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I have posted here before just to vent or for advice and I am back again with an update. Mom fell in SNF a month ago and broke her arm, but is not adhering to rehab schedule. She has been seen by her orthopedist, GP, nurses, social worker, PT/OT staff and dietician. Since her pain and nausea have subsided, all have agreed that there is no reason why she should not be eating or following her therapy schedule. Mom is only eating 30% of meals, hardly drinks and lays in bed most of the time. Just this past week she has begun to get out of bed and do minimal therapy. She is on 6 protein shakes a day and the GP has ordered an appetite stimulant. Today when I spoke with Mom she repeated how she does not like it there and that the Nurses' Aides as not gentle enough. Then she pleaded with me to not let her die in there. Already she has lost 15 lbs. and I think she may be starving herself to death. Reason: She wants to live with my husband and I instead of in her private room in a 5-star continuing care community with every imaginable amenity with Medicaid footing the bill. For a multitude of reasons, Mom cannot live with us, e.g. many chronic healthcare conditions, med management, bathing, dressing, etc. as well as the fact that she has always been abusive, manipulative and narcissistic. Before the fall, she was getting around fine with her walker and eating very well. I am on the phone with her1-3x/week to lift her spirits and visit every other week to check in on her, take her snacks, clothes, meet with staff, etc. We have taken her on a couple of outings, but now there is no chance of that. Has anyone else out there experienced a similar situation?

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Visited again with Mom today and she is adhering to PT and OT therapy with improved eating. Thanks for all for your support and compassion. :)
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You call her once to three times a week and visit ever other week. Couldn't you call her more often, if more frequent visits are not possible? She's old and lonely...even narcissists get lonely.
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Wants to feel loved & important is my quick guess.

"She wants to live with my husband and I instead of in her private room in a 5-star continuing care community with every imaginable amenity with Medicaid footing the bill". .

Shes cares NOTHING about the practicalities- the money, the bills, how hard it would be for you.

If family takes her in it is because they love her THAT much (would be my guess to her thinking).

If this is possible for you, let her know how loved & special she is. The most amazing, loving Mother that anyone had. Or, to be more realistic, simply Thank Her. Thank her for being your Mother.

This is the final task of life, according to Erikson’s 8 Stages of Development :
Older adulthood – Integrity versus despair.
To be at peace & to have felt our life was useful.

By being a beloved Mother, that is her payoff. Currently she may be heading to despair.

You could arrange a Councellor to talk to Mother instead, if you preferred. I've seen this turn in a day. Oh woe is me, my family won't take me - to - I've had a good life, I was a good parent, I am better off here being cared for, I have chosen not to be a burden on my family. I feel at peace now.
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MissGypsy Sep 2022
Thank you for your insight. Yes, feeling loved and special is so important and that is why I make it a point to tell her every time we speak that I love her and remind her of the good times we have had over the years.
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I know that this isn’t “compassionate”, but honestly, if she “may be starving herself to death”, perhaps you just accept it. She isn’t happy, and nothing that’s possible is going to make her happy. If that’s her choice (instead of rehab and doctor’s orders), you may have to let her go that way. Just fading away has been the choice for many older people over many many years.
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MissGypsy Sep 2022
You have a good point here, but I guess it is hard for me to accept. That's where the "Serenity Prayer" is most helpful. I need to find some peace with all of this...thanks for your input.
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I would love to know what state you are in with such great Medicaid coverage. We are in Washington and my 93 year old mother is on Medicaid in a memory care, and she pays for her half, and it is pretty basic care. Maybe we need to move!
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MissGypsy Sep 2022
We are in Pennsylvania. My mother's only contribution is her SS check each month out of which she gets to keep $45.00/month for clothing, shoes, snacks, etc. Of course, my husband and I help by supplementing, but she doesn't need much! And my aunt is in a different SNF but in memory care, also PA, and it's the same Medicaid coverage as my Mom.
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Is your Mom in Rehab with Medicare footing the bill? If so, if she does not cooperate, Medicare will have her discharged. Then she will return to the care facility you have her in.
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MissGypsy Sep 2022
Hi JoAnn,

She's doing rehab at the SNF, so everyone already knows her as she did therapy with the same group in the past.
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It sounds like your mother needs a strong anti depressant to deal with her depression and anxiety. She doesn't need to "talk" to a therapist because women like this refuse to acknowledge they have a psychological problem in the first place! My mother was doing this very thing in 2011 so I called her PCP and told him she was depressed and not eating or leaving her apartment etc. So he agreed to put her on Wellbutrin which snapped her out of her depression quite quickly and everything went back to normal. And she didn't even have to address her real issues with a therapist, so she was happy. 😑

Maybe you can get mom's doctor to put her on antidepressants which might help her like they did my mom.

In any event, she can't come live with you so figure it out mom. I was in the same spot for the past 3 years with my mother living in Memory Care Assisted Living and insisting on coming to live with me. She had more issues than Newsweek and was wheelchair bound to boot, and 190 lbs. There was NO WAY I could care for her at home, but she would cry and play the guilt card on me every time I visited her. So again, her anti depressants were increased and calming meds were added in as well, which did help. Like Alva said, some things can't be fixed, and extreme old age and disease is high on that list. Mom passed in February and I can say I did my best to make sure she was as happy as a person like her was capable of being.

Do your best getting mom treated for depression and let God handle the rest. We're just daughters, not miracle workers or able to fix such situations for our mother's.

Wishing you the best of luck with a difficult situation.
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MissGypsy Sep 2022
Hi Lealonnie,

I appreciate your compassionate reply. My condolences on the passing of your mother.
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This is very difficult for you to face and hear. Please do not embrace any guilt as that is not appropriately yours. This is the facts of aging today, and there is little to be done about it. Let your Mom know you understand she is grieving these circumstances, bu that you cannot care for her at home, and she is in the best circumstance that could be found for her. Meanwhile continue to visit but make those visits short and sweet when they lead to more UNhappiness than happiness, and let Mom know that will be the case.
No one is happy with seeing a loved one suffer. I am 80, a nurse all my career, and no one knows more than I do that the losses are dreadful and one after another. Our mobility and our balance, our appetite and our sight and hearing and our continence. And none of it leads to an improved state of mental well being. It is a crucible. We live too long. Let Mom know you love her and you are doing the best you can and you understand that just now you are both suffering. No one knows better that their own time will come than the child watching this suffering for a parent.
I am so sorry. Not everything can be fixed. Not everything has a wonderful answer and a happy ending. My heart goes out to you.
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MissGypsy Sep 2022
Thank you, AlvaDeer. You certainly have the experience and the compassion for what you have done and continue to do. Your insights are taken to heart!
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She is manipulating you. You can tell her that she can only be released when she can show her doctors that she can do all her ADLs. This puts the responsibility on her and the blame on her doctors. Remind her that your home is not set up for someone with her current level of care needs. Keep putting the onus back on her. This works with my MIL. For years she refused to get out of bed at her facility. Now she's in LTC but is willing to participate in life there. At the quarterly care reviews she always asks when she can get out and "go home" and we tell her exactly what wrote above. She doesn't like it but she stops hounding us because we're not the gatekeepers. Is your mom on something for depression/anxiety? Did she have any mental health issues prior? Try working on that first and maybe improvement/acceptance will follow. It may take time.
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MissGypsy Sep 2022
Thanks, Geaton. Good ideas that you present here which I will add to my arsenal of strategies. Yes, she has suffered from both depression and anxiety throughout her years; however, it has not been diagnosed because she showboats with the medical staff and adamantly refuses to see a psychotherapist. Recently the SNF has offered "someone to talk to" but she sees through that and will not participate. Both of Mom's parents and various relatives also had mental health issues.
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