My mom is going to get kicked out of assisted living. Then what?

I’ve not felt with dementia much except in mental hospitals as an RN Of 40 yrs, but there is still a person in there that still has feelings and knows they are slowly losing their life and now their freedom, and if it were you now wouldn’t you be angry? Would you just cower down and comply with all the rules? She didn’t ask for this disease. I know you’ve been through a lot but it really helps if you can walk in the older persons shoes. It helps you too if you understand where they are coming from. Sometimes behavior such as this can be caused by knowing life is ending and they are losing control of the least little things that made them a human being in their eyes. Perhaps this realization is lost in distraction then remembered and the upset starts again. What can you do to give back some perception of control? To her she might feel as if in prison and to a large degree she is and for doing nothing wrong. How does it feel to know you’ll never again go home to your own home? No one can truly know that until they have to face it themselves.
I told my mom to put my grandma in a nursing home when I was 20 and grandma had loss of bowel control due to meds but I didn’t understand about meds then that you just stop those and find others. She stopped talking, eating and breathing deeply and got pneumonia and died. Since I became an RN and realized this I have regretted it so badly I can hardly get over it. For almost 50 years now. Our parents and grandparents watched over us, found everything they could about how to help us, kept us alive and well as best they could and contributed to the community and world as well as us and we have to try to give back. I didn’t know to look meds up in 1969. But I should have found out. I should have thought-what is different? What could be the cause? This never happened before... but I didn’t put myself in her shoes and she died for it. I know it’s not the same situation but I don’t want anyone else to suffer as she did, we in effect threw her away, And I still suffer. I want everyone to remember their loved ones as they loved them best and know that they did the very best they could with love and understanding. No regret; only peace and love for you and for them.

Fluffy. Congratulations for getting out from under her manipulative power. I know she is your mother, but she would not be selling her manipulative behavior if no one was buying into it. I have been in a similar situation for a short and was lucky enough to figure it out early on. Who knows what happens next, but it won't be going on in my house.

I am so sorry for your situation. Personally I love science since they have discovered all kinds of mood altering meds. But so far nothing for dementia....
Anyways, does your unhappy mother perhaps have a lifetime of untreated depression? Has she been assessed? Is she anxious? In Pain? My MIL has depression, anxiety and pain which makes her a pain. The SSRI she takes has actually helped a lot, but more is needed. Maybe there is a way to make your mom feel better without turning her into a catatonic zombie. Are you sure you will feel ok longterm about walking away from this? She may want to smoke, but if she doesn't have the butts readily available she will have to depend on her caretakers to provide the time and place. This is not unreasonable. Remember you are dealing with a person with the emotional control of a 2 year old, probably temper tantrums and all. Like a 2 year old she is unable to set priorities or make good decisions. Don't let her griping get to you. Do what you have to do and feel good about it.

Fluffy...if "walking away" works...PLEASE let me know how you do it. As Mom's only relative, I have ALL the responsibility for everything. I am 53 years old and want to "run away from home."

Its very sad...I dont blame you..one can only take so much.
Sounds like its her way or no way. Your a wonderful daughter and she
is very lucky to have you. Take care of yourself.

I would make sure since you have been involved in moving her to assisted living facilities that you won't be responsible for moving her again if she gets kicked out. I had an uncle, who was in the ending stages of Lewy Body Dementia and was extremely difficult. He got kicked out of a couple places. Since I was his conservator it was my responsibility to remove him and find another facility. Who has been signing the contracts for your mother's assisted living? Do you have Power of Attorney or your mother's health directive? If so, I would speak to the attorney to see what legal responsibilities you have and how you can remove yourself from being liable for your mother's care especially since you have been so involved up to this point.
I am now going through it with my father. Through many tests doctors can get pretty close in determining which kind of dementia your mother has. Different medications work well for certain behavioral problems depending on which type of dementia the person is suffering from. My father was extremely difficult. Once they determined which type of dementia he had, looked at his behavioral problems they came up with a good medication regimen that works extremely well for him. One is a mood stablizer and the other is an anti depressant that has a sedative effect which is given at night.
Elderly with dementia is one of the most difficult things to deal with for caregivers. Many are like big rebellious toddlers. In fact, many probably have declined mentally to a toddler stage. It is so hard seeing a parent or loved one, ripping off those clothes in public, urinating in places they shouldn't, saying and being mean, spitting on sidewalks, picking their teeth with their finger nails at the dinner table, etc. They have lost all the manners and social graces they grew up with. They may only remember the family members from a time when they were young children. Their mentality and behavior is also like a young child or toddler. Understanding that may make it a bit easier, but it doesn't take away the feelings of wanting to turn around and run away. We are now the parents of our parents.

My Dad was thrown out ten years ago because of smoking. He moved in with me a non-smoking house. Six months later he was smoke free. We used smoke-away scented oil and tapes I played for him at night. It worked, I hope everything works out for you and Mom.

i like the stuffed cat idea. the kitty litter would stay fresh indefinately.
i think the AL should give your mother a smoke outdoors from time to time. i think they are money mills tho and would rather replace her with someone " easier " . of course they will always claim to have your mothers best interests in mind. bee - ess..

Completely understandable. Have a similar issue in my life with my Sis and 95 yr. old mother. Everything is "don't upset Mother"

I always thought that the worse thing that happened to my elderly aunt, was that she had to give up smoking. She had had a stroke. Smoking was about all she had, to make her happy. At my Mother's nursing home, the patients smoke outside, supervised.

My grandmother smoked ,but the nurses station had her cigarettes and gave her at a time and only in the common area. This was before all the rules about where and when people could smoke. She was in a nursing home for quite a long time and as far as I know she never quit, but it was up to the staff to give her her cigarettes.

Whatever you do don't take the cat away she needs him. On the other hand the smoking has to stop, she"ll burn the place down. How is she getting the cigarettes? If they are stopped she will need a replacement. She clearly needs some medication to modify her behaviour for her own safety and the safety of those arround her. I hate to say this but she may have to be tricked into taking it.
Will she take any kind of pills?.A dementia unit may have to be the final choice but right now she is too aware to agree and they probably would not allow the cat . It is very hard to "make" someone go somewhere there are laws against that. You can enroll the assistance of adult protective services, her Dr and possibly a psychiatrist to help you find the best alternative. Fluffy for your own mental health try to allow others to make the difficult decisions. I am afraid you will be dragged into the mix anyway if you are the only child so stand your ground and have back up with you like a husband or adult child some one tough you can trust to administer the tough love and ensure you don't get bullied. My heart goes out to you so blessings and good luck, let us know the out some. everyone here learns and contributes so much.

If she was a mentally challenged 13 year old, would you consider this decision differently? Making her happy, is a losing battle. Making her safe and secure is possible. If you talk to her doctor, he will prescribe something to help with the smoking. Before my dad died my mom was drinking about 1-2 bottles of wine a day. She wouldn't realize/remember what she had already had. She wasn't stumbling around either. She was extremely billigerent with my dad and us regarding her drinking. "We are not going to tell her what to do or control her life." When my dad died we were afraid to let her continue, so we filled her empties with non alcoholic. She found the empties and annonced to everyone that she had discovered this wonderful NA wine. She said she wished she had discovered it years earlier. She quit cold turkey. You would have thought that she would go through withdrawals, but not. Abilify helped dramatically with the billigerence. If they kick her out, you will have worse stress.

Save yourself Fluffy! I know it's painful but you and I both know that you are never going to solve her problems. Good for you: take care of yourself and get her needs met the best you can.... Best of luck to you!

Thanks for your comment and advice. I do plan to offer mom the help of a nicotine patch or gum. But I doubt she will take it. But I will offer!

fluffy, it sounds like you have hit your limit with your mom. I don't blame you for saying enough is enough. Your mom isn't going to have enough money to support all of her habits and nowhere is it written that you have to pay for them either.
If you don't mind my sharing...your mom is addicted to nicotine. I don't know how long she has smoked but giving up smoking is extremely difficult for some. I've been there. I was younger and relatively sane. Your mom is older and has dementia. What a combo! I'd be surprised if she could do it on her own at this point. Her cat and cigs are all she's interested in now. Please ask the doctor to help her. No, she should never have taken up smoking but she did, and now she will need help to kick the habit and addiction.
You are so correct. Some people are not happy, never have been, never will be. That was my mom but she didn't have dementia. My dad was always happy and when he got dementia he stayed docile and sweet. It's a cruel disease for them and for their families. You are seeing that firsthand with your mom being so difficult. My heart goes out to you.

I would not do so unless you tell her, that her behavior
will really put her over and you will not be able to save her.
Just because we may not want our Seniors in our home and I am not being judgemental, does not mean that they don't wish to be there or are afraid of where they are, but it might be more beneficial to get a doctor to help her to quit smoking.
Since she is in an ALFacility, and that is their rule
they must have some kind of service for this.

How unfair of AL facility to place you in this predicament, with no support, assistance or options. Shame on them, your mother cannot help herself.

After reviewing all the suggestions, this is what I've decided to do. I'm giving my mother the $64/month she is allowed after Medicaid, to support her sugar and pop addiction, all her smokes, and over the counter drugs, and a phone card. Then she can decide where her priorities are, and I'm walking away. I've spent so much money trying to make her happy, and she cannot be made happy. She has spent a lifetime of being unhappy. And I'm going to condone or contribute to something she should not be doing. Period. I'm done. Thank you all. I feel better but it was a painful decision to make. And it will not go over well!

I was going to suggest the e-cigarettes, too. They have to be filled and charged, though.

I know someone that bought their mom a stuffed cat and she never knew the difference. Good luck.

Fluffy, I wonder if a person who has dementia should be smoking at all. It is fire after all. Just take her smokes away from her and don't buy anymore. Then deal with the fallout. I know it would be difficult but must be done.

Can you get her one of the electronic cigarettes? Why do some people think they can do whatever they want with no regard for others? Does sound like dementia aggravated by a UTI.
Are you afraid of her? Why can't you get in her face and tell her she cannot behave like that and knock it off? She will be shocked and back off, but you can't feel sorry for her then. Manipulation!

Oh my. Was she like this at all before? Does she have any pain or any infection going on? Urinary tract infections are especialy notorious for aggravating behavior and cognitive problems. If there is no medical reason for the behavior, she probably will need to go to a specialized geropsych unit...at some point; as much as everyone would want to respect her choices and preferences, there are limits and she is most definitely incapacitated. She almost certainly does not have enough insight to realze that her behavior will eventually get her exactly what she does not want to happen, or someone would have set up a behavior plan/contract already. Does she ever say why she won't do anything?

Thank you all so much for your suggestions. I have looked at other assisted living situations when we first placed her, but she had to have her cat with her and smoke, and this is the only facility in town that allows that. I have to say they are just wonderful and have been so good to mom. It really doesn't matter what they ask her to do though, she doesn't want to bathe, take her breathing treatments, dress, come to meals, etc. She just is so angry she won't do anything. Yesterday I took her to the doctor for a physical and they asked her to put a gown on, and her reply "No, I won't do it." Just putting on a gown. Really mom?????

Fluffy~I assume you have DPOA since your mom has dementia??? If so, do not supply your mother with cigarettes and inform the staff to take your mother out for cigarette breaks. The AL my mother is in (she is mentally incapacitated due to Alzheimer's) will do this if my mother smoked. Mom is in memory care from 8:30-6 everyday and during that time, the aides come to her apartment every 2 hours to walk her dog. I realize that not al AL's are the same, but if this one is not willing to do this look for one that will. Even the SNH my father was in would take residents out for a smoking break twice a day. Good Luck to you!!

Well, a geropsychiatric admission might be next - be careful, there are good and bad ones out there. But maybe there would be a smaller board and care facility that would allow the smoking or be more personal about "the rules" you could try? Or a different assisted living? Start the search now, both online and by driving around both (found the best ones for my mom just driving around running errands and keepng my eyes open, believe it or not.)

Fluffy, So sorry about your flight. I, too, extend a warm cyberhug. I can only assume that she will have to go to a NH and then they will medicate her to the point that is not combative and argumentative. My heart goes out to you, b/c we are almost at that point. But don't be afraid of medicating her. It would probably help.

I don't have experience with this and I can't help you, but I want to extend a warm cyber hug. My heart goes out to you in this difficult situation.