Mom's not really trying -and I feel guilty. How do I cope?

Detail is good, that way you know that people know where you're coming from. I wouldn't put off the POA thing, even if it is difficult. You've got to explain to your mom that even though you respect her desire for independence, if she falls again and gets hurt badly and no one is there to pick her up and get medical attention, she will need someone to coordinate her care, pay her bills and what not. If she's as independent as you say, I'm sure she cares about getting her bills paid on time! I too, lost my brother to suicide, and it IS tough talking to my mom about it. Let her know you understand how she feels, but that you want to be able to take care of the small (actually big!) stuff and you need the authorization to do it. And yes, by all means, take care of yourself first...you're gonna need all your resources together for what's ahead. The "not trying" part is definitely, in my opinion, a symptom of depression...not wanting to "bother anyone" and feelings of not being worth people's time and attention keeps our mom's from reaching out and self-advocating. You must let her know that she is worthy, and people are there to help and glad to do it...that's why they chose those careers! Above all else, let her know you love her and understand her moods and fears, and that you want to help. No need for guilt at all...you wouldn't be writing in if you didn't care! Good luck :) and do take care of your own needs...you can't give someone else your best if you're not physically and emotionally healthy.

I agree that she 1) needs to be evaluated for balance issues and 2) may need a live-in caregiver. My mother is a lifelong "victim" as well, and was constantly telling me she was falling in her apartment. She had to be 911-Ed once when she hit her head but managed to get up and call the EMS. You are doing all you can. Short of moving in with her or visa versa, you have covered all the bases. But, once again, please have her evaluated by a geriatric specialist.

Sasha340, you must have missed that her mom is only 73 so has always had a telephone and should be able to learn new techniques and devices. Heck my dad is 95 and uses a laptop, email, reads online etc.
the more I read some of MB's details the more I think her mom likes the drama perhaps and is self centered, therefore likes and needs the attention. MB you must set boundaries. I'm not sure why you feel guilt...what did you do wrong?

MBFoster: Yes, I guess there are some people who, in their minds, convince themselves that they are older and can't do much to help themselves. Sad, really, because we all know that the body in motion stays in motion. Hereditary genes ARE strong!

MBFoster

First of all, you are doing a very good job. Our parent's generation is from an era when the children came to the parent’s home and took care of them. Hold on, I am not saying you should do this, I am sure the answer in our modern world is (you should do that going home to take care of mom’). I am an only child also and both my parents are now deceased. However without knowing it they made me feel so guilty for not being there for them (after all, they had taken care of me and been there for every new adventure whether ask or not).

The care you have provided so far sounds excellent. Don’t worry about her reaction to your calling law enforcement to check on her. She very possibly was proud you had done that (showing how much you cared). Our generation is the nomadic one and most families are spread out all over the country and/or world. You are doing what is necessary to keep yourself on top of your business, as well as taking care of her. Your care shows there was considerable thought into how you could best meet her needs (hiring home health, having some help to run errands and having someone to check in on her as necessary).

I believe your mom is frightened to be alone and you are the most logical person for her to vent frustration. While passing the video regarding how to get up after a fall may have seemed like a good idea for you or me, it possibly exemplified her frailty and loneliness, this lesson required some abstract thinking that may not be present at this stage of her life. Also, when she falls not calling for help is a common reaction. The fright of the situation causes older folks to forget protocol they have not lived with all of their lives. Telephones are relatively new to their world, being here for only sixty to seventy years or so.

Since I am unaware of your mother's medical issues (please be careful putting this information online). It seems to me she would be oh so happy if you were closer. I would suggest you sat up visits and provide a calendar with the dates of your visits. This will give her something to hold on too. She will know you will be there for a visit in ‘X’ number of days/weeks/months. Try to use you leave from work to benefit her needs realizing that emergencies are or FMILA (Family Leave Act which is a law). I am sure you realize for your mom to learn new techniques or the use of modern conveniences is expecting a lot. Concentrate on putting extra help in place – longtime friends, hobby friends, past working friends. You may be able to get some information regarding these people from Lutheran Social Services, Catholic Services (neither of which require being a member of the church and are not suppose to prophetlytise), Senior Centers (in the area), Looking to the community Mom is living in will make all the difference for both of you.

Most of all, try no to expect the next call you get to be either berating or riddled with a quilt. Rather look to the positive side of every communication with her or her medical team. The worse that can happen is that you will come away from the conversation with a newfound consideration for the situation. While this is not easy at first, you will find it easier and almost second nature after a short amount of time.

Oh dear. I have a sinking feeling that I ought to put you in touch with my daughter :/

You're not my daughter in disguise, are you???!!!

No, I'd know about the real estate - phew!

But if you were my daughter, and there are many parallels there including the belief that you are responsible for your mother's happiness and mental health *which you are not*, I would be able to confirm categorically that I was proud of you, happy for you, no conflict. Also relieved that you had avoided repeating mistakes I'd made.

Unfortunately, that wouldn't make me richer, younger, healthier or happier *in myself* and any problems that were already there would still be real.

How do you get on with setting boundaries with your mother? Will I be sorry I asked?!

Wow, Churchmouse - you hit a chord there.
While my mom was my hero from the time I was about 10 until 18 (because she withstood the miserable marriage to my father, worked, and seemed strong), my mom has always been semi-disengaged from my life since I left for college. She's proud of me, but conflicted. Since college, I have married a man she adores (while she divorced my dad), had two children (and raised them happily, while her parenting was fraught), earned two master's degrees (one of which she then pursued herself, ending up stopping short of earning a PhD), and bought and sold homes (while she went from being an employed home-owner to living on social security in subsidized senior housing).
She's never been the type to remember or acknowledge birthdays consistently. Basically, other people are an afterthought. As she has struggled all her life with emotional/mental health issues, her issues always, always come first.

And I feel guilty for not being more supportive of her. Of course.

"Does she ask what's going on in your life?" -- as CountryMouse just asked. Very good question. And the answer might shed new light.

My mom started aging beyond her years in her late 60s. Her only topics became bills, chores, paperwork, who has what disease, who died. And how "busy" she was. Always so busy. Most of it I chalked up to an old-age amplification of her life-long "I know the best way to do everything and I'm the only martyr -- I mean person -- who can do it."

The "busy" mantra pushed all my buttons. Mom hadn't worked outside the home in 40+ years, did not volunteer or socialize or travel, and had no nearby grandchildren. It was just her and my step-dad rattling around. With mom obsessing about the mail and their next meal and a to-do list that she could never quite articulate.

Meanwhile, my life was a monument to multi-tasking -- as it is for most 40-somethings. Crazy job (company losing financial stability as my workload and hours increased). Ridiculous commute; driving 50+ miles per day. (Mom hadn't been more than 10 miles from home or out of the house for more than 60-90 minutes for nearly 10 years. Trying to describe my 11-hour workday got old fast. After all, mom is busier!) Trying to be present for my sig other, who is awesome and deserves a real partner, not a frazzled robot. Periodically placating "the in-laws." Enjoying friends, hobbies and tbe occasional personal accomplishment.

Conversations with mom became quite stilted and one-sided. Her tape-loop of busy-busy-obit-busy. If I injected anything about my obligations, she'd one-up from her small planet. If I mentioned anything fun or enriching or relaxing, she'd fire back with a version of "it must be nice...." or act like I didn't say anything.

Over this same period, mom was developing progressive balance deficits. Unsteady. Slow. Falling. Falling more frequently. Eventually unable to write with her dominant hand. Early in this deterioration, she'd report her episodes to us. Describe everything she "powered through." And furiously reject any suggestion that she get checked for internal injuries or fractures. Always acted like her loved ones had the problem, not her. That got old fast.

Then mom got secretive about her falls. And bruises. And hours on the ground. And the times she'd cave in and call 1 person for help -- then make them promise to not tell me.

This transitioned into mom's widowhood. One less witness, which fed into mom's comfort zone. It was mom's world. And we could all kiss her azz. Until she needed someone to come over and write checks, run the weed wacker, bring t.p. & and orange juice, et al.

What did her doctor say about all this? Not applicable. She refused to seek medical care. (Financially stable and excellent health insurance, BTW.) But -- get ready -- she was too busy to take care of herself. Too busy to get a diagnosis. And too intractable to understand that her loved ones' peace of mind was at stake.

Mom got more and more frail. More and more apathetic/unreasonable. (Altho sharp-minded in the sense of knowing people, what day it is, current events, good word choices, still a math whiz.) The falls became daily.

Eventually mom died. In her mess of a home. Alone. Autopsy revealed a parkinsonian syndrome and 2 forms of dementia.

I refuse to beat myself up over not knowing what I didn't know. But in hindsight, my mom's switch to small mind/small world -- and loss of ability to engage with the most important people in her life -- was the first sign of neuro deterioration. I mistakenly thought she was just beciming garden-variety weird and self-centered with age.

In addition to your grief for your brother, your are grieving for your mother. Now. If your current support group does not understand this, find one that does.

With your mom's type of decline, loved ones experience the most painful losses while the elder is still alive. It's SO crushing. Over the past 5 years, I sometimes wished I would "go" first -- simply to Make It Stop.

Keep coming back here for support, too. The AC community understands. Even when conflicting adivce comes your way, there's value in all of it! Hang in there.

MB...

Your mother is living in a suitable environment, among people who know her well and are, clearly, keeping a close eye on her. Or as close an eye as she will let them, anyway. Take comfort from that.

You tell her you want to know what's going on. Then when she gives you the full gory picture you think she's enjoying it. Supposing she hadn't sent you pictures, and you'd decided to visit her, and found her covered in bruises - you'd have gone ballistic that she hadn't told you the whole truth, wouldn't you? She can't win, really, can she.

Are you sure you want Power of Attorney? I agree that it makes life much easier administratively; but with the greatest respect you are, for very good reasons, not involved in your mother's day to day care. You don't pay her bills, you don't oversee her activities, you're not responsible for her welfare; and, here's the key thing, YOU DO NOT HAVE TO BECOME SO, either.

Please don't take this as a criticism: I don't believe children *should* automatically assume or accept responsibility for their parents. And you have other, important obligations: you're not even particularly well-placed to take on a greater burden of care for your mother.

What concerns me is that you mentioned almost casually that your brother took his own life a year ago, and that you felt you ought to get that sorted out in your own mind.

Er, yes, you should. I cannot imagine what level of anxiety and guilt you must be carrying from such a tragic family event, and my heart goes out to you. It does not surprise me that you are in a state of constant worry about your mother, nor that she is giving you chapter and verse about what is going on in her life.

Tell me, does she ask what is going on in your life? May I ask?

Your mother sounds stubornly independent and proud of it. She will not take help forsed on her. She is living her life as she wants. Please do not over-worry. One day she will realize she needs help and ask you for it. Make her feel she is in control of the help and she will accept it..

She seems to enjoy all of the extra attention she gets from her falls and injuries, she probably needs more activities and contact with other people. I know you just got her moved, but I would seriously consider looking for an AL, perhaps something closer to you?
I'm sure the docs have probably checked for this already, but the falls and your description of "shuffling tiny steps" make me wonder about Parkinson's disease.

Cwillie - I feel like such a jerk for rolling my eyes about her bruises, rug-burn and scrapes. And yet -- this isn't her first fall. Far from it. And she always bruises horribly. Why does she seem to enjoy it so much? Why does she offer to send photos, and tell me she's worried that she'll get blood on her sheets 'again tonight' from her scrapes? How am I supposed to respond to that? I am shocked, horrified, guilty ... and angry, because in a sense these are self-inflicted wounds. She had her phone; she could have called for help.

Make sure you get her to sign a health care proxy also. If she is falling, she could become unconscious, and you would definitely need that proxy to make sure you know what is going on and to work with the doctors.

To Llamalover47 -- Some bodies seem built to keep on goin' on better than others. There's probably a psychological component; my mother's mindset has always been that she was born to suffer. Where did it all start? Who knows - but she has always had manic-depression and migraines, and as she's aged she has developed arthritis, high blood pressure, thyroid disease and maybe fibromyalgia. She has never been athletic or a risk-taker. She is, you could say, slowly becoming paralyzed. Her gait over the last year or two has become a shuffling of tiny steps. Physical therapy seems to have done little to no good; she just complains about how much she hurts afterwards, but doesn't speak of improvement.
Perhaps it's a blessing in disguise that I have much the same body type as her; though I am just 50, I already have quite a bit of stiffness and joint / connective tissue pain. So I am sympathetic. I'm also terrified. Will I end up in the same shape?

To all those who urged me to use an attorney, I am heeding your advice. I assume that I will want one who practices in Arizona. And I assume that there is some way that this can be handled largely by phone and e-mail. Thanks for your guidance. I know that things will seem better when I work through this -- if only because it will force me to think about the inevitable. When I know what to expect, I can cope a lot better.

MBFoster: I am very SHOCKED that your 73 year old mother is acting very much older than her physical age. Is she on medication for her "lifelong depressive?" You should get her checked out by a psychiatrist. My goodness, I'm 69 and 1/2 years of age and I would immediately get myself to the doctor if I "tottered" and also if I had lost that much of skill set to know that if I've fallen, I call 911 stat and don't scooch, crawl, et al.

The Health care power of attorney also allows HIPPA access so you can handle her medical affairs later should that be necessary. I agree on using an attorney for both types of POA.

Plus, there are technical things that may need addressing that only a lawyer may know about. New laws can change requirements. I wouldn't take the chance.

I strongly agree with Sunny, use a lawyer. It's not that expensive.

Also, if the language of the poa is written correctly you can use it to take care of her affairs and finances now as long as she agrees. Don't get a limited POA that gives you no power until she is declared legally incompetent.

There are different types of Powers of Attorney. I'd contact an attorney to make sure it's done properly. Getting things online can be problematic to a lay person. It's not that expensive to go with a legal professional. I've seen people do them by themselves and then it turns out that something is not right and they are worthless.

Please ignore previous flurry of questions - I googled around and found the form for Arizona. Now I just need to figure out how to present it to my mom in a way that doesn't make her upset.

Is Power of Attorney simply a form she - or I - fill out?
I imagine that it needs to be witnessed. Or certified somehow... Or do I need an elder-care lawyer for it to be legal?
Is it state-specific?

Thanks for the input, cwillie. We will take a look.

Cands, Jan is talking about a gait belt, while it does give you something to hold on to if you are helping someone I myself have not found it to be very helpful in helping mom off the floor. You can see many helpful videos on using gait belts and getting up from a fall by searching YouTube, it is a great resource for lots of caregiving info.

Thanks tornadojan! That's a great idea. Although we've heard about these items, it just didn't occur to us at the time that there might be a need for one. We'll be on the look out - maybe at thrift shops in area.

Hey, cands!, can I make a suggestion regarding picking up dad? The home agency we use gave us one of these belts - like a seatbelt - to use with my mom. If you've ever seen anyone do physical therapy after surgery, maybe you've seen it in use. Anyway it is like a safety belt so the patient doesn't fall. I have used this at least 3 times when my mom just went down. I don't understand the physics of it, but just putting it around her waist and grabbing on has allowed me to pull her up with ease. Without it, she is like dead weight and I just can't do it. I wouldn't have believed it until I tried it myself. Good luck!

MB--I feel for you, caregiving is hard enough when you can actually get to your mom and see her and watch her "in person".

Maybe time for you to visit and address everything at once? At 73, being "tottery" suggests to me, anyway, that she is not getting much physical exercise and there could be some serious muscle atrophy. My mother is 86 and since her hip replacement, she is VERY tottery. She needs a walked but refuses to use on in her own house. That battle was lost....but prior to her surgery, she was falling all the time, 3-4 times a week, and would also kind of "play up" her injuries. That's just the sympathy vote, in her case.

Maybe if you came to visit you could assess the situation, get in place the POA, check her living environment and make it safer, get her to the dr., etc. Oh, this sounds like a joyous vacation, doesn't it? But I think trying to do all this long distance would be harder.

It IS hard to talk about end of life things with our parents. Some just refuse, but hopefully your mom will be compliant. Fuss her a lot when you visit (sounds like she asking for attention)...and let her know that you come from a place of love, not anger. My mother doesn't do well with the criticism that sometimes comes, and now I am older and get some from MY kids, I get it.
I wish you well. I am sorry about your brother. Please try to come to terms with that too. You have a lot on your plate, but you can always come here to talk.

We feel the same way with 90 Y/O Dad and we are right here! He lives semi-independently next door to us and we have monitors in place so that we can keep an eye on him when we are not there or he is not here. There have been a few falls recently - fortunately with no apparent or expressed injury, but mostly due to the fact that he "forgets" to utilize his walker.
He is tall and heavy making it difficult for even both of us to pick him up, so husband and I have literally gotten down on hands and knees and shown him how to get himself up. Unfortunately his retentive abilities are not what they used to be and he is unable to recall this info - especially at the time of distress and disorientation.
This is very difficult for us and of course our primary focus is prevention, but we tend to think more logically than Dad can given his current physical and mental conditions.
And his PCP so wisely reminds us at every check-up, "It's not going to get any better"!
BTW -where can we find the video showing the elderly man about how to get up from a fall?

All good advice from many people who have been there, or are still there. I'm wondering if your mother is just starting into dementia because she is exhibiting many of the signs. If showing bad judgment is not part of her behavior in the past, I'd have her evaluated. (but keep in mind that elders can often fool a doctor into thinking they are "normal" - my mother did for years also lying to the doctor.)
You mom may be beginning to feel her limitations and is fighting them, and part of that fight for continued independence is denial (and doing things they know they shouldn't - like standing on a chair to hang curtains, etc).
By all means, get a POA before it is too late and see if you can get your name on her accounts so, in case of emergency you can pay her bills, etc.

I can't stress how important getting the Durable Power of Attorney and Healthcare POA as well. There will never be a better time to get it, since your mom could suffer from mental decline and then not be able to appoint you. Then, it's much more complicated. You can make up a story about someone you know and how horrible it was that they didn't have the paperwork signed. And it's true. You can read about that all the time around here.

Since you are long distance from your mom, you might explore getting what I have read about called a case manager. I hope that's the right term. They can assess your mom's needs and even keep check on her to determine how she's doing. It would be ideal to have someone go into the apt regularly to ensure that your mom doesn't have spoiled food in the fridge, plumbing is working, that she is clean and nourished, etc.

Will you be in contact with the doctor she will see for an evaluation? It might be a good idea to provide him input, since, you can't be sure what your mom might tell him. She could suddenly say that she never fell. So, I'd try to confirm that the info that she reports to an evaluator is correct.