My husband's grandmother is uncooperative with transfers and therapy. Any advice?

Good job Serenity. You have all done your best to give his grandmother what she wanted. She just isn't strong enough. Hopefully the therapy and a little more time will help you make the best decision for all of you. Thanks for the update.

You also need to get a full cognitive workup, either while in rehab or before. As someone mentioned, dementia often follows a stroke; her understanding of instructions and consequences may be damaged. Good luck!

Look: Rehab is the best place to start. To learn from P.T AND O.T.
By law, here in CA, they have to be eligible and participate three hours per day. They can't refuse to go to the gym and do transfers, pivot, chair to bed, chair to shower bench, and they even have training in the kitchen. You and husband can and will be able to get the best help there. Nutrition, diet, videos on several topic applicable to her. Evaluation on speech and cognitive competence. The works. Your M.D. needs to make a referral. You and hubby need HELP!, immediately. The personnel at the rehab will give you an honest appraisal of grand ma's long term care, short immediate assistance and long haul predictions. They're the professionals, and usually patients behave their best there. If grandma is able to be selective and is turning the act on and off......................and you 2 with injured backs...................take some lessons on PT AND OT. observe the sessions. It will be a lifesaver.

Just an update. We had another incident in the barhroom where she didnt want to do a full transfer and barely got to the chair. I panicked, tried to get her up better, and pulled a muscle in my abdomen. I asked her to help and she yelled no, so i told her i was going to call the ambulance because i hurt myself and cant lift her. When i went to get the phone she pushed herself back into her chair.

After that incident my husband and his family all agreed shes going back into the nursing home for more therapy. They told her she gets one more chance to come back home after this stint, and if she refuses to help shes going to another facility permanently.

Im worried its still not getting through to her. Even after the lecture and me telling her the doctor told me not to lift her anymore she threw a few tempet tantrums about me not taking her to her chair and giving her dinner in bed (after her grandsons put her in bed.)


I hate to throw in the towel. But either a)she is capable and refuses to help, or b) she is not capable. Both paths lead to her, me, or both getting hurt and its not responsible.

I'm concerned more for your spirit, your health and your back than for grandma.

I learned the hard way that you can't lift and carry around a fully-grown adult person for very long. I also learned to never assume that an elderly person is "jaking it" aka deliberately not cooperating. In my mother's case, it was being assumed that she "wasn't trying" because she wasn't complaining about pain or anything, but as it turned out she had a fractured spine.

I would be concerned that much of your grandmother's behavior is due to brain damage with her strokes. Maybe her brain tells her body to move a certain way, but it doesn't always cooperate. I'd hesitate to assign her behavior as intentional under the circumstances. I would consult with a neurologist to investigate further. I would be hesitate to label her until I knew more. However, regardless of the cause, it's not likely you will convince her to change. She needs constant care. I'd explore what outside resources that may be available and locate suitable placement. There are good places. Many underestimate the amount of care for a person who has limited mobility and is double incontinent.

Serenity, if her attitude is that folks "dump" old people in facilities, you need to announce to yourself and to her that that is not what nh care is about. It's about professional caregiving. It's caring, but it is informed by the elder's needs, not how much they can guilt a family member into doing. I think that it's a shift in everyone's attitude that is worth working on.

Many years ago, my grandma broke her hip. She had surgery and announced to all and sundry "I'm an invalid, "my daughter will take care of me". My mom "the daughter" had three kids, including a 2 year old. She told my gm in no uncertain terms that she was going to rehab ( a new concept...this was 1966, a year after Medicare started) to learn to walk again, that she couldn't possibly care for her if she was bedridden.

My grandmother was furious and never really forgave my mom. She'd cry everytime mom would visit in rehab and say "i can't believe you would do this to me". But she walked again, and was able to return to living on her own again for another few years...one can respect one's elders and still get what's best for them. It doesn't have to be mean or insulting. Just calm and authoratative.

Thank you everyone for your answers. Reading them has helped so much. I have been feeling really down on myself and guilty for feeling like this is such a burden and having a bad attitude about it. A lot of people around me (family and therapists) keep telling me I need to be harder/stricter with her, but that is a very difficult thing for me to enact. I have been lately, and feeling terribly guilty for it. Hearing it from you guys gives me comfort that I am on the correct path.

Firstly, I must apologize for the 'dumping in a home' comment. It was insensitive, and I don't think ill of people who put their loved ones in homes. I was typing from her point of view, and I should have been more careful about how I brought it up.

Just a few facts to clarify and give a clearer picture:

-She is my grandmother-in-law. It might not mean much to some, but the dynamics do feel very awkward for me when it comes to being strict with her. Whether its temperament or upbringing, I feel a greater need to act respectfully at all times with her, even if she is being witchy to me. (Which is my failing completely.) My husband is even harder on her than I am.

-When I say I fear I won't be able to know if she is really having a hard time, I mean future-wise. I know that, eventually, she will regress and things will become harder. She has a lot of health problems (diabetes, chronic heart failure, stroke, high blood pressure, A-fib.) I fear in the future she may genuinely may not be able to stand (heaven forbid it be from something like another stroke) and I will get stuck on thinking she is being stubborn and miss something. This is the only thing giving me pause to just mentally strong-arming her into doing the work she needs to do.

-She is actually on anti-depressants now.


I am completely well aware I am being manipulated, and I feel like that is a lot of where the resentment is coming from. If she genuinely weren't able to help me and I was still hurting, that would feel better to me. I choose to put my body through the punishment to help her. But instead she is being selfish and possibly putting my husband and I though harm for her comfort. I'm just trying to find the line between being a bitch and tough love.


The cooking comment (from 97yroldmom) is really spot on and touches a sore spot. Her diet was garbage before she "came to me" for care. All carbs all the time, and she is very picky. I have succeeded in introducing her to a few dishes, but otherwise she is very hard to please when it comes to food. If its green, she won't eat it, lol. I am scared of being too strict with her because I have to give insulin, and I don't want to give it if she doesn't eat. Maybe I need to grow a pair and make her eat healthy meals. And if she doesn't eat it, oh well, you aren't getting frozen waffles for dinner anyway. As sad as it sounds, I just got over her expectation that I will eat the garbage she eats because 'every needs to eat the same thing at dinner.' Once I gained 5 lbs I said 'enough is enough' and I eat what is healthy while Husband and her eat whatever else they want (Mac N' Cheese, Frozen Waffles, etc.)


Overall, it sounds like I just need to grow a pair, which I accept. Tonight was a particularly bad night with her getting changed for bed (refusing to help, dead weighting, not wanting to stand.) She was in the bathroom for half an hour because she refused to stand up to get her butt wiped clean. I told my husband refusing to let her just lean on me the entire time was hard, because I try to be as efficient as possible and its hard not to just get it done as fast as I can (hold her up while wiping and dressing) and get her into bed so I can do laundry and dishes. I feel like if I was capable of being difficult and belligerent with my elders I wouldn't have taken up this 'career.' However, I feel like the fault really is with me and I need to stop enabling the destructive behavior if I expect my situation to improve.


Again, thank you for all the input.

Your intentions were awesome. And you really thought you could keep Granny in her home as she wants. Good for you!

But the stroke changed her, changed her needs, and impacted her personality. Stroke often is accompanied by changes in the brain. Many people who have a stroke are eventually diagnosed with dementia, but even without that diagnosis they may very well have damage in their brain.

So your question about whether she truly can't do something or is being manipulative is a valid one. If we could be certain that there is no brain damage then it sounds like manipulation, doesn't it? Then the "tough love" approach can produce some good results. It might be worth trying.

But we really can't be certain that there is no brain damage, can we? If she acts helpless at some point it may that her damaged brain is giving her signals that she is helpless. And this can fluctuate throughout the day.

I'd say that through no fault of your own, you've gotten in over your heads. There is no shame in backing out, or in bringing in additional help. You made a decision in good faith, and now that you see the reality you can (and should) make a different decision.

You quit your job. Are you being paid for caregiving? Is it set up as a legitimate job, with tax withholding or quarterly filing? If you are out of the job market for 10 or 20 years, and you are not establishing your own SS account, how do you expect to support yourself in your old age?

If all of your energies and your husband's energies are focused on a cranky old lady, how do you expect to maintain your marriage relationship? That takes some focus too, you know!

You diddn't really know what you were getting in to. And you know what? Granny probably didn't know, either. She was not trying to trick you into sacrificing your youth. She sincerely thought this could work out. All three of you were wrong.

Sorry.

These are just random thoughts but why not assume she truly can't do the exercises and get better. Perhaps you should tell her that she is going to have to go into a rehab until she gets on her feet. Tell her even though you and husband really thought you could help, you were wrong. That you underestimated the work and overestimated your ability to handle her care. Put your head in your hands and express your sincere regret that you misjudged the situation to such a degree. In her presence start looking for a job. Start trying to find care takers. And stop cooking high carb ( if you are). Apologize for not cooking what she needs to eat. Explain that you will have to learn to cook for nutritional value. That your cooking is causing her to gain weight and preventing her from being able to manage her weight on her own. That you will have to work on portion control. Go to a chiropractor and get adjustments. Perhaps one of those support belts. Or look into a hoist. Make phone calls in her hearing about how those devices work. If she is playing games give her something to think about and if she is not then you might need to explore these options for real. As much as I like in home therapy there are some doctors who prefer rehabs because they think the patient gets better sooner in a rehab. For all three of you, I hope you can get the therapy going. While she may have been independent before the stroke she probably wasn't that active and therapy is hard work.
Nobody really likes it but it works. It's extremely important that you get her plugged back in. Maybe an antidepressant is needed. Call her doctor. Don't give up. You have to shift the dynamics. The goal is for all three of you to thrive. You've got to manage her care not succumb to it.
Well I just read where the last poster had similar thoughts as mine but I think they are worth repeating so I'll go ahead and post my answer.

I know you love her , but you are being manipulated! You have observed her standing straight up and under her own power when she Really wanted something, and wasn't willing to wait for your husband! When you really injure your back and can no longer do these maneuvers for her, who is going to care for her? You need a tough love approach with Granny, or you will soon find your way to permanent back pain, that will haunt you the rest of your life. Unless she has dementia, and cannot retain information expressed to her, then you should be able to reason with her. Tell her flat out, that your back is really hurting from lifting her dead weight and that if she doesn't participate 100%, as PT has shown her to do, the you will have no choice but to put her in to a Nursing home, where they have 2 person transfer available for her 24/7. Another thought is the THREAT of hoyer lift though she probably doesn't qualify for one. Yes, they are big clunky, slow and time consuming, and nobody ever wants to use one, unless there is absolutely no other alternative, so that may a little fib you could tell her to get her to cooperate. Remember, everybody hears "be careful with your back" when they are in their 20's and 30's, but 30 years later, you'll know exactly why!

If grandma wants to stay at home then she's going to have to make some sacrifices just like you and your husband have made sacrifices. I think you should explain this to her.

While I was reading your post and before I even got to the point where you talked about your back problems I was thinking to myself as I was reading, "She's ruining her body." Your back may recover but not if you continually strain it. You're looking at back problems now for the rest of your life and you're only 29!

If you're transferring your grandma and she goes limp don't continue the transfer. Put her back where she was and tell her that until she can participate you aren't going to transfer her. Give her verbal cues each transfer, "Now scoot to the edge of the seat, push up from the arms of the chair, on the count of 3 we're going to go. 1....2....3....up you go." Etc. And while you're transferring her continue to encourage her to keep her back and legs straight.

You wrote that you weren't sure if she was being stubborn or if she actually isn't able to help in her transfers. Yet when she wanted to get into her chair, you wrote, and didn't want to wait till your husband got home she got into her chair just fine. That should tell you something.

You're not being a jerk and I think some tough love is needed. Hand her the hairbrush and let her brush her own hair. Set her up so she can brush her teeth herself.

I don't know how old grandma is but if your husband is only 30 she could be in her early 80's and this could go on for years. Stop carrying her around so she can participate in her own care.

You guys are 29 and 30 years old. Granny could live a long time. You quit a job, both your backs are injured. You have to make a choice. Are you willing to sacrifice you lives to be full time caregivers?

You guys and Granny will be much better off if she is placed in a good facility. Would you want your 30 year old grandchild to sacrifice their life to care for you? You guys need to give some serious thought to this. The only alternative is round the clock help in your home. Depending on funding this may not be realistic.

Why do people always say "dumped in a home"? My mom is in a well run nursing home because she needed more care than any of us would be able to give her in a private house. She has medical supervision, social stimulation and a well regulated diet. I don't see the downside.

You can lift her? Except you've injured your back. No. You CAN'T lift her.