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Mom will be 90 next month. Has been living with us for three years since we moved...she didn't want to stay in her place in another state. Before moving in with us, she was always having issues with GI issues (being polite)...found out she was using outdated food items, eating things that should have been tossed, etc. Wonder why she was sick, right? Since moving in with us, those issues have resolved because we make sure everything is fresh and nothing is left out where it could spoil. She has had some respiratory issues and now has issues with arthritis in her back. She has become extremely nasty, argumentative, critical & verbally abusive to my husband (who is less than one-year out of a cancer diagnosis and surgery, along with vision issues). She has difficulty with her memory, finding her words, balance and so on, but refuses to comply with doctors suggestions (physical therapy, memory care evaluations, walking, etc.). She is never satisfied with anything (food, hearing-aids...pick one). Has implied we never give her enough to eat, yet will not avail herself to the food we have on hand (she says it's not hers despite from day one being told whatever is in the house is hers)...acting like she is stealing something if she takes it from the freezer. Will buy her things to eat that she asks for or we know she likes, but then she doesn't touch it. We have thrown out more food than we want to think about...then she gets mad because we threw it out. It's getting harder and harder for my husband and me to deal with her. She literally thinks she should be waited on...as in, we should serve her. She hides in her "den" and only comes out when we tell her the meal is ready. As soon as she is done "shoveling" her food down her throat, she jumps up from the table and heads back to her space, regardless of how many times we have asked her to stay at the table to chat or join us to watch TV (especially when she's watching the same thing we are). She just fell last night and, despite the fact we thought she should go to the hospital, she started crying and carrying on that she didn't want to go to the hospital (not the first time she has done this). We are more than concerned about her being rational and understanding that there are certain things we cannot do for her or treat her for. We're actually afraid something is going to happen to her and someone is going to accuse us of elder abuse or negligence. My brother-in-law hasn't seen my mother-in-law in over three years and hasn't called in I have no idea how long. No help there. We can't do anything or go anywhere (except out to dinner on Saturday evenings...a fact that she gets all twisted about telling us she isn't wanted). We don't know what to do or where to turn. We're not trying to kick her off a cliff or anything, but we've sadly begun to wonder how long she's going to hang around. Any ideas, suggestions? Anything would be appreciated. Sorry this is so long.

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Your MIL is just coming up to 90. My MIL lived to 99 years and 9 months. Think about a 10 year future, not just about what is happening now.
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Ah yes, the ravages of undiagnosed dementia, sounds like to me. Next time MIL falls, call 911 immediately. You are not a doctor, nor are you qualified to say whether she's hurt or not. She does NOT have to be bleeding profusely in order for you to call 911; trust me on that. The EMTs will arrive at your home and you will insist that she be taken to the ER for evaluation b/c this is not the first time the poor dear has lost her balance and fallen. She can be crying hysterically, all the better........you can take the EMT aside and let him or her know that you strongly feel poor MIL has dementia & needs a psych evaluation at the hospital right away, along with some x-rays/scans b/c you're certain she HIT HER HEAD in this fall. Then, off she goes to the ER where you will tell the doctor in charge the same thing you told the EMTs. This is what I did in 2016 with my mother who I KNEW was suffering from dementia but she was showtiming up a storm and refused to address the matter. She had her 2 millionth episode of vertigo and I called an ambulance, had her taken to the ER where I literally BEGGED the doctor to admit her for a cognitive evaluation and a medical workup for Parkinson's and other diseases b/c of her chronic vertigo. He agreed (he knew a desperate woman when he saw one!) and BOOM, she was diagnosed the next day with progressive dementia (amongst other things).

That's your best bet. Once MIL gets a real diagnosis, you go from there. I can tell you this; if she's dx'ed with dementia, it tends to become impossible to care for her at home (as you are starting to see) because they become belligerent, paranoid, and other ugly traits develop to the point where you cannot deal with them! My mother (soon to be 95) has fallen EIGHTY TIMES now!!! She lives in Memory Care Assisted Living (thank God) otherwise I'd be dead by now just from dealing with her histrionics and trying to pick her up after all those falls!

Talk to DH and both of you get on the same page about what to do. Get her diagnosed, then get her into a nice Memory Care ALF locally where you can go visit her and leave the hands on caregiving to the teams of young people who work 24/7 to accomplish the task. If she has no funds to private pay, then apply for Medicaid so she can be placed in a Skilled Nursing Facility nearby where you can visit at your convenience.

Wishing you the best of luck formulating a plan moving forward.
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DaughterInLaw78 Oct 2021
Hi Lealonnie-Thank you for sharing your experience and you sound advice. I truly appreciate you taking the time to respond to my quest for help. My husband and I have already determine the next time she has a fall, or goes off the rails like a lunatic, we are calling 911/EMS/EMT and will insist she be taken to the hospital. I have also reached out to her physician and will schedule a visit with her to discuss the matter to get some help on that front as well. We obviously need to do something, much like you did. It really helps to hear from people who have been where we are (and maybe are still there). Makes the suggestions and advice more meaningful and makes more sense. Thanks again! DIL78
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Mom needs to be seen by a geriatric psychiatrist. She is sufferiing fron unsustainable levels of agitation, depression, suspicion bordering on paranoia and difficulty regulating her mood.
Meds might help

Hpw much help do you have coming in?
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DaughterInLaw78 Oct 2021
Hi BarbBrooklyn: I am absolutely certain she needs to be evaluated. My husband and I have this conversation constantly. There have been various efforts made, with the support of her GP, to have her evaluated. She refuses to see anyone other than her GP. She flat out told the doctor she didn't need any of those things, gets angry with the doctor when she asks questions (then complains to us the doctor is too nosy)...AGH!

As for help coming in? None. His brother won't even drag his behind down here for a visit, never mind help. She also doesn't like when she's needed to have nursing visits after her stints in the hospital and rehab. She has literally told them they ask too many questions and has told them to leave. Besides this forum, which I can see will be helpful in a number of ways for me, we really can't make her do anything unless we have her declared incompetent. However, she is mentally competent enough where she wouldn't be declared otherwise...although I can see that changing in the not too distant future.

I think your suggestion of doing what we have to do the next time she falls and/or hurts herself (i.e. calling EMT, etc.) is a great strategy and something I will do.

Thank you for your support, sharing your experience and your sage advice.
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Sounds like a very challenging situation.

If she fell and didn't get hurt, I see no reason that she needed to go to the hospital. If she was bleeding a lot or hurt, of course, you would take her even if she cries her eyes out. We used to have to counsel my MIL to NOT call 911 JUST because she fell. OK, you fell. Are you OK? Did you hit your head? No? OK, just relax and give it a minute to assess the situation. Cut down so much on her ER visits. Now she's 95 and in a nursing home because she chose it instead of staying in her own apartment.

I would not buy her any special food anymore. Yes, there should be some food she likes to eat but I would think she would be happy enough with some of the foods you regularly buy and serve.

I think I read that she has dementia - if so, that explains most of her behavior.

It is REALLY hard when they will not comply with doctor's suggestions for how to improve their situation. If she has dementia, could your husband try to gently just tell her that she is going to this appointment, etc. instead of asking her? She really probably does not know what is best for herself anymore. PT can come to the house if taking her out is an issue.

To get her memory evaluated (or anything else that could/should) be done - some use a theraputic lie to get the LO to cooperate. Something like the doctor said you need to go to this appointment. Don't have to go into a lot of detail. Or that it's required by Medicare.

Are her affairs in order? Does hubby have POA for when she is not capable? Does she have a will, living will, etc.?

These things are really hard to deal with. I know, as do many others here, from first hand experience.

Get yourself some help so you have more time to do things by yourself and/or with your hubby. If she won't allow help, hire someone to be there to cook and clean for a few hours and maybe spend some time chatting with her.

Good luck.
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DaughterInLaw78 Oct 2021
Hi! Thanks for your input. Yes she did hurt herself (she does every time she falls). Her left arm looks like someone took a baseball bat to it; that's how hard she hit whatever it was she hit. Her shoulder was banged up and she is having pain whenever she moves her arm. It really should have been x-rayed to ensure she didn't fracture something or chip a bone in her elbow, but she was totally freaking out at the thought of going to the hospital. My husband wanted to call her doctor the next morning and get her in for an exam (in the hopes the doctor would send her for an x-ray), but again, she went ballistic and refused.

We've only had her to the ER twice since we moved to where we are now, which turned out to be the right move because she had pneumonia both times requiring extended hospital stays and one stint in rehab. Once we got her to the hospital both times, and the doctors/nurses got a good read on what was going on, they took over and did what needed to be done. When she was a little more aware, she was angry and wanted to leave, but she needed to be on IV antibiotics, have nebulizer treatments and meds to bring down her fever; the hospitalist was having none of her nonsense and the social worker they brought in told her that she needed to allow the doctors/nurses to help her and, if she decided check herself out and leave, they couldn't be held responsible. She didn't like that either.

Her doctor has made several attempts to speak to her, under the guise of having to ask different things because it was required for Medicare, but she told the doctor she didn't like being asked questions and wasn't going to answer them. She told the doctor she was just being nosy. The doctor also mentioned a memory eval as being required, due to her advanced age, but again, she shut her down and told the doctor she wasn't doing it. I have to add, as an aside, when she had fallen several times in her previous home, EMS came b/c her life alert called them and took her to the hospital. After her stays, social services sent in home nursing people and physical therapists...and MIL threw them out. Said they were nosy, asked too many questions and she didn't need their help.

We do have all the appropriate paperwork. Hubby has POA, is her health-care guardian, she has a DNR and living will. However, unless she is determined to be unable to make decisions on her own, we can't force her to do anything. Kind of hard to get a true determination when she refuses to allow the doctor to do or get the appropriate evaluations. If she even thinks there may be an insinuation she is not capable, she starts in on another whole tirade about how we're trying to get rid of her, she isn't wanted, we should have just left her where she was when we moved (it was her request to come with us because she didn't want to live there alone and was afraid to because she kept falling) and so on.

Thanks again for reaching out. I'm very glad to know that there are people, like yourself, willing to try to help another out with their situation. I'm grateful for your support and your suggestions.
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She needs to be places in a facility. She will receive care and proper nutrition. If she doesn’t have funds, get qualified for Medicaid. Your husband does not need her nasty attitude after a cancer diagnosis.
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