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She is currently in a respite care/assisted living facility nearby, as she recently fell on her knee, which aggravated her osteoarthritis in both knees. She is using wheelchair/walker. Our house is not handicap accessible and has steps/no grab bars in bathrooms but only the handles on the sides of the toilet. Her bedroom and bathroom for a shower is upstairs. Also, she gets up multiple times per night to go to the bathroom so if she ever came home, we would never sleep for fear of her falling.
I have been the primary caregiver for the last three years doing everything for her as there are other health issues (I.e., diabetic/insulin shots, Macular degeneration, Dr appts, etc.). So yes, I have created a monster (expectation of immediate dedicated care). She is a strong willed, independent person and we are approaching the idea that it is safer, and she may need to stay there, but she is very resistant. What is the best approach to get her on board? My next step will be to bring the doctor/physical therapist into the conversation and let them be the bad guys to say she cannot come home safely, and then we can make her feel better by saying she can come home for the day during holidays or other family events if she is on the walker.

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You are already on the right track, but attempting to do a “carrot on the stick” of coming home for any reason may very well not be the helpful tool that you think it is. NEVER make any promise that you aren’t 100% positive you’ll be able to keep.

Her proposed residential care site NEEDS to BECOME HER HOME.

How did you become the “designated caregiver”? Did you offer?

Does anyone in this care giving process have POA?

Does “age related decline” mean symptoms of forgetfulness, overt hostility, refusal to participate in therapies? All or any of those may be symptoms that the “independence” at home that she says she wants are reachable goals for her.

Then there’s this- YOU have cared for her for three years in a set up in your home that was less than ideal for her VERY COMPLEX NEEDS.

You soldiered on, and you are weary and afraid that if you continue to be her primary source of care and attention, your situation AND HERS, could quickly become much worse. She is NOT an “independent person”. She may once have been, but no longer. And that means that her ability to participate in decision making is no longer appropriate to leave in the thoughts of “the monster” BECAUSE YOU AND YOUR FAMILY COUNT TOO.

You have reached a point that many of us ultimately reach. I gained 60 VERY UNWANTED POUNDS and added a sleep disorder before I placed my mother, the most stubborn woman who ever walked the earth, in a very good SNF, where she lived over 5 happy and contented years before her death at 95.

SO- stop trying to figure out how to continue to let her rule your household, and allow her to be placed in the very best near by facility you can find.

Allow HER to adjust to her “new life”, STAY AWAY from the facility if they ask you to do so, until she realizes that this is now her “HOME”, and NEVER AGREE to any or visits or treats.

“We’ll see what ‘they’ think…” works. Blame doctors, therapists, whoever, but don’t commit to ANYTHING that you can’t or won’t be able to do.

BE STRONG. You’ve paid your dues for THREE YEARS. It’s time for a change. Make one.
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Cover999 Nov 2022
Can't blame her for being resistant. These places tend to be depressing.
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I would not encourage the offer to come home for family events, the home is now her new home, once you start the back n forth she will never settle in.

You've done your due diligence; it is time for her to be placed where she can be well taken care of from a safety prospectus.
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You are never going to get her to change her mind so you cannot present this as a CHOICE. She needs to be told that you are no longer physically and mentally able to care for her at your home. Her needs are more than you can handle. If you have to be the bad guy, own it. So many people on this site are afraid of upsetting the elder. Yet it is ok for the elder to work them into an early grave without giving it a thought. She isn't going to get better. She will only eventually get worse. You can't do this anymore. You gave her three years, how much more does she expect?
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Isthisrealyreal Nov 2022
Yep, being the bad Guy and owning it is actually pretty awesome.

I found that once I was labeled, I didn't get calls for assistance.

For me, win-win. Get your home back and no more manipulation, who can ask for anything more?
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As others have already commented, you should not present your continued caregiving as an option. Say both you cannot do it and also you don't want to do it so she doesn't attempt to negotiate a workaround.

Can she afford in-home aids? Is she willing to wear an alert system 24/7? Can her home be rearranged so that her bedroom and bathroom are on the main level with no stairs? Is she doing her PT? If she's not willing to do those things, then staying at home will be unsafe. Yet, if you aren't her PoA (or she doesn't have one at all) and she doesn't have a diagnosis of cognitive/memory impairment, she gets to make her own decisions -- it just shouldn't include you as the solution.

Consider researching good, reputable care facilities that have a continuum of care. Make an appointment for just yourself for a tour, discuss price, Medicaid, etc. Take your own pics/video of the residents doing things together and show them to your Mom so she can see that modern facilities are not awful warehouses of the elderly. Help her figure out what she can afford and what happens if she runs out of money. Assure her you'll help her transition every step of the way and make it easy for her. If she still resists, it will become a waiting game for her next fall or medical incident. That's as much as you can do.
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Cover999 Nov 2022
No many are places that have their own cliques just like in high school
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Your husband needs to tell her that returning to your home is no longer an option. The house is not safe for her anymore and you can no longer care for her. Your are Seniors too. She needs more care than you are capable of giving her. She really has no option since she cannot live alone. If he can't say this, then u have to.

It does not matter what she wants, its what she needs. You should be enjoying your retirement years. She still has her independence. She will have her room. She can walk around the AL. She will have a social life, activities and entertainment. There is no talking her into it. She has no choice. This is how it has to be.

What you need to do is allow her to adjust. When u visit u do not need to stay long. I stayed no more than an hr. She needs to get used to the staff caring for her. If she calIs numerous times a day, put a stop to it. Tell her to take advantage of what the AL has to offer. Use the aides. If she gets mad, oh well.
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Cover999 Nov 2022
From her point of view she would be in this place while daughter and law can leave and/or not visit at all.
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She needs more care than you can provide, and you need to keep telling her that. Also, bringing her home for a holiday isn’t a good idea because then you’ll face the weeping and wailing when it’s time to take her back to her new home. Maybe next year…..
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Welcome to the forum. I'm sorry you are new here and had to find such a foul, guilt inducing comment from someone who has no profile themselves, just a history of leaving foul comments for others.

Assisted Living is not some house of horrors that an elder is being "dumped off at", for petesake! It's a luxury environment where an elder gets care, meals, activities, entertainment, outings, and all sorts of other amenities too numerous to mention. We should ALL be so fortunate to be able to afford AL in our old age. Your MIL, at her age and in her level of need, is no longer capable of living with you and needs more care than one person can safely provide. She needs a team of caregivers working 24/7 to care for her now. Those that don't understand this need have a Superman complex or an extreme level of ego combined with ignorance blinding them to the reality that they're simply incapable of being All Things To All People At All Times. Fortunately, you have the intelligence and presence of mind to realize the need for AL for your loved one.

Get her doctor on board to explain the need to your mil and that at 94, it's simply too dangerous for her to live anywhere else but AL. Let her know you'll visit frequently, too, and then be sure you do. Before mom went into a wheelchair, I'd bring her to my house for Sunday dinners and holidays, then it got too difficult and she was too high strung when she did come over, and wanted to get back to her apartment almost immediately. By then her dementia had gotten pretty bad and she'd segued into Memory Care. So we'd bring the festivities to her instead in the library which was nice. You'll figure out what works.

Wishing you the best of luck.
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Cover999 Nov 2022
Where are these ALs that are "luxury" environments? They sure aren't in Cleveland Oh?
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Cindy, here's the deal.

She won't be safe at home and you and your dear husband (dh) can no longer be adequate caregivers.

There's no "convincing" her. YOU say "no, we can't do this anymore" and accept that she won't be happy with you.

You have to steel yourselves to not be afraid of her anger, her displeasure and her sadness.
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TouchMatters Nov 2022
and ... if she isn't safe in their home, she won't be safe there during the holidays so not a good strategy to use. It doesn't make sense - and mother (IL) won't be in a mental / psychological / emotional place to hear 'home for the holidays.'
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I am so glad that you and your H are on the same page! Since H works full-time, it's YOU that needs a life. Did you retire early to become her caregiver?

Keep stressing the "unsafe" part of it, not that you need a life. She obviously doesn't realize or doesn't care that you are not having much of a life now as her caregiver.

Does H have POA/HCPOA?

How did she come to live with you and H?
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Good thought don't lose this opportunity while she not in ur home..
Past post replies, just refuse to allow her back to ur home.. ur her only source of transportation.. Tour, choose the Al that has a bed available that u trust And that's the only place she will be driven to. Work with AL staff to get this transition done.. they have been through this before... Al staff will even go to meet with her at respite care center. When we toured the woman giving the tour said she gets embarrassed sometimes that an elder will be so polite, co-operative to her while just treating their LO like dirt.
She said the LO will ask what they r doing wrong...... Nothing it's just the way it is for most.
And the tours of AL will make this more real for u and ur husband.. and give u something to do besides worrying. Make u feel more in control in a situation u feel so out of control
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Cover999 Nov 2022
Elder is probably pissed LO is doing this to him or her
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This is really on your husband to tell his Mom, not you.
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my advice is to leave her there if you can afford it. For her own safety & for you & hubby sanity. . You’re not getting younger & she will get worse & fall more. Don’t mean to be so negative & a Debbie Downer..but it’s reality. We can get so emotional about our loved one care & well being..but also need to think smart as well as emotional. You can go to restaurant for holiday with her instead of bringing her home..because she’ll never leave house again..Hugs 🤗
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You already acknowledge that you created a monster, so you have this. You will have to stop enabling the behavior. Have a good sit down with Mom about what you can and are willing to do and what you cannot and are not willing to do. Give her phone numbers to engage with help providers and for emergency services when you aren't available.
Beatty, who posts here, says that "There will be no answers as long as YOU are all the answers". It is true.
This won't be easy. Habits have been formed on both sides. You might consider an few hours of time with a Licensed Social Worker in private counseling practice. They know the drill, they know the resources and they are best at counseling on life change work. My best to you.
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TouchMatters Nov 2022
Excellent reply. Thank you.
Gena / Touch Matters
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The best approach to get her onboard with staying in the AL would be to refuse to allow her to move back into your house.
She will be angry and will carry on. You know her being in AL is what's best for her and everyone else.
Be plain in your speech when you explain to her and the administration of the AL that she is not coming back to live in your home then state the reasons why. It is not up for debate and do not allow your decision to be questioned.
There's no "bad guy" here. You're not taking her back and there's no blame here because it isn't wrong. It's the right decision and you do not have to justify it to anyone.
Make sure she knows that she's not going to miss out on anything like holidays or family events. It's not prison. People move to AL not as punishment but so they can live in safety and get some help with managing. It's for people who don't want to be a burden to their families and don't want to ruin their adult kids' lives by forcing them to become slaves to their neediness and demands. It's not a nursing home and it's not a memory care.
You're still independent, only with a little help.
She'll get over it.
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Isthisrealyreal makes an excellent point about being the "bad guy" and it's true. Sometimes being the "bad guy" can be a good thing. When people see that you don't have a problem saying no they soon understand that you're not a pushover and they stop trying to take advantage of you.
@Cover999
The OP and her husband do not want the MIL coming back to live with them and they should not take her back.
How many loving and caring parent/adult child or SIL/DIL relationships with in-laws that were totally wrecked and devastated because they took on caregiving?
People get fooled when they hear the word "caregiving". It sounds wonderful, doesn't it?
I've seen so many families over the years destroyed by caregiving for an elderly parent or in-law. Loving marriages that broken beyond repair because of caregiving. Brothers and sisters at each other's throats over preserving inheritances or resentment going too deep for healing because one sibling gets saddled with all of it and the others don't get any.
CindyAL and her husband should keep the MIL in assisted living for their sake as well as hers.
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Cover999 Nov 2022
Maybe the key is finding a good one.
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You cannot provide the care she needs.That is the bottom line. You are all fortunate that there is a place for her. She is afraid of a new place. She isn't going to like it; won't like it for months, or admit it to herself or you. Try and get your husband to make it clear that you and he agree about this. You do, I hope? Guilty feelings only cloud a necessary decision. Forces greater than you or your MIL have made this decision. You all have to recognize this.
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MeDolly Nov 2022
So agree with your statement regarding guilt, a self imposed emotion that keeps one stuck.
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She can be resistant, but if your home is no longer a choice for her, she will have to choose among other facility options.
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We had to move my dad to an Assisted Living Facility a month ago (93 with Alzheimer’s) when he started to become more of a fall risk. We tried to keep him at home as long as possible but it was taking a toll and was no longer safe
we looked at many places and researched state reports. We found one close to several of the kids so we can visit often. And we made sure there were good activities almost every day. They have an activity director who organizes games and special events all week. We also met with all the staff and they had good positive attitudes. Dad has a nice suite with living area, kitchenette, bedroom and orivaye bathroom. We filled it with his and my late moms things from home. Parents can be resistant to an ALF as they remember the nursing homes in the 60s and 70s. Depressing. Get your mom involved in the decision. If you can, take her on the tours of the ones you narrow it down to. Tell her there is no choice but you want to find one she likes best. Maybe do a respite weekend so she can enjoy some of the activities and meals. Many offer that.
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Why do you have to get her 'on board'? Do not allow her to move back into your home. Whether she is on board or not doesn't really matter. Cruel? Do you want your life back, do you want your marriage back, your home back - if yes to these things then it is time to release her hold on you and your husband and give her to care, physical therapy, recreation, and nearby doctors, nurses, and social workers she will benefit from.

I realize some people think we 'owe' our parents, but now they live to 100 but lost their brain at 85. Bones are brittle, sight and hearing are gone, mobility is gone, bodily functions are not reliable and multiple aging diseases have to be managed - YOU cannot give your life up. So don't.
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Your question: "What is the best approach to gt her on board?" is really asking:
"How do I get myself on board?"

* You need to realize you/your husband are in control.
* Set your boundaries
* Expect 'kicking and screaming" - OF COURSE she'll be resistant... why wouldn't you expect this response?

* UNTIL and UNLESS you change your mindset, she will continue to do what she always does - she won't change.

THE BEST APPROACH:
1. Be clear
2. Be concise (don't make excuses)
2a. DO NOT give too many examples of 'why' (give one: it isn't safe for you to be in our home due to no wheel chair accessibility" - that's enough). Long explanations = feeling guilty or out of control of the situation, if not intimated).
3. Be firm
4. Do not argue.
5. Walk away as needed (as she'll want to engage / scream / argue - give her time to cool off / cool down.)
6. Make needed arrangements.

GOOD TO BRING IN THE PROFESSIONALS...
Realize there is NO easy answer to what she needs as she won't accept what she needs. DON'T MENTION THE HOLIDAYS YET. That won't register and she'll think why "JUST" the holidays. And . . .

If she can come home for the holidays, why can't she be there all the time?
Be very very careful what can of worms you open.

Gena / Touch Matters
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Safety is the concern and, you have pointed out several safety issues with her in the home.

Have " the talk" with her with Physician and case mgr support WHILE she is already in a facility.

Expect her to disagree, argue, pout, try the guilt trip on you and, overall not cooperate. This is normal and most families experience this in some fashion. She is grieving the changes that she realizes and her loss of control over her independence. You will likely feel some grief needing to make this decision for her safety and your well being. Focus on her safety....
Get support for her and yourself via your or her local faith clergy ( if you have one) or if not, access a chaplain who visits the facility. Also get the facility social worker involved and they should also be helpful sorting through the range of emotions, grief and needs for both the MIL and yourselves. Be kind to yourself....practice good self care... Do not cave in to bringing her back home unless you are prepared for making major changes continuously and allowing this to control you and your life instead of you controlling the situation for her safety and, your and your spouse / family health, survival and we'll being.

Best regards jnm
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Don't force her into one of these places. She is absolutely right not to want to go there. The abuse and neglect is horrible. When you talk about safety ...then keep her OUT of these places if you care at all about her well being.

There are other options. You can look for in home care for her if you are no longer willing or unable to care for her.
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againx100 Nov 2022
Give me a break!
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A Geriatric Psychiatrist can assist you in finding the right placement. If there is a lot of drama, he/she can prescribe medications to keep her calm and let her understand her reality and yours. It would be helpful if you visited a few assisted living facilities and then take her to visit your top three. If she chooses the place, then you don't have to be the bad guy............always let her make choices for as long as she is able and then take good care when she is lost.

An Elder Law Attorney can advise on all the issues that affect her and you. The financials will be very important in a proper placement. If your home is not up to ADA standards, then she really needs your attention in finding the nearest place to you, so that you can watch over her medical and emotional treatment.
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CindyAL: She needs to remain in the assisted living facility. Have her physician state the need for this to happen.
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Again so sorry Cover 99 has never been in your exact shoes, but I have. Depressing situation at AL?, what about the depressing situation for you and your spouse in your home.
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Sometimes there are no other safe or viable options for your loved one, other than AL or SNF. When my father died my mother wanted to move into our house. We didn't have a room for her, our house isn't handicapped accessible, and she needs a high level of care. With two teen-age kids and working full-time from home, it was not an option. Also, I didn't want her living with me. My mental, physical and emotional health would be destroyed, and I would not be able to give my own kids the support and time they need.

She couldn't live on her own, so I put her in AL (eventually SNF). Of course, she was resistant as she was losing her independence, but she had lost that before she arrived at the facility. The only reason she was able to stay at home was because my dad did everything for her. I couldn't and wasn't prepared to do that.

Not only is AL the safest place for her, but it also ensures you can have your life back.
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