How do you convince your Mom that it's no longer safe or healthy to go back home from a nursing/rehab to my Dad with dementia?

Even the Lord cannot help those who will not help themselves. You have placed them in the hands of God, and you should also notify County APS to check on them too.

@ pstiegman Thank you & I completely agree. I just need to hear from others sometimes that we are doing everything possibly we can do for them. Its a very trying situation to say the least and we by no means just want to give up on them but sometimes we must still do what is best for us too. God Bless!

I agree.. God helps those who help themselves.. or however it goes. If they want your help they need to help you. Get The POA, etc. I know you dont want it, but someone NEEDS it before things get worse. And it will... Do not quit your job, lose your house, etc. This benefits noone in the long run, more so with no will, etc. Good luck with this, I feel for you!

Is there a social worker at the SNF where your MIL is now? If so, maybe involving someone outside of the family would start the ball rolling toward POA and changing the living arrangements. Also, have you been allowed to speak with the health care providers for your in-laws? They may be willing to help.

Next time she falls and ems is called, don't respond. Let the professionals talk to them about what needs to be done. You've tried your best. You don't owe these foolish virgins (biblical reference I assume you'll get) your lives, health and future security.

They are no longer who they once were. They will destroy your health, your financial security, your future, your lives. They need 24/7 care and you need to heal. You can advocate for them much easier when they are in skilled nursing 24/7 and all of you can begin to take your lives back. I know this from personal experience.

To second what AKDaughter says, discharge planning at the SNF should be involved in informing them that it is no longer safe for them to live alone without full time help and talking to them about how that can be arranged, how it will get paid for, etc. You need to talk with Discharge about the fact that there is NO help at home and no, you and your husband will not be moving in to care for them, which is likely what your MIL has told them.

Expanding on the comment about them no longer being who they once were:
Some people do get more obstinate and more demanding as they age. Some of it is probably based on lifetime habits or views, other times possibly by health issues. Things like malnutrition can affect the way we think as we get older, for example. I'm not suggesting that's the case, just saying there are many reasons that people become unreasonable.

Just knowing this probably doesn't make you feel better. But it will hopefully put it into perspective. We can feel bad all we want, try as hard as we can, but we can't force people to do things. And, ruining your own life over it won't make them grateful. When people are stressed and/or just not thinking straight, whether it's emotional or medical, they will not behave in a reasonable manner. Thus, logic is not going to work, doing what they want isn't going to work, blaming yourself isn't going to work.

Do your best. It's a shallow thing to say to you, I know, but I hope by hearing it multiple times from many in this group that it will help you sit back and give yourself at least a tiny, little moment of peace about this. Some days, that tiny moment is all we get (if we even get that).

Since this is your mother-in-law you really do not have any legal obligation, your husband does if he chooses. It sounds like the best course of action is to do nothing. Let the chips fall where they may and then when she sees she needs help Medicaid can step in. Walk away as this is a drowning situation for you and your husband. It sounds like you have given your best efforts to no avail. Enough...

My mthr chose not to have me in her life but called my husband monthly. When she had a severe need, APS stepped in. APS said that if we did not want to take over, that was a valid choice and they could help. Basically, a state appointed guardian takes care of their finances, places them, and makes the hard decisions. You can still visit and maintain contact, but it's out of your hands. APS knew what a tough case mthr was, and was willing and able to take it on. (we did not go this route, but it was fully explained)

I highly recommend that you enlist their help for a public guardian. That way, when mthr runs out of funds in the NH later in life, the shortfall is handled by the state and not by you. They work with Medicaid and all the safety net programs all the time, and will always be able to. For you to do that would mean time from your family.

You remember Paul's words, "if a man will not work, he shall not eat." This is talking about logical consequences of actions. Rephrased, if she's not going to work with you, then she's not going to have you all to push around. It's a logical consequence. You can love her better if someone else is telling her what to do. God bless.

I am sure you hav explored these avenues but if not, is there a PACE (a program of all-inclusive care for the elderly) or health/social adult day program nearby that could help with care and respite? Is your father-in-law a veteran?

My father was in a skilled nursing home when he lost the use of his epiglottis. My mother was beginning to show signs of dementia, this was 6 years ago. My siblings kept saying that things would all work out and to let things go if that is what my parents wanted to do. My father had been in the nursing home for 100 days and Medicare was no longer going to cover his expenses there. He still needed to be tube fed and was not able to walk. There was no way that my mother was going to be able to help him or feed him, and there was no money in their checking or savings accounts to pay for inhome care. It was recommended to me that we file for Medicaid while my father was still in the nursing home and that he could stay there until we were approved. Once qualified, Medicaid will retroactively pay for three months back. My father did not want to die in a nursing home and I told him this was the only way he was going to be able to go back home. He kept begging that he would sleep on the floor if he had to in order to go home but I did tough love and told him no that mom couldn’t handle it.
So, I stepped in and hired an attorney and got a DPOA put together for both my sister and myself since we were the ones that were the ones that were responding to any emergencies that would happen. We were also the only ones visiting and helping. We both convinced our mother and father that having a DPOA in place was the best thing for them both.
We had to take my father, in his pajamas to the bank, with our mother, and have the paperwork notarized.
We changed the deed on the house to just my mother’s name, we got only him qualified for Medicaid, and after 3 months my father was able to go home. He qualified for 4 hours of care each day and a caregiver came in to help with his showering, bedding and the cleaning of his room. We ended up having to hire the same woman for 4 hours in the evening (at a rate of $10/hour) so that she could help assist my mother in the setting up of his feeding tube and the crushing of his medications to be put in his feeding tube.
He ended up surviving at home for another year.
My parents are very stubborn people and fought tooth and nail to stay in their home and we did the best we could. After my father passed away last year my mother was in the middle stages of dementia and we had to trick her into leaving her home. She is on a permanent vacation at my home now.
It’s been a very tough 6 years for me. My siblings rarely help with the financials, care, or decisions and still figure that what will be will be.
It sounds as though your husband’s siblings are involved to a certain extent.
Discuss all of this with them and see if there is a solution for your MIL.
In the next few months I will be going through the qualification process for my mother for Medicaid so that we can get her into a memory care facility.
Would I have stepped in and done all of this all over again. Probably. Was it easy, no.

You can in most cases depend on the Almighty Creator to supply strength to endure heart rending situations, plus courage and on going love for troubled individuals.

There are always many sides to a story. Situations vary in so many respects due to individual circumstances.

On one side of the fence it is very scary, down deep, if one is able to think at all, to become old and face losing ones independence to make choices that are reasonable, practical, and comfortable to live with.

One's income enters into what government help can be supplied to a troubled health situation. From my personal experience, one is expected to be near the point of living out of a box under a bridge in below freezing weather, and if able to survive long enough to have help offered to survive, you do well. If your income comes just a few pennies over the line to qualify for medicaid, forget that. The next near help might be spin down type help from social services, which is expected to be paid back when you pass off the scene of this world, or pay back before that if you come into any money. At present my personal position in regards to caring for a loved one touches on that viewpoint. So you pay out of pocket for in home care, until there is nothing left, then you may qualify to have some government help. That is just the way it is. So individuals must decide personally what they will do in all different situations. No one can make that decision for them, if the circumstances are such that they have control over their decisions for the moment.

We can put ourselves in the other persons shoes and ask ourselves, how would I personally feel if my life was falling down around me in such a manner that I have to let others help me. Then you look at the younger side of things, and reason that they have had their life, and most likely would be better cared for by others. (If they really would be cared for better than those close to their situation).

I have had personal experience from various angles with care centers. Even if you find an exceptionally good care center, in most cases, you will find they are limited on funding, controlled by government rules and regulations (that limit their actions for comfort for individuals residents living there or their families concern for their comfort). It all goes back to "money" in so many respects.

( A statement was made to me personally once regarding the "law" of following all of the rules passed down to care centers, which went like this---"they fine us if we do not comply with all the rules, or close us down." ) Love of Money and me first attitudes prevail in so many avenues of life. So one has to do a heart felt sorting out of what is the most important and logical way to handle each given situation.

Many people will not agree with your choice in how you decide to handle your personal situation. I will give you an example of a situation that I am in at the moment. I choose to have my bed ridden husband here at home, paying for in home care out of pocket to help me two to four hours per day with the heavy care of keeping things on schedule. He has many serious medical issues. Dear friends will even say, you need to put him in a care center, it is to hard on you to care for him. I do not know how long I will be able to care for him, but hopefully for a few more months or years if it comes to that. I am 79 years old, with osteoporosis, some heart problem factors, and have lost 6 inches in height due to my health issues. That is why I have others come into the home to help me with the moving of husband's body to help keep his skin in good condition.

So compared to the "give or take a few dollars" I spend out of pocket around $1000.00 per month and sometimes more, for in home care helpers. When you put them in a care center you pay from $4000.00 up out of pocket for their care.
Once again, "money". They say you can have a division of assets when you put them in a care center, then when their half is gone, the medicaid starts to help out, (you may have to verify that, not sure to the detail how that works). Then the mate's remaining assets are left for them to live on. (Not sure if things change any after that either). But, I just plain did not search into that further, for I wanted him to be in his own home as long as possible. Our kids have their life to live, as I am well aware, so I try not to over use their help.

Down the road, both my husband and I may have to give it up, so to speak, and that will be very hard for me, for I am still with it enough to wish to be able to stay in my own home as long as possible. His condition is such, that he could transfer to care center and not realize all that is going on, but still enough that I do not wish that upon him any sooner that necessary. I lived in a rest home for two months and three weeks. Had broken left arm and left leg at the same time. No one offered to care for me.
It was not a choice place to be. My husband's been in and out of care centers due to health factors, and it was not a choice place for him either. So we just hope we can keep struggling a while longer. Staying in our home as long as possible. It is the normal feeling of life, to be in familiar surroundings. It is hoped that somehow, you will be able to find help that your family will agree with, in order to lighten the burdens. Here is a hug for you and your family. joylee

It sounds like they both need to be in an assisted living, if things are that bad, I agree to let it go to the hospital and the nursing/rehab. the social worker there can be a great help. I got my POA while my mom was in a nursing/rehab when she was at her best, so that she knew what was going on. Good luck to you all, don't quit your job or give up your home, seems like you have given up part of your lives already. Most of us on this site have given up something to take care of a loved one, it's not easy that's for sure. This is as I watch my mother pace around the house for the last 4 hours. She has Alzhemiers and it is not an easy job that's for sure.

I feel for you, it is obvious that you are all in great distress over your in laws, their health and welfare. Everyone has given great advice, sometimes it is easier to give that advice when we are not talking about ourselves or our own personal circumstances. At times like this everyone's emotions run high, nerves are raw and it is easy to get caught up in what is going on.

If your in laws have a close personal friend, lawyer, preacher, anyone other than you "kids" perhaps they could make them move on the will, trust and POA where you are unable to. When they are spoken to a lot of people should not be around, and it should be a low key conversation. Without DPOA there is actually nothing you can basically force them to do and you may have to back off as everyone has said. I know this is easier said than done. Have a conversation with your spouse and tell them how much you love them and make a vow between you two that NOTHING WILL COME BETWEEN YOU, THAT YOU WILL WORK TOGETHER ON THIS AND WALK AWAY IF NEED BE TO SAVE YOURSELVES AND YOUR MARRIAGE. This can and does break up marriages every single day.

In my office we use to have a sign that read, "A lack of prior planning on YOUR part, does not constitute an emergency on MY part." Perhaps this statement is true in many circumstances.

God Bless you and your family. May God grant you peace.

Thank you all for your input. I appreciate all that it being suggested, it's not a healthy situation all around. What is actually happening currently is that since Medicare payments have run out their supplementary insurance through the military is kicking in 90%. Now I'm not sure how long they will do this but at least this has bought my MIL some time as well as some time for my husband & his brother to figure out how to get her onto medicade so that she can be admitted into a skilled nursing facility. Hopefully the one that she is currently in but all we can do is try. My in laws have us backed up to a wall with not too much room to move. Their part time caretaker (15-18 hrs / week) is helping as much as she can but when finances are the biggest hurdle and no long term care planning was put in to place years ago it's making it difficult on everybody. I highly recommend Long Term Care Insurance and WILL & TRUSTS and Term Life Insurance at the very least as well as saving for a rainy day. My husband & I are still too young for LTC but we do have a small life insurance policy and our 401(k)'s. Now to plan for the rest. I do not plan on being the fun grasshopper who doesn't want to plan but be the ant who prepares for the long winter. However if the 10% is not paid for once she can no longer utilize the supplementary insurance then she has run out of options & I know they won't pay for it because they don't have any money set aside for anything. They even reversed mortgaged their home so they could live. How very sad!! I DO NOT EVER recommend doing that. As for me I have turned this completely over to God & am trying to regain MY LIFE & rekindle the spark that went out so long ago. Again, thank you all and God Bless!

I just spoke to the caretaker for my in-laws and they have filled out the Medicaid paperwork and my MIL has 30 days to remain in the nursing / rehab via her supplemental insurance that pays 90%. Let's pray that she is approved so that my FIL doesn't have to be worn ragged trying to help her at home in his frail state and also that we can have more quality visits with her during her time left instead of it always being stressed out and it's only quantity visits and it only adds more stress on everybody because nothing is ever accomplished other then them telling us that they will THINK about things. Well the time frame has passed on the THINKING about things part and it's time to act on things now. She can not go home and my FIL can not care for her alone any longer when the caretaker is not there. So she must realize that she has a better quality of life in the nursing home where family can visit, even the dog, and the nurses can care for her properly. SIGH!! I'm so glad that something is getting accomplished now with this new caretaker. Their last one only stole from them and did drugs. Thanks again for being my sounding board.

@HolyCow Unfortunately they don't have any close friends and even siblings my MIL has chased away because life wasn't perfect for her and she had to always make everybody else's life difficult because of it or make others feel guilty. It's a very sad situation for someone who is a very pessimistic miserable person. She's envious over anything anybody else has because it's not hers. Oh believe me I have known her for almost 30 years so I'm not making up a story. There have been things that she has said to me that have really hurt and I've tried to push it under the rug to save my marriage but I can't allow it to consume me any longer or hurt my marriage. Her home was always immaculate and she would tell family not to come over because it was dirty and it eventually stopped certain family from ever visiting. So the only people she has left are her children and her husband who she has worn down to the core with not allowing us to help them. They always feel as though they can manage on their own until she falls and is in the hospital and then everybody needs to jump and run with no excuses because they feel no body has lives. We don't have children because of this situation and it's a HUGE regret of mine. But at this point it is what it is. :-( We pride ourselves for being able to find the caretaker that they do hire for 15/18 hrs weekly because she is a God send and really gets things done. Please don't get me wrong, I like my in laws its the situation that I can't stand. But enough is enough after 14 years and the last 4 being completely consumed by their needs. Anyway, I could go on and on but it's time to for us to live our lives and have our own joys of which my in laws have already had. God Bless and thanks for the suggestions ALL. :-)