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:
The sibs made their beds.
The ole "outpatient for observation" label jumps up and slaps everyone with cold cruel reality.
I'm aware of that whole debacle, from the last hospital admit and the underpinnings of the whole thing, having read here, an article someone was kind enough to link, from AARP and the controversy thereof.
Seems MIL's label is "outpatient for observation", and so we all know what that means.
Seems like the "Hospitalist" (no longer do private docs do hospital rounds, "hospitalists" do it now), would like to talk of discharge to a rehab facility. Ahh, but that ugly label rears it's head. Not to be.
I told SIL yesterday to check that, .. and had explained to her the prior hospital admit, and linked that article to her ... the last hospitalization. She said .. yesterday .. that her mom has Medicare with a Plan F supplement (which I think the best one can get), .. and that covers everything.
I think she was referring to the fact that hospital staff present with something for you to sign, as the patient, .. and the wording of it, .. it generally states ... you have to sign here, to be aware that as an "outpatient for observation" patient, your hospital stay may or may not be covered in full.
We ran into this very thing the last hospitalization.
I think SIL .. maybe not understanding where I was going yesterday when I urged she get in front of that issue .. she answered to it, that the Plan F .. it covers everything.
Nope .. not Rehab facility .. not if patient isn't "inpatient and for 3 days".
I tried to urge her to take a stand ... MIL's safety. I don't think they are ready to discharge her today anyway. But nonetheless, how safe is she going to be, does the hospital want to accept that liability .. she is already compromised as to her mobility and balance issues.
Sounds like SIL doesn't think it possible, at this point in the whole scenario to have that label changed to "inpatient" .. unless some other issue arises. I tried to get her to persuade docs to "find" another issue, that would change that label. She doesn't seem to think that's possible.
I'm not going to jump headlong into it all, .. like I once was, .. to try to move heaven and earth on it all.
She will be discharged, whenever that is, to come home. SIL will be the one on the front to care for her mom when that is done.
As to why DH isn't on the scene, allowing his sister a break. He has talked of going there tomorrow, if she is still in the hospital .. to spend xmas day, or at least in part .. there with his mom.
I urged, .. "you may want to go tonight, .. and spend the night there ... but we're supposed to go tomorrow morning, early-thirty .. get there before the kiddos wake up .. so we can be a part of the Santa scene at DD's house .. but I guess .. if you spend the night with your mom .. you might miss that ... "
He hasn't answered. Again, between he and his sister. If I were her, I think I'd be asking my sibling if he is willing to take a shift.
Though, why MIL has to have round the clock presence, .. is unknown to me. I know her, it isn't at her demand, that's for sure.
Maybe SIL wants to be there, as someone else pointed out, .. to "control" the flow of info. That explanation makes more sense than any other.
Get this. Last night, had DH's ear for a few minutes. Asked him again, .. "when are you and your sister going to sit down and have some adult conversation on the situation with your mom"
His answer, "there are no easy answers, .. why does this all fall on sister to deal with ... it's not fair to her that she should have to take mom home with her, .. and that's the end all be all .. and mom's care falls solely on her .. it needs to be a shared thing ... we take her for some duration and sister takes her for some duration".
I answered that, .. "I can't be your mom's f/t caretaker .......... she won't even come to our house to visit for family occasions/dinners ... how do you think she could possibly "live in our home", I can't be her f/t caretaker .... she has far too many needs, and it doesn't HAVE TO FALL all on your sister .. if she doesn't want to take her to her home, then there are measures that need to be taken to talk about placement in a suitable facility".
At that he shook his head in dismay ... "there are no easy answers anywhere, .. mother doesn't want to be placed in a facility".
I answered that, "kids don't wanna go to school either ... but you do what's best for them, when they are young and don't understand/comprehend the ramifications of their own decisions .. your mom is much like that .. she maybe doesn't understand all the ramifications of her stance that she wants to stay in her own home .. but the day is coming ..if this isn't it already .. that she cannot stay home .. period .. it's unsafe .. and the people in her life .. who do supposedly have sound mind to make those calls, should be talking about what that's going to look like".
His response: "if she would come to our house, .. if not for you .. and your stance .. I'd bring her home tomorrow .. but you won't allow it .. you don't want any part of care taking . so my hands are tired, .. I can't take some of the burden off of sister by offering to take it for some of the duration".
I answered that, "if you want to find another way to make a living that affords you the ability to care for your mom f/t in our home ... then go for it .. but what you are asking me to do, I can't do .. and I wouldn't ask it of you .. change your life entirely .. to care for one of my parents .. and I did, I was on this front for a long long time, .. headlong, dug in .. more than any other DIL anywhere would do ...".
His answer: "But now, we're down to the wire here .. she is unsafe to continue living alone, but there aren't any easy answers anywhere".
My response: "Nope, but you and your sister failing to discuss it all, and plan accordingly .. is no answer either".
With that, I dropped it.
You see, DH wanting to take the path of least resistance here.
His mom would be wholesale displeased with placement in any facility anywhere .. in fact, even if she could afford the very best of the best places (and she can't) .. she STILL would not want to be housed in a facility ... that is his mom's most deepest wish .. that she not end up in a facility somewhere in her waning days .. wasting away (as she'd term it).
So that leaves, .. I guess .. in some cases, .. the offspring .. on the front of caring for the aged person. The only offspring are DH and his sister. His sister who lives 1K miles away ..
This isn't a person who lives around the block .. and we can offer sister respite from it all.
As I told DH .. "at one time, your sister's plans were that when they retire .. she'd sell her home .. she said it herself, she didn't wanna be living in a cold climate and shoveling snow, .. she'd sell her home and buy a home here .. that was her plan forever. But somewhere in it all, that changed. She doesn't want to leave her husband's healthcare practitioners where they live .. the area where they live, her daughter lives there now ... a lot of reasons .. she no longer wants to leave that area .. and so ... there ya go ... but you two need to have planned .. in concert with your mom, for what this would all look like".
I can say it and say it and say it all, .. but I might as well go outside and talk to the bricks affixed to my home. I get about as far.
Not going to fight about it .. but this . the yellow bedroom .. is not an option. He knows, .. that if he thinks that's the only option, then he will have to, on his own .. figure out how to caregive .. and work for a living, .. I won't stay here and do it. I won't.
I have told him I will help them, to navigate what needs to be done as to placement, I will partake in any conversation .. and be a part of that if he wishes ... but I won't take on that role as f/t caretaker. He knows that.
It's enough to make me pull my hair out here.
And in the meantime, I am planning for about 15 people tonite for dinner here .. and have to get busy with preparing some things. Didn't go to church so I could stay here and do some of that, .. and so I will get on with it now.
I agree that DH needs to be at the hospital to control the direction of the conversation and to object to sister binding him to something he is not prepared to accept.
Is MIL perhaps demanding that someone be with her at all times?
Otherwise, we visited at a time when we were told the docs would be rounding.
Her kids will have to talk with a social worker/discharge planner.
I am hoping she was “admitted” as well. They can’t send a 88 y/o home not being able to ambulated and the cause of her fall (maybe syncope from heart block or something) will have to be investigated.
Heart block? Aortic valve? Anemia? Who know, but she won’t be home for Christmas, I ‘ll bet.
Hospital staff will now get the family involved. Hoping your DH will be there & not afraid to discuss his concerns.
I don’t understand why SIL is staying in the hospital all night with MIL? Maybe so she can control the answers when the docs etc come in to talk with MIL?
My mom told me to go home when she was in the hospital. Nothing will be done during the night unless it’s an emergency.
This may be it - time for her kids to be forced to discuss MIL’s future care. We will see...
Agreed Barb. Why isn’t DH there now? Ooops it’s Sunday, we know where he is...
And THAT is news that MIL isn't ready to go home yet! SIL will accept that and not attempt to change MIL's mind, yes?
I did have one question, Dorker. SIL is staying at MIL's bedside. How much time is your H spending with MIL at the hospital? (Now here's an idea -- if H and SIL are both there, sometimes all visitors are made to leave the room while the patient is bathed/sheets changed, etc. Wouldn't THAT be a good time to force the discussion about what happens now?)
"observation"?
From my own recent experience, a bruised but not broken rib makes breathing hard and takes as long to heal.
Wonder what in the world. From what I hear .. when she was originally found, she couldn't catch her breath ... said the breath was knocked out of her in the fall, .. but she couldn't catch her breath .. said it hurt to breathe .. this was originally .. and that continued on thru the night .. thus the strong pain meds administered.
I don't think that's the case any longer, but she isn't moving (which isn't good) .. hurts too much to move. Then what the hay? If there is no broken rib ... then why is it so painful to even move.
SIL says PT came in yesterday and had her sit on the edge of the bed, just get to a sit up position and dangle legs off the side of the bed. That wiped her out completely.
And .. unlike all previous times .. MIL herself is saying to staff there that she isn't ready to go home, . .she knows she can barely move. This is new. She has always been a horrible patient .. so eager to get out of there, that's all she'd focus on. Not this time.
He did voice some sadness at his sister staying vigil there ....
Questioned, where is SIL's daughter (she'd gone to work out, and gone in pursuit of *decent* coffee). Questioned why SIL's daughter isn't sitting up at the hospital so that SIL can go home and shower or rest some. I didn't answer, .. don't honestly know.
But I do know the daughter of SIL is considered to be some sort of untouchable prima donna .. while the daughters here, the ones that live here .. are the work horses that get called upon.
I personally have a problem with that approach .. but ... my daughters are grown and can speak for themselves. SIL's daughter, also grown .. and I suppose chooses not to be front and center in the "care role".
I stay out of it, but it displeases me.
I almost hesitate to say this, because in doing so, it will sound as if I'm "glad" that injury befell MIL and I am not. But here goes.
The irony isn't lost on me, this would happen when SIL is here and present .. and OBVIOUSLY .......... had "other" plans. Plans which have now been upended by this latest debacle.
SIL's husband has a niece that lives/resides here. Niece and her toddler children. The mother of that niece is a sibling .. to SIL's husband. That mother is here in town, as is her husband. Their were plans on the radar for this evening, that SIL and her husband .. as well as their daughter, . go join the other end of that family for dinner out and some scenery viewing in town ...
That has been upended at this point, at least as far as SIL's presence in the above.
I think SIL's husband and their daughter, still intend to partake.
But the irony there also in the fact that I have tried multiple times over the last few years to pry SIL away from MIL and that role of caretaker and ever so vigilant watchful eye .. to no avail. She couldn't possibly leave her mother ... her mother unable to join (MIL) thus she really couldn't possibly leave her. (FWIW .. MIL is shoving her and her bothersome neurotic self out the door, .. does no good).
But I do know they had plans .. with the niece that lives here in this city ............ SIL's husband's niece and their family ..
Hmm. Okay .. I try .. over the last few years to pry you away .. so that we can, A) go have some fun perhaps, but more to the point, B) talk about some planning as to all of this .. and nope .. couldn't possibly do that.
SIL expressing to me, about tonight's plans she'll now be nixing, as far as her participation, her words, "I want B to go (her husband) .. he's been .. ever since we got here, .. landlocked there at the house .. while I'm in the roads running mother to doc appts .. he needs to go enjoy his own family for a little while".
I didn't say it, but I did think, .. "...and you ...???....enjoy yours....???....ever ...???....guess not".
So, in saying the above, it almost sounds as though I'm rejoicing this could happen to MIL at this point. And I am not, not at all. I wouldn't wish this on her. But I do see the glaring irony in all the above.
So, as to DH asking me, as we parted the hospital .. feeling sad for his sister, sitting vigil at the hospital .. and his asking me, "where's her daughter, why can't she come sit here and give her mom a break .. ".
Don't know, don't care. SIL isn't being forced to sit vigil at the hospital .. and probably would do good for all involved if she'd leave and let the medical professionals do what they do there. But .. I'm not going to dictate. Nor am I going to offer to sit in her stead.
Yes it’s most probable she’ll get discharged with no social worker intervention. Discharge planning RN only who will feel comfortable sending her home with her daughter if the daughter is willing and says the right things.
If your DH and SIL decide to allow her to come home, and SIL returns to her home, surely something else will happen when DH is indisposed. You know exactly how to call 911!
Not likely that will happen, as I don't intend to, not even in this instance .. return to days of old, and sit vigil at the hospital.
Look no further than this past summer when MIL was hospitalized .. and I was there, in DH's absence (because he was *far too busy*) .. and of course, that's where the cognitive impairment was picked up and orders for her to have some testing along those lines, .. that as a part of discharge planning.
Only to see SIL breeze into town and undo it, hanging the cognitive impairment on the UTI . She would have one believe, there is no cognitive impairment. I never disputed that UTI can be a source for confusion, etc. But that doesn't explain the broader picture .. and I said so at the time, to no avail.
Not doing that again. Would do me no good, to sit vigil and try to explain my concerns only to have them upended by a SIL who has no intention of taking any actions to make things go in another direction.
You're absolute right Barb ... fly on the wall ... as MIL and SIL assure SW and MD's .. "all is well, she can manage just fine".
Me over there, pulling my hair out.
Not doing it again. I will try to urge DH to take some proactive steps . but that's all I can do, it's all I'm willing to do.
I'm not trying to be Debbie Downer here. I've just been through this scenario with one of my cousins many times. Demented Uncle always insisted he was fine at home and was discharged.
Nausea and such, seems to have abated for now (hopefully) but no narcotics on board either, at this point.
No appetite. SIL got her to eat, literally one bite of jello, and a swig or two of Boost and one bite of her dinner roll that came on her tray. But that was it.
I can't even imagine how she will go home tomorrow?!?!?! She hasn't .. not yet ... and doesn't look in any shape to do so .. proven she can ambulate even in the slightest. How can they send someone home that can't even get up in the bed at all, .. and she hasn't. Can one day make that much difference, that she'd be bounced outta there tomorrow.
She was sent for more xrays and no the pelvis doesn't appear to be part of that picture, .. it was said that's not where she experiences any pain, when I asked that question of SIL (MIL was asleep or I'd of asked her).
Seems like at this point, .. but that's my laymen's view here ... the worst part of it all, .. at least thus far, .. was the horrible side effects of pain meds. I'm sure the worst is yet to come though, w/regard to a fractured rib.
As to any dialogue .. between SIL and DH. DH actually landed there before I did, he and I both, respectively, out doing errands. He hadn't taken any opportunity to talk with his sister. I'm guessing he considers her weary at this point (she hasn't left the hospital and it sounds like she doesn't intend to).
As we left, walking to the elevator, he and myself, he remarked there is no way that his sister will be able to leave to return to her home. I responded, "that's January 9, she leaves". He remarked, .. "she's not going to be able to go home .. or she's gonna have to take mother with her when she does". I asked, "you think your mother will be travel worthy to make that kinda trip?". He said, "Well she's not gonna be able to just leave her .. ".
I said, "you and she both need to get on this .. you need to be talking to the hospital SW .. if not her, then you .. or both of you .. I can't do it, .. she's not my next of kin .. but you guys .. if you don't see that she cannot live alone and start taking some action to change it, I don't know what to say".
At that, we parted ways ... me to go to my car, him to his .. and that was that.
I have no idea if he will press his sister on it all, .. and if so, when.
I have zero control in any of this, never did have any. Still don't. All I can do is try to persuade the parties in it, to step up .. and that I am doing.
The difficult thing here is that MIL controls things, because she hasn't been declared incompetent. And neither of her children appear to want to cross her in any way, shape or form.
So what is going to happen?
(Meanwhile, Dorker, you enjoy your family and those grandkids. Narcissa's dilemma is not yours to solve.)
But I can’t imagine Dorker being barred from attending any planning or discharge meeting - do you really think anyone would stop her?
If you don’t want to do that, then seriously I would get your husband in a room and let him know how you feel! It’s a perfect opportunity to get her in rehab, Christmas or not.
Too bad SIL is wiped out. She needs to deal with her mother’s safety.
I would be quitting the nice guy role by now & letting them know their lack of a plan is pure denial on their part & they are setting her up for a worse injury next time which will happen again soon.
Good luck. It’s still early here on the east coast, the social worker should still be available. I would do that, Dorker.
You’ll be able to make a case that she already had homecare this year & obviously didn’t learn from them. Your SIL will get her dc’d saying MIL wi be looked after.
Quite a while ago I said that even though Dorker wants to be out of the picture- more or less - wouldn’t it make sense in the long run for her to take the bull by the horns and start the ball rolling for a better MIL placement- since SIL and DH are unwilling to. That just getting it over and done with would be ripping the bandaid off quickly - rather that enduring the torture of watching MIL decline as her children did nothing.
I was shut down by everyone.
Now - everyone is of the opinion that Dorker needs to step in. Really? Finally!!!
Go to the hospital. Go to any discharge meeting. Say what needs to be said since - as we are all knowing - SIL will gloss it over and assure the SW and the docs that - yes, MIL does indeed have someone at home to look after her... leaving out that it’s only until January 9th.
If this doesn’t occur, you can bet that this whole situation will be on the hamster wheel.
BTW - I do realize that MIL is very unstable on her feet to start with. But I have to wonder if SILs dragging MIL all over town, seeing every specialist under the sun - didn’t contribute to the fall by making MIL extra tired, in both body and mind.
And - I do apologize for being a know-it-all, smartass- but this situation is just frustratingly nuts. And I’m not even involved other than being a co-dependent personality type who’s been following this for seven months. I can’t even fathom how poor Dorker feeels!!!
You may HAVE to step back in, Dorker, just for a bit. Make your voice heard, loud and clear. SHE HAS NO ONE TO CARE FOR HER 24/7!!!!! SIL and DH will just dither and fuss and then MIL will be sent home in worse than ever condition! (Of course, you know that!!)
This is the perfect time to move her to rehab and then to AL...but you KNOW that.....at least someone was there when she fell, what if she'd been alone, as she usually is? Obviously, she could have lain there for a few days....and this doesn't convince her to move? (sigh)
What a year, right?
I do wish you the best. Seems like the worst stuff always happens this time of year. I know your MIL didn't 'want this' to happen, but maybe it's a blessing in disguise.
FWIW, I agree with Barb--unlikely a broken rib cause that level of pain. She may have more fractures than they initially thought.
Keep us all updated. We feel for you--and for exactly what you've been for! "The fall". Let's hope it leads to better living conditions for MIL, and less stress for everyone else.
I got advice here on the same subject...
Saved my sanity and my dads welfare!!!
Doc is switching her to a strong NSAID for pain ... ??....
She can't eat, no appetite.
And they want to "make sure she can navigate before they release her". She is to be kept an additional day, at this point.
I will ask if they filmed her pelvis, I don't know. I would guess they did ... but I'll ask that question.
DH .. this should all be in his corner to do .. of course, and be getting up to the hospital.
This morning's debacles handed to him .. he was getting dressed and broke his glasses he uses to see (to drive). Has super-glued those . no time for a visit to optometrist at this point. Waiting for those to dry .. so he can move on with his day. Went outside, found he has a flat tire on his vehicle .. so is gone now, (old glasses on) .. to get that fixed. Good Grief, when it rains it pours.
I don't know how it can't be painfully obvious to all involved. She won't come over here anymore, because it's "too hard to navigate around". She can't even do something as simple as lean over and pull down a bedroom shade without a fall.
But "she's fine, she can manage" .. to live alone.
Why doesn't any of the parties involved get more proactive here and get this addressed.
Damn .. SIL .. texting with her, "they are thinking of discharge today". I then responded (this was earlier) .. "Seriously?, I don't think that's a good plan at all, she can't even ambulate real well on her best day .. and now .. now that she's injured .. that's gonna be nil .. the ability to navigate around .. and get to the bathroom and any other thing she needs ... and they think it's okay to bounce her outta there?".
The above is what I said to SIL.
I'm sure SIL making a picture there, that she's able to care for her mother. And she is .. when she's here. But SIL is worn out herself, already ... was already worn out .. from dragging her mom to doc visit after doc visit ... and everything else she does while running full tilt on that hamster wheel when she comes here.
SIL .. not at all on the page that she needs to maybe make hospital aware this is a person who lives alone, sans her visits here every few months. Not at all on that page.
And I try to persuade DH that HE needs to take the bull by the horns and have some earnest discussion with all parties involved, .. and I get nowhere.
Not a doubt in my mind, this too will pass .. and nothing done. Nothing at all.
But "she's fine, she can manage".
I worry that she will get pneumonia .. she's not going to be able to breathe deeply and/or cough .. that's for sure ..
What are they going to do to try to prevent that ...???....
Nope, send her on home .. and SIL will care for her, .. til she leaves. I think she leaves January 9.
This is an elderly person .. they don't heal quickly from broken bones. I doubt that MIL will make some miraculous recovery in the next couple of weeks.
But she's fine. She manages. Uhm .. oookay.