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My 75-year-old mother lives with me. She has had two strokes. The only lasting damage seems to be a vascular dementia. However, the only things that my mother EVER has enjoyed is shopping, sleeping, eating, or watching TV. She does not cook anymore and will not try. She does not do puzzles or read. She gets virtually zero exercise. She does not pick up after herself or even get dressed daily. She barely comes out of her room and sleeps all day long. She is also very mean and has no boundaries within the house or with people. She has always expected people to do things for her. She complains about being "sick" constantly, and has gone to the hospital by ambulance on several occasions only to find nothing wrong with her (starting infrequently at age 33 and becoming far worse over the years.) She has been on anti-depressants for years and years. She complains, talks about people, insults, "tells on" people, all the time, and she is getting harder and harder to live with. She is never wrong and any disharmony in the household is blamed on everyone and anyone else. She would never accept outside help, nor would she join a senior center or accept counseling. Her only friends are relatives who are often occupied or limited by their own lives and/or health. Any offer to reunite with past friends is met with excuses and reasons not to go. Quite frankly, her demeanor has always been harsh or negative, and now it's coupled with her constant complaining, so people don't WANT to be around her, including me. Truly....she would accept NO PROFESSIONAL help. She would become angered and fly off the handle. She has no zest for life, and although fears death, seems only to be waiting to die. However, I should mention that she can put on somewhat of a phony/"crazy" show in front of others not close to her to give the impression that she is anything other than miserable.

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Occasionally we read of people who mellowed out as they developed dementia, but more often typical patterns of behavior become intensified. Someone who was a drama queen before dementia is not likely to become meek and self-effacing.

The behavior you describe does not sound like typical depression to me. It sounds like she has some other mental health issues, perhaps in addition to depression. The first step in addressing that is obvious, but you can't get her to a doctor if she won't go.

Your question is what should you do with her. This may sound drastic, but what I think you should do is get her out of your house. You cannot control where she goes (unless you are guardian) but you can control who lives in your house. Since she has dementia she really shouldn't be living alone, so an apartment may not work. Maybe assisted living. Maybe memory care. Maybe a group home. Maybe a nursing home. Not your decision, but you could be thinking of possibilities to suggest.

Work with professionals to get her resettled elsewhere. I'd start by calling the Area Agency on Aging in your county. Explain that your mother, with vascular dementia, is living with you now but this cannot continue. Ask for a needs assessment for your mother, to establish what level of care she needs. Then discuss with them how to find a suitable residence for her. They can't force her to accept a particular place, either, but once she understands that she has to move, perhaps she will be more receptive.

The agency on aging varies from state to state. If yours cannot help with these things, they should be able to refer you to resources that can.

Another way to get professionals involved is to make an appointment for a needs assessment with your county's Human Services (welfare) department.

Be present during the needs assessment. The people who do them know that the person they are assessing lies or exaggerates or just doesn't remember accurately. But they have to write down the answers they are given. You can help that to be accurate. For example, my mother said, yes she could prepare her own meals. The daughter who was with her for the interview said, yes, Mom, but you can't get your own groceries, and don't use the stove. You can microwave things but it is getting harder and harder for you carry them to the table. Mom admitted that all that was true. She got Meals on Wheels. But if the social worker had had to take her at her word that she could prepare her own meals, that might not have happened.

Look into the eviction process in your location. Let us hope that it doesn't come to having the sheriff forcibly remove your mother, but having that option makes it clear that you are totally serious about this change. "Mom, it really isn't working for us to have you living here. I think you are not happy here, either. I will help you find another place to live if you would like help. But you must be out of here by the end of September."

If this solution is too drastic, then I think the alternative is to grin and bear it, and come here often to vent!
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This is similar to the story with my dad. He lived alone and refused any and all outside help, even to the point of his wife of over 67 years having to remain in a NH due to needing help with everyday functions and still dad refusing any outside help.
Dad refused to see a Dr., although he was loosing weight, would take his meds only now and then, and showing signs of dementia. Did I mention he would take about 1/2 dose of insulin morning and night, but never would he check his sugar level? He fell a few times. I told him the next time he fell or had a medical issue, he was going to a NH, and that would always be met with "You better NEVER put me in a NH. I just walk out!"
Looking back, he always was Mr. Negative, always pointing out why something would not work, never on the positive side of things.
Anyway, his sugar bottomed out and wrecked the car [minor damage-no injuries], went to the ER and later his Dr, who recommended NH placement in a locked dementia unit. He is now doing well, just still pissed about "Who put me here? I'll knock them out!" That has been a little over a month ago, and slowly getting his meds straightened out. Things are looking better now.
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Dear Delta,

I'm very sorry to hear about everything you are dealing with. I know its frustrating and exhausting. My dad also suffered a stroke and I found it very difficult to cope with his negativity. I tried and tried to make him happy but nothing I seemed to do was ever right.

In hindsight, I do blame the vascular dementia, the side effects of the meds, the loss of his independence. It was just spiralling downwards. My dad has since passed and I do have terrible regrets about his care. For your mom, I wonder if maybe an assisted living or nursing home might give her more company during the day and more relief for you.

Thinking of you. I know its not easy.
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Depression is "catching"---I live with a hubby who has been severely depressed for 10+ years. When he is out of town, amazingly, MY depression really lifts. I know that having him home, never knowing how he is going to feel or act, is exhausting. He has finally agreed to therapy and is doing better, but I have ZERO expectations that this will really change. He sleeps 24/7 when he is not actively supposed to be at work. (He's 65). Retirement looms. I asked what he wants to DO in retirement and he says "Climb into bed and never get out." I expect that's what he will do.

Now, this is very different from having a "houseguest" as it were. But your mother's refusal to do ANYTHING makes it very hard on YOU. And she can't see it, b/c depression sucks the light right out of a room.

So--either you continue to live with this mopey, angry person, or you don't. She really does NOT have the right to ruin your life. At this point (75 is still quite young!!) if she simply refuses ALL help offered and available, I'd be looking for somewhere to place her. You do not "owe" her anything but respect due an elder.

Yes, it is hard. Yes, she will be mad. But it's hard now and she's mad now. You are going to kill yourself caring for her and trying to get her to engage in life and she obviously doesn't want to. She'd probably be as miserable in one bedroom in a NH as she is at your home. She could certainly live 20 more years.

Sounds like you have a terribly difficult choice and I do not wish that on anyone. But, she isn't going to change, so you have to.
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Oh dear, so sorry to read what is happening to your Mom, with her being so young. When I read the title, I first thought your parent was in their 90's, but 75 is far from being elderly.

No wonder Mom is depressed at her age. She's already had two strokes. She can no longer hop into a car and drive to the mall. She can no longer visit with girl friends. She basically has nothing to do, so gossiping is now her past-time. Where is your Dad, or has he and your Mom gone separate ways... that can be very heartbreaking, too. This isn't the retirement she suspected. I would be grumpy, too. Being "sick" gives her attention.

I would have Mom see her primary doctor, or go to urgent care, to have Mom checked for Urinary Tract Infections [UTI] as those can cause a person to misbehave, lose their filter, even become violent. This can be treated with antibiotics.

What was Mom's passions when she was younger? Doing volunteer work is the greatest pick-me-up if Mom is willing to do that. I know it would be a challenge, but give it a try.
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Your mother can live for many more years. You should start thinking about how you want your life to be and decide her living arrangements based on that. Knowing what I know now about how much care my MIL needed and how needy my FIL is, I am glad we chose to not live with them.

A good friend of mine placed her mother who had dementia that eventually became severe in a small, private nursing home with only a few dozen rooms. She visited her weekly. Her mother lived with dementia for nearly 25 years and died at 100.
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*Delta* -- I can relate to many things you mentioned. Clarify a few points:
1. She moved in with you? What happened to her home? Does sale of it pay for her needs? Will this provide for her in a home besides yours?

2. She flies off the handle at the mention of outside help. How far has a fit gotten? Was it life-threatening? Could she bar professional help from entering the house?
I agree with *Jeannegibbs* that you need to be present during an assessment, stating very plain truths. My parent had a whole group of us maintaining cleanliness, safety, ect, She thought (in her dementia) that she was doing it all. Not true. Say it -- gently.

She gets mad? How mad can she get? Life threatening to herself or others? If this is grumpiness, then treat it like a toddler and walk away.

Trips to hospital? Can you get a list of those trips? Showing reason, and outcome. Also look for "triggers." Too much tv show junk, a holiday or other significant occasion? Visitors?

With her being 75 years old, and if she is coddled in the health system she could live for many years -- physically ok enough, but mentally at risk. I "enabled" mine for 22 years to age 93, hoping she would "get happy and do things" but it did not happen. I lost a huge chunk of my life and opportunities.

Take a really realistic look at this. What are you going to gain? Family happiness? Money or property? Think again and do get some professional assessments involved, talk with financial planner for your parent and find her a nice senior community.
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When you say the only lasting damage of the strokes seems to be vascular dementia...

The "only"?

Imagine if you felt incredibly ill and incredibly tired every waking moment; that the gloss had come off everything you used to be interested in; and that everyone seemed to be carrying on as normal while you were drifting further and further away from your life. That's pretty much how your mother feels.

Your mentioning the meeting up with old friends made me smile at a memory. My mother's friend from her days in the army, so going back sixty years and more, also in her eighties, travelled alone for two hundred miles to come and see her. After dinner I settled B in mother's sitting room with the coffee tray then went back to the kitchen to find mother still firmly in her chair at the table. "B's waiting for you, aren't you going to join her?" "Do I have to?" "Yes, of course you do, she's come all this way to see you, you can't leave her sitting there by herself." "Well it's very trying!" snapped mother, and spent the rest of the evening in a grump.

The insults and rudeness, by the way, become more extreme because your mother's social filters are gone. Inhibition, which stops us telling people what we think of them when it would be hurtful or inappropriate, is a frontal lobe brain function; and it seems, from reading here about other people's elders too, that it's one of the first noticeable things that vascular dementia attacks.

Please don't think I don't sympathise with you. I've been through this and it is a black hole of negativity, almost as depressing for the caregiver as it is for the sufferer. But you can't restore your mother's brain, and she can't alter her behaviour either. There are techniques which will help you keep the stress under control. Other than that, it's a matter of judging whether you can learn to live with this in your home, or looking for a facility you trust to care for her well.
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Delta, what you wrote about your mother fit my mother to a T. After over 7 years of living with her, I know that there is no way I can fix things. She isn't going to go places and she's not going to let someone come into her house. She has no friends since she pushes people away (hermit). She stays in her pajamas and watches TV all day. I don't try most things anymore, since it would be like walking into a wall again and again. I let most things go, but inside they bother me. My mother has always been lazy, but now she does nothing at all. I feel like a slave. I would love to leave, but there is no one who will help and she fires professional help. She won't go into a facility and is considered competent, so no one could make her.

You do have an advantage I don't have. She lives with you, instead of you with her. That gives you a lot of leverage in getting her into a better living situation. I would go for it, because it can make life miserable. It would be better to live apart as daughter and mother than live together with resentment. The advice that others gave above is excellent. One thing that is good to remember is that you are as important as she is. You have the right to a good life. My mother started going downhill when she was 75 with what may be vascular dementia. She is 90 now and may live many more years.
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I was struck by your comment that your mother "only" has Vascular Dementia. That's a big only, since that diagnosis is huge. It literally means the person has brain damage and will eventually lose their ability to function or do their daily activities without assistance. I might confirm this diagnosis and then try to figure out where mom can get help. It's not the kind of thing that she's going to get better with. It only gets worse and regardless of how annoying the behavior might be, it's not her fault. I think that that if someone has been annoying in earlier years, it's hard for family members to look past that, because old wounds are slow to heal, but, taking issue with dementia behavior is really unproductive.

I'm not surprised that she doesn't want to do much. People who have brain damage often can tell things are changing and they are scared and confused. I get why they don't want to leave the house. Not remembering things like how to open a car door or how to stir your coffee is embarrassing. Often the comfort of home is safer for them.

I'd read a lot about what she may be experiencing and find something that she might be able to handle with small steps. My LO would only do something, if I was right by her side. It still scared her though. She often felt that she was dreaming and things weren't real. I can see how that frightens people.

Blaming a dementia patient for their behavior, regardless of how odd we may consider it, isn't really helpful. They are disabled and need help and empathy.
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