Mom is 83 yr.'s old and is in rehab for a broken femur; this isn't her 1st fall and break. We want her in AL but is very strong-headed and refuses.

Sheri, You need to learn from M. “We can't force her to do anything”. And SHE can’t force YOU to do anything. Be very very upfront with your sister. You both need the same line. If you stand firm but sister crumples, you could easily get sucked in to help your SISTER. M and sister both need to know that you won’t be providing any in home care.

# femur can be a life changer.

A strong will can be a positive - can help Mom recover by being aimed at her recovery goals.

Right now she is all "I'm going HOME". Over some time, she may gain insight & acceptance about this fall & fracture. That her life has changed. How much remains to be seen.

Firstly, can Mom put weight on her leg yet? (The time will depend on plaster only or surgery for internal rods).

A 20yo could go home with crutches & hop about... but often respite care (AL or NH) is needed in this non-weight bear period for the elderly. This could even be as long as 6 weeks.

Then, transfer to rehab location for rehab to walk again. Maybe 1-2 weeks (often depends
on insurance & speed of recovery of course).

After nearly 2 months from home, then she gets to the choice NYDaughyerInLaw described:

"She has two options: she will be discharged home with home health services or she will be going to assisted living"

Patience Grasshoppers.

Get Mom evaluated while in Rehab for 24/7 care. If found she needs 24/7 care and no one will care for her, Rehab cannot release her because its considered an unsafe discharge. You make sure the SW is aware that you and sister cannot take care of her 24/7. You have told Mom for a while she needs AL. Maybe the SW can make her understand she will not be going home because no one can care for her there 24/7. Her choice is a NH or finding a nice AL.

Tell your mother together, you and your sister, that she cannot stay in her home alone now, and that you will not ENABLE her doing so by giving her any supportive care. Tell her that she is on her own if she returns home, and will be until she thrives on her own OR accepts that she requires in facility care now.

Tell her when she accepts knowing that she cannot do this alone, and that you are not going to be participate in her living in an unsafe manner, you will check in with her by phone and be certain she has emergency support numbers.

I would enlist a social worker at the facility to facilitate this honest and hard talk with your mother. This will let the social worker know her case needs help and care and will keep her/him in the loop.

Solid advice has been given to you.

I will add that "very strong-headed" is what the beginnings of dementia looks like. Dementia robs people of their logic and reasoning skills. They lose their ability to empathize with others' situations and problems. So, please move forward assuming she is not making sound decisions because she is now in cognitive decline. Don't argue the care issue with her - you won't be able to get her to comply through normal reasoning.

Whoever is her PoA should now read the document to see what triggers the authority. Usually it is 1 or 2 medical diagnosis of incapacity. This will be important in order to get her into a facility and keep her there. The "unsafe discharge" strategy would work here.

But if no one is her PoA, this is another story. Without someone advocating for her (legally) and no diagnosis of incapacity, she technically can check herself out and go home, as long as no one in her family goes to take here there. This will require a discussion with a social worker that the rehab can refer you to.

Make sure anyone who is a possible "accomplice" is told to NOT give her a ride home from the rehab.

She will be livid. She will take it out on you all. You don't have to respond to her irrational rantings or anger. Ignore it and change the topic for as many times as it takes for her to get the message.

Things will be bad for a while but then once she goes into a good facility things will improve in terms of the caregiving arrangement. If she doesn't do the PT, she most likely won't ever return to her prior mobility, and maybe AL is not the right level of care for her. This means she may qualify for LTC, which is covered by Medicaid.

You may also talk to her doctor about meds for her agitation and anxiety. This may help her adjust to any forthcoming changes. I wish you all the best as you move through this tough spot.

No one forces adults to do anything. Adults *choose* to do things including enabling family members. You *choose* to enable her "Sheri will do it" lifestyle. Stop.

Call her case manager and tell them that you and your sister will not be able to provide any in-home assistance to your mother. You and your sister must put on your big girl panties and show your mother a united front that the days of you both enabling her charade of independence are over. She has two options: she will be discharged home with home health services or she will be going to assisted living. You must tell her that she will not be coming to live with either of you.

She's a spoiled old woman and how you and your sister *choose* to move forward is very much within your control.

You and sister need to tell the discharge planner at the rehab facility that mom going home is an UNSAFE DISCHARGE and regardless of what she is telling them, you guys can not provide her care, period.

This will lay the decision on the facility and not you guys.

Just because your mom wants, doesn't mean she gets. You are grown women and no longer under her authority to dictate your actions. Tell her it's not gonna happen, no explanation needed. NO, it is a complete sentence.

DO.NOT.LET. HER. DRIVE.THIS. BUS.

9 months ago my MIL fell ( has had many falls) She went into a rehab for a few weeks then was determined to be imminently dying--so Hospice was set up.

At THAT TIME, my DH, who is POA, should have stepped up and told his 2 sibs that mom needed far more care than they could provide. (DH was still working FT and BIL's wife was beginning her own health challenges.)

SIL fought him on this and said "Mom wants to be home. I'll take care of her".

Bad, bad idea. Within a month, SIL is burnt to a crisp and MIL is becoming more and more 'out of it'.

DH was forced to retired before he was ready and forced into daily care for MIL b/c she will not allow anyone into her home. She fought on the Hospice nurses, but HAS to allow them in the house or she can't continue on Hospice.

It's been 9 months of hell, that's all I can say. MIL calls the shots as to who she wants on what days and what she wants them to do/not do. DH reports to me that she gets mad very easily and screams at him. Slapped him across the face one night b/c he wouldn't do some dumb thing.

She also is very strong willed, and so are all the kids. It's just an ugly situation with a person who only cares about herself. (This is not new. She's always been selfish and actually mean).

IF DH had been open and honest with MIL 9 months ago, she would be in the nicest and best ALF. As it is, she's lonely and bored and depressed--but she's in her own home. And 6 other people are miserable. There's no way they can move her, now, they're just waiting for the next 'fall' and then, maybe they'll have no other option than to place her.

It will be hard and she will be mad. But deafen your ears to her pleas and grow a spine. Placing your mom will allow everyone to have a better QOL and even mom will acclimate.

I'm furious at my MIL for how upset she keeps the family. No one person should have this control, at this level. Makes me insane. And I don't even see her!