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I have two older sisters. The middle one is closest to my mother (85, but with it), and has been helping her through hip surgery, PT, and recovery. My mother is and has always been hyper-independent, and is not taking kindly to medical advice. She's barely doing her PT and has been threatened with winding back up in the hospital, but that doesn't sink in. She's also talking about having the other hip done, which just about sent my sister through the roof to hear.


We need our mom to move closer to that sister, who has given every single night of the last two weeks to staying with our mom who gets up in the middle of the night and needs help. She's exhausted with that and the 45 minute drive.


Our approach needs coaching, and I have no idea where to turn. All advice is very welcome!

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In all honesty, by traveling this distance, your sister is enabling your mother to make the decisions she is making.

You cannot change people. You can only manage YOUR OWN responses.
If sister doesn't wish to do this "Rehab work", or feels she cannot continue to do it, then she must speak to your mother about it, and about why she will not continue it, nor do it again. That is up to her to tell your mother. And your mother will respond however she responds. As long as mother has no dementia, her decisions are her own. As yours's and sister's are your own.

Without Sister mom will be down to hired help or to temporary in-facility rehab.
Ball will be in mom's court once sister tells her she will not play the game.
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This is something that oldest sister and I encourage middle sister to do. Don't enable her, recognize that her choices are hers and she has to deal with the consequences. I can see middle sister's point that mom's consequences are also her own because she has to be the one to handle them, but we've also encouraged her to look into elder care so she doesn't have to do it all. It doesn't help that both of them are very anxious in general.
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Castle Feb 4, 2025
Hold on, I hear your basic point, and there are parallel ideas in society. But holding those ideas rigidly is pretty cold in a family. Some states mandate that children will take care of their parents, and cultures that believe in doing the care themselves, that it's an honor. I offered to "try to help" my youngest brother, born disabled, having seizures and belligerence at home - my mother agreed and I started helping - then saw that he could not accurately advocate for himself as all expected, nervous breakdown, damaged 2 shoulders for life. I put him in a rural area, more friendly and helped for many years. Elder Decisions is a company that facilitates family conversation around this - they start by interviewing each child separately to hear views, life preferences and options, then all together. That kind of a meeting is needed, for otherwise, family conversations can follow old paths, sometimes sexist. AND you or your sister could take on other roles besides caregiving, or provide money, or help to the caregiving sister, not just the mother, though planned visits matter. Someone else could look at nursing homes, and let anxious sis define the best options - the bureaucracy parts of the job are huge. This challenge can help adult sibs come together, not just leave it all to one - when involved, seeing pain and fear and finding ways to help those, it's not so simple to also look into bureaucracy and stand back. If she does the care herself for 5 years or so, she should get a bigger piece of the inheritance = I asked my family for the first slice just for me, when I was solo caregiver for my disabled brother. Still being worked out, but my long and loyal work saved the others a bundle, which they got at the end. I wish you luck and hope you talk with elder care organizers to find ways to help each other - there's more value involved in family, than avoiding "enabling" an anxious sister. Not enable unmanageable conversations, but find ways to plan repeated conversations together, in a restaurant, or have each one write a list of goals and share before any conversation begins. And if upsets, say we can't talk more now, lets plan to do it next week. Not just avoid enabling and leave them alone,
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Your Mom is "85, but with it", yet makes illogical choices and is hyper stubborn. I would have her memory and cognition tested (like a MoCA test which assesses judgment/executive functioning). YOU may be very surprised how she's not "with it". Not doing PT for her recent surgery yet talking about doing the other hip is fantastical thinking. For now Mom should pay for overnight aids so that your sister doesn't become exhausted. None of you is obligated to be passengers on a bus driven by a possibly cognitively impaired elder. I'd question *your* sanity if you continue riding it. FYI your Mom not drinking water may mean she's dehydrated, and dehydration symptoms in elders can look like confusion and cognitive impairment. Eventually it will impact her kidney function and her hip surgeries will be all for naught. Are any of you sisters her PoA? If not -- and she doesn't have one at all -- then this is a looming disaster for her. Even with a legal and active PoA it is extremely difficult to get an uncooperative, resistant adult to do things in their own best interests -- like transition into a facility or accept in-home private aids. Please let us know if she at least has a PoA. If so, this is now the person who steps forward and gets her in for a cognitive/memory test in order to activate the authority. A declining elder without a PoA is on a track for a court-assigned 3rd party legal guardian. None of you will be able to access or manage her finances or her medical care. She must have a legally assigned representative. Hoping it's one of you sisters.
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I was an in-home caregiver for 25 years to more stubborn elders than I can even remember. Tell your mother what I've told so many of them and their families.

Nothing gets a senior a one-way ticket to a nursing home faster than being stubborn.

This should get your mother on board with moving and accepting help. She can either accept help and maintain some level of independence, or she can continue in the asinine stubbornness and end up in a nursing home where she will have no independence. Her choice.
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Sister doesn’t “have to” do any of this, just like mom doesn’t have to cooperate with what is likely in her best interests. Don’t be so sure mom is “with it” when she’s making illogical, unreasonable choices. That’s not simply stubbornness. In your position you can’t make mom or sister change any of their dynamic, seems they might like it. I have a lot of family members who insist on doing it all and then griping of how exhausting it all is, they don’t get a pat on the back from me. I think they need to change the martyr mentality, but that’s me. In your position I’d leave mom on her own to prove she cannot handle her false independence like she’s currently convinced she can, sounds harsh, but it might be the only way
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Over-entitled elder brat. Enabling sister. Mother who isn't "with it" but you and sisters go along with that delusion. What could possibly go wrong?

Well, everything, if you wait long enough. My cousin, who was 85 at the time, had various joint surgeries. She faithfully did all her PT despite the pain. Her doctor told her that most patients her age do not, and that's why most did not fully recover as cousin did.

No point in telling your mom this. She doesn't get it. She never will. So you let the chips fall where they may, and that's that. I'm sorry.
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JooFroo Feb 5, 2025
Well, it’s not necessarily someone willingly enabling them…. Wi
th my mother in law, she kept getting declared “competent” and because of that, she was legally allowed to refuse help, refuse meds, fall 6 times in 12 hours and be allowed to refuse and kick out emt’s that were called to her house for assistance. She was also in the process of electing to have SPINAL surgery at 77 years old with a diagnosis of WORSENING MS. She was mean, and flat out rude. But because she could pass the MMSE, we had NO choice but to “allow” her to act this way. Stepping out and leaving her to her own devices was NOT an option- if she were to hurt herself, die, neglect herself and we just “stopped enabling” there was a very real chance of legal percussions against us in the form of neglect. You cannot just simply “ignore” them knowing they need help- it’s flat out neglect. Which is hard to even do when you’re a caring person anyway. So sometimes people get backed into a corner with no better option. Not all people that are stuck in the insanity of enabling are sick people too. Sometimes there is no alternative until you can find one. Which if you’ve never been through this before, you have NO idea where to turn. Thank GOD we were able to hire an elder law attorney that helped us file for emergency guardianship. It is through that process my mother in law was court evaluated and declared incapacitated and guardianship was awarded to us. It was only then when we could stop “enabling”
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Oh boy !! I’ve been in your sister’s shoes , but with my Mom it was recovery from a stroke .

Caregiving has to be on the caregivers terms . Your sister should only do as much as she wants to do until she is not able to or no longer wants to .

Hired help for overnights should be implemented or Mom goes to rehab . If Mom refuses either , then Mom stays alone until she gives in .

Mom can not force your sister to keep doing this.
If Mom is that unreasonable , she may have dementia .
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Hello, sending you best wishes to get lots of rest yourselves as you work through these times. Children over-estimate how much talk their parents can do - I worked in eldercare - and there are ways to talk with them, namely agree with what they say, then just add your own point, even if it's the opposite. Don't take it seriously. I'd recommend you or find someone to look around at nursing homes or assisted livings near that sister - find a place that looks great enough and is near enough for her to visit (I assume from your post that she would want to keep visiting her mom). Talk with the social workers, and they can guide you through the process. I find it best to not tell the elders in advance - all of their arguments are just fear of change. Either say this HAS to be done, and you will take her just to have a look - and drive by, go in for a tour. No pressure, but important to look. I used to bribe my disabled brother, that he should stay for a month, and if at that time, he wanted to leave, I'd back him up. After a month, he never wanted to leave. It's just a process, and talking is a minimal part - otherwise act as if you're following her wishes, end talks with a smile. An elder does usually understand if their child says I'm exhausted, cant continue. you need to live where you get help. And if she refuses, wait a few weeks, next time she calls for help or suffers, say, we really need to go look at that place. it may take a few months, but once she is moved, then support that fitting in, often it's a comfort for them to have folk around to talk with!
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Am I understanding correctly that your mother had elective hip surgery--NOT a broken hip? If so, what was she told would be the probable outcome (with PT)? If it was expected that she would be able to live independently again, then I agree that she is being enabled. If your mother does her PT, perhaps she won't need to move in the near future, at least. Your sister should set a limit on how much longer she will stay with your mother at night; after that, your mother is on her own with hired assistance if needed. If that doesn't work out, then that's the time at which your mother needs to move.
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☆Here's what I've learned..as bad as it feels & you feel you know what needs to be done & what helps, you can't live someone's life for them & you can't tell people what to do. So, it'll have to be what it's going to be until she has absolutely no more Say.. THEN, you can step in & handle things because before then, will only stress you, cause you illness & could damage your home life & relationship with a partner.
I tried & tried & some things were OK but for the most part my 80 year old mom fought everything, we had high strung arguments, she's combative negative & argumentative & she has said, old people want to be able to still make their own decisions even if they're spinning in a circle.
So, I handle for her what I can, but when she starts the arguing, I'm out.

Trying to help her in every way put me on pills & into therapy. I only went once & I can't take the pills as they make me groggy but, I learned to let it go & let her do it however & go on about my business & THAT is the only thing that works for me!
And when she goes into full dementia or whatever happens where she's not able to do things anymore THEN, I'll take over! But, until then, I try to decrease my stress level!
I wish you well!*
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FixItPhyl Feb 5, 2025
So, so true!! Been there, done that, and had to learn the hard way. Thankfully I got it (just what you explained) before getting on any meds to cope. I hope that readers of your answer take this to heart, before they end up sick to death.
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Perhaps your mom is doing everything she can think of to get what she wants which is staying in her own home and having your sister wait on her hand and foot there. Her refusal not to do her rehab in her mind might keep her immobile longer, tying your sister to her. When that seems like it's becoming an overused plan, then she shifts to mentioning a 2nd hip replacement, requiring even more family assistance in her home. Of course, I'm just guessing, but for sure I know how some family members definitely are "with it" enough to manipulate others. I like the long-term caregiver's suggestion of "you all" telling your mom "Nothing gets a senior a one-way ticket to a nursing home faster than being stubborn".
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I suggest starting with a POA, and moving towards Conservator/Guardian. Your sister should get a caregiver to replace some of her visits. It is a tough road ahead, but I wish you the best.
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Unfortunately, your experience and your sister’s is all too common. There are parents who believe they should remain in complete control of every detail of their lives even though they have unrealistic expectations for the care givers upon whom they are totally dependent. My sibling and I have dedicated
3.5 YEARS of our lives to taking care of our disabled, stroke impaired parents in their home. It has been incredibly disrupting to our personal lives, exhausting, and difficult. I have been in counseling for the last four months and have learned that I do have a choice in the situation. I could walk away and so could my sibling, leaving two completely helpless people to figure out what to do next. We have chosen to continue on with it to the end.
*Our choice is not right for everyone.*
You and your sister are in the very beginning stage of your mom’s situation and you are already miserable. Don’t expect your mom to change, as she will not, and there is no way you can make her change or bring her to a point of reason. She will continue to put herself and her preferences before yours. I’ve learned through counseling I cannot change my mom’s demands, poor decisions, or her selfish/narcissistic attitude. Since I have chosen to see this situation through, I must separate myself from her power to upset me. I work hard to take nothing personal and to keep my own identity. This is difficult. It does help if you and your sister can maintain a united front in dealing with mom. When the two of you are not in solidarity, your
mom will pick up on that in an instant and use it to her advantage to manipulate her wishes. No clear answers friend. I wish there were. I can tell you this experience has placed my husband and I in decision making mode for our future. At 70 years of age, we know we are not that far away from age related problems of our own. Therefore, we have planned and prepared now to prevent us from placing our own child in this type of situation as we age. Good luck and best wishes to you and your sister on this journey.
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Bulldog54321 Feb 4, 2025
Some of the posters here have had parents in ill health live to 106 years. You have only been doing it for 3.5 years. Please listen to your therapist and start gathering info to keep in the background for when you all have your nervous breakdowns and can’t do it anymore.
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pspan520: Unfortunately your sister must cease enabling your mother.
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If your mother needs help in the night, then she is not as "hyper independent" as she deudes herself to be. It sounds more like she is "hyper stubborn" and unwilling to admit she needs help.

Your mother should pay for this help if she is able to; if not, the three of you sisters need to chip in for whatever in-home care your mother needs; one sister should not have to be on call.

If your mother is resistant enough to having hired help, maybe she will be more motivated to do the PT necessary to stay independent.
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BurntCaregiver Feb 4, 2025
Why should any of them 'chip in' to pay for her care? If she can't pay for her own homecare, put her in a care facility. They'll take her income and Medicaid will pay the rest.
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so what you are saying is that your 85 year old mother is not fact “with it”

It sounds like all of you need to turn off fantasy land and deal with reality.
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JooFroo Feb 5, 2025
You can say what you mean, mean what you say, but you don’t have to say it mean. Maybe you could explain a little more so that along with your offense comment, you could provide a partially helpful answer
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This is a sticky situation. My sister in law, father in law my husband and myself went through this with my mother in law. We went through many episodes of over exhausting ourselves to keep my mother in law safe, keeping my father in law safe as he is not capable of caring for her. The biggest problem was, she was still declared as “competent” and if she refused, we had NO choice but to allow whatever to happen. We all got sick with stress, and we kept telling VITAS (very limited in home care through hospice- ONCE a week for an HOUR) and they kept giving competency exams and passing them. Although my mother in law was smart enough to pass the competency exams, she completely lacked the mental capacity to make reasonable decisions. Passed the 4th competency exam one day, then the next we had to call the police because she locked herself in her room with MANY firearms (some she had hidden from us) and threatened to shoot anyone who came through her door- all because she was refusing help and was stuck in a hallucination and delusion. She got baker acted by police and that started a long drawn out process of multiple baker acts and ending with my sister in law being granted full guardianship and a diagnosis of dementia and declared mentally incapacitated. We were able to find a beautiful place for her to reside- an assisted living with a locked memory care unit. She still fights us to this day- she hates it there and refuses her meds almost every single day with maybe the exception of 1 day a week taking her meds. She is not any better, but we are. We had no idea how bad it really was until we placed her and my father in law started gaining weight back as the stress was lifted off of us all. It’s still exhausting and mentally taxing though- sick family members have a way with us….. but she’s safe, fed, and very well liked where she is. At least one of us visits daily- so we see how great this facility is with her- God bless them because they can do what a lot of us family just cannot.

if I were you I’d talk to an elder law attorney- they can guide you through the process of POA or guardianship- they will know how to help you. At this point, you’re like we were- you need some outside help from someone that is highly qualified. Your sister nor any of you need to go through this. It’s hard! And I know how helpless it feels! Get some help for you ladies, please! I wish you the best of luck and I pray for strength, stability and patience for you all!!!
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Igloocar Feb 5, 2025
You and some others have stated that something needs to be done about the mother's POA. The ONLY way to get a POA is to have it assigned to you by the person for whom you will have POA. Suppose the mother has already assigned a POA. In that case, if it's a contingent POA, it will need to be activated, usually by a physician's statement that the mother is no longer competent to make her own decisions. If it's an immediate POA, it's already active, which is how we all do it in my family,

If there is no POA in place, if she were willing, the mother might be able to assign it now, but if there is an attorney involved who questions her competence to assign a POA, she probably won't be able to do it. If she has already been declared incompetent, she probably can no longer assign a POA, although occasionally an attorney will deem someone with dementia to be competent to assign a POA. However, the bigger problem in this situation is that if there is no POA in place, the mother may not be willing to assign one!

To be in charge of the mother's actions, it may be necessary to get guardianship, which is often a long and expensive process. If the mother has not been declared incompetent, then it might be very difficult to become her guardian. It's also more responsibility than many people want to have. In that case, the state in which she lives could become the guardian, which would remove all decision-making capability from her children. That may be what some children want, or it may be exactly what they don't want!
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Let mom get the other hip done - and go to rehab!

She needs the "push" that everybody in rehab offers to get moving, to get strong, to get back to her usual life. Let them threaten her with skilled nursing facility if she doesn't progress.

Please try this and get the monkey off of your backs.
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Igloocar Feb 5, 2025
No surgeon is going to replace the other hip in a non-emergency situation if her mother is not doing her PT and is not showing improvement after her original hip replacement!
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You guys need to evaluate what legal options you have in place and start making a plan. Someone needs POA. She needs a neurological appointment to evaluate her executive decision making ability. Assuming she is evaluated as not capable of making important decisions, getting a second, confirming opinion is even better, and will help the POA exercise their power. My Dad was found to appear on the surface to be “normal” but further conversation and testing by the neurologist revealed what we already knew. He has underlying dementia and a total lack of insight into his ability to live alone. His refusal to accept that he can’t drive landed him in AL for now. You simply can’t let a stubborn elder drag you down. I understand not abandoning them - that is not my choice either - but I have come to the decision that I do what I can - not what I can’t- and will value my life as much as theirs. Be an advocate - not a martyr.
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Parents often resist suggestions from their children. While I don't know why this is, I have seen it happen over and over while I was working in Geriatric Research. I have also experienced this with my own geriatric father.

Pushing them to do anything is difficult and getting them to leave their home is nearly impossible (understandable to some degree actually).

Things like telling them they are going to end up back in the hospital would seem to be motivational but in my experience, from family, its not well received. In the research I worked on, we had to convince very frail elderly people to exercise and go to the bathroom. Some were very motivated and some were not. We had to learn how to motivate these non motivated research patients and I learned not to ask questions or to push them in any way. There was one thing that seemed to work nicely which was using "Its time to ....." Quite often, they would comply without too much pushback. We would help them walk to the toilet and use the bathroom every two hours. The walk was up to 10 minutes and we did other exercises as well such as sits to stands and used elastic bands for "strength training". This helps to keep their remaining muscle mass and to help them to be continent.

Maybe this will help you and your siblings to work with your mom. Unfortunately, I don't have any way to help you get your mom to move. This may not be something that can be done unless she can be convinced that its going to be better than what she has currently.
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