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His wife is a full time caregiver and overwhelmed. He forgets why he is there and forgets not to bend his arm, which interferes with the dialysis. The center wants his wife to stay with him during sessions, but I can see that she is getting overwhelmed and this is her only time to run errands and to have some type of time to herself. The center doesn't think that getting a attendant to sit with him will work, and that he needs someone close to him there. Unfortunately, all of the kids live far away and there aren't any close family friends, because my MIL has stopped getting out, now that she is caring for him full-time. Any suggestions are appreciated. Thanks!

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Dialysis center needs to reconsider their edict that the spouse stay. That would be easier for them, but NOT for her. Is it part of a hospital? They usually have sitters to stay with dementia patients. Or perhaps a volunteer can stay as it is not about providing medical care but rather keeping an eye out. Call the center and see what alternatives are available --- at this point it is just impossible for your MIL to research even one more thing. If the center has no ideas, find out if there are other centers available for his treatment. Perhaps a hospital based program will provide more help.
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Babalou is right, it's time to reconsider dialysis, since he is not getting much out of it. My grandfather had kidney failure and caring for him is what killed my grandmother. If you want to save your MIL's life, your spouse needs to make some difficult decisions and intervene to save MIL from dropping dead.
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Could your in-law hire someone to help out during the week so that your mother-in-law won't be so overwhelmed? I know that is easier said then done, and some people won't let strangers in the house.

I can't imagine your mother-in-law sitting at the dialysis center for four hours for each treatment, she would be so exhausted she might not be able to drive home.

I doubt this is the first rodeo for the workers at the center, they must have seen their fair share of patients who have memory issues. They must have something to use to keep a patient from bending their arms.
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How advanced is his dementia? I'm not going to dance around the his; is it time to consider Hospice and discontinuing treatment? Sorry to be blunt, perhaps others here will have a different perspective
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