Mother refused annual assessment

[Methuen]

Last night was a difficult phone call with mom.

Our local public health authority had contacted mom to set up a date/time for her annual assessment.  She has had two of these already.  She referred them to me to set up the appointment, as she does with her doctor's appointments.  They contacted me with a time/date, so I called mom to check it with her to make sure she didn't already have something planned for that time.  That was when she told me to tell them she didn't want them to come to her house.

Then ensued a 40 min conversation.  My H and I made sure she understood the assessment was so that she could continue with services, such as what she is getting now with home helpers coming to her house 4X per day to give her medications, and that said services will actually help her to stay in her own home longer.

To make a long story short, she is fearful of being stuck in a "home" in a small room with only a bed.  She doesn't understand assisted living, and isn't willing to listen.  She isn't capable of being rational.  She more dysregulated than usual.  She is so fearful, scared, terrified, angry, resentful, and still looking to blame anyone and anything.  

After that conversation last night, it occurred to me that what could be happening here with her is a nervous breakdown.  When I woke up in the night and couldn't sleep, I googled it.  I focussed on the Mayo clinic and other reliable sites.  It fits mom.  She has both diagnosed anxiety and depression, she lives independently (and in the pandemic she's even more isolated), and she has multiple chronic illness causing her intolerable stress which she can't cope with, and which are all progressive.  She can hardly see, has hearing loss, can't move (mobility issues and uses a walker inside her own home), she has complained of digestive, dizziness and nausea issues for years (anxiety), she has advancing Parkinson's and has recently been diagnosed with mild cognitive impairment.  She recently had a Cat scan, but the results of that aren't in yet.  Her last Cat scan in 2015 already showed binswangers (vascular dementia).  Despite taking her to medical appointments to get her support, she is noncompliant with what the doctors prescribe.  For example, she was recently prescribed Cinimet for her Parkinson's, and she is refusing to take it.  I cannot see any way this can end other than utter chaos, hospitalization, and eventually being "committed" to a care facility probably when she starts hallucinating.

Today she called the elderly services consultant at our public health office for home care services, and told her she "couldn't handle" having someone come to her house to do the annual assessment.  The elderly services consultant said ok.

I am retired, but still work about 10 hours a week.  I have been recruited and offered a new job, and decided to accept it.  It will bring me up to about 30 hours a week, working with a team of caring people in a job that uses the skills from the career I retired from, but in a new environment and with a new audience.  I will be earning income for work I have previously volunteered doing.  I am looking forward to it.  I just accepted it this morning.

I have not told mother yet.  I will probably tell her this weekend with my husband present.

She will have to walk her own path, and if it takes her to a nervous breakdown, that is unfortunate, but it is the path of her own choosing.  I have done everything I can to help, including pleading with home care services, and her family doctor.  But she is the driver of her own life choices.

I have found a new path, and am going to explore it on a new adventure.  We will see where that goes.

It is a bit surreal.  I feel a little bit outside my own body, looking down at all this.  Perhaps that is what some people mean as being more of an observer.  Mother and chaos are one and the same.  This new income opportunity for me will also give me space from her.  She will have to sort her own problems.

While I am filled with gratitude for the great opportunity to work in a fulfilling job with good people, I am also filled with sadness and hopelessness at the unfortunate situation with my mom.  But I am moving on, as well as I am able.

[zachira]

Congratulations on your new job! In my experience, when we make decisions to put our self care first, somehow big positive changes come about in the relationships with the disordered people. It is not that they change, it is somehow the message gets communicated that we are no longer available to be mistreated and they have to find other avenues for their deranged behaviors which they do. Not sure who your mother will enlist to help her, and there will be some big changes coming for sure as nothing every stays the same forever. It sounds like you have a job in which you will be much appreciated for your caring ways and dedication to service to others, and above all, it is a paid position which gives you more power to make some important differences in the lives of others. I have found many caring dedicated people in so many professions from bankers, lawyers, etc., to people in helping professions like therapists that make such big differences in the quality of life of others and the services provided. We are here cheering you on!

[Turkish]

Congrats on your job!

Where do you see all of this going with your mother? It sounds like trying to avoid that which is feared becomes a self fulfilling prophecy, as it happened with my mother.

I tend to bristle when people from other cultures judge Americans/Canadians/Westerners for sticking old people in homes. Given elder abuse and conservatorship laws we as non governmental entities can't force loved ones to take care of themselves.

As my T said about my mother, "you're a home, not a hospital." Say I had quit my job to be home full time. I'd still be at risk of being accused of criminal elder abuse (as I was) given what my mom wanted at the time.

How do you see this playing out?

[Methuen]

Thanks Turkish and Zachira.  I appreciate your well-wishes and congrats.

It feels liberating.

How do you see this playing out?

Not sure exactly what you mean, but in general terms I see it playing out much as your mom played out her story.  That which is feared becomes a self fulfilling prophecy.  Time will tell.

we as non governmental entities can't force loved ones to take care of themselves.

Exactly.  Sadly, while other cultures may judge Americans/Canadians/Westerners for the fact that elder family members go into long term care, it's also our own neighbours, community members, colleagues, even friends, who know nothing of our situation, and will pass judgement on us.  If I had a dollar for every time someone asked me "how my mother is", or "does your mom live with you?", I could holiday across the pond.  People have no clue.

[Turkish]

Yeah, I got enough of that guilt here in Cali... "She's your mom!" Unless you're in that situation, you don't really know, or can judge.

[Riv3rW0lf]

Methuen,

I am happy to read you this morning, and that you are putting yourself first.

From reading all your posts here, it's clear that you did try your best to find the best possible avenues for her but there is a limit to your power and it's healthy to let go and care for you and your family.

Congratulations on your new position!

Hugs

[Notwendy]

I am so happy for you with the new job!

I think my job is also another "boundary" as well, in addition to distance. Because I value my job, I am not available to my mother at all times. Boundaries reflect our own values - and they are values we stand by. So valuing my job isn't about her, but the result is, due to my job, I am not able to answer the phone if she calls at work, or leave at a moment's notice.

I am also filled with sadness and hopelessness at the unfortunate situation with my mom

I understand. I am sad for my mother as well. But I have watched my father try all he could and I have tried to. My father was one of the most intelligent and capable people I know. He put tremendous effort and financial resources into helping my mother and giving her the best possible, and most comfortable situation he possibly could. He planned well for their elder years and left her financially secure. She has had extensive mental health resources- but it was up to her to follow through with them and make them successful.

When I visit, I try to do nice things for her, but she's not content with what I do. If my father's efforts didn't succeed in making her happy and functional, then I don't think mine would either.

I think for all of us, if we had the power to make our mothers happy and have a normal relationship, we'd do it- we've tried to do it. Methuen, you have made an enormous effort with your mother.

[Goldcrest]

Well done Methuen, I think this is a really good decision. 

[GaGrl]

As we've said before, they are competent to make their own bad decisions. She is now in a situation that will change only when someone who is able can declare her NOT competent. And you can't do that.

It's good that you are caring for yourself.

[Teabunny]

 
Congratulations! We are all cheering you on as others have said. My friends who did something similar to you in retirement with a new job opportunity have had really positive experiences and I wish that for you also!

Being an observer and knowing the limits of your power to offer services to your mother are two excellent things you're doing, so keep it up! If I could do more for my mentally ill mother or support my parents in tangible ways I'd actually want to do it, but we must ignore the judgement of others because even wanting to do what others say you should be doing isn't possible when the parent's mind is in certain places. Instead, I support a couple of elder friends locally like family.

Speaking of, I just found a 2nd cousin of mine, who is much older, moved to my unlikely area and joined my church where we discovered each other joyously! Maybe redirect the judgement towards who you ARE taking care of and away from who you can't do any more for (your mother) but just ignore the ignorant if you can and banish the self-doubt making you care what they say in the 1st place.

Congratulations and keep flying forward!