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My MIL is 69, has severe and untreated arthritis (total destruction of all joints, no longer treatable), COPD and various hbp/heart issues. She's been either inconsistent with or totally refused taking meds for years. At this point she can walk with a walker short distances but cannot get in and out of bed or a chair, dress herself, prepare meals, bathe, etc.

She won't consent to a nursing home so my husband set up home health services as best as he could, but she often sends those aids/nurses away without allowing them to do anything and then calls my husband over to do xyz. Or she'll call 911 to get immediate help and then refuse transfer to the hospital.

Here's my question. DH is fed up. She has lost bladder/bowel function. She demands that HE is the one to come and clean her up. He's not comfortable with that but does anything she asks because of some weird, twisted sense of obligation (there's history there). He is the only one to do these things because she is estranged from the rest of her children, family and friends (with good reason, she is a bad and abusive person). She will allow me to help with these things but only if he is absolutely not available. Also, we are busy. We are in our 30's and have two young kids at home and both work FT. Moving her into our home is not an option, even though we do have the space and resources. We don't allow our kids around her unsupervised and only for short periods even if supervised (for good reason... again, history). They hardly know her and I think it's unreasonable to make two young kids witness her decline and eventual death. Plus she refuses hygeine so she is quite smelly and unsanitary.

She has refused to give DH or anyone else any sort of POA and she is mentally "there," so providers keep telling us that it's her choice to refuse their care. Also she's so awful to them that many of them refuse to continue care - they send her on to someone new, which just makes her mad.

My suggestion to DH is to report her as an elder-in-need and allow the state to take over, but he's not ready to go there yet.

So I have a few questions.

1. He's willing to force her into a nursing home... I think. Is that possible without involving the state and/or getting a medical POA? She's totally lucid without dementia.

2. She has stopped moving on her own, except to walk, but can't get up on her own so often only gets up out of bed once per day. How long can a person live like this? If I knew it was only going to be another year or so, I think we could handle helping her to live independently, but we can't commit to this for several years.

3. We had her in a nursing home before for about a month and she demanded to leave so DH took her home. If he wouldn't have, she literally would have had no one else to call for a ride. Is that an option? Just refuse to take her home?

4. Because of her horrible health and deplorable living conditions and personal hygeine, could DH be charged with elder abuse? I worry about that since he is her sole caretaker. She's in bad shape. He can only do so much (once daily visits) and it doesn't meet her needs and again, she refuses home health most of the time. Is he legally obligated to fill in for what she's not getting from home health? In his defense, he calls her providers all the time to request additional care, doctors, etc. He plays an active role. Although his other family is estranged, they don't want to see her suffer, so I'm afraid they might step in, see how she is living, and pursue charges against him because they really don't understand the situation. Also, the other siblings want their inheritance. There is no will or anything, and DH is on all of her accounts as a user. If he dips into her funds to pay for her care (he has never forced her to pay for her care to this point), could they go after him for that money if he spends it without her authorizing those payments? I assume we'd need to document every expense made from her account. Is that enough or do we need her consent?

If you made it this far, thanks for "listening."

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Mom - great advise as always from Jeanne.
Yes you will be the evil DIL. I've found in dealing with the elderly that you can be the witch of the west or the witch of the east but never Glinda the good witch.

You likely need to file for forced guardianship or conservatorship and will need an attorney to do this. This is a pretty specialized practice and ask about for recommendations. If you live in a large city, you probably have a division of Jewish Family Services - (no,you don't have to be Jewish) which seem to have taken on providing counseling services related to adoption and guardianship. Both are done in probate court.

Another way to get attorney names are to go online to your counties probate court and look at the dockets to see what attorney's names come up over and over again working probate. Experience counts as this can be super sticky when the person is like your MIL. You really should not do guardianship without an attorney
imho. I've been executrix twice and spend more hours than I ever thought in probate court and guardianship needs good legal to work for you.

Doing a timeline on what she does or doesn't do will be most helpful. You really will have to build documentation that she is not capable. And they can be most clever and manipulative at this but rest assured the probate judges are very savvy. The sticky part may be that she becomes a ward of the state rather than having you all as her guardian. So also document all that you do and spend on her and what you spend ANY and ALL of her money on. At 69 she could go another another 20 to 25 years and that thought should scare you enough to start the notebook now.

You can get a judge with proper reason to do an emergency guardianship like they do a suicide attempt but otherwise you're looking at a minimum of 90 days to get the hearings and background checks done (both on your MIL and on you and your DH to see if you are suitable as guardians). That is why often the court appoints a temporary guardian while this happens. They are usually very knowledgeable and can create openings in NH and hospitals where there were none. A good temporary is your ally in getting your MIL into a facility and with proper care and then turning it all over to you. They are paid from her assets.Good luck.
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Thanks, Jeanne. You are so right. We agree that the "inheritance" should be spent for her care and that's what we have been trying to convince her for years. I do get pretty upset when DH pays for things for her. She hoards her money. I try to explain that it will be used for her care eventually under medicaid laws so she might as well start now!!

DH talked to her nurse and social worker and asked them to look for NH placement for her. But he says that she says "she's not ready yet" because she's still "OK on her own" (which I find laughable). I truly hope I can convince DH that he will have to be the bad guy and force this through the state or the courts for her own/his own good. I know that is my issue. I have been dancing around getting this done while keeping my marriage intact. I know that on the surface I could come off as the evil DIL who is making DH put his poor mother in a "home." But it comes down to this: he is miserable, she is miserable and our kids are missing out because he's either not around because he's tending to her needs or he's in a foul mood around them because he's exhausted. No one is winning, expect for the fact that she has her beloved boy around a lot. That is the only upside to this whole situation. I think that expecting your grown son to tend to your personal hygeine needs is sick and deranged. I can't, for the life of me, figure out what she is getting from that. It's not like there aren't other options (i.e. the home health aides she sends away). I told him to "put me down before my grown sons would EVER need to do something like that for me." Maybe I just don't understand what it's like to be helpless like that. He is devastated about it, but he does whatever she asks. Sick co-dependency, IMO.

Say we were to go the court route. How long would that take? It's this a months/years thing? Or would they make a home visit, witness her deplorable health and living conditions and take immediate action? Also, would they pick the home? One thing that we want for her is her own room becase we feel that she's more likely to be happy with that.

I think I am going to start researching homes on my own so that I'm ready in the event of a miracle and she just agrees it's best.

Thanks!
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1. I doubt it.
2. Many years
3. Certainly you can refuse to take her home ... but you have to get her into the NH first!
4. Yup, I think someone could make trouble for your hubby. Whether the charges would stick is another matter. But spending her money on her behalf but without her consent will be a tough one to defend. Absolutely keep every receipt.

The problem point that can be "fixed" as you no doubt know is not your mother-in-law, but your husband. If he continues to enable this self-destructive behavior, she will self-destruct. The best you can hope for is that she doesn't take your family with her.

Sorry to be so blunt and so discouraging, but unless Hubby is willing to set and enforce reasonable boundaries, turn this over to the state, and let the chips fall where they may, I see a pretty miserable future not only for MIL but for your family as well.

Since there is a lot of history here and that isn't easy to overcome on one's own, I suggest seeing a family therapist -- as a couple, as individuals, privately or in group sessions -- whatever it takes for hubby to overcome his unearned guiilt and obligation feelings and for you to function as a healthy couple and family.

You are both working full time and raising children. Many couples manage to do those things and also help out an elderly parent. But what you describe goes waaaay beyond "helping out." Nothing you do at this point is going to fix your Mother in Law. Work on protecting your own family unit. Put your kids and your marriage first.

I am very happy to see that you realize bringing her into your home would be disasterous.

(And an aside, on my hot button ... your MIL does not owe her children an inheritence. Your husband does not owe his siblings protection of their inheritence. If MIL has funds they should be used for her own care. If going into care facility uses up all the funds and she then needs to be on taxpayer assistance, so be it. Your MIL owed her childeren a loving, healthy, nurturing upbringing. I'm sorry if she did not provide it. But she still does not owe anyone an inheritance!)
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