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I need some advice from you awesome people! A little history on our family. My husband and I have been married 25 years and have four kids (two in college, two in high school). Last spring my husband was transferred out of state and we are currently living across the country from each other while our two youngest (twins) finish their senior year of high school. We have one in college in NY and one in college in TX where I am with the two high schoolers. My husband is in Michigan. Last spring his mom was at the point where she could no longer live alone in Florida. My husband flew to FL and packed her stuff and arranged for the sale of her house. He flew her to Pennsylvania and rented a uhaul to drive her stuff there. My husband's sister is in PA and that is where my mother in law's sisters and entire family is. At this point my husband was living with my aunt in MI and I am in an apartment in TX - we didn't have an option to take her in and really felt it would be best for her to be near her sisters and other family. My husband travels a lot for his job and to see us and our son in NY. He is currently in PA for his second visit since moving her there in the spring. My mother in law has MS and probably bipolar/manic depression. She is not easy to deal with at all. I can spend 5 hours with her on the phone, easily! The problem we are having is my sister in law is terrible to my husband. I understand her frustration but she calls my husband names and yells at him for "sticking her" with the situation. My sister in law is a professional and works a lot of hours, her husband is a nurse. They have a son in the service and a daughter in college. I know that she's probably just angry at the situation and taking it out on my husband. She yells at him for not helping but can't think of anything for him to do to help. They moved my mother in law into an apartment and want to sign her up for a service to take her to the doctor, grocery store, etc. which I think is fine. It would be nice if they could just visit and not have to take her places. I've told my husband when I move to MI next summer we could have her live with us but until then I don't see any other option than keeping her in PA. My grandmother lived with us for two years and I also cared for my mom for five years. I understand the toll it takes on you. And my siblings all lived out of state. My question is - am I missing something? Is there something more we could be doing to help out the situation?

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It seems that since MIL is in an apartment, there would be less for your SIL to do than if she was living with SIL and her husband. But there is the transportation, grocery shopping, laundry, cleaning, etc.

What concerns me is that MIL has MS, which is degenerative. Is she really able to live alone and care for herself?

What I think might go towards easing the harsh feelings your SIL has is to help pay for some apartment home care and/or assistance for MIL in her apartment. Depending on the stage of her MS, she may not be able to cook, clean, or keep things up. Someone to do that would relieve SIL of the obligation.

Her doctor could also script for nursing home care, to monitor her MS and BP issues.

Perhaps your husband can give you a list of what SIL does, and you can determine if there's a way you can help by funding some of those activities, including transportation to medical appointments, or by finding providers who can help.

Alleviating the physical burden through paid caregivers and assisting with the funding are I think the most practical ways of helping.

But I wouldn't rule out the benefit of cards and flowers. Your SIL probably really feels dumped with all the tasks and is overwhelmed. Maybe you could even make some suggestions such as these and those made by the other posters and ask SIL if she'd accept them.
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It can be overwhelming to have an elderly parent with many needs dropped into your life as in your SiL's case. It certainly was for me when my dad landed with me in Texas when his house was damaged in Hurricane Sandy in NY. Except for handling the sale of our dad's house, my brother has never come to visit or help out in almost 3 years. My family includes taking care of a 25 year old with autism. My brother did not even come to help with my dad when my son with autism was in the hospital. I have never lashed out at my brother. I would be very insulted if he sent me a gift card, but I would appreciate a thank you card. Your SIL is in crisis and needs help coping with all the responsibilities that have been put on her shoulders. I have been there and I had to have a big blow up with my dad and husband before I could see my way to how I was going to cope with everything. So one of the moves we made is moving my dad to assisted living. My brother had no objection to that and in fact goes along with everything I suggest for my dad's care. That is his way of supporting me and my family. Your family needs a better plan than the current one for your MIL. Your SIL is entitled to her feelings and she needs to know that you are understanding of that and willing to help her come up with a better solution for your MIL.
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The gift cards and some cheery notes both for your MIL and husband's family would be a great help; they don't even need to be big amounts, just for them to know you care. Even Thank you cards can go a long way in smoothing things over. It's your sister in laws choice as to whether or not she wants to work towards fixing her relationship with your husband, but you can rest assured that you are doing what you can to help and there is no reason to feel guilty that you live far away and have quite a hectic life of your own to deal with.

I would think your MIL would do well in assisted or independent living and it sounds like she can afford it. Do you have the time to look around for possible placements and get some information to the family? Day care might be another option to keep her busy and involved. Peace and good wishes!
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Thank you for your answers! My MIL is financially stable. My husband encouraged his sister to evaluate mom's needs before making a decision but they were in a hurry to get her out of their house so they found an apartment and moved her in. My husband's schedule is crazy. He's on the road for weeks at a time for work. I'd like to send gift cards for dinner or flowers but honestly the sister is so hostile toward my husband I'm worried their relationship may be over.
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Your family, or more accurately, your husbands family needs to decide who is going to be responsible, or get stuck with, Mom. It sounds like she needs to be in a facilty that offers skilled nursing care. This may be beyond assited living where family has to deal with all sorts of logistic and care issues.

Your hubby needs to wrangle this out with his family. Given that your family is all over the country the logistics of mil care will not be easy. I'm dealing with my parents from 600 miles away. It can be done, but I make regular trips. You can only do so much over the phone.
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Well, I have a few ideas that you may consider.

If SIL and her husband are having to dip into their own funds to pay for things for your MIL it would be good to help out financially.

Is there any way either of you could visit more often to give SIL a little time off?

I'm thinking if she couldn't be alone in FL then she really can't be alone back home in PA either, would an independent living community or assistive living be more appropriate?

Who has financial POA? If he is able your husband could take over the task of managing her money and paying bills, most of that can be set up with automatic payments and on line banking, so he needn't be present.
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