Making a decision about N mother

[Lizzie]

Well, I'm back again - more to deal with mentally with my mother.... she was sent to the psych ward over 2 weeks ago from her assisted living facility. Social worker was there talking to her and she brought up suicide again. Her way to get me out there by trying to manipulate, but it backfired sending her to the nutty bin.

Now she is going to be released and my husband and I have to make the decision about where she ends up. They can take her back at the Assisted Living facility, but only with many changes. One is an aid in her room 24x7 for several weeks to watch her, plus upgrading her care plan to more nite checks in addition to getting her out more.
This is going to cost - nothing is free....
It's either that, or it's back to the nursing home where there are open doors, people walking around and nurses on duty, etc..
Not as nice and private a situation, but constant care and attention (which she loves).

We are both pretty upset and anxious even having to talk about it. Tempers are flaring and short only because of the strain.

Am hoping that there are others out there who have had a similar situation. I know what I would like to do, put her on an ice flow like the Eskimo's do when someone is no longer a contributor to the community! Bye, bye!!

Of course, I can't do that but would like some guidance from someone who is not close to the situation.

[vunil]

Could you give a sense, if you are willing, of the tradeoffs here?  What is the difference in cost, is the nursing home horrible or dangerous, what does your mother want, what is the benefit of the more expensive care, etc?  It might help us help you hash it out.

You just have to balance what is best for her with what is best for you (I know, duh) which in the real world means balancing the lack of care you'd like to provide (e.g., ice flow) against guilt you might feel later.  Brutal to put it that way, but I think that's your trade off. 

I think it depends on how awful the nursing home is, frankly, and how much cheaper it is.  Also, what is her health like? Is she likely to be in a nursing facility soon anyway?  I know assisted living is reserved for healthier folks.  Is she on medication now?  Will both places make sure she keeps taking it?

SORRY you are going through this.  Really a tough thing.

[Kaz]

Hi Lizzie,
I have a mother who lives in a retirement village and has just gone from her own unit into the assisted living apartments because she thought she was going to be totally blind after a gluacoma operation she just had. She didn't go totally blind as she expected (the surgeon actually told her that she would not be able to see for a few weeks etc. which is normal) and is now finding that she's sitting around with not much to do.
The point I'm making is that she chose to move and now she has no one to blame except herself for her panic reaction.
Is your mother able to make this kind of decision on her own or do you have some sort of gaurdianship arrangement? Sorry if you've already explained this elesewhere.

[mum]

Boy, I wish I had some concrete advice for you.  I don't. All I can do is say I feel for you. This is tough.  Aging parents are difficult enough, even when they are sweet people. Can't imagine what it's like for you.....I'll send you positive thoughts for a good solution...hang in there.

[Lizzie]

My mother has been a cruel and hateful person for most of my life - a true Narcissist. I bear the burden of her as I am the only one around (my sister left 35 years ago). I'd be in the looney bin with her if it wasn't for my husband and seeing a shrink.

She is manipulative - pulling stunts (like suicide threats) to get us out at a moments notice. This last time it didn't work, and she landed in the psych ward. Now they are going to release her back to Assisted Living. Her suicide threats are meaningless, a trump card of sorts to control. The care people want a 24x7 aid in the room with her. We know it isn't necessary and way too costly. Her money would dry up PDQ if we went that route.

We went over to the AL facility yesterday and spoke to several people. One was a woman who runs the Alzheimers' care unit (this place has different levels). She didnt' think that she needed that level of care either, once she knew the situation.
Everything hinges on what the hospital says about her mental condition...I think we are going to base what we do on their evaluation. One good thing, the head of the A. Unit mentioned another facility close by that takes care of Geriatric psych types. We were aware of this place but didn't realize that they were that type of facility. She said that they are very used to taking care of people who have "issues", like my mother and know how to deal with them.

I am at point in my life where I don't want any contact with her. I need to start living my own life before it's gone. The ideal situation is putting her somewhere where they know the drill and can control her. Other places, like where she is over react and panic and start calling us. Am getting pretty sick of that situation - my life is constantly being interrupted!

[miss piggy]

Hello Lizzie,

I'm sorry I didn't read your thread earlier.  My aging N parent is the very reason I am now participating on the board.  Misery loves company!   

It's really difficult because you know what kind of person you are (normal, nice, giving) and yet, to save yourself, you have to make difficult decisions that won't seem normal and nice to outside observers.  In fact, to outsiders, it appears cold and heartless.  Gee, if they only knew.  Just be true to yourself and do the best you can with what you've got.  I think you are already onto a solution and that is, read the evaluation and go with that.  I cannot stand to read that your mother is threatening suicide so capriciously.  That's the ace of Emotional Blackmail.  Good for you for seeing through it.

Wow, how great to know there are geriatric places for people with "issues".  I didn't  know that.  I only knew about places that dealt with Alzheimer's, etc.  Is there a name for this type of care?  I'll tell you more about my situation later.  Just wanted to say hi and hang in there. 

MP

[Moira]

Hi Lizzie! wow- what a tough position to be in. I can relate. My N mother died in Feb. and she  was a nightmare to deal with. She started to threaten suicide a few years before we put her into a nursing home. Lots of rambling messages and calls in the wee hours of the a.m to me alleging she'd overdosed. I always told her I'd send ambulance- of course she wouldn't answer the door and my enabling dad always slept through the nocturnal drama! Or I'd say to her that I had a collection of blck dresses to wear to her funeral- sounds harsh I know. Once in the home she continued to threaten suicide. We finally did the same as you and had her assessed by a geriatric psychiatrist. Best decision we ever made. She ended up staying in the same home but was moved to a geri-psych ward where they were a bit better equiped to deal with her. The nursing home was certainly not the greatest facility requiring daily care by family emebers in terms of helping with feeding, hygiene, going out etc. Hey you take what you can get. My sister lives in my home city and by default took on my mother's care.If there's a heaven, my sis will definately be going there for her sacrifice. I couldn't do it nor would I have taken it on if I had been living there. even though my N  mother was suffering from dementia- until she was totally shut down- remained the N she was and almost killed my sis with her abuse and threats. I agree with withholding your decision till you get the evaluation and speak with the specialists. will there be a family meeting with whoever is involved? Hang in there.

[Lizzie]

Hello there -

Thanks for your replies.... I appreciate your words! For an update - my husband/we spoke to the case worker yesterday. She is basically a ditz, making comments like; you should try and find where your mother (in-law) would be the happiest... blah, blah, blah. Happiest?! Knowing fully well what our position is, she makes an assinine statement like that. Again, us telling the truth to a professional only to be turned off by it. "How heartless, what a miserable daughter, how could you do that to your mother" - I know that she was thinking those things by the tone of her voice.
It's called self perservation lady.
The doctors say she is not suicidal right now but cannot predict how she will act in the future. The head of her care network at her current assisted living place is still freaking out, insisting that we have an 24x7 aid. Sorry lady, that ain't going to happen. She is only worried about liability, nothing else.

Today we are going to see the alternative assisted living facility with geri-psych levels. There is a doctor and psychiatrist there round the clock. I hear if you are naughty and misbehave, they send you up to the psych floor. No calling the family, just dealing with situations as they happen. Sounds like heaven to us both.
No more phone calls, no more; I want, I need, you should buy this for me, this doesn't fit, always complaints, and never a thank you. I want and need my space and I WANT my life back (not that I ever really had one up to this point).

I will let you know what we find after touring the place and talk to the staff.

Please feel free to reply about your situations if you want - I am here to listen!!

[Plucky]

Hi Lizzie,
what happened?  did you have your visit?  I can imagine the pit of dread you have in your stomach about the possible outcomes.  I wish you the best.
I just have a suggestion I use when speaking to my aging N mom.  When she says something triggering, I just listen or at most say, 'mmmm'.   When she asks if I heard her, I repeat what she said.  Then no comment. or I bring up some topic she is interested in to distract her.  Try not to let her comments get in.  Picture your mind as an inner chamber and an outer chamber.  When your mother is talking, don't open the inner chamber.
Plucky

[miss piggy]

Hi Lizzie,

I join Plucky with intense curiosity 

Also, I reread your last post about the social worker/ditz.  Does she work primarily in the "geri" population or the "psych" population?  In my initial visits to seniors land, I heard often how we won't know what it's like to get old...I think every field has its throwaway lines. 

Although, I have to say, before I became more versed in psych pathology, I was just a young naive pup in a cubicle.  There was a new coworker who attempted to jump out a window.  We were ten floors up.  She was actually outside the window, sort of dangling, and someone was able to talk her in.  My other coworkers and I were shocked.  Our HR person called her emergency contacts and her brother and boyfriend came.  They were (we thought) blase and unfeeling.  Oh, not again, hmm, said one.  We were all so baffled at this reaction.  But now if I put myself in their shoes, I would probably be close to just that: calm, okay what do we do with her now? kind of thing.  I felt very sorry for them.  It was sad for them and for her.

I have to say that I'm still a ways off from not caring how things look to others.  The social worker in my parents case commented on my calm demeanor, saying most people she sees are practically hysterical.  So I told her my parents have given me a lot to think about over the last few years.  Besides, my N is the one who is hysterical!  And we all need relief from that.  Then she sort of got it.

Hope to hear back soon.  Best, MP

[miss piggy]

Hi Marta,

Argggh!  That would drive me nuts! 

Maybe you can introduce relatives to the concept of "manufactured drama" without naming names, before they think you're on endless holiday.    (But I have to say, that's a great idea, too..)  If they don't get the message, tell them you are teaching your mother to face the consequences of being so careless.  Tough love, baby.

Hang in there, MP