How do I get my mom to change her clothes and clean up her apartment?

Yikes! Well, that sounds like the state was a bit heavy-handed! My mom's in my house - in her own apartment - and I'm going to take off the chain on her back door so she can't ever lock us out (which she's threatened to do whenever I talk about coming down to help her with things she's not doing on her own anymore). We have an appointment with a local organization that specializes in keeping people at home, providing nursing home services at home. They also provide day care at their location so caregivers who work can get some relief and know their parent isn't home alone. All of this is going to be awful at first, because she REFUSES to allow anyone in to help, even me. If i do a dish, scoop her litter box, straighten up anything, she's angry and snarling. I just came back from the grocery store with stuff for her, and instead of saying Thank You, she said, "Do I ever get to have my own life?" in a very accusatory way. I got her all the things she normally buys for herself, but I saved myself 3 hours in the grocery store and endless arguments ("Mom, you already got peanut butter. See? It's there in the cart." "Oh. Well, I guess I'm just a stupid old woman!" and a lot of attitude and snarling. )

She is going to resist and be a total horror next week when we take her over to the place that provides these services. I knew it would be even worse if they came to her apartment (or to my part of the house) because she'd feel "invaded" - but she will pitch a serious fit when we take her there to meet their staff next week.

I just need to steel myself for her response and tough it out. It's the only solution to her wearing the same clothes 24 hours a day (she doesn't even put on pajamas anymore) and not bathing or cleaning anything. She was about to drink coffee out of a mug that had god-knows-what floating in it last night, and got really mad when I made her give it to me and I poured it out and washed it. What am I supposed to do? Let her get sick? She weighs nothing, so a good bout of food poisoning could kill her.

I'm at the end of my rope, my patience, and my desire to coddle her feelings. Her health and overall well-being have to take precedence over her desire to deny she has any deficits from Alzheimer's.

My mother-in-law, who had Alzheimer's lived one house away from us. She didn't wander, but she forget to do her laundry and pick-up. She dressed herself in unappropriate clothes for the different seasons. We brought in a visiting nurse after MIL took a spill on a branch in her front yard. The nurse then arranged for a home health aide to help out with bathes and light house keeping, for a few hours a day. That worked well for a while, until the home health aide thought MIL needed more help then that. She contacted the visiting nurses who contacted a State agency, who deemed her unable to be alone at all. I was going up in the morning to make sure she was dressed properly and fed, then I would call during the day on my work breaks and lunch to check up on her, then spend time with her at night, getting her meal and getting her tucked into bed. Once the State became involved, it was deemed the house would be sold and she was to be placed in a nursing home. And that's what was done. It's a shame her other children didn't want to get involved with her care.

True. I have to get over worrying about the fallout, because yes, it is usually short-lived. We had a huge fight about the condition of her apartment last week, and the next day she acted like nothing had happened. And she's a CHAMPION at grudge-holding, and "I'm not speaking to you" nonsense. She even did that to me as a small child. Ah, memories...

I realize her messiness isn't a choice now - I was just making an observation that things that send me into a worried tizzy are things that are "normal" for people who choose (or don't know any better) to be sloppy and not clean up. She knows how to dress, because if it's an "occasion", she does put on a different (although not recently-washed) outfit. And she does her makeup (well, oddly enough) when we go to the store, and combs her hair, etc... Like so many other dementia-based deficits, they're all over the place and she remains "good at" some things.

The problem with dementia though is that, unlike the sloppy single guy who chooses to have a messy house, many people with dementia forget to clean or forget how to keep things clean. Even changing their clothes becomes a chore if they can't figure out the right clothes to put on! Your mom may also have some depression which can cause similar symptoms. As far as you lying to your mom goes, your mom probably will get mad at you when she realizes where you are. My dad gets mad when I take him to day care and lie about where we are going, but if I didn't lie, I would never get him there. I hate doing it but I do what I need to do. Their memory span is so short that they will have forgotten about you lying by the next day! You have to think of it like you are doing it for their own good.

Thanks... It's funny the stuff she can still do on her own, and that nobody would blink an eye over if someone younger did it. How many messy people who don't have dementia are out there? Lots of single men, for example, don't bathe every day and their apartments are a mess. Of course, she used to be much tidier, although in retrospect, she wasn't the most scrupulous housekeeper even when I was a kid. My dad's very retentive about cleaning and they used to fight about it all the time (they divorced 20+ years ago). Anyway, she's OK in her own apartment downstairs for now, as she doesn't cook or iron, and I can keep up with the cleaning (and hope to get some help from the organization/s I've called). She makes frozen dinners and sandwiches for herself, makes coffee, feeds her cats and keeps their litterbox clean on her own.

A new doctor will be a big help, although if I lied and said we were going to the store or something and then turned up at a doctor's she'd pitch a fit about me lying. She has no memory for anything short-term (where we're going, what's happening today, what she did yesterday, conversation details, etc... but she's not easily fooled and she notices facial expressions, fake smiles, sounding "too chirpy" (when I force a happy voice to avoid sounding annoyed, etc...). The one place I called about in-home help does bring in a Dept of Aging person to assess the person, so that'll be a big help (though she'll be a complete b*tch about it the day of) in terms of figuring out exactly what her status is, what services she needs, etc... without my either being in denial about or being too critical of her abilities.

You may have to just use some "therapeutic fibs" to get her to agree to going to the doctor's or wherever she needs to go. Tell her that you want to go for a ride or ask her to help you get something. I often have to do this with my dad. He no longer insists that he's fine like he used to, but he does not enjoy going out. That phase she is in can be a hard one to deal with. Switching docs is a good idea, if her's is clueless. Maybe start looking into a care home that will accept medicaid if she will not allow you to help her. Get on a waiting list for services by calling your local Area on Aging. I would also look into getting POA over her finances if possible. It sounds like she is no longer able to live on her own and care for herself. She is going to be angry, but if she gets very agitated then that is where a doctor experienced in Alzheimer's may be able to help. It can be a trying time, been there done that!

Hi... and thanks for the feedback! She was diagnosed in February of 2009, and she was just forgetful ("Where are we going?" 5 times on the way to the store, forgetting how to get home so I had to take her keys, paying her phone bill 3 times in one month so I took over paying her bills) and she stayed at about that level until this past spring/summer. Then she started getting more forgetful and losing things (home from the store 5 minutes and would lose whatever she bought SOMEWHERE in her 1-bedroom apartment), etc... In the last 3 months or so her memory has gotten worse, and she's gotten messy in her personal habits and housekeeping. Prior to that, other than being someone who didn't mind some clutter around, her house was clean.

Ever since her diagnosis, she's been on Aricept 23 MG, and Namenda 10 MG, and I also have her on a supplement she was in a trial for right after her diagnosis (uridine), and it helps (I saw a real dip in her abilities when she was without it for a week once, due to a delivery snafu). I will look into finding her a geriatric specialist - that's a good idea. You nearly have to forcibly stuff her in the car to go to the doctor's, so that'll be another fun event. She's SO belligerent that nothing is wrong with her, everything is fine and we're just treating her like she's stupid. And we're not. I run out of patience and I'm sure my voice loses its sing-song "That's OK!" quality after several hours with her, but I answer questions 10 times in a row without flinching, I listen to repeated and made-up-stuff-filled stories over and over, I take her to the store 2 or 3 times a week, we take her out to lunch every week, and in the summers, she goes to baseball games and spends all day in "her" garden (she's decided our yard is hers) ;-D The most frustrating part is not being able to take over things that she needs help with because she pitches such an ugly fit. If she'd be cooperative, I could spend an hour a day tidying up in her house, doing a little wash for her, helping her pick out something clean to wear, and she could take a shower (at my nudging) when I was in her place visiting/cleaning. But she WILL NOT allow any help - it's going to take a 3rd party coming in and saying it's needed and that it's going to happen - because she won't think they're just being mean, which is what she says I'm doing.

AAAAAGH!!!!!!!!!!!!!! Thanks for listening.

I agree with NancyH. Change doctors. See a geriatric psychiatrist or a behavioral neurologist. If they don't specialize in dementia it is very common for doctors to throw up their hands and think nothing can be done. Not true.

laurie, have you ever asked her why she goes out with stained clothes or doesn't do the things she used to do? Sounds like the BEGINNING of dementia to me. Need to get her on Aricept or Namenda or whatever to hold it off as long as possible. Change doctors.

The problem is her doctor is clueless. He prescribed the meds she's on, but that's as far as he goes. He did convince her to take an antidepressant, at my request, but that's all he's going to do for her other than sign that she has Alzheimer's for any organization that wants a doctor's note that she has in fact been diagnosed with it. I know she can't stay alone indefinitely - and she's not "alone" in that she's just down the stairs and I see her several times a day and can hear her moving around, opening closets, walking around her apartment. She does chores around the yard (she insists on doing them), so she keeps somewhat busy, and her back porch and our back garden are pristine - she just doesn't clean INSIDE the house anymore. Weird. She makes food for herself, she takes care of her cats, she brings in the newspaper and brings up the mail every day, she has her routines. She doesn't wander, and other than repeating herself a lot in conversations (and making up things to fill in gaps when she can't remember things), she's not babbling or anything. She remembers who everyone is and hasn't shown any problems with speech or coordination or anything beyond just having no short-term memory. I know it will get worse.

The not washing/changing/cleaning is new - like in the last couple of months - and prior to that, she'd been on a several-year plateau in terms of getting any worse in her dementia. We had quite a long run - almost 3 years - where she was no worse than when she was first diagnosed. I have a call in to a local organization that helps keep people at home and helps with chores, personal care, etc... and I hope to talk to them after the holiday. She's VERY resistant to any help and will NOT allow anyone in to her apartment to "treat her like a stupid old woman" (her favorite way to describe how "everyone treats her".

She has no money, and I don't have any to give her, so her going to live anywhere else is not happening. I keep her place from being anything worse that just cluttered, but it's a huge fight every time. She doesn't like other old people, so any of the places where she could go and hang out with other people during the day are a no-go. I've tried.

I'll report back after the "keep people at home" organization calls me back on Monday. I hope they have answers. I see from their website they accept medicare/medicaid as payment for their services, and I know they bring in someone from the Dept of Aging to assess (THAT'LL be a fun visit), so hopefully they can provide some of the help she needs that I can't provide.

Thanks...

I see on your profile that your mother has dementia. The sad truth is that persons with dementia cannot live alone, certainly not beyond the very mild earliest stage. It appears that your mother is now at the point where she needs supervision and help. Perhaps you could extend the time she can live in her own apartment if you can get her to allow help in (and the Elderly Waiver program of Medicaid will cover in-home help). If not, I don't see any alternative to moving her to a clean, pleasant, safe place where there will be some supervision. This might be the memory care unit of an ALF. Possibly a foster care group home would be suitable.

Discuss her current status with her doctor. You cannot provide the services that Mother needs. That is perfectly understandable. But someone needs to provide supervision, cleaning, and grooming help. Do what you have to do to arrange that.

Is this a personality change or has she always been like this? It sounds like this is something new. If so it may be good to get her into her doctor or for you to discuss it with the doctor. Is she depressed. or are there other cognitive changes going on? This is a tough One but I think I would get her into her position to be evaluated for depression, psychiatric or cognitive changes.