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Mom is 99. We live 2000 miles apart. The assisted living is not very helpful. There's always an argument about taking out the garbage or washing her hair or her clothes...every week it's something new. Mom's quality of life is zero. She is in constant pain, deaf, and doesn't see well. Her legs are useless so she drags herself every where. It's really horrifying to be part of this. I am the only child.

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Assisted living plan for your mother is to increase time to meet her needs. Sometime there is not a increase in cost.
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https://www.aarp.org/caregiving/basics/info-2019/long-distance-care
. Find a local coordinator
A local care manager who can supply local knowledge and help with caregiving logistics often can be useful.
 
One option is to hire a reputable caregiving professional, often called a geriatric care manager, aging life care manager or eldercare navigator or coordinator. These professionals, often licensed nurses or social workers, also can be valuable mediators or sounding boards when family members disagree on care decisions or you're facing tough choices, such as whether it's no longer safe for your loved one to live at home.
 
Verify credentials. Look for professional certifications, for example from the National Academy of Certified Care Managers, the Commission for Case Manager Certification or the National Association of Social Workers. Consider how long a person has been in the field, and request references. The Aging Life Care Association, a professional membership body, has a search tool to help you find licensed eldercare professionals in your area.

Discuss availability and areas of expertise. Certified care managers offer a wide range of services, from a few hours’ consultation to develop a care plan to fully managing your loved one's care. That could include hiring and overseeing in-home caregivers and interacting with medical professionals, accountants and people with power of attorney.

Consider cost. Care managers typically charge $50 to $200 an hour. Medicare does not cover this service, nor do most health insurance plans. But if you can afford it, an experienced manager may be able to save your family time, money and stress with even a brief consultation.
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You are your mother's only advocate, and you need to step in no matter how hard it is. If she is in the condition you state, she should not be in Assisted Living, she needs a much more intensive group of people available - aides, social worker, nurse, physical therapist - all of these are available in nursing homes. She should NOT be living on her own, with minimal assistance. Find a place nearby you, and have her flown closer. I know it sounds overwhelming, but she needs YOU now.
I will definitely pray for you, your mom and the journey.
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Frances73 Jan 2021
Agreed, AL is for people who need help with a few ADLs. The staff is not trained to care for people who need a lot of help physically and mentally. Nursing home staff go thru additional training. She should discuss this with the AL director, many have relationships with SNF or can recommend alternatives.
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Call social work at her assisted living facility, Your mother needs hospice care. If no response call EMS to get your mother to a hospital so the social worker there can get her into hospice.
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Call hospice to get your mothers pain managed if that’s a problem.
My DH aunt, 94 is on hospice. I was amazed. All I wanted was another bath from her home health and they advised she was eligible for hospice based on her dementia alone. She seems in much better shape than your mom.

With hospice, she will get more care. If for whatever reason she is turned down, call another hospice to see if they concur.

Call the Area Agency on Aging in her county to see if there are services available that could help her. Discuss her condition and the care at her Assisted Living to see if they feel she is at the correct level of care.

I would not recommend moving her (especially now) without a prior evaluation as that is very difficult for her and you.
Are you in Washington or is that your mom?
About prayer. Listen when you pray. Learn to meditate and you will be comforted.
“Be still and know that I am God.” Accept what you can’t change. She is 99. There is a reason your mom and you are on opposite coasts at this late date. I have to assume you both chose to be where you are long ago. You sound too tired to take on a big move and all it would entail.
Do get more help. Twenty minutes a day or three hours a week etc would get the chores you mentioned done.
And recognize that you need help as well. Therapy, exercise, bubble baths. Any and all possible resources to comfort you and rest you for the benefit of both you and your mom. I know it must be very difficult to do you right now. We understand. Let us know what actions you take. We want to support you.
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I repeat the Lords Prayer a few times a day in the car, when I am walking, when I feel the need to, every day, I feel the need to say the Lords Prayer. And when its a beautiful day: I say: This is the Day the Lord has made, so rejoice and be happy in it. It makes me feel good for a few minutes.
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getting her closer to you will help your stress level alot. covid is a huge issue, so that being stated, things may be very tough to change.
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MJ1929 IS RIGHT...
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Pray to God for help and guidance. I feel for you. I feel for your mom.

My mom is 95 and would never have wanted to live this long!

My dad died in 2002. She’d much rather be with him in heaven.

So sorry that you are struggling with this situation.

Hoping that your mom will have an easy transition and that you will find peace and joy.
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Just to repeat what others have said -- she's WAY beyond assisted living-level needs. She should be in a skilled nursing facility.

Knowing the terminology of different levels of care is vital, and this is a good example. She needs daily nursing care for pain management, mobility issues, and basic living needs such as bathing. That's skilled nursing.
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I think it is sad but I think it is true. We, the families and they the elders DO come to praying for it all to just end. I just finished Elizabeth Berg's book about her parents last years, in their 90s, supportive children trying to move them out of their home in Minnisota into assisted living, the misery of the Mom and of the Dad and of all the kids. Just truly awful, especially since I, at 78, am between Ms. Berg's age of 70 and her parent's ages of 90s. 10 years on either side and there am I am so much misery for all involved. I am sorry, as a Nurse I have concluded that we live too long, and that it is for the most part loss upon loss upon loss upon loss, finally our mental faculties and our physical abilities, our dignity, our memories. I am truly so sorry. There seems no answer.
But if you want company, the Elizabeth Berg's WONDERFUL BOOK called "I'll Be Seeing You". You will, at the least, know that you are not alone.
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I have to agree, your Mom needs LTC. The AL is no help because they can't help. They have less aides. As said, they assist. I am surprised they haven't told you they can no longer give the care she needs.

I would find a nice LTC facility and use the money Mom has left for her care then apply for Medicaid when it runs out.

As said, you may want to see if she qualifies for Hospice.
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God is the one to pray to for this journey to end for your mother who's in chronic pain and misery. I pray daily, to both my deceased dad, mom's deceased siblings, and God himself to please come take my mother out of her misery to be reunited with them again. She will be 94 this month, with bad leg pain from neuropathy, wheelchair bound, moderate to advanced dementia, mostly deaf, super confused, etc. etc. Her quality of life is pretty non-existent as well, and she's in Memory Care with a very high level of care round the clock. It's not how much care she's getting, as much as how much quality of life she's NOT getting. I too am an only child, but I live 4 miles away from her MC. Complaining is part of the routine for ALL of them, I believe, so I wouldn't get too worked up about that aspect of things.

As far as hospice goes, my mother does NOT qualify for their services, even WITH all of her issues. Your mother may not either, but she may. Have you looked into it? My mother takes Tramadol 4x a day for her chronic pain, and says it doesn't help at all. For hospice, she doesn't meet the criteria (even WITH dementia advancing) because she hasn't lost 20% of her body weight, believe it or not!!!!!!!! She eats like a trucker and weighs 190 lbs. So...........that's where we stand on the hospice matter.

Anyway, I hope God decides to take your mom sooner rather than later because being 99 and in the shape she's in is too much. Sending you a big hug of empathy and understanding. I get it.
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Assisted Livings (ALs) offer just that..... an "assist" to residents with the activities of daily living (ADLs). If she can't walk, not sure why a wheelchair has not been prescribed for her but that you can discuss with her MD. Als are simply not staffed to deliver a higher level of care which, by your description, your Mom definitely needs. Please look into getting her hospice which will provide extra "eyes" and care for her as has been suggested. If that for some reason doesn't work and funds are not an issue and she doesn't not need skilled nursing care, perhaps consider hiring outside help to help with the hair care, bathing, whatever.
Wishing you and your Mom peace on this difficult journey.
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Well first I must say(being a Christian), that God is the only one to pray to, not only in our times of need, but every day. Secondly I will suggest putting mom under Hospice care, where she will have more eyes on her, and they can help get her out of the pain she's in. At her age, I'm sure she won't have any problems qualifying for their care. A nurse will come out at least once a week to check her vitals, and an aide will come at least twice a week, to bathe her and wash her hair.(you have to request her hair to be washed) They will report to you, any neglect they might see while there, and if they feel a higher level of care is needed. And it might just give you more peace of mind. Wishing you the best.
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I agree with AnnReid that your mom seems to need a higher level of care. I too am an only child. I manage care for 4 people, ages 85, 91, 98 and 101. Two are local to me and 2 are in FL while I'm in MN. My point in telling you this is that you will need to make some decisions based on what you want the outcome to be. It is not easy to manage care when thousands of miles away, especially when the care is not enough. If I were in your situation I'd work to move my mom into LTC very near where I live. Yes, easier said than done, but once done, it will be easier to manage. You won't have to provide more hands-on care but you will be better able to work in her best interests when she's near you. It won't be less emotionally challenging, but I don't see the downside of moving her. Not sure if you are durable PoA for your mom and what her cognitive levels really are at this point. She may be totally resistant, in which case you can employ a "therapeutic fib" to get her moved. If finances are an issue you can apply for Medicaid for her. If she doesn't have a lot of assets, the app isn't that hard to complete but you will access to basic info like her bank account and what assets she does have. Being an only child in this situation is hard in many ways but at least you get to call all the shots, unlike people who are constantly at battle with siblings over control. All you can do is the best you can. May you gain peace in your heart as you make decisions and work towards the outcome you think best.
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What constitutes “Assisted Living” in your mom’s state? It sounds as though she really requires a higher level of care than her present residence provides.

My LO is in the memory care area of a very good LA, and there is a tiered set up providing progressively increasing levels of care as needs emerge.

Do you have any possible connections in her area whom you could employ to provide surveillance over her circumstances and loop mom’s needs to you, especially concerning her day to day care?

Prayer? I pray. What I forget sometimes, is “Let go, and Let God”. If YOU are doing the VERY BEST YOU CAN, whether from a distance or next door, in Covid World, that may be all you can do.

I deeply appreciate your intention of doing the best for her that you can. I’m linked in a situation in which my LO has 2 POAs, one of whom lives over 1,000 miles away.

Until Covid I was able to provide companionship and oversight, and of course for the time being, that’s not presently possible.

The other POA writes a check once a month and calls and complains about what I do (“due diligence”-LOL).

I think it would be helpful for you to pursue to possibility of a “visitor”, ideally one who could “drop by” at different times during the day to see what’s happening in your mom’s residence.

I’m assuming that you’ve gone over your mom’s contract with her residence, to be sure that she receives ALL the services she’s paying for. Times are unquestionably strained, and things that WERE done and should be done are lost in the Covid struggles, but there should be some parts of her contract (laundry for example) that should be absolute baselines.

I know my few ideas aren’t much help. Hoping some others can do better for you.
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