My mom, 83, lives alone at a distance. She refuses to move, but is showing some cognitive and physical decline. Do I wait for a crisis?

Me, my mother, lived in the NC mountains, alone, one had to climb up a flight of stairs to get in her house. She was at the point that she could no longer drive and did not know how to use a computer or a cell phone for that matter, land line only.

My brother & I tried to get her to move permanently to Florida into AL, she refused.

Finally at age 94 she had a slight stroke, and was afraid to stay alone at night, she was calling the EMT's most every night. Well, they started charging her $600 per trip, so that ended that.

We put our foot down, scooped her up, moved her into a very nice AL near us.

Here is irony, she loves it, people her own age, activities, decent food and more.

Yes, we laid in the woods for 10 years, waiting and finally something happened, took the patience of Job though.

Good Luck!

Yes, you’re in the “waiting for the fall” club, the club no one ever wants to join. While waiting you may want to decrease the frequency of your visits to help mom see her need for help other than you. A wise social worker friend told me when I was greatly frustrated with my dad living unsafely on his own “events will happen that will force change” It proved very true, it always does. My dad had the same wish to die in his home, and he got his wish, but it did reach the point of him having to accept hiring a helper in order to remain there. If he’d lived much longer, the helper wouldn’t have been enough, it was already a questionable solution though she was truly wonderful. Meanwhile for you, take mom to an appointment you arrange with an elder care attorney and have the attorney discuss her future and needed documents, this is better coming from someone other than you. I wouldn’t tell her much ahead of the appointment. And then you wait. I’m sorry you’re in this position, it’s truly not fun at all

Yes, get that DPOA and Medical Directive. If she gets stubborn about it, you tell her that without them there is a chance the State will take over her care when she needs help. That means they will be take over her finances.

On one of your visits see if Office of Aging can come to the house to evaluate. They will point out what needs to be upgraded for her safety. Maybe even tell her its unsafe to remain in her home and think about moving closer to you were she will have family near by. Sometimes, coming from another person, people are mor susceptible to suggestions.

I understand her desire to age in place. And yes you will have to wait for 'an event" before you can force her to do anything.

As suggested I would space out your visits telling your mother that your husband is 76 and you cannot leave him for prolonged periods. Tell her it would give you great peace of mind if she would allow a companion to come in 3 times a week to check on her and to assist her with anything she needs. This way if she does have an emergency someone is checking on her physically on a regular basis. I had one for my father but he was too cheap to take her on for more than 1 day a week...yet assumed she would be 'on call' when he needed her. I could not get him to understand she needed to fill her time with other clients if he did not want to regularly book her.

Christine,

Wow, welcome to Forum. Your post is so well written and is so succinct; moreover, you have thought already of so much here. You've thought of ALL of it, really.

I am 81. Myself and my partner of 35 years, 83, live still in our own home and manage everything for ourselves, but we have come to the point where our four children (he raised two and I raised two before we met) are in the 55-70 age range and starting to worry; we can tell in that we get the question "do you have plans". Partner always teases them and says "Yeah, feet first out the door". Quite honestly it is what we HOPE for, tho I would make changes were I to be alone. Our paperwork is done. Things are downsized. We still garden, walk daily, shop, do repairs, do a museum, enjoy the city, keep our health up luckily. Because THERE'S the key! Health!

But the kids know that INEVITABLY if we do not get ourselves into someplace safe, something will happen.
We all talk and they are comfortable to say their piece and we answer. Thank god I have always talked openly to my kids about end of life.

I would watch and wait. You visit frequently. Make it for shorter times perhaps. No more than a week. And a bit less frequently. Then just hope. Be honest with your Mom and use the word that YOU YOURSELF are fearful; don't know what to do to keep her safe, are worried. Use YOU and not her pronouns.

You have already suggested and tried, and this is where you are. Hopefully your Mom WILL pass as she wishes to. The shocking call will come that mail wasn't picked up and blah blah. Or you will get the call I got about my brother from a hospital saying "are you aware your brother is with us". If so try to pat yourself on the back that she went as she wished and you didn't have to take that last thing from her, her own will and decision.

I just don't know what else to tell you. If she would agree to do this, you could act; she won't. You are stuck until there is a situation of mental loss so bad it leads to incompetency and guardianship, or a physical loss so bad she understands; then placement, probably where she is as a move would be too difficult.

I wish I had a better idea. Keep trying. I can identify so with BOTH of you. My heart goes out to you, and to my own AGING kids.

I would say instead of every 2 months, change to every 4 months. Stop being so reliable.

Of course we all want to stay in our own homes where it feels safe and cozy. For probably 80% of us, that is a fantasy.

It’s hard. They are difficult for many of us, and it’s emotionally hard to go up against it.

I was waiting for something bad to happen to my mom, too, because she was not going to be assessed, would not let anyone come in to help her or anything else.

I kept good documentation about the changes I had seen in mom over the years and sent it to her primary. Do the same to be sure they are aware. Then call the primary to reiterate your concerns.

Alert her local police and ask for a welfare check and they will visit her, especially since she lives alone and you are not local to her.

It looked like my mom was shutting down, not eating or getting out of bed. I called 911 as she wasn’t responsive to me. By then, local police knew mom shouldn’t have been living alone and it was ‘easy’ for them to transport her to the ER. From there, she was stabilized, went to rehab and entered a LTC a month later. She is well cared for, has friends, eats well and enjoys the activities there that are numerous and daily.

Wishing a successful transition for your mom.

I love hearing that your Mom loves the change to AL and that the frustration led to a positive outcome. Thank you so much for your response as it shows a possible light at the end of the tunnel!

I am trying to develop the patience and faith of Job right now! That's for sure!

Christine,
Thanks for your responsiveness to the Forum. So many post a question and never come back and it is so crucial that we know we have a REAL person there, who is thinking about all that gets said, and feels it is of value.

I am an OLD RN with much experience of HOSPICE, the OLD hospice that was so great. We need you as end of life doula, and I am fascinated and thrilled you are doing that.

Please stick around on Forum and help us answer and give some perspective to our questioners. Again, you are so welcome here.

It sounds like her cognition is fairly decent at this point except for the occasional "fog."

Have you sat her down an. asked her how she expects you to handle her situation? Does she want to have that crisis where she might fall and not be found for days on end?

Enlist her in the process of planning for the possibility (read: eventuality) of something happening to her. Ask again for medical POA in the event she is unable to communicate her own wishes (and leave out the dementia discussion). It might help to have her feel she's part of the decision making.

Once you've done all you can, then yes, you wait for the crisis, out rake it clear to her that you have to be able to act when that day comes.

I am so sorry that you are in this situation. It’s hard enough when loved ones live nearby, when they are far away it makes the situation even more difficult.

It becomes a burden on adult children and their families when a parent feels as if only their child is capable of doing everything for them.

I’m sorry that your mother won’t hire someone to help or move into a facility.

It’s draining for you physically, emotionally and financially to have to travel back and forth.

There will come a point in time when aren’t able to travel to her home. You have your own life to live with your husband.

It’s time to have another conversation with your mom to settle this matter before a crisis happens.

Emphasize that this is becoming more than you can handle. You must stress to her that this arrangement is no longer feasible and that you are more than happy to help her find an alternative solution.

If you make the conversation about her, she will most likely give you a million reasons why she should stay in her home.

Wishing you peace as you navigate this difficult situation.

Transitioning is hard, but so worth it in the end. She will adjust to others caring for her and then you can return to being her daughter.

Help her as an advocate overseeing her care.

Oh my I swear we are living the same life ,

HI Mom,
Instead of me traveling to you, it is time you come visit us :)

Mom, you and I both need a change. Let us entertain you down here..

Then take her around, and have the talk that needs to be done, gently.

Hopefully, she will get the message..

Or just switch it up... You fly down every 3 months, and I will fly up every 3 months, and we have FaceTime, and other video chat rooms.

do go to a doctor visit next time you are up there. Get a well check on her, and cognitive check...

My parents did this later in their 80’s. I finally convinced them to move to where I live and go into assisted living after a couple of years with me. It’s a situation where there are no good solutions. I started with the worst case scenario and worked backwards. It wasn’t easy, but it kept them safe, and I was able to put out the fires before they were unmanageable. Good luck!

I lived 4 states away from my mom as she declined; she was determined to stay in her house, not move, no retirement communities. Thankfully she had a woman who'd done light housekeeping for her decide to become my 'eyes and ears', feeling it was her calling to befriend my mom in her decline. Mom would not have let anyone live in her home, either, but this arrangement worked very well. I could visit now and then to assess her condition; when it looked more serious I spoke with her area's aging department who told me with 'stubborn' elders you have to let nature take its course, basically, and if there's a crisis where they can't take care of themselves the State steps in and places them wherever a bed is open. Sounds harsh, but hopefully you have time to recruit such a helping familiar person for your mom, that she trusts and will not bug her about making any changes in her living situation. Meanwhile, research facilities that could home your mom within her means and perhaps begin a gentle dialogue with her about it, but not right away, as her condition determines. If you can be in touch with her doctor, you can also get a sense of your mom's needs step by step. My mom's doctor Would Not Talk To Me until a favorite nephew of my mom wrangled a 'permission slip' out of her so her doc Had to give me pertinent information. Do not uproot yourself to move closer to her unless you really want to live where she does; keep your life as just that, your life. A person's home is their 'refuge' and clearly your mom is deeply attached to where she lived with her husband, etc. If you haven't already, consult with an Elder Law specialist in her area; they are familiar with situations like this and can also be a source of guidance for you. All the best for all concerned. (We can use these stories of our elders' declines to help us best manage our own affairs as we age; for example, the 'Swedish Death Cleaning', as morbid as it sounds, is a sensible way to simplify as we age and make it easier for those we leave behind: the elder individual does it on their own with or without a trusted companion, a way to honor their lives and possessions and begin to 'exit' their longtime homes on their own terms.)

You are not alone in this, see if a companion care taker can come in and assist her. My mom was very much like your mom. Sadly, one day my mom started falling in her house. The last time she fell in her bedroom, she has one of those life alert t hings, would never wear it. I live long distance from my mom as well, had my older son who lives an hour away go to her house, the care taker was stuck outside waiting to get in. When my son and the care taker went in to help my mom she refused therir
help so it was call 911, off to the hospital, then off to the nursing home where she presently resides. You may want to discuss with your mom t he next steps to take in terms of care, like I know you don't want help but a little help might be nice.

The bad part about this is usually a crisis has to take place before your loved one realizes they need help. My mom was unusually stubborn and did not even want me living with her. I tried for 3 years to get her to move without success.
I hoep you will be more successful.

Yes you are in limbo right now. In time her situation will change. There will eventually be a crisis, because that’s just how these things go. If she does not have one yet, set her up with a medical alert system with the fall alert. Put keys in a lock box so EMS has access.

In the meantime think about the various options for her future care.

Good luck.

Dear Christine,

All these responses are wonderful, but I have to share my story with you before you get hit with the reality check that we got hit with.
I visited my 96 year old rich uncle and his long term lady friend back in 2019. They were happily living in Sunnyside Queens NY and loved their home and their neighborhood. They were cordial with me and took me out to eat at their favorite restaurant, but there were some serious signs of decline. She was serving me coffee with the coffee grounds still in the cup and serving him bread with peanut butter. He was refusing to wear his hearing aid and was vomiting into the garbage can once in a while. She had signs of alcohol induced dementia and they claimed that there was a thief breaking into their home and taking things. These are textbook signs of dementia.
I was extremely concerned and begged my able-bodied adult cousins in New Jersey to come and check on them every so often, after I went back home to Michigan.
They never did.
I went so far as to have an APS worker open up a case for them but by then, COVID hit and home visits were shut down.
In November of 2020, we got a call from his sister, my aunt, that my uncle was dead. No warning that he was in the hospital or anything, he was just dead.
That was when the circus began.
My aunt rushed down from upstate NY and moved into his house, brought his lady friend to tears and proceeded to take over, My cousins from NJ rushed in and grabbed up all his important paperwork, grabbed some important keys out of my aunt's hands and wouldn't let the rest of the family see anything.
It turns out, my uncle neglected to sign the will he had been working on for 20 years and so he died intestate. His lady friend had serious dementia and thought for days that he was just sleeping on the floor at the foot of their bed so we never found out he was dead until five days after he died. His body left a large stain on the wood floor.
His lady friend was scooped up by her relatives and placed in assisted living with memory care and I was the one that was called in to help get my aunt out of the house, even though she refused to leave for months, and I ended up having to help her clean up the mess they left behind. For the first half of 2021, I was back and forth to NY trying to get things done. It was a nightmare. My life was completely derailed and nobody appreciated my help at all.
We finally got my aunt in an independent living senior residence in NJ but she wasn't happy there. She made a nuisance out of herself and finally moved on to a 55+ gated community. I knew she had signs of dementia and cognitive dysfunction but had no evidence to prove it, until we were able to get a court order to have her psych evaluated. Sure enough, I was right. My sister, my cousin and I are now in the process of petitioning the courts for joint guardianship over my aunt. Of course she is not happy about it, and is not speaking to us these days, but as far as I know at this time, there is not much she can do about it. We want her to be as happy, comfortable, independent and as safe as possible, but we know that if we do not seek guardianship, there is a great risk that she could fall under state guardianship and we will never get her back. She is famous for attracting Good Samaritans to come to her rescue. We cannot take that risk.
Just so you know, it cost $3500 for the lawyers retainer fee and about $750 per doctor for each of the two required doctor visits needed. One was a psych eval and the other was a medical eval. The lawyer maintained a list of qualified forensic doctors. New Jersey requires two doctor reports, but other states like Michigan only require one. I am not sure about New York.
I know how difficult it is to effectively manage these types of situations, so I hope that my story is helpful to you. I wish you the best of luck and be safe.

Same thing with my very stubborn mother. Daddy died in 2004 - she was 77 at the time and my brother and I started working on her to sell the house of 45 years and at least move into a single-story ranch nearer to us.

No go.

(My dad had tried for quite a few years prior to his death to move into a home with no stairs but even then she wouldn't budge.)

So, my brother and I had to let it go because neither of us had the stomach to deal with the drama.

Fast forward to 2017 and she had yet another medical emergency that I had to wade through with her. In the end, it was apparent that it was time to bring her to my home (as I had promised her I would do if necessary) and here we are 6 years later.

So yes - if your mother continues to live on, then sooner or later you'll have to step in and rescue her.

If living alone has becomre unsafe for her, help her arrange in-homoe care at whatever level might be required. Home maintenance, help with errands and appointments, cleaning. If is or can accept hiring help as needed, this can extend to help with perosnal care if that becomes necessary.

I am currently going through this same situation and while I can tell you what I think I should have done, doing it is much harder. My Mother lives in FL and literally seemed to develop dementia overnight. We put her in an assisted living memory care and while all was right for a while, she had some bad reactions to medications and had to be sent to the hospital 5 different times. Being that we are in IL I received numerous phone calls telling me one thing, then the opposite, telling me they couldn’t control her, didn’t know where to send her because no one would take her and much more of the same. We tried so hard for so many years to get her here and she wouldn’t come and believe me it is us now paying the price. At this point I don’t know where my mother is going next and not well enough to be brought here. My advice is to get her near you as soon as you can.

My mom lives in NC, refusing to move to OH. I have a sisterc(who has schizophrenia)?who lives in a group home 2 hours away from moms, and who sometimes rotates back to her house at roughly monthly intervals. She is not helpful or observant. Mom had few friends. In 2004, she fell breaking her hip and laying on the floor for 3 days before being rescued. Back then, she used to pretend that she would consider assisted living, which I supported and signed her up for. I had taken a leave from work, and set up at home rehab for her,After I returned to OH, she left rehab AMA, called a cab went home and fell. Rinse, repeat over the next 17 years. She hired a “ carer” I knew and diss approved of, who got paid for doing nothing, and who graduated to outright check forgery over the years. Mom had LTC insurance, so I engaged an agency to help after we pressed charges against her “friend”. Mom only utilized the agency to do shopping, or during her many crises. Way too many to detail here. Things got worse and worse until, after a series a falls, she was placed in skilled nursing. I activated her LTC policy against her will to n 2021. She has dementia and is wheelchair bound. I just returned from my quarterly visit. She is finally safe. She “Zooms” with my sister and I in between visits. I would advise taking your very first opportunity to intervene in the inevitable crisis. For me, 17 years was way too long…,

I can understand her wanting to stay home. This is her home and has probably lived there for many years, a lot of memories. Maybe you could consider getting her some in home care or a care giver to check on her every day.

I’m in the situation now. My mom died 4 1/2 years ago and my dad has gone downhill ever since.
In planning our move to be closer to our son last year, my dad said he would move with us and now he says he doesn’t want to leave his house that he’s lived in with my mom for over 50 years. He has early onset dementia, and does fairly well on his own, and although he’s not happy, he really wants to stay there. So for now I am letting him because I feel like I can’t really force them to move, but I am watching him closely and having neighbors watch him. It’s a hard situation for sure.
I wouldn’t want to be forced, so I try to respect his decision, although I think he’s be way happier here.
it’s kind of day by day for us.

Yes, you are caught in the proverbial " rock and a hard place", that also yes many others go through.
Your mother is as most aging seniors grieving the changes that aging brings and perhaps is in denial about the reality of not only what she is facing but also what that means for you. When you go to see her next, try to go with her to her PCP and ask for a " level of care needs" assessment. This will offer a professional objective place to restart the conversation about her needs and decisions and options. She may resist this of course but you can stress that it is for her safety that this must be done and that you as the " POA" , are accountable or may be held accountable for her well being; especially if she is assessed with some cognitive decline limiting her ability to make rational safe decisions. If she is deemed by the professionals as A/ O cognitively appropriate to make her own decisions and refuses your interventions ,conversation and professional recommendations then it will be documented as such; then if she chooses to stay in her home, perhaps some form of in home support may be an option, although often this is not a positive experience for many reasons.
You can also tell her that if she chooses to stay in her home, that it may reach a point where you or possibly others will have to call APS, Adult Protective Services, to visit the home and assess her safety, well being and make recommendations. This is usually not something anyone finds pleasant and is best to avoid if possible.
You can also confer with an Elder Law Attorney to get the best legal guidance through this mindfield of choices, responsibility, accountability etc etc so that you will know what's what for your own sanity, well being.

In my experience (working with elders; not family members ... which is very different emotionally in making decisions), I find:

1. I offer my thoughts / experience / recommendations.
2 Then, ultimately it is up to the person (or family member(s) to decide how to proceed).
3. There comes a time when TOUGH LOVE is to be recognized as LOVE and the most loving gesture to do, even though it is emotionally difficult - for everyone concerned.
4. If she / you wait for a crisis, it will be much more difficult for you to help or manage - and you might need to be there in a moment's notice. Your mom may not 'care' or be in a mental space to 'care' what happens to her or the ... impact 'waiting' will have on her - and you.
5. We all do what we can and then realize there is nothing more we can do.

Realize that 99.99-3/4% of elders / disabled / stages of decline/dementia will not be thrilled to move. It is the LAST thing they want to do. No one wants to leave what is familiar to them. Plus going into the 'unknown' is a very frightening thought - to many of us, let alone someone in decline, mentally and physically.

Gena / Touch Matters

Virtually the same situation. My 83 y.o. mom has been living for 18 months alone in the family home with her 3 aging dogs. My sister and I want her to remain as independent as possible, but she doesn't seem to care about taking appropriate measures to maintain her independence safely. No fall detection devices or monitors. Barely knows how to work her cell phone; won't keep it with her. We had to strongarm her into hiring a much-needed cleaning person, who comes monthly (with the non-housebroken dogs, it should be more). She is having difficulty hiring anyone reliable (and cheap enough) to do her extensive yardwork. The house is in need of significant repairs, but we are just trying to limp along until "the time" arrives. She is growing increasingly lonely and bored, but still likes to drive, which in itself is a bit alarming. She is resistant to visiting any facilities with the intent to get on "the list", but understands the many benefits to them and can easily afford it. I don't want to forcibly move her, but you can definitely count me as a member of the "Waiting for the Fall" club, at which point she will have no choice in the matter and neither will we.

Christine0819: This, too, was my mother, who was adamant about living solo in her own home many states away from me. In the end, I had to move there to provide care for her. I do not advocate this as I had to leave my husband behind when we were already elders ourselves.

My dad is like 4 hours away from me. I too am an only child. I have POA for my Dad and access to his bank accounts. I have started having his bills sent to my house. My Dad wants to stay at his house. He owns cattle and a farm. He's still knows us. He's able to care for his cats and cattle. In May, we had checked into a caregiver for my dad. I went through Aging Care for a caregiver. They sent me different agencies that serve through his area. The first caregiver wasn't very good at all. The one he has now is really good. She enjoys helping my Dad three times a week. There was an incident where my Dad went to try to pay a bill and went out of his area to drive and ran out of gas. That was the last straw. He can only drive his truck on his property. I have two trackers on his cell phone. I am thinking about putting up cameras somehow to see what and where he is. It's hard not knowing. The trackers help if he has his phone with him. I would say talk to someone about home health care and perhaps check into different facilities. I too would like my Dad to be closer if possible. He's got friends and family out by him though.

Oh my, I am in a similar situation with my Mother, i fortunately have an on site or close enough, lovely gentleman/ handyman. Mother had worked with this gentleman prior to retiring. I worry about both of them daily.

mother is physically in much better physical health than any of us but her mind is similar to a roller coaster and all to often gets stuck on repeat. This past few weeks she is stuck on a grocery list. This is her last freedom. Every other day she buys an enormous amount of tv dinners, ice cream candy bars and cat supplies, ( wet and dry food, litter and 15.00 per box Temptation Cat treats that we can’t get her to stop feeding them as dry food!!
I fear she is going to be close to 0 in her account at the rate she has been going. It is a daily struggle at least 2 phone calls and usually 4-5 per day.