My mother had three subsequent health issues right after we lost our dad; she fell and broke two ribs, then had a small intestine infection, then had pleural infusion. All these conditions have resolved months ago. She had home health aides helping her while she recovered. She has no health issues now and doesn't even take any meds. She's very healthy. She uses a walker but probably doesn't need one. She continues to have the home health aides 10 hours a day. This is very expensive as you can imagine! She refuses to work on being more independent. She lives in a senior apartment complex where there are activities, one meal provided in a dining room 5 days a week, etc. She refuses to do any of these things. She does have some friends in the building but doesn't have any desire to see them apparently. She wont even go down stairs and get her mail. She has these aides do everything for her that she could mostly do for herself. She does dress herself and go to the bathroom by herself. These aides are often are just sitting around with her! We were with her at Christmas time and took her out to dinner three times, church and to my brothers home near by (I pretty much didn't give her a choice and told her this is what we were doing and she was going).
She did just fine. She admitted she felt stronger and didn't even need to use her walker the entire time. I had been a geriatric social worker for 30 years. I know very well that the less she does the less she will be able to do, the more dependent she will be. I also know that her not getting out into the community and socializing with others is not good for her cognition. She does have some cognitive decline. My brother and sister-in-law, who live near by have asked her to attend church with them, etc. and she refuses. I feel that these aides are actually doing more harm, to some extent, then help.
I'm about ready to say to her that if she just wants to sit in her den (she has a very large apartment that she pays $3,000.00 a month for) and be waited on she might as well move to the assisted living care level where she would just have a small room and be waited on. At least in assisted living she would be pretty much forced to be around others her age and be exposed to activities etc.
I know I can't control her but the choices she is making are driving me crazy!
Thoughts?
I doubt you mean it to sound that way.
I realize you are simply trying to give us your version of "the truth".
But your mother is 88 years old.
Your mother has cared for, then lost her husband. Has endured illnesses and falls.
As a trained geriatric social worker I know your training gives you to understand that illnesses are common to the newly bereaved.
As to whether your mom was EVER outgoing socially, I cannot know. I myself am NOT, so I sympathize with her.
I do think you are right in one thing.
It is time for ALF for your mother.
This move may in fact be good for her, as she'll be with others for three meals, and--given that some ALFs (such as my brother's) are sort of cottages, with about 14 residents around a dining hall and a common room for socialization, more socialization occurs just naturally.
I would speak with your Mom about this possible move for her own safety and well being.
I know that, as a trained geriatric social worker you are aware that walkers aren't always about "muscle and blood and skin and bone" but about balance, and balance is poor in the elderly. Yes, they can become a sort of emotional "crutch", but at 88, why not?
Other than that, I don't know what to say to you.
You are a geriatric social worker.
I am a bit surprised at what seems to me (and I could well be wrong) your lack of empathy and sympathy.
I would encourage you to examine, if not your feelings, your presentation of them.
I wish your Mom well. I hope things will be better for her. I hope you will practice patience with her in these last years she spends bereft of the man she loved. I hope you will allow her to "do it her way" in so far as that is possible.
An 88 year old woman with cognitive decline and a pleural effusion ALONE is serious enough to warrant using a walker and getting the help she's getting now! Nevermind that she's a recent widow who suffered broken ribs and a "small" intestinal infection! My dh had a pleural effusion in 2020 and has never regained his full lung capacity to date. And he's 65.
What on earth is the difference if mom uses a walker if it makes her feel more stable? If you read these boards, you'll see how we struggle TO get our loved ones TO use walkers to cut down on their falls. And here you are insisting yours doesn't need one! Do you realize the absurdity of that statement? She's not depending on a wheelchair or lying in bed all day....shes using a walker to help her feel more secure. Good for her. In your quest to make her more "independent" you may wind up causing her to die from a fall because she "doesn't need" a walker at 88.
At her age, your mother has earned the right to live as she sees fit, using her own money to do so. AL is a great idea at her age but does not guarantee she'll socialize or take part in activities. Plenty of elders lead cloistered lives in AL too!
What's going on right now isn't broken, so why insist on fixing it?
first of all the broken ribs were 6 months ago. The pleural effusion was 5 months ago. All resolved. She has better oxygen saturation than me! The stomach infection was resolved 5 1/2 months ago.
she was evaluated by an OT who said she probably doesn’t need a walker and should have been weaned off of it as she is capable of walking short distances without it. We have no problem with her using the walker though. For Christmas I got her a tray for the walker so she could carry things on the tray. She is very capable of doing things on her own. She is independent in ADLs except for some help with bathing. She has no health conditions and takes no medication. Our concern is if she doesn’t do all she can for herself she will use the ability. Being waited on for everything when she is able to do most things on her own isn’t good. Also it’s concerning she is spending $450.00 a day for someone to be with her and do things for her she can do isn’t good. She could live another 10 years and she needs to be sure she has enough money to prepare for possible future care needs.
I know she is grieving and probably somewhat depressed.
Surely you know that at 88 becoming "more" independent is an uphill battle because she's not only not being able to maintain existing abilities, she's actively losing those, never mind trying to add or improve on things. Your expectations are the thing that needs to change.
When was the last time she has a cognitive/memory exam? Does she have a baseline?
You aren't responsible for your Mother's happiness. You can't/shouldn't project your expectations for her senior years onto her.
Expectation = premeditated disappointment
Maybe AL would financially be the better solution for her, but don't have any expectation that she will be "forced to be around others" because it's not the staff's job to force anything onto their residents. She may never leave her room and they can't make her. Not even to eat.
Are you her DPoA? If so, please check to see if you should now be making decisions for her in her own best interests, not decisions that only make you feel better about how her life should be and look. It's hard to separate our emotions to make wise, objective decisions for our parents. I wish you clarity and peace in your heart on this journey.
You might consider hiring companions, who are not for medical care but will encourage her to go out, drive her around, take her to lunch, and accompany her to activities in her facility. They won't toilet her, may help her get her medication when she starts taking some (though not administer it, just make sure it's on the table where she can take it) etc. Companion care is not as expensive as a CNA.
If I were you I'd consider not being as involved with mom as you are. Let her live as she likes. At 88, she certainly doesn't have the energy she did when she was younger, and if she's happy sitting and chatting with people in her apartment, so be it. When I'm 88, I hope I can take it easy, free of others' expectations of me.
Why her choices are driving you crazy?
She can live however she chooses.
Has she been assessed for depression, recent cog tests ? Maybe an antidepressant would help .
Big events can cause a significant step down at this age . Perhaps she’s improved as much as she is going to . After big events many do not return to as much independence as before , they are too tired at this age and prefer to have things done for them .
If cognitive decline is happening , she may prefer to not go to activities , it’s not unusual . My experience is that there are joiners and non joiners . Activities can be encouraged but not forced .
She seems to like having a companion . Maybe leave it alone for now until you try to get Mom to agree to go to assisted living . Are you POA? IMO it’s time for assisted living.
If Mom is content being waited on that’s her choice, let her be content. Try not to let it drive you crazy .
Many of us wish we had a parent who would use their walker and seemed content in their facility .
she broke her ribs 5 months ago. All healed. The pleural effusion was months ago. My daughter who Is an OT doesn’t even feel she needs a walker anymore. She’s independent in all ADLs except for maybe help with bathing. At Christmas time she refused initially to go out to dinner but then went and did fine. Refused to go to church and then I suggested she should go and she did great. Didn’t even need her walker. Had been asked to go to church other Sundays and refuses. Refuses to go downstairs in her senior living independent complex to get her mail. Said to me “why would I do that ? “
She has always done this before. She just wants to sit in her den and be waited on. She may be depressed and cognitive changes of course can add to that. I worked as a geriatric social worker in mental health for 12 years. Paying $450.00 a day for someone to wait on her is a little hard to take when she is independent in ADLs and is even able to get her breakfast on her own ( she did this on her own when the aides weren’t able to be there.
I’m a grief counselor. This opting out of things and saying no to a lot of things and depending on others to take care of her has been a long term pattern for her. It’s very hard to see her want to be waited on for about everything when she has no health problems and she doesn’t even take any medication.
I think she was so codependent on my Dad she just doesn’t no how to “be “ she doesn’t know how to have her own identity.
Frustration may be a manifestation of grief for you. She is no longer her former self and it’s sad to see and hard to accept. As a former geriatric social worker it has to be difficult being on the other side. Like working in hospice and then needing it for a loved one or yourself. It’s a whole other experience of emotions and decisions. Take care.
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