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Mom has not been diagnosed with Alzheimer's. She has a variety of illnesses/conditions: Diabetes, High Blood Pressure, heart disease, kidney issues, and recently diagnosed with Cirrhosis of the Liver. Her primary care doctor says she does not have Alzheimer's, but last year, he did tell my sister that Mom has Microvascular Brain Disease.

A little over two years ago, she had a heart attack, which required a triple bypass surgery. I moved her in with me after she was released from the hospital because I was scared she'd fall down her stairs and didn't feel that she'd be safe in her home alone.

Her memory and cognitive skills have declined a lot over the past couple of years. She rarely knows what day of the week it is. She does not take care of herself, won't bathe unless I ask her to, etc. She forgets to feed the cats or take her medicines. When I discover this and point it out, her answer is always "Oh, I thought I did."

She had a staggering 20 lbs of fluid removed from her abdomen in September due to her Cirrhosis. And that was only a portion of the extra fluid she was carrying. She spent most of September and October either in the hospital or in a rehab facility. Through the fluid draining and other treatments, she dropped about 90 pounds in two months. She's still being treated to keep her ammonia levels under control.

The only things she wants to do is to either sleep or play games on her computer. She shows very little interest in anything else, even the cats she used to love. If they try to come into her room, she yells at them to get out.

I have no other means of financial support, so I cannot quit my job (which I'll be laid off from at the end of March) to care for her full time. I have an Intermittent Leave of Absence in place so that I won't get fired for the time I miss having to take Mom to her various doctor appointments (primary care, GI, Nephrologist, cardiologist, and vascular doctors, etc.), but that time off is unpaid.

She shows no concerns for me or anyone else. Just about the only emotion she ever shows is getting upset when I mention that she needs to go to assisted living.

Shortly after she was released from the rehab facility she was given a nurse who comes by once a week to check her vitals and measure to see if the fluid from her liver comes back. She also has a physical therapist who comes by once a week. Nearly every week or two, one or both of them call me because she doesn't come to the door or answer their phone calls. (I have a landline and she has her own cell phone.)

I've had to leave work twice because she wouldn't answer my calls either. I've provided a cordless phone in her bedroom and one in the living room so that she'd have one nearby. She keeps losing the one in her bedroom. (I spent three hours cleaning and straightening her room...she's a "Messy Marvin" and keeps messing it up, clothes and food strewn all over the room.)

I'm at my wit's end. My health is suffering due to the stress of not being able to get her to do what she needs to do: take her medicine, be available for phone calls and home visits, etc. I feel guilty that I'm not able to help her. I feel like I'm failing her.

I've lost my cool with her on more than one occasion lately because of her lying to me about taking her medicine (I've caught her in multiple lies about it). I've set up alarms on her phone to remind her to take her insulin and other meds. She turns off the alarm and goes right back to playing her computer games without doing what she was supposed to be doing. Each time, she insists that she'll do better, but she seems incapable of fulfilling that promise. I tried allowing her to prove that she can do it on her own, but she can't. I tried to go a whole day without saying anything and seeing if she would take her medicine as she should. She didn't. What happens if I keep saying nothing and let her skip doses? I don't want to know because my conscience won't allow that. It would border on abuse in my mind. She needs help.

How can I get her to understand and accept that she needs help that I am unable to provide? She insists she can take care of herself, but time and time again it's proven that she cannot. How do I handle this?

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Thank you all for your help so far. There's definitely a learning curve to all of this. I have looked into the cost of Assisted Living facilities around here and the costs are truly shocking! They've all been way above her means, like about twice what she gets from SS and her pension.

I don't intend on remaining unemployed. I was laid off in 2008 and it took me six months of active looking before I found my current job. I have been looking, but it's scary how little is out there and what the jobs I am finding are paying. Ouch, major paycuts! I will have a 3.5 month severance, so I will have that to fall back on, but I hope I'll be able to find a job before that and unemployment runs out.

I also hope to have Mom with some sort of higher level of care by then.

I truly appreciate all of the information and advice and hope to learn more in the near future. Thanks everyone!
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I second what Rainmom says. In addition, I've NEVER had any problem with getting the social workers/discharge planners at Mom's hospitals to see that mom needed to be in a facility. No one EVER suggested to us that family should care for her. Maybe we all look VERY employed or something, but we were upfront about mom's finances and these folks were VERY helpful in steering us in the right direction. This may be entirely luck, but I've never had anyone suggest that I should provide hands on care for my mom, at my home or in hers.
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In re-reading my comments I see I neglected to answer your question! Sorry. I'm in agreement with the other posts that say there is no point in trying to get your mother to see reason. Even though I know better I still catch myself expecting my mother to be reasonable. I mean, something can be so obvious, so basic, so simple - how could anyone not see it, right? Nope! As Babalou said, it may have to come down to the next health crisis before anything can be done. Then you just have to stand your ground against your mother and probably some type of hospital/rehab social worker - you firmly state you can not take care of your mother. They will work with you to find a skilled nursing facility.
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I second GardenArtists advice regarding your employment! You can find it here on this site - dozens and dozens of well meaning individuals finding themselves unemployed, unemployable, broke and often homeless after having cared for a loved one full time. I hesitated to use the words "full time" as that is a massive understatement. I also agree with GardenArtist that it sounds like your mother needs a higher level of care. Since you say you are new to this all - I may be the first to tell you that "Assisted Living" is really not all that assisted! For most places that fall under that heading - it usually means someone can pretty much get along on their own but may need their medication managed for them, need someone else to do their laundry, can't or shouldn't be cooking (usually there is a dining room on site), needs help showering and maybe some assist with dressing/undressing. The tennent needs to be able to be left alone but someone will poke their head in the door on a frequent basis to check on the person. Mind you, all these "assists" come at a price. Usually the room is a flat rate and then the assists are selected off of a type of alacarte menu - each having a price. And don't think you can eek by on selecting a minimal amount of "assists" as most places will do an accessment and then tell you what they think is needed to have your loved one live there. I have found that most AL will be flexible the first month - maybe dropping a service and/or adding one. But the kicker, for those on a budget is that medicad does not pay for Assisted Living. This may be a mute point however because it does sound like your mother has significant medical issues that would not allow for your mother to remain in AL for long, if at all. What I would worry about in your situation is that you will take care of your mom at home full time and not work outside the home. After a while you will become less and less "marketable" - less able to find employment. Your mother will need to be moved to a skilled nursing facility due to her considerable health issues and deminishing mental capacity. While I have absolutely no way of knowing this beyond what you've described - it does not seem realistic to think you could care for her at home, on your own for very long. So there you'd be - with no way to support yourself, not to mention the physical and emotional toll caring for your mother would take. This has nothing to do with whether your a good daughter or not or how much you love your mother - it has to do with taking care of the life you will be left to live AFTER your mother needs more care than you can provide and/or passes on.
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Adult Protective Services. There's also your local Area Agency on Aging, they might be of help in that know about local services such as Wheels on Wheels and Adult Day care. But APS is the agency that will come to investigate if a neighbor calls the local authorities to say that your mom is not being cared for. If your mom is being difficult and not allowing care, it's MUCH better if you call them first and tell them this. They may have some suggestions how to proceed.
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Thank you, everyone. I'm still very new to this, so forgive my ignorance, but what is APS?
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Both Babalou and Yogagirl are right; this is a situation that defies reasoning. In addition, I think she's allowed herself to become addicted to computer games as an alternative to facing reality.

I doubt if you could ever convince her to move to AL, although I'm also wondering if she might need a higher level of care than that. If you have HIPAA authorization for her, can you discuss the issue with one of her doctors, perhaps her PCP, or even her nephrologist as it sounds as if the liver problems might be the most serious (hard to tell without knowing the extent of the other issues).

You should definitely not quit work, and should also begin looking for another job before you're laid off in March. Staying home and caring for her might be disastrous for you; given her level of self neglect, you would feel obligated to care for her and she would exploit it.

You might also contact the county APS and ask for their advice. They might have to intervene to ensure that she is in fact taken care of, one way or another.
I don't want to scare you, but you also want to make sure that you're not being held responsible for her lack of self care.

I don't think more home care would help, given her approach to her condition, which seems to range between neglect and denial. So please don't blame yourself; you can identify the situation and work toward solutions, but you can't implement the solution entirely by yourself.
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Babalou is right, you can't explain or reason with her. I tell my parents that it's Doctors orders or medicare wants it this way. It is very frustrating because any disaster that occurs becomes our problem to fix.
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You can't explain it to her. She can't reason any longer.
1. Apply for medicaid for her
2. If she doesn't answer the door, call 911
3. Next time she is admitted to hospital and rehab, don't take her home.
4. You might seek guardianship. This can be expensive.
5. There is an article about getting one's parent to agree to assisted living in this board.

I know how frustrating this is. But YOU have tr practise aelf preservation. Have you spoken to APS? Her doctor ? about getting her onto a higher level of care.?
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