Elderly mum needs a shoulder replacement and wants me to do her care afterwards but I’m not up to it

[Cardiganwearer]

DM is 80. She fell on her shoulder and broke it in Feb 2023. The hospital just put her arm in a sling and hoped it would heal. It hasn’t at all, the bones are not near each other to be able to heal as far as I can understand. She is in terrible pain as you can imagine. She hoped to get away with injections as she did not want an operation with a GA as she has many other serious conditions (heart failure, stage 3 kidney disease, rheumatoid arthritis, unstable high blood pressure, under active thyroid) But yesterday she was told that injections might make her arm useless and the only thing to do is a total shoulder replacement.

She was widowed 4 years ago when my DF died. So lives alone now. When she first broke the arm she stayed with my DSis for 2 weeks broken by a weekend at her home with me staying with her. My sis was going crazy so I got meals on wheels and a fall alarm etc sorted so she could move back. She has now asked for me and my sister to look after her like we did after her original fall when she has the operation. But things are all different now. My sister has an ill teenager who is pretty much housebound and in no way could they cope with my M there again. DSis also cannot leave DN unless his dad is there and he works very long hours.

So that leaves me, effectively. She cannot come to my house (stairs, no downstairs loo, no spare bedroom) and we would all go crazy. We are me, DH and DD 17, doing A levels. DH has fragile mental and physical health and is massively affected by any stress and a very private person to boot. For all of our sakes, it is absolutely no go. I would also worry she would never leave!

So that leaves me pretty much moving in with her for however long. Our relationship is pretty dreadful although she is fairly oblivious. Everything is fine if you ignore it! I actually went LC with her in July 2024 because I couldn’t stand the belittling and nastiness anymore. She would shout at me if I suggested things to help (eg LPA, antidepressants for DF, pharmacy deliveries instead of walking miles to the chemist in all weathers) so I stopped trying to help and stepped right back. I actually had chronic pain in the skin on my arm and pelvic pain that has disappeared since going LC. She was massively affecting my health, both physical and mental. I have always been the scapegoat and my sis the favourite. This has extended to the grandchildren too. So when DF died and then my DSis was largely out of circulation, she took all her unhappiness out on me. This has been my role since I was 5 when DSis was born. The dumping ground, the emotional punchbag. M is repeating her own family patterns. She was also the oldest daughter with a favourite younger sister. She complains long and loud about this while seeing no parallels whatsoever.

The weekend I was with her, I felt I was disappearing, being erased. My personality, my interests are not acceptable to her. My DH and DD visited and I cried the whole time because I wanted to go home with them. (Completely involuntary, I am not a crier). DM would not help me with the children (I have another grown up DC) when I had life threatening post natal depression and in fact made things a lot worse. It’s lucky I’m still here. I had to have counselling to cope with her behaviour. She did childcare for my DSis of course!!

I feel weakened by the post natal depression which I had for about 6 years. It doesn’t take much at all to slide back into suicidal ideation. DH thinks doing her care would break me again.

I feel I would last a day max looking after her. And how long would it be? How long is a piece of string? Will all her other health problems? And then I’m Carer. Even if our relationship was perfect, I am not a nurse in anyway and have a repulsion of doing personal care.

So I’m going to have to tell her today, that I can’t. I’m willing to do cleaning, laundry, shopping, admin, sorting care but not the care itself. I feel very guilty as you can imagine. I feel I have been telling her by not going oh, I’ll look after you Mum! Whenever surgery has been mentioned. But no, it will need to be explicit clearly.

I don’t know what I want from writing this really. Some info about how your olds got on with a shoulder replacement. Some reassurance I’m not a monster for not wanting to do this? It’s so hard.

My relatives care home regularly used to have people in to convalesce after a hip/knee replacement, so imagine that'd be possible if you have a look about. Might be easier than care at home for at least the first 2 or 3 weeks.

My very fit and strong 75yr old neighbour had their shoulder replaced, I’d say they were in a sling for three weeks or so and back to normal after 2/3 months.

Stand your ground and tell everyone and anyone what you will and won't do. I get on ok with DM, but when she got it of hosp after an operation recently, I told everyone (the hospital discharge people, the OT, the physios, the post discharge team) that I would be there for a few days, then I would be there once a week to support housework and food shop. I'm not saying you should even do as much as that, but by standing form and biting back the guilt or urge to do more, care was put in place.

An aunt of mine researched local care homes as an after operation solution although in the end she decided against having it done. Maybe your mum would be more comfortable if you were able to do a bit of research and then take her to the most suitable home for a visit having worked out the costings. You must be very firm with both the Hospital and Social Services if they get involved that you are not able to care for her at all. Don't volunteer for even a day. It is tough but you will have to be firm - kinder for all involved if you are just upfront and have a solution to offer. You may find anyway that with no one at home she will qualify for a place in Rehab.

Is she one of those people who will defer to a refusal of it's from someone else? 'My Doctor says I'm not allowed to drive every day', 'My husband says I have to be at home to look after him and DC' ?
You can make it up, she doesn't need to know.

You are not an available. This is a critical time in your daughter’s life. As already said rehab or carers. My mother had 2 months rehab in an NHS hospital last year after a fall and a fractured hip.

Just tell her you can’t look after her.
If any hospital staff ask say the same.
Use your own health or your children as reasons - no one can argue with that.

You can recommend she has her operation or goes to a nursing home.

Alongside both of my siblings, we cared for our elderly windowed parent after surgery and god it was hard work!!!! I couldn’t imagined doing it under the circumstances you find yourself in. It would be a hard ‘no’ from me. Be very boundaried and only commit to what you’re happy to do.

My DM had this op and if she has a good as result as my DM had, it will be a good thing.

She definitely needs to make other arrangements. Caring means organising appropriate care sometimes, not killing yourself to do it personally.

I've been in this situation a few times and looking back, I should have insisted on outside help, rather than trying to muddle through, get overwhelmed and on a couple of occaisions, leaving abruptly, which was less than ideal.

You need to ensure that both your mother and the hospital know you are not available for aftercare. It is very common for the elderly person to tell the hospital that family will do the care, and then the hospital don't arrange anything.

As others have said, do not give any explanations as to why you are not available. If you give reasons, people will try to find ways around them. Just keep stating that you aren't available.

In similar circumstances (hip rather than shoulder), mine had to go into a care home for a couple of weeks after surgery.

There are lots of people for whom having an elderly relative to stay for recuperation wouldn’t be practical, nor can they stay with them or do it by visiting.

The care home is a much better option as it’s 24/7 staffing, people who know how to care and assist, different people(!) making the meals.

You don't have to do this. Social services and hospital won't push it on you if you make clear it's impossible: there is a discharge system for this. Flawed, but there. And reablement/rehab will be funded so she needs to use it. Good luck.

Don’t feel guilty. My Dad had a major ankle op when he was about 80 and couldn’t go straight home as he lives alone. Both I and DB live about 4 hours away and had work and family commitments. Our housss are also unsuitable nor could he have spent that long in a car post op.

He went to a council rehab centre for a month. It was grim and he hated every minute. He then came home and has largely regained his health. I would suggest seeing if you can benefit from something similar. You can visit (be moaned at) and leave her to recover.

God no, don’t do it! Discharge coordinator at the hospital can arrange 4 visits a day for 6 weeks for free, or possibly discharge to an old people’s home for short term care. Just make it extremely clear that she would be by herself with no one to help.

One of the care homes near me is explicitly for this scenario, a reablement centre. She would do better there anyway, say that on repeat and don't feel guilty..

Solidarity Op. I can identify so much with what you say especially the loss of sense of self.

You absolutely MUST say no to caring for her. She won't be able to take on board any reasons you give her so I wouldn't try.

I'd just say "I'm sorry I can't manage that" and rinse and repeat. Don't try and explain or justify. If she says "Why can't you, you have time, aren't working etc" then "I've got too much other stuff going on so I'm sorry I can't manage it" Don't be drawn on the "what stuff" - just "Oh, lots of things"

When she gets to guilt trip you and she will, just accept you will feel guilty as she has spent your lifetime conditioning you to respond to her manipulation. You will feel guilty but you don't need to. It is false guilt generated by her in order to try and get you to do something.

Hi OP. Lots of brilliant advice and clear opinions here that point out that you simply cannot become her carer (which I agree with).

I just wanted to say (as someone with professional experience) that if adults social care do become involved, maybe to do a needs assessment to explore carers/care homes, please be mindful that unless you explicitly tell them you do not have any capacity to be her carer then they will expect this of you. Your mother may also tell them that you will care for her, as this is what she wants to happen. Tell them yourself that you can’t and won’t.

If you are offering anything (laundry/shoppings etc) then tell them the absolute boundary of this. For example: I may be able to visit once per week and bring perishables / meals to last for 2 days.I may be able to do one load of laundry per month but not bedding or towels. I cannot 100% commit to any of this and there needs to be a back up option if not able to do this. This means that you won’t get written down as the person responsible for all the shopping and laundry, and you becoming the default option. It’s a slippery slope. . If you do end up being able to do more than that sometimes, this is fine… but it’s not a commitment or responsibility.

adult social care services being where they are resource wise , they will snap your hand off for any offer of care and you need to be very brutal and firm about your limits… don’t be persuaded to do just a bit more. Again, it’s a slippery slope.

I wish you very well xx

Say no, in no uncertain terms, and remain consistent. Rinse and repeat.

When she goes into hospital you need to contact the hospital social workers straight away . Explain to them that you cannot provide care and they will arrange care workers , usually four times a day , to do her personal care . This can include getting her out of bed and helping her to wash and dress . They can also ensure she takes her medication and that she has food and drinks too . They will help with toileting if she needs it and the last call would be to help her to bed.
This usually happens for someone x weeks and there shouldn’t be a charge .
Don’t let your mum bully you into doing her personal care . You will probably need to have a key safe put up by her door so the carers can access the house . Good luck .

I love my mum, she was a far better mum than yours. But following a recent hospital stay she lost a load of independence and (be warned) contrary to what we all hoped, has not regained it.

But no way were or are dsis and I willing or able to provide care beyond social visits and admin. We made that clear from the outset. But actually it wasn't challenged anyway. And no-one is making us feel guilty now either - webecause it's obviously a ridiculous amount to suddenly put on someone.

If youe mum cared about you, she wouldn't even ask, like mine didn't. She has carers. She doesn't love needing them because she doesn't love being so helpless, but she likes them, they know what they are doing and they're great.

What I am trying to say in a roundabout way is that you don't need see your refusal to help as some kind of punishment of your mum for her nasty behaviour. Your refusal is perfectly reasonable purely on its own merits. It shouldn't even be a question .
Even if she was lovely, it would be the wrong thing to do. But if she was lovely she wouldn't be asking. You are only on this rotten situation feeling guilt and wondering how to word things, because she isn't lovely.

💐

@Cardiganwearer physio here who has seen many carers destroy their own health to care for elderly parents - it is OK to put your own needs and the needs of your children & husband first and health care staff should understand this (especially if they care for their own demanding rels!) Hospital discharge won't like it,your mum won't like it, but there are plenty of people with no family at all who receive care packages/ stay in rehab/ go for care home respite. Shoulder replacements have a really good likelihood of reducing pain but for obvious reasons the risks of GA at her age with such a bundle of co-morbidities isn't low. Ideally you need a surgeon who has done plenty and that she protects her arm after and allows recovery, I have had patients whose replacements have failed because they are so independent and wanted to eg.mop the floor or hoover!

Thank you all again! You gave me strength when I talked to her.
She had texted last night to ask that my sister and me looked after her again like last time. And I thought of course not. It’s nothing like last time for a start off. My sister is going to be doing the square root of nothing at all for one thing. I left it because it was late and I couldn’t cope with the conversation. This morning I was on Mumsnet talking to all you lovely lot ❤️ and she left a message on my answerphone obviously in floods of tears and I thought here we go. I texted that I neede to take DD somewhere and I’d phone her afterwards. Much psyching up!

Well! I got reasonable ha! lovely mum who didn’t mean that at all, me to do her care, goodness no! Heaven forbid. She thinks she’ll be good if they let her have a few days in hospital, to get rid of the anaesthetic and she can have her meals on wheels and crack on like before! Seems to have completely forgotten how long she was at my sister’s and what state she was in. How I stayed with her and had to set alarms to wake me up so I could give her her morphine. How upset I was and how much I hated it. She actually said if she needs respite she would do that but yeah, she changes her story all the time. And my sister (I could fucking crown her quite honestly) said to her, oh no, you don’t want to go into respite, where will that get you? Looked after, maybe?? It’s alright if she wants to volunteer but she isn’t is she? That volunteers ME. So M has got no clue how bad it’s going to be. She used to be a nurse! Just wishful bloody thinking. She did say she will look into getting a cleaner so that’s something but it’s not cleaning I have a problem with. I don’t want her to blindly walk into this, realise, when it’s too late that she actually needs a fuckton of care for months and I get landed because I’m right there and can’t let her actually die. I think I go to the appointments and whatever and make it crystal clear to everyone repeatedly that it is a NO!

Go to the appointments, record that she has no one to care for her. Renablement care is 6 weeks NHS funded care visits or 6 weeks in a rehab placement. Keep reiterating no. Don't be too willing to cover life admin either or you'll discover she's cancelled the care visits (can you tell I've been there !) nobody will push you into caring, keep saying that you are unavailable. Care isn't social visits with a bit of shopping it's hard gruelling work.

OP I think you need to emigrate.
Tell her you are moving to Australia.

Don’t go to the appointments with her. That will put you on the hospitals radar and they will put you on the spot and assume you will be caring for her.

Respond to her with “I am not able to do any physical care, so please make arrangements for the hospital to arrange this”. DO NOT go to any appointments or meetings.

If the hospital or SS try to contact you to persuade you simply repeat that you are not able or willing to provide any care. If they ask for a reason you are not obliged to give them one. Tell them it is due to your own private circumstances and it is not up to discussion.

I would love that! I have been looking at houses in Northumberland. We are in the South! I would like the coast very much. It’s not realistic but boy I wish I’d got a career and moved far away when I was first married and this then would not even be a question.