Elderly mother in decline

[AmazingGraced]

I didn’t want to derail the other thread about a similar issue .
I have a nearly 89 year old mother living independently in a first floor flat. She has remained in very good health generally, but things are very much in decline now. She has diabetes , gout and a minor heart issue. She’s had two or three falls in the last three years, one resulting in a broken arm. The major concern however is her failing cognitive health. She’s increasingly confused and recognises herself that things are going downhill. Her moods are erratic, she can be very spiteful . She accuses people of stealing things and is struggling to work her washing machine, the tv etc.

I live in the same city and she calls me when she’s in a panic. I deal with her finances and sort out crises but am don’t see a lot of her otherwise as she is liable to turn spiteful which I find very upsetting.

The issue is that I plan to move hundreds of miles away closer to my children this year. She’s very upset about the prospect, but I am unhappy living where I do and am getting older myself.

My sister lives at the other end of the country, and she wants my mother to come and live with her . The problem is my mother doesn’t know the area, has never seen the house, and my sister lives in a chaotic way with a teenager. She doesn’t have much tolerance for my mother and only sees her once a year for a few days anyway. I’m not sure what her motivation is , and it’s dependant on her getting a bigger house anyway. This is tied to her partners job.

I can see that in the next few years things are going to go quickly downhill. If I am a long way away I will have to deal with it from a distance. My mother has a number of younger friends in her church who she is close to. I’m sure they would help her , but they aren’t family.

My question is really, should I go anyway without guilt or stay and wait until she dies? Given that by that time I may be struggling with poor health and low energy . I already am. I don’t like my mother or enjoy spending time with her but feel a sense of duty.

I think you should put carers in place, it’s not right to put the burden on others, and then go.
Is there a will and both POA’s in place? Have you spoken to the GP about her mental state? Have you asked SS for an assessment?

You don’t mention what your mother wants for her final years. Have you asked her? Does she know the options? Do you? Extra Care housing for older people with onsite carers exists. It’s a community and there is probably one local to her. My parents spent a very happy 5 years living in a rented flat with increasing carer visits owned by this organisation until my father died and my mum needed to move to a care home as she had dementia.
https://www.housing21.org.uk/

is her current home future proof? Is there a lift to get out, an accessible shower / bathroom? If no lift she will become housebound at some point increasing her isolation.

I think you need to sort her living arrangements out in the coming months so you can leave with a clear conscience and less guilt.

Given that she's nearly 90, while she's done very well to live independently till now, if you're moving away you need to future proof her arrangements. I would be thinking about a residential care place in her current area, where she can live safely and be looked after and where you and your sister can visit and also her church friends who are local can drop in and maybe take her to church.

Get a care needs assessment, get carers in for your mother and move. Otherwise you could be stuck where you are, unhappy, for years. You can do all this and your sister can still work towards having your mum wirh her, if it's what mum wants, but it sounds unlikely that that will happen.

She won’t consider that at the moment

There is no lift and there’s no way to install one. I have talked to her about this but she won’t listen .

I’ve written to her GP. She doesn’t need carers yet but the time is coming.

What does your mother want to happen? (other than you not to move) does she want to move?

You need to ask for a care needs assessment through her local council. hopefully GP will refer to memory clinic for a proper assessment although waiting times can be long depending on area.

If she knows you want to move but is burying her head in the sand re the suitability of her current arrangements then all you can do is look after your own needs ie move and wait for the crisis.

Get the PoAs in place and get her a care needs assessment done so she is on the radar of social services.

POA is in place. I sorted that years ago.

Would your mum consider moving to sheltered housing where there would be more people around her and possibly a warden. She could opt for a ground floor flat but if not then at least there are lifts. Would she perhaps move to sheltered housing where you are moving to or near your sister? If not then at least look into a careline device for her to give some peace of mind. Also consider a key safe so if something happens, fall etc then at least someone can gain entry without having to break in

OP, you really do have to put yourself first. I would go ahead with your move. You need to speak to your mother and tell her what her options are. Don’t give in to tantrums. She can move into a home, move in with your sister or stay where she is without your help. You cannot go from full on helping her with problems to no help at all so perhaps you could slowly stop doing things for her and if she asks tell her she needs to get someone in to do her washing, cleaning etc. Don’t give in when she has a crisis. Tell her she just needs some sort of care. Maybe she needs a carer. She probably does need some form of assessment. How much money does your mother have? This is important because the local authority will only pay for carers if your mother really needs them and doesn’t have money of her own. If she has her own money then she can pay for them.
Move nearer to your own children and then don’t put all this on them when you get older. Have this conversation with them now. I have.

@BizzyLizzyandLittleMo
Given OPs mother’s age and cognitive decline, I don’t think sheltered accommodation is going to last for long. If bought, these homes are ridiculously hard to resell and come with huge fees that must be paid even if the occupant has moved out.

get her a care needs assessment done so she is on the radar of social services.

^ I think this may help.

Then if you are less or not in the picture they will become more active (my experience anyway).

In a way OP only you can answer this question.It depends so much on things only you can know, eg your prior relationship generally as well as now, and as you say your own heath, adult children etc. Would you visit at all? Every few months? If you are not close in any way and she doesn’t want to change her circumstances in any way, it seems limited as to what you can do, from near or far. Can you get the ball rollling now to move; it may take time anyway. Or is it something you can do quickly/easily once you decide?

We are all different, and our relationships with our parents are different.

If you move away, trying to manage her care from a distance will be a total nightmare. If you stay, it will be a different kind of nightmare.

The final years of an increasingly frailer parent's life are pretty shit for most people. The only way it isn't shit is if you genuinely do not care what they are going through. The truth is, it only really works if you have unlimited funding to get them into a good home, or there is a family member prepared to drop everything to meet their ever increasing needs. What most of us do is muddle through, often doing more than we want to but less than we feel we should. So it is a mess and most of us lurch from crisis to crisis until it ends. It is time limited, but no-one knows how long and for some it goes on for years.

I don't think I could choose to move away at that stage, but I do like my mother and have a lot of empathy for how she would feel managing that situation alone.

If you do move away, it's likely the next crisis will precipitate the move to a care home. That might actually be the best thing all round. I agree that sheltered accommodation is often too little, too late and rarely solves the ongoing issues.

Sorry you are going through this, it's so tough.

You don’t need to do anything.

you can move. Sounds like all the legal stuff is in place and she’s refusing to do anything sensible in terms of preparing for increasing problems.

your sister is willing to take her in subject to some conditions so that’s good.

just go.

Given that the OP’s mother has declined residential care and is not yet at that stage and does not require carers, sheltered housing may well be the best option especially if she is not willing to move to be with or near either daughter. There are plenty of places that are not extortionate and in my area the moderately priced ones sell reasonably well. It’s often possible to obtain council places too - there are some quite pleasant ones available. There’s often a good network of residents in sheltered housing where they look out for one another as well as social events if people are so inclined. Yes it may only turn out to be for a couple of years or so but in my opinion it’s a much better option than doing nothing or the usual response of shove them into residential care without even a thought about what the person themselves would prefer. It sounds like the OP has already been down both routes and they’re not suitable so if her mother is willing this might be the safest stop gap until things deteriorate further. Only other alternative I can think of is a private carer arranged by the family but that would depend on her mothers finances obviously

This. She won’t consider the sensible option, then go.
The wants of someone at the end of life, don’t trump those of others in the prime of theirs.

Get a lasting power of attorney for health and finances. Choose a carer's agency to come and see her daily to make sure she eats and take her meds plus light house work. Get a cleaner to come once or twice a week if needed for general tidy and laundry, even though many carers do that for elderly so you might not need to. Make sure her her physical health is up to date and there are no UTIs or other infections which might affect her cognitive health further.
Everything else can be sorted from distance such as food shopping.
And do go and live your life while you still can x

The problem is that a lot of people who haven’t yet been through this assume the lovely little white haired old ladies will be happy to live in a nice care home and play bingo. It really is not like that. They usually refuse to move out of their homes (I’m sure we will too), and have crisis after crisis (from the TV remote not working to falling and breaking a bone) that worn out daughters will
sort out. Care services are shit, the old folk refuse to let them come in, social workers don’t care until they are really struggling and residential care, unless you can pay, has to be begged for.

You could wait until the next fall OP, ensure she goes to hospital and is then not discharged until a care package is in place. Your mum will find it harder to refuse that, and if they try to discharge her, tell them you want a full assessment or it will be an unsafe discharge (use those words). She is then on the radar of the (albeit largely terrible) social care team and it’s then easier for future care to be increased.
Sorry if this is not want you want to hear but so many of us women become trapped in this system. Stay put for now.

Beware with the POA. You say you put it in place, you must be clear that your mother put it in place when she was fully able. You cannot act as POA until the necessary time.
If your mum may go to your sister it might be better that she has the POA,
POA makes things easier for doctors, hospitals, nursing homes etc. But for the person holding it it can have many negatives and can be time consuming from a distance. A lot of people use it to siphon money from a parent hence the banks etc do have to make checks and can and do make allegations. If your mum is of a spiteful nature she may use this to her interest. Please be cautious.

My mother was the same with falls & broken arm, decline in mental ability etc but wanting to remain living independently although I was the means to her independence as she expected me to do everything for her & it was honestly a nightmare that I won’t go into detail about but I never want my DD to do some of the things I had to. With her last fall the hospital discharged mum to a care home as she wasn’t ill enough to stay there or well enough to go home. We convinced her it was the best option for her own safety (which it was).

it took me at least 2 years after her passing not to feel sheer panic when my phone rang or I heard/saw an ambulance. I’m not sure what would have been worse, being nearby to deal with everything, or guilt from living far away & not having to deal with it.

But, we only have one life & my DD & DGC are here, if they had lived elsewhere I would have moved to be with them