My mother-in-law just dismissed the home health care provider, now what?

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Back in Sept, my husband and I were able to convince my MIL that it was time to have a aid come in once a week to do light house keeping. This also gave us a 2nd set of eye to see if there were any problems. Well, a piece of jewelry has gone missing and now MIL thinks the aid took it but also has stated that she may have missed placed it. But just the thought that the aid may have taken it has left it's impression on her mind and now she doesn't want any strangers in her home.

She liver 45 min away from us. I care for my mom who is in assisted living 2 miles from our home. I work and my husband is retired. I also help with taking care of my grandson as needed.

My MIL, has high blood pressure and breast cancer. we are sure that she has dementia, but she refused to be taken for testing. She will not take the med's that have been prescribed to her for blood pressure or the cancer. The breast cancer tumor is the size of lemon, close to the skin, so there is concern that it will rupture and ulcerate. She can't go shoping any more, walks with a shuffle, can't pay her bills with out a lot of help. Doesn't understand her finance. She won't go to church any more. She is worried about something happening. We know that she has taken some falls. She fell with us once. She lives alone in a condo and all that we would like is to have someone come in for 2 hours once a week.

Before we had the care giver come in, she was not cleaning house, but we think she was doing laundry, but we can't be certain. Not sure how she is getting her meals. My husband does shopping for her, he will pickup hot foods when he is at the store but I know that there is left over food in the fridg that is bad.

As for my husband talking with his mom about care. Every time we bring it up, she gets mad. He is fearful of making her angery. She will say nasty things to him, and he is very thin skinned.

I am at the end of my rope with her. While I understand with dementia, they aren't thinking clearly but my husband won't stand up and say this is what needs to be done. He alway says to her "Mom it's your choice" when we know that she is making very bad decicions. He does have POA. I want to call Social Service for a welfare check but he doesn't want to. Afraid that his mom will find out and get really mad at him. He is afraid that she will shut him out of her life. But he is an only child.

What other options do I have?

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Even though she doesn't go to church, could her pastor talk with her? Does her church have Stephen Ministers? These are trained lay people who visit people like your mother-in-law, and could perhaps convince her that she'd be better off in assisted living.
Eventually, your husband must realize that something needs to be done. I'd try the softer method of a church person or good friend first. Sometimes people tune out kids, but they will listen to a friend. However, a call to social services for a welfare check may be needed.
Take care,
Carol
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The cancer is serious; she needs medical care. It's not about rupturing, but spreading to other organ in her body. That could be life threatening. I agree with Carol about getting someone she trusts to talk to her. My father didn't listen to me either, dispite my medical background. He was the dad and I the daughter. When his friend or caregiver told him the samething he often agreed. Find the senior services center in your area. They deliver daily hot lunches, have resources on everything you want to know, a variety of daily activities, support for caregivers, and more.
Good luck, I hear your frustration and anger.
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It sounds like it is time for the child to become the parent. Which is worse, having her in an unsafe environment and possibly die because she can't take of herself or in a nursing home or assisted living situation where someone can make sure she is taking her medication properly. Yes, your husband risks having his Mom mad at him, but that is a small price to pay. Solicit the help of a third party, preferably a doctor to get her in the hospital and then to skilled nursing and then look for a permanent living solution from there. Why is she refusing to be cared for medically, she must have a lot of fear or is she just forgetful or she doesn't like the side affects. I liked the idea having someone from her church whom she trusts possibly visit her. A welfare check may be in order as Carol suggested. I eventually got my Mom into a nursing home using her doctor. She didn't see it coming and it was upsetting for both of us, but it has been a year now and I know she is safe in her surroundings. Good luck to you, this is not easy and I know you want to do what is in your MIL's best interest. BTW, did you offer to help her look for the missing jewerly. Maybe she should place all her valuables in a safe deposit box or a locked safe in the house. I opted for the nursing home over in home care, because my Mom hated anyone coming into her home and possibly stealing her stuff. Her dementia and paranoia was getting progessivly worse. Even in the NH she thinks the staff steals her stuff (they don't) but that is a whole other story. Good luck to you.
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First of all this is not your primary concern. It is your husband's concern. She is his mother and he should be the one concerned, not you. You do not need to be at the end of your rope. He will just have to become more assertive whether she gets mad or not. I know this because my mom is quite angry at me, but I have learned to just let it roll off my back. For you, hands off for a while and let him take care of her needs.
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About the dementia: there is some very interesting information about dealing with dementia. Do a web search for dementia and dementia whisperers.
I have talked to people who have used this approach. I think it might help you and your husband, too. Good luck.
My previous comment about assisted living homes was not meant to be a criticism. They can be the best solution at the right time, for the right person. But they are not the ultimate answer for everyone. There are homes that specialize in care for people with alzheimers, if it comes to that.The treatment is much different than that in nursing homes.
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I've been on the same roller coaster ride with my Mom since 2008. I am an only child, living across the country from my Mom. I believe my Mom's dementia started around the time my Dad passed in 2006. All the things you mentioned about your MIL struck a chord. In 2008 I was able to visit and organize her finances and go through her home and get an idea of where everything was. She was functioning OK, but could only find her way to Walmart and the Bank but she maintained her independence and was still driving. In June of 2010, she called me and it sounded like she was having a stroke so called 911. She was having a brain hemorrhage. She then spent the next few months in and out of the hospital and rehab with me assisting her. When she appeared sufficiently recovered I made sure her finances were in order and hired an attorney to put together the necessary POA, Health Care Surrogate, and a Trust fund in which to place her assets. I also had a financial advisor to assest me with this task. Also around this same time I began the application for VA aid and attendance benefit, for which she was qualified. I tried to get her into assisted living but she refused at the last minute. She wanted to stay home. She eventually became so distraught with me living with her that she asked me to leave. After a long conversation with her doctor, I reluctantly left and went home. However, within a couple of weeks, her legs swelled up with blood clots and I had to make arrangements for her to see her doctor and find a neighbor to take her to the appointment. At this point, she wasn't driving but didn't know how to make important decisions on her own. From the hospital, she was placed back into rehab and eventually into a really good nursing home. She does not remember any of the last two years and hates that she is in nursing home. My husband and I came to see her in the Spring of 2011 and she is being well cared for. This was when we packed up her home and moved all the items to our home. Sold her little place and her car. That was hard!

Every decision I made was difficult, and not necessarily to her liking, but I did it out of love for her. She is good about taking her meds when given to her, but was not good when it was up to her. I wanted her to maintain her independence, but knew she was not safe in her own home. My Mom is not happy having people care for her and refused home health care any time it was offered. She was constantly losing things and became and still is very paranoid. This was our only solution. She is 91 now and somedays are better than others. I call at least every other day and we talk for over an hour each time. She will never like her new living accomodations and I can't change that. I am glad you have family who can help you make these difficult decisions. Whatever, you do, I know you will do it out of a loving heart. Good luck, and hang on tight, cause it is a wild ride!
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Again thanks your replys. JudyC, we are well ware that the POA does not give us the right to tell someone how or where they will live. As for her meds, we have put them in a weekly pill minder and she still only takes them, maybe one day a week. If you call her to remind her to take them, she becomes angry. So a weekly pill slip will not work. As for her know when the right time for to move will be, she won't know. She will always think she is just fine. She can barely make it up the stairs now, and is at great risk of falling. But try to tell her not to climb the stairs, those are fighting words. The stair are her form of excersie. Can my MIL get dress, sure she can. Can she use the toliet and take a shower, sure she can. Can she get meals for herself, that is a ? I have. I hope she only uses the microwave and not the stove.

Today when the new aid came, my MIL had a list of things that are missing and accused the last aid of taking them. A list of five things. My husband was there and was able to tell her that she left her cain at a relatives house. The rugs that are missing, my MIL put in storage after the Dr told her it wasn't safe to have throw rugs on the floor. In fact my husband got them out of the store room and showed her. As for a couple of other things, who know where she has put them. Can you imagin how the new aid felt when my MIL as accusing the first one of taking things?

gailmcg, thank you for the info about dementia. My Mom has dementia and I have done a lot of google searches and have read quit abit about it. I will have to look up dementia whisperers. We have know about my Mom's dementia for almost 3 years now. In fact she had to move from her home to assisted living, and it has been a great move for her. I will agree that assisted living homes may not be the answer for everyone but just like nursing homes aren't. But I can say I am worried about my MIL and her stubborn attitude that she is just fine.
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dilynn, Thank you for all of your feedback about your MIL. You clearly care about her (despite your frustration) and it sounds like you are doing (or trying to) all the right things. You can "... lead a horse to water, but not make them drink" as the saying goes. Someone needs to look in on her daily; I would echo the suggestion of getting meal on wheels, or at least try it for a month. Not only is it a hot meal every weekday, but also that means someone comes around and can report a problem if she has fallen, become unresponsive, etc.
For now, check up on her, show her your love, and TAKE CARE OF YOURSELF.
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Here is an up date on my MIL. We had a visit with her Medical oncologist and I want to say it felt like a battle. The tumor in her breast is the size of a lemon and because she is not taking the meds daily, 1 out of 4-5 days, the Dr is unable to say that the meds are working. The tumor is very close to the surface of her skin and it may only be a matter to time before it becomes and open sore. The Dr suggested that she have someone come in daily to give her the med, MIL said a flat No, my husband said that he would call her daily to remind her, again a flat No. The Dr went so far as say maybe its time for assisted living. Not sure if my MIL understood what the Dr was say but agreed that she would take the meds. That was 2 weeks ago. Still in checking her meds, she had only taken the meds one day. We ask why, since she said that she would take them. She claims that she is taking them. We show her the pill minder and say, look only 1 day is gone. Then she said she know what is best for her.

Well today, the new aid was coming to the house, so we got there 30 min early. My husband started to help her with paying the bills. Well, the meds came up. No she had not taken them. We had a long talk with her, advising her about the risks, and she finaly said she would take them. I got up to get her a glass of water and I find the stove is on, with an empty pan on the burn. The setting was on low but the pan was still hot. Also we notice that she was wearing the necklace that she thought the aid had taken. After telling her that the stove was on, we said, this is just not safe living her alone anymore, we need to do something. Well, she just shut down. I have now found out from one of her church friends the reason she stopped driving was because she was getting lost. And then today, I find out she is not taking showers. She said that she had her own way of caring for herself. Now I don't smell body oder but I'm not sure how she can be cleaning her self. Also, I checked the laundry bucket, and my huband said that the same clothes have been in that bucket for weeks. So I don't think she is doing landry.

We are now talking about getting what family we have together to have a meeting with her to let her know that we all think that it is now time for her to move. It is very hard to watch the ones you love change like this.
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dllyn, sorry to hear about this but at least u were their in time to get the pot off the stove before major diaster could had happen. We had to move my mnl into our house for the similar reason, stove left on or oven and over 85degrees in house, wearing same clothes, not able to wash clothes, use microwave for she had forgotten how to use it. Not to mention hiding pills in drawers, some on the table or in couch. We just took the keys of the house/car for she would get lost as well when driving. Instead of renewal her driving license, I had them exchange over to I.D. online and we kept all the important stuff like that for she would lose it anyway. Sounds like you two will have to make some major decisions where to place the mnl for y'all know it is no longer safe for her to stay alone anymore. Hopefully someone here can give more suggestions for I'm a newby for AZ caretaking.
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