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This is in regards to aging and declining inlaws and a husband who is scared and was in firm denial until a year ago. FIL has what may be dementia. MIL was in denial and hiding it (even normalizing weird and unhealthy behavior) until very recently.


I was raised in a family that had no healthy respect for boundaries. For my child's, spouse's, and my own safety, most of my relatives are not in our lives any more because of this. In my family of origin, how it worked was you either let people stomp on you or you bullied others to get things done.


I don't want that relationship with my husband and his parents, but so far I'm the only person who seems to realize what a serious situation they are in and who actually is trying to take action about it. So I'm very nervous about taking this on, but it seems like I don't have a choice...unless I want to turn away and let something horrible happen (BTDT—my grandma died horribly of a stress-induced stroke—never again).


The thing is I worry I will take over this too much. I don't want to take away my husband's and his parents' power to make choices for themselves (quite the opposite), and I want to make sure I take time for self care as well. Right now, they need someone to help them get over the first hurdle of denial and start to bring in outside helpers.


How can I do that without burning out from a self-induced self-reflective anxiety?


What helps you be calm, communicate well, and keep others' feelings in perspective (while still being realistic)?

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FIL had a physical and a number of other tests (including an MRI). They found nothing. I know some forms of dementia are not found on MRIs and other things can cause it (they already checked for UTIs and bloodwork—like B-levels and such).

MIL is very responsible about bills. She's always managed them even before this all went down. Maybe we need to talk with her about a POA or something like that, though? My big concern is the stress will kill her...possibly sooner than later, and that is so unnecessary.

I am not doing this alone, though. Not anymore. DH is completely on the same page now. We've been coming up with plans together this weekend.

Something, though, I can do that he can't. I get more information from his mom. She tells me so much more than she ever tells him. I don't know if it's she because feels safer talking to another woman or whether she wants to shield him since he is her child. Probably a bit of both.

I love them. I will look out for them...but not alone.
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I meant outpatient. Sorry, I am tired.

I feel we have enough information for now to know my ILs are not in a safe situation, and it can quickly escalate to a crisis if we don't get outside help soon.

We do not need to go digging in their house further. We did that a little last year already, and they *still* managed to hide things from us.

MIL has opened up, and we know enough (including details I'm not going to disclose on a forum at this time). That is a big step!

We are going to see if we can get their doctor to pay attention, and we will see if we can get MIL to understand why we need to bring in family members who live close by. Bringing up how this could negatively impact her grandchild seemed to give her pause.

I believe if we can get the doctor to cooperate, the ILs will follow through with testing and following directions (like maybe not driving)—especially FIL. He *loves* doctors.
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Husband has no siblings? My opinion here is it's husband's parents and he needs to step up. See, I hate where our culture primarily feels that the Wife is responsible in all respects. You can help him but as the Son he needs to handle his parents. The first thing you can do is have MIL put you on her bills as a contact if they aren't being paid. Check on them as much as possible. Keep track with what Dad is doing that make u think he is declining. The best thing to do is get him in for a physical. There r other reasons for a person's decline. UTI, dehydration, low potassium, and diabetes. Mom should have one too.
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"She had inpatient work done. ""She came home the same day as the surgery."

Where I live, those two statements are usually mutually exclusive.

Was she admitted to a hospital (inpatient).? Or did she have outpatient surgery?

Something doesn't seem to add up.
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I don't know how you are going to really know what is going on without a personal visit and for more than just a few hours. I'd plan on staying at least 2-3 days so you can see what is going on. Without seeing and knowing things yourself, I don't know how you or husband can get ahead of this.

It's great to get support and have supportive friends, but, I'd make sure MIL and FIL are safe. Sometimes, you have to look past your own comfort level and look out for your senior parents.

A professional assessment is a good idea, because they can determine what level of care your FIL and MIL may need, however, that is only valuable if the person taking the assessment knows the truth about the situation and is informed of their needs, challenges, abilities, etc. That's why someone who knows the truth is helpful when dealing with the doctor and evaluators. If MIL is holding back information, then the doctor and other professionals won't be able to properly recommend care or treatment.
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She had inpatient work done. She came home the same day of the surgery.

She is going to rehab. MIL and FIL are wonderful about following up with doctors over most health matters.

Hubby went up several days last year and this past November. We both have noticed pet smell (they have had pet incontinence issues). It was much better this time around. It was just in one room. It is difficult for us to get right now, because my husband has undergone some big changes at work. We'll find a way around it. It just will happen in a couple weeks versus this weekend.
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I'm still curious about who took care of FIL and the elderly grandparents while MIL was having surgery. And did she have rehab?

When was the last time one of you visited and saw what the situation was, in reality and not just via MIL's repoet, which frankly may be suspect?
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Right now I am very thankful for my friends (a couple of them have been really supportive) and the internet, too. Thank you, All, for the advice. It really helps me coordinate a plan and stick by it.
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My husband is taking this hard. It's finally really sinking in, but the stress internalizes and actually causes issues with his health. He gets respiratory problems and back pain from the stress from this. This is why I've approached it and backed off before.

In emergencies like the he has a tendency to freeze. He wants to believe his family is healthy happy, and normal.

Truthfully? I can't fault him for this? I had a similar issue with my family of origin's abusive nature. When we see horrible things happening to (or by) people we love, it's very easy to want to normalize and disregard—especially if you have seen it your whole life (like me) or it's come on gradually (as it has my FIL). I love him and want to do what I can to help as he has helped me through hell with my family, but I know I need to be mindful of myself in regards to my health and stress.

We both spoke with MIL this weekend to get a better clue about the situation. She has delusions about how we'd be able to care for FIL if she had an accident or worse. She thinks if something happens to her, we can simply call a temp agency and have someone live with FIL. She also doesn't want us to tell other family members who are closer because she doesn't want to "worry" them.

I also confirmed the injury she had was a kind that is very common in a fall (a doctor friend I spoke with pointed this out and warned me). She's telling us it's from lifting, though. Hubby doesn't believe she may be making this up since she cared for his grandfather after his fall. I am not so quick to buy that. Yes, I think it could be possible FIL hurt her—not necessarily on purpose.

They have an appointment with their doctor set up in a couple weeks. Hubby is going to talk with this person. Initially his plan was to tell them of his mother's concerns. I quickly told him, "No. You are going to tell them about *our* concerns and observations." He wants me to put dates on our list of things we noticed so that is what I will be doing tonight.

In the meantime, I may be researching help in their area more to see what resources MIL (or even we) could use. I friended a lot of family that lives near her. I haven't told them.

Hubby agreed to look into visiting a care-taker support group. I am considering helping him find a therapist. I'm seeing one myself. It was going so well I was going to stop, but this came up and she's been wonderful for advice. It may be a good idea to find someone he can talk with through this given it impacts his health.

We talk about moving much closer, but that will take a couple years and a lot can happen between now and then.
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I'd get the legal opinion from an Elder Law attorney in their jurisdiction. Make sure, it's someone who litigates in Guardianship/incompetency matters and knows what you need to prevail in court, IF it comes to that. If you aren't sure as to when to intervene, it might help to know what the court in their jurisdiction needs to see, before they think there should be intervention. An attorney can give you a check list of somethings to look for.

If your MIL is allowing a person with dementia to drive.....I'd be concerned with HER judgment and I'd want to make sure that FIL is a safe driver.

In light of your more recent post with new info, I'd also suggest the following. I'd arrange to go and stay in the house with FIL and MIL so you can see first hand what the situation is. If FIL is unmanageable, you need to know. ALSO, if MIL is in denial and not being reasonable about the care that FIL needs, then she may not be the person who can drive the train either. I'm a pretty pragmatic person. If a loved one is suffering and another loved one is not willing to allow them help, then, I'm going to be proactive. Of course, it's really your husband's responsibility. Why can't he step up? HE needs to get better informed and if the situation warrants, intervene.
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I saw your post about the MIL thinking it was ok for FIL to drive.
You know the answer to that one.
What happened when your MIL had her accident? Who took care of FIL? Of Inlaw GParents? Did MIL need rehab? Did she get it?
If her accident had been fatal, what then? A visit to a qualified legal attorney for the necessary documents and plans are needed.
It's a good place to start with a consultation for you and your husband so that when it comes time, you are able to take necessary action.
Another meeting I had with the folks I've personally had POA for is let's play what if. What if you were making bad decisions? What if you were hurting dad? What if you were expecting more than I could or can do? What if you died? It's kind of like the DNR conversation but drilling down to more everyday concerns. What if you were spending all your money online shopping when you needed it for health care.
Another is Who matters?
Are my children's lives important? My grandkids? Are my husbands parents important? Is my life important? To me a family is a unit and makes decisions that are good for everyone or at least take everyone affected into consideration. MIL life will most likely be shortened with all this prolonged stress. She is already making poor decisions.
Your love holds you hostage. There are no perfect answers. You can be ready and prepared to take action when the event occurs that demands it. Life ends for all of us regardless of the decisions that are made. It isn't necessary to wear yourself out trying to meet unrealistic expectations of others although most of us do.
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Another thought...

My aunt and uncle had a truly incompetent doctor. My cousin could see that her dad had dementia (actually, anyone could; he thought everything that was happening on TV was actually going on right outside his door--it made 911 a real treat), but her parents had a doctor who said "Nice people don't get dementia. Your parents are nice people; ergo, your father doesn't have dementia".

Well.

For several years, there was a circus of repeated hospitalizations, discharges, aides hired and fired. When my aunt (who did NOT have dementia) fell and broke her hip, Uncle dragged her around on a throw rug for several days. A family member stopped by and discovered this. EMTs were called; Uncle attacked them, attempting to prevent them from "taking her away from me".

Aunt was in rehab for 6 months and then willingly returned home.

Aides were hired (cousins told her mom they were for dad and vice versa). Fortunately, these folks were quite wealthy and were able to use their own funds to pay for 24/7 aides for several years. Aunt pre-deceased uncle by 3 years.

I guess the point is, denial can run deep, and an incompetent doctor can fuel the denial. For some, having dementia is still a mark of shame, I think.

Who cared for FIL while MIL was having surgery?
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I understand that what I wrote above probably sounds terribly mean-spirited.

MIL is in denial about the fact that she needs more help. She "says" that the doctor blows her off...I wonder if that is actually the case or if s/he is actually begging her to get help at home, or place FIL.

I wonder if FIL injured MIL.

I wonder, if the local Area Agency on Aging did a wellness check, what they would find.
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My dear, if MIL is refusing your help, when it becomes "a big emergency" you call 911.

I have a dear friend who has a mother in her 90s; the elderly lady is living alone and has been getting more and more frail each year, developing memory problems and the like.

When Hurricane Sandy was about the reach the East Coast, my friend called and asked what I thought she should do. I told her that she should go get her mother (who lives by the water) and bring her to her own home until the storm either blew over or hit. Either way, it seemed to me that we'd all sleep better. I also told her that if she decided against doing that, I wouldn't be involved in any "rescue" of her mother, that she'd have to find other resources.

Ultimately, my friend decided not to get her mom. The storm hit, she was unable to get in contact with her mother because, predictably, the area was without power and electricity. Friend called me, hysterical. I declined to put myself or my husband in danger effecting a "rescue".

So my friend called another friend who biked into the area and walked up the 16 flights of stairs to determine what was going on.

YOU see what is going to happen. YOU are offering council, resources and help. SHE is refusing them.

I understand that this is family. But when family is too stubborn, proud or whatever to accept help, then you need a higher authority to be involved to force help upon them.

Calling 911 will set the ball in motion.
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Thank you for your advice. I really appreciate reading it. We want her trust us first and foremost. We love her and really are blown away how much she's taken on herself this past decade. This includes caring for her parents who are still alive, live in their own home, and are in their late 90s.

The question is this... She's recently really injured herself pretty badly. It required surgery and she cannot drive right now. She has FIL drive.

We don't know how she hurt herself, and she herself claims not to know how. Meanwhile FIL gave us an elaborate story that doesn't seem to completely add up—which could be a factor of his memory issues rather than either of them trying to hide things from us.

She cares for FIL what appears to be full-time. She's recently told us FIL hallucinates and has memory issues. we are hoping to speak with her soon and ask her a lot more questions about this.

So how long do we have before this situation becomes an emergency?

I feel we are coming up to a fine line between being respectful versus looking out for a loved one's safety. We want her to get help on her terms first, but we fear letting it continue to be swept under the rug could end badly for both of them.

My husband has no brothers or sisters. We have family near them, but the responsibility will land on us if or when there is a big emergency.
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Don't go behind your MIL's back. Your MIL has isolated herself from her family for fear of their reaction. If you betray her confidence, you'll be next. It is essential not only to ask for but to deserve her trust. It is not for you to judge her best interests as long as she is capable of doing that for herself.

Read 'Being Mortal' by Atul Gawande which is an excellent overview of some of the ethics at play. Treading the fine line between concerned assistance and unwarranted interference is extremely difficult even in loving and well-balanced families. If you have had to extricate yourself from one precisely because you found its approach too heavy-handed, you don't even have the benefit of a good example to follow so it's hardly your fault that it's hard to judge the right balance.

Respond constructively when your MIL talks to you. Encourage her to be more candid with her family, and less afraid of their reaction to FIL's challenges. Suggest she imagines that one of them approached her for help when they needed it: would she mock them, shun them or begin to meddle unduly in their lives? Of course not - so why would she fear they would do that to her?

Research options for them. Find out the contact details, services provided and rates charged by organisations which could be useful to them. Offer practical help in arranging visits, assessments or perhaps a trial period of any service she finds appealing.

Consistently and encouragingly repeat to your MIL what you think she should do, and assist her when she asks you to. Do not take action on her behalf without her permission, and most of all do NOT do anything that she has categorically asked you not to do.

It is right to support, advise, encourage and assist your MIL. But you have no right to overrule her or force decisions on her. Do not "disregard her wishes."
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At this point, I feel very powerfully that doing nothing is not an option.

I've done nothing (aside from trying to get others to talk and do something about this) for 10 years while everyone else was in deep denial and normalizing it. After how my grandmother died caring for my grandfather, I could not live with myself seeing that happen to another person while not even attempting to make a change. I don't care if it pisses them off. I'd rather them angry with me and alive than super hurt/dead, and my husband and I stuck dealing with the aftermath.

Hubby started to wake up last year, and now he seems to be relying on me to get the ball rolling for him (and has asked me to help). I feel like we can't do this alone.

This week I called some professional resources outside and have made contact with family near them. I haven't told any of our family what's up yet or asked anyone to intervene (professionals or family).

I want to give my MIL a chance to reach out first—or at least give us her blessing to do so if we decide to tell her family. When we spoke last week, she asked us not to and told me she's been avoiding them for a long time in fears of them noticing how FIL is behaving. This breaks my heart as she has always been close to her family in the past. Now she is isolated and stuck doing things on her own.

But I don't want to go behind her back. I'd hate that if someone did that to me. She could totally take care of herself. She could probably even be fine with help in the house with him staying (which seems ideal for a lot of reasons). Doing it on her own doesn't seem safe. She was recently injured, had to have surgery for it, and cannot drive right now. Meanwhile she is caring for him and their aging ill pets. She told us she feels awful she can't clean, but turned down us hiring housecleaners. She tells us his doctor blows her off, but she won't let my husband talk with the doctor.

At this point, I feel like we may have to disregard some of her wishes for privacy for her and her husband's safety, but I just want to try to talk with her to help her understand we aren't doing it to take her rights away or because we think she's incapable. We love her and want her around for a while. Refusing help in this situation is self-destructive and will be destructive to us by extension. If actions are taken, FIL's doctor(s) may be able to help him, and we can also help MIL have to deal with less stress from it and be there for her for the stress she still has to go through. That to me seems like what a family should be, right?
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Does your husband have Durable POA for his father? Whoever has that, should step in to manage the finances. Same goes for the Healthcare POA. If there is no one appointed, then, it's really up to your MIL or husband to make some arrangements. I'd consult with an Elder Law attorney to get advice on how to proceed to get Guardianship. They can explain the process, evidence needed, costs, etc.

If your husband nor his mother wish to do anything, you have the options of standing by or taking action yourself. Eventually, a crisis occurs and something has to be done. If it's a real safety concern, like FIL driving unsafely, wandering, violent, etc. then, I might be more proactive. It's a personal decision as to how you voice your concern to your husband and/or call authorities to intervene.

You might get them reading material or show them online videos on dementia. It might help coming from a third party.

Your goals sound admirable, but, when dementia is involved......it's frustrating. Often people won't listen. They underestimate the condition and impact on the home and family. They overestimate what they can handle. And they remain in denial for a long time. 

With my situation, it wasn't really about boundaries.  Respecting boundaries is nice, but, when it comes to people who have brain damage and are in dire need, those things may not be possible to use.  Often, getting the person somewhere safe and protected becomes the biggest priority. Eventually, a person with dementia cannot keep driving the train. 

There's usually a lot of stress and anguish, because the ability to reason is diminished. I'm not sure how a family member of someone with dementia avoids stress and distress. You can avoid burn out by asking for help and getting the loved one the care they need. Avoid taking on duties that you are not trained or equipped to do. Realistically, getting the patient to see things clearly, cooperate, and accept help is quite rare. It's usually a struggle and quite stressful, HOWEVER, eventually, things will get in place and things will be resolved. It's not easy. That's why there are so many people on these type of boards pouring their hearts out.

I hope you find some suggestions that help. I hope you'll get some other responses too. Each case is different. Please post as to how things go.
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