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My mom had a stroke almost 2 years ago. She's a very focused woman and strives to improve herself regardless the situation. She is doing great in the assisted living where she's been over a year now, making friends dad and has a routine, which is very important to her. I have been her main rehabber for this time and she continues to improve, although slower now of course, and have had very little of any help with others coming in not associated with the state rehab program. She loves visitors, but we live and hour away from her sisters. In all honesty, they likely wouldn't be by any more often than they are, especially with some of the deaths we have hadn't in the family. Basically, I have little to no help, the visitors have lessened (even when I pay them!), and mom turns to me for MORE support. I have hit and gone beyond burnout, even trying to take a couple days a week off. She does keep herself busy with learning to write and puzzles, but she use to do so much and was so active before. I can't be active enough for us both, I have tried. It's just tearing me down. What suggestions do you have for helping me to get myself put back together while keeping mom maintained and happy?

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I might add, I am an only child and have no children. My husband works during the week and doesn't mind taking a few hours in a weekend to walk mom. Everything I do for her is physical rehab; walking, strengthening, speech. She can walk with assistance, but there are no CNAs with time to do that or help her stretch her non working arm more than she can herself. They can help with speech, but it's sporadic according to how busy they are. That's why it seems to fall on me to do any care outside of basic assisted living home care (which I couldn't do any of this without the blessing of God provinding for her.) I just know I won't be doing my best and am trying to avoid guilt when she does pass that I didn't do enough. That may be my biggest drive to keep the pace up. But it's driving me into the ground, so to speak.
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One of the best pieces of advice I have received on this site (im a newbie too) is to accept your limitations and build boundries. I finally had to do that can call in a caregiver for my 90 year old dad who insists on staying in his home and lives an hour away from me while I work full time. Our first caregiver just flat out quit. our second I am meeting on Wednesday ,, my mothers day was spent on the couch in tears drinking wine .. enough is enough .. give yourself those couple days off ,, if you don't your going to get ill in one way or another. If you aren't well you can't help anyone else .. let go of the guilt ,, it serves no purpose,, and just do the best you can. Women will sacrifice themselves to death over guilt ,, step back .. breathe ,,, and incorporate days that will help you (and her) in the long run.
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To get yourself back together? Take more time for yourself. If that means you visit Mom less often, so be it. I'm not talking abandonment here -- just a little more detachment.

How old is your mother? It is awesome that she still works on improving! What is a realistic prognosis? No one can predict for sure, but what is the medical opinion of how much more improvement is likely?

Can she afford private therapy? What if she had a speech therapist come in twice a week, for half-hour sessions? Is there a private-pay therapist or exercise assistant at the AL? Having something more regular rather than hit-or-miss might be more helpful, if Mom can afford it.
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Where do u live? I have never heard of a family being responsible to rehab a parent. Yes, maybe help with exercises the therapist recommends. Medicare should pay for a certain amt of therapy and they aren't there everyday.  Can u hire a CNA to do this for you.  You say Mom is pretty with it then explain u can't be there all the time. You have 
Ur own home and hubby to care for.  Tell her the one reason an AL was picked was because of the friends she made and the activities.  No one can keep a person busy 24/7.  We all have to learn to be alone at some point of our lives.  And yes, the visitors stop. 
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You don't say how old Mom is? My friends mother lived to be 104 in a nursing home. Friend didn't put her life on hold. Can you go for years the way you are now?
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You have to take time for yourself. There is a law of diminishing returns meaning that x amount of effort put into something yields lower and lower returns after a certain point. I expect that is true of your efforts with your mum.

" I just know I won't be doing my best and am trying to avoid guilt when she does pass that I didn't do enough. That may be my biggest drive to keep the pace up. But it's driving me into the ground, so to speak."

You might want to seek some counselling for yourself about the guilt and need to drive yourself into the ground trying to help your mum improve. Many people feel guilt after their parent passes,  and think that they didn't do enough for their parent.   It is part of grief and I doubt you can avoid it, no matter how hard you try. It doesn't mean they actually didn't do enough. They did enough, but they still feel guilty. You cant stop illness and aging from progressing.  Don't make yourself sick over this. You and your health are important too.
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Thank you all for the encouragement and info. We are in Alabama, but from what I understand and have been told, the rehab helps a person, then teaches the family how to help their loved one if they can't do it all themselves. Mom is about to turn 74 and she has pretty well reached the furthest she will go overall in recovery. Since she isn't able to walk herself, the leg effected by the stroke does tighten up and I have been working to keep away as much atrophy as possible. Her arm is just now seeing some strength, although she can't really use it. I know she realizes I need to be elsewhere and she sees how tired I get. She gives me that look Mothers give when they don't know what else to do but hug you to show how much she appreciates what I have done. Since her speech didn't come along, part of her feels stuck in her own world, but the girls there are really good at knowing what she needs. Heck, I get stuck knowing what she's trying to say sometimes.
Yes, I have thought about if she were to live, say, 10 more years. There's no way I could totally give up my life like that. My calling isn't caregiving regardless of how the CNAs say I have been such a help to her.
My husbands mother is in the nursing home dementia hall, so he is not able to visit at times without his mom going through a spell of yelling or being ugly. It has helped him, and my mom, to be able to do things for her. She loves his visits. I definately plan on keeping his day going with her.
when she started having the TIAs a couple years ago, I couldn't get her to visit (I'm an hour away from her actual home) or let me come get her, so I probably feel guilty I didn't do more. She wouldn't allow it though. I really hope I don't turn this way as I age, but keep an open mind as far as seeing a doctor.
I realize also, she remembers more now and knows if I have been there or not. When she first had the stroke, she wouldn't remember if I had missed a day or two or was just there.
Dad was a mean, horrid, verbally abusive man I couldn't get her to leave. She's finally free of that and much happier even though this happened. I do wish many things could have been different and I suppose I had been trying to make up for her not having as Happy of a life as she could have. I realize it's not my job though to sacrifice myself to the point of loosing my sanity and happiness. You only get one mom and our relationship wa strained by the choices she made. Just makes me sad I or her sisters couldn't have done more before it all happened.
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Maybe you can find a nursing or physical therapy student to spend a couple of hours with her 3x a week

One is never too old to make a new friend
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I will ask about that. Goodness knows I know all the regular rehab people now. We may be able to at least get speech back.
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While she hasn't had a stroke my 94 year old mom has had visiting PT for a few sessions when Medicare will approve it 2x a year or so but I have a private caregiver with her 4 hours a day at her facility to
Help give her company play puzzles and take a nap and take her to the bathroom

I know how hard the staff caregivers work with 8 or more residents to get fed and put to bed in the evening and to get up and dressed and given breakfast and lunch in the day
No way they could ever spend time doing any one on one therapy

Hopefully you can find some extra helping hands
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Taylor, try to adopt the attitude of managing moms care, not providing it. Her dr could order her pt and or ot to keep her leg and arm limber. My mother couldn't use her right arm unless she had therapy. If the therapy stopped, her arm was too weak. She had it two or three times a week for years. So see if you can get her dr to order it. She could get an evaluation and they could see what they could do for her. Someone outside of the AL. 
I love the idea of the student helping her. Perhaps if a student came in and read to her that would be beneficial also.
AND when did you last get a massage? Treat yourself to some care as well. Try it once or twice a month to see how you feel afterwards.
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"I do wish many things could have been different and I suppose I had been trying to make up for her not having as Happy of a life as she could have. I realize it's not my job though to sacrifice myself to the point of loosing my sanity and happiness."

Ah, that old tug.....when you spend your formative years as a pawn in an ugly marriage.

You're conditioned to be mom's only hope, only joy, etc etc. I can tell that you already realize that you CAN be your own person AND be good to mom. Oh yes, you can!

You just need a boost, eh?? Listen to the all the fine folks who posted before me. They'll steer you right. 🙂
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When mom was in rehab, we definitely had to have someone with her at least through the nights and early mornings as she would forget she couldn't walk or stand after going tot he bathroom. She took a fall once when the RA left her for 30 seconds in the first 2 mi this after the stroke. Scared the mess out of me. I saw the girl walk out of the bathroom and about the time I realized the other girl wasn't in there and she was alone, we heard her cry. She was jammed with her legs under the toilet and her head going up the wall in front of her. Needless to say I panicked! She turned out ok, but I don't think I will ever get over that. It may be part of the reason I don't like leaving her alone for too long, but she's completely aware now of everything.
We kept someone there with her, but the money ran out for that super fast. Assisted Living is more expensive that it should be I think, but it is what it is. I am concerned if I were to get someone there half the time I'm not, the money may go fast again. Her personal monthly check (SSI) takes care of her basic needs I have shipped in, but I will look into how much a helper would be. Even friends I would pay to be with mom have other jobs now or are busy.

I went to day, and during a rest while walking she asked when I had to leave. I said I would take her on to lunch and had to go. Well, she welled up with tears faster than ever. She's not 100% as it's time for the Botox shots that take the pain from her hand and legs, so I know she's tired. I asked her if she wanted me to stay through lunch (which I knew she wanted me to stay longer), for her some Meds and she was ready to take a nap anyway.
It's so HARD to look at your mom, who's gone through so much and accomplished so much, and have her cry for you to stay when inside I want to take a month long break to breathe.
My hats off to all of you who have someone at home you care for. You are the warriors.
Mom made it very plain for years she did not want to live with us and put any strain on our marriage or disrupt our home. I couldn't do it anyway- but she may have known that too. Moms are like that.
I'm taking tomorrow off and I will Skype her to check on her. That helps her.
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