My 82 yr old mom has her own apartment, the one I grew up in. In July of this year she fell (nothing broken) but had to be hospitalized due to urinary traction infection and then go thru physical therapy to regain her strength for walking. She was real eased in August and has stayed with my wife and son since. Less than a month ago she had to be hospitalized again for the infection but was also diagnosed with early cirrhosis of the liver. She was supposed to follow up with the specialist today but canceled cause she's "much better." And she'll get one when she goes home.
She can't live alone, doesn't want home care, and doesn't want to I've with us.

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Sorry, just to clarify: has your mother been staying with just your wife and son, or with you too? How far away from her own home is this?

Also, I don't mean this combatively, but who says she can't live alone (with appropriate support to be negotiated, that is)?

You don't say that your mother has any cognitive problems. If she's clear in her mind, and she wants to go home to her home, then home she goes. It's her life and she's in charge. Doesn't mean you have to be her accomplice; you can always say you think the idea is insane and you wouldn't touch it with a stick, then walk away. But I assume you can't see yourself ever doing that.

In your difficult position, I think I would start with talking to her sympathetically but without pulling punches. If you believe she's just delaying the inevitable, and will need nursing home care sooner rather than later, tell her that and tell her clearly why. You could also point out that it is better to walk in to a care setting you've chosen than to be carried in to the nearest one available: she'll have more time to adjust, make friends and benefit from the advantages while she's still able to do so. If it's going to happen anyway, better to get one step ahead of the game.

But unless your mother has lost the capacity to decide for herself, then your role as perfect son (or, for that matter, as a caregiver complying with best practice guidelines) is to support her in her wishes. This means arranging the home adaptations and assistance needed to make her apartment safe for her to live in; and ensuring that emergency and contingency plans are in place. Expensive, hard ongoing administrative work, and never perfect: eventually there will be another fall, or another medical emergency, and she'll be back in ER. And you'll be back to Square 1. Well, that's not the end of the world. It doesn't even mean it's not worth helping her to stay independent for as long as possible. You have to judge whether you're prepared to take the project on, bearing in mind how much co-operation you're likely to get from local service providers and, of course, your mother...

If she's also saying she doesn't want home care, have you asked her how she thinks she is going to manage? If you have, and the response is some tetchy equivalent of "oh I'll be ok don't fuss," then I'd guess that she's intentionally not thinking it through because she doesn't like the conclusions she comes to (and who can blame her). If you can somehow reassure her that all you're trying to do is make her choice one that can be put into practice, you might have more luck in persuading her to think in practical terms.

PS above makes the good point that all arrangements will need to go past the discharge planner anyway. If your mother is acting for herself, she will have to have workable plans in place before the hospital will discharge her. Sit in on the discussion, if that's all right with your mother, and see what can be worked out. Of course that doesn't mean the plan will necessarily translate to real life; so you're likely to have carers telling you she won't let them in, missed appointments just like today's, carers not turning up when they're scheduled to, or turning out to be people you wouldn't want in your house either… It will mean problems large and small to be tackled one by one. Are you up for that?

You mention signs of cirrhosis of the liver (which she's also avoiding, do you suspect?): I don't want to jump to silly conclusions, but would you say alcohol might be a factor having an impact on her life? If you think it's possible, it's another thing that will need keeping a close eye on.

The way you describe your mother's apartment as being the one you grew up in makes me sense that you do respect your mother's wish to live independently, or at least understand her reluctance to leave it. I agree that it's unlikely she'll be able to fly solo forever, but I don't agree that it's ok to treat her as if she's a child or an idiot. Go through the pros and cons of her options with her, then respect her decision and help her to achieve what she wants safely.

Then stand by and be ready for developments. I wish you every success.
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Somehow I don't think that you should be the main one to tell her that she can't live alone. If medical professionals have determined that she needs more supervision than living alone she should hear it from them. Then you are not the bad guy -- you are the problem-solver who will help her figure out how to follow the doctor's orders in the way that is best for her.

UTIs really take a toll on elders. (My mom is in transitional care right now after being hospitalized for a uti.) Another uti is possible whether she lives alone or not ... as you found out, when she got one living with you. She may have fallen because of the effects of the uti. That could happen anywhere.

What are the reasons that she "can't live alone"? Is she confused? A fall risk? Does she not eat well alone? Has her doctor said she shouldn't live alone? Help her figure out how to meet her needs in the ways least disruptive to her independence now. Depending what her specific needs are, there are several options.

1) She may be able to continue to live in her apartment with certain kinds of help. My mother was able to live in her apartment probably 5 years longer than she could have without help, because we arranged a homemaker to clean and do laundry, a visiting nurse to set up her medications, meals on wheels for a daily hot meal, and a visit from at least one of her adult children weekly. She didn't think she needed all these services, but without them she could have not safely been alone. This year, at age 92, she moved in with a married daughter. She didn't need that much help five years ago; she does now. Exactly what help does your mother need at this time? You can adjust to changes as they occur.

2) She may enjoy going to an adult day health program. She could be picked up and returned on a bus or van, have breakfast and lunch at the program, and there are often extra services such as toenail care and showers available. With this kind of daily program she may be OK to return to her own apartment for the evening, and spend some weekend time with you.

3) Depending what her needs are, assisted living might be a suitable choice. She would have her own little apartment but also have help available when she needed it. A wide range of services are available. Meals can be provided.

4) She could live with you. If you are considering this route be CERTAIN that you have arrangements made for respite -- no one can be a 24/7/365 caregiver and retain sanity. So even if she lives with you, she could also use adult day programs a few days a week. You could arrange for a professional or other family member to take care of her one night a week or every other weekend or on some schedule that would give your family breaks.

Your mother can make her own decisions about following up with the specialist. I would hope she will at least hear what the treatment options are, and then she can decide whether she wants to follow them or not. She should at least learn what she can do to continue to feel "much better." It may be just too much for her to process right now, but discuss it with her again after some time has passed.
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The discharge planner at the hospital will help you place her. Do not take her back home, just tell her no. Talk to her MD about recommending a proper facility for her, it is easier to get her into a nursing home directly from the hospital. She may object loudly, but hold your ground. If you take her home from the hospital, blame yourself for giving in.
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