Hello,
I am the primary caregiver (and legal/medical POA) for my 83 year old Grandmother. She is in the final stages of Alzheimer's and after 8 years of caring for her at home, I had to move her to a residential care facility earlier this year. She is now under hospice care and is no longer walking or talking and usually only tolerates a few bites when we feed her. She is easily exhausted and I find myself trying to spend time with her without requiring her to give anything back that would take any kind of energy. Unfortunately, my mother is not so sensitive to my Grandma's condition or needs. My mother has a long history of recreational and prescription drug dependency and has multiple psychiatric issues. Because of this my Grandma raised me and my mom has not been in the picture much over the years. Recently, when she visits my Grandma it is very clearly stressful for my Grandma. She often withdraws and closes her eyes or puts her head down. My mom can't understand this and continues to seek feedback from her mom. My mom will say "tell me you love me", cry, hold my Grandma's hands and won't stop talking. It is almost unbearable for me to watch and the staff at the home notices these issues too. Am I wrong to want to tell my mom to back off?

Dear Grandma’s Girl,

I am so very sorry that you are caught in the middle of this problem. I can understand why it would be painful to witness this scene. You have a grandmother you adore; she’s been good to you. You’re trying to care for her, protect her, and help her transition comfortably from this life. Meanwhile, you’re mother has her own agenda. Due to her emotional neediness, and possibly her own feelings of shame and worthlessness, she is trying to get her needs met from your grandmother. Obviously, your grandmother cannot meet her needs, and is distressed. As you described, your mother remains insensitive to her mother’s needs. Your mother’s level of emotional immaturity is such that she can’t perceive the needs of others, because her own internal pressures take all of her energy reserves. I believe your mother is doing the best she can right now, but she needs guidance to be appropriate.

My suggestion to you is to have the hospice care staff play the role of the police. Let them be the bad guys. Let them use their moral authority to create boundaries and to restrict your mother’s behavior. Do you have a social worker involved? Someone can take your mother aside and talk to her about acceptable bedside manners. For example, your mother can read to her or listen to music with her. She can make positive uplifting statements such as “You’re safe now.” and “You’re hair is lovely today.” However, she cannot make requests of your mother, or ask her questions. If any questions need to be asked, then you or hospice staff may ask those questions, not your mother. Such questions may be inquiries about whether she is too warm, or needs water, etc.

It is okay for your mom to hold her hand, or put lotion on her hands, but there needs to be a “no-talking rule”. The staff can tell her it is doctor’s orders! Your grandmother deserves peace. Your mother has no right to torment her like this, and the hospice care staff are the ideal people to structure this. If they don’t, then you will have to. We will help you do this. It’s just that it creates a difficult dynamic for you to have to enforce these rules with your mother. Again, see if the hospice staff will help you draw up a list of bedside rules, and then enlist their help in enforcing them. If you have trouble with this on any level, then call our 24-hour helpline @ 1-8800-272-3900 and ask to speak with a Care Consultant. We will help you figure this out any way we can.

Thank goodness you’re there for your grandma. She is so blessed for that.

Call us anytime at all, we want to help.

Kathleen

Thanks so much for the suggestions. I love the idea of utilizing our social worker (yes, we do have one assigned to us). I don't want to be mean or hurtful but my mom definitely needs boundaries. My Grandma has been so wonderful to me and I want her to be as comfortable as possible through this difficult time. I will take your advice and see what kind of help I can get from hospice.

Well, unfortunately we seem to have hit a hiccup with using our hospice social worker. They claim I'd have to add my mother to the HIPPA form allowing her access to all medical info for my Grandma in order to utilize hospice staff support for my mother. I guess this makes sense but I'm not comfortable adding my mom to that form. I can see her calling the hospice office constantly asking for information. I guess I have to be the one to set guidelines for my mother directly.

You can do that even though she won't like it.I'd refuse her period.She's harming your Grandma keep her away......Hard hearted well yes so who cares??