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I went through something similar and this is what worked for me. Hopefully your Mom has all her finances in order and you are her durable POA. Do a budget for her and factor in a local aide for her. She will balk at the cost but show her it is do-able (hoping it is) and find someone who is a good fit. Since she's used to "being taken care of" she will adjust. Try to validate her feelings but stay firm.
Right now she is lonely and completely on her own - something that she doesn't know how to cope with - yet she is petrified to lose her "independence" and mom boss status. It's normal. Thus, she uses manipulation via guilt. Ask family members to visit and/or call frequently. Have her over for dinner once a week if your schedule allows. Eventually, mom will fall into a new normal.
Whatever you decide to do, put your well being first because the more you start doing for your mother, the more she will expect, and the more you will burn out.
Take one small step at a time. Stay on this site - it's a Godsend!
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STOP IT YOU ARE ENABLING HER. Sorry but you are. You have to look at it this way WHAT IF YOU WEREN'T THERE. I am sorry but that is what it will have to take to make her realize she has to either get help or move to a place.

Please don't put a strain on your marriage you working is the best so that you don't have to give up things.

Prayers.
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I got the same problem...Mom refuses to get rid of useless junk and move in with us. She can't hardly walk, wants us to move in with her, and doesn't understand that she will soon need one on one care. My brother and his wife live close to her, but their caring level is like 5%, my husband and I are doing the other 95%. The only thing I'm learning from all this is....downsize early, get rid of useless clothes and clutter, make your home senior friendly and get ready to hire someone to do all the things you won't be able to do.
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The person who needs help needs to move to where the help is. Period. Not the other way around. A facility or your home (although that is another problem in itself), it’s on them to relocate. Nobody can force you to give up your life to be a caregiver. I would sit down with your mother and tell her you are going back to work and can not continue to care for her the way you have been and then give her options, in home care in her own home, or a facility, or move in with you (if that is something you really think you can handle). If she refuses you have to back away and wait for an event that triggers placement. If she refuses and just stays put with no help then maybe wait a couple of weeks and call APS. Tell them your mother is living alone and is unsafe. They will come out and do a wellness check. From there the dominoes may fall and she may be placed against her will. There is only so much you can do and giving up your own life is not on the list of options.
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Be very clear about what the plan is. Keep telling her you are returning to work(even if its just PRN) and she will have caregivers. Do not move her in with you! Not sure what her age or health is. Get groceries delivered to her door. I used "Mom's Meals" for my mother which is a better quality of food and can be catered to health needs like low sodium. Can your mom use a microwave? Do as much online as you can including ordering house supplies. Get her prescriptions delivered and I requested child proof caps to keep mom out of the pills.
As for the caregivers start out slowly like two days a week or half days & increase as needed. My mom enjoyed a split shift 10-2 & then 5-9p.m. She napped in between.
I changed mom's insurance so she could have a visiting physician. We also use a mobile lab and a mobile Imaging company.
Good luck & do not let her demand your life away.
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You need to stop allowing your mother to take advantage of you. Her choice is between hiring more help or moving to a living situation that provides the level of help she needs.
You do not need to be one of her choices. You do not even need a list of justifications for that decision. You need to stop being he Go To Option.
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Good Morning,

In all honesty I disagree with the response on the tough love because you have to realize that yes some personality characteristics come into play but with dementia and old age the brain is wearing out.

As you said you are an RN so you are well aware of the safety issue but you also know your mother. This things are so hard.

I literally told my mother about 6 years ago pull the car over, give me your keys you are not driving. Mother is/was on Coumadin blood thinner now on Eliquis. I have the responsibility of my mother's safety on the road and ALSO the safety of others.

One morning a week my mother goes to a 4-hour morning respite. Health insurance covers speed and physical therapy and there is a fee for the facility which includes and RN, continental breakfast, hot lunch and most of all supervision. This way here I can to to my doctor's appointment. It had to be done. Transportation is provided but I drive mother to and from.

You could start with that and it may take an emergency with the your mother living alone where is the decision is made for her. Even the nicer neighborhoods word gets out when their is someone vulnerable living alone. Usually the nicest neighbor on the street can have grandson who is not nice. Basically, the elderly need to be protected. You can't be polite and say I don't want to hurt their feelings and they up end being hurt or hurting others.

Just say NO and explain why, hold your mother's hand look into her eyes she is loved, cared for, has a family and a place to live but not alone. Tell her your needs will be provided. Whatever you need we will see that you get it. This does not mean you have to do everything. Call on the troops--I told my mother's pcp that. Speech, VNA, Occupational Therapy, home blood draw, food delivery, cleaning women, Church people bring Communion on a Sunday.

Get Grandma a headset and have her Skype twins on the weekend, everyone will love it. I'm with you sister. You have a great husband, never let him go....
Amen!
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PS I just read that dementia may be part of the picture?

That does change things...
The *denial* can be *Anosognosia* (lack of insight). Look up the care topics for that & see if it fits.

My LO has been dx with this. Appeared selfish asking family to do all, want at beck & call etc. Lacks insight to understand own needs. Says "I can manage" but lacks planning skills to do so.

So reasoning was useless (cannot reason with people who lack reason 😜).
But the Social Worker advise worked.

Each step of accepting 'outside' help was a hard won battle. But now working quite well.

I am calling 'Age in Place', Plan A. When it stops working, Plan B (move to AL) will be arranged.
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Stop.
Just stop doing it all.

Obviously not just 'cold turkey' but as safe as possible.

This is my 3 step plan as advised by a Social Worker for my LO - living alone but definately NOT independantly.

1. ADVISE
Have a good chat.
Make it CLEAR what you can do going forward & won't you can't. If you are going back to work, tell her this.

Advice her if she wishes to 'age in place' she can! Having the right help/support will allow her to age in place longer.

2. LET HER DECIDE
Help her make a list of what she needs help with. Then help her source all the required services eg dog walker, house cleaner, grocery deliveries, meal service, personal care support aide for showers of required. Include transport: Would taxi/uber be safe? Maybe you will keep doing this? Or a paid personal aide drive her?
Mother decides on the services she needs, can afford, what to trial etc.
(Umm.. you may even find the list so long that an entire village of people would be needed to keep her boat afloat. Let that sink in 🤔. For both of you.)

3. CONSEQUENCES
The consequences are hers.

Fired your dog walker?
Pooch may have to live elsewhere.
Refused meal delivery but can no longer cook? Eat toast.
Refused to let the shower aide in? Stay unwashed & undressed that day.

Then you circle back to 1, 2,3 as often as you need.

Tough Love.
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Thank you so much. Hearing it from someone outside of my family makes it sound more sensible.
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InFamilyService Oct 2022
We have all been through the same challenges and its hard. You want the best but cannot be caregiver 24/7.
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Jessica you are a nurse.. you know where this is going. don;t keep running her around to 5 different Drs if you can help it. when my folks moved in I found a Dr who could handle almost all their issues. If you can't,, make as many apts as you can for the same day. I know it's a long day,, but it pays off in the end. If you need to get her home care ,, do it and don't feel bad, and she pays for it!. we got my Dad a "buddy" from his money and it was a blessing. Go back to work so you can keep up your benefits and retirement. I am getting ready to retire and I am so glad I didn;t stop working to care for my parents. ( my hubs did but his job got downsized and I made the "real" money and bennies anyway. Plus my Mom did not have issues,, only Dad) I am wishing you luck here, and stay strong
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By doing everything for her, you are allowing your mother to 'refuse' to do this, that & the other thing. Once she's on her own and SEES what is actually required to live 'independently', she'll realize in short order that she's not capable of doing so. Of course, dementia may prevent such a realization from setting in.........but time will tell, ONLY once you stop enabling her. Dementia causes an elder to become self-centered to the point where nothing & nobody else exists except THEM. They lose all sense of empathy as they become focused only on their own desires 24/7. You're going to have to wait for a crisis to happen that forces mother into managed care from the hospital or rehab. Either that, or you use your POA to place her in a Memory Care ALF against her wishes IF she's been diagnosed with dementia and/or deemed incompetent due to that diagnosis.

If you don't stop doing everything for her, your entire life will be consumed with mother's needs in short order, and it still won't be enough. The reality is, she needs 24/7 care by a team of caregivers now, but the dementia prevents her from seeing the logic of the matter. I hate dementia and dealt with it for years with my mother who died in Feb at 95. She lived in Memory Care AL, thank God, and it was difficult enough for me as it was with her in managed care. I can't tell you how much I STILL had to do with her in MC.

To answer your question & summarize this comment, there is nothing you can do to make your mother understand she cannot live alone. Leave her alone to fend for herself entirely and MAYBE she'll see she needs to move into AL, maybe. It's likely a crisis has to happen in order to force her into managed care, though, that's how it works with the vast majority of elders (including my own parents who were forced into AL after dad fell & broke his hip after refusing to use a walker).

I suggest you read this 33 page booklet (a free download) which has THE best information ever about managing dementia and what to expect with an elder who's been diagnosed with it. It'll give you better insight into how your mom thinks nowadays.

Understanding the Dementia Experience, by Jennifer Ghent-Fuller 
https://www.smashwords.com/books/view/210580

Jennifer is a nurse who worked for many years as an educator and counsellor for people with dementia and their families, as well as others in caring roles. She addresses the emotional and grief issues in the contexts in which they arise for families living with dementia.

The full copy of her book is available here:
https://www.amazon.com/Thoughtful-Dementia-Care-Understanding-Experience/dp/B09WN439CC/ref=sr_1_2?crid=2E7WWE9X5UFXR&keywords=jennifer+ghent+fuller+books&qid=1657468364&sprefix=jennifer+ghent%2Caps%2C631&sr=8-2


Wishing you the best of luck with a very difficult situation.
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JessicaNfl Oct 2022
Thank you. Everything you said is true. And it makes me feel better about myself and not some ungrateful, selfish daughter.
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You are enabling her. As long as you prop her up she has the appearance of independent living. Back off. Let her fail so to speak. She might realize she needs more care or she ends up in the ER and you tell them that she lives alone and it is an unsafe discharge. Go back to work. You can't afford to jeopardize your own future to appease your mom's stubbornness.
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PatienceSD Oct 2022
This is nearly impossible when it’s your mother. We have a sense of responsibility, there is no reason to “teach” a grown woman. It takes the ability to communicate and sometimes that’s difficult with your mother who has been the teacher of her children and doesn’t recognize the changeover.
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As long as you jump when she orders she will continue to not cooperate.
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Please consider that dementia is causing her to become someone you don't like anymore. It may not have been your step-dad's doing. Maybe he didn't realize she was sliding into cognitive impairment so he just did the best he could.

Are you or your sister her PoA? If so, this person needs to read the document to see when their legal authority to act on her behalf kicks in.

Her "urgent needs" and demands do not dictate whether you should jump to react. Right now the most important thing may be to get her in for a check-up to see if her symptoms are being caused by other treatable ailments, like a UTI, dehydration, vitamin deficiency, thyroid problem, over- or under-medication of any meds (OTC or prescription), stroke, tumor, etc. Most of the time dementia is only diagnosed after all other problems are tested and discounted.

Once you know what you're dealing with, then you can start thinking about longer-term solutions. Please think long and hard about inisisting she live with you... if it is dementia she will only get worse and need more and more personal care and oversight, and most likely become more difficult to deal with as she continues to lose her abilities of reason, logic and empathy. Also, she will require hygiene attention and may not be cooperative. She may become incontinent and lose her mobility.. is your home ADA compliant? I'm not saying to not take her in, but there will be responders who have "been there, done that" giving you sage advice from actual experience, so please ponder it very carefully and realistically.

You will not be able to work and care for her very easily. There will be a time when she won't be able to be left alone for any length of time in your home. And, there is a price to pay in your marriage and children. Please remember they are a priority over your mother's care. It may boil down to the "least bad option". I wish you much success in working through this challenge.
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Keep up the good work! NO, NO, NO! is your answer! She could have a UTI or she needs to have a neurological test to check her mental capability. I had this done with my Daddy and it put me on the track. When he was in an agreeable mood I had my name put on everything. I had him resign from his trust. It all took time but let me tell you an elder attorney is the best money you will ever spend! My Daddy declined so fast that my siblings did not see it because they did not live with him. I saw it coming, I noticed the change and just reading about your situation you need to start the ball rolling now. Make sure she is in an agreeable mood and find out about her POA situation, Trust, etc. No one tells us these things but let me tell you starting now will help you in the future!
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Your mother will not consider help other than you as long as you continue to be all the help. Harsh as it may sound it will take you backing off and refusing to jump at her demands for her to see that she cannot cope on her own. And please reconsider believing that moving a demanding person with many needs into your home is a good idea, it would likely ruin your home and relationships. Go back to work, leave mom to it, tell her your income is needed, and she needs to find other help. Don’t continue a pattern of being all the help, it’s not sustainable without great cost to your health and well being. When mom sees she’s unable to make it, hire in home help for her or arrange her move to assisted living. Feel no guilt, it’s okay to be sad that it can’t be different or better, but guilt is for those who’ve done something wrong and you haven’t, you’ve simply been placed in an impossibly hard place and need another plan
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