I've posted before about in-law care-giving. Aged mother in law, lives in same town.
We are at the tail end of a visit from sister in law from several states away. Sister in law has been here for 3 weeks caring for her mother. A much welcome respite.
It had been discussed, prior to her arrival here on the scene, she would be talking it over with her mother, to try and get her mom to come up to her home, for a stay of maybe a few months.
This, in my opinion, is absolutely essential, as I am expecting twin grand-children, due in about 1 month (if they don't come sooner, as is the case a lot of times with multiples pregnancies). The expectant mother also lives locally here, and has a 4 year old daughter. I will be on that front, helping .. as much as is needed. And not on the front with mother in law and care-giving, and have made that as obvious and apparent as I know how to make it. It would be great if mother in law would agree to go to her daughter's home (several states away) for a period of a few months .. and allow me the latitude to put my energies where I want them to be, on my daughter who will have had a c-section .. and my grand-daughter (4 years old) and new twin babies.
Nothing doing. Mother in law has dug in her heels, and will not hear of it, going to stay with her daughter for any period of time.
What are her reasons?
In mother in law's defense ... her daughter ... I don't even know how to describe it. I will say that when her daughter comes here to visit, she all but breathes for her mother and if she could find a way to do that, she'd do that too. She is the most nervous nelly, never sit down - ever ... worry wart, do everything, all the time .. person that I've ever encountered.
A great example, as I was taking her to the airport yesterday for her departure, . I reached into the fridge to grab myself a bottled water and shut the fridge and turned to walk away, as I've done for all of my 50 plus years living on this earth .. and she said to me, "Oh make sure that fridge shut". WTH???? Like I don't know how to shut a fridge? That's just a small, very small slice of what she is ... how she is.
She is so very hyper-vigilant, seeing to every minute details down to it's finest most minuscule point, fine tooth comb, questioning every point along the way, "should we do thus and so, but maybe if we do thus and so, then such and such will happen, maybe we should do it thus and so .. but then so and so might happen, maybe we shouldn't do thus and so, but do "x" "y" and "z" instead, but if we don't do it that way then ..........", on and on and on and on it goes. And usually in hyper warp speed, as to every single friggin thing.
If her mother moans .. "what's wrong mother?, why did you moan, are you alright?".
Mother: "Yes, I'm fine, I was just sighing out loud".
Sister: "Why did you sigh? Are you hurting, are you sure you're alright, why are you sighing what's the matter?"
Mother: "For God's sake __________________, I was just sighing, .. calm down, I'm fine".
Sister: "Are you sure, .. because if something is wrong you need to tell me".
Mother: "Everything is fine, I'm fine".
Sister: "Are you sure, we did a lot yesterday, did we do too much, maybe we shouldn't of gone to two doctors in one day .. was that too much for you, are you too tired now, maybe we need to move those other doctor appointments so we won't have two in one day, is that too much for you, for one day .. is that why you were sighing .. what's wrong, are you sure you're alright".
Hopefully that kinda gives a little bit of a snapshot of what goes on when sister is in the ring directing things.
So in mother in law's defense.. I do get it, why she wouldn't be chomping at the bit to go to her daughter's home.
BUT ....
The only experience she has with her daughter, in the last years as mother in law has aged and been unable to go anywhere much, has been the daughter coming here, periodically, for periods of about 3 weeks at a stretch. When her daughter comes here, she moves heaven and earth for her mother and then some, and doesn't sit down, doesn't stop .. the WHOLE ENTIRE TIME.
Is there a possibility maybe (as I said to mother in law, when she expressed that isn't happening - talking to me - her going to her daughters .. ever) .. could it be possible that maybe if you would go to where she lives .. she'd be more busy managing her own life in that setting than your's and she would get out of your backside .. and not be as hyper-drive-vigilant as you experience in her, when she's here, could that be possible.
The daughter is retired, lives several states away. Does come here, generally, every few months .. and stays for a period of about 3 weeks at a stretch. I wish I could make a list of everything the daughter did when here this last time, but it would take up the whole character allotment:
I can only speak to my own experience here in Georgia, trying to find a place for 2 aunts at different times.
*If a patient can walk with a walker or sit in a wheelchair and scoot herself around
*AND transfer herself from the walker or wheelchair to the bed or another chair,
she is usually an acceptable candidate for AL.
*MIL's ailments and conditions sound extremely similar to my aunt. In fact, their behaviors are nearly identical. At times I've wondered if my aunt and MIL are twins. They are even the same age.
*My aunt has some dementia, is diabetic, on oxygen, has CHF and pulmonary fibrosis, neuropathy, is obese, has chronic arthritis and back pain, bladder incontinence and is in kidney failure that is hovering just above needing dialysis and she is in assisted living. We had the very same battles getting her to leave her house.
*She is in a facility that charges a flat rate - no a la carte services. They encourage the patient to do as much as they can, but when a patient needs help showering, they will help. They administer all meds.
*This AL facility costs $2540 per month. It isn't big or fancy, but it is warm, clean and decent. She is well fed and entertained. Her favorite thing they do daily is Wii bowling!
*Between MIL's $20K savings account and monthly SS, MIL could probably reside in one while paperwork is slowly working through the year long pipeline for LTC placement.
The first orders of business are: Eldercare Attorney or Geriatric care manager, POA, and cog assessment. Put on the blinders and focus on those 3 things.
SW said that she does not appear to require Skilled Nursing. What medical conditions does MIL have that requires 24/7 medical attention?
They DID listen to you. They told SIL to contact Betty, the Medicaid Liaison to get going with finding an AL that will address MIL's needs--remember the line where SW said "yes, you need to be aware of which AL's provide that" or something like that?
Just because YD worked in ONE AL that wouldn't have been enough support for MIL doesn't mean that there isn't an AL that WOULD be enough support.
She needs SUPERVISION. Not nursing care.
She also needs to agree that she can't live alone anymore.
Step away from this train wreck; let SIL and DH manage.
Yes, so she walked 250 feet with her walker, stellar... pleased.
What they are not listening to ..
1. She fails to take her meds without prompt .. consistently
2. She fails to understand what meds she takes/why - consistently
3. She, has needed assistance bathing .. and this newfound ability is .. an anomaly
4. She fails at nutrition/hydration - routinely, consistently
5. Fails to understand/comprehend the relevance of a nurse button and why it would be directed for her to utilize and do so
6. Dressing herself .. rarely occurs .. it's too much of a struggle (they say she dressed herself, with the exception of shoes/socks .. needed assistance)
7. She fails at time management - routinely
So many more that I could cite, but those are the few that come to mind right off the top of my head.
So she walked 250 feet today .. so she did in fact, bathe herself .. and even stood up appropriately using the grab bar, to wash her own bits and bots .. got it ... (that doesn't happen .. I'm tellin ya, she needs help) .. so her strength/stamina is being worked on and showing improvement.
What of the above .. that is not going to improve . and is her SOP.
I can't get too vested in caring enough to jump up and down and holler it all in every direction ...
That should be SIL and DH's concern . .as it has been thru 6K posts here . .all along.
SIL . until . .. very very recent . .like within the last week or so .. was very much firmly drowning in the river of Denial . .and wouldn't see it. She does now .. oh does she .. oh boy does she!
DH .. .. he saw it . once he got called to the front lines more than had EVER been the case .. but as his DD said to him yesterday (calling him on it) .. "Dad you go with whatever popular opinion is and whatever your big sister says . she says her mom will manage .. well by GOD that's what we'll do .. you just listen to your big sissy .. and what she says .. Big sissy now admits it's too much and she isn't managing ... so now you hop on that train too .. whatever .. ".
GOOD ON HER .. calling him on it.
Will he step up and sort thru the minutia of all there is to see to . not a chance in h377... in part, why I agreed to go to yesterday's meeting .. I "thought" I was going to get the floor to get my agenda addressed (we all did) .. of course, you all know how that went . .we hopped on their assembly line and they twisted the widgets we are . and sent us on down the line.
But he at least went to that meeting (that's an improvement) .. without balking and excuses of church orphans and church meetings and wild game that needs to be hunted. . He went.
You just have to find the humor in these situations or you are doomed!
I have a couple of thoughts this morning to add to what I posted last night.
MIL may be the rehab superstar. I find the PT report hard to believe, she walked 250 ft? Okay, whatever, maybe she did. She’s gaining strength, stamina, and so on. Fine. Great. But, if she can’t retain the info she’s learning from OT, to manage herself safely when she’s alone, then the shining PT report might not mean much.
MIL signed the form put in front of her regarding financial responsibility. Either she’s accepting the fact she will be there longer than 20 days or she’s not with it and she will sign anything. Whatever the case might be the family needs to NOT sign anything! Doing so could hold them financially responsible.
It has already been said but I will say it again. There is a big difference, wide gap between having Dementia and being incompetent. If the family consults with an Elder Care Attorney, which, again, I highly recommend, the Five Wishes Document needs to be taken to that meeting. The Elder Care Attorney can explain in what capacity that document can and can not be used and if DPOA and MPOA are also needed. If necessary the Attorney’s office would visit MIL in the facility and if they think she is understanding what she is signing in the moment, she signs, even if she has a Dementia diagnosis at that point.
Like Rainmom says, this is just the beginning. It’s gonna be a marathon not a sprint. Choose wisely what you are willing to do.
We'd gone to lunch after hopping off their assembly line of function there.
All 3 of us ..
Note to self: Should MIL land there as her permanent residence, bring your own sandwich. There was a little cafe for the public's use .. (a very nice dining area, complete with picture windows looking upon the gardens outside and the beautiful fountain) but that was for residents only. Public has to continue on down the hall to what is a cafe for the use of the public, guests, etc.
Ordered our lunch there .. it was a beautiful day out, so we sat outside on their patio . and waited and waited and waited .. and sigh .. waited. SLOW ..
Finally got our food that wasn't all that good. Ate our lunch.
Then went to visit MIL for a while.
After visiting her for a while, .. we left.
On our way out .... as we were about to approach the threshold of what is their foyer .. to the glass doors that slide open and closed to let you in and out ..
There was a woman .. a slumper .. slumped over in her wheelchair .. old old old woman .. not sure that she was even really mentally there.
She was .. with her feeble little feet .. in her wheelchair .. trying to get her wheelchair scooted on past that little bump of a threshold .. struggling.
SIL .. "oh dear you can't get over that bump, let me help" . and gave her wheelchair just a nudge enough for forward progress ..
DING DING DING DING ... horns/alarms sound everywhere .. LOUD .. and the doors that fly open and closed with the exit and entry of many . lock shut .. and no one can come in and/or out .. and the alarm bells that I'm sure they heard even over in Russia .. sounding.
A security guard appears .. from out of nowhere, .. "Ms. so and so .. you can't go out there", .. pushes her back into the area that I guess is deemed appropriate to where she needs to stay in the confines of .. and I notice as he's wheeling her back into what would be where she needs to be .. she has some kinda ankle alarm on. No doubt that triggered all the alarms .. SIL having pushed that wheelchair, just over the threshold there, thinking she was helping the poor little old soul.
Took all of about 5 seconds .. security guard guy then pushed some code in and the alarms stopped and the doors now worked again.
Lesson learned there .. don't help . you don't know who is who in this place and what their limitations are .. don't help them.
I'm only familiar with Medicaid Pending as it applies to SNF, and only from reading here.
I'm not sure if Florida Medicaid as it applies to AL (which is a waiver program) has a Medicaid Pending provision. I'm not sure, for a waiver program, if you need to be down to 2K in assets. Here in NYS, the waiver programs have very different requirements.
This is all why SIL and DH need to hire either an Eldercare attorney and/or an experienced SW/Geriatric Care Manager to help them navigate this territory. And to deal with granny.
This may help:https://www.payingforseniorcare.com/medicaid-waivers/fl-assisted-living-for-the-elderly.html
And this: https://www.agingcare.com/local
Keep in mind that local Geri Care Managers may know about small group home settings that might be more palatable to MIL than a "facility".
Only you folks . that are the ones who keep coming back .. and Thank God you do, .. have been my only lifeline to a thread of sanity at times.
And myself, of course, living it.
I have a question, just to satisfy my own curiosity ....
Something was said yesterday that MIL would need to use her $20k in reserve .. liquid assets .. to private pay (of course, makes sense). And then when she is down to $2k .. she can apply for Medicaid (can't apply til then, makes sense).
So my question then becomes ...
Let's assume by some miracle (and I don't think that'll be the case) .. the Rehab site where she presently is .. has the wonderful pie in the sky AL that they all dream of .. with all of it's not ala carte expenses attached . but all the support she needs ... and a bed available .. .
She could then fork over the $6k a month or whatever that cost is .. (I don't truly know what their AL fee monthly is, didn't ask) .. and that would be gone inside of 3 months.
So .. then she applies for Medicaid .. I guess, now that her assets are dwindled, can't even apply til it gets there. Then .. it becomes "medicaid pending" ..
So .. I don't understand .. those of you who do, maybe school me a bit .. "Medicaid Pending".
How long does an AL (or whatever site she lands in .. NH, LTC . .whatever it is) .. just how long does one of these sites live in limbo .. of "Medicaid Pending" as to any payment they should be getting monthly for the bed she's occupying.
We all know Medicaid is gonna grind it's slow gears the way it's gonna do .. that's a fact of life, like day and night. That ain't gonna change. So .. how long ... I mean .. is the site gonna let her stay there, .. "Medicaid Pending" .month after month after month ..
I don't think so ...
How does that work?
Let SIL and DH take the lead. You went to the meeting with them and acted supportively. Let SIL assign tasks to her brother if she thinks that's useful. SIL, not you, is interested in having her mother placed.
As CountryMouse says, MIL is a free agent who can go home if she desires. The rest of you can step back let that discharge plan work its magic.
I will share that at the initial "care meeting" (post stroke my mom was moved to subacute rehab after acute rehab for a few days), they painted a rosy picture and were happy to plan for her moving as an LTC client in their very nice AL (which is why we had chosen this particular rehab).
Her vascular dementia didn't become evident to the staff (or to us) for about a week when she announced that the male CNAs were having sex in her bathroom all night, that she was having to pay for everything that was done for her and that she was having to manage her own medications (this last, as the nurse gave her her afternoon pills!).
They refused to accept her as an AL resident (they didn't accept residents with dementia--had lots of them, but did not admit folks who already had a dx). Mom ended up in a nearby AL/MC where she fell, broke her hip and proceeded to SNF.
I'm glad that MIL is making progress in PT; they seem to think that she will continue to progress and are planning for her to be in rehab for the entire 20 days that Medicare will pay for at 100%.
And since she is clearly able to do for herself, please tell your daughters not to wipe her backside for her anymore. Is granny playing them?
If MIL states that she cannot do something for herself, staff should be called and it should be noted in her chart.
Be very careful. You sound like you the commanding officer here. Are you willing to do the things that SIL assigns to H? How much ARE YOU willing to do? Once you start doing, it will be very difficult to get back to the position you were in once you held firm on your boundaries.
Lizzywho61: "Some of what I read stated that NH Medicaid is an entitlement. AL waiver is not. It is a subsidy to the tune of $1,100-$1,200 dollars a month to help pay for AL."
I remember vaguely reading this sort of thing when I looked up FL Medicaid for AL last year. What good is $1100-$1200/month to a Medicaid (very poor) person when they still have to come up with the rest of the thousands needed for AL? Maybe the asset allowance/income allowance is much higher than NH Medicaid? And remember - MIL will need a higher level of care in an AL. And a wait list. MIL doesn't get to jump to the top of the list. What's going to happen in that waitlist period? And who is going to pay for it (if SIL doesn't continue to be the 24/7 help)?
And, still, the elephant in the room is the POA issue. Until that is taken care of, I wouldn't be doing much of anything, Dorker, other than giving SIL the names of elder law attorneys.
The only time you need to step in - and not you, by the way, I mean "the family" - and make corrections is when mistakes will *materially* affect what happens next.
Suppose you all sat on your hands and did nothing. MIL is, after all, technically a stand alone free agent. She has not created POAs, her choice. If you and DH and SIL all took it into your heads to drop off the radar and set sail to the Bahamas tomorrow it doesn't, technically, make any difference. The role of the discharge planner in MIL's case is to plan the discharge of a lady who lives independently in her own home, which is mortgaged, is of limited means, has chosen to make no formal plans for her latter years, and is now incapable of living safely alone. The role of the family is to support MIL in making her choices, such as remain to her, and to assist the discharge planner by supplying the required information.
Meanwhile, SIL and DH are *sad* that this is happening to their mother. It is sad. But it isn't anybody's fault, and this is not the moment to be thinking - let alone saying - told you so, and it is also important to remember that even if they had all thought of this before MIL would still be declining and they would still be sad about it. Don't get hoity-toity about how if only they'd listened to you this wouldn't be so bad now. Yeah it would be, just as bad. Only in a different way.
Of course MIL will be doing a lot of that in the coming days, just so she can prove she's well enough to go home ASAP. So unless SIL has been shortchanging MIL's true abilities to function independantly (MIL can now fully shower herself dry herself off and get herself dressed as well as wipe her own bottom), which I doubt, then more is to be revealed as she finished out the week and onward, and her true weaknesses shows itself in their assesment as the days go by.
While on one hand it is good that SIL is getting the rest that sge needs to get better and to let the facility do their job of rehabing, but it is also shame that she cannot be there at least hour near the late afternoon, to check up on her progress and see for herself.
You have been given such great advice to go on from here, I hope that SIL is definately getting on the phone 1st thing in the morning to demand the nessasary assesment testing orders from MIL's PT, and to get the legal ppwk in order from an Elder Care Attorney, and is Documenting Everything into a binder from this point forward, poor Dear, I do feel sorry for her, as this is going to be a lot of work towards getting MIL into Long term Care.
I am glad, that everybody is on the same page towards placement, this is just the begining steps, and there will be no rest for SIL and DH until it is done and I pray that they can continue to work in harmony and be of support of one another, that and that MIL can be made to accept the uninvitable without too much trouble, but there really is no other option any longer, as all three of you need to get back to living your own lives.
Do try to not stress and do get some rest as much as possible, and only do that in which is not sucking you back into the fray! This can and will happen if all of the nessasry steps get taken! God Bless!
The good news is SIL's clarity about how MIL needs 24/7 from here on out, and that SIL simply cannot provide it. I think this is positive. Build on this.
I actually get a chuckle out of it - given how basic most of the advice is verses how complicated the actual situation. I’m sure the intention comes from a good place
I dont know all the threads over the years here on AC - but I’m willing to wager that Dorkers thread is a bit of an anomaly.
only time I had when I wasn’t being yanked in six different directions.
Edit: And, yes - you were being “processed”. Absolutely. I imagine, as well - the SW and therapists could probably smell “Newbie” and took advantage of that.
Sucks.
So we have Monday and Tuesday they had to get a real read on any "progress" so to speak.
SIL is past the point of going any longer. Just being around her and the change in her, and her approach is nothing I've seen before .. it's stark. She is so sold .. that her mom's needs are more than she can continue to step to.
But beyond that, this person I formerly knew, to never sit down fluttering about bumping into walls in a nervous frenzy of what to do next .. sits now .. worn to a nub.
I look at the list of things that need immediate (like yesterday) attention . that atty . the ADL look over, the cognitive assessment .. Medicaid Liason .. so forth .. and I don't even know that SIL is up to the task any longer .. she probably needs to be hospitalized herself for shear exhaustion.
And I don't want to get .. ever again . so mired in it all .. that I myself need to be hospitalized ..
I didn't talk to SIL anymore today .. after we parted ways at the Rehab center.
I intend to contact her tomorrow with kind of a list of above and see if she'd like maybe to assign her brother some of it .. and .. go from there ..
That's about all I know to do. I myself am actually just really astounded .. that we were so railroaded thru what is the process today . .that I felt like am assembly line piece of a widget ..
I'm taken so far back that their view of her .. doesn't at all coincide with what I would report of her .. not in any way/shape/form . that just confounds me.
But how much do I want to get involved in . trying to counter all that and the work it will take to get it all looked at and addressed .. how much of it is SIL up to .. not much.
Just .. I'm gonna go to bed finally and try to unwind from the pent up tension of it all.
First: A “Progress” meeting? Seriously? Mil got there - what, last Friday around dinner time? Today’s meeting - Wednesday morning. So, mil has been there four full days and some change. Two of the four days were the weekend - and let’s be frank - seeing as mil got there at quitting time on Friday - just what type of plan was being followed by the staff over the weekend - designed by whom? From yd and dd’s first hand observations- as well as MILs own accounting over the phone to Dorker-AND dorkers phone conversations with staff - getting to the point here... it sounds like mil had been pretty much left to rearrange furniture on her own... So let’s realisticlly cut MILs actual structured therapies and planned activities down to Monday and Tuesday... Just what the eff are THEY referring to as “progress”?!! Based on what? Compared to what? MILs first day out of a hospital bed? Yeah, right. A formal sit-down meeting with family and multiple staff to discuss TWO DAYS of PROGRESS???
A bit of a ramble - but you see what I’m getting at? Seriously?!!
Okay - for the advice: Document. Document. Document. Keep notes on every single interaction you have with any and all staff at this posh bureaucracy. Date. Name. Length of time of contact. Topic. Follow up dates. Times. By whom. To whom. Everything. Instruct sil, dh and daughters to do the same.
This is place is yanking your chain and they are planning to process mil through by route. Wham. Bam. Thank You, Ma’am. And - as I’ve said: This is just the beginning of the beginning.
1). Your husband should come first, then everyone else. When do you have quality time with him?
2). I am sensing that your MIL can do just fine for awhile on her own. Did you say she still drives? Arrange Meals on Wheels for a couple of months. Teach her how to order from stores and restaurants that deliver.
3) Yout husband needs to step up and do more. Have him grocery shop on a Saturday morning or one evening.
4). If you set up MIL’s medications, do two or three weeks at a time. That way meds can be ordered and there aren’t last minute trips to the pharmacy.
5) Medicare is not going to provide a home health aide without there being other skilled care needed in the home. It sounds like MIL needs intermittent non-skilled assistance which she would have to pay for.
6). You need to be firm and schedule your time.
7). Enjoy the grandbabies. Twins are fun and your daughter is going to need you! By the time you get one baby fed and diapered, the next one will be awake. Sleep? What’s that? Lol
Again, be firm and let her children arrange care in your absence.
I know you are exhausted and befuddled. I hope you have soaked in a hot bath and are headed to bed.
I read a bit concerning Florida Medicaid. Honestly, what I read makes Texas Medicaid look like a cake walk and I assure you getting Texas Medicaid eligible is no cake walk.
Some of what I read stated that NH Medicaid is an entitlement. AL waiver is not. It is a subsidy to the tune of $1,100-$1,200 dollars a month to help pay for AL.
Someone mentioned you guys need to meet with a Board Certified Elder Care Attorney. Yes, you most certainly do. Yesterday.
Elder Care Attorneys in my area usually offer a one hour consultation at no charge.
Your family has probably used an attorney for something over the years. Get the name of an Elder Care Attorney from an Attorney you know and trust.
One positive thing I did read is having a Dementia diagnosis seems to be a plus in Florida when going thru the Medicaid process.
TX Medicaid allows the Elders funds to be used to pay for an Elder Care Attorney. That would be my first question for a FL Elder Care Attorney. Can MILs funds be used for an Elder Care Attorney to handle the Medicaid Application?
Letting an Elder Care Attorney handle my Mom’s Medicaid Application was money well spent. Yes, it was still frustrating, time consuming, etc, but had I tried to do it myself I would probably still be sitting here 6 years later still searching for the magic word to get the dang thing approved.
Medicaid Applications are not Rocket Science. No they are not. I think they would be easier if they were. At least then someone in the general public could find the right answers without all the back and forth involved.
A good Elder Care Attorney will guide you on what needs to be done first.
Disclaimer: I know nothing about Florida Medicaid, only what I read on the Internet.
"Mother is gonna have to get over it with whatever her deal is that she won't join and socialize with "old people" .. she's just gonna have to get over that .. whatever that is".
NOT LIKE SIL . who would, heretofore . have a million excuses and not force her mom . or persuade or cajole .. but make excuses.
Sitting in that meeting .. .and at that moment drawing attention to her deficits in memory . .and SIL speaking up . that she'd been hospitalized herself in IL .. while her mom was there in her care .. was away for two days, confined to her own hospital stay, and her mom failed to take her meds .. resulting in a TIA for her mom and a hospitalization .. and then another small TIA .. a week later and another hospitalization.
Point there being . she herself ... speaking up .. drawing attention to her mom's deficits rather than making excuses . which was always the approach prior ..
Her drawing attention to the fact that her mom has been on Elliquis for years now .. but every morning as her mom picks thru the pills laid out for her . .that she asks .. "what is this pill for?" .. and one of them is Elliquis .. "Mom that's Elliquis remember .. that helps you keep from having a stroke". Her pointing this goes on every morning . .she doesn't remember from one day to the next .. and this is a pill she's taken for years now.
Her pointing and drawing attention to that as a deficit in her mom's memory.
Her drawing attention to . in this same conversation . the fact that her mom wouldn't bathe there at her house (even with her assistance, which was required btw) .. and she once went two weeks with no shower/bath .. that it was too hard for her, . to swing her legs over the tub apron . to get herself into that tub . on the xfer bench . and she'd have to literally lift her legs that won't lift .. and do it herself .. and help her bathe . but that she'd fight her, . .it's too hard .. and that she hadn't bathed at one point, for two weeks . because it was a struggle for her .
Folks, if you knew what I've seen as to the sister's denial . the firmly entrenched denial and subversion and excuses she can come up with .. anything .. anything at all, to not look at the elephant in the room. All thru these years.
Not the case presently.
I don't know if that's because she's sick presently and so worn down . and she is .. she is hoarse even still .. and so so so weary and tired . not her usual flitting about self .. not at all. So tired.
Maybe some of it is that .. but maybe also the last several months of being her f/t caretaker .. maybe she has worn down . to where she now sees it .. in full bloom . in full technicolor and knows she can't keep making excuses ..
It was rather stark . the difference. I'm used to dealing with someone who won't listen to reason . .that won't "see" the obvious .. and has so many zillions of excuses .. about the flying monkeys ... and whatever .. but not now.
Observation about the Facility and that meeting:
We walked right into their "process" that's it in a nutshell, .. they didn't hear us when the appt was made . or don't care .. I don't know .. but their agenda . was that Progress Report and nothing more .. and .. they were going to attend to their biz at hand .. and that's all there was to it.
I did feel it sitting there .. this is like being a piece of something on an assembly line .. and we just pass on by .. on the assembly line . and feel it even more . now . in retrospect.
Observations as to MIL:
WTH?
Why was it .. YD was there a couple of days ago . and she couldn't even wipe her own butt. Now .. she's doing absolutely stellar. Bathing herself.
WTH?
Why is it that it gets nothing more than a blip of any radar when I mention that she is up and moving about . and not asking for assistance as instructed .. and bracing off with her head .. why does that not cause horrors of concern. Seems it doesn't. Barely registers.
Yet we arrive there today and it's like we'd been summoned for a Progress Report meeting that we were fully aware of .. we were not.
Just befuddled, to put it lightly.
Yes, I did talk to two different nurses on the phone and noted to them the cognitive issues and ADL's that I want looked at and both told me they'd make note to her MD .. and ask for referral to psych .. for eval .. though one told me the ADL's are being addressed in OT.
I even cited those conversations and names today in that meeting when the nurse and SW both stated they don't do those evals there, has to be obtained via PCP .. and a referral to neuro .. not there.
Didn't change it .. I did cite that, but it didn't change the answer.
Why did the nurses tell me they'd refer? WHO THE H3&& knows ..
Some observations from today:
SIL.
She is so done .. it's just so obvious in so many ways .. so different than how things used to be with her. She's so spent .. so done.
As an example. It's well known by all who know and love MIL .. she has been for the last several years .. one who seems to have this .. oh I don't know .. snobbery .. what is it .. vanity .. I don't know. But years ago .. when she was gaining in age .. but not immobile .. but getting pretty isolated .. her little small circle of friends falling away with their own infirmities .. and her also now aging .. (but not yet with limitations as to her own mobility) .. we tried so many times to get her to engage with senior centers .. and she had zero interest. Even SIL having taken her a few times .. gone with her, . to try to engage her in that setting. Nope. Nothing doing. Her answer to that always: "Those are all old people . . I don't want to go hang out with all those old people".
<<Scuse me . but have you looked in a mirror lately .. you kinda fall under that cap yourself dear MIL>>
No interest ever.
Of course the years have waned on .. and that ship has sailed mightily . . she can no longer go anywhere anyway .. so it doesn't get harped on .. at this point . that she is so isolated . .and should engage . etc.
Fast forward to now ..
Her confined now, to a Rehab .. a Rehab that also encompasses AL and so forth there .. and so there is an activity room. There in that activity room are various different programs of which one can go participate .. and be a part of things.
SIL encouraging her mom . go join them (I think if SIL could wave a magic wand this would be her home now .. this posh place . .and there'd be no moving her .. she'd just stay there .. and we'd be done . don't know if that's gonna work out . but I think that's SIL's angle). SIL has tried repeatedly to encourage her mom (it's just down the hall from her) .. "go join them, what's on their calendar today . oh I see, it's candy Bingo . you like candy . go join them .. go meet some other folks mother".
Nope .. "I don't want to go down there with all those old people".
YD was there with her the other day wheeling her around ... and they came upon that activity room with something going on . and YD tried to encourage her, .. "let's go in and see what's up". Nope .. she doesn't want a thing to do with it .. will tell you .. I'm here to do my rehab and be done with it. ZERO interest in integrating there.
Today as SIL and I passed by that same room .. SIL stopped to look upon the goings on momentarily with the other seniors .. and then walked away and joined me . I hadn't stopped. She said the following (not at all typical of SIL, who has heretofore .. always had a zillion excuses for whatever roadblock her mom throws up):
"Mother is gonna have
Yes. She does.
And her CHILDREN have now heard what needs to get done. Step aside and let them figure it out.
MIL also needs a thorough MEDICAL workup to document her CHF issues.
Medical documentation of need for SNF, including continued medication non compliance..
Documentation of incapability for ADLS, (and please tell MIL to SHUT UP about how much help she has "at home".)
Hope that the Medicaid liaison at the "posh" rehab is a better facilitator.
Documentation of her cognitive disability.
I was a guardian and conservator for an aunt who had dementia and had broken her knee. She had some money, thankfully or this would have been a nightmare for me.
Anyway, my sister (also guardian) and I were called to the facility for a meeting. Things were very vague. It was obvious they didn't really know how to conduct a meeting or answer questions. Every question we asked was met with "Hmm. I'll need to get back to you on that." Kind of a waste of time.
In the meeting they told us my aunt was progressing nicely with the PT, could be out in a few weeks, able to return to AL. Exactly one week later I'm on my way somewhere and get a phone call from the facility informing me that Medicare has rejected her PT because she cannot put weight on that leg (she had frigging knee surgery). They informed me she would be moved to LTC and that I needed to bring a check for $6000 THAT DAY or I would need to make other arrangements for her! We had been told by her ALF she could not come back there until she could transfer herself from a wheelchair to a chair or bed. Thankfully she had the money and I had the AUTHORITY to write a check on her behalf. I made a U turn and showed up with a check immediately.
That's the kind of crap they pull. I wonder what they would have done had I said "She does not have money and cannot go back to AL and I will NOT take her to my house." Would they just push her to the curb in her wheelchair and tell her she is on her own?
Dorker, if you only do ONE THING, it needs to be to bug the crap out of DH and SIL to get POA from their mom ASAP! They will be powerless to do anything without it. Bet they've never even asked her to sign one "cause it just makes them all so sad."