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:
If DH tries to flake out at the last minute, you don't go either!
IF they try to force you to take the lead during the meeting, do not fall for it.
Let it be known that you are simply there to listen and to share info with the SW.
Nothing more.
Do Not Go To That Meeting. Do not. Don't.
This -
"but I didn't want to be seen as the miscreant that somehow doesn't wanna work "WITH" the family .. since I have an integral part of the puzzle of all this thing . in having been so front line to it all"
Miscreant or not, you ARE the person who has no further intention of working at all in any way on the project of your MIL's care. You are not involved in planning or delivering her care.
You are not an integral part of the puzzle. Not any more.
You *have* been, sure. But you're not any more, and you don't want to be.
If you go to that meeting having been flattered into it by the recognition of your "expertise" what do you expect to happen?
Need someone to sort thru a list given as to facilities that have Medicaid placement and what ratings and so forth .. I can do that on the net .. and maybe get some info . and dial down on that, for you and DH to go and visit and view."
And doing any of this will be for naught if there is no POA for SIL and/or H to act. The first thing to do would be to go to an attorney to get those papers in place. To do anything else would be premature.
My main fear for you is that you will be seen as the Ringmaster in this circus by the SW. Simply because you will be the only one speaking sensibly or with any knowledge on the subject should DH and SIL sit there in stunned silence.
I too feel this is a preliminary meeting especially since this meeting was called by the family not the facility. I would think if the meeting was called by the facility then the subject of early discharge would be a problem. But stranger things have happened.
I confess, the reason I would find it hard NOT to attend the meeting would be the control freak in my personality. The fear DH and SIL would mess this all up. And curiosity, knowing I would not get all the details of the meeting, accurately out of DH and SIL.
I am a naughty girl.
I don't know that SIL would .. and so .. have at it . get to steppin SIL.
Sadly.
No way would SIL stand any ground on that. Her fear would be they'd find a place alright .. but some hellhole that is a living nightmare .. and so that would negate her ability to stand firm.
Legally, MIL lives alone. I doubt this will happen. But be prepared😀
It has occurred to me .. that could happen and on a moment's notice.
The only conclusion I can come to on that one .. having no direction forward .. which there is none at this point ... guess what SIL .. you're up to bat again ..
And ... because SIL .. until within the last few weeks . she was gonna be her f/t c'taker and no consideration/plan/talking .. as to any path forward .. she gets to wear that hat .. should that be the direction that falls in their laps .. and it very well could happen.
And so be it .. and no .. the yellow bedroom is off limits and hasn't even been asked about but the answer is a resounding no.
Did DH and SIL come up with a list of questions that they want to ask?
In your shoes, I would make a list of what you see as MIL's deficits in ADLs that are making it impossible for her to return home. Include as many as you can that you've observed before the hospitalization, in her home environment. Make sure the SW knows that she got outpatient PT in IL (and thus that's been tried before and it didn't seem to improve the balance/gait issues).
As I've said, I wouldn't go to this meeting; it's a very preliminary one, not one that is going to result in any sudden change (unless they have already decided that she's too compromised to remain in their care and they are arranging for discharge tomorrow--trust me, that's happened). In which case, it would really be better for you NOT to be there.
Keep us posted.
Edit - You WILL make it!
I want it out on the table and right in front of DH and SIL .. what I view as her deficits . .that need to be looked at placement and need vs the setting and capabilities there to serve those needs .. I want that looked at.
I don't know .. I am not an authority on all this . maybe all that gets a look thru anyway as part of any placement plan and so need for dialogue on it.
But .. minimizing it is no longer an option .. and blaming it on UTI's and unfamiliar surrounds and whatever flying monkey distracted MIL . is not the matter . it's broader, much broader than that . and needs to be addressed.
I've mentioned this to two different nurses at this point and it was my plan to follow up with said nurse(s) today to see if that has been done. But then this whole "will you go to the SW meeting with us" came onto the radar.
That's ground I intend to get right out onto the table .. at the getgo.
And yes, .. I could've emailed the SW on the side . and/or scheduled a 2nd appt . and had my say in a different setting . but I didn't want to be seen as the miscreant that somehow doesn't wanna work "WITH" the family .. since I have an integral part of the puzzle of all this thing . in having been so front line to it all.
Kind of (if you will) ... I'm not gonna hide over here in the corner and shout out my concerns .. outside their presence ... nope. I'll say it .. right in front of them .. and if it's disputed and/or minimized I can cite numerous examples where UTI and unfamiliar surroundings .. can't be blamed.
I just think about the times that SIL used to come here for her 3 week stints and literally walk on water . and my begging her .. "stop doing every living breathing thing for her .. let her get her own glass of water, let her feed the dog .. let her make her own damn sandwich . YOU aren't getting a clear read . on just how compromised she is . and unable to do for herself . you waltz in here and do every damn thing for her, but breathe .. and you'd do that if you could .. .and you don't see it . what we see, .. when you aren't here to do it for her .. stop it". To her responses at that time .. "Well that's what I'm here for, to help her". Sometimes you can help someone by standing down . and letting them .. try to do for themselves and when you truly see what their limitations are . you can then objectively address it ..
But anyway .. in the end .. having talked to church lady and to my sister in law .. on MY side of the family .. both .. it seemed .. would .. if given the same circumstances .. turn the other cheek and move on . .and not be seen as perhaps an obstinate . .and ornery, more importantly now that they are both on that page . finally .. the page you were trying so long to get them on . .and they wouldn't hear you . they do now .. so step up . and be a part of the solution and not part of the problem.
BTW - for those that are keeping up ... DH intends to pull away from work and be there, no matter what .. and has asked, some valid questions as to the goings on . and what to expect . he is at least "engaged" more than has been seen before .. and no there hasn't been any balking and excuses and so forth. Fully aware those excuses are to come, as that task list gets formed . and he now has to see to tasks A, B, C, D, E, F . .. and on and on . it's coming .. fully aware of it .. and no .. I won't be delegated to .. moved on past that.
Against popular opinion .. I am going to go to SW meeting.
One goal there, at least for me, .. there will be task list I assume . .and I want to pick and choose what it is I do or don't care to have any part of.
Need an atty .. sure I can get on the net and search out that atty for ya . .and you and DH can go sit with said atty
Need someone to sort thru a list given as to facilities that have Medicaid placement and what ratings and so forth .. I can do that on the net .. and maybe get some info . and dial down on that, for you and DH to go and visit and view.
That kinda thing .. is kinda what I envision .. as to .. "IF" I take on any part of it all .. and I want the latitude to pick and choose .. what tasks I see to. Being on site, .. I will have a better scope of what is needed in the way of tasks.
This decided after long convo's last night on the phone with two different folks that I care about .. and have walked this walk themselves. One of them my brother's wife (the same brother who had the kid electrocuted on his property). His wife has walked this walk with her own mom . (now deceased). Her mom was, for a brief time, in an AL .. and it was thought to be (she was private pay) exorbitantly expensive. This . likely ... in part, .. because it was an AL . and every service needed in that setting nickel and dime'd them to death. Ultimately against popular opinion between she and her siblings .. she took her mom out of that setting and into her home to care for her, herself. She says of that time, it was the worst decision she ever made, and wouldn't do it again . .and it was one based in shear emotion and against the advice of her siblings, and caused fights between them.
How does that situation impact what I'm looking at?
Her advice .. "Dorker when I was in this .. I couldn't see the forest for the trees either, they tried to tell me, we fought about it, went bouts not speaking to one another .. unfortunately that happens in families sometimes. But in the end, it's family. I should've listened to them, it wasn't good for mother .. me doing that and it certainly was no good for me . and my life .. but I didn't listen .. all you can do is hope that .. anyone who has been hands on in all this . and you have .. can provide some input that will be listened to .. I fear .. in your case .. that .. of course, you were on this page and they wouldn't listen to you and were cruel and unkind for all you did do .. but now . they are . on that page . .and are listening . or so it seems .. seems like they've finally seen it themselves .. finally .. and maybe they just weren't ready to see it before . but now they do, it sounds like . and so .. when people love each other and care about their well being .. they forgive, they forge ahead for the greater good .. and they don't let past transgressions stand in the way of what's best .. and for you to stand down at this point, when some of what you bring to the table having been hands on . can be invaluable . .if they'll listen . and it sounds like they're there .. ".
Synopsis of her advice.
Same pretty much with church lady . .along with .. some scripture as to forgiveness and using the gifts God gave us .. etc.
I HOPE .. that I am not making the WRONG WRONG WRONG choice here . in stepping up to the plate, to line myself up to be maligned and worse.
I do think (????) I have gotten to the point in this whole saga that I no longer .. as Barb described at one point . am the person who assumes I take orders from SIL .. as silly and rabbit hole as they may have been at one time. I've moved past that, and no longer am willing to be the stooley to her direction.
I want it out on the table, to the SW .. and in front of both DH and SIL . .and no minimizing . and I can't (unfortunately) count on DH to do so .. and all I know of SIL in the past is her skills at minimizing ..
Sometimes I feel like: If I just... (do this one thing)... it will get (whoever) over the hump and things will be ok. Well, it never works out that way. There are always more "humps".
I lean towards giving the social worker a brief heads up though. Just to emphasize the reality that MIL has No One at home to help her. Might be appreciated.
But otherwise, I think try to let it be.
You can call your parents' doctor and tell them about the abuse situation and the fact that you've had to leave your dad in his weakened condition to your mom's care. The doctor can't GIVE you any information but you can and should report what is going on to the doctor.
You CAN'T make someone make a living will.
Can dad read? Can you leave some written material about "end of life choices" for him to peruse in his own time frame?
When he arrived, he found them BOTH tangled up and on the floor! Apparently one tried to prevent the other one from falling and they both went down.
The SW managed to get into the house and both the man and woman immediately started begging him NOT to call an ambulance or family members! The husband was pretty banged up from the fall and the wife had a broken wrist and several broken ribs! But they didn't want to go to the ER! (they knew this would be the road to the NH).
The wife finally relented to allow the SW to take her to the ER but with the demand that he take her to her HAIR APPT. first! She had a hair appt. that morning and didn't want to miss it!
It is maddening that the law allows elderly people to live like this, make horrible choices, not be interfered with by their family, yet the family can be charged with abandonment or neglect for not preventing things like this? How does that even work?
Same with MIL. Ultimately, if she demands it, she can probably go home, if she raises enough of a stink. How can her family then be FORCED to give up their lives and take care of her, or be charged with neglect or abandonment? How does that work? This is why people are very reluctant to move in with a parent or move the parent into their homes. They know on down the line when more care is needed, the parent, if they can still articulate their wishes, can ultimately call the shots and demand to stay put and be taken care of, it seems.
As guestshop’s(?) wise therapist said: Sometimes you have to put your hands in your pockets and shrug.
That is perfect advice for people like you and me.
I’m wired exactly like you are, Dorker. I knowww in my bones why you want to be at that meeting.
Get tough and just (I know, “just”) push it aside. And get on with your day.
YOUR day.
Let DH & SIL represent themselves and MIL however they care to. Even if it’s false. Even if they don’t take good notes. Even if they don’t ask good questions.
One more thing: If you disappoint DD and M, tough sh*t. (Another difficult one for people like you & me!)
The granddaughters’ request that you attend is not in your best interest. They admitted as much by enumerating all the people who WOULD benefit from your attendance: DH, SIL, MIL, SW and the 2 of them.
No mention of Dorker on that list of beneficiaries.
Resist the manipulation, my friend. I know that flutter of feeling flattered. Fight it. With everything you have.
If you fall into your old role as “facilitator” - even for a 45 minute meeting - you will come out of it drained and resentful. (After the high wears off, that is. We “fixers” are weird like that.)
Do not put yourself there.
And despite the syrup that has been poured this week, your family will resent you right back. Maybe not right away. But as soon as it’s convenient for them.
Key word = scapegoat. They’ll never say it, but that’s what all 3 generations here expect from you. (“For chrissakes, Dorker....”). It’s the old go-to, and it has always worked very well. For them. They have no incentive to abandon that “hack”.
Dorker, only you can short-circuit this time-worn pattern.
Now a re-boot of Rovana’s sage advice: “Dorker, you are advocating for MIL — by holding SIL and DH to the fire.”
Big hugs, Dorker. Stay strong. 💗
Skilled Nursing Facility
Days 1 – 20: $ zero co pay for each benefit period
Days 21 - 100: patient pays $167.50 coinsurance per day during 2018
and $170.50 for 2019."
Dorker, the SW should be able to tell DH and SIL whether or not MIL's supplemental insurance will pay the $170.50/day co pay for each day beyond Day 20. Or do they already know?
I am with the others on this thread. Do not go to today's meeting. Don't let H and SIL flatter you into thinking your expertise is needed. They don't need it at the meeting; they want you to do things after the meeting. And before you know it, you will be steppin' and fetchin' just like you were before.
They (wrongly) expect you to be as invested in their mother's wellbeing as they (think they) are. And we know that in H's case, that is not that invested. In SIL's case, it is an odd kind of co-dependent over-investment. Neither is appropriate for your involvement. This is not your mother.
If H actually attends the meeting (there could be a work/church crisis), he is probably going to not commit to doing anything going forward. Thanks to your staunch boundary-setting, he won't promise to do something and then try to make YOU do it. He will be quick to announce his work issues at the meeting (he'd better NOT mention the churchin'/huntin'/orphan campin'/missionary lunchin'!) SIL will make promises to do this and that, and then possibly bail when it comes to actually doing things.
I do think that MIL coming home is a real possibility. H or SIL could ask the SW what is the tentative discharge date for the various therapies that MIL is getting (this is assuming the various assessments have been completed). I think this is something the facilities know, but rarely tell the families of the patients. And then of course that is the facility's determination, whereas Medicare could disagree and stop the therapies sooner.
As I've written previously, there could be very little notice when MIL will be discharged. A Medicare appeal can buy just a little bit more time. But, still, H and SIL will have to be ready to go with what's next for SIL. And if they dilly-dally and she goes back to her home, a LOT will be lost in the forward momentum.
This is just for you to know, Dorker. You don't need to tell H and SIL. I hope the SW is honest with them. I've just been through all of this with a 92 y/o mother in better shape than MIL back in October, but who is now in a NH needing assistance with every ADL except for eating. Fortunately, though, my mother was not a spendthrift like MIL, paid into a very very good LTC insurance plan, and should be set for the rest of her life and never have to dip into her substantial trust to pay for it. (The LTC company hasn't started paying the claim yet, but they are in the process of assessing it - we are assuming it will be approved.)
Is there any way you can plant a bug on H, so you can hear the whole meeting? :-) We would all love to be flies on the wall at it (and so would you!).
A final piece of advice from me: DO. NOT. GO. TO. THE. MEETING.
Mother's house was a minefield of fall and trip hazards. She was lucky to survive the dishwasher door alone (her left shin didn't survive it, it was skinned alive). She had two flights of steep narrow stairs with a cunning half step turn at the bottom of each almost custom-designed to fool the foot. And that was before I found out that her method of filling her hot water bottle was to wedge it between her feet while she poured in the boiling water. Social Services mandated two weeks of rehab in her sister's apartment after her hip replacement. Five days in, Sunday evening, she calls me from her house, where my brother had just dropped her off - And Left Her There! -because she rang and asked him to rescue her. Social Services did their best to catch up the next week but apparently their powers stop short of being able to have irresponsible cretins publicly flogged. But - she survived. And they do survive, more by luck than judgement, but they do.
Until they don't, of course.
Do not go!
Do. NOT. Go!
DH will cancel at the last minute (work emergency) if he knows you will be there to handle things. They NEED their feet to the fire.
Before discharge home, rehab sends an OT to the home to assess safety. I would pay money to be there as SIL shows off the washing machine set up, the dis-alarming procedure used to let in the lawn guy and the ironed pjs.
Dorker, as you say, although you know some of the ins and outs of NH admissions from hanging out here, it's not the same as someone who does this for a living ( a Medicaid lawyer). I get the sense that DH inflates your expertise and will use any excuse to bail on this project to go hunt.
Maybe the Church ladies have some knowledge/ contacts at other facilities? I think they could be a good source of support for both DH and MIL at this time.
Stay home.
How quickly they forget.
Not so many months ago dh was treating you so shabbily over this topic that you had to get your minister involved.
But now he's sorry. Now he needs you. Apologies are cheap and flattery even cheaper when it’s used to manipulate. Did it cross your mind tha dd and dh are using the same page in the playbook? “We need you. You’re so knowledgeable...”
As for sil - heck, she wasn’t even speaking to you a couple of months ago!
Dorker, you’re being manipulated- and not even in a particularly creative way. It’s really kind of insulting, if you ask me. Which you didn’t. But - you’re just too smart a cookie to fall for this.
Go tomorrow. Don’t go tomorrow.
This really isn’t about just tomorrow. Go into this with you’re eyes wide open.
My mother always use to say “Actions speak louder than words”.
My dad always use to say “Many a slip ‘tween the cup and the lip”.
I say “Past performance is the best indicatior of future behavior”.
It wouldn't be the first time that the ball rolls backwards a bit, but at least 2 of the 3 players are finally getting on board to finally do the right thing, which is the eventual placement of your beloved MIL for Everyones health and wellfare. It's gonna happen, and it would be best to be supportive in whatever capacity that You Dorker are now comfortable with.
I too that think that Dorker might be blamed initially by MIL, but with her diminishing mental capacity, she too will hopefully forget that (undeserved) label placed upon you, and she will eventually settle in wherever she ends up in long term care, just like the millions of other deminished elderly folks do, for their own safety. It is very difficult and sad and unfortunate, but it's a fact of life which most of us face to some degree or other. You guys will do the right thing.
MIL has supplement plan F I think you told us on one occasion. That pays the other 20% that Medicare won’t pay after the 21 days.
That ( her staying longer) depends on her cooperation so good that they aren’t telling her anything to upset her.
“After you have been in a hospital for at least 3 days, Medicare will pay for inpatient rehab for up to 100 days in a benefit period. A benefit period starts when you go into the hospital. It ends when you have not received any hospital care or skilled nursing care for 60 days.”
So you want her to stay as long as she is progressing but not longer in case she has to go back within 60 days.
Good that you know about the RM. One thing off your plate.
SIL is probably on her bank accounts and her bills, utilities already so that’s not a problem.
Great about the attorney.
I have mixed feelings about you attending the meeting too BUT this is not the only meeting to be had!
This is only the first meeting.
What is YOUR purpose for this meeting?
If it is for the two of them to have a moment with you not making it easier for them then don’t go.
If you think something will be decided that can’t be undone then go. But what could that be?
They need you and they know it. You’ve worked a long time to make this happen.
If they mess up you can fix it...if you want to.
Pretend your best friend is in this situation and not you. Give her your best logical advice.
By you unlocking the phone to SIL, I think you're on a very slippery slope. You might have opened up a can of worms.
I will repeat - this is still just the beginning of the beginning.
Just a side thought... Dorker, how do you suppose sil and dh will hold up
to their new found commitment to “The Same Page” when mil Is told of the pending “plan”... and her tears start? Steely resolve or sloppy puddle of Mothers Little Helpers?
Maybe the answer to that could help guide your decision.
Certainly, everyone here pretty much stated their bit. One thing
l’ll agree with is that you’re gonna end up The Bad Guy. But I think that’s inevitable - regardless of what you do or don’t do now or what you do or don’t do going forward.
Keep in mind how fast mil turned on M. The minute mil figured out M’s agenda would ultimately take sil away from mil - and therefore mil couldn’t live as SHE wants.
Anyhoo - I’m a “worst case scenario” kind of thinker. Horrible habit. But in situation such as you’re facing- I ask myself “what’s the worst that can happen”... Give it a shot. What’s the worst that can happen if you do go and if you don’t.
Then ask yourself if you are prepared to deal with the fallout of either.
DH wants to keep it in the family - well how about the day that APS, the cops and emergency guardianship are on the radar? MIL goes home and unless you can afford shifts of caregivers, you are looking at abuse/neglect. Has DH thought about that? How about what his fellow church people would view that one?
Dorker, you are advocating for MIL by holding SIL and DH to the fire. And Linda 22 is right - this is not rocket science.
Who knows how long that all takes.
And they are on borrowed time already .. Medicare only pays . I think like 21 days of a Rehab stint . and we're at .. ??....5 days already . down to like 16 more days (if they keep her that long) and she's bounced outta there .. and SIL you're up to bat. Go get her and bring her home . and now try to navigate it all .. from her home where you're caring for her . .where I warned you . is much much harder to get placement.
Go on .. get to steppin.