We just went to visit her when she was transferred out of the hospital and put in a cab to go to a lovely rehab facility. She didn't want to go, only asking "Why?" Difficult to pick up what her mindset is here in this question, but she really has lost the will to live.
She's currently enroute to rehab, but I think we may get a phone call soon asking that we pick her up because '...there's nothing they can do' for her if she won't undergo rehab.
She's had a recent fall, broke her wrist, had surgery for it, had an out of control blood sugar issue and a UTI to boot. She's been through hell. She does live in AL close by.
We just don't know what to do at this point.
Find out if there is a geriatric psychiatrist who calls in at the rehab. Get mom evaluated for depression.
Is there a chaplain? My mom connected wonderfully with the chaplain and the nuns at her NH.
Ask if there is pet therapy, music therapy and other activities that mom can participate it.
Can you visit during therapy times to be her cheerleader?
"I am caring for my mother Carol, who is 83 years old, living in independent living with age-related decline, alzheimer's / dementia, anxiety, cancer, depression, diabetes, mobility problems, and urinary tract infection."
I see that she's actually living in AL vs. IL, so that's good. I would say if your mother has dementia, she may indeed not make any progress in rehab and therefore, may be released as result. If that's the case, and she goes back to AL and you see that she still has 'given up' the will to live, you may want to have a hospice evaluation for her. But she may just be reeling from her recent hospitalization and surgery, which is difficult for ANY elder to bounce back from. Give her time to get back into a routine in AL and see how she fares, that's my suggestion. Speak to her PCP to get their feedback as well. She may also be depressed, which was the case with my mother after she was hospitalized twice for ulcerative colitis & pulmonary emboli. Wellbutrin helped her ENORMOUSLY.
It's always taken my folks a couple of weeks to get their bearings after going thru a hospital stay and/or rehab afterwards, so give her time. She may turn around and show you she has spunk left in her yet!
Wishing you the best of luck.
Do know that the UTI is no time to assess Mom's current mentation. She is suffering an acute problem and quite commonly UTIs have a dreadful affect on ones mentation.
Do also know that Mom's not wishing to go on much longer is both NORMAL and APPROPRIATE. While some mild antidepressants may help her to get a second wind, the truth is that MOST elders, having to sustain loss upon loss upon loss upon loss in a time when they are very weak and feel of little use in this world, descend into an honest exhaustion with trying to maintain a good attitude to comfort their families. MANY of them wish to go on to their final rest, in all truth. They are tired. And there is no upside. Nothing good is coming. Only more loss.
As a nurse I listened to elders express all of this over and over again, and when I asked if they discussed it with their families it was very clear that most families negated everything they said, didn't listen to them and denied that what they were feeling was both real and appropriate to their current life. They didn't even get to say what they really felt about life. Their families didn't want to hear it. And they felt even more a burden by feeling it. The plastic smiles they tried to paste on to comfort their families was often so pathetic.
I tried often to draw family aside and tell them that while they were young it was difficult to believe, but we finally get tired; we finally get ready to long for our rest. I am so glad I was a nurse because when my own Dad expressed these feelings I was able to listen to him and comfort him, instead of denying all he felt.
Think about all this on the deepest level.
Tell your Mom you are so sorry. And that you understand that she is exhausted and often thinks it would be easier just to go to a final rest, but that we aren't in control of that, and so these are the options. That you understand how hard this is. That you want to listen to her, how she feels, what she thinks.
May be time to discuss palliative care, hospice, soon. At least it may be coming. I am so sorry. You are in a place of trying to avoid anticipatory grief, but the reality will keep coming at you. It may be easier to accept it, and let your Mom express what she must now feel.
With the dementia she may be better off in Memory Care rather than Assisted Living. That might be a good choice when she is done with rehab rather than bringing her back to her AL move her into MC, the move can be coordinated while she is in rehab so she does not settle into AL then have to move again.
You also mention that she has cancer. Depending on the cancer, the progression and prognosis it might be time to consider Hospice as an option.
While on Hospice she can not do rehab but if they do call you and tell you that there is nothing they can do it might be time to make that call.