My 93-year-old mom has been independent all her life but over the past 18 months has become increasingly frail and debilitated. She has congestive heart failure and has fallen multiple times and broken various bones. My brother and I, who do not live near her, have done all we can to honor her wish to stay with partial home health services – the most she would accept, and as unreasonable as we thought it was. I have been to visit her many times to help with her care. But it has all become increasingly unsustainable and we receive multiple calls throughout the day and night where she lets us know how sick she is, even as she refuses additional services. Until today she has not wanted to go to the hospital, but increasing shortness of breath and rapid heart rate changed her mind. She is now at the hospital and we are waiting to hear what the plan of care will be. I don’t expect that the hospital will support her being discharged home, and for the first time, I won’t take on the responsibility of bringing her to her home and setting her up. She is very strong willed and focused only on herself and what she wants, but it’s not safe and I’m not comfortable with it. When I was in to see her a couple of weeks ago, she told me she would disown me if I put her in assisted living. I’m okay with that. But I wonder if there are ways that I can speak to her with kindness and compassion about living options other than her home. And if she’s deemed competent to make her own bad decisions – which she cannot carry out without our help – how do I pull back and still try to be a caring daughter?
The hospital will want to have you meet with a discharge planner u less your Mom tells them not to speak to you. Ask to see the social worker. Make sure they understand about the issues with broken bones and falls. Have your Mom also assessed for mobility by discharge nurse.
Falls and injuries do not admit someone to care. And the hospital can only make recommendations if your Mom has capacity. You need to meet with your mom and the social worker. Tell your mother you are her daughter but that you are not her caregiver. You do not have the energy to manage two households at your age. You love her but if she wants to be at home with her increased needs she will need to wear a lifeline at all times. And she will need a home care helper in the day and for her needs such as meals. Hospital should make arrangements with a pharmacy to have meds delivered. She will need to pay for that. Reassure her that she is important. That you would really appreciate her in a safer environment so you can spend quality time. Do not go there to do errands or housework. Order her groceries online. Deliver them. Get her a housekeeper. Explain things to support her in her wishes. I have had to do all the above. I wanted to be involved but the accusations were too much and embarrassing. It gets easier. They will never understand. Decide what you want to do and make arrangements for the rest. Do not rescue. Social work will help you. This is very common. Very.
She must have forgot or not realized, this hospital can arrange rides for discharged patients, which they did on this case
Al means your own apartment, no more cooking, cleaning and laundry. That the modern AL is not some horrible asylum and she still keeps her own space. Yet if she needs help, she rings a bell. She can go to meals, or fix herself snacks in her room.
Tell her you aren't setting her up anymore. Her care needs are not sustainable anymore. Tell her feel free to disown you all she wants. That's not a real threat anyway.
While you are this ill, you must consult the doctor in charge of your care.
We can ask him tomorrow.
If she says she doesn’t care, you can say “the doctor is in charge of this decision now.”
If she says she will disown you, you can say “I’m sorry this makes you so angry. I am now 70 (or whatever) and I can’t provide the care you need. I love you and I will still call/visit you.”
I know how hard it is. Wishing you peace.
Also agree that leaning on the "the doctors say". Throw them under the bus, shamelessly - it's not YOUR fault she can't get what she wants, it's her health + the doctor's orders. (And it's not your fault. It's not.) You can still be kind, you can still be caring...but that doesn't mean you need to give her what she wants, and it doesn't necessarily mean she'll be ok with the changes. She likely won't. But you will still have been as kind as you can be, and that will help YOU even if it doesn't help her in any way she can recognize.
You already know what you need to do. Talk with her doctor and have the doctor order her transition to assisted living, or skilled nursing facility.
If she is allowed to make her own bad decisions, you don't help to facilitate. You are still a caring daughter. The fact that you are discussing this and carefully considering your next step show how much you care. But, you can not reason with a stubborn elder. Let her know that you do not support her decision to try and live independently in her own home. Whatever help she needs, you will not be providing. When she calls to complain of how sick she is, keep the conversation brief. Tell her, "I'm sorry your feeling that way, Mom." Don't offer a solution, you don't have to fix it for her. She stubbornly thinks she can manage this. Let her. I'm sorry, it feels counterintuitive, but this is the only way she will see that she does indeed need more assistance, and that you and brother are not able to provide it. She may stubbornly refuse until the day she dies. Alone, in her home. You cannot prevent this no matter how much you care.
Instead, you can commiserate with her (because this is a very sad milestone in someone's life) and say things like "I wish you could be home too" and "You can go home when the doctor says it's ok", etc. Then change the subject to something more pleasant. Looking at old family pictures always makes my mom happy.
If she continues to harp on why she can't be at home, or other such complaining, don't reward bad behavior by letting her go on and on about it. Cut the visit short and say something like "It sounds like you're not up for a visit today, I'll come back another time when you're feeling better" and then leave.
You can do the same thing if it's a phone call. Also, as long as she is under some type of supervision, you don't need to answer every single time she calls.
It might be worth asking her doctor if a mild antidepressant would help her. A low dose of Lexapro did wonders for my mom.
Then you can just use the excuse that she can't go back home until the doctors say she can, and of course they never will tell her that, but that way the blame is on the doctors and not you.