New to caring for an abandoned relative.

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I attended a doctor's appointment with my husband's sister and her husband on September 3, 2013. My husband and I are her legal guardians for medical care. Due to a simple misunderstanding by her husband regarding her appointments on that day, he had an explosive verbal outburst in the waiting room of the Dr., the police were called and he took off, abandoning her. We have not heard from him since. Of course, I could not simply leave her there, so I called my husband and we took her home. It is now 9-19-13. She is safe with us, and we are awaiting a court date of 9-25-13.

After bringing her home with only a t-shirt, pair of shorts, and a single shoe in a duct-taped wheelchair, we frantically scrambled to obtain the mere basic necessities for her safety and health. She requires 24 hour care with assistance in every aspect of personal care.

We borrowed equipment from the local Senior Center, set up in home health care through the VA and Medicare, bought a baby monitor so we can hear her at night, built a temporary wheelchair ramp to go outside and went to the local Goodwill to purchase several outfits.

We are addressing an overwhelming avalanche of needs for her, from psychosocial (clearly, there was emotional abuse prior to her coming to us, and she was left in bed 20+ hours a day) to safety issues (I am proud to have learned what a gait belt is) to medical (of course, there is an abundance of health issues and she doesn’t have her meds handy) to legal (she has zero access to any of her money, no ID, and none of her medical assistance equipment).

So. Sometimes life sucks. Well, we are getting through. There are so many issues to address that it is impossible to do more than touch on any one thing for more than a few minutes at a time. I breathe, in and out, and sigh a lot.

I think the worst part of a situation like this is not having the answers and authority to address my sister in law’s needs on a mid to long term basis. I have spent every day reordering my priorities on the basis of what is most critical, to what is “merely” important to what can wait.

The best part is there, too. My sister in law is learning to trust me. She knows she wants to stay away from her husband. She has better vitals regularly than she’s had in years, and she is eating healthier and visiting with family (also new, she’s been very isolated).

In the middle of chaos, I am learning quickly to celebrate the “small” victories, to address the big picture as I can and to ask for help to learn how best to care for her (and me). My trusty notebook holds every event that needs to be recorded (yes, there’s a lot), so I don’t even have to have a good memory myself dealing with all of this information.

Are there other people out there with similar stories or with hints or tips that may be helpful for me? I am anxious to provide the best level of care for her that I can.

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Thanks for the picture idea, blannie. I will certainly start that project immediately. I already have the white board and we go over the plan for the day every morning, but the photo idea may help with recognition. Good suggestion.
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Wow, you've got your hands full. As Assandache said, your SIL and your husband are lucky to have you doing such a great job.

The only suggestion I'd have about all of the folks coming in and out and her fear of strangers would be to take pictures of the folks (if you're seeing the same ones), print them out and write info about them (if they're willing to share). Like, "This is Sally Jones, your physical therapist. She's got three children, Luke, 7, Sarah 3 and Julie 5." Or whatever info they might be willing to share, or their schedule of visits. Maybe their likes or something like that, just so they don't seem like strangers but nice people and she so can see their pictures in between visits. I have no idea if that would help...just throwing it out there. Another idea would be to do what a lot of hospitals do, where you have a white board and post on it daily who will be coming to see her and what they help her with. If you could put their pictures up there, maybe that would help.

Otherwise, it sounds like you're very sharp and have things covered pretty well. Please keep coming back here, as it's a great place to vent and even share what you've learned.
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Good luck..You seem to be handling with situation wonderfully, she is lucky to have you in her life!! Just remember to take time for yourselves...
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Thank you all for the comments. I am gratified to have found a place to turn to for practical guidance and support. I will try to clarify on the issues that some of you asked about.

I am looking for practical answers to everyday issues involved with caring for my SIL in order to insure her safety and as much dignity and independence she can have. The basics of a wheelchair and walker (remove obstacles, rugs, etc…) I have. I do wonder, though, if there are tips to help her move around better or feel more confident with her walker. Of course there will be more questions later, but that is an example.

As medical guardian for my SIL I have been going to her Dr appts with her and her husband since March. She has significant cognitive decline (we are unsure if it is a result of neglect, mental illness or other at this time), schizoaffective disorder, diabetes, and heart disease. While we have been able to stabilize her medical conditions at this time, her biggest challenge is that she has spent the past 4 years isolated 20+ hours in bed, with no mental stimulation to speak of. So, we are struggling with the atrophy of muscles and working to build strength. She is very anxious around strangers and getting her to trust in home health care workers (without panicking) is a challenge (any suggestions out there?). She also sleeps during the day and is awake all night, despite our best efforts to shift her sleep/wake patterns.

We currently have a psychiatric nurse, physical, occupational, speech therapists, as well as a dietician, nurse’s aide (3x per week) and respite care either happening or slated to begin (we are trying to stagger new people to lessen SIL’s anxiety). I must say I have extraordinary support from every professional involved, from the judge to the doctors to the in home workers.

SIL’s husband has significant functional issues of his own. He is illiterate as well as exhibiting signs of psychosis (according to SIL’s psychiatrist). These very significant issues have been well hidden from the family until SIL’s situation deteriorated to the point that we could intervene. The significance of his issues in his ability to function and care for my SIL did not become apparent until after we gained medical guardianship. His outburst and abandonment of his wife was a surprise to me because I have not been exposed to this type of issue before and never saw it coming.

The court hearing is the continuation of SIL insisting she neither wants nor needs a guardian. We are attending an evidentiary hearing on 9-25. The Judge has been informed of the situation we are dealing with and advised (thru SIL’s atty) NOT to contact her husband at all and see what he will do. Because of his emotional volatility and the court’s direction we are simply getting through for the next few days.

I anticipate full guardianship, although the conservatorship for finances is another matter. I do not know what the judge will do on that, if he will make a temporary ruling for us to obtain her funds, or if procedure will force him to have another hearing on this separate issue (any thoughts?) Until we have conservatorship we are unable to open new accounts or redirect her SS and VA payments. There are no documents anywhere that would suggest any preplanning on the part of SIL and husband. We will be requesting a court order to allow us to go to SIL’s home to pick up her personal belongings, including medical equipment and meds. I am hoping the judge will do that so we can make the transition as easily as possible, or if the police do get involved, we have all our ducks in a row, so to speak. To complicate the court stuff, SIL and husband live 3 hours from us (the court, too) and we are still working people who have to take vacation days to deal with this.

For those of you who asked, I hope I answered your call for clarity. For those of you who offered support and good wishes I thank you very much. I find it difficult to put so much information in a few words or less, so forgive the length of my response, please. If you would like more information to perhaps offer suggestions, please ask.
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I have been giving your post a lot of thought. Encourage your SIL to be as self sucificient as possible. Accept all help offered. Seek respite care from both Veterans and Medicare, you will need it. Humor will smooth most awkward situations. Listen to what your SIL needs and wants. If she has no dementia, she should make the decisions, and as hard as it can be to do, you should honor them to the best of your ability. This eases alot of tension, and you become a team. Take care of yourself, take time to exercise, meditate, and be with your friends. Give up perfection. This are things I learned the hard way. Good luck.
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I agree with what MichaelS said. There is something to be said for hitting the ground running but I don't know about you but when I do that there are days when I can't slow myself down. Too much to do and it all has to be done immediately.

Everything will get done in time but try not to spend every waking minute trying to get things in order with no break and no down time or you'll burn out quickly. It will all get done. Take it easy.

You've done a good thing and bless your heart. You had no idea that day when you woke up that you would become a caregiver. I hope you access this site often, there are great resources and wonderful people here.
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What will happen at the court date?
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I am curious what happened to SIL's husband. Is he the financial POA? Surely you need financial reources to care for her. If he has gone MIA, or even if he hasn't and just being difficult, I think you need to contact an ElderLaw atty ASAP, and see about getting the FPOA for her or a conservatorship.
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It would help us to help you if we knew more about your SIL's situation. Does she have mental issues/physical issues or both? How old is she? Can you tell us more about her history? Does she have dementia? Give us more info about what her medical/physical/mental issues are and you'll get a wealth of advice. I also agree that your husband needs to consider getting police/courts involved to go to her home and retrieve her belongings (clothes, meds, financial records, etc).
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Make sure you have her contact Medicare with the new address, as well as any other retirement funds she might get. It also needs to go into an account his name is not on with her but maybe yours is. You might also look into getting Durable Power of Attorney or he can take her back home at any time.
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