My MIL has only one living relative, my husband, so we are solely responsible for her. At age 94, she is declining in health. The biggest issue is how uncooperative she is. She won't take her meds, she rarely wears her hearing aids, she won't use a shower chair or walk-in tub (even after getting stuck in her tub and having to be fished out completely naked and then passing out after being fished out). She only uses her walker when I put it in front of her and she has severe arthritis in her toes. Last week she fell and was lucky as she only bruised her face. We use nanny cams to monitor her during the day. We have decided to take a vacation and we would like to have her in respite care, but she refuses it even though it will only be for 10 days. We can't live tied to her 24/7, and she is likely to live to be 100. I explained this to her, how she is hurting her 68 year old son's health, but she won't listen. Her doctor even ordered her to do respite care while we are gone and she pretended she didn't hear by giving him her sweet old lady smile and assuring him that, as a nurse, she could take care of herself. This was after he determined she said she was on no meds, then that she took it sometimes, then that it gave her headaches, then that she tried it again and it didn't give her headaches and that an alternate drug he tried made her dizzy (which she complains about whether she takes it or not). She is still mad we took away her car keys last year after 2 known major blackouts and a call from the police about a confused driver. We do not have guardianship for her as she has some cognitive ability left, but we need her to cooperate. I said we should just go and leave her to her own devices, which sounds cruel, but that feeling abandoned might be what makes her rethink her stance. Our backup plan exists only because our son lost his job a few days ago. That is for him to check her cameras on occasion and only call 911 for an emergency. She no longer cooks, but can do microwave meals. Most of her day is spend sleeping or staring blankly out her window. We have thought that assisted living would help with her lack of socialization and boredom as well as meals and oversight, but she will probably have to be forced out and into memory care within a few years.
She is probably beyond AL but not quite ready to MC or LTC, since she is still mobile but a very high fall risk. I think the back-up plan for your son to call 911 if she falls or has a problem is what I would do. Make sure your son knows to not pick her up -- call 911 even if she doesn't seem injured or insists she isn't hurt. From the ER to the inevitable rehab she can be transitioned to a permanent facility but have tempered expectations that she won't care about the socialization. I'm sorry for this distressing situation. It's hard on everyone in the family.
Maybe while ur away, she may find she likes the AL.
Suggestions:
1) Phone her every morning and evening to check. Very brief phone call, not one to dominate your mind and time.
2) Talk to Respite Care, tell them the situation, and ask if she will be able to go in at short notice if necessary. Keep their contact details, and leave them in MIL’s house with a written explanation for 911 if necessary.
3) Get her an alarm pendant, with it set to contact you and/or 911. If she won’t wear it, leave it in the most likely place for falls – probably on the floor in either the bathroom or next to her bed.
4) If your son is willing, ask him to visit Grandma, and lay it on the line to her that she is a pain in the but. It's not fair to his mom and dad. He has a lot less to lose, and young people have a good vocabulary about these things!
I hope that there are more useful suggestions. Your, Margaret
2. The assisted living facilities need a solid yes or no.
3. We got her an alarm pendant and she refused to wear it.
4. I'm not sure she would listen to anyone.
Great responses for Grandma Bulldozer (our kids nickname for her)
Then go on vacation.
If her doctor doesn't say she is incompetent, then you have to let her make her own bad decisions for herself.
I would tell mil that her son is seeing a specialist wherever you are going. He needs to for his own health, you say, and you two will not be having your phones on.
If she is in your dwelling, tell her the only way to stay in it is to go to respite so that you don’t have to worry about her burning the house down or etc. And if she’s by herself in her own place, she follows your sons instructions or he gets the authorities involved.
Your MIL gets to decide whether or not she stays in respite care while you're away.
You see the difference? You and DH are responsible for what you do. MIL is responsible for what she does. The error lies in believing that DH is responsible for her choices. He isn't.
You already have a system in place to catch any emergencies. Check she has all the supplies she'll need for those ten days - medications, groceries, disposables - and off you go.
Family is family, yes, but made up of individuals. Who can make decisions *for themselves* not for others.
A Social Worker told me this:
1. Give advice
2. The person makes a decision - 'good' or 'bad'
3. The consequences are theirs
But I get why you just don't sail off & wish her luck.. you feel a great obligation. Fear (to leave her), Obligation (only family) & Guilt (forcing the respite care). This is F.O.G. (Google this term of you like, it blew my mind when I did!)
So MIL is dependant on you & your DH but refuses to be looked after by others when you are away? I am wondering about her problem solving & planning ability 🤔
Does she understand but taking a stubborn stance as a gamble she will win & you will not go? (ie manipulation)
Or does she NOT understand her care needs (ie lack of insight?)
MIL's Doctor's opinion on this aspect could be a good idea.
For people being stubborn as a rock.. not going etc, using a firm stance back that you WILL be going may work. Try explaining they will be home ALL ALONE. Not to be cruel, but to break through.
For those lacking insight, tricks may be required.
The last resort may be go but build as much safety around as you can. This may inc;
- ensure she has a phone
- her Doctor's number preset
- ask neighbours to check-in
- wellness check from local Police/Fire
- easy open snacks/drinks
Call the Doctor to advise MIL is a vulnerable elder home alone.
Then tell MIL to call her Doctor for any problem & go.
You may only need to inform MIL of this plan with assertiveness for her to back down. Best of luck & Bon Voyage 😄
It's a fine line that I struggle with everyday. She is adamant about not going to AL even though I think she would do well there. She is adamant about "not being treated like an invalid." She is adamant that she can take care of herself while ignoring the many things I help her with. I really appreciate the response about her choosing and living with the consequences even if I also have big time FOG.
Good luck and try to enjoy your break. You NEED it!
Families have to learn what to avoid in order to not get trapped.
1) Ignore guilt-tripping and manipulation. If you're willing to help an elderly LO, it has to be on your terms not theirs. You are not responsible to be your elderly LO's social life.
2) Do not prop up an elder by supporting them in the delusion that they are still fully independent and calling the shots when they aren't. All this does is encourage them to be on a power trip to control the lives of their family.
3) If there is stubbornness to accept help, encourage them to. If they refuse wishe them luck and ignore them. Unless there's dementia and they will have to have others managing their lives. If some senior has to learn the hard way (and many do) that's how it has to be. It is not their family member's fault if they refuse help.
4) Always remember that YOU are not the only person on earth that can help or provide for their care needs. The elder may demand that only YOU will do and will refuse anyone else. Then you refuse them. Offer nothing. Caregiving is only successful if it's done on the caregiver's terms. Not the care recipient.
5) BOUDARIES! This is the most important one of all. Do not take every call. Do not allow abusive or negative behavior when you're talking to or visiting your elderly LO. You are not one of their doctors or a therapist. Therefore you do not want to hear their health complaints or a detailed description of their latest BM. You will walk away and the visit ends when gaslighting and fight instigating start. Treat actual emergencies like emergencies. Running out of pudding is not a reason to go rushing over.
People follow these things and they will not get caught up in the drama and games that come with elder care.
So, we decided to book respite care. Thankfully we had some help from the VA. But it wasn't fully covered, so he was hot under the collar about having to pay for his own care (the horror). He decided that he could take care of himself. Spoiler alert - he cannot.
We got his reluctant permission to book home care and went ahead and booked it, working with the provider and the VA and scheduled everything - with him insisting that he didn't need it. We were going to be gone for a week. He kept saying he didn't need them and that once we were gone he was just going to send them home anyway because he didn't have the money to pay for them (he did) and that if he needed help we could just come home.
Some little voice in my head told me to cover all of the bases so I called APS. Not to report anything but just to get advice. I just said that I had a question and explained that we had a vulnerable senior who was competent but physically incapable of taking care of himself. That we were traveling and has scheduled 24/7 care for him for the duration of the trip and he was strongly suggesting that once we were at our destination he intended to fire them. The person chuckled and said they heard that a lot. They said that all we could do from our end was strongly remind him that if he did do that, he'd better be prepared to sit alone for a week with no prepared food or REALLY be able to take care of himself, because we have done everything we can to make sure he is taken care of for the time we are gone and HE would be the one that is removing that help. BUT no, we would not be legally responsible for that - we left him with care - he removed the care.
So we spent a lot of time really reminding him that if he fired them we wouldn't be coming home (I think he thought at the last minute one of us would stay home). We left for our trip and stayed up to date with the caregivers. Ironically - HE didn't call one time - which is unusual. We had to call him to check in. He didn't fire them. He actually enjoyed having someone new to tell his stories to. He was kind of sad to see them go. We started off with three shifts of three but they whittled it down to two shifts of two before it was over with. He sleeps a lot so they had plenty of down time. And it was the same two for most of the week.
I never in a million years would have thought it would go so smoothly with him. He is a dyed in the wool narcissist so I was 100% waiting for the call that he fired them and that he was expecting us to make the 6-8 hour drive home.
BIL and SIL should by no means be providing care for free.
The lot of you should sit down with a few spread sheets and show him how much a nursing home costs and how much 24-hour live-in care would cost if BIL and SIL left.
Then negotiate a price on what he will start paying them. Room and board is not considered sufficient payment for service.
Tell her it is to help her son with the many responsibilities.
If she refuses then she is on her own.
No one can force her to accept help coming into her house unless someone else is making her decisions.
They should not support her delusion that she's still fully independent and totally taking care of herself because she isn't. This only encourages stubbornness.
There's no shame in someone needing some help around the house or with self-care. Especially when they are elderly. Take the shame out of needing help without supporting delusional stubbornness.
I've been an in-home caregivier for almost 25 years. I have told many, many elders who were suffering from ESS (Extra Stubborn Syndrome) with an underlining case of stupidity that there's no better and faster way to get themselves a one-way ticket to a nursing home than an acute case of ESS.
So you tell your MIL this.
Assisted Living would be better for her physically and mentally. Don't worry about memry care being needed down the line. There are AL facilities that also have a locked memory care facility.
Leave her to her own devices. That's not cruelty. It's tough love and your MIL is in serious need of some. Going on your vacation is the best thing you could do for her. Many elders have to learn the hard way that their stubbornness will not be tolerated from their families and no one will be playing their games.
If your MIL wants help from you and her son then you will help her but it will be on your terms, not hers. If she means to control your lives through her 'stubbornness' and thinks everyone will dance like puppets while she holds the strings, she is mistaken.
Make your language plain when explaining this to her so that she doesn't misunderstannd. Then go on your vacation. Don't play her game.
You cannot continue beating your heads against a brick wall on this. You’ve tried every loving thing you could think of, for naught.
MIL has apparently stated she wants to die in her home, and it sounds like she firmly means it.
It’s time you accept what she is saying, and let her go to her death her own way. It may not be the way 99% of us wish to shuffle off this mortal coil, but she has stated her wishes, and you two aren’t HEARING her. I think she will continue to block all of your efforts.
You aren’t being harsh to accept her wish to die at home, you are realizing there is nothing more you can do to help her since she thwarts every helpful effort.
It sounds like your husband might benefit from a therapy session (or more) to help him realize he must back away with love and understanding that she chooses to live her own life and not acquiesce to the comfortable care home (AL or MC) that you all wish for her.
I hope you have a wonderful trip, and I’ll be thinking good thoughts that your dear son soon finds a great job.
Her son and DIL should not be centering their lives around propping up the MIL's stubbornness and delusion that she's living independently because she isn't.
People have a right to live and die on their own terms. Don't refuse any ideas about AL or outside help from the family, then call hysterical in the middle of the night because there's no pudding.
Nobody gets it both ways.
What have you got to lose?
Turned out my mother showtimed for the staff. Her rage and rudeness were all for me.
I knew she was slipping cognitively, and was shocked when her assessment revealed that she couldn’t name the town in which she’d lived for almost 20 years. She didn’t know her age or date of birth. She thought her parents were alive.
She is now in permanent care, as of spring 2022, and is content there.
You may find your MIL is already at the stage for MC.
Save yourselves. Don’t wait.
Tell her that while you are on vacation that you will not be available to handle her emergencies.
Tell her that while you are on vacation that you will not be calling to check on her.
Tell her that if, as a nurse, she feels confident and competent to take care of herself that you will not second guess her.
Do not ask your son to watch her - that is unfair.
Remind her that she should call 911 for emergencies.
Then, you nay have her in respite care whether or not she agrees. When you come back from your vacation (now would be better) get her cared for 24/7/365 since she can not care for herself alone.