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My 84 year old mother is in a rapid decline in health. She is stage 5 kidney failure, and has uncontrolled diabetes. She's already been told by the Dr that she can't drive and she shouldn't be home alone. My sister and I found a very nice assisted living facility but she refused to move. This was about 6 months ago. My niece has been staying with her during the day, driving her where she needs to go, feeding her, taking care of her. My mother is a very difficult woman, to put it mildly. My sister and niece get the brunt of her very bad attitude. My niece has had enough and refuses to be verbally abused any longer. I can't blame her. Mom has said she can take care of herself, which we know she can't. But she also is refusing help now. Neither my sister nor I can stay with her and if she refuses to let my niece continue caregiving any alternative is unacceptable to my mother. Please help us with ideas of what to do.

Thank you all, for your very helpful thoughts. Just a few things, I should have been clear about my niece. Neither my sister or I are guilting her or making her feel she has no choice. She does this out of the goodness of her heart, but as she's not being appreciated by mom, it gets frustrating for her. We've already told her she needs to cut back and not be there as often as she has.

Sister has been in continuous contact with her doctors, and has an appointment later in the week. It's been discussed that she may be diagnosed with dementia at this point. Mom has stressed she doesn't want dialysis, and she wants no treatment if (the next time) she has a diabetic episode, and if she has a stroke or something similar, she wants treatment withheld. We have both told her we respect those wishes.

For those who asked why she can't be alone, she has the diabetic episodes where she is unresponsive. 911 comes out every time and eventually she comes around. My niece has also come to the house and found her like that and has brought her around, It's been terrifying for her but she doesn't want her Grandma to die (understandably). She also loses track of her meds, and she has taken several falls, but mostly it's the diabetes.

It really does sound like we need to leave her to her own devices for now. I will take your thoughts into serious consideration and share with my sister. She's Mom's PoA and has been overseeing her care for years now.

Thank you so much for this. It's very helpful to hear these things from people that have gone through this.
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Reply to lynnmarie62
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AMZebbC Dec 31, 2024
Thank you for replying. Wishing you the best. It is a difficult process to navigate.

Has your mother updated her MOLST (medical directive)? This is essential if you or your sister are not present in a medical crisis.
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Please let your niece quit, for her sake and your mother's. Don't guilt-trip or make her feel obligated. Her care has been generous but it is enabling your mother to continue thinking she can live independently.
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Reply to MG8522
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Allow your niece to resign from her caregiving duties. Tell her her mental wellbeing is far more important than giving her grandmother non appreciated care. Thank her for all that she has done and that her main objective should be to focus on herself and succeeding in a full life.

There are not many ideas to ponder when you are dealing with an ill elderly person that is obstinate and abusive. You and your sister will need to sit with your mother and directly tell her she needs to either hire help or go into an assisted living or nursing home. You will need to treat her like a two year old child if she has a tantrum.

Good luck with this challenging endeavor.
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lynnmarie62 Dec 31, 2024
Thanks for your reply above. Yes, her medical directive is updated to reflect her wishes. Good question, there's so many things to think about.
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My mother refused to move to AL, she was 93 living in the mountains of NC, one had to be a billy goat to get in and out of her home. Plus she was still driving, and refused to stop, her last debacle was checking her mail at the end of her driveway. She forgot to put the car in park and it shot across 2 lanes of traffic on a busy hilly road, it ended up in the neighbors gully, taking out their mailbox as well.

We had tried to convince her to move nearer to us and eventually be placed into AL, this went on for 10 years. We sat and waited, finally she had a slight stroke and was afraid to be alone at night, we scooped her up, moved her into AL, a facility near us.

Well, she is now 99 and has been in AL since she was 93, here is the kicker, she loves it, lots of things to do, made new friends and she doesn't have to lift a finger.

Go figure huh!

Don't know who has your mother's DPOA, however whoever it might be needs to step in, it is no longer about what your mother wants it is about what she needs to be safe and cared for 24/7.

Step back let the chips fall where they may, because you are her daughter doesn't mean that you have to sit in the front row and cater to her needs, she is not independent, be patient something will happen.

I would begin planning now, explore your options be ready when the "Event" happens...it will.

Sending support your way.
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Reply to MeDolly
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Was in a similar situation with an aunt. Very uncooperative. Refused help. Sat around in loaded depends and threw a fit when you wanted to change her. When she threw fits, there was no calming her down. She would literally go on for hours screaming about how she lived on her own for years and what has changed now?
It was too much. Your niece should not be doing this and I hope you're not asking her to.
My family felt this should all be on me. I knew I was in way over my head after a week and a few days. She even argued at me about having someone come in yo help her.
I, too, agree with others to step back. Even if your mom wasn't verbally abusive, it's more than anyone can handle.
Leave her to her own devices. Aunt got rid of the help I got for her because she thought I would be around propping her up. Once I stopped coming around, my nearby cousins got aunt home care that she balked at when I was coming around frequently. Step back and let your niece have her life back.
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Reply to Tiredniece23
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Step way back . You all need to stop , including your niece. Your niece needs to be able to live her own life .

“ Stop doing for Mom , let her fail “.
These were the words I was told from a wise social worker from the County Area Agency of Aging . Let her fail at living alone so the authorities can remove her from her home . Have a facility picked out ahead of time for them to take her to .

Call your Mom’s local Agency of Aging , or try APS .

If Mom ends up in the hospital , do not take her home . Tell them no one can care for her , again have a couple of facilities picked out so they can send her to one that has an open bed.
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Reply to waytomisery
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What you describe is that your Mom is 84, has a number of medical issues, and refuses to leave home. You did not mention mental capacity or dementia, whether or not that is present.
Regardless though...... people are allowed to refuse medical treatment, and from what I have read the courts support the "least restrictive" living environment if possible, so if someone really really wants to stay at home and not be in a facility that would be considered " least restrictive".....
But if she cannot manage on her own at home - thats an issue. One thing she cannot force is adult children and nieces to do things. Because she insists to stay home does not mean you are mandated to do all this stuff for her. You cannot be forced against your will. As others have said, you can step back from propping up. Then as to what your Mom does/gets for help can fit into a variety of scenarios: getting professional in home care, going on palliative care/ hospice (some in home stuff can be covered on insurance then) , or she may give in, when given the alternatives and decide to move to a facility, if things change.
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Reply to strugglinson
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I agree with others who say you and everyone should back away 100% from propping her up in her home.

When she has a medical incident, which seems inevitable, then you call 911 and meet her at the ER. There you bring your PoA paperwork and make sure they know she is an "unsafe discharge" and fights all other help and assistance. Make sure no one is contacted to take her back home. Then ask to talk to a social worker to arrange for her to go straight to a LTC that you have picked out in advance.

Even with PoA authority it is almost impossible to force an uncooperative person to do something against their will. Do not feel guilty over how she gets into a facility -- whatever it takes is acceptable and moral.
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Reply to Geaton777
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Why did her dr say “she can't drive and she shouldn't be home alone”? If she has been diagnosed with dementia, and you or your sister or someone has durable power of attorney, you can get a letter from the Dr saying in his medical opinion she is not capable of caring for herself or making decisions on her own behalf and use that to activate the DPOA and step in against her will. This would entail taking over her bank accounts, likely selling her house to pay for assisted living or memory care, etc. The idea here is if she has dementia, she could set the house on fire, cause a flood, leave the doors wide open around the clock, give away all her money to scammers, might live in filthy, dangerous conditions, forget to eat, can’t call 911, etc. She isn’t even capable of understanding what is wrong with her, that she needs diabetes meds, etc.

If she does NOT have dementia, and is capable of making decisions on her own behalf, there isn’t much you can do. I know it feels so frustrating, like why won’t she just take her meds and do what seems reasonable (to you and your sister). But if this is the case (no dementia) my advice is to step WAY back and concentrate on your own sanity and mental health. If she has rejected 999 suggestions and offers from you, you can bet she’s not going to accept #1,000 either. I woke up to this during the past year in my own situation. I agree with others who say you can check on her as your time allows and monitor for increased issues. But don’t beg her or nag her to act like you wish she would. Don’t come up with a hundred new suggestions for her to reject. Don’t run yourself ragged or sacrifice anything about your own life satisfaction.

You can’t cure dementia and you can’t make a legally competent adult do anything they don’t want. I know sometimes it seems like there is a gray area where they are not diagnosed with dementia but are just so contrary and aren’t acting in what to you seems like their own best interest. It’s really frustrating. But legally, it’s black or white. She’s competent to make her own decisions — or she isn’t.
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Reply to Suzy23
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None of you need to accept “the brunt of her very bad attitude” Leave her alone, a doctor telling her she cannot live alone is not a mandate for any of you to step in and take verbal abuse. Mom will need to be left on her own, minus being propped up by family, for it to ever be proven she cannot manage on her own. Do nothing, leave mom to it
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Reply to Daughterof1930
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Why do you feel she cannot care for herself?
I am 82 and partner is 84 and we both are capable of taking care of ourselves quite nicely.
Don't tell me "the doctor said" because I am not interested in what some 10" a year visit person has to say. I am interested in what YOU see and think about her ability to care for herself?

If your mother doesn't wish to go into care, and is competent, then leave it alone.
We all die.
Should she fall at home it is as good as anyplace to fall to be honest.
Get one of those nice alarms, consider a camera system and stop enabling this in any way with shopping for, cooking and cleaning for her. Allow her to hire in her help as she wishes.
Discourage your Neice from enabling bad decisions on your mother's part.

As I have aged I have come to think there is far too much of this putting someone in care who doesn't wish to go. As I said, we all hope to exit our homes feet first. Most of us won't be safe to stay home and at some point will have to enter care. That often enough happens AFTER the call.

So, do daily checks. Divide them up among the family. Ask if you can install cameras and if she says no, then don't. You may get the call. From EMS or Hospital or Coroner. You will deal with whichever one is on the phone as I did when Desert Regional Hospital called me about my brother.

Best out to you. Be sure you understand advance directive. Be certain NOT to encourage dialysis if she doesn't wish it, and assist her instead into Palliative care of Hospice.
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Reply to AlvaDeer
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Let your poor niece leave and get away from this very unhealthy situation, and then you call APS and report a vulnerable adult living by themselves who is a danger to herself and let them come out and do an assessment.
And then you let the state take over your mom and her care.
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Reply to funkygrandma59
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When we were kids, our parents didn’t let us do whatever we wanted. They made decisions based on what was good/bad for us. Well, that is how I choose to approach these types of things with my mom: She isn’t capable of making the best decisions for herself, she can’t have whatever she wants, and that’s a harsh reality for us humans. This is how it’s going to roll, it doesn’t mean we don’t care or that we’re intentionally trying to “ruin your life.”. The reality is that it is-what-it-is. We’re taking care of you as best we can and at this point in time, that means we’re setting you up with good care in a facility that is there for that very reason.
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