In-law caregiving

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Caring for mother-in-law, who doesn't live with us and lives independently (if you want to call it that) in her own home. Weary.


I read another thread on here about the frustrations that come with caring for in-laws, but it was dated. So didn't know if it would see any activity here.


My husband owns his own business, and as another posting read, team work, I suppose. He has to be free to "earn a living", so, by default, the caregiving falls to me, daughter-in-law. I guess I just need to vent.


There is a sister that lives several states away (husband's sister). She is retired, she comes periodically and generally stays a few weeks when she does come. It has been 4 months since she's been here this time. She needs to come with more frequency in my opinion. I try to understand how hard it is to upend one's life and have to come here for several weeks, and care for your mother. But it doesn't satisfy the reality that gets dealt with here on this end.


If I could wave a magic wand and resolve this, mother-in-law would go live with her daughter. Daughter doesn't necessarily "want" mother-in-law to come live with her, (mother-in-law can be cruel to the husband). But the daughter has tried to encourage mother-in-law to come live with her, simply because I think, it would be a more manageable situation for all. But mother-in-law, heels dug in, does not want to leave her home. No one will fight that I don't suppose.


Mother-in-law suffered a stroke, oh about 14 years ago. It left her with balance and mobility issues. Those issues have worsened through the years, as she ages (she is presently 87). She has had several, dozens of rounds of PT through the years. It helped some, but the fact of the matter is, she is aging and becoming more and more frail, as it happens. She has been advised by all the healthcare practitioners to use a walker. She is so unsteady and even complains that she feels like she's going to fall, "ALL" the time. She has a walker. Does she use it? No. She opts for her cane, everytime. I have asked her, since I seem to be the one more on the forefront in it all, why don't you use your walker. Her answer doesn't even make sense. "Oh I use that, I do. That's how I carry laundry back and forth or whatever my dog needs or whatever." That's not what I'm asking. Fine, use it, and the seat on it, to carry what you need, but don't just use it when you need to carry something, use it ALL THE TIME like you've been advised to do. But she doesn't, won't.


She is going to fall. It's not "if", it's "when". She is going to. She wobbles as she walks with that cane, and sways and goes backwards and catches herself. She has fallen a couple of times, but no serious injuries "yet". It's coming though.


And in case anyone wonders, is she a candidate for a SNF or ALF, she isn't. She has no resources to pay for such. Her home is reverse mortgaged and she has no long-term care insurance. None of us have the resources to pay for such care.


Yes, she can get on a list of Medicaid facilities, one might suppose. And maybe that's what should occur. But see above, heels dug in, she does NOT want to leave her home. She wants to stay in her home "independent", if you want to call it that.


No one, not her son (my husband), not her daughter that lives several states away, will fight that notion. Instead it's just piece mealed together here, as far as her care, and what/when I can do for her. That leaves me resentful, it takes away time I could spend with my own aging parents (live locally also). Fortunately, as of yet, my parents, while they are aging, they both have significant others and aren't in as poor health as my mother-in-law, and so for the most part, they do relatively okay. But mother-in-law, her needs are many.


The most recent of which is the following. We had found some time back, that she wasn't eating adequately. I'm aware that's a problem with the aged. If you ask my opinion, her mobility prohibits her doing so. Though, I do question even that, to some degree. When we found she wasn't eating properly, she was also getting sick, a lot. When she gets sick, it's usually weeks and weeks of diarrhea and stomach upset. Sometimes culminating in dehydration, further weakening an already pretty compromised aged person.


So *meals on wheels* you say? No, in her younger years as a service project through her church, she used to help prepare those meals and she has a real disdain for same. Won't even hear of it. No, she'll do okay, just listen to her, she'll manage, no she's fine. So she continues on, not eating properly. She gets sick, repeatedly this vicious cycle goes on. We found a program that will deliver senior meals and hot fresh meals. But they left town, they were the only ones in town.

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When it got to the point that you are at now...my Mom called a family meeting. Anyone not attending was told they would have no say in the decision.

In advance, my Mom announced that effective the end of the month she would NOT be the caregiver for MIL.

She told everyone...figure it out. But after 10 years, she was quitting.

Suddenly...the family figured out how to arraign for a NH and rotation of family members to be with MIL each week to she moved.

See, once everyone had to be hands on...suddenly it was OK o put pressure on MIL to enter a NH. Until they had to deal with it weekly...they were fine with letting the situation continue the way it was.

This family has gotten far too comfortable with YOU doing the work. Now, let them figure out how it will work from here.
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Thank you for the input. You summarized in a few paragraphs, the sum of what I experience. A lot of anxiety as I see the situation deteriorating, and nothing in the way of her two biological children, pushing back just as hard as she digs in her heels, that things can't be status quo as we move forward.

A great example of recent interaction between myself and my sister in law. Her several states away but very much engaged in her mother's well being, from afar. (She does come here, don't get me wrong, she does come here .. and when she does, .. she does everything but breathe for her mother). When she isn't here, she is on the phone with her mother, typically 3 or 4 x's daily .. and any urgent need(s) are addressed .. either by sister in law contacting me or her brother.

I had encountered an elderly woman at my church and she'd recently had some home health care practitioners assigned to her, subsequent to a recent hospital stay. She asked me, as we talked of mother in law's inability to eat adequately (mobility issues, .. that's my opinion, as her impediment). This elderly woman from my church, is on a walker. She has a husband who is just as aged, but helps her, at home. But she went on to tell me that they had assigned an "occupational therapist" to her. The job .. mostly, as she described it, .. the occupational therapist wanted to help make sure she can navigate her home safely, but also that she can adequately care for herself, be that bathing, or fixing herself something to eat. She asked if we'd checked into having an OT assigned.

We have not. This was all news to me. But from what was described to me, it sounds as though that would be beneficial to mother in law. She struggles with mobility. It's my observation that her stamina (of course, she's 87 yo), is not good. Likely, that is in part, . because it's such a struggle for her to stay upright (using only her cane, won't use her walker for reasons that aren't clear to me). Likely that wears her out, just trying to get one foot in front of the other daily, to let the dog in and out, to go to the bathroom, .. to take a load of laundry to the hamper, .. to go brush her teeth, you name it. For younger folks, . these things are 2nd nature. But when you have to literally give it everything you've got to plant one foot firmly and the next foot, without falling. I would imagine it's exhausting.

It's my opinion that an OT might prove beneficial. I relayed the above dialogue to my sister in law (who is very engaged in her mother's well being). Her response: "You know mom, she's so stubborn, .. she probably wouldn't agree to that". My response to that: "Have we asked?". Her response: "No, .. I hadn't ever considered that as an option, but you know how she is .. you get PT set up and she goes along with it long enough to shut us up, then when no one is present any longer for the PT visits, she sends them packing .. and tells all of us, she just isn't up to it ... and off goes that part of any care team .. I just know her, .. she will fight that, she doesn't want anyone coming there".

This is how the dialogue goes. But I'm expected to be front and center, to help. I get disgusted and frustrated, .. I see this, as you said, .. more upfront than the two bio kids do .. being on the forefront of it all. I don't have this issue, not yet, with either of my parents. But I would hope that when my day comes, I would be more forthright than either her son or daughter seem to be able to muster.

"You want to continue to stay in your own home, it's going to be on these conditions, .. we are going to set up PT .. you will see it through to it's conclusion until you are released from what they deem the appropriate course of care, same for OT .... and same for a home health aide ... and if you won't agree to that, then we will be looking for options where you can be safe".

That's about how I'd like to think it might be stated if this were my parent.

As to the upcoming birth of the twin g'children and my stance that I will be front and center on that issue. I have stated it just as plainly and as many times/ways that I know how. Even going so far as to tell my husband and his sister, .... that they both need to be of the mindset that should mother in law become ill or needy in some way .. the 911 phone number is on speed dial and I will use it. I won't be going there, to attend to her, not when I have a daughter who is recuping from a c-section and bringing home twins and already has a 4 year old that I dearly love, and will need attention also.

IMO, there are two capable adults here that should be taking the bull by the horns .. and their failure to do so, isn't going to make it my problem.

All I can do, going forward here is wring my hands with worry that mother in law will somehow stay well, at least long enough for me to keep a lid on things with my daughter. That .. I find infuriating and frustrating, that I should have to be that concerned. This is not my mother!
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I had to put limits on my mother's outings (I'm her driver). She gets taken to Mass once a week, to any medical/dental appointments and ONE shopping trip/week. She groused a lot about only one shopping trip/week, but has come to accept it. So there's an idea -- she gets ONE shopping or lunch or whatever outing a week. She needs to start learning that there are limits. 

If you take MIL to a lot of doctor appointments, I know it would make it very hard to say that you couldn't stop somewhere on the way home that she wanted to go. My mother doesn't have many medical appointments, but you can believe that she's always angling to get an additional stop at a store on the way home. (And yes, I do allow these add-on trips, but I do tell her what time it is -- she doesn't wear a watch and has NO idea how slow she is and how much of my time she takes up -- the other week it was 1.5 hours to get through the grocery store with not a lot of items!)

I'm not a pet person, and wouldn't do pet care (including vet visits) at all. If there is a mobile vet, that is who should be used. If the dog is old and sick, it might not last long. NO ONE should take her to get another!
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I've been thinking about your dilemma a lot today. I'm no expert, but I do have some thoughts. There are some real straight-talkers on this forum, and I hope they chime in, too.

Your SIL and your H are taking the easy way out and not challenging Queen Mama's dictates. To their credit, they do get involved. But you are left being involved the most, because you are the one right there.

If your MIL allows a housecleaner in, would she allow more help? Suppose the doctor ordered some home health care? Would she let them in?

I'm concerned that as your mil becomes more frail, that she will need more help. That will involve heavy physical labor on your part. Will you want to lift her from wheelchair to toilet? Lift her into and out of a bath or shower? Change her Depends?

DO NOT back down on your plan to not provide any help while you are helping your daughter after she has her twins.

Sooner or later, you MIL is going to have a fall that will render her incapable of living alone. And that is the point where your H and SIL have to insist on facility placement.

If they don't, YOU will end up being the one who provides the daytime help because you will be perceived to be the one who has the time. And that you DO NOT WANT.
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She does do her own laundry. Stays in PJ's most days. Too much effort to get dressed, unless she has somewhere to go, a doctor appointment perhaps.

She does get diarrhea .. and when she does and there are accidents, she has .. at times thrown the clothes away .. saying they are too soiled to even be able to do anything with. PJ's mostly, underpants. She does have adult diapers that she deploys at times when there are flare ups.

If there are messes .. and there are, .. she generally cleans it up. But, .. when one of us is next there, it's almost always apparent she missed some places, and so we will clean it up, either my husband or myself.

Or if it's a particularly bad bout, my husband has been called upon to come and clean it up, and he's done so, many occasions.

I have an extremely weak stomach for such things. I can't even deal with pet excrement without gagging and creating my own mess by throwing up.
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Ok wow- you did need to vent- lol. Many times it's the stress of being sucked into the vortex of their craziness that is overwhelming. I've been having panick attacks . They call and yell and bark orders. Threatened to take NH to court. They have the NH social worker so scared she agreed to take them to see their house to make sure we haven't stolen anything. My 84 year old FIL can use his text on his phone and he sends messages with !!!!!. He just bought mil her own phone online and it was delivered to NH. Now you have her with mid stage dementia able to call. She doesn't know how to turn off the phone so when it goes to message we get an earful of their interaction . He yells at her and says what did you tell them that for? They don't need to know ..... He is a big fat bully. He is a liar and a manipulator and has lived for years on credit cards and never intended to pay them back. Lived two years without paying a mortgage and got away with that. No one even foreclosed. She's been hoarding junk mail and now we've been stuck driving 180 miles on the weekends to go through her mess. Plus my kitchen is half demolished as we were going to redo it ourselves- already been waiting 5 years . Do I complain? No. I just have anxiety attacks. So I hear yeah. Not to mention my own mother is stubborn as heck too.
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Does she do her own laundry?

When she has diarrhea, does that result in messy clothes? Messy bathroom? Who handles those cleanups?
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She's also an avid reader. But with her arthritic hands, holding a book became a problem (she does have a Kindle, but doesn't like it). We got her a stand, .. looks kinda like a miniature bookbag . has a cushy smushy bottom to it, . and you can stand the book up on it, thus free your hands. That helped.

But there are also trips to the library in the above, .. that's on me. To get her there.
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Mother in law has a housekeeper that comes 1 x, every-other-week, funded by daughter that lives several states away. The housekeeper changes her bed sheets, blows off the deck outside (leaf debris and sticks that gather from shade trees that overhang). She vacuums, mops the floors, dusts, cleans the bathrooms.

Mother in law does shower on her own, though she doesn't do so but every few days. She doesn't go anywhere or do anything much, but stay at home.

If she needs groceries, I go get what she needs, she tells me what she needs, and I go get it, and bring it to her home, and put the items away for her. If she needs anything from a specialty store, ..i.e...makeup from a department store .. that's me, I go get it. If she needs something from a department store, say Bed Bath & Beyond or the like, we will generally go by there, on one of the outings when I have her for a doctor appointment. If she needs something from a hardware store, that's generally my husband that handles that.

As for daily living, .. she manages, though it is an all day affair most times, simply because she struggles now to write a check .. can't remember how to write at times .... has to struggle if, for instance, she is to write an "S" letter, has to stop and think about it .. and then make a concerted effort, arthritic hands, brain slowing, etc. It takes her a long long long time, to sit and pay any bills she has. She has very few. When she needs assistance, as she sometimes does, if there is an amount in question as to a bill, cable TV for instance, . she will usually consult with her daughter, and her daughter will try to handle things via phone call, for her. Too hard for her to navigate the prompts and so forth with phone systems and calling anywhere these days to dispute like a phone bill, or whatever. This is at her insistence, wanting to remain independent. Her daughter has offered, and they offers stands, to this day .. to take over her bill paying. She won't hear of it, wants to remain independent and do all she can, on her own. It's a struggle for her her.

There was a recent issue/question with regard to her pet insurance ... and that, I took over and got to the bottom of it for her.

When there are doctor appointments (and there are many), that's me .. I go get her and take her to said appointments and usually do most of the talking as I'm knowledgeable as to what meds she's on, what her health history is. If there are rx's .. I go get them.

If there are any problems that crop up, .. most recently, a piece of fencing in the b'yard that blew over in a windstorm .. my husband handles that, .. as fast as he can, which usually isn't fast enough to suit someone who has nothing to do with their time, but look at the broken fence in the b'yard .. vs the person who is to fix it, works for a living.

She fixes herself some breakfast each morning. Usually that's a bowl of cereal (she prefers that), and maybe a banana cut up in it, or some strawberries. For lunch, .. she may eat a half a sandwich that she prepares herself, .. or whatever leftovers I've brought her way. And for dinner, .. as said previously, if you ask her what she had for dinner (maybe we should quit asking), she says she just ate a cracker and a handful of grapes. Usually by that time of day, her motor has conked out, .. any motor she had. She does nap daily, after lunch. But her stamina is nil.

That about sums up her daily living. Her outings include, whatever we can do, as to taking her out to lunch/dinner, which we try to do occasionally. That's it. She doesn't belong to any social networks of any sort, such as a senior center, or a church group or neighborhood organization. Her outings are, whatever we can do for her, my husband and myself, .. and doctor appointments.
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Dorker, it is the grown children who are so physically and emotionally exhausted whenever one's parent(s) insist on living "independent" in their own home. What is wrong with this picture???

Oh how I wished I had taken more control when my 90+ parents insisted on staying in their house, on their own.

Make a list of everything that you do for Mom-in-law, now cross off half the items, now cross off a couple more.... stick to the list. Learn to say to Mom-in-law, "I am sorry, I can't possibly do that". I know it won't be easy, but enough is enough.

Too many times we are enabling our elders to remain in their own home when we know it is too much work for them. It would be different if they said "yes" to cleaning crews and caregivers... nope, nadda, never.

Then we sit back and wait for something to happen. I was on pins and needles the 7 years my folks were living in their house.
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