Am I allowed to just ask you all something, and will you understand? Tell me if this happened to you.

If, after you get a firm diagnosis from a specialist, there is a dementia going on, here is a video that will give you an idea of what could be happening to your mother. It is called, "Common Issues with Dementia".


It's about 10 minutes long, and is a good introduction.
https://www.youtube.com/watch?v=u5QMeQpkPhA&list=PLq77KZF7Pi1R-bHg7OjshZq3iGIz73UIa&index=3

My mother was 78 when her dementia really began to take hold.

Best wishes to you.

Plantlady, your post said “I am not legally her POA but ye, I am all she has”. Right now, she is mentally competent and compliant, and a POA is not necessary. When and if all that changes, you may need a POA and mother may not be able to sign it. This is the time to get the paperwork in order, no matter what else you decide to do.

Hi Plantlady
I posted on different things that might cause the malaise and realized I still didn’t answer your question.

And it’s a really good question IMHO.

First check her for a UTI which can be a big problem that may be why you are seeing rudeness but more importantly can be toxic. Insist she be tested even though she may not have urgency or burning. Urgent cares are easy ways to get this done. during COVID they will sometimes allow you to bring the urine in for the test.

I would take her to specialist on the different issues she has. Not for strenuous procedures but to know that there aren’t things being missed, better meds available for her condition and that she is basically doing the best she can given her comorbidities. Ask each specialist for a recommendation for a geriatric primary or internal Med doctor that works well with elders. Then choose one as her ongoing primary.

She needs to see a cardiologist and a neurologist. While you are waiting for the appointments try to keep a daily log of her O2, BS, BP and temp. Weight at least once a week unless she has CHF then daily after peeing. Also log her hours of sleep.

Make the appointments in the city where you have the best medical care. I see your town is in Pa. I’m not familiar with Pa but there is probably a good teaching hospital in the city or one rated the highest for your moms conditions. I took my mom three hours away as was her preference. We saw all her doctors once a year on the same day. You can arrange that when you make the appointments. Most offices will work with you when you explain. I never had a problem. I worked with a HHA (home health agency). They came weekly to set up meds, help with baths, PT/OT. Have one picked out that you have checked on or used in the past and then you can give the doctors the name of the HHA you want to use. They will fax orders to them and you can manage her care from your home. Telemed is great these days for follow up.

There are many things that can cause her condition. Start with where you already know there are issues. If you can get copies of her medical record from the hospital to take with that is also helpful.

If she is not eating and staying in bed too much she will be a fall risk. You could ask her current primary to order her HH now and they can go ahead and get started. Ask for a PT evaluation as well. Tell your primary you need help managing her care. See how much push back you get. She should qualify as a homebound patient needing intermittent care under Part B of her Medicare. If the primary doesn’t want to order then you will have more incentive to find someone more accustomed to working with the elderly.
Not knocking your doctor but sometimes it is good to look around. Sometimes you find a better one. Sometimes you might realize you have a good one already by comparison.

PlantLady,   I think another factor that I read in your profile bears heavily on your mother's situation:  You wrote that your mother moved in with you after your sister committed suicide.  That must have been so traumatic, for her, you and anyone else in the family.  

That could still be weighing heavily on your mother's mind.   She may wonder if there was something lacking in her care of your sister, if she was a contributing factor, and importantly, if there was anything that could have been done differently.    Regardless of other and independent factors, that can haunt some for years afterward, and may be the reason why sleep is so necessary for her.  It can be an escape, and perhaps that's what she needs.

Has she ever raised the issue with you, so that she could air her feelings?  

You're obviously still active in your field.  Have you tried to "bring" your mother into that environment, sharing with her the challenges and rewards of working with plants?   Do you share nonprivileged information with her about your day, such as plants for the greenhouse, advertising issues, moving with the season and changing plants, investigating new ones, as well as how to best market your greenhouse's services?

Was your mother a gardener?  If so what kind of gardens did she plant?  

Are you familiar with the concept of "forest bathing"?   If not, it's worth exploring.  It addresses the calming, soothing and nourishing effects of forests, plants, trees, and that kind of environment.

I don't think your mother is going to respond to negative treatment or suggestions as some have made here,  and I'm just guessing, but I do think that you could build bridges by bringing her into YOUR daily life.  Ask her opinion; give her garden catalogues to review, let her help participate in your current life.

As my parents became less mobile, I began bringing flowers to them every time I visited their home.  Mom loved carnations; I found a good source, and brought different colored ones every time.   Both were gardeners as well, so I focused on that.  Even looking at gardening magazines and catalogues was inspiring.  

My father also kept busy and interested in life by continuing to read woodworking magazines.  I was surprised when I began going through his magazine stash after his death and found calculations that even with several math courses were beyond me.    This was when he was well up into his 90's!   He also read magazines and books; all of my family did.

Do you think your mother would perk up if you asked her to participate in your work functions, such as reading and commenting on magazines for indoor gardening?  You could start just by leaving some tempting gardening magazines or catalogues in her room.   (It may be that she sleeps not just b/c she's tired and aging, but b/c she doesn't have interesting activities to prompt and motivate her.)

Another poster has with my suggestion bought a subscription to the British magazine, English Gardens, filled with stunning pictures of beautiful gardens, with some features that are definitely for estates, but others that could be modified for less extensive real estate.   Fine Gardening and Country Gardens are also inspiring; most of mine are filled with comments and sketches I've made while reading the magazine.   And I think of new configurations every time I reread a magazine.

That might stimulate your mother, especially if you discuss her thoughts and comments.   You could also create your own indoor garden with artificial plants and flowers, giving her something of her own to care for and rearrange.  As I inevitably grew older and less physically flexible, I began to switch to artificial flowers. Every morning when I wake up, I see vining roses tumbling from milk glass vases.  It's a beautiful thing to wake up to flowers, and these don't require any care except dusting.

Burnt caregiver gave good advice-start with that . Then perhaps move into outings - do you belong to a church ? That would be good for a start of so. Also nature can be helpful for depression .. who wouldn’t be depressed without stimulation of being out and about - which becomes a vicious circle . Does she have any old friends or em relatives nearby to visit with? If these aren’t possible sometimes there are senior centers or libraries with free programs for elderly . Or some senior living places have respite care or daycare which have activities depending on covid issues unfortunately .

Your mom should see her doctor and have her checked out to make sure her meds are right and her health conditions are being managed.
If that all checks out show her some tough love because this is what she needs. She doesn't need a nursing home. Tell her that your house is not a nursing home or a hospice facility and will not be turned into one for her. That if she just wants to stay in bed and die, then she can do it in a nursing home or hospice facility.
You have to insist that she wash up and get dressed every day. Meals are taken at the table and not in the bedroom or in front of the tv. Then insist that she take a short walk with you every day. If she can't do that then take a drive. Slowly she will come around to where she'd probably enjoy going to adult day care of your area's senior center. She needs some tough love from you though. If she's able to do for herself in any way, she must be forced to do for herself.
I've been in elder homecare for many years. I've had clients who became homebound not because of sickness, or dementia, or mobility issues. One day of staying in the house ran into the next, then they become depressed and afraid to go out even when there was no reason preventing it.
You have to start off slow. Little things like making them get washed and dressed every day and meals at the table. Even if you have to demand. When mom gets rude to you, give it right back to her. Do not tolerate that for a minute.
Your home is not a nursing home and will not be turned into one by your mother. This has to be at the forefront of your mind at all times to help your mother. If you have to make a big sign for her room that reads, 'THIS IS NOT A NURSING HOME' then do it.
Then maybe down the road get her a paid companion to take her out a couple times a week. It would be good for you both to have a break from each other.
You have to stay strong for her. She may get angry and resent you for a while for it, but you'll be doing her a favor. She'll come around.

A couple of things....it sounds as though she does have a few medical issues that tend to be more problematic with age. Management of diabetes often starts with medication and checking HgbA1C (measures the average blood sugar over the past 3 months) and the actual fasting blood sugar can be elevated and the HgbA1c is in the acceptable range. The blood thinner suggests that she has had problems with her blood clotting too easily - and those little clots have likely been a factor in accelerating the age of her brain. All of our body systems get tired out with age, no matter the lifestyle of the person.
While it would be great if your mom were to see a counselor, my guess is that she won't see it that way!
With COVID, seeing a counselor on line is easy, and one who has experience supporting families who are providing eldercare could be very helpful.
Check with the local hospital about support groups, check with the local Council on Aging about support groups - having some familiar faces and the chance to get support from them could help you gauge where you are in the caregiving journey.
Also, look into the concept of palliative care. It is not the same as hospice. It is focused on quality of life, not quantity of life.
Take whatever works, and know that you are doing a great job with your mom. No matter how she responds.

It sounds like she could benefit from a light anti-depressant. Find a geriatric psychiatrist for an appointment. She could benefit from counseling too. Even though many work virtually, in-person sessions are more impactful.

Take her on outings. When you go for those labs get “fancy” carry out. Something different, fun. You can play music in the car which matches the food. Park in a beautiful spot or a place that fits the food’s theme for a special “Car Picnic.”

I found nature and music helped immensely. Flowers, birds, beautiful art. Get away from the electronics, the traffic and crowds.

She may suffer from feelings of uselessness - if this may be possible, ask her for advice. Tell her you need her help. Assign her small tasks around the home.

Put away the cell phone and dust off the checkers or playing cards.

Get her moving around to increase her energy.

I am so sad that you and your Mom cannot have an honest talk about how she feels. When my Dad was in his early 90s he began to TRY to stay in bed later in a.m., and to have long naps and go to bed early. My Mom worried and worried the whole thing, and had him on the scale every a.m. as well. What was the POINT? They were life-long lovers and I didn't meddle in any of it until one a.m. I knew Mom impatient for breakfast and I went in and sat on the bed beside my Dad. He told me all about how hard it was, how tired he was, and how ready, will, but unable to die. He said he tried so hard for my Mom, but he longed only for sleep. As a nurse, patients shared this with me over and over and said they could NOT share it with family who simply would NOT hear them. I think that is, as I said, TERRIBLY sad.
Let your Mom rest. Don't become her Mom. You are still, whether you can understand this or not, her daughter. You really have no right to tell her how she "should" live her life, and in all truth, I wish the word "should" were removed from our lexicon.
You are a loving daughter. I understand that, because NO ONE could have ever loved anyone more than my Mom loved my Dad. But................................
Talk with your Mom. Sit in bed with a cup of tea and LISTEN to her. In all our talks my Dad told me the worst thing he did in his life, the thing he could never forgive himself for. Would that his worst were the worst any human ever did. He shared so much with me.
My heart goes out to you, but it goes out more to your Mom. I think you don't mention her age, unless I missed it, but I am 80, and GIRL, we get SO tired. I love your on line name. I hope you both take care. And yes, caregiving is the hardest thing you will EVER do. I would be incapable of it, myself, to do inhome. So you have my admiration.

Hi:

How long does this last? If only during the winter months, she could be suffering from Seasonal Affective Disorder, SAD. Very common for this time of year,

You are not taking as good care of her as you think. You are sounding burnt out from constant wanting her to do this or that. In a facility, there are many good ones, she will have the opportunity for stimulation and to establish frienships. Are you cheating her of that? What would you have her do while you work? Be grateful she doesn't bother you while work, she sleeps instead which must be helpful.

If she's had strokes and blood flow issues, she may be affected by vascular dementia. My Mom has it and sleeps a LOT! does she have a problem with solving problems or deciding what to do next in a sequential process? Mood changes?
Also, is it depression or could it be that the part of her brain that "cares" about doing things is no longer working?

Poor old Mom has a quite a few health issues going on, doesn't she.

As a natural nurturer, I can see why you want to take care of your Mom & ensure you are doing things right. I can understand the frustration when a medical checkup report is *fine* (but you can see she is not). "Breathing? Yes, BP, ok - all good then". But I can also see the other side - there really isn't much that can be done for *old age*. She's just wearing out.

I feel like this is where you are. Starting to grieve for your Mom, for having lost the younger, active Mom you had, losing hope for her future? 🙁

Maybe refocus on *here*. Don't worry too much about 'nursing' duties. Be her loving daughter & keep up the hugs.

Have you read the book 'Being Mortal: Medicine and What Matters in the End' by Atul Gawande? I really recommend it.

PS you are allowed to ask or write anything you like 🤗

I'm going to post some helpful info from your profile:

- mother is 83 years old, living in my home with age-related decline, depression, diabetes, heart disease, and sleep disorder.

- mother moved in with us in 2011, just after my sister committed suicide. My mom was active, now she is not.

Is she actually being treated for her depression? Is she staying compliant with her diabetes treatment? You say she doesn't go to her labs, so without accurate diagnosis I'm not sure how we can help you -- we need more info and she needs an accurate diagnosis. At 83 it is totally possible she is starting to have dementia.

Are you her PoA? If not, is anyone? Time is running out for her to create this legal protection, especially if you wish to continue to help her in any capacity. I agree that 9 years is a long time to care for someone, and it won't get any less challenging. First you she will need a diagnosis and then stay compliant with any meds she is prescribed. Then after that if her behavior doesn't change you will need to consider she has age related decline and must discuss with her where this all seems to be going and what more you're willing to do, if anything.