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Mom has moved into my sister's house. We brought in several accessibility experts to identify what they recommend doing to keep her safe while shes aging in place there. She was there during the assessment and today when installation was scheduled she was screaming at the installer telling him she didnt want safety bars installed next to the toilet. This is my sister's house and they agreed with expert that it was a fall risk and signed contract for install. The PT even came out with installer to walk her through why the bars were important if needed. My sister is supposed to be my moms personal care person but has a very difficult time doing anything my mom complains about...which is pretty much everything. Even things she asks for she changes her mind about and has a melt down. My sister thinks this is just because there has been a lot of change. I agree with that but the ranting and confrontational behavior seems like it could be more than that. Shes acted out in the past but this seems over the top. Any thoughts? Thanks

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I believe your sister can be sued if someone gets hurt on her property. Tell her that if she will not get safety bars she should purchase an umbrella insurance policy.

You know that your mother waffles (dementia), so do what makes sense while she is out of the house.

You sister is not strong enough to be a caregiver. It's not a bad thing. I'm not strong enough to be a wrestler so I don't do it.

You really have to re-program. You must accept your new role as strong loving protectors and decision makers. There is no discussion.

Before my father moved in I had the tub removed and safety bars installed. Since he passed I enjoy the bars not only for their main purpose as I am now older, but they've also become a useful place to keep or hang things to dry.

Don't engage crazy talk. You are being split by your emotions. Tell her she's right, or that you will take her ideas into consideration and deflect. Just relax and take the steps that make sense and are safe. It's going to get worse so toughen up. When she sees something in place that she demanded to be otherwise, tell her "doctor's orders",

Best of luck.

I'm going on 16 years as a caregiver and living in an alternated universe. You must do what you know makes sense and things will go much better.
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It was recommended my LO get grab rails near the toilet.
Refused. Didn't want "holes in the wall".

Full-time Caregiver advised to arrange the rails, take LO out while work done (as per much advice below). Wouldn't. Let the tantrum rule the day.

My mantra:
- Advise
- Let them decide*
- Consequences are theirs

Note: Let the *competent* decide. If not competent, others need to step in.

Result?
Fall near toilet has followed.
No breaks & not fatal - this time..
I do not hold LO responsible due to lack of insight & judgement but the caregiver needs to spine up imho.

Awayshelp, so your sister is in a similar spot & I am in a similar spot to you.
Your sister may be firmly entrenched in her 'nice gal' role.. but maybe you can step into the 'Tough Love' role?

Let common sense prevail!
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First and foremost, I always tell my Aunt who uses a rollator, is unsteady on her feet (neuropathy)..
Safety First!! She already broke the toilet paper holder and towel bar cause she lost her balance. Been reminding her to call the handyman to install grab bars....guess we just have to wait
for the next fall.
Just do the right thing, install the bars... ignore her complaining.
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You all need to have a talk with her as a group. Explain that you are trying to keep her safe and happy, but you need her cooperation. It is your sister’s house and she should not allow her mom to bully anyone. That should be part of the conversation. Immediately have the safety bars installed! If you can’t reach an agreement tell her your only recourse is to have her move to assisted living or a nursing home. Tell her she has no right to treat anyone badly, and absolutely no yelling. Why would any of you allow her to treat your badly? Tough love is tough!
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Take her out for a drive while the bars are being installed. When you get back from the drive, she will have to deal with it. You don't let a child throw a tantrum and control the decisions you are making about their safety. This is no different.

Obviously she can no longer make sound decisions for herself or take care of herself. If she refuses to let you take care of her, then she more than likely needs placed.
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If you can get her out of the house for several hours, then that's the day to get the installers to get this equipment installed. Since it's not her house, she cannot tell your sister what remodeling your sister deems necessary for her safety. This is the perfect example of "better to ask for forgiveness than to ask for permission". Your sister could also tell your mom that she had the equipment installed for herself, not your mom. Sooner or later, your sister will enjoy the benefits of these safety bars herself.
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Alwayshelp: Your sister will have to be the individual in control especially since it's her house. Mom does not get to make decisions about HER safety, e.g. if she were the one calling the shots about toileting safety bars and she said 'no way,' your sister would then have a fall event to deal with if your mother fell.
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YOU need to tell your sister that she needs to have more of a backbone and she must do what mom NEEDS and not what mom wants. there's no way around this. Don't be as passive as your sister. It's going to end up unsafe for your mom if you don't do anything.
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They have grab bar toilet paper holders now. We installed them in all of my parents' bathrooms because the space was too narrow to have regular grab bars. They worked great -- just be sure that you install blocking (wood) between the studs where they're installed, or they'll just pull out of the wall.

We installed the Delta ones here in the search. No one even knew they were bars, including my mother for whom they were installed. (She learned to use them eventually.)

https://www.google.com/search?q=grab+bar+toilet+paper+holder&rlz=1C1XYJR_enUS797US797&oq=grab+bar+toilet+&aqs=chrome.0.0i512j69i57j0i512l4j0i22i30l3j0i15i22i30.4848j0j7&sourceid=chrome&ie=UTF-8
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We had bars installed for my mom. They are slippery if hands are wet. I can tell you that my mom would ask for a dry washcloth to hold onto the bar when getting out. For some reason this helps.

A nurse told me that if a person falls to give them a towel to place underneath their hand and it will help them get up. I know that it sounds weird but somehow it helps. It also helps when using a grab bar.
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Change is hard for elderly (or disabled). From my perspective, experts are experts to a degree of what they sell and what they see as specialty assisting items. Your own observation for your mom will give the clues of what she needs. You have to be creative in seeing what may be a mobility issue and coming up with a way to accommodate that issue.

Examples: Some folks run out and buy a lift chair because mom has a little more trouble standing than she used to. My mom saw advertisements for these and said if I let that chair lift me up, it would be no time at all that I would lose my leg muscles. Made sense to me so we never got one. Her legs and arms stayed strong enough to get herself into standing position where she then grabbed a rolling walker. My goal was to keep her walking so I'm sure the struggle for each standing played a role with upper and lower body strength.

Mom's walker could not turn around once she got into the bathroom, so she would turn it around at the outside of door and drag it behind her to get to toilet. I could see that was a fall waiting to happen. I took a closet rod and cut it to fit the length of bathtub and braced to the wall. She could now use one hand on sink and the other on the closet wall to make her way to toilet. At bath time, I would just remove the pole to make tub accessible again.

Go ahead and install the grab bars by the toilet. She may not use them for a long time, but there may be a time she needs a little help with lifting and will use it. There may also come a time she needs the toilet seat to be a little higher and they make those to attach to existing toilet, but may not be needed at the moment. An expert would probably suggest hand rails in the shower. Again, great idea and she may not need them right now, but they will already be there in the event she does.

Seeing those items puts her into frustration mode and 0 to rage because it causes her to face the inevitable. Would be hard for anyone. Don't ask if she wants the stuff, just do it for safety sake. Tell her you know she doesn't like it, you don't either, but you are trying to be prepared if she ever did need them. Just don't argue with the rage/anger she may have.
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This is a rough one, since your mom lives with your sister, in your sister's home.
The only option, as I see it, is that you support your sister as much as you can to 'empower' her to make decisions that are in your mom's best interest, and not allow your mom's response / behavior to dictate your sister's decision-making.

* Having gone through all this prep to do what is right - to have your mom 'take over' during the critical time of installation is truly unfortunate - and for anything to do with her safety - and changes (as installation, etc). This scenario must change. Some ideas of how ...

* For any 'improvements,' tell your sister that:

1) either your mom is taken out for lunch or something when these things are done; and / or
2) Sister needs to learn how to feel secure / confident in her decision making and be clear with 'mother' - this is being done for you. ... or/and "I know you have feelings about this and I understand that; this is being done for your safety... then change the subject.

3) Your sister needs to learn to:
a) Not to argue (or be right) and
b) Not talk logic - with / to your mom.

These / this way of communication doesn't work.

And most (99.99%) of family fall into that hell hole due to:

1) they do not know how to respond - not having this experience before; and

2) these communications are often life-long instilled patterns of behaviors between parent and their children.

3) Your sister isn't (totally) reacting out of what's happening now, she is reacting from a lifetime pattern of behaviors - and psychological / emotional responses. I believe your sister is TRIGGERED and needs to understand this in order to have the will and confidence to change.

4) Your sister might need to role play (what your mom may say and sister's response).
- And, this may be 'too much.' It might be much easier to have your mom go out for an event or lunch when new safety measures are put in place.
- Just don't tell her what is changing. Just do it.

5) If you can't and/or in addition to you supporting your sister (in changing her response(s) to your mom, she likely would benefit from therapy or an intervention-or - perhaps a social worker.

I am VERY IMPRESSED with the thought that went into changing the bars in the bathroom.

In closing, I would say to 'ask your mom "why don't you want / like this? (way before installeers come or work starts) so she will feel some independence (as she is also reacting to losing (more) independence, physically and perhaps cognitively. No one wants to set up this emotional upheaval at the time of installation.

And remember, your mom knows how this goes - she knows your sister and how to push her buttons to get her (mom's) needs met - or at least cause a lot of discord. Your sister needs to change as your mom won't.

- And, if she is losing cognitive functioning, it is magnified (from her point of view - she is fearful and perhaps confused). Compassion through all this makes all the difference "I understand how you feel" goes a long way.

Gena / Touch Matters
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Mental illness can be treated if she is not a candidate for Memory Care. Please consult a Geriatric Psychiatrist who can medicate her and educate the family.
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The bigger problem is the elephant in the room.....her behavior. Agreed, a lot is going on and is disconcerting to mom. However, being irrational about simple things like safety measures leads me to believe much more is happening with her mental and emotional state. Acting out with such defiance and lack of control is a red flag. Excuses for her outbursts will only prolong the inevitable.....the need to be tested for a possible UTI or dementia. One is pretty easily treated, the other needs to be met with caution and careful deliberation......This isn't easy, I wish you the best of luck.
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JaniceM Mar 2023
Thank you. My MIL is going down this path. She won't lock her front door when she goes out. She is unstable walking, age 95, won't use a rolling walker and consequently fell last week and broke her collarbone. She won't pay for a 911 necklace service if she falls inside the home, even though she can easily afford it. She doesn't have outbursts, just feisty attitude. Wishes she was dead because all her friends are gone and she's bored. I do what I can.
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If she's unwilling to have adjustments made that keep her safe, it's facility time for mom. Luckily it's your sister's problem, don't let it become yours.
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BurntCaregiver Mar 2023
Zippy,

That's not right to say luckily it's the sister's problem. No, it is not exclusively the sister's problem because she is not an only child.
The mother is just as much the OP's responsibility as she is her sister's.
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Getting mom placed would seem to be the best option if mom is exhibiting uncooperative behavior.

Does mom have dementia?

I always remember a moment, shortly after mom entered rehab after a stroke. Mom started exhibiting very strange behavior, became delusional and irrational about a lot of things.

I think we all had assumed that mom would complete rehab and go live with my brother and his wife, who got along with her and were best situated to care for her.

My dear, dear SIL, the kindest person in the world said "well, mom can't come to live with us if she's crazy".

It was the most accurate assessment of the situation possible. It would NEVER have worked, despite how much love there was on all sides.

Mom went to a good facility and lived well there for a long time.

Dementia is a game changer.
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First of all, it isn't her house. It's your sister's. She can scream all she wants about not "allowing" safety bars to be installed for her own good and safety but it's not her decision to make. You and your sister need to make it clear to her that she is not in charge and that it isn't her house.
I was an in-home caregiver as my profession for 25 years. I operate a homecare business now. I never tolerated a 'meltdown' for one second. Your sister needs to learn how to put the brakes on the meltdowns and the senior brat nonsense quick. Otherwise her life will become a living hell. You don't tolerate complaining or ranting and raving either.
This kind of behavior would not be tolerated from a child. If it came from an adult who is not elderly it would be considered abuse. No one should tolerate it from the elderly whether they have dementia or not. Your sister has to learn how to ignore your mother. When she's acting up, deprive her of attention. Ignore her like she isn't even there. Do not give her complaining, ranting, and raving any credibility by giving it any attention.
It's a good idea to get her tested for a UTI and also to have her visit her doctor as suggested if any of her behaviors are new.
Start looking around at care facilities for her. No harm in looking. In the meantime helo your sister arrange some homecare aides if she doesn't already have them coming in. Your sister needs to have help coming in.
As for your mother's refusal to use the safety bars installed by the toilet for her own benefit. I have a saying that I've told more elders still at home than I can remember.

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

So, if she wants to be stubborn and not use the safety bars, she can fall and get injured. Then she goes to a nursing home.
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Way2tired Mar 2023
I’ve told my MIL who refuses a walker. that she has bought a future one way ticket to a wheelchair .
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Is this anger a normal part of your mom's dementia manifesting, or is this new. You have great suggestions below. But you may need to have now family conference, because I feel your sister may have some unrealistic hopes for the future of this caregiving. This may not go away. It may, in fact worsen, dependent of the type of dementia mom is suffering from. And there may be limitations for sis in dealing with this as a 24/7 in home caregiver. Placement in memory care may be needed in future.

I am sorry about this difficult adjustment, but dishinhibition is sure "a thing" with elders suffering dementia. I am sure that the installers understand when told. As to Mom, this is sister's house and she will need to explain to Mom she herself would like to have these safety bars. She can plead bad knees or whatever else she wishes. I also agree with Way2tired that it's a good luck to catch some urine in a plastic "hat" and test for any signs of infection and need for further checking with MD if this outburst is unusual, and continues.
Sure do wish you good luck as a family.
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My mother would act out also and it puzzled me until I figured out it was a matter of control; her loss of control in her surroundings and being at a loss over her environment. When this happened with my mother, unfortunately my brother yelled at her and told her if she didn't comply he was going to place her in a home. After everyone calmed down I told her that I was sorry she didn't like some of the changes we were making but they were for safety and for her to remain in her house. I gave her a choice then to either accept this or to consider living in a place such as a nursing home. It was a more subtle threat but she then could accept what we had to do. As one ages changes equal loss of control which manifests into bursting out in inappropriate ways such as tantrums. If installations need to be done as a group you and your sister, and any other siblings, need to tell her these things will be done and that's it. Perhaps one of you can take her out on installation day so she can't voice her objections or harass the worker. You might also consider having an evaluation done by a doctor fir depression, which many older persons have, and possible meds to handle her anxiety. Another point to understand is that any changes to a set routine is not easy for older persons to adjust to. Spreading out repairs etc. will make it easier for her to handle as just a small adjustment to the routine rather than too many things going on all at once. I would also say help your sister as much as you can as being the primary caregiver is a tough job and she will probably have to face the bulk of these outbursts, she'll need support too, I know I've been there. Eventually as routines set in, repairs as finalized she will calm down but there might be times where she still feels out if control so I would say pick and choose your battles and find simple things of which she can have control, for me it just consisted of giving her choices over her wardrobe. I wish you luck in this difficult time of adjustment.
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Way2tired Mar 2023
Sound advice and could work IF the woman becomes more reasonable .
The whole “ for your safety” and giving them choices when possible unfortunately sometimes doesn’t get through stubbornness and/or dementia .

May be worth a try after Doc sees and treats .
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There are now some nice looking safety bars that look decorative and don’t look quite as institutional. You can find them online or in a home decor center. Install them quietly.

Your mom is having some trouble accepting these unavoidable life changes. Be supportive and kind. Try to help her see the positives in living and never dwell or even discuss disability. Don’t hammer on about these subjects that are painful to her.

Let her know how valuable she is to all of you.

Give her “jobs” that she can accomplish safely. Tell her how much you appreciate the help.

She is torturing herself emotionally because she doesn’t want to see herself as needing extra assistance or having any incapacity. Be a soft place to fall and assist her to find a place that’s mentally happier.
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As Wendstrong has said, get your mother away from the house to get those grab bars installed for her safety. Get her evaluated by her doctor for UTI and other health conditions. If your mother complains after all the bar installation work is completed, it is time to place her into a facility for her safety and care.
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Get her tested , UTI, dementia , give her any meds prescribed whatever else Doc thinks . Then if it doesn’t improve , and she’s still giving sis a hard time , time for AL or MC.
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I agree with what has been said.

Your sister's house, so she does what she wants, not what her guest wants. Mom really has no say in the matter.

Get her checked for dementia. So much of what you wrote made me wonder if she is either has a current UTI or dementia.

Keep being there for your sister, Alwayshelp. Don't let mom cause any divisions between the two of you. Your sister has taken on a lot of responsibility. You don't say where she lived before moving in with your sister. If she was with you, then you already know what your sister is experiencing.
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Sometimes you just have to use a ruse. Take Mom out to brunch and let the installer do the work while she is away. She may not even realize the change at first.
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Way2tired Mar 2023
Great idea! Love it.
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Alwayshelp, ah yes, how I remember my Mom's reaction to having various things installed in their house per suggestion of a female accessibility expert.

My Dad was all for it, but not my Mom [both in their 90's]. It would ruin the "decor" of the house, yada, yada, yada. Good grief, it's not like she was hosting a fancy get together every weekend, it was just I and hubby who visited.

So a couple months later my Dad made an appointment with a plumber. The male plumber made the same suggestions and Mom was more than happy to have the work done.

My Mom always had issues with other women making suggestions. Mom even didn't like doctors who were female as she believed male doctors were so much smarter. I always had to bite my tongue as I was the smashing of the glass ceiling type.

So, I wonder if your Mom is doing the same thing?
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Sister can tell mom...these are for me..you do not have to use them if you do not want to.
Chances are mom WILL use them because they will be there and it is a normal thing to use what is handy to help yourself. (One of the reasons I suggest people remove "towel bars" next to showers or tubs because "towel bars" will not support someone and the natural thing is to grab hold of one when you get out of the shower or tub. Same with the bars on glass shower doors, people use those to support themselves and they are not intended to be used in that manner.)
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TopsailJanet Mar 2023
Yes, we have grab bars in all our bathrooms but I noticed my mom was grabbing a towel bar for support. It would have given way with any force on it. I replaced all our towel bars with grab bars that are securely anchored, but look and function the same.
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I agree, your sisters house, her responsibility to make sure Mom is safe.

I think Mom needs to be evaluated for a Dementia. It may be her anxiety and being in a new place but I would have her PCP evaluate. Make an appt late in the day. This is when "sundowning" shows up. People early on in their Dementia can "showtime". Meaning they can seem normal for a period of time but can't keep it up. If mom was living alone, you may not have notice her cognitive decline.
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Sounds like your mom could be suffering from dementia, based on all of her unhinged behavior. She should get tested by her doctor with a MoCA or SLUMS cognition test and scored accordingly.

Your sister has to lay down the law: this is HER house, HER rules, and if mom is so against having safety bars installed in her daughter's bathroom, she can move to Shady Acres Assisted Living where there are ALREADY such safety features installed in all the bathrooms. It's common sense 101.

Why on earth did your sister take mom in when she has such difficulty doing anything HER way and must jump to do things mom's way? That's a short lived experiment, I think........one that will fail and make both of you realize that mom needs senior managed living where she can act out with all the other residents (which she won't) instead of with her loving daughters. Autonomy is the greatest gift any 'child' can give her senior parents; living in their OWN space and making their own decisions (to some degree) is what allows them to feel independent, in the long run.

Your sister should have those bars installed in her bathroom b/c even if mom moves out, those bars are great for all of us as we age.

Best of luck.
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I’m sorry that you are going through this difficult situation.

Your profile states that she has anxiety and UTIs. Are these recurring UTIs? Has she been checked recently? Is she on any medication for her anxiety?

I would speak to her doctor about her changes in behavior.

Best wishes to you and your family.
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