They tell you to “start where you are” but, when you need this advice most, it means nothing to you.

Case in point: Mom.

Everyone I know is struggling with their moms right now. I’ve noticed a dramatic increase in complaints about irrational behavior amongst moms since early November 2016. Something happened then that seems to have knocked them for a loop. Hmmm.

Earlier this year my mom, in particular, made me crazier than usual. (Not that I was crazier than usual, but that she was making me more crazy than she usually does, which is a pretty high baseline anyway.)

It started around November 2016, she started losing weight and she slowed down – she stopped walking the dogs, and she started sleeping in more and taking more naps during the day. Throughout 2017, she was in and out of the ER and the ICU several times. She developed AFIB which seems to be something you can live with a long time, as long as your medications are correctly prescribed and as long as you stay active. Oh, and lung problems – which she should have been taking oxygen for and wasn’t.

More worrisome, she kept losing weight and she stopped exercising altogether. She became isolated, seeing only my local sister and her family, who she saw every night for dinner, which my sister catered to mom’s house. (Nothing like making dinner and schlepping it to mom’s every night to do wonders for a mother-daughter relationship.) No cognitive decline – thank goodness – but all the little things that your mom did that made you crazy are magnified like anything when she gets older. For my mom, her stubborn refusal to admit that she needs help.

We could see what she needed: a full-time caregiver, PT, and a dog-walker to wear her two large hounds out so they don’t knock her down. She fought us: I don’t need someone here with me, I’m fine. I don’t need PT, I exercise on my own. I’ll walk the dogs, I just haven’t had the time the last couple of weeks. BS. She’s wasn’t, she didn’t, and she hadn’t walked the dogs in months. We finally hired an assistant to keep the house neat and make sure mom gets out of bed in the morning and takes her pills, arranged for PT twice a week at the local hospital, and got the dog-walkers started.

And then her cardiologist adjusted her meds and she ended up back in the ICU again. I flew out to spell my sister who was burning out and took over night care. One of the first things I did was interview a potential evening caregiver that my sister had found. Mom liked her but “I don’t need someone at night.” She said.

When she was going to bed the next night, I offered to help but she directed me to go to bed and let her do it herself. So I lurked about outside her door until the lights went out and peeked in. I could hear rhythmic breathing and see a lump in the bed, so I went upstairs to the guest bedroom to sleep. About 4:30 a.m. I heard the dogs barking and came downstairs to find mom on the floor. (“I didn’t fall,” she said, “I just sort of slid down. I’m not hurt. I just didn’t want you to fuss.”) She said she had tried to wake me up for hours but I doubt that – the doors were all open and my east-coast sleep patterns hadn’t adjusted to the west coast yet, so I was awake. Worrying. About her.

All of her caregivers said the same thing: her heart and lungs weren’t killing her. Her problem was that she didn’t exercise, so she wasn’t building muscle tone; and she didn’t eat, so her body was converting what if any muscles she had left to energy. She needed to eat more and exercise and if she didn’t – well, the outcome wouldn’t be good.

The doctor had told her this – she hadn’t heard him. I’d told her, she didn’t believe me.

And she stubbornly kept insisting that she was fine. That she could take care of herself.

I was convinced that if she choose to eat and exercise, she was stubborn enough to live for a very long time. But – and here’s the point – she refused to start where she was — needing help — and grow back from there. She insisted on starting where she wasn’t – able to take care of herself – and so she kept falling.

Contrary to what one young candidate I interviewed believed, you don’t start as CEO.

And you don’t train for a marathon by running 10 miles.

And the first step to physical recovery – or any kind of recovery – isn’t refusing help when you need it.

You have to start where you are and grow from there.