What to do when the caregiver is too old and fragile to care for someone even much older?

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Hello - my wife's mother is now 75. 30 years ago she married a man 21 years her senior who became my wife's step father. He is still in "good" health at age 96. Generally speaking, all the important stuff is still healthy. However, he has lost almost all vision because of macular degeneration, and his hearing is probably only 5% of normal.

Over the past few years, my wife's mother has been having health issues. She had kidney cancer caught at the right time (kidney removed and seemingly all cancer with it). She has also had heart issues, and they've shown up once again. All the doctors say it is largely stress-related.

She and her husband live at home, and she is is full time caregiver. She dresses him, lifts him out of bed and to the toilet. He has a catheter. She helps him down the hall, down the steps, cooks every meal, etc. He is a grumpy and demanding at times and has shown some signs of dementia.

But of course, she cares for him out of love - bittersweet to see wedding vows unbroken.

Yet it is clear to all around her that this job is far, far too much for her and taking a growing toll on her own health.

With her, we've had many discussions. In-home care, moving him to a home, etc.

But at the core, even at 96, he still runs the show and dictates how things will be. And he wants them exactly as they always were - with her, at home. She feels extreme guilt. If she were to move him to a home, aside from the fact that her phone would ring non-stop with him calling, at age 96, it's likely that would be his last home. And he'd be spending it there vs. passing peacefully with her at home.

We love them both, and simply want the best for both.

It's a tough situation. But we think the main problem is that any major change would have to be driven from her, and her guilt prevents change.

However - if the decision was NOT hers - then a new situation would simply be a fact of life, not her fault, and easier for her to handle.

Quite honestly, we believe she is no longer even capable of providing proper care for him. There are probably related laws to that (they live in Pennsylvania).

She needs care herself.

If you can no longer see - you can't have a driver's license. If you can no longer care for another human - might your ability to provide care be restricted?

As such, if there was a law, or even if there were "doctor's orders" that stated she was no longer allowed/capable - then it's neither his decision OR hers. It's simply a fact of life.

Thus - does anyone have any familiarity with that?

Directly related - my wife (her daughter) and I - we are in our early 40s with 3 young children. We live 1000 miles away sadly. However, regardless of any laws or doctor's notes - how can we make this situation OUR responsibility?

For two years, we've said the situation cannot continue, but been rebuked. Is there any way we ourselves could gain authority of the situation and ourselves mandate, for example, that he move to a home? Or even that they both move to a home?

There is no abuse going on - only love. But by comparison, is someone wasn't caring for a 5 year old properly - some authority would need to step in. Despite the love, the real situation is not a good one. It is past the point of needing intervention.

So we're looking for any help or direction on the topic.


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08/24/16.... denmantis, sometimes we have to wait until there is a serious health issue at a parents home before anything can be done, and even then it can be a challenge. My parents were in their 90's and still living in their house, which had a lot of stairs. All I heard from them "we can manage". I tried to bring in caregivers but my Mom shooed them out the door. I couldn't even bring in a cleaning team to help.

It's all part of their generation, those born 80 and 90 years ago. They want no help from anyone. I feel so sorry for your wife's Mom, at 75 she shouldn't be doing all that heavy lifting. Once someone reaches senior citizen age, their energy level goes down. I know for myself I have lost half my energy over the years.

Stress can kill someone. At least 40% of caregivers die leaving behind the person they were caring. Then what?

Regarding moving them from Penn to Georgia, it really is better for the elderly to remain in the town where they have lived for many years. That way when the local newspaper is delivered and the local news is on TV, the elders can relate to the location and the anchors are familiar faces. Otherwise it is like going on a trip and you turn on the local TV there, you can't related. Plus changing doctors isn't easy. Heavens, even changing barbers can be difficult.
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Oh I completely understand, but this is just so Sad! Anyone of us who are married vow " In sickness and health, and to death us do part", but when safety becomes a concern for one or both, and either is too stuborn to make the nessesary move to make it easier for the other one, then they are not making good judgment or have lost their ability to reason properly. You are right to intervene.

Are there any other family members who can assist you in convincing the husband of the probability that eventually one or the other will become ill or injure themselves in a fall at some point, especially if there are stairs involved, heck, they could both fall down! A welness check from APS to evaluate a vulnerable Senior is probably one of the best ideas. It would at least open a case file, and could be a starting point. Other than that, seeking Guardianship of one or both, but I would still start with APS, and discuss this with them. It would be expensive, but at least then you could force a move for them to be closer to your family. Good Luck, and good for you for being so caring!
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Call APS to do a check and also call the local agency for aging for ideas,

A trip there to visit them for a while and document what is happening and any deficiencies in care would be helpful. I think you need to present your concerns to your mil's doctor who may not be fully aware of the situation. The doctor may not be able to discuss it with you, but that does not prevent you from giving him/her your concerns in writing. I gather no one has POA - or perhaps your mil has.

It is very hard to intervene in this kind of situation and, unfortunately, often it is a matter of waiting until a crisis occurs - a fall or illness that is severe enough to send one of them to hospital. When that occurs, and you can be pretty sure it will, you have to be ready to communicate with hospital staff about the situation and get evaluations done on mil and fil regarding their ability to continue to live in their home. I am so sorry you and your wife have this to deal with, I know it is difficult. Please stay in touch ad keep us updated.
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Hi - I'm the original poster and had one more note. My wife and I have great jobs and we and our 3 kids have really deep roots where we live outside Atlanta. My wife's mother and step-father (noted in the original post) live in rural Pennsylvania. Moving our family to them is not an option.

Her mother would move to where we are in an instant and we welcome it, but he prevents it, wanting to continue his time in the town he was born in. It is sad - but he usually doesn't even know where he is. He is not interacting with other people in Pennsylvania. The two of them could easily move to Atlanta and his daily routine would be 100% unchanged. Yet due to his wishes, this has not been possible either.
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