What to say when my mom won't talk about anything but going home?

Xinabess, the ray of light in your situation is that your mother has capacity, and she is in a formal care setting. Those two things together mean that the issue of when she is discharged and where to are NOT your decision. You are not keeping her locked up, this is not up to you.

For the next week at least, don't cross the bridge. Come discharge day, if the clinical advice is to defer again, repeat as often as necessary that it is *great* that she is making progress in rehab and vital that she doesn't give up on it. That gives you more time in hand.

With that time, you devolve to her care team all responsibility for discussing with her how she is going to cope at home. Again: not your decision. They have to do the explaining and the planning, not you.

Now, it seems probable that the "I'm fine to go home, this is all rubbish, what are you talking about" arguing is all talk. What happens when she makes the attempts to get out of her wheelchair and can't? Have you tried saying nothing and waiting for her to comment? You could prompt her with "so what happens now?"

She would be entitled to rant and rave about being disabled by the stroke. She must be angry about it, who wouldn't be? I wonder if this is her method of ranting and raving. Ask her what her plan for managing is. Don't argue, if she says she can manage. Just say she'll need to show the discharge team that it's so, and let her come to her own conclusions.

Not your decision, remember. It's a clinical decision about rehab, and it's for her to make a practical plan with her advisers when the time comes for her to be discharged. And when she's thrashed out one that everyone agrees will work, you'll back her up.

Xina, if you feel bad not visiting her and you were planning to go today anyway, then for heaven's sake go!

The guidelines for and against visiting are:

DO go if

You want to
You have time
You are not carrying any infectious diseases
You are not vulnerable to any infectious diseases that might have broken out in the rehab facility
You have not been asked to co-operate with any kind of no contact/settling policy

DO NOT go if

You have other, more pressing engagements
The staff have proposed leaving your mother to their care to assist settling in
There is some other good reason not to go, including above all that...
You don't want to.

The purpose of visiting your mother is not to have a rational conversation with her about when she is going home, or not today anyway. It is to see her, to offer her your company and love, and to satisfy yourself that she is fine and doesn't need anything.

I wouldn't take the duffel bag, mind. You'll only end up packing and unpacking it every time you go. Say "d'oh! Silly me! I'll bring it next time, remind me..."

I'm confused that you say she is fully grounded in reality, but she insists on going home alone when she needs two people in order to transfer. That sounds to me like she is not dealing with reality. Has she had a mental evaluation?

Do you know how she was operating in her home before the stroke? She may not realize what she can and can't do due to the stroke, if she is only able to transfer with the help of two people. I think I'd try to explain that the doctor has ordered this and if she ignores it, I'd try to figure out why.

I would think that there would be an assessment of her needs before she is released from rehab, to ensure that she can function at home or wherever she plans to go. If there is no one at her home to assist her, then she can't go home.

I'm sure you'll get some more responses with some suggestions. I hope some of them help.

You say she doesn't have dementia. Well.

Dementia comes in many flavors. What is common the many of the dementias is the inability to reason. It sounds like that's where mom is right now. Oh, she'll pass a mini mental status exam, but she clearly no longer understands the reality of her situation. It's very sad.

There are a couple of ways to handle this. One is to let the rehab docs,, therapist and social worker tell her that they are not legally allowed to discharge her into an environment that is demonstably unsafe. You can empathize with her and be on her side, but your hands are tied because of all the regulations.

Another is to play hardball. If she's been unreasonable all her life ( which might mean she's got a personality disorder) tell her you are walking away and will let the state take guardianship. She'll end up wherever there is a bed. Or, she can cooperate with you and help pick the place she's going to live.

I'm sure others will have more creative ideas.

I agree about the evaluation. Mental decline may not just be about memory. Often it's poor judgment or delusions. My cousin was completely convinced that she could stay alone in her home with neighbors checking on her. But, in reality, she was not able to to cook, bathe, take medications, operate a tv remote, pay bills, or even know what day it was. There was no convincing her. Thankfully, the doctor was able to convince her she needed therapy, so REHAB, which is what we called Assisted Living is where she went to live.

Xina, in your shoes, i would not be the one bringing up the subject of "not going home". If SHE raises the issue, develop a list of stock phrases...we'll talk to the doctor about that, the therapists are so pleased with your progress, mom, hmmm, need to get strong here right now, lets concentrate on the task at hand, which is therapy.

As someone wisely pointed out previously, the more you emphasize it, the more she's going to fight you.

I have literally gone through this identical scenario twice, once with my mother-in-law and another time with my mother.

Both of them would say "get me home and I will be ok" when they could not get out of bed without two people lifting them. You say your mother still has all of her cognitive abilities but I suspect she may have the beginnings of dementia.One epiphany I had was that I had to view my mom/mil as a child. Children don't always possess the necessary decision-making skills to know what's best for them so adults have to step in. It's the same for your mother. Buy her a Kindle or Ipad even if she says she doesn't want it. Arrange for her to go to a NH even though she says she is going home. I remember getting so frustrated at my mil that I said "Ok, right now, if you can raise up and get out of bed and walk on your own you can go home". Of course she could barely lift her head let alone get up. That hushed her for awhile, but in the end the decision had to be made for her to go to a NH as going home was not an option. I am so sorry you are going through this, OP, as I know how bad it makes you feel to see your mother so sad and in decline.

It's the stroke, Xina. You get a neurological problem called 'sensory deficit' or 'sensory inattention' (these aren't exactly the same thing but they seem pretty much intertwined as far as I can tell). It's to do with the way the brain processes input from the eyes via the optic nerve - I am very much at the limit of my understanding, here - and very roughly all of the data that was previously being handled by the part of her brain that has been damaged and/or cut off by the stroke is not getting through. So whole fields of vision are just absent, and the person isn't aware that they're absent. She's not seeing a blank, or any distortions, it's just not there at all.

She can see things on the right, so she moves the paper over to that side. But actually that isn't going to make any difference to what her brain sees, it just feels as though it ought to - like when you're looking at a screen, and you feel as though if you could stick your head inside it you'd be able to see round the corner, even though you know of course you couldn't because the image isn't there.

Try this experiment with a good, clear analogue clock face. Put it where she can see the whole clock and ask her to tell you the time. If both hands are on the right she shouldn't struggle, but if it's - say - a quarter to three or a quarter past nine you might get all kinds of variations on the theme as her brain tries to work out where both hands are. I found that if I put my finger on the visible clock hand, and then asked mother to track my finger over to the other clock hand, she would sometimes then be able to see it and she'd give the correct time promptly. Very weird! Also not really important enough to her dwindling quality of life to make it worth the effort for her, so I didn't pursue it.

If your mother continues to make progress you might find her vision improves, too. I wouldn't discuss this too precisely with her, though, because it might not; and thinking she's going partially blind is not going to cheer her up!

Xina, have to agree with CM that the stroke has effected "something " about her vision that may be affecting her reading ability. Her vision, grossly may be fine, but other aspects such as tracking are interfering.

I had a friend whose stepfather finally realized that his post stroke reading prob7was being able to know where the end of the line of text was. We were able to figure out that a postit at the edge of the page was all the signal his brain needed.

Xina, if your mother wants to read, the fact that one arm isn't working won't stop her for long. There may be other issues at play right now...attention, tracking, comprehension. Follow her lead wi this. Maybe borrow a tablet and see if she's interested.