<p>I agree with jym626 about you checking out the ALs yourself, and then taking your mom to see the best 2. that’s what I did with my mom. I narrowed down the choices for her on my own, took her to visit the finalists, and let her decide which one she preferred.</p>
<p>Dharma, I was in a similar situation when trying to physically get my mother out of her home and into AL. She too gave mixed messages; yes one day (usually to those outside of the family) and then no to me the next day. The professionals can try to help you “convince” her but don’t really have the power to make it happen and she knows it. If she doesn’t voluntarily agree, the only way (in my mind) to make it happen is to have her declared mentally incompetent. Perhaps the caseworker can verify your options in this case and provide concrete suggestions as to how to get her physically out of the house. I’d also make sure your sister is on the same page before you enact your plan as your mother may call her for help. Your sister could hopefully reinforce that neither of you are going to support her at home any longer and that her choices are facility X or Y. If she still refuses, there may be some uncomfortable weeks where she can’t go to appointments or grocery shop because you are no longer doing it. You will have to stay strong and not give in. Let all the professionals know you are no longer supporting her at home in case they get calls. </p>
<p>In the end, I had to go with the mentally incompetent route. It was awful for her and me and I would avoid it if possible. It did work though and after a few months of not talking to me, she assimilated and acted as though it never happened (thank goodness for memory loss!) I sense what a hard time this is for you. It was the most stressful time in my life up to that point. Keep remembering that what you are doing is in her best interest. </p>
<p>Shellfellwhen I started making plans,I did not think three was unreasonable. Others (much younger,importantly) have seen many more. But, in our case, two would have been better,as you say. We already saw one. We will see two this wk, tomorrow and Fri. </p>
<p>Oldmom, the eldercare laws change on 1/1/15 and she cannot pay the higher prices by any possible stretch of the imagination. So it is no longer"spend down and go to NS" With the new laws,her assets will run out in months and the loss on the RM would be a disaster. The house must be sold at or slightly below market price…The only choice is AL. Actually I thought I was paraphrasing you in a way that just spoke to me more clearly–“starving her out,” “cut off her lifeline”.I thought I was simply paraphrasing what you were saying. I was trying to echo what you were saying which was essentially, step out of her life. So sorry if we misunderstood; I don’t know what I did wrong for you to say "you will never escape if you continue to look at it that way."IF she calls me to cancel her AL visits this week, I will cut her off entirely and refer to the people jym refererred me too. I read the whole page and nearly every link and though my husband says No (we just talked about it), I am prepared to take that step. </p>
<p>I drove both caregivers to and from the train station this evening (caregiver took the wkend off and found a wonderful substitute–how I admire these woman who live and work hard),and I waited in the car for them outside the house and did not go in the house. Let my mother think about that.</p>
<p>I appreciate so much the kindness and quite astonishing good, highly intelligent advice (so many remarkably helpful links…and I know it takes an effort to find and post them!) from remarkable people I have met here. Please forgive me for hogging the board. I am not quite right. When we went to the piano lesson this morning, seeing the teacher whom I have known and loved for 10 years spontaneously made me cry and cry in her arms. I collected myself and gave her a few,concise concrete details, and simply said that seeing a sympathetic friend unleashed my emotions. xxx Dharmawheel.</p>
<p>LF- I get your questions and am responding In the context of my experience. Once I had brought my elderly parents to a Drs appointment and been privy to a medical update while there with the parent, plus had office paperwork complete, Drs continued to be willing to check in with me and respond to my infrequent, but salient calls. Additionally, some notified me of changes in health status, providing recommendations (there was never anything contentious going on) including that my competent but frail mother, then out of state from me, needed assisted living plus. </p>
<p>The communication was focussed on best interest of the patient, not any other agendas. This varies by individual physician, but over the course of 15 years of elder management, I found Drs. quite responsive in my state and my parent’s state to the involvement of their children. They broke me into the nature of the communication that worked for them and it made a lot of difference over time. This is different then signing forms that discontinue care or signing off on a specific medical procedure, which likely requires a higher, legal authority. It is organic and evolves over time, in keeping with more broadly written parameters. </p>
<p>Additionally, many health care providers could choose to listen to family members concerns while sharing no personal patient information, though in some cases that is contraindicated and the professional may opt out. </p>
<p>Best with it all Dharmawheel. It is not clear to me that your mother would test out as competent based only on my very removed position of reading your posts. YMMV. She is inconsistent, misunderstands regularly and uses very poor judgment. She will likely not be able to hang onto any decision or rationale over time, regardless of whether it comes from you or an “expert”. She blows in the breeze, up and down. Try re-framing her going to AL as compassionate. If you can’t see it that way, all the wisdom shared here won’t help. You have parented a long time. This is similar. If you believe AL is best, walk her through it, towards the proper outcome with confidence and few words. Otherwise, you live for your mother’s whims first and foremost, while enabling her to fall victim to her limitations. It is a very personal choice. We are all well-meaning here, but we may not get what compels you to rely on convincing your mother fully to own this decision in its entirety, despite apparent evidence that this is beyond her. </p>
<p>Travelnut, I am still on line and was so touched to read your understanding (especially about the MDs) compasionate post. The point that I–I am sure to the frustration to many- do not get is this; how to " we may not get what compels you to rely on convincing your mother fully to own this decision in its entirety."I do not get that all all. She is hostile and speakis to me viciously that she will not go. I do not know how to compel her to AL without, hopefully, a profesional’s persuasion, or–if worst comes to worst–a legal intervention. </p>
<p>You wrote such a kind, empathetic note–thank you. </p>
<p>In 1961, my mother was diagnosed with severe bi-polar disorder and over the years of my (and younger sister,of course) was often ill, and over the years of reading and learning, I am sure beyond a doubt that she suffers from Narcissistic Personality Disorder and quite possibly because of her outrageous behavior and absence of friends who can "cope"with her, and other factors, borderline personality. I have tried here to give her credit where it was due. She overcame alcoholism which I think is a profound achievement. Until a few months ago, she was able to maintain all her bank info and bills,MD appts and shopping and cooking (with my help). But myself? I believe that by the way I know she behaves in private (mostly with me in her bizarre remarks and observations) she is eligible to be assigned a “guardianship.” She is so skilled talking to her shrink,I think he will disagree. We will see how the next two AL visits go. If she speaks vile words against them, I will need her MDs and other professional assistance.</p>
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<p>No, it’s a fair question. You do it by leaving her no other choice. </p>
<p>How do you leave her no other choice?</p>
<p>You say, “Mom, after X date (soon), I will no longer be able to do all the work involved in keeping you at home.” (NOTE: Do not get embroiled in a discussion about why. Simply state it as fact, repeatedly if necessary.) Then say, “After X date, you need to either be in AL, or you need to have found someone else to manage all of this.”</p>
<p>And then, without further discussion, you leave her alone to ponder that.</p>
<p>After a few days, you can ask her, “Remember I told you the other day that I can’t do this any more after X date. What steps have you taken to find someone to take over for me? [None] Then you might want to talk to the lawyer about finding someone.”</p>
<p>Of course, the key to this is that she has to believe you mean it. So you really do have to mean it.</p>
<p>ETA – Actually, oldmom put it better (and more succinctly):</p>
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<p>Bottom line, at some point you are going to have to tell your mother she cannot have what she wants. Period. And you’re no doubt going to have to endure some nasty words as a result. (She cannot physically harm you if you stay out of arms’ reach.) Can you do that?</p>
<p>I really should think before I hit “Post.” :)</p>
<p>You can start the process now. For example, the next time there is any kind of issue with the aide – payroll, scheduling, a form to fill out, a call to return, anything – send her to your mother. In fact, why don’t you dump the $1000-fee problem in her lap??? “Not sure what needs to be done, Mom, but here’s a phone number.”</p>
<p>I’m not clear if the RM is underway, but if it is, send all calls and forms to your mother. </p>
<p>Next time she needs groceries, tell her that she will need to find someone to do that – “Perhaps the teenager down the street would do it? I don’t know, you can call him…No, I don’t have his number, you’ll have to find that…No, I’m not going to find someone to do it for you. This is part of staying at home, and you will need to manage it.” </p>
<p>In other words, let her start taking some responsibility for her “decision” and see how she likes it.</p>
<p>Dharma, when your mother or the caregiver asks for a ride to the station: “Oh, sorry Mom, I can’t do that, I have something else then.” (Do not elaborate. You can’t do it. End of story.)</p>
<p>When a problem comes up with the payroll people: “Oh, sorry. I can’t handle that issue. Call Mom.” (Do not elaborate. You can’t do it. End of story.)</p>
<p>When your mother thinks she needs groceries: “Oh, sorry. I can’t fit that in my schedule. If you give me a list, I can buy things <a week=”" from="" now="">."</a></p><a week="" from="" now="">
<p>If your mother is hostile, leave or hang up the phone. You don’t have to listen to abuse, and you shouldn’t.</p>
<p>You are enabling the decision you don’t like. </p>
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<p>There’s a psychological concept that people understand and respond better to things phrased in the positive. Maybe not, “No, you have to,” but, “Oh, it’s such a nice idea, you were excited about it last week.” No offense, no defense. No exposing your emotions. Can disarm.</p>
<p>Agree that a positive response is preferable. And perhaps easier for dharma to do. Saying something like "I am available on <<<xxxx>>>> to help you with that. Or “I can’t do XXX but I can do YYY”. </xxxx></p>
<p>This is also why it was preferable to have a caregiver who drives. But moot at this point. and also, with respect to the AL, if mom carries on, saying “I am sorry you feel that way, but this is what we need to do. You cannot afford to stay in the house any more” is sufficient. </p>
<p>As I wrote yesterday, I did not go into the house when taxing the caregivers. I waited in the car. Point one. But in the scenarios you advise above and which I will put into action, please advise me on some fine tuning. Unless she reverses, we are visiting two ALs this wk. A good sign. should I do her grocery shopping this wk (as a "reward for agreeing to go) or tell her to get a taxi for the caregiver to go? In other words, be easy on her this wk, but if after Fridays visit, if she refuses all three ALs, go on strike Saturday? Ar 2 am I was pondering whether to get her groceries by taxi this wk, or remain "friends "and cordial and wait to see how she responds to one or both of the ALs?</p>
<p>LasMa, the rev mort idea was abandoned when at the lawyers she “agreed” to AL. We said instead we would simply sell the house asap.</p>
<p>She can’t do the math. I doubt she’ll connect her behavior with the reward. Especially not days later. It helps to think of all this as dealing with a young child- but the difference is, children are growing, learning to put 2 and 2 together. In some respects, because she’s volatile, this isn’t about positive reinforcement, but disarming the negative behavior. Plus, grocery shopping is yet another task for you.</p>
<p>Hugs @dharmawheel I know you are anticipating a tough week. Thick skin.</p>
<p>Give yourself the time and attention to build yourself up emotionally.</p>
<p>Practice the no answer and actions. Prepare for some canned standard answers.</p>
<p>Do not involve your daughter in AL visits - it just will open the door for your master manipulating mother to jerk you and your daughter around some more.</p>
<p>Use the resources around you to be supportive in the move for your mom to go to AL.</p>
<p>Deal with the wrongs on the caregivers pay situation after mom gets moved to AL, or at least committed to AL.</p>
<p>Remember to give your DD the attention on the college application/visit process.</p>
<p>Glad to hear the RM has been abandoned, Dharma. Then I’m not sure I understand. It’s a done deal. She’s moving. She’s apprehensive, which is understandable. Just be matter of fact with her. Ignore her outbursts. </p>
<p>Honestly, while it is kind to try to be supportive of the caregiver, the “finders fee” is between the caregiver and the agency. It stinks, for sure, for them to double dip. But its their issue.</p>
<p>Dharma,
Have you done any research on NPD (Narcissistic Personality Disorder)? You say that you suspect that your Mom has NPD and also other personality disorders (BP). If this is the case, then it explains her behavior completely as NPD people are not like other people. And they can be truly toxic and master manipulators. </p>
<p>Boundaries. Boundaries. Boundaries. They are the only way to deal with a person like this. </p>
<p>I think that Pea Pod from Stop and Shop may deliver to your area. I finally set this up over a year ago with my Aunt because she played the same game as your mom. I used to take her to the grocery store, (because no one but her could pick out the right meat, fruit, etc.) It was excruciatiing, long and also had to deal with her very nasty comments. When she came home from rehab after her stroke, I put my foot down and said Pea Pod! When she complained about the order, I would not answer her. I also switched her over to pharmacy mail order. I still do the ordering and oversee things, but it is much easier for me and I can do this long distance as well. Good luck today.</p>
<p>I get what you’re dealing with- and think you want to know, in the end, that you tried to be a good daughter. It’s what my mother dealt with, with her own mother, for her whole life. </p>
<p>These situations get complicated when one is volatile and there’s a history. Dharma, you are a good daughter. Take a breath and realize you are. Give yourself that credit. Feel it. You’re going to have to find that pat on the back from within yourself. It may never come from your mother. Let your therapist help with that.</p>
<p>Then, you look for strategy that meets her needs and your own. I’d try smiling, having the right tone in your voice, patting her arm: “You were excited, they will take wonderful care of you.” Tell her you and the girls will be there, let her visualize you coming to share dinner. I’d suggest initially, see if you can pay the nice Polish aide to come visit, for coffee and chat a few times, to maintain the continuity, ease the transition. Make it feel viable, safe and with comforts. Let her feel like she’s still the queen bee. No arguments, no defense, just say it and hear nothing else. It’s a form of Sales 101 (or the concept of Getting to Yes.)</p>
<p>For now, set aside taxi money for the aide to take her on errands or for coffee. (Part of her fussing may be boredom, let the aide handle this.) </p>
<p>DW- I understand that you are in a situation that is extremely complex and very worrisome. If your mother’s situation is to be viable, she will have to get out of her house and move to a care facility. This may be smoother than you fear if you keep things moving in a positive direction and limit your contact with her when she is “off track”, all in a matter of fact, not punitive way. In another words, you have a power now that you did not have as a vulnerable kid with a mother who struggled to make sense. </p>
<p>I have a background that put me in contact with many people with similarities to your mother; your description is not abstract to me. Such people are so difficult, that family members and professionals tip-toe around their rage, and children usually try to placate them out of fear. Such people can not be consistently pleased, no matter what one does. They take their discomfort in their own skin and hand out to others instead of dealing with it internally. Now she elderly and weak. Not a big chance of any constructive change on her part. As you have information about your mother’s current functioning that would paint a broader picture to her Dr/s, it does make sense to share it prior to the visits. Financial realities are not trivial either. As others say, good to keep sister on board. For yourself, I would suggest keeping a running, brief list of examples of cognitive decline or inconsistencies with your mother, hoping you will only need to use it to get appropriate care. If you ever need it, formal cognitive testing could be done to determine her status also. </p>
<p>As to rewards for visiting or behaving, I would avoid it. Like others have said, she is unlikely to keep this all in her head and behave rationally. Additionally, it sends a message that the visits are something to be endured, a problem, or done for you, not as an opportunity for her. Best if you can behave as if it is a privilege to go to these places and as if you have the expectation of positive experiences ahead, even though right now it is a big change for everyone. You will do with her and for her what works and makes sense to you- regardless of her behavior. Keep it positive, focused and unemotional. Don’t engage in her drama, shrug and state something positive, then move on or leave. Win an Oscar for your performance. I know it is hard! There is a light at the end of the tunnel. </p>
<p>You are getting really good insight and suggestions here this morning, Dharma. </p>