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My mom is an active, independent young 70! She lives alone and passed out at home and we think she fell down the stairs. She suffered a severe concussion and ended up having shoulder replacement surgery. She was discharged from the hospital one week ago and I’m caring for her 24/7. She’s definitely starting to move around and uses the bathroom on her own etc... BUT I’m so paranoid she’s gonna have a fall again! I have my own family, took a leave from my job to care for her, and our youngest son (who is 18) has high functioning autism and still needs me and a regular schedule. I asked her if she would be ok with me hiring a caregiver at night so I can go home (and be here during the day). She initially agreed but then said no the next day; she doesn’t want anyone here she doesn’t know. I’ve explained that this is only temporary; I’m thinking 2 weeks at most but she isn’t budging. How do I handle this?

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You have to do what's best for you and your family first, and if that means hiring an aide to come spend the night with mom, then do it. Mom really doesn't have a say in it anymore, so don't ask her, just tell her that an aide will be starting soon, and that you cannot continue with her 24/7 care. You have to take care of yourself and your family, and be able to get some rest to be able to continue helping mom.

I am needing a shoulder replacement, and was told that I would not be able to move my shoulder/arm for a good 3 months, so moms care will continue for quite a while yet, so please take care of yourself (and your family), and get mom the additional help she will need. Best wishes.
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Medicare pays for an external SNF or facility for 20 days for rehab, in which they would medically monitor her and give her at least three hours/day of intense rehab. She got out a week ago, so if this is the option, you guys should act on it.

If not, the cost of my ILs night time aide is $290/day for 14.5 hours. $2,030/week.
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JoAnn29 Dec 2020
Peggy, Medicare only pays if rehab is warranted. U also have to be in the hospital a certain number of days. My brother just had his shoulder worked on and he is home. PT/OT can be done in the home or out patient.
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I totally agree with funkygrandma on this one. Your family comes first.

Don’t ask but tell her. She is resisting because she knows that she can.

Tell your mom, ‘I am going to sleep at my home, not yours, I have hired help to stay with you.’

She won’t any other choice but to accept it.

When my children were young, I took them to the neighborhood park with their friends to play.

When it was time to leave, I gave them a count down of five minutes.

If my children were resistant to leaving, I got up and started walking towards the car. They would come running behind me.

Give choices for less important issues. Don’t give a choice when there isn’t a choice.

Mom may be resistant. You still have control. She cannot manipulate unless you allow it.

You have been kind and generous. It’s a new day! Mom will get used to it.

My husband’s grandfather would fire his live in caregivers everyday.

The caregivers were told by my father in law to ignore it and continue to stay on the job.

They were paid generously to compensate for his grumpy behavior.

Start looking for help. Tell mom that you found a lovely woman to help.

Warn the caregiver of her resistance. Be extra kind to the caregiver.

I’m sure she is used to dealing with all kinds of personalities! Give her a Christmas bonus!

Good luck!
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I don't know how you can hire a nighttime caregiver for your mother if she refuses to let her in.......right? She can send the person home & say No Thank You, and that ends THAT in a hurry. Therefore, unless I'm missing something here, your mother HAS TO agree to having a nighttime caregiver, otherwise, you can't force one on her. What you can & should do, however, is tell her you can no longer be her personal caregiver, your family needs you.

Why was she not sent to rehab like PeggySue mentioned?

What worries me is why your mother passed out & fell down the stairs in the first place? Did the tests at the hospital determine the cause for such an incident? Did she have a seizure? Is she a big drinker?

In any event, wishing you the best of luck trying to convince your mother she needs a bit more help than SHE thinks she needs!!
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NeedHelpWithMom Dec 2020
Rehab is best! Not sure why not.

I would supply a key! LOL
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I agree with all below. She should be in rehab. And if she will not accept the help you need to tell her that you will have to withdraw your own services and she may have to "go into care" until more healed. I think the problem is that you are asking here, and accepting her answer that no this isn't what she wants. Well, YOU didn't want her to fall and mess up her shoulder, either, but hey, that is life and she did it. If she can't cooperate then you can't participate. Sadly sometimes you have simply to lay down the law.
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I am pretty sure she is high-functioning. I can understand her reluctance to have some stranger wandering about her home while she sleeps - creeps me out too.

You are concerned that she will fall again without anybody there to help her. The fact is that she can fall again after 2 weeks - alone or with somebody there. It would be better to have her evaluated by her doctor to understand her fall risks: medications, needing to toilet in the middle of the night, cardiac problems, mobility problems.... Once you know what probably contributed to the fall, you can address minimizing her risks.

Since she has had a joint replacement, she will need daily physical therapy sessions. It appears that you will not be able to be transport for all those appointments. May I suggest that you set up transportation through the county/province transportation system, Uber or the like. If she needs assistance with bathing, dressing... her insurance will probably cover having home health visits for the period of her recovery.

If none of these can be arranged, her best option may be to go to rehab facility until she has regained optimal function and strength.
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Your Mother has the right to refuse in-home help.

She does not have the right to insist YOU are the home help.

Make this distinction clear.

(I am dealing with same concept).

Does she need to use the stairs at night? Where is the bathroom? Work on improving safety with lighting, no rugs, wellfitting slippers.
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A couple of questions:
Can your mother have a commode next to the bed, so that she doesn’t need to walk to the toilet?
Does your mother know that with low blood pressure, before she gets up to walk, she needs to sit on the side of the bed for five minutes to avoid fainting?
If she does get out of bed, are there things (furniture, rails etc) for her to hang onto?

None of this is great, but if you are seriously stuck they could be better than nothing. At least you’ve tried!
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Your mother can figure this one out for herself.

You are going home, where you are needed, on [date]. She must decide on and source whatever support she thinks she will require after that. Her problem, not yours.
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My mom also had a shoulder replacement at your mom's age, before she got dementia, and she was living in a different town in her own place that also had stairs. She needed the replacement because she was hit by a car and badly fractured her shoulder.

I went and stayed with her for about two and half weeks, and that included her hospital stay.

My mom was very much like caroli, she went to PT outside the home 2 X a week and did exercises at home with the pulley rope. She got good at using the shoulder immobilizer and her biggest complaint was also using the blow dryer.

I was very comfortable leaving after 2.5 weeks.

For your mom I'd be more worried about the possibility of another seizure, when does she see the neurologist? Was she put on any seizure meds?

My mom also developed a seizure disorder following a stroke in later 2016. Her first seizure came when she was back home. She had a fall and was alone, luckily there were no serious injuries. She managed to call a friend after but was so disoriented at the ER she was immediately evaluated for another stroke. Long story short she's been on seizure meds since and there have been no other seizures.

Because of the possibility of a new seizure disorder it might be wise to have your mom in rehab until she is fully cleared to be alone.

Your mom doesn't have dementia, so reason with her. Let her know your son, her grandson, needs you at home.
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I am with caroli1 here. As I responded, my brother, 64, just had rotor cuff surgery. He was home not long after. Therapy can be done in home or out patient. My Mom broke her shoulder. No rehab but once it healed she did have therapy. OPs Mom is only 70. Last place I would want to be is rehab.

I found a while back not to ask, tell. "Mom, I can no longer stay here. I need to get back to work and Tommy needs me. I am a little paranoid about you falling again. I would feel so much better if someone was here during the night." Automately its her decision.

You wouldn't have to hire a CNA. I had a woman who helped with Moms bathing. She was not certified but had experience caring for people. I would say for a nighttime shift where the aide would sleep, maybe $10/15 an hour. At 70 don't think Mom will need Medicaid in the next 5 years so can pay under the table. (please no comments this is done all the time)

Is Moms house set up where there at least is a powder room on the main floor. Maybe set up a twin bed somewhere on the main floor. Its just temporary.
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I suggest you hire the caregiver but start a couple of hours to build a rapport. Respite care at a assisted living facility is another option. Introduction to the caregiver as a companion instead of a caregiver or aide may help with anxiety of having someone unknown in her home. Choose a caregiver that have similar hobbies and interest.
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Just do it. Mom is scared true, but no one can do 24/7 care. For safety sake - so you dont fall asleep and she falls - for your own safety - driving to and from while over tired. Your family needs you too.
She is lucky it will only be for a short time. If you can afford it just get round the clock care - if not at least 12 hours so you can sleep and take care of your own family.
Its called compromise - you are there a lot during day and she has good care the rest of the time.
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Tell your mom that you will not be showing up at night and let it be her choice if she allows a Caregiver or not. Then don't show up at night!

either your mom can get along without Night Help or she'll change her mind and allow a Caregiver.

During the meantime, to give your mind ease at night, install a camera or two and you'll be able to see, hear and even talk to your mom 24 7 any time day or night.

I had my son install the Nest Cameras at my Dad's house and they work great and are easy enough to install.
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It sounds to me as though the problem is with the OP not trusting her mom to be alone more so than with her mother demanding she be there 24/7 - yeah, it's nice to be waited on but it isn't necessarily needed at this point, people who have no family go home alone all the time. She's ambulatory and can use the bathroom without help so IMO she's fine to be without an overnight caregiver (although a little help with meals and daytime tasks would probably be welcome), and hovering around every time she gets up through the night isn't necessarily going to prevent a fall.
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When will your fear go away? I am guessing it won't. You say 2 weeks but your fear will still be fresh.
If she feels confident that she can manage I would let her be on her own. If it would make you fell better ask if you can have cameras installed. That way you can check in and see how she is doing.
You could also get one of the many "alert" services so if she falls help is not far off. (would not help if she is unconscious until she regains consciousness)
If you feel VERY strongly about this then suggest that she go to rehab for a few weeks. But there are problems with that with COVID just as there is the possibility of a caregiver a carrier of COVID.
Make the house as safe as possible. Remove any trip hazards. Place grab bars where necessary. Move items to lower shelves so she does not have to reach to get items she may need while you are not there.
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Imho, your mother is becoming accustomed (perhaps a little too much) to having you there. I would urge you to determine why she passed out (low blood pressure and other things could come in to play). Prayers sent.
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Looks like lots of good suggestions and info. Just wondering though. If your mom is becoming fairly independent now and the main issue is your fear of her falling again why not get a emergency fall button? She can wear it like a necklace or pin it to her clothes. You aren’t going to stop her falling if she gets up for the toilet in the night and you are asleep or if you are in another room. The main thing then is to get help if she falls and needs it. And then you also need to find out why she passed out and fell and take steps to prevent a recurrence. Like sitting on the side of the bed for a minute before she gets up in the night.
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