The daughter's situation isn't uncommon: A stubborn parent who needs help but won't take it. A caring daughter caught between duty and guilt, stymied by indecision and inexperience.
Eleanor Roth, a friend in North San Diego County, asked me for help dealing with her stubborn mother on the East Coast.
"I think she is terrified of losing her independence. She is mentally all there, but physically, she's a mess. Of course, I feel guilty because she's in Florida, and all of her seven kids are spread around."
Eleanor tells me her mom is only 74, but has almost no use of her right arm and hand. She's also lost some toes to diabetes and has no feeling in her feet. "It's only a matter of time until she falls."
A stubborn infection this year landed the septuagenarian in a rehab facility. But, Eleanor says, "we can't even bring up the subject of moving her out of her home. She just changes the topic, switches to baby talk."
Though Eleanor and one of her four brothers have been the most involved with their mom, I suggest a family meeting. Strength in numbers.
Usually, I recommend that older parents who go into rehab and obviously need long-term care, stay there. It's easier than prying them out of their home later.
The next option is hiring a caregiver. But, Eleanor says, "Mom's notoriously cheap and doesn't want help." The daughter has arranged for an occasional housekeeper and someone to do errands. "But Mom doesn't want anyone checking on her."
Short of a caregiver, the older woman needs a personal security necklace or bracelet. Eleanor promises to try. "She probably won't wear it; she'll be afraid we'll take her to a home if she falls."
Meanwhile, it's past time to get rid of the car. Eleanor needs to alert the DMV. She can ask for anonymity and deny she ever called. White lies, lovingly offered, are a vital part of caregiving. Get used to it.
I suggest Eleanor offer to buy the car and put the money in a taxi fund. That way, her mother might feel better about forking out cab fare.
I tell my friend what she already knows - It's time to take charge. Perhaps she can start by talking about the future instead of the present: "Mom, someday you might need help. If we make plans now, we won't make bad decisions in a crisis. Maybe we can look at a few retirement homes, have lunch there or even stay for a few days. Then you can choose the one you like."
The National Eldercare Locator, 800-677-1116, has a list of homes and services for older folks. I suggest hiring a geriatric care manager or other professional to mediate the discussion. That way, it won't be so easy for mom to weasel out.
Eleanor's mother has signed a power of attorney, but also needs a health-care release, allowing doctors, insurance companies and others to talk to at least one of her children.
As we chat, I discover what might be the root of Eleanor's timidity. About 10 years ago, her mother locked Eleanor's grandmother out of her own house and forced her to move in with her. It didn't work out, and the grandmother was moved to a facility where she rapidly declined.
I remind Eleanor she's a loving daughter who will treat her mom with firmness, tempered with love and respect.
She agrees. "I know I'm being manipulated. I've got to be assertive, not let her play me."
Marsha Kay Seff is editor of The San Diego Union-Tribune's www.sandiegoeldercare.com, a Web site for older folks and their caregivers. She can be contacted at email@example.com.