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Lately my FIL is worried about dying before MIL and who will care for his wife who has a neurodegenerative illness called multiple system atrophy. They live in indy living and MIL has a caregiver who helps her with her ADLs every day and goes home before dinner when FIL takes over for the rest of the night. MIL now wears Depends overnight. MIL has a catheter. I found a visiting nurse service - skilled nursing - to visit them in the event MIL needs more help but so far it hasn't been necessary. Nonetheless FIL worries that his wife will end up in a nursing home. In our case FIL is independent but MIL is not. Has anyone else used visiting nurses when their elders live in independent living?

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In the event FIL does pass before MIL, it sounds like our choice is between a nursing home and moving to a bigger house where she can have in-home care while living with us. Am I missing another option?
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I haven't been in their situation, but I'm thinking that perhaps the best way to reassure FIL that his wife will be taken care of is contingency planning, which is what you're trying to do now. Identify sources of care to support him now and take over after his death, and help him be comfortable with these new helpers so he feels confident that they'll take care of his wife.

Help him develop a plan for care for her outside of a nursing home, review it with him, and let him help develop the plan so he knows he's a major participant.

I think if he knows there are plans in place, and he's comfortable with them, he might feel more comforted.

I think this is soooo sweet, to be so concerned for his wife. It sounds as if he's a very loving man.
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Thanks, freqflyer. That's a ton of money for round-the-clock in-home care. I was thinking that if the nurse came three or four times a day then her current aid could stay on for the things that we don't need a nurse for like feeding and bathing and we could get another aid to do the night shift.

Tacy002 - Thanks for your answer. I think that by the time we reach the point of needing skilled nursing we will be beyond PT and OT, which she already gets and has helped to keep her from becoming bedbound. She is wheelchair bound. I'd like to hear more about your nurse like how many times a day he comes and what he handles for you. Private message me if you prefer.
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NYDaughterInLaw, I wonder if the Dad-in-law is of that generation where they have a certain stereotype about nursing homes, thinking these places are dark and gloomy. Maybe if you could take Dad to visit a couple of places that would ease his mind that his wife would be getting a higher level of care in a nice place.

Now if something should happen to Dad-in-law, it would be very costly to have 24-hour caregivers with the skills needed unless your in-laws can afford to do this. The cost could be up to and even more than $20,000 per month. Unless Mom-in-law qualifies for Medicaid, but then Medicaid would want her to go into a nursing home.
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Even though the boyfriends parents live at home, we've had skilled nursing for 3 years. Our nurse is great and i call him whenever i need to for anything. It is quicker to used the skilled nurse to get orders from dr. Since your mother in law is not self sufficient, i would suggest you ask the nurse to get an order for pt and ot to come to the facility.
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