Mom's dangerous decisions could have bad consequences, how do I reason with her?

A fellow caregiver asked...

My parents are 74 years old. My mom is making more bad choices as she ages. It's like caring for a 3 year old in a 74 year old body.

This past Monday she had rotator cuff surgery. The first two nights I staying with her to relieve my dad. The very next night she went outside at 2:30 AM to throw sand on the driveway since the weather was getting very cold. Her explanation was that she did not want dad to get hurt doing that. I told her that was a stupid thing to do and she needs to think about the consequences. I told her I would be speaking with her surgeon.

I called the nurse and shared with her what happens and told her that she has a pattern of doing things that can put her at risk for complications. I asked the nurse if I was out of line in calling and she said not at all and was glad I made the call. Based on the kind of surgery she had, the nurse said it was very important not to do things that would complicate the surgery or the fact that she had the medicine in her system that could trigger her to fall.

She has a pattern of taking on unrealistic things to either protect my father (he's in very good condition), or just because she's not using good sense and doing what she wants to do. A few years ago when it got icey, she went outside with the heater plugged in. Then she poured hot water on the sidewalk and burned her hand, second degree burn.

The adult children have been so frustrated because it doesn't matter what we say or my dad, she will do whatever she wants to. If the same message comes from a doctor, it will have more credibility and she will listen more.

Do you have any ideas on how to handle the situation? Is there any medical diagnosis that you may have based on her decision making?

Expert Answer

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

Protecting parents from making unsafe decisions is a difficult challenge. As long as an adult is competent, they have the right to make poor decisions. The only way to legally prevent this is to have the parent declared incompetent in a court. Of course, unless you move your mother into full time care, she could still get up in the middle of the night and pour sand on the driveway. I'd advise against legal action.

A good first step is have your mother assessed by a psychiatrist who specializes in older adults. If your mother has a history of impulsive, unreasonable behavior, she could have a pre-existing personality disorder. These usually do not respond well to medication. If the actions you are describing are more recent, she may have a neurodegenerative brain disorder that may improve with treatment.

An important step is to remove yourself as your mother's conscience. It is not your job to tell your mother what she can or cannot do. After all, she raised you to recognize reasonable behavior! All behavior is purposeful. She may be attention seeking, or her behavior may have been part of a marital game with her husband; you know, I'll do it before you do and then you'll never hear the end of it. In any case, it is not part of your role as a caregiver to reprimand her.

I benefitted from reading the book, Dance of Intimacy, by H. Lerner. She discusses how relationships are like a dance; when you change the step, your partner has to change also. I suggest that you try a new way of relating to your mother, which is to ignore her unreasonable behavior. Perhaps ask her if she thought sanding the driveway at 2 AM the day after surgery was a wise course of action, and then leave the topic. To be drawn into a discussion with her would be to join her craziness.

It probably was helpful to her doctor to know that any complications to the surgical site would be due to your mother's actions rather than an medical error. There was no need to tell your mother that you were going to tattle. Decide on the right course of action and do it. When you tell her what you are going to do, it may be preceived as a threat or a dare. Remember that the person who will suffer the consequences of a longer recuperation period is your mother, not you.

You already know that there is nothing the adult children can say or do to improve her behavior. So act on that knowledge. Do and say nothing in response to her unwise courses of action. Be available to help if needed, or not. Your behavior, your responses to her unreasonable actions, are your business, not hers.