I've posted before about in-law care-giving. Aged mother in law, lives in same town.
We are at the tail end of a visit from sister in law from several states away. Sister in law has been here for 3 weeks caring for her mother. A much welcome respite.
It had been discussed, prior to her arrival here on the scene, she would be talking it over with her mother, to try and get her mom to come up to her home, for a stay of maybe a few months.
This, in my opinion, is absolutely essential, as I am expecting twin grand-children, due in about 1 month (if they don't come sooner, as is the case a lot of times with multiples pregnancies). The expectant mother also lives locally here, and has a 4 year old daughter. I will be on that front, helping .. as much as is needed. And not on the front with mother in law and care-giving, and have made that as obvious and apparent as I know how to make it. It would be great if mother in law would agree to go to her daughter's home (several states away) for a period of a few months .. and allow me the latitude to put my energies where I want them to be, on my daughter who will have had a c-section .. and my grand-daughter (4 years old) and new twin babies.
Nothing doing. Mother in law has dug in her heels, and will not hear of it, going to stay with her daughter for any period of time.
What are her reasons?
In mother in law's defense ... her daughter ... I don't even know how to describe it. I will say that when her daughter comes here to visit, she all but breathes for her mother and if she could find a way to do that, she'd do that too. She is the most nervous nelly, never sit down - ever ... worry wart, do everything, all the time .. person that I've ever encountered.
A great example, as I was taking her to the airport yesterday for her departure, . I reached into the fridge to grab myself a bottled water and shut the fridge and turned to walk away, as I've done for all of my 50 plus years living on this earth .. and she said to me, "Oh make sure that fridge shut". WTH???? Like I don't know how to shut a fridge? That's just a small, very small slice of what she is ... how she is.
She is so very hyper-vigilant, seeing to every minute details down to it's finest most minuscule point, fine tooth comb, questioning every point along the way, "should we do thus and so, but maybe if we do thus and so, then such and such will happen, maybe we should do it thus and so .. but then so and so might happen, maybe we shouldn't do thus and so, but do "x" "y" and "z" instead, but if we don't do it that way then ..........", on and on and on and on it goes. And usually in hyper warp speed, as to every single friggin thing.
If her mother moans .. "what's wrong mother?, why did you moan, are you alright?".
Mother: "Yes, I'm fine, I was just sighing out loud".
Sister: "Why did you sigh? Are you hurting, are you sure you're alright, why are you sighing what's the matter?"
Mother: "For God's sake __________________, I was just sighing, .. calm down, I'm fine".
Sister: "Are you sure, .. because if something is wrong you need to tell me".
Mother: "Everything is fine, I'm fine".
Sister: "Are you sure, we did a lot yesterday, did we do too much, maybe we shouldn't of gone to two doctors in one day .. was that too much for you, are you too tired now, maybe we need to move those other doctor appointments so we won't have two in one day, is that too much for you, for one day .. is that why you were sighing .. what's wrong, are you sure you're alright".
Hopefully that kinda gives a little bit of a snapshot of what goes on when sister is in the ring directing things.
So in mother in law's defense.. I do get it, why she wouldn't be chomping at the bit to go to her daughter's home.
BUT ....
The only experience she has with her daughter, in the last years as mother in law has aged and been unable to go anywhere much, has been the daughter coming here, periodically, for periods of about 3 weeks at a stretch. When her daughter comes here, she moves heaven and earth for her mother and then some, and doesn't sit down, doesn't stop .. the WHOLE ENTIRE TIME.
Is there a possibility maybe (as I said to mother in law, when she expressed that isn't happening - talking to me - her going to her daughters .. ever) .. could it be possible that maybe if you would go to where she lives .. she'd be more busy managing her own life in that setting than your's and she would get out of your backside .. and not be as hyper-drive-vigilant as you experience in her, when she's here, could that be possible.
The daughter is retired, lives several states away. Does come here, generally, every few months .. and stays for a period of about 3 weeks at a stretch. I wish I could make a list of everything the daughter did when here this last time, but it would take up the whole character allotment:
I think for DH .. just my assessment, it's the sadness that his mom would be relegated to a place she NEVER wanted to end up in ... in her wildest nightmares.
I don't see it as that, but easy for me to say, sitting here, late 50's .. not facing that dilemma (but I will one day, good thing I don't see it that way). There are activities one can partake of, meals that are served, and more importantly safety can be a paramount concern and dealt with, is how I see it.
MIL .. and by proxy DH ........ they see a sad dreary place, where there are people warehoused in wheelchairs in hallways, heads slung low .. don't even know who/where they are, urinating and defecating on themselves and no one to attend to them .. lonely. A waiting room for death.
That's my assessment anyway, my objective opinion of what DH's hesitancy is .. maybe born of MIL's description of what she doesn't want. I don't know for sure.
SIL? I sometimes think she's actually a few bricks short of a load. I think maybe her hesitancy to "act" in any of this is born out of just how daunting it all is ... (though that's probably not a fair assessment, it surely is daunting what she is doing, and has done in the past, as a f/t caretaker). Whether to try to nurse her mom to enough health to make a long trip to where she lives, and house her there .. that surely musn't be a pleasant proposition to consider .. especially knowing that these kinds of things .. this f/t care of someone who .. while when SIL arrived here, .. MIL was at least getting her own b'fast and such .. in the event MIL falls ill and/or injured, this is SIL's fate .. round the clock care, with her mom in her home. And a mom who is sometimes cruel to her husband .. surely that is part of SIL's hesitancy to make any real moves in any of it. It has to be. If she can just buy one more gadget, one more this or that, to make her mom's home .. more user friendly and justify her continued existence there .. surely that will make it all "fine, she can manage".
The whole dilemma for SIL as to an ALF (if ever) .. and if so where? Her end of the world, or ours? She hasn't answered that question for herself ... she seems to think it important that an ALF be found near her, .. so she can keep her finger on the pulse of the goings on . and be an active part of her mom's life. But .. hasn't answered the question for herself (or consulted with her mom by all I can tell) ... as to how that would work, ... a dog that needs to be considered, and a mom that is wholly unable to deal with said dog in such a setting .. and having to make her mom part with the one and only thing she holds most dearest, her precious dog. And what to do about that, .. even if they could find a setting for her, near where MIL lives .. the chances of even finding one that will allow she bring her dog along ... she better be able to handle the dog herself, and she cannot. At least where MIL lives presently .. the dog can be let out into the b'yard .. and there, a secured fencing .. dog can't get loose .. dog comes back to door, door is opened to allow the dog back in. Won't be the case in a setting in a facility and when I say MIL is no more capable than the man on the moon, of getting on her walker, and taking dog outside (much less in a snowy cold climate in the winter) .. and walking her dog, and then bending over to pick up excrement to dispose of it .. it can't/won't happen. She is not able. Won't be able, hasn't been able to do that.
SIL has some tough decisions that she isn't willing to make.
DO you want your mom close to where you are, so you can continue being a part of that .. and in a setting in an ALF near you?
Well then what legwork have you done, as to VA bene's .. and placement .. and availability and Medicaid funding for same. None? Well, it isnt' going to happen just by a magic packet falling from the sky and all is in place.
Do you want your mom to not have to part with her dog ... then what have you done to search out where/how that will work? Nothing .. that too, isn't going to happen just by a packet falling from the sky with all the answers.
Do you want to make the tough decision that maybe an ALF here would be a better setting .. and you will just continue to fly here periodically to look after her. Then what have you done ...???....nothing you say .... well why not.
Probably because every time she comes here she is in crises mode ..managing whatever the latest crises is ....... and when she's at home, she's living her own life .. as we all want to do ... me included, she's not my mom.
DH .. he is a firm sideline sitter as has been made apparent through these months. He won't take the ball and run with it, .. and probably wise of him not to do so ... he would be fighting an uphill battle in his sister and his mom. Look no further than the last hospitalization about 4 months ago .. when DH tried to tell his mom that some tough decisions need to be talked about and she banished him .. told him she will be fine, she can manage, and she doesn't need him treating her like she's an idiot .. she can make her own decisions .. and if that's how he feels then he can just leave (her hospital room).
For him to take the initiative and do this on his own .. he'd be doing it .. for nothing. He'd have his sister and his mom to fight on it. That leaves .. is he willing to then shun it all, "well then sister you're on your own .. you don't want her in an ALF and fight me on it, .. then you figure out how to deal with her on your own, and don't either of you call me .. because I"m not an option and I mean it".
He's not there .. he isn't there mentally .. to take that kinda stand . not when the above description of how he sees an ALF thru his mom's eyes .. is the result. He isn't there emotionally, to take that kinda stand.
I am. But I'm not her offspring.
He did say, ......".........if sister leaves and thinks it okay to leave mom here after she nurses mom to health .. she is gonna be made to understand .. that I WILL take the initiative her and go talk to who I need to, without her .. and get this ball rolling".
My answer to that was: "...and what's stopping you now ... if that's your intent .. then do it".
Got a blank stare in return. Deer in the headlights stare.
He isn't there on an emotional level to put the gamut down on it all.
The sister I think has some tough decisions to look at .. what will be compromised in it all, what specifically ... her want to have her mother near ...???....her mother's want not to leave her home ....????.....her mother's wish to never ever GOD FORBID have to part with her dog ...????.....
What ....??.....what will have to go in the "wants" above. SIL ..... unable to make any move as there are too many "wants" that she doesn't seem to be able to answer in it all, herself .. thus stymied.
Sitting back, to me (and I know, many others) this situation would be unbelievable if we hadn't been following you for 9 months.
I cannot imagine the level of codependence/mental disarray that DH and SIL have with their mother. It boggles the mind. Truly. The dance they do to keep from having to really deal with the problems at hand--must be exhausting!
As to the bedrails--I got those for mother and she slid in between them and the bed and got stuck, first night home. PT AND OT said they were much more dangerous than NOT having rails--so they went. Also, they said they did NOT provide a real support and if someone was compromised, mobility wise, having them lean heavily on them for support was a recipe for another very serious fall. Is SIL also helping her as she gets out of bed? I'd be VERY concerned about the rails being able to hold MIL's full weight.
No grab bars in the bathroom? Well, here comes another fall as soon as MIL tries to "manage". My mother uses a walker, but has grab bars all around the apartment, so she has a strong handhold every step of the way. She cannot walk at all w/o full support.
Dorker, you could stand on the roof and scream at these two (well three!) people and they'd look up and go "huh? what's HER problem"...they simply are not listening to you at all. How very demeaning and frustrating. You were the front and center for years and now you step away and you're ignored and belittled. And you STILL have the MIL from hades to deal with.
SIL's grasping at ANYTHING to keep MIL home is crazy. First it was "it's was the UTI, right" and now it's the fear of C-Diff. This is irrational and silly. But you know that.
I guess I am just so sorry for you and this situation. The answers are all right there...yet DH and SIL sit, frozen, exhausted, scared and totally dancing attendance to a cranky old woman who still thinks she can have everything she wants, just the way she wants. Well, sorry, but NOBODY gets that. You sure aren't.
No great words of wisdom. Just do not let her move in----no matter what. And know there's about 100 of us out here in cyberspace pulling for you.
Hoping for a better, saner 2018.
Liz
I think the next step is working on other projects so that you're too busy to be bothered by the circus.
DH is on his way out there this morning, 4 yo in tow .. she spent the night with us last night, and she rarely gets to hang with her papa .. and he misses that, as does she. He is on his way to MIL's this morning, at SIL's direction. Need to remove the door from the master bathroom and set it out in the garage. MIL has a dressing room which can be closed off by bi-fold doors, and the bathroom is in that dressing room, but that bathroom is too small to fit a walker into. She uses the walker, with assistance from SIL who is right there, every step MIL takes .. but the walker has to be set to the side to enter that master bath, no room for it. So she is trying to grab for anything she can to hold onto, as she enters that small bathroom. One of those, "anything she can grab ahold of", .. is the bathroom door, which as we all know, is not stationary. It gives .. and so isn't a stable force for her to use to grab ahold of.
DH is to remove the bathroom door, and set it out in the garage .. until "better days" (???). Install a grab bar, on the wall there, as you enter that bathroom .. so she can grab that, as she enters rather than a door that gives. She already has a grab bar by the commode, been there for years .. to help her to get up. But I suppose, now there is need for an additional grab bar, as you enter the bathroom and the door removed.
I find it all very infuriating. I really do.
SIL had me order, online, per OT advisement, I suppose. A little bedrail brace thing, ... so that MIL can then work to brace off on something to bring herself up from the bed.
My (I guess I would be termed to be a negative nanny here, I don't know) ... my problem with that, and I said so ... "she can't really butt crawl ... she has to lift her toes up to get up onto the bed ... it's so high (what she needs is a hospital bed that lowers and rises .. and I said so, but my suggestions go unheard, as we all know) .. she can't really butt crawl .. so you place that little bedrail there .. braces off with an apparatus that tucks under the mattress to stabilize it.... you place that on her bed, where ???.... you put it where she can use it to get up from the bed, by grabbing it to brace against, .. but it's in her way then, to "enter"the bed, .. and so she now enters the bed from where, ...???....and then has to get into position how ...????...most of us could butt crawl or use our hands/arms to now position ourselves better, she can't .. she can barely move without assistance, and believe me there is no one in this situation strong enough to pick her up and move her to where she needs to be. Seems to me that apparatus will be an impediment to her "entering" the bed. But "apparently" (So I'm told) OT recommended the one to get, .. and so since I have a Prime account on Amazon .. and MIL's cc on file there .. since I used to order her specialty dog items for her, .. I was summoned to order that for her, and I did so. I said .. out loud, my misgivings on it all, as I did a year or so ago, when it was said she needs a stationary exercise bike .. but nope .. my misgivings go unheard. Where has that bike we had to stop the presses and go get, poste haste .. where is it. It sits where we delivered it, .. unused .. since it was placed there. And .. interestingly enough .. it's likely that's what MIL hit on her way down as she fell lowering a bedroom shade.
And the whole "Nursing homes are notorious for C Diff", so it's good that wasn't her placement. From SIL. Preposterous! I mean seriously! SERIOUSLY. Cruise ships are notorious for Norovirus .. or whatever it is .. but people still go on cruises by the tens of thousands ... hospitals are notorious for Staph infections .. that doesn't preclude that there are times people are hospitalized. For God's sake!
No, .. obviously SIL has all the (wrong) answers no matter what the scenario proposed. This all came from my having proposed she should've been willing to fib to hospital staff that she is only here briefly .. and has to return to her home and will be flying home and that MIL will be alone. That the hospital staff would've had to opt for another plan (I suppose ... ??.... I don't really know .. would they have honestly sent someone home who can't even navigate to get into an automobile, and has to be sent home via ambulance/stretcher, . would they do that ...). From what I heard, MIL was willing .. for the first time ever, to go at discharge to Rehab .. that's a first. MIL is a horrible/deplorable patient .. generally ... always wanting to go home .. only home. Not this time, from what I heard. And as MIL has said, this fall .. this is the worst thing she has ever experienced .. ever! She was "willing" this time .. to go to Rehab rather than home .. but it wasn't to be, because of that "OBS" status at the hospital.
So my suggestion that I think were it me, I'd of had to fib to the hospital staff .. and let them know that I won't be here to care for her, .. she will be on her own, and a danger to herself, unable to adequately care for herself .. that was met with the "well they wouldn't of sent her to Rehab anyway, she didn't have the inpatient status to be able to do that, .. the only option they'd of had likely was a Nursing home .. so OT says .. and that isn't good, they are notorious for C Diff .. and that's no where you want a loved one to be".
Yea, okay. All the (wrong) answers.
Sadly the best place for me in all of this .. is removed from it. The above dialogue only angers me, infuriates me. I want to shake the life out of SIL and her brother both. But of course, that too would I guess go unheard.
Have either of them sat down with their mother .. "Hey mom, you can see .. this really isn't sustainable any longer, I can't move here and be your f/t caretaker .. and I don't know how viable it really is to try to move you to IL where I live .. and brother .. he works f/t he can't be your caretaker, .. what do you propose that we do here, It's looking more and more like .. unfortunately .. we need to pursue the avenue of an ALF .. ".
Has either one of them had that conversation with her? Nope. Not to my knowledge.
Interestingly enough .. back in the spring when I began my exit from this whole thing .. saying then, that her care was becoming more than I can manage .. and that she is a hair's breath from a fall .. a fall that will render her with some options she won't like . that you guys need to be sitting up and taking notice .. and of course nothing happens .. and here we are .. but the continue to nurse her back to her (such a compromised state of being) is status quo, it seems. With no action/discussion on a direction forward.
As someone pointed out here, co-dependency issues .. that I have to step back and allow people to make their own boneheaded decisions that I don't agree with. There ya go, .. that's where this has been all along, and continues to this day.
The yellow bedroom is NOT an option. I haven't yet told DH .. because I don't want to harp on it all, like some kinda fly buzzing in your face, but he will be told in short order, .. the day and hour your sister leaves here with your mom in the already compromised state she is in .. and she is hospitalized with this ... OBS status .. and they don't/can't send her to rehab .. I will stand firm, the yellow bedroom is not an option .. and I cannot and will not go out there and do what your sister is doing 24/7 and you can't do it .. so I suggest you get your mind wrapped around the fact that you as her next of kin will be put in the horrible position of refusing to pick her up under the guise that she has no one to care for her at home.
And .. unbelievable as it is .. one would think .. "this is great .. I mean not great that MIL had a horrible fall .. but great that if it had to happen .. at least it happened while SIL is here and she gets an upclose in your face .. day in and day out .. 24/7 caregiver role hoisted upon her .. let her see it, live it breathe it".
One would think the above. But this isn't the first time by a long shot that SIL has been hoisted into this role .. it has happened before .. one time a few years back when MIL had diarrhea that wouldn't relent .. and SIL doing everything in her power to keep her home where she wanted to be ... and not in the hospital as had been recommended by PCP .. for weeks this went on, until she did ultimately end up hospitalized. SIL has seen this, ... a lot .. this caregiver role ... another time when MIL took a nasty fall .. not seriously hurt .. but so sore she could barely move and had to be babysat .. around the clock .. and until SIL could get here, via her car .. it was DH and I taking care of MIL . then when SIL arrived, I clocked out.
SIL has seen this role, more than once. And she is currently living it again.
As to whether there is residual anger at Dorker .. and her exit from this whole scene. If there is I don't see it, hear it, .. feel it. Nobody really says much about any of it, . sans DH and his, the other day "well you won't let me bring her into our home .. so ....", .. but SIL never mentions it. I can imagine there is some frustration .. I do know that there is a brother in law that recently was taken from FL to live in TN with his one and only daughter that will care for him. There is a son in that picture .. a son that still works (the daughter is retired, but lives in TN) ... the son still works for a living .. but even when the dad did live here in FL .. he rarely did anything at all with his dad .. or for his dad .. and he "gets talked about". So I can only presume, I too, .. as the spouse of the son in this picture .. maybe I too, am "talked about".
My answer to that, should anyone care to face me with it. I did help .. for a long long long time I did, and was probably in part, a reason why MIL could stay in her own home as long as she did .. and was happy to do it, .. until it got to be unsustainable and I said so, .. the fact that no one wants to hear the words that I speak, isn't on me. Nor does it then become incumbent upon me to step in and help sustain this charade. No one has approached me with any anger on the topic .. not yet .. if they do, the above will be said. Ready for it.
SIL has stated that she knows the plane reservation for January 9 .. her set return date, .. will have her husband on that plane and not her. She hasn't said how long she will stay .. I haven't heard that. I would presume .. if it's as it has been in the past .. she will stay and nurse her back to what she calls "she can manage, she does fine" ... and she'll be off again. Whenever that is.
Feel like I'm talking to a brick wall, might as well. As SIL with her whole line the other nite when DH approached all this, "she was fine when we got here, she gets up earlier than we do, so she gets her own bowl of cereal .. she gets her dog fed, lets her dog out .. she was doing fine".
I did remark, "No she falls .. she fell a month or so ago into her shower door and scraped up her arm .. she caught herself and didn't fall all the way down, but she had a horrible scrape on her arm .. she falls she is not FINE".
That was met with, by SIL: "I didn't know about that". DH: "She begged me not to tell you".
You tell her this, .. what you're trying to do is open her eyes that it's NOT FINE ... she is NOT managing.
But it goes nowhere. I have to just stay out of all this .. I really do. My suggestions go unheard .. my attempts to implore they do things to set this in a better path ... nope .. goes unheard. I have to stay out of it.
But don't even look at me, .. not for a second .. that the yellow bedroom needs to be a consideration. I think I will blow my top. Completely. In fact, that is likely what needs to have already occurred in front of DH and his sister both!
'Shelton says it’s “virtually impossible” for ethicists to tell an elder person with capacity who has made up his or her mind to go home that he or she can’t do so, regardless of the risks. “We do have patients who leave against medical advice. Even if it entails some risk, we can’t stop them,” says Shelton.
The clinical team struggles with seeing a patient leave, knowing it’s likely unsafe. “Sometimes the patient comes back with additional problems,” Shelton says. “This is one of the prices we pay for autonomy.”'
ahcmedia.com/articles/137775-is-hospital-discharge-unsafe-ethical-response-is-needed
So it seems that a patient could insist on being discharged to an unsafe environment, and it could happen. Hmmm...
I don't see placement in a facility happening anytime soon for MIL (unless her medical condition becomes compromised further and she actually needs skilled nursing care). First off, who will pay? Do H and SIL have the funds to private-pay for MIL? Seems like MIL doesn't have any funds, and isn't her house reverse-mortgaged? And then there's the issue of the dog, as MIL will steadfastly refuses to go somewhere without the dog. (I actually think the dog may end up being the death of her...pun intended.)
Seems like SIL needs to settle in for a nice long stay at Chez Narcissa.
H. U. G.
Because we all love you and I think you may need it!
It would frustrate me to no end to speak with SIL, the way SIL has all the (wrong) answers when D brings reality into the conversation.
Again, DH is MIA. He’s still keeping Yellow room option open. And it’s dawning on me that perhaps your SIL is shaping her responses & conversations to make you Dorker capitulate & say “well then, we’ll just have to take her in”. My guess is SIL harbors some anger towards Dorker for stepping back last Spring & SIL realizing that Dorker was correct in that MIL was progressively getting more needy. SIL probably recognizes that her denial or procrastination back then has led to the situation Dorker was trying to warn both SIL & DH about. SIL and/or DH still appear stuck with no solution and discussions with Dorker (reality) are like pouring salt in the wound.
It IS exhausting taking care of a senior. Fortunately MIL doesn’t have advanced dementia.
Both siblings are still looking to Dorker to fix it- acquiesce to the Yellow BR - & all their problems will be solved - Dorker to the rescue!
So SIL said MIL could be eligible for VA assistance- did SIL apply?
Finances will need to be reviewed. AL is costly, especially with the “extras” MIL will require. I’m not quite sure MIL meets the requirements for a NH. Would her PCP write the order?
24/7 in home assistance in the interim while they figure out where to place her? Might have to make MIL agree even as she was adverse to any aid coming in. SIL/DH could be calling agencies and checking rates & availability. That’s not another “snap your fingers & voila!” because the agencies will need to come to MIL’s home to assess her level of need.
Let’s see what DH & SIL can come up with over the long New Year’s weekend to make a plan for after 1/9. I am assuming DH is not working Monday. No excuses for him not to be available.
AL sounds like the best option but finances may preclude that.
We all know that’s what the three of them should be discussing over the weekend. Will it get done?
Don’t know.
SIL is gonna hit the Wall of Realization that this is not a job that she nor Anyone can sustain for any length of time, and Decisions Will be Made!
Whatever you do, don't cave and make this easier on her then you probably would like to, because you are a kind and compassionate person! She needs to live, breathe and eat this all by herself, so that she is forced into the hard decision to place Mom, however sad that is.
She's still grasping at straws with the whole C-Diff reasoning. Hang tough, your SIL is going to need your support the most, about a week After her Mom is place, as her guilt will be at its highest, even though she knows its the only viable option. Eventually you guys will all be on the same page, to bad its taking all of this to get her to that point. God, I do hope she reaches that point Before the pressure get to her!
I don't know what will become of the situation. I wish I could say "the talk" will happen .. but I'm pretty sure it won't.
We just ran into this last week with my FIL. He fell but couldn't be kept the required three days, didn't have a dx and was under observation, which meant we had no right to challenge. And, yes, he was refusing to go to rehab and he's pretty sharp cognitively. So we're spending our much needed break from work scrambling to doctors, pharmacies, meeting with home health and arranging o2.
It is indeed a miserable system, and having parents digging heels is not helpful. In the next two weeks, we'll be having The talk because we're exhausted now, and once work starts up, we can't continue at even this level. The only sib lives elsewhere so it's on us. The stress is exacerbating DH's health issues so I have to be right in the middle of it.
Wishing all of you caregivers some peace and calm in 2018.
I remember asking SIL when she said the Hospitalist wanted her discharged to Rehab .. but that isn't going to be possible as they have her classified as "observation", not "inpatient". The info I've read, .. in my limited capacity to know much on all this, .. it's almost impossible to get a hospital to change that status. About the only hope is to involve the PCP. I did ask SIL to put in a call to the PCP and see if we couldn't get some action from that angle. She didn't seem to think anything could be done to change it, and so didn't opt to call PCP.
I guess it's probably a good thing I wasn't around and present there. My first problem would've been when they began talking of discharge to home, after having mentioned wanting Rehab .. and then talking of an ambulance ride to transport to home.
Why? Oh because she can't ambulate well enough to get into a car to go home. Then, .. she isn't coming home, would've been my answer. There is no one there to care for her, so what's your Plan B hospital?
SIL is paying dearly for her hesitancy to hit this head-on .. and try to advocate for "inpatient" status. She is a sole caregiver at this point, 24/7, to a person who still, cannot even rise to a sitting position in her bed, without assistance, much less get up out of the bed and navigate to the bathroom.
I have to wonder what would've been the result if SIL had refused .. and told them, "I am flying back home to Chicago tomorrow, .. and there is no one there to care for her".
What would've happened. Would they have still bounced her out of there, via ambulance.
do everything" adult child. Been there, done that. The name of the game is to simplify
care, and often a narcissistic elder is content having care from other sources as long as
the attention is firmly focused on them at all times. A well trained servant,
whoops meant adult child, sometimes forgets this.
The issue about lying to get her admitted? Sometimes, a reason just needs to be tweaked so they can enter that into the system properly. It's simply crazy to be passing
up on nursing care, or hospital care due to a technicality. Nursing staff are hopefully the most competent and trained people for the job. My back has been damaged from doing a lot of unassisted lifting of my 200 lb father, when the facility he now resides in has lift assist devices as well as trained caregivers to do the lifting, etc.
Firm boundaries are your friend. State what you are willing to do and don't deviate from
it one iota, as if you do, it will undoubtedly become the new normal. Good luck!!
The only thing she can take is Tylenol. If that is not enough and I suspect it would not be then other narcotics should be tried. there are plenty of them out there. personally i would suggest a fentynal patch which would give her continuous pain relief and only need to be changed every 72 hours.
She may have been given IV fentynal for pain in the ER. That seems to be the narcotic of first choice these days because it acts so quickly.
She probably needs a higher level of care than AL so start looking at NHs and come up with a list to give SIL and DH and let them take it from there. Involving Senior services seems an excellent idea. otherwise the only option is to wait for another fall insist on admission for at least three days get her into rehab and don't let her leave.
Sorry Dorker you may have to install a doggy door and fence your yard but thats a small price to pay.
It's not that mother can't take care of herself safely or has mental decline. Obviously we have simply been addressing the wrong end of the problem!
I get a text from SIL earlier, .. telling me the bedside rail she had me order (my Amazon Prime account, MIL's cc on file there) has arrived. I told her I'd gotten a text that informed me of same.
I asked her, (shouldn't of done that) "ever get an answer on the Ibuprofen/Elliquis issue, has PT arrived and begun their end of things?".
Here is the dialogue that has me so frustrated:
Her answer: "Yes, .. doc has put her on something that should help with any GI issue .. and they are in fact, leaving her, for the time being on the Ibuprofen as rx'd but the cardio doc isn't wild about it, .. bur for the time being, that's what they are opting to do. And yes, .. the PT folks are on the scene, as is the nurse, the nurse assistant (?), OT .. all of them coming and going, it's wearing her out, and ME".
I said the following: "Probably a good thing, no good for her to sit sedentary".
SIL: Yes, but I don't think she's getting enough rest, I know I'm not .. between the comings and goings all day . and the night time, and the dog and her needing assistance to get up .. and she can't get comfortable and needing adjustment 2 and 3 x's a night, .. there's no rest for either of us in it all".
My response: "shame it has to be that way .. I remember going to see MIL's sister when she was in a Rehab place a couple of years back after a fall, .. we traveled down that way and visited with her, while she stayed there, that would be a better setting for all involved, .. for her and for you, so you wouldn't have this 24/7 caregiving role".
Her response: "According to what I hear from the folks that come here, there is no way she'd of gotten an "admit" .. not with just being sore .. and no broken bones .. it wouldn't of happened, no way she'd of been sent to Rehab .. they couldn't even give her an "inpatient" status not with nothing they can classify for that.
My response: "I think, personally, you should have flat out lied to them and told them you were returning home to IL and there would be no one to care for her .. what would they have done then, .. they certainly can't run the risk of sending someone home who can't even get to a sitting up position in her bed, without assistance, much less toilet herself or feed herself, .. I think they'd of had to come up with a different plan .. you should've just lied to them".
She responded: "From what the OT folks have said on it, they wouldn't of done inpatient, the best they could've done in that instance, was a nursing home .. and that C Diff is bad in nursing homes, not anywhere you want your loved one ..".
***Thus, I have gotten too close to the flame in all this. I find the above extremely frustrating*****.
I want to say to her, "well you seem to have all the answers that there was no way around it, so enjoy that role there .. it must've been what you wanted, because you didn't stomp your feet and cause a scene to do otherwise, .. and I have to believe I'd of lied, or whatever else I needed to do, rather than do what you are doing, 24/7".
But I didn't say the above, no matter what I say there is always justification/excuse .. so forth.
So fine, live it, breathe it, eat it .. be it... 24/7.
I have to believe .. (I don't know, and I might be talking out of my ear here because I certainly am not in the know on such things) .. there HAS TO BE ANOTHER WAY .. there has to be. No she didn't have any broken bones, .. but she has A-fib .. (chronic and not an admittable classification apparently, so I'm told) . she has CHF .. (chronic, again, see above, not a label for admit) .. she is a stroke victim with balance/mobility issues (again, I'm told .. chronic .. nothing that would warrant an admit) .. thus there is no way .. so I'm told.
What the hell do they do with a patient who has no one to work around the clock to care for them and their precious mutt ... what do they do? Send em home to fall again and again and again?
I think not.
But no matter what I say .. it seems there was no way around it, thus SIL is worn out, working around the clock .. and MIL worn out .. from trying to recover and the various modalities there showing up to do their jobs and lack of sleep at night, from discomfort and so forth.
and nothing changes ...............................
If you've got a cardiac patient on blood thinners taken to the hospital, you need to jump up and down and make a BIG deal about what they are giving the patient.
When my DH) artificial heart valve, on warfarin for years) gets to the ER, I put in a call to his PCP and cardiologist if the ER doesn't do it first. If the hospital won't involve the patient's docs, then you ask for a cardiac consult. (Can you tell that MY Loved Ones get admitted?, because I'm a PIA and if they try to blow me off, I call our lawyer?).
You don't sit around and wring your hands. You don't have fits. You say "We need to fix this"; and you get the professionals over to YOUR side of the fence so that the situation can be fixed.
There is also; "I'm really sorry, but you haven't answered our questions about the medications adequately. We're not signing for discharge until we get that consult".
The first time I did this, my mom cried bitter and hysterical tears. I told her to look pale and that everything would be okay. She trusted me, got the message and we got the hospital to fix what was wrong.
“To do nothing. It's a great idea, really. Maybe if I just wait and see long enough, then I won't have to do anything or decide anything, you know? I mean, maybe if I'm lucky enough, someone else will decide and choose and do things for me.”
~ Homer Wells, Cider House Rules
While it is indeed very, very sad that their mother is old, this in fact happens to almost EVERYONE. While they want their mother to have what SHE wants (ie her dog, her house, her way) she has proven herself to be completely incompetent when it comes to taking care of herself.
Sad fact: MOST OF US DON'T GET WHAT WE WANT.
Dorker--just stand strong. DON'T let MIL move in with you for one night. If she does, you leave. I hate to be confrontational, myself, it makes me physically ill, but the times I've had to stand up for myself--I don't regret.
SIL will hang around, smooth some rough edges, exhaust herself and go home. DH will continue working and churching and guilting YOU for not being more involved. MIL will totter along until she falls again and then the circus is back in town.
"Doing the same thing over and over and expecting a different result is one of the hallmarks of mental disease". Quote from my psychiatrist.
As GA said, this is apples and oranges. Once MIL had this bad fall, everything changed. The hamster literally fell off the wheel.
I'm just so sad and so sorry for you.
Your husband and his sister don't want to make decisions. They don't want to do the long-term heavy lifting. My husband and his brother didn't either. My MIL is now in the skilled nursing facility because she is incontinent and has a catheter; FIL is unwilling to do that part of hygiene and won't pay for home health care.
You are going to have to just keep standing back. If your husband brings her to your house, unless you are staying elsewhere, he WILL leave MIL with only you for care. Period. He has shown you who he is - believe him.
I am not quite sure how cardio doc got wind of concern there, to then throw in their input .. "no can't be on Ibuprofen . pull her off of that".
I would say SIL .. 2nd guessing and worrying, wringing hands .. maybe put in a call to cardio doc on that concern and was told the above. The problem then began to be .. "well she can't come off the Ibuprofen .. she's in too much pain (can't take narcotics they make her throw up). So then of course, it became, a call to the docs that tx'd her in the hospital and that recommendation .. and vs .. the cardio doc's instruction .. and now what do we do?
SIL when last I heard, unable to speak to cardio doc, but did talk to a PA there .. and PA advised that she'd ck with MD .. and get back to her, but that for the time being, it may be advised to cut back to half a dose of Elliquis .. if we have to continue with Ibuprofen on board for the time being.
So SIL was awaiting answers/direction on that whole front.
The monkies are running the circus.
She is so frazzled and addled and worn out, in her functionality right now, that she is really kinda scattered. I didn't see any ability to "focus" and plan to make headway forward. Her talking of, "well she's injured right now, .. I'm just in survival mode right now, and trying to coordinate upcoming doc visits (PCP to see her, as well as derm doc in coming weeks for the squamous cell carcinoma on her leg) and her questioning, .. when .. as it is presently .. she wouldn't be able to get down the hall even to get thru the house to her car, to go anywhere. Her expressing herself in survival mode right now, trying to coordinate with the visiting nurse and appts, and the OT and PT and appts .. and a problem they were having to dial in on, .. hospitalist put her on rotation of every 3 hours for pain, Ibuprofen/Tylenol .. but those who are on Elliquis .. shouldn't be taking Ibuprofen .. so the cardio doc wanted that pulled from her meds .. and there's no way .. she's in too much pain. And so SIL then having to phone the hospital doc that rx'd above and dial in on that issue. Her in "survival" mode at this point and expressing same. Couldn't get her to "focus" on the topic that was being discussed. And her then talking of "really she was fine .. I mean when we got here, .. we don't get up as early as she does, .. she was coming in here .. getting her own bowl of cereal, feeding her dog, letting her dog out .. she was doing fine ... ".
Couldn't get her to dial in on the topic.
DH asking, .. what can he do, does he need to schedule appts at some of these places, and they go take a look. She was off on the above topics .. scattered. as I said.
I could absolutely do some of this legwork ... for sure. And I will. But I want some direction first. Are we indeed going to proceed with that as the path .. before I waste my time with all these phone calls and appts., etc. Because I am not interested in doing any of the above legwork .. if the end result is that SIL intends to nurse her back to her compromised state and then waltz off again, .. with the whole "she's fine, she manages .....".
I don't see that there has been any mandate at this point, as to a meeting of the minds between those two that MIL will have to be approached and some earnest discussion about the path forward. I don't see it. Too scattered, the thinking.
I could call SIL myself, and say to her, "Listen I know you and your brother talked the other night, about the direction forward, and ALF's .. and there didn't seem to be any concise answers .. I will be glad to work that angle, and see what I can get in the way of answers as to some forward progress, but I'd like to know, before I waste my time doing so, is that indeed something you and your mom and your brother are going to sit down and get your mom on that page .. is it a given at this point, when do you guys intend to have that conversation with her, ... is this something you intend to nurse back to stability and take her to IL with you .. do you want to nurse her back to what you consider stable and then return for her in the spring, to take her to your home, .. give me some answers .. if you can't do that, I'm not real sure what direction I can take to proceed with helping to get some direction in any of it".
I could certainly have that conversation with SIL .. most definitely .. to help. But I don't have a lot of patience for all the scattered talk, ..
You have to look at things from where I sit. I started with this almost a year ago, that this isn't tenable any longer .. I can't keep doing this ... This is when I was the one on the front doing what SIL is presently doing .. but yet I am not retired, I have my own home here to manage, .. and my life .. and DH at work all day .. she at least has the luxury of her husband, front and center, who can run to the grocery for her, deal with the dog .. do the dishes .. etc. I didn't have that luxury ... I was doing what she is doing, plus what her husband does, and the only relief, .. when was when DH would get off work and come clock in, and I could then go home exhausted, ..
I began to make noise I can't do this anymore, she needs more help.
You all know how that story has gone. So for me to take much of any vested interest in perusing any answers here, I need to know what page they are on, for certain.
Not sure I can get any answers from SIL .. and she seems to be the one at the helm of it all. She's too scattered and frazzled right now, and I can hear it, before I even approach on it, "well mother is just far too frail right now, and compromised, I don't really think we can approach her with all this right now ... ".
Translation - my plans are not what you guys are on the page to do.
SIL has already stated that she intends to send her husband home on the plane. Their reservations were for January 9th, to return home. And she will stay and extend her visit here. She hasn't said for how long. I guess that kinda depends on the situation.
This happens every time she's come here, though she usually has come here under some crises situation .. and had to stay on .. to manage it. This time, she merely came here for xmas and to cart MIL to cardio appt, neurologist appt., eye doc appt., and vein doc appt. And then do xmas .. and then of course, all hell broke loose, because MIL fell.
Yes, MIL gets up routinely 2 and 3 x's nightly to let her dog out, .. before this happened. Right now, she's not getting up to do anything, other than to sit up to eat, .. for what duration she can stand to do so .. and to go to the bathroom.
Her dog is old, . and I guess, because he's a small dog, he has a small bladder, .. I don't know .. and so needs to go out .. 2 and 3 x's nightly.
SIL tries to, when she's here .. and can work that angle, .. I don't think she can presently .. too much else going on .. she tries to make the dog stay up later than what MIL normally does .. and let's the dog out one last time before she goes to bed, like at 11. But MIL can't do that. Generally MIL is in the bed at night by about 8 or 8:30 at the latest .. and lights out .. and so the dog .. he is waking her 2 and 3 x's nightly to go out.
The dog is her whole world. It's been her reason to get up and function. It would be like if someone told me they were going to get rid of one of my kids, because I can't manage any longer. To her, that's how it would feel.
I don't know what yesterday's news was on that front, didn't ask, and if DH did, he didn't report any news to me, we didn't even talk about it.
I worked at the church yesterday for the church sect'y who has gone out of town for xmas and then I got my head on straight with some bills and things around here that needed attention, and then he and I both went last night to babysit the baby twins .. so DD and her husband could take the 4 yo on a dinner out and movie date night. That was our yesterday, not any geriatric front.
I asked DH this morning before he left, .. "when is it you are going to take a shift for your sister and stay there overnight, did you and she work that out?".
His answer: "She never answered me as to what she wants me to do".
I didn't pursue that topic any further. IMO, .. he is going to have to take the bull by the horns and tell his sister what works for his schedule, be that tonite or tomorrow nite and go do it, .. she is so scattered and addled right now herself .. that she's not going to focus on any question asked of her, .. unless it has to do with the geriatric care front and what is right in front of her radar. I won't push it, .. not my mom. These are some of the things that used to cause some consternation in this household, my pushing him to do x, y and z .. on the front with his mom. And blow-back on me for my efforts. I won't do that any longer. I will suggest it, .. but then I will drop it.
I know the last time that his sister was encouraging, from afar .. that he go spend the night with their ailing mom .. and I tried to press that, within the last several months, forget the ailment at that point, . when I pressed it, .. I got blow-back for my efforts and I said then, I will not do that anymore. He did end up going, but not after having some consternation here over it all.
It makes you want to scream .. "SHE IS NOT MY MOTHER .. and I'm not gonna fight with you about this!".
I can only hope that he will see to it, to go help his sister out, without prompt on this end, or that his sister will dial that up herself in dialogue with him.
Like Barb, I too fear that H will propose the "temporary" Yellow Bedroom solution until SIL can take MIL away to Illinois. If he insists on that solution, he will be doing MIL-duty 24/7 (with none to very little working/churching/hunting!) totally alone, as Dorker will move out.
I think SIL will possibly find that Illinois requires a year of residency before MIL can start using IL Medicaid funds for ALF or a SNF. I assume SIL will realize this BEFORE she takes MIL to live with her. Or maybe not?
Barb had another very good point -- if it hasn't been done already, can H call the local council for aging to get a needs assessment for MIL?
Please keep us updated, Dorker.
Look no further than her attempts at justifying that she's fine in last night's discussion. Her saying to DH .. "When we got here, she was fine .. I mean .. we don't get up as early as she does, .. she goes into the kitchen and fixes her own cereal and gets her dog fed, lets the dog out .. she was doing good".
Translation - she manages, per SIL.
It was then that I interjected, "But she falls a lot .. she just hasn't gotten seriously injured. Yet, but it's coming".
Then cited the most recent fall before this one, .. where she scraped her arm pretty bad falling into the shower door somehow. And SIL: "I didn't know about that one", DH interjecting: "She begged me not to tell you".
It was then that SIL interjected with the, "Well what is an ALF going to do to assure that you don't fall, she could fall there, she could fall living with me .. they don't follow you around 24/7 at an ALF to keep you from falling".
I didn't say anymore, but I wanted to hop in and explain to her, .. "there are trained medical professionals on site there, working their shifts around the clock, not one lone individual responsible for all of it".
I had to note .. at least to myself ... her remarking how worn out she is, and she is ... she is worn to a frazzle at this point. And she said "at least B is here (her husband) and he can take care of the dog, and the dishes and get the trash out and run to the store for me".
I so badly wanted to say .. "and when you aren't here .. that's precisely what I was doing for her, in times of injury or illness, .. without the help of DH who is NOT retired and unable to be here on site, precisely why I can't do it anymore".
I think I have a sneaking suspicion that SIL intends to nurse her back to her compromised state of being .. (though I think if that's even possible, it's going to be a long haul .. she was already so compromised anyway). SIL thinks she is going to nurse her back to her "oh she's fine .. she manages .. she gets in there and makes her own cereal bowl .. yadda yadda yadda". And off she'll go again.
I was never so glad to hear her daughter's voice in all of this! Her daughter sharing with me that she doesn't think her mom can keep doing this. Her mom is 67 years old, has a bad back, had hernia surgery back in February .. she can't keep doing this, at this pace. Her daughter expressing worry about her mom considering taking her into their home .. and granny who has a propensity to be mean to her dad ...
SIL's daughter has some very valid points. I did ask her if she shared any of that with her mom and she said she has. That her mom agrees .. she has some reservation about bringing her mother into her home .. and that she too realizes she can't keep doing this.
Her daughter expressing to me how their lives are so on "pause", her mother and dad's. And they have to then fund a flight there on a moment's notice when something goes wrong on this end. It's not fair to them. And I agree, couldn't agree more with her sentiments.
Now .. to get SIL to agree .. that she can't keep doing this and that she and her brother need to sit down and get some real conversation going with MIL .. and get some action.
I think DH went there last night, and opened that dialogue .. it was met with a bunch of hooha from SIL .. and somewhat *resistance* in her, "well she's injured right now, I had planned to ............................................", rather than deal with the topic at hand.
Here is what i'm afraid of for Dorker - SIL will go home in Jan to get the house ready to take MIL in March. DH will insist that for only two months - MIL should stay in the yellow room. Then in March MIL will refuse to move. Dorker - hold your ground. Your DH is still not getting it. Before you allow her to move in - have your DH pull his head out of his azz and spend 48 hours with her taking care of her, on his own. THEN see what he has to say. Stay strong - we are cheering you on. You said to DH the issue in the correct terms - MIL needs a level of care you cannot provide - so yellow room is not the answer. It is a cheap bandaid.
I have said no to the yellow bedroom and I mean it. And I will up-end my marriage and leave if it comes to that. So what would be accomplished by having an ambulance pull up here to offload the care of MIL to me. I wouldn't be here, and I've said it and meant it.
But still, the problem keeps reoccuring when I'm asked, "can't *we* bring her here and let her stay here". What part of "no" the other 10 x's you've asked this, did you not think I meant.
Yes, it's hard to let go and let others make their own decisions but when there are no decisions being made, it's even harder. It's as plain as the nose on my face, there needs to be some proactive work going on here, as to placement. And yet it doesn't.
It's about like, to me .. it feels about like, .. back when I had kids .. and that kid .. staying out late, .. not doing their homework, .. not staying up with their assignments, ..and the report card comes and the failing grades that are the result. Only in that instance, I had the power to say "that's it, you're grounded, and I will be in daily contact with your teachers .. until we can figure out how you can manage this on your own and not have me in your business". And the course was righted.
Feels like in this instance, .. the train is barreling forward 100 mph .. coming right at us, .. and yet anyone who has any say so to stop it .. won't ..