Knowing when to push for change and when to leave well enough alone.
My mother in law and her husband live in an independent living apartment, and have for a little over a year now. The purpose of them moving there was to make life easier and more enjoyable, and to have them closer to us.
However since they've moved in, they do nothing but watch television (sleep), and occasionally go out to eat and grocery shop (even though the cabinets and fridge are full to the brim). My mother in law has really declined. Her legs are like rubber and she's supposed to use a walker, but she's vain and we have to stay on her constantly about it. She also has no interests. Her retirement community offers activities of all sorts and she won't take advantage of any of them. She says it's because the father in law doesn't want her to do anything without him, so she just doesn't even try. In his 80's he's still controlling, jealous, and overpowering. He's pretty sure one of the old men downstairs is after her. She's always allowed him to dictate her every move and she still does. At least, she blames her lack of activity on him. Not sure if that's all true or if she just uses him as an excuse sometimes. We're constantly trying to encourage her to do things like Chair Yoga or Bingo to socialize her more and give her a little exercise, but no matter what we say she won't do it. She gives us the impression she "might" think about it, but never acts. The latest is doing laundry. She bags up her dirty laundry in trash bags and puts them in the closet. For 2 weeks we've been asking her if she's gone downstairs and done her laundry yet, and every time she says no. She makes excuses for everything, and they're never good, rational excuses. She's either so busy going to the doctor or she's just tired. It's like she just doesn't care about anything anymore. It's more difficult for her to get around, but she is capable of doing some things at her own pace and with the assistance of her walker. We suggest to her that she create a routine for herself where she does laundry on Tuesdays, chair yoga on Wed, grocery store on Thursday and so forth. She could care less about structure in her life. She won't even open her mail daily. She just puts it in stacks and then we have to clean it all out and make sure she's paying her bills. She doesn't like to throw away junk mail or anything for that matter.
We just don't know what to do. Every time we talk to her or visit her it feels like we're just lecturing her the entire time. If she has clean clothes to wear, should we care that there are two trash bags of dirties in the closet? If she moves at a snails pace because she refuses exercise or do physical therapy do we just let her make that decision for herself as we watch her decline? Does it do us any good to tell her she has to stand up to her husband and do what's right for her if she's never done that in her life?
Just feeling a little frustrated and have lots of questions about how we're handling things. I'm sure part of her problem is that she's depressed. She is on an anti depressant (20 mg Lexapro). Don't know if its working or not, or if it will help as long as she's stuck in the apartment with "him" all the time.
Would love some advice.
They are still in their home but things are deteriorating. Your mil sounds a lot like my mom. I've been lecturing her for 30 years to do something, ANYTHING, healthy. I've gradually taken over the finances, bill paying etc., mom resents this a little but she just can't summon up the energy to do much of anything. I've pretty much given up on lecturing about eating, meds, exercise or anything else.
After a recent week at home due to a crisis I've hired an in home care company. I had to do it under the guise of "Just in case you ever need help". The caregivers are just visiting a little for now, getting to know the folks and gain trust and maybe start helping with household stuff and driving if all goes well. I'm not terribly optimistic but it's their last chance to stay in their home. With dads dementia he has to be tricked into any help, carpet cleaning etc. I'm very good at elaborate fibbing to get stuff done, but mom "Just can't bring myself to lie to him". OK fine. Have a filthy carpet.
Moms mind is good and She knows full well that the next diabetic coma, broken bone and she will probably never come home. She can accept some help or refuse it and what happens, happens. I no longer agonize over every minute of the day, are they eating? Bathing? Meds? Mom is quite capable of doing all the basic stuff without much effort but she usual prefers just being pitiful.
It sounds to me like you guys are doing all that can be done. It will probably take a crisis to make any major changes. This may sound hard assed but I think at some point we enable our elders lax behavior by falling into the pity party/guilt suck hole and providing a sort of an executive class consierge service. As caregivers we need to watch over and provide but at some point we have to take a step back and look,at the larger, reality picture.
I think the answer is no. From your description of the situation, and knowing how dominating some men can be over their wives, trying to get her to stand up to him is only placing her in a more uncomfortable position. The dynamics between the two of them are that he's dominant, she's submissive. Those were likely factors when they married as they each sought out partners who subconsciously satisfied those needs, which probably goes way, way back to their childhoods.
I'm not one for pop psychology, so I hope this doesn't seem as though it is. I think it's more that these are learned behaviors and responses, and aren't going to be changed at this stage of their lives.
As to the dirty laundry in the closet, I would just take it and offer to do it so it gets done. For whatever reason, your mother may be having trouble doing it, especially with weak legs and having to stand just to put the clothes in, pull them out, and hang them to dry or use a dryer. Perhaps she isn't analyzing that this is the issue; perhaps she's overwhelmed by aging issues, but something about doing the laundry is causing her to just put it out of her mind.
Windy is so right that we can enable older folks by our own behavior, albeit sympathetic, loving, caring, and hopeful. It is hard to be forthright, but if you asses the situation as you have and see that changes aren't going to happen, it's more of a realistic adjustment on your part.
I would back off on the activities issues and just focus on making sure they're getting enough food, seeing their doctors, monitoring their health and intervening if something dire appears about to occur (such as a serious medical issue) or has occurred.
Years ago one of my bosses and I were discussing the need for change in the workplace and he gave me some wise advice. He said he chose his battles carefully, focusing on only those he could win. This wasn't an arrogant statement; it was a concession to reality.
That's what many of us face when caring for older people. If the facts suggest something like going to activities or standing up to one's domineering husband isn't going to happen, it's a battle you can't win, and can only make your mother feel more dominated. So let that one fall by the wayside.
These are times that require so many adjustments on our part as we see our parents slipping into habit and inaction that we feel aren't advisable or helpful. The question then can become whether to try to encourage or push the desirable behaviors, or accept that our parents are dealing with a reality we really won't understand until we're in their situation. If we accept that reality and work with it, it's less frustrating for us, and easier for our parents.
"He said he chose his battles carefully, focusing on only those he could win."
I've been struggling with this since my mom moved in with me 2 years ago. I've never reached complete comfort with it, but my experience has taught me that basically I have to take care of myself first, put my own oxygen mask on first in order to be able to help those who can't help themselves.
It seems like the boundaries I set to not drive myself crazy are also good boundaries for not enabling her helplessness....
I try different things, and then keep going with what works -- advocating with her doctor works well for me and gets her better care; advocating with the rehab where she is now recovering from a broken hip; I told them she was very depressed and they sent a therapist to see her, which she apparently likes (though I'm sure she would NEVER agree to it if she knew I wanted it!); giving her hugs works well, too, and when I'm taking care of myself and not driving myself nuts I can hug her with sincere love!
The employees of the rehab suffer from the exact same dilemmas! I figured they'd be experts at it, but, no, they call me to see if I can nag her harder because their hard nagging isn't working anymore!!! That cracked me up.
The more I nag, the harder she pushes back! I just gotta give it up....
When they first moved in I studied the monthly activity calendar and showed them all the fun activities they could possibly do.. even went to a few of them with them. Well... they never went to any activities unless I was with them of course.
Before they moved in I had visions of them having a great time, making friends, using the conveniences like the cafeteria ... which of course would make my life easier. None of that materialized.. instead they have become very dependent on me and insist on me coming over twice a day (after I work my full time job).. They are still very dependent on me for any socialization or entertainment.
They even have a caregiver now.. and they STILL want me to come over while the caregiver is there. I am at least trying to back away and not go during lunch since the caregiver is there till lunch so I am not needed really then. .. but even that is a battle.
It is frustrating.. yea.. pick your battles... the more I want them to do something.. the less they want to do it. I no longer even look at the activity calendar now...or the van schedule., or the cafeteria menu.
It's true that she might be depressed, but it could also mean she has something else going on. That's how my cousin behaved when she first got dementia. I could barely believe how she had laundry piled up in the closets. It was because she couldn't figure out how to operate the washer/dryer, but she was embarrassed to tell me. The reason she wasn't paying the bills is that she had lost the ability to figure it out and write a check. She had refused to go out shopping or to family events too, claiming she was sick, but she was scared and panicky due to her forgetting what was going on.
I would just look real close at what is really going on and if it's that she chooses to let things go, then that's her choice. I would back off and let her live her life as she pleases. But, if she is not able to do things, that's different and she may need someone to step in and help her with her daily needs. A lot of the time, they are embarrassed to ask for help.
I just spent a week at home and know full well there are a 101 things they could be helping with but I can't force it. At least I have a good company on deck when the next crisis occurs.
Often, it's a crisis that will bring things to a head and force the issue. Of course, if it's bad enough, there are legal remedies, so as getting guardianship. Then you are legally allowed to decide what care they get. You might consult with an Elder Law Attorney to get details and see what you would have to prove, if you took that route.