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elliemay Asked March 2019

How do I deal with sister-in-laws in denial?

My 4 Sister In-laws are moving my MIL to a new facility where they are convinced that her Dementia will be “cured” if she is with residents that are more “with it” ( I hate that term). I have tried to explain that it is a progressive disease and cannot be cured. They ignore my recommendations, although I took care of my mom for 2.5 years when she developed Alzheimer’s. At this point MIL cannot dress herself, or take care of any personal hygiene. She can sit next to a ringing phone and not know to pick it up; can’t use a tv remote. Her physical health is deteriorating. She cannot get up from a chair independently nor does she have strength to use a walker. She has AFIB, UTI issues and is a fall risk. I agree that her current AL facility is no longer able to care for her. I believe she needs a skilled nursing facility. However, my sisters in law are moving her to a small AL facilty because they blame all her ills on the current AL place. New place is staffed by CNA/LPN and a part time RN. If she had a medical emergency, they would need to call 911 as they can’t treat her. The Doctor on call would not be able to get to her fast enough and is not on staff, only for routine health checks. She is 92. I apologize for this rant, but I am so frustrated and upset . My husband tells me to let them be, and just step back. I do want to add one more thing, I visit her often and have a wonderful relationship with my MIL. The sisters do not not visit often, although they are nearby. Seems that my Golden Retriever is the only one I can talk to...

CTTN55 Mar 2019
elliemay, I didn't realize that your H doesn't agree with his four sisters. Regardless, he is probably right and letting them do their thing. How does MIL's health care proxy read? Does one child have it? All?

My three brothers and I all have my mother's health care POA; we can act individually or together. I know my mother wanted us all to act as a committee, with the majority vote deciding the course of action (this was a previous health care POA).

My mother's NH is wanting to put her on comfort care. I tended to agree (I'm the only one who is local). One of my brothers seemed to be heading that way, too. But the two brothers who are least involved did not want that (yet), and when there was a decision to be made on whether or not to hospitalize her a week later, we were split 2 - 2. The default WAS to send her to the hospital, since comfort care wasn't agreed upon. So to the ER she went. (Turns out she came back to the NH that evening.)
elliemay Mar 2019
one sister in law has total POA for health. She is a RN (who thinks she’s a physician). She has quarreled with doctors over medication and treatment, since she thinks MIL’ s conditions are caused by present facility. She has had her taken off all meds that were prescribed for agitation and violent behaviors. (Serequel). My H has POA for all things financial. He pays all bills, orders all necessary supplies and reimbursed his sisters immediately for any out of pocket expenses. Also of note , MIL does not have a primary care doctor. She does have a cardiologist and urologist but does not see them on a regular basis. When my mom was ill, I had a geriatric doc for her, who we saw monthly. When I suggested such a doc for MIL, I was told that she would take care of it. Well, it’s been three years and still no PC Doc...
elliemay Mar 2019
thank you all so much for listening..

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JoAnn29 Mar 2019
I stepped back from my MILs care. She had 3 intelligent sons. One a Dr. of Immunology. I allowed my DH to do for her. (She and I didn't have a close relationship)

Like said, let them find out. Her "rent" will be determined by how much care she needs. Also, the move may cause problems. People who suffer from Dementia don't do well with change.

Visit, be a constant for her. Help SILs when you can. There will be care meetings and Moms progress will be brought up.

97yroldmom Mar 2019
Your SILs are not where you are in experience.
This is their mom and perhaps they are in denial about the disease and the requirements to manage it. The disease will progress regardless of where she lives.
Your best bet is to visit MIL and enjoy your special bond.
We don’t all get to the same point at the same time. Sometimes I think the denial is in part from fear that what our parents fate is will become our own.
In the larger scheme it won’t matter too much as long as her basics are met.
She is blessed to have a large number of women who care for her. Your role in this may be to demonstrate calm and peace and love. You are freed up to be the DIL and not the caretaker. That’s a blessing to MIL right there. Don’t waste your energy trying to convince them.
If you haven’t already, pick up the book “ Being Mortal: Medicine and What Matters in the End” by Atul Gawande. It might help.

CTTN55 Mar 2019
Why do you care more than your H and 4 SILs? It's their mother; their issue.
elliemay Mar 2019
It’s not that my husband does not care. He has four younger sisters and they have taken to over rule everything he says. There are five siblings and they can’t sit down together and civilly talk about her health issues. I would have given anything to have had someone to cry to and support me.( I lost my only sister and Dad around the time the changes in my mom were happening.) My husband and I are against the move for all of the reasons this forum group have given.
Sunnygirl1 Mar 2019
They'll see for themselves how things like that work. With all those health issues, dementia and age 92! What are they thinking? Odd. Do you know what's wrong with their thinking?

Actually, a place where the other residents are more "with it" as you said, may not be for the best. My LO was like that in a regular AL. It wasn't good. She did much better when she transferred to a Secure Memory Care facility. They had much more assistance, supervision and knowledge on how to manage the care of someone with dementia.

Didn't the facility require an assessment to see if they could meet MIL's needs? If they can't, they'll let the sisters know and they'll have to relocate her. It's a shame they won't listen. Too bad that someone who is more informed is not in charge of her healthcare decisions. I wonder what her doctor thinks of it.
elliemay Mar 2019
The facility did come to assess her. MIL became agitated and angry when she was asked questions. My SIL started answering all the questions. My husband told her to be quiet and let Mom speak. Basically, it seemed to me that all they were doing was justifying “selling a room”. It’s a business and empty rooms means less cash. Thankfully my husband asked for a copy of the assessment form they using. When told they did not need the form, my husband whipped out a copy and asked they to complete it.
( there was a copy of the form on their website along with all the paperwork). When the meeting was over, he asked to discuss the assessment. He was told he would be contacted. Still waiting... meanwhile, a care plan meeting was held at her current facility and he was not told about it.
worriedinCali Mar 2019
I agree with your husband, just step back. Even at a nursing home, there isn’t, in my experience, a doctor on site 24/7 and they call 911 if there is a medical emergency. That’s just my experience though. You’ve voiced your concerns and I understand your predicament. I’ve been the daughter-in-law who sees exactly what is going on while everyone else is in denial. It’s not a good feeling at all when you care about your MIL. But unfortunately as a DIL, you have to step back, you can’t undermine her daughters unless you want to seek guardianship over her. Your husband doesn’t seem to want to get involved so just step back. I’m so sorry, I know exactly how this feels.

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