She lives with me in NC. Due to her diabetes, I have my mom on a meal schedule, count her carbs, test her blood sugar and give her insulin, and make sure she takes her medication. I have healthy high protein, low carb snacks for her close by. She is prone to UTIs due to her urethra not closing at all, and poor hygiene, and pressure sores because her arthritis makes it painful for her to walk so she will not move around enough, and fungal infections because it is a struggle to get her to bathe. My mother will raid the refrigerator at all hours, drinking a couple of glasses of milk at a time, eating a quart of yogurt in one sitting, etcetera, which sends her blood sugar soaring and all that sugar feeds the fungal and bacterial infections that she is prone to getting.
There is absolutely NO money for a decent nursing home, though her doctor says its getting to that point because she is so resistant to following medical advice. My mom is dead set against a nursing home, and with the lack of funds I can only imagine the sort of place she might wind up. It is getting to the point where if she doesn't comply, the doctor might take steps to take that decision from her. So, is it ok for me to install a lock on the refrigerator to keep her on track for her health? I have tried talking to her, explaining about drinking too much milk and overeating, and she would just snack and eat all day long and get no exercise if I didn't keep my eye on things.
I do have to work, and when I am out of the house ,all bets are off. There is no money for any sort of home health assistance, so I really need to keep her from raiding the refrigerator when I'm at work. I really cringe at the thought of locking the refrigerator but I need ingredients on hand to cook for us, and if I don't prevent her access to it, there is no controlling her blood sugar and helping to prevent the subsequent infections that come from it being too high. Another concern is that when I tell her that her blood sugar is too high, on occasion, she has gotten her insulin from the refrigerator and given herself 60 or 90 units to bring it down, and I am concerned about that, though lately she's been forgetting how to fill a syringe, so that's not the danger it once was.
When her doctor mentioned a nursing home, she got better about regular meal times and bathing, and for about a week, that's been ok, but the snacking continues and I'm having trouble steadying her blood sugar. I'm hoping with a few more weeks of regularly scheduled meals 3 times a day and a couple of low carb snacks, her urge to snack incessantly will stop. She eats when she's bored, and spends all her time on the Internet, so if the Internet goes out or she gets confused and can't remember how to log in, she gets bored and just eats and eats. If we could get her a new prescription for reading glasses, she would read books when she can't get online, but with her blood sugar up and down so much, new glasses would be useless because her vision changes from week to week based on her blood sugar and its effect on her eyes.
I feel like some sort of monster for even asking about the legalities of locking the refrigerator, that seems like such a horrible thing to do. I just don't know how else to keep her on track with her meals and blood sugar control and now that she's afraid of a nursing home after her doctor spoke to her about that two weeks ago, she is more willing to be compliant with her treatment but the snacking is a long ingrained habit.
I wonder if you're under additional pressure because of your professional background. Just like the doctor's children always being the ones who are ill, I can only imagine how desperate the idea of your mother's care not being 100% brilliant must make you. You are, like it or not, a bit of a role model. Your higher level of expertise does mean that people will be watching you to see how it's done; and I don't envy you one bit.
But, especially because of your professional background, is it maybe time to have the quality of life debate with yourself? That is, with yourself and with others you trust - your mother's doctor, maybe colleagues, people you network with and whose opinions you respect?
Your mother, you say, is competent but wilful. You could say that about any person who smokes, drinks to excess, eats to excess, fails to take sufficient exercise… She is taking risks that many, if not most (it's most), adults take with their health. It's only a matter of degree.
The key difference, of course, is that you feel responsible for her welfare. Are you? In fact? And how far?
If no, then she can eat and drink what she likes. You can advise, you can provide a high quality diet, you can encourage and educate and inform. But you cannot decide.
If yes, then by all means lock your refrigerator if you judge that best. Your house, your responsibility, your decision. The only thing is, then: what are you trying to achieve? It isn't very likely, even if you do take that or similar steps, that you will be able to get your mother to A1 fitness. If you can get her to healthy and happy, then it's worth it. But slightly healthier and miserable? I wouldn't see that as a good enough reason to take away more of her autonomy.
I don't think you're going to cure boredom in three weeks. If she is snacking for that reason, is there anything else that could be done to divert her? Any voluntary organisations in the area that provide befriending services, outings, just something to occupy her?
I'd also look for resources online to find no-holds-barred pictures of diabetic complications and pin those up in the kitchen. Go to diabetes.org as a start - they also have an 'in my community' section which might have helpful ideas. If the threat of a nursing home made her shape up (briefly, alas), then surely amputation, blindness… get as gory as you like.
I'm curious about her computer usage. Is there any room for negotiation on that? If it's your computer you can just sell it and make her go cold turkey… wishful thinking, I guess? But it might be worth taking a closer look at what she's getting out of that chat room and seeing if you can't wean her onto something parallel that doesn't keep her immobile for so many hours at a time. Deadly.
You can get washable absorbent pads, by the way, on a practical point, to go on chairs. They're not expensive, hold up to a litre of fluid and save a lot of tears before bedtime. You wouldn't pick 'em for your loose covers, but there's a choice of colours so they don't have to look terrible.
Perhaps the one key thing is to remember that you do not have to carry all of this responsibility alone. Even if your mother were not competent - and I can't agree that making foolish choices is proof of dementia - you might feel more comfortable remembering that there is a whole community of people who will gladly support you; and I would have thought the diabetic community above all will get how difficult this challenge is.
Truly, I do understand how it feels to feel responsible for someone who Will Not Comply - for no good reason, yet! - and it is torment; but don't set yourself impossible goals for how much improvement you can achieve. It'll drive you round the bend and, worse, make you angry with your mother. Good luck with picking the battles, please come back to us.
Yes, you can put a lock on the fridge. I've watched shows about families of Prader-Willi children and they lock up everything when the kids are alone, and overnight. Lock the cabinets too if there's cereal, bread, crackers, or anything else she should be having in excess But essentially I agree with what was said by jeannegibbs above - your mother seems to be mentally impaired. It may be time to let her be moved to a nursing home. And, in either case, take control of your own home back. If she's not mentally impaired, you need to stop putting up with this disrespectful and harmful behavior (thank you jeannegibbs!). Caregivers have rights too!
Most persons with dementia cannot live alone beyond the very earliest stage. Your mother is alone while you work. That simply isn't adequate. Not Your Fault. Not Her Fault. But something must be done.
Given your career I'm sure you'll quickly become an expert and finding resources to make it happen.
And speaking of your career, it must be especially galling to you to see your mother's self-destructive behavior since you say, "All my professional life has been about helping people take more control over their own lives, and being responsible for themselves as adults. I am at a loss regarding how to deal with what is essentially, willfulness on the part of a competent adult."
Certainly your mother's behavior LOOKS willful. Even with dementia it is a best practice to encourage the person to take as much responsibility as they safely can. BUT with dementia there is a definite limit to what can be expected from them, and that limit gets lower and lower over time. There is physical damage to the brain and the person truly cannot always control their behavior.
There is a huge difference between falling short of the legal threshold for an "incompetent" ruling, and actually being "a competent adult."
Her doctor obviously knows she is not compliant with her care plan. Have you also told him about other behaviors at home, like not wearing incontinent briefs?
From what you've said, I believe your mother is mentally impaired.
If this is truly willful behavior then I agree with blannie and freqflyer. It is time to take charge and stop putting up with this disrespectful and harmful behavior.
(Tough love simply doesn't work with dementia and that is what I think you are dealing with.)
If your mom does have cognitive impairment, then she needs to be in a place that can handle her needs and you need to go back to being a loving daughter and not the food police/nurse/maid/poop cleaner.
If your mom doesn't have cognitive impairment, I'd give her the option of behaving like a responsible adult, or she's out of your house (assuming she lives in your house and not the other way around). You've taken on wayyyyy too much responsibility for her if she doesn't have a mental impairment.
And why should Lost suffer even more by not having what she likes in the house? No bun on a burger at McD's, for Mom? Fine. But never any buns or bread for the caregiver at home, either? Way too burdensome for the OP. And eliminating carbs is contrary to the American Diabetic Association advice, as well as that of most certified diabetic educators.
Being diabetic is NOT like being sensitive or allergic to particular foods or food groups that you can learn to avoid. It is needing to control how much and when you eat the foods you need to eat. Huge difference. And in this case it seems Mom is out of control if left on her own.
Frqflyer, I don't remember enough of the details of your situation -- do you have diabetes? Ever lived with someone who does?
I'm trying to think of how I would "keep those items that would give me a sugar spike" out of the house. Since with the exception of non-starchy vegetables, pretty much any food that has carbohydrates can cause a sugar spike in someone who has diabetes. Sure, the wrapped candies I keep in a pretty bowl on the coffee table would be easy to remove. No problem. But, no milk in the house? No fruit juice? No fruit? No cereal? Crackers, bread, frozen hashbrowns? Wow. It would tremendously expensive to buy only one meal worth of such items at a time. I think that this solution would be a big burden for Lost. Locking up the "dangerous" foods makes more sense to me.
Do like anyone would do with a spoiled child, no pull-ups, no computer time.
As for the food issue, keep those items that would give her a sugar spike out of the house, even if it mean stopping by the grocery store on the way home from work every day. Find fresh veggies that don't have a lot of natural sugar. I can't vision your Mom finishing off a stock of fresh carrots.
Have you actually looked at nursing homes that accept Medicaid? Don't make the assumption that they are inadequate compared to those who only accept self-pay.
As to your specific question, I don't see a problem with locking the fridge, especially if she has access to a reasonable number of snacks and plenty to drink during the day.
My heart goes out to you. You are doing your utmost to help keep Mom healthy, and yet her own behavior is self-destructive. How frustrating and painful! You obviously have to work, and there she is, unsupervised, and offsetting all your hard work!
I suggest expanding your focus to advocate for some kind of financial aid for Mom. I know you are already overwhelmed with managing her health concerns, but in the long run spending some effort in getting her financial help to afford the daytime care she needs could be a very worthwhile investment.
Continue to do your best. But also accept that this is not entirely within your control. Your mother's inability to help care of herself is Not Your Fault. (It is probably also Not Her Fault, if that helps any.) Take pride in all the care you are providing, and PLEASE do not fall prey to guilt feelings. You are doing an awesome job!