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,
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.
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.
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.
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.
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!
Thank you for the reply. We have been able to talk my MIL to have the aid come back into the house 1 a week for 2 hours. As for taking her meds, there is no way we will be able to see that she takes them, unless she is living in assisted living and they bring her her meds daily. And she refuses to even talk about moving. We understand the seriousness of the cancer. In Dec, when the test were run, the cancer had not spread but every day that she doesn't take the med we know she runs the risk of it spreading. She states that she understand what will happen but at this point, she states that it is her choice to take the meds or not. So some days she takes them but most of the time she doesn't. Maybe she is taking them when she doesn't feel well???? She was put on the meds about 57 days ago and she has only take it 22 of the 57 days. She refuses to be evaluated by skilled provided for dementia, but her primary provider has stated with out having her tested by a specialist, we will know what kind of demenitia she, has but he strongly suspects she has it. Any suggestion on how we can convince her to see a specialist in this area?

As said early, she needs help in paying her bills, I'm starting to wonder if she is doing laundry or even taking showers, as I have noticed that some of the clothes that she is wearing aren't clean. She only talks about the past and it is the same story every time we visit. But boy point these things out and she is angry, doesn't want to talk about it or states "you forget too". Then she doesn't want to talk about it. She claims that she will know when the time is to have someone come in and take care of her.

And gailmcg, you are correct I am frustrated. I have my mom who lives 2 miles from us in assisted living and wants me there all of the time and then there is my MIL who is 30 miles and she doens't want us there. At least my Mom with her health problems was willing when the Dr advised her that it was time to move into assisted living, followed the Dr advise.

Again thanks for the replys.
Let me first say that I know how you feel when you feel like your hands are tied. I would like to make a few suggestions and see what may work for you and your husband. You can make an anonymous call to Social Services and she cannot find out, they are required to keep calls confidential and you can block your phone number if that makes hubby feel better. You can call a Home Health Care agency. I used Amedysis and they have locations in several states. They provide a nurse, therapy, home health aid, OT, social worker. Your next option will be to place her somewhere safe or bring her to live with you because if it is found that she is not getting the care necessary with your husband having POA, he could be found neglectful. Also, I just learned of someone from the state called an Abundsman, which as I understand is a representative from the state who will come in an evaluate the situation and make the according recommendations which she must follow. One last suggestion, I had to cook enough food to last for awhile, in my case several months as my mother lived long distance, buy plastic containers and freeze cooked food in freezer in meal size portions. You have a lot on your plate so please take care of yourself too. Hope this helps.
You state that your, "MIL to have the aid come back into the house 1 a week for 2 hours." I don't understand why the Aid has not contacted you or reported to her agency about your mil and her personal hygienes and other certain stuff that need to be brought attention. Well, at least you know this and from my past exp. with my stubburn, resistant, cussing mnl. I basiscally had to let my husbandj-his mom know that she is wearing the same clothes for a wk and they and I found cob-webs in the bathtub! I knew she was not taking a bath and I knew she was not washing for their was junk in the washer machine. He finally step up to the plate and made an appt to have her checked for AZ and yes she was diagnose with mild Alzhemeiers. We had to take over for twice a person has came over to her house and rob her and took all her identification and etc because she left the door unlock again. Fortually, she was okay. All that came out of her mouth is I shoot him or hit him with a hammer next time with a few f-words in between. She was also choosing what to take out of her medicine and that just was not getting it.
I'm not sure but you would think that elders would have a right to take their meds or not but if they are diagnosed with AZ then they to me are not thinking quite right and they don't know what may be best for their safety and health. My husband and I sat with her and told her we did not feel comfortable or her to stay by her self even though she lived right down the street from us. Luckily for us that worked for her safetyness and health. Can you talk to your husband and get him to understand and just make an appt to get her their and have a AZ check? Tell her yall going shopping or something just to get her to the doctor to be exam. She may hate y'all for a while but her son can let her know that he loves her and that he is just concern about her and health as well as her saftey.
My mnl still lives with and will for awhile and yes sometimes I will go outside to scream but, I know it is for her own good. Now that she is living with us, my husband has notice that she gets confused late in the evening and he notice that he has to repeat himself to his mom as well. He is thankful that I pushed him to do something. Not really sure but it may be consider elder neglect if something needs to be done for her saftey but I could be wrong. I hope this help somewhat.
Brandywine1949 is very correct. This is your husbands issue first before its yours. Secondly, I also agree with the person who is wondering why the caretaker that comes in once per week has not called the proper authorities regarding the living conditions and hygiene. HIPAA laws protect the person/people who prefer to stay anonymous in order to get the help that is needed. So if you contact the dept of aging, it is illegal for them to give your name and you DO NOT have to give your name either. Maybe hubby needs to realize that if he does take the POA control he should, that he would prefer to have her angry with him as opposed to feeling horrible the rest of his life when/if something happens to her that he could have easily made an anonymous call to have circumvented?? What is the lesser of the two they say? He could also speak to her dr about the situation and have the dr intervene without mentioning his name as well.

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