems to think that all we do is scold her for her undesirable behavior. Im attempted to put her into assisted living which she doesn't want to go, but I think they'll kick her out. She gets up a couple times a night on the Ambien to smoke. Should we have a care-giver come in and evaluate her for a week before we make that step?

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I think you should not make any permanent decisions for at least a few month. No doubt all of you are still a little emotionally fragile from your father's passing, and your mother perhaps most of all. You will remember and miss him forever, but you will all be stronger with the passage of time. Cut yourselves some slack right now!

You can research your options at this time. Is there a pleasant ALF in her area? Can she afford it? Would they accept her? Many ALFs will not allow smoking. (We got my mother on e-cigarettes for that reason.)

What would an experienced caregiver cost? Can Mom afford that? Does she have any long-term-care insurance?

Try to cut back on the "scolding her all the time." (I know you aren't doing it all the time, but reduce Mother's perception of it if you can.) If I had to pick one thing to work on it would be the night drugs. Talk to her pharmacist. Look them up on reputable sources online. They don't seem to be keeping her asleep throughout the night, so I'm not sure what the point is. Talk to her doctor. (If you don'f have a HIPAA form to do so, that is a necessity.) See if all this research will help you and her doctor come up with a new plan for sleep problems. Perhaps there is a better medication. Maybe not drinking alcohol after x pm. Maybe a certain soothing routine before bed each night and always going to bed at the same time. I don't have a plan, but I'll bet you guy together could come up with one. Ignore how much she drinks, just move it to earlier in the day (if that is part of the plan). Ignore the smoking (at least for now). Just focus on the sleep problem and the drug addiction. One thing at a time, and in the spirit of "Gosh Mom, that is a bad sleep problem you have. Let's figure out what would help." No scolding, or anything she could twist into seeing as scolding, if you can help it.

Actually, the exercising would contribute to better sleeping, and I'd tackle that before the wine and the cigs. But one thing at a time. It must be overwhelming to mother to all of a sudden not only to lose her husband but to have her busybody daughter come in and try to tell her the way she has been living for years and years is all wrong and she has to change everything. I know you mean well and you are right. But take it slowly, please.

I wish you great (if slow) success is helping your mother to live a more healthy life.
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Thank you so much for the advise. Your right my sisters and I should focus on one thing at a time. Its all too overwhelming for her. I personally am not concerned about her sleeping. When I stay there she never wakes me in the middle of the night and when she gets up in the morning usually @ 5am it doesn't bother me as I get up @ 3am for work each day. Its the 4 others that assist with her care that can't handle the early hours.

I think I'll focus on the excercise as I've been trying to get her to walk since her stroke. I have purchased at least 5 pairs of comfortable shoes for walking. After my fathers passing I was looking in her closet and found them and discovered they've never seen her feet. However, it wasn't as if it was a surprise. I visited my parents multiple times a week on my way home from work and if she would have gone walking they would have been boasting about it.

One step at a time and after walking then the sleep aids. Sincerely, Thank You
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