Dear Carol: My 84-year-old mother has been living in her own condominium, but her problems with dementia are making this a scary situation. She forgets that she’s cooking and leaves the stove on, and she’s left water running for hours. She forgets what day it is and how to do basic self-care. Mom has physical problems, too, including damaged lungs and mobility and pain problems from post-polio syndrome.

I talked her into in-home care twice in the past, but when the caregivers came, she refused to let them in. I understand because I doubt that I’d like strangers coming in either, but something needs to be done for her safety. I try to talk with her and ask her what she wants, but she ignores me when I do. I think that we need to move her to assisted living, but I don’t know how to physically get her there. — LE.

Dear LE: Your note to me was filled with compassion. Many adult children don't understand why their parents resist extra help or a move to a safer environment. You do. Your mom is fortunate to have you as her advocate.

Your mom’s reaction to the in-home caregiver isn't unusual and, like you, I can understand that. Some older adults eventually adjust, but many don’t. Most likely, your mom’s cognitive disorder is preventing her from recognizing her need for help and she just doesn’t want things to change.

Normally, I would suggest that you ask your mom about her goals and preferences for her future, but you seem to be trying to do that and, due to cognitive issues, physical illness or both, she’s not responding. That means that you’ll have to move ahead and do what you feel is best for her.

Your mom’s cognitive problems could help her qualify for some memory care units in assisted living, but her physical problems may disqualify her. You’ll need to tour local facilities and ask about their requirements, but my feeling is that your mom may need to move to a nursing home. Her doctor would likely be happy to provide some advice here, as well.

As for making it happen, I often suggest that someone take the person out for lunch and something else fun, or even simply a long ride if she’d enjoy that. While she’s out, other family members or friends can look over her home for the most essential personal items to move to the ALF or NH. Then the person who is with your mom can take her to the new place and can say something like, "Oh, Mom, there was water all over your kitchen floor so we had to move you here temporarily while we deal with that."

Act confident that you are doing the right thing for her (you are). Do we like subterfuge? No, but sometimes it’s the kindest way to accomplish a necessary goal when we are trying to help someone with a cognitive disorder. My heart is with you.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at www.mindingourelders.com. She can be reached through the contact form on her website.