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I am new to this site but have been impressed by the support offered. So, I am hoping you wonderful folks can give me your perspective.



I am the sole caregiver for my mother who is almost 93. We have home healthcare coming to the house due to recent bout of pneumonia and a hospital stay. She has been given exercises and is now on a standard walker (she used a rollator for years) and in a wheelchair as needed. Mom will show off when PT or OT are here and do everything fairly well.


Afterwards, she is extremely tired. However, when I am working with her she fights me over everything. I know this is a common problem/situation and have discussed it with her healthcare team. They acknowledge the problem but told me to keep after her or "she won't get stronger." I know they are correct but it is hard to be a "drill sergeant" (Mom's words).



I try to be gentle or cajoling or even silly but it doesn't work. She is sloppy with the exercises and incautious when walking or transferring. For example, when she is walking with me around the house she will have the walker in front of her so that her arms are totally extended and she will even push it away from her. So far I have been able to catch her before she falls. However, I live in fear due to safety concerns. She can't move around without assistance but my life would be easier if she followed my directions as well. She knows and acknowledges that my corrections are how she should be walking, exercising, or transferring but she continues with her methods.



So, I am wondering when do I acknowledge that it is time to stop trying to improve her mobility and simply be available for safety. I am tired of arguing with her everyday and several times each day. Yet, it would be nice if she could achieve a little independence; such as walking to the bedroom without me needing hands on. The therapists have told her this is possible if she does her 'homework.' Other than this, we rub along well together.

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I understand your worry and concerns. I too am sole caregiver for my brother who had a 2nd stroke along with falling and breaking 3 ribs. It is totally exhausting and frustrating for you. Frustrating and exhausting for mom too. He is combative at times. Does not want to follow directions.
I said to my brother "you have two choices eat exercise and get stronger or do nothing and wither away, your choice." Its tough love but they need to understand there is no one else and if the caregiver "hits the wall" all is lost, their screwed!! I tell my brother who dislikes change "if change is good for you, why do you reject it?"
I tell the nurse, OT and PT he's putting on a show because your here. Your mom dies the same thing. Your the one who can give them the true picture. I hope you take care of yourself, give yourself little breaks with in-home services. You cannot do this all by yourself.
Your a loving daughter to your mim just as I'm a loving sister who has their best interests at heart.
God bless you. You deserve an atta girl air hug.
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I’m sorry your mother is being difficult. My 87-year-old mother is very cooperative, and even she used to put off doing her PT exercises when she lived by herself. I can’t hold it against her because I’m just as bad about some exercises I’m supposed to do! Anyway, two things have been useful for my mom. Both have to do with living in a senior independent living facility. First, she has three meals a day with other residents, and they hear about others who take falls and the results — surgery, rehab, wheelchairs, debilitation, being moved to assisted living (not bad but more expensive) or nursing care (way more expensive). Mom doesn’t have to be reminded by me what might happen if she falls because she sees it all the time. Her table mates encourage each other to avoid losing control of their lives. Could you approximate this somehow, with church friends or another group? Is there any way to get her positive peer support? It’s hard to be motivated without friends to keep you going.

Second is that her physical therapist comes to her little apartment to work with her, so it’s like she’s in charge of it, not me. She can also see the results because she has to get around in the facility as part of her daily life. I will say that the therapist works her hard twice a week, and it’s reasonable for her to be tired the next day. Have you discussed with the PT what is reasonable to expect from your mother in between sessions at her age? Regular healthy adults do well with three work outs a week.

My mother-in-law was impossible, insisting on living in her home well beyond being able to take care of herself well. At some point, a social worker said, “you’ll just have to wait for a crisis.” That was true. A year later, she fell on her front steps and ended up with several days in the hospital with a serious concussion. Then the fun began — trying to find a place for her before she got out of the hospital. So I definitely recommend that you research now what your options are based on availability and cost and location, including specific nursing care facilities and their availability so that you are prepared to make arrangements quickly. Maybe you could take her to tour some places, to give her some ownership of the challenge.

I don’t know that any of this is helpful, but I hope it is. It sounds like your mother is depressed, and it’s hard to find motivation when depressed. It does also sound a little bit like some early signs of dementia.

So, yeah, let it go. Set a schedule for exercises and remind her on schedule, ask her if she wants help, then let it go. If the therapists tell you to “keep after her”, I suggest politely informing the therapist that your mother is a grown woman and has the right to control her own body. You will remind, encourage, and offer to help, but you will not “keep after her.” She deserves the dignity of making her own choices.

Best wishes.
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At age 93, aim for safety and comfort. Try to get her to exercise, but if she refuses, you don't have to be a bossy drill sergeant, as you put it. She is an adult and bears responsibility for her own health, if her mind is still sharp. These last years will be better for you both if you let her do what she wants as much as possible. Also think of yourself. Do you need help and breaks with her care? Do they offer senior daycare in your area? Would it help to get an in-home caregiver to help you out a few times a week, or a few hours a day? If you do, lock up your valuables and financial papers. Make sure all of her paperwork is in order so that you can take over her care if she becomes unable to make her own decisions. She needs to set up powers of attorney for medical (health care proxy) and financial matters, have a living will with her advance medical directives, and a will, if she has assets. All the best to you and your mother.
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Hello Friends, I need to apologize for abandoning my question. I posted my question/concern and got so many wonderful responses. Many I tried and some with success! Then the bottom fell out of my world. I know everyone on this site will understand how fast things change in our world as caregivers.

We do not know what happened but Mom’s health and cognition went downhill in a matter of less than a week. Calls to the nurse, doctor and a trip to the ER and we are still unsure. Our healthcare professionals are as confused and worried as I am. Sigh!

Currently, I am playing a waiting game while more tests are run. We are also looking at a hospice evaluation.

I really wanted to post again to say, “Thank you!”

CoffeePaula
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Llamalover47 Mar 2023
CoffeePaula: Thank you for your update.
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My opinion is that it's time to stop trying to improve your mother's mobility when you realize that she doesn't care, and you're tired of pulling her along and arguing with her over it.

It's the same thing with an alcoholic. You can drive yourself into the sickness of codependence while trying to get them to stop drinking when they never have any intention of stopping.

After 17 years of caring for my now 96 yo mother - the last 5+ in my home, I'm just too exhausted and depressed to constantly cajole or remind her to do this or that.

My mother literally doesn't want to do anything for herself. But that is how she's been all of my life, so why change now...

There are only two things that I demand. One is a weekly shower (which I do for her while she carries on like she's being mistreated). And the other is to sit up during the day rather than nap all day.

Those two things are worth the effort but not much else is at this point.
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You just described my husband perfectly. I’ve tried everything and come to the sad conclusion he’s just giving up. To save your sanity, set boundaries for yourself. Please, don’t cater to her as it will only increase excessive dependence on you. Stepping back forced my DH to regain some independence as he is able. I’m looking forward to responses as I appreciate the experience of those on this forum. Hugs to you, it’s a hard road.
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Way2tired Mar 2023
I had similar experience . After my moms stroke ,at 80 years old, she returned home after rehab barely walking . For 2 months I stayed with her all day long and argued with her to get up and walk more than just to the bathroom. Finally I stopped doing for her . I refused to bring her meals and pills to her at her recliner . I put the food and pills on the kitchen table, I stopped laying out her clothes for her. Made her walk to the kitchen and to her closet and dresser etc. Even my Dad was getting lazy . I would say dinner is ready and he would go sit at the kitchen table and wait to be served . He didn’t offer to set the table , pour drinks , or carry food to the table which at the time he was fully capable of . After a few more weeks she was doing better so I went back to work part time for my sanity . Mom improved in walking and could take care of her own personal needs . After that my parents did ok for a while still in their home . They made easy meals , got their own pills . I still did shopping and still brought a lot of meals , which they would still sit down at the kitchen table and wait to be served like they were in a restaurant. Lol. So then sometimes I would just put the meal on the counter and tell them I had to leave to force them to at least move around the kitchen . I had housecleaners come when my parents would allow , which wasn’t often, so I did deep cleans in between . Dad could do light housekeeping and laundry until his cancer got worse .

At 93, though this woman may not have the energy to improve . Let her be , see what happens , she may improve or may end up in AL.
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My mother straighten to attention, sarcastically salute me and say “aye aye CAPTAIN” at any of my requests, comments or directives.

Funny, but it gets tiresome.
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Talk with the therapists about her resistance to stay safe and do her exercises. It sounds like it is time to switch focus from strengthening and regaining ability to keeping her safe - even at the expense of her losing mucle strength.
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CoffeePaula: My late 94 year old mother performed physical therapy outside of her home in a nearby facility. As I was living with her, I took her to a limited number of visits as instructed by her physician. YOU can only do your best, but do not injure yourself by 'catching her' if she falls.
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We all pretty much know the benefits of doing exercises necessary to help keep us strong and ambulatory. Explaining that to those over a certain age is frustrating and mind numbing at times. I went through this constant battle with my mom (after breaking a hip) and in the end, I just gave up. She was 92, and even with dementia she deserved to have her wants and needs based on her terms (within limits, of course)......not matter how annoying and frustrating it was.

It' not easy, but keep in mind no matter how hard you try you can't prevent the inevitable... protecting her from herself. Do your best.....that is all that is required. Good luck.
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At some point, I gradually realized my dad enjoyed much more with my emotional support, sitting by him to watch TV, and paying attention to his talking, etc. as well as improving safety around the house, rather than walking with me and eating out. I felt sad to see him declining physically but tried to adjust myself for his needs.
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Next time PT is there and you/mom/PT are together, as PT person to allow you to do whatever exercise will be done with your mom...say something like, 'I want to be sure I'm doing these correctly with her and that mom is doing what you want, too. I'm trying to get mom to do these when you aren't here and I think the training will help us both'.

Then you might have a very calm discussion with mom about the need to keep moving. It comes down to if she can keep moving and trying to get stronger, the current arrangement can be continued much longer. However, if she CHOOSES to refuse strengthening exercise, she will get weaker to the point you may not be able to care for her at home. You hope her goal is the same as yours, for her to stay where she is as long as possible. Say it and walk away so she can think about it a little on her own.
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Your mom is 93. Her days of independence are over. I’m sorry to sound harsh, but it’s true.

For your own piece of mind, stop arguing. Try and keep her safe. Eventually, safety may also be something that becomes too difficult for you. Can you lift her in and out of shower/bed/toilet? If not, it may be time to consider a facility where she has 24/7 help. You then would be free to visit and spend quality time with her, rather than all your time arguing/being a drill sergeant.
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You say "So, I am wondering when do I acknowledge that it is time to stop trying to improve her mobility and simply be available for safety. I am tired of arguing with her everyday and several times each day."

* My heart goes out to you. These scenarios - all as different as the people in them - are not easy to manage or cope with, esp when it is a family member.

* Sounds to me that you ALWAYS need to put her safety first.
- If it were me, I might tell her "if you decide (let her feel she is in control, which she really is) to walk w/o the walker (or however you want to reflect what / how she is doing in an unsafe way), tell her you will need to hire a caregiver 24/7 to walk with her EVERY STEP she takes. She may not want this.
- However, you need to say this seriously and not as a fake threat otherwise, she'll continue on as she is. She'll test you.

* She seems to take a kind of pleasure in irritating you, like a 'child acting out.' This could certainly be underlying relationship issues between a mother and daughter, and/or she sees you as the primary 'police' / 'manager' (which you are) and she resists.

- She may realize that the rehab, etc., come 'now and then' and they will leave. You don't. So you are the target of her 'acting out,' if this is what she is doing.

* Unfortunately, unless someone is walking with her every step, she may fall. And that might be what needs to happen if she doesn't want to avoid falling. It sounds to me like she enjoys (or feels a kind of personal independence, which she enjoys) 'playing with you,' or 'aggravating you.'

Do you want to try a new strategy?

1) "If you want to walk alone and risk falling, that is unfortunate although it is your decision." If you do this, she may feel / see that there is no 'payoff' of you reacting. And, she might stop. And she might not, and fall.
2) Get a caregiver in there for one day on a 24/7 basis and be with her 100%. She may realize she doesn't want this and do what she can and needs to do which is proceed (walking) with caution, and doing her exercises.

DO REMEMBER: If she falls, it is NOT your fault. You do what you can and you make decisions based on her safety as best you can. That is all you can do.

REALIZE THAT ARGUING IS A NO 'WIN-WIN' so do not set yourself up to argue (usually answering her "I know what to do") Arguing is you biting the fishing bait, which is a no 'win' and sets up frustration esp for you and overall, for her too.

- You be clear in setting boundaries and follow-thru. Making empty threats will result in her continuing as she is doing. Say:

"if you do xxx again, I will need to get a caregiver to supervise (your every step) you day and night." Ask her: "Is this what you want?" She'll say no or make excuses...
- Her response: "I CAN do xxx by myself."
- Your response: It is not safe for you to do xxx alone. You may fall. No arguing, stating a fact. Guess I need to arrange for someone to come in 24/7 today since you do not want to xxx (use walker when walking and/or do exercise).

- When calm and she seems open and relaxed, talk to her, asking how / why she can do xxx with rehab (nurses, etc) there and not do xxx when they leave? What's up with that? (use your own words). Don't ask this in the middle of her walking without the walker.

- If she'll listen (caring how you feel) tell her: I am very concerned about you / your welfare and safety. I love you. What can I do to help you (giving her independence again)? See what she says. Sounds like a 'heart-to-heart' in this situation won't work, although it is worth a try or at least incorporate your caring in your conversation and decisions.

We do not know how an older person feels losing independence, mobility. It is likely frightening to her as well as frustrating. Remember how she feels - so (try to) proceed with compassion and calmness. Do not allow yourself to be pulled in emotionally which continues to drain you.

Touch Matters / Gena
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Please get an Elder Law Attorney to advise you on placing Mom in Assisted Living. You will benefit from changing your role from caretaker to visitor.

At 93, I vote on letting her do what she wants to do and pay someone to clean up her messes................that would lessen the need for the two of you to play, "Tug-o-War." Put your end of the rope down and plan a vacation.
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KaleyBug Mar 2023
I am baffled by your response. She basically is asking when she should quit helping with exercises. My response is don’t stress over if she does the exercises or not. Just monitor her and occasionally help if there is a safety concern. My dad did his exercises when PT was there and a few on his own. I never pushed it and he did fine. Never needed an assisted living facility.
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As an OT and as a daughter, I have accepted that "No-Kay" is sometimes the best and only response I can give to the situation in front of me. You are obviously a caring daughter and want the best for your mom in maintaining her safety and her independence. She has told you and shown you that either by her deliberate, self directed choice or by her current cognitive abilities, this is what she is going to do. Keep gently reminding when you feel you can. Embrace no-kay when you can't. In many ways dealing with my dad has much overlap with dealing with my teens. You know what would work but for their own reasons they won't do it. If she does something that is immediately dangerous, step in on that. For all the rest, trust yourself to be able to deal with the consequences of their decisions, recognizing the frustration that comes with that. Just swing at the ball that is pitched at you, one at a time. Truly best of wishes to you!
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Beatty Mar 2023
Great answer!

Could you clarify "no-kay" for me though? Do you mean saying No to dangerous requests? Or as a concept of letting a situation go - instead of ok, let it go "no-kay"?
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CoffeePaula, my situation is very similar to yours. I live with my mother who is 86 with dementia as well as frequent UTIs. Last summer after an 8-day hospital stay and 6-week rehab, she came home very weak and hardly able to hobble around with her walker. Since then she has declined despite home health PT coming to the house almost all this time. She will not do exercises and so not surprisingly is now almost completely wheelchair/bed bound. I also have a full time job working from home, which doesn't allow me a lot of time for cajoling and browbeating her to exercise, not that it would do any good anyway. She seems to want to stay in bed and it's all I can do to get her in her wheelchair for part of the day so she can sit at the table in the kitchen where she loves to be.

But I'm so far making it work, and have learned all sorts of things about caregiving, such as changing her diaper, moving her in her bed, moving her to wheelchair, etc. I have accepted that she is not going to be up and about walking and using the toilet again, and that's gone a long way to helping me be at peace with her situation and mine.

I now do everything I can just to make her safe, comfortable and happy and as healthy as possible. She still has a good appetite and even a cute sense of humor despite her dementia, and that is what keeps me close to her. She'll usually laugh at a simple joke or play on words, and loves to whistle and sing along with the music we always having playing for her.

If I'm having trouble with her--sometimes she gets combative and contrary such as when I'm changing her and want her to turn on her side, or when I'm trying to get her to help me transfer into her wheelchair--I find that if I look into her eyes and speak gently and lovingly it can change her channel and she will try to do what I need her to do. She really does respond to love and softness, rather than a controlling manner.

Of course I don't always succeed and sometimes I have to just leave her and both of us take a time out, and that works too. Sometimes.
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My mama did not like doing the PT. She said it didn't work. So I never forced her why... because I would get upset and she would get upset... what's the point. My mama wanted to sit in her chair and watch tv. Then my daddy he loved the PT. He would do it and do it correctly. I think he loved my attention. Anyway, my suggestion, don't argue your day and her day will be ruined. Be there for her as much as you can, get help for yourself, and you may need to call her PCP and she may need to be assessed for palliative care. If she argues about going to the doctor tell her that her prescriptions are due and will not be renewed unless she goes to the doctor. Blessings
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I am not sure using a nursing home as a threat is a good idea. It may be a necessary reality soon. It isn't always punishment for lack of effort. I would suggest exploring which are possible, and going for a visit with her to a few of them. There may be a match that is better for her and you. Also, it is hard to envision a vague idea. Much better to have a true idea of the choice.
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Wolfpack Mar 2023
I agree. Threats are never good--especially if dementia is involved as they are already afraid and anxious in general.
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it sounds like her behavior is rather childlike.

Sometimes a parent is unable to tutor their own child for this same reason.

Can you bring in the therapists more often or hire a CNA to come do the exercises with her?

Stop watching her so closely and stop criticizing. She may be doing this to get a rise out of you or attention.

Don’t fight with her about this. She may grow bored with the game.
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I have a soon-to-be 92 year old mother who isn’t big on PT or OT either, as it does help her mobility. She lives with me, and my family. We have caretakers who come to the house while I am at work. She uses a walker, and isn’t to great with balance. I am an only child.

I read this article (linked below) on this site a while back, and I tend to read it over again, kind of like a reminder that we can’t fix old. It is good to acknowledge their old age, what they’ve accomplished and where they are in their own journey.

https://www.agingcare.com/articles/caregiver-fix-it-mentality-leads-to-burnout-152629.htm
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Wolfpack Mar 2023
Holy cow! This is me! I cannot thank you enough for sharing this link. You have instantly changed my entire caregiving life in one short read. THANK YOU, THANK YOU!!!
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After 4 yrs I gave up advising/ helping my mom. I now am her daughter only and let nurses give the advise.. life is so much better!
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I'm looking forward to the answers you get from your question. I am dealing with a similar situation only it is in regards to my 91-year-old mom not eating well and drinking water every day. She knows she should be eating better and drinking water daily but she doesn't. Her doctors stress this. We have tried lemonade, ice tea, etc. etc. I think she wants me to fix all her meals for her although I know she can do it. I am also tired of being a "drill sargeant" and wonder when it is okay to back off. I know she will continue to get UTI's and dehydrated but I am tired of pushing her daily with no results.
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swanalaka Mar 2023
My mother was adamant about not drinking fluids! She thought an 8 oz glass of water was plenty for the day!
5 trips to the emergency room for severe dehydration, 2 by ambulance, still didn't convince her she needed to drink more. But when blood work showed she had suffered significant kidney damage from dehydration she got scared straight! And now she's used to being hydrated and enjoys all the benefits-fewer aches and pains. More clearheaded, better digestion.
Sometimes they just have to hit a real low to understand!
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I'm 67 and very active until further notice.

Life is worth living, but no one can tell when you get to age 80 or more; depended on strength and health.

Hopefully, I will have help to move me to assisted living or NH when I reach around ages 80 to 85 since I live alone without local relatives. My remote family has been very nice and told me to not worry about family coverage I will not run out of. My brother's extended step-family said they will step in when he and his spouse cannot help me anymore.
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You need to acknowledge that your mother will do as little or as much as she wants to do in terms of working on her mobility. You can tell her if she doesn’t have some mobility she will have to go into a nursing home. Maybe that will scare her into doing more.

Your mother will start falling at some point soon. It’s not an if any more. It will happen. It’s important she has a medical alert device so if she falls EMS will come. Get a lock box so that the keys are available so EMS can get in easily without destroying her front door.

Having a home health attendant for four hours a day is a good start for her to get used to having some help for her daily needs.

Try not to get too annoyed or frustrated. I know it’s hard. Good luck to you.
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My mother is 98, her mind is good, her body, not so much. She needs a scooter, she refuses to get one, she does use a walker tho.

At her age, I let her do whatever she wants, why not? She has lived a long life on her own terms, I think that she should continue to do so.

Your circumstance is a little different as it appears you live with her, my mother is in AL, I would never live with her or visa versa, definitely, not my thing. Florance Nightengale I am not.
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What I have found is, unless your Mom has something to live for or can get a positive outcome consistently and immediately, she isn't going to do what needs to be done.

The way I think of it is this. When we are young, we want to travel, go places, meet with friends, etc. Hence it is in our best interests to be without pain and to take the advice of others on how we can be healthier and live better.

However, when you get to 80s and 90s, you figure you could die any day, so unless you have something to live for, you are not going to work toward improving your health. Saying things like "your pain will go away" may or may not work because as a senior, if it isn't a pain here, there will be a pain somewhere else. She doesn't give a damn to "get stronger" until you show her why "getting stronger" will benefit her immediately.

At the age of 96, my mother didn't give a hoot about how she used her walker, how strong her leg muscles or abs were, etc. until she decided that we would go on a cruise. For 8 months, she ate healthier, did the exercises her PT gave her and took care how and when she walked. I swear she was the oldest person on that cruise ship who walked, with her walker, at the various ports in Greenland.

Once the cruise was over, she declared that was the last time she would ever travel as the plane rides were too difficult for her. Back home, she reverted back to not doing exercises, complaining about her aches, etc and of course, physically, she can no longer walk like she did in Greenland and needs 24 x 7 watch.

So regarding your question, I would back off. There are some of the exercises you need to do to maintain her ability to get out of bed, use the toilet, and walk around. You could turn the exercises into a game. Talk to the PT person to see what alternate exercises you could do that would strengthen the same muscles.

The other option would be to find a tangible goal that she is truly interested in and link the exercises to that goal.

I'm the exercise police. I told her that the day she is unable to walk from her wheelchair to the car, is the day we stop going out for drives.

So far, she is willing to keep up with some of her exercises. It turns out that the exercises also help her stay regular without meds/herbs and also help her circulation so that it isn't painful to sit, stand or walk.

It is tough getting old. It is a lot more work than I, as a child, ever realized.
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CoffeePaula, I feel your pain! My mom is 84 and was hospitalized due to Covid and a bladder infection. We found out that she has several small strokes before her hospitalization and I can see that it has affected her choices. Her bladder infection is an ongoing thing for her which is not helped by her lack of fluid intake, it makes the infections recur frequently ( she is currently on number 4 in the past 7 months). She was in the hospital and rehab for a total of about 7 weeks and had PT in rehab to help her gain her strength and walk/move around better. Then we had about 3 months of in-home PT that she did really well with. The problem began when the PT ended due to her insurance.

I explained to her that I (58 years old) with my bad back would not be able to lift/turn/move her if she became bed-ridden and would need to place her in a nursing home (her greatest fear), if she didn’t continue the PT exercises to keep her body strong and be able to be mobile. She uses a rollator walker now and has not been doing her exercises. She is completely exhausted after going to a doctor appointment (and she has many), and is currently on the fast track to becoming bed-ridden. I have stopped arguing with her, I did tell her that I was not going to push her to keep up the exercises and that this would be her decision as to whether or not she ended up in a nursing home sooner rather then later. It appears that is not a huge concern for her right now. It just makes me more bitter about having given up a rewarding career that I loved to take her into my home and care for her instead of putting her in a nursing home where she can be cared for.

I feel horrible that she has made this decision, whether she realizes it or not. Do not stress yourself out with this. My relationship with my mom is not the best and hasn’t been for years. I resent having to care for her for many reasons and hopefully you can avoid feeling the way that I do.

My best suggestion is to not argue with her, but you will also need to accept that she is making the choice to do nothing and must accept the consequences. Good luck to you!
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againx100 Feb 2023
So frustrating when they choose to be inactive and contribute in such a big way to their decline and eventual nursing home residency. My mom would never be able to see it that way, but those are the facts.
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I went through this same exact scenario with my mom after she had her knee replaced. Went to rehab and did really good with the therapists but when I tried to get her to do her exercises in her room like she was supposed to, she trotted out all her excuses, including a whiny voice that reminded me of nails on a chalk board. It hurts! I'm TIRED! No matter how often I'd tell her that she really needed to do it to get better. She really didn't care. But always cooperated with the professionals. On her 2nd knee replacement, I already knew that my plan was to do NOTHING. I couldn't help myself and would offer to help her from time to time and sometimes she would actually take me up on it.

Once we had caregivers and do to her lack of activity, she ended up in pain and in need of PT again, and one of their jobs was to do her exercises with her. Worked great! After my first bout of trying to help her, I was DONE. I would get worked up just thinking about doing it, expecting her to whine and complain.

I never had the talk with her in depth but would tell her that having her knees done kept her out of a nursing home because if she couldn't walk that's where she would be. There was no way I was caring for a wheelchair or bedridden mother in my home.

So, I would let her know the deal. If she becomes immobile due to not doing her exercises and staying active even when discharged from PT, she will be writing herself a ticket to a nursing home.
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If your mother has dementia then what JoAnn says is right. There won't be any reasoning with her.
If she does not have dementia then have a talk with her. Let her know that if she refuses to keep up on her physical therapy and refuses to use her walker correctly and pay some care to how she gets up and transfers, that will be on her. You will not be the one who will get injured by her sloppiness, she is. Let her know that if she continues to get weaker from lack of exercise, she will become immobile and will have to get around in a wheelchair. Let her know that you will not be able to take care of her in the home if she becomes wheelchair bound and bedridden. That will mean placement in a care facility.
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