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I have been my mother-in-law's full-time caregiver for over 6 months now. She had a massive stroke, has diabetes, severe receptive and expressive aphasia and various other health issues. My husband and I have made the difficult decision to move her into a skilled nursing facility because her health is declining rapidly. (Please no judgment; we are set on this decision)
The problem we're facing is dealing with my husband's cousin (my mother-in-law's niece); let's call her "Debbie."
Well, Debbie used to (before the stroke) hang out with my mother-in-law 3x a week, have my MIL sleepover and has claimed many times that they are best friends. Debbie has only come to see my MIL 3x over 6 months and has not helped us at all with caregiving despite having the time to do so. She has made a few weak offers to stay with my MIL for a few hours so my husband and I can get out of the house but every time we've tried to take her up on that offer, she says she's busy. She really only checks in about my MIL if we all miss Sunday church.
We know she is going to be angry with our decision and I'm not sure when and how to approach this conversation. She has caused issues in the past when my MIL was in rehab with Debbie not respecting our wishes to not have a whole bunch of people visiting my MIL days after her stroke without telling us.


My husband is already struggling with guilt because of all of this and I don't want Debbie to cause him anymore stress/pain. Any advice would be helpful. Thanks!

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This is you and your husband’s decision, not hers. Why would you concern yourself with her feelings about it since she is not even playing an active role in her care?
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Honeybee0409 Feb 2022
Very true! She is the least of our concerns.
Thank you!
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It’s fab that she did that with your MIL, but your MIL has been very Ill and now needs skilled care that you two lovely people can’t give, hence the decision.
I totally get your husband is struggling with guilt and doesn’t need any more confrontation, and I think everyone’s posts below are brilliant advice.
my OH gave me “a lot of advice” once, I pointed at my shoes and said walk a mile in them then tell me what to do; Like crazy sue said no one realises how hard it is until they have to do it.
sending love and all the best for the move
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Honeybee0409 Feb 2022
Thank you so much!
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Honeybee0409: Since the cousin's help was nil, perhaps you could inform with little fanfare.
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Honeybee0409 Feb 2022
Definitely! Thank you.
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If you have done your homework on this facility then move her and tell everyone afterward. Don’t worry about what they think. No one realizes how hard this is until they do it. Prayers and love coming your way. 💕
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Honeybee0409 Feb 2022
Thank you!
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Speak plainly to Debbie. Tell her straight that your MIL is going into a nursing home because her care needs cannot be met in your house or by you anymore. Let her know that she can visit her in the NH as much as she likes and as much as they will allow. Then let that be the end of it.
If Debbie carries on and tries to get all about the guilt trips on you and your husband tell her to go pound sand and that neither of you owe her any explanation for why MIL is moving to a nursing home. Tell her this. That you're only explaining to her out of respect for the friendship she has with your MIL and that you could easily have had her transported to the NH without telling her at all.
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Honeybee0409 Feb 2022
Good point. Thank you!
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Debbie can go and visit MIL any time she likes. Perhaps she'll show up a bit more often now that MIL is more easily accessible.

Why is your husband even faintly concerned about Debbie's opinion, anyway?
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Honeybee0409 Feb 2022
He doesn't like confrontation and Debbie has a very confrontational/aggressive personality. I don't mind because she didn't help us when we needed it most so I agree she has no right to say anything. I'm more concerned with his feelings since he feels like he'll be looked at like a neglectful son, which I've tried to reassure him is not true.
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You basically answered your own question. Unless she has selflessly been a great help to you taking care of MIL, she has no say in it. Do it and tell her later. I learned too late in life not to worry when people get angry. They are trying to control you and taking care of my sweet Daddy help me see that HE was my priority.
A stroke is no joke! My aunt had several strokes and her next door neighbor best friend had a duck about it when he son moved her into a skilled facility (she had been helping care for her). BUT, this neighbor let her drive when she wasn't supposed to etc...
Her son moved her into a facility and she was the life of the party until she died. She loved having people around her and because she also had dementia, she never really knew the time had passed, and loved visitors.
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Honeybee0409 Feb 2022
You're right; I did answer my own question lol thank you for your advice!
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Tell them immediately.
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LightnLife Feb 2022
What would be the reason you would tell the family member(s) if this were you? I am asking because I like to know both sides and I may face this in the future. Thank you.
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I hope your husband can get over the guilt. Maybe some grief counseling can help him (having to move his mother to a nursing home is a form of grief). She will have professional care in the facility. Try to visit as often as you can to make sure that her care is good and appropriate for her. Your husband's cousin is just a trouble-maker. Tell her after the move. Speak with staff at the facility and limit who should visit your husband's mother. We are still in the middle of a pandemic, and visitors should be limited to close family members and close friends. Hopefully the facility has rules about wearing masks, etc. If your mother-in-law is not vaccinated, speak with the facility about giving her the vaccinations. It will keep her safer in a group setting. All the best to you and your husband and MIL.
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Honeybee0409 Feb 2022
He has just set up his first appointment with a therapist to help him with all of these emotions.
Thank you for your advice!
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Here is how I would "try" to handle it when she expresses her objections... Thank her for her concern and simply ask how "she" would handle it! Her answer will probably involve what "you" can do. Ask her if she is willing to handle everything herself according to her own suggestions... sounds like she would very quickly say no. IF she says she can handle it be prepared with a list of issues you are dealing with and the consequences you risk which would enlighten her to what she would have to deal with if she were in charge. If she insists, then insist you aren't willing to risk the consequences that will fall back on you if she fails.

Whenever anyone suggests ways to care for my husband, I have become quick to say that "I" have to face the risks of consequences for every decision I make. When my husband began with mild dementia, if he knew about a future event too soon, he would become obsessed and very anxious. He would have endless questions then on the day of the event, before I was half dressed, he would have his hat on ready to go and a couple of times even sitting in the car. My sons felt he needed something to look forward to, which I agreed but not at the risk of the stress it added for me. It took a while, but they finally saw it for themselves and now support me. This is now my standard answer... I know the potential consequences and am not willing to risk them. The consequences, I am referring to, relate not to just heightened stress and anxiety but also the potential injuries one or both of us may have.

If she brings up an argument there will be consequences of moving her to SNF simply let her know you have already weighed them to be less than potential consequences of caring for her in your home and found this best for all involved.

If she continues, tell her to you can't discuss it anymore because she is adding to the stress and anxiety her SON is already having with the decision and you are concerned for his health.
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Honeybee0409 Feb 2022
This is a great strategy! Thank you for your input!
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Hi there, how wonderful that you have been caring for your mother in law following a major stroke. I’m so sorry that your family has had to go through such a tough time.

Like a previous post, I am sure Debbie is experiencing grief as she obviously had a great past relationship with your mother in law. Even if she hasn’t been very present since moving in with you folks, there may be other reasons that she hasn’t been visiting in addition to just having a difficult time facing what has happened to her dear friend/aunt.

I imagine that if she visits your MIL at the nursing home, it would bring joy to her. I see that your MIL is only 72! These days, that is very young.

Don’t assume how Debbie will react;, she just might surprise you now that some time has passed. Given your description of the situation, I would tell the cousin, along with other family members as soon as you can after she moves to the nursing home. People should know if her condition is rapidly declining, particularly those that love her and may visit her. Keeping loved ones away isn’t going to help her. Nothing made m happier than when my dad had visitors when he was in long term care. When his friends visited, he was so pleased. You know how much fun friends can be!

Because you mentioned that you attend a church, you might want to send up a little prayer before you speak to your loved ones. It’s amazing how God can give you the right words.

Good luck with this tough situation!
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Honeybee0409 Feb 2022
Yes, we are definitely praying about this. Thank you for your perspective!
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This is a private decision that doesn't need to be discussed for anyone's approval. I am sure it was gut wrenching just coming to this conclusion. Just tell her next time you meet in Church or make a phone call. Say, "husband and I are so sad to have to tell you that MIL will be/is now residing in a NH". If you hear any negatives, just say "This was a very hard decision, please respect our feelings". Do not feel the need to elaborate.
If you want to talk about visiting, you can let her know when is the best time to go. (Due to Covid restrictions & screenings, I don't think you will need to worry about her bringing crowds there). I wish you all the best during this most difficult transition.
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Honeybee0409 Feb 2022
Thank you!
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First, I am very sorry that you're all going through this.

Secondly...and please, don't take this as I'm making excuses for her behavior, nor suggesting "Debbie" get a free pass, I'm just offering this as a thought: I imagine "Debbie" is grieving the loss of her "best friend". That you say she used to see your MIL often, but since MIL's stroke you can count her visits on one hand and still have fingers left over is, to me, very telling. If she's close to your MIL in age, she is likely not only dealing with missing your MIL's company, but perhaps this is also a sort of a reality "smack in the face"; now she is seeing - live and in person - the concept of her own health decline and mortality.

That said, it in no way gives her the right to stick her nose in business that doesn't concern her. I'm sure, in her own twisted way, she thinks she's "helping" by offering "suggestions". That maybe no one has ever told her that her suggestions suck means she feels free to continue to offer them - although there are people out there who continue to offer, even after they've been told in no uncertain terms their suggestions suck. I believe the clinical term for THEM is "a**hole".

You know, you don't really have to tell her anything. I'm going to assume that MIL is elderly; it's not out of the realm of possibility that she's going to stop doing things, like attending church regularly. If "Debbie" asks where MIL is, you can say "she's home". Not a lie - the SNF will indeed be her home. When she asks how MIL is doing, you can answer with a vague " she has her good days and her bad days". Also not a lie. I don't know that I would even mention the move unless "Debbie" really makes a push on to visit; and since she doesn't seem able to "handle" seeing her BF in such decline, I don't know that you have to worry about that happening anytime soon.

And if "Debbie" ever DOES find out that MIL was placed in the SNF and accuses you of keeping her in the dark, you can even tell her that you saw no reason to "burden" her with that information, knowing as you do how close she is to MIL; you saw no reason to cause her undue worrying, especially since MIL adjusted so beautifully to her new home, and was getting the very best of care! If you say it with just enough irony in your voice, she might even take the hint!

Good luck and (((hugs)))!
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Honeybee0409 Feb 2022
Thank you for showing me a different way to look at Debbie's behavior. My MIL is 72 and Debbie is in her early 50s. You make a good point about just answering vaguely until we're pressed for an answer. Just knowing Debbie's personality and having had her give me problems separate from this situation many times over the years, I think this is the best approach. Thank you!
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Your husband's guilty feelings about the move are more to deal with than the cousin. As care givers, you and your doctors are better equipped to make the decisions of which the cousin has no say in the matter. You can let her be angry and say your sorry she feels that way or ask why she never offered to let her "best friend" move into her house. I wouldn't loose any sleep over the cousin's approval or lack of.
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Honeybee0409 Feb 2022
I agree! Thanks!
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She is going to try to get her way no matter what, You don't have to be concerned about what she says or anything. Just do what you know you have to do.
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Honeybee0409 Feb 2022
Thank you!
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It always seems to be the people who have no input with the caregiving that seem to feel entitled to dictate what happens to a relative, with no thought for the caregivers. It doesn't affect them but they feel the need to object to things they don't like. There's usually an ulterior motive!! Stand your ground and tell her your decision. You don't need to explain yourselves to her or anybody else!! You're the ones that will be affected by long term care, not her. So it's not her decision to make unless she is prepared to take over the care!! Good luck.
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Honeybee0409 Feb 2022
Very true! Thank you.
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As hard as it is, ignore the SIL. She was not a caregiver so she can’t call any shots. I don’t think there will be any good time to tell her. She’s trained family members to be afraid of her objections. She’s going to raise a huge stink no matter how you present it. When non-caregivers want to butt in they have no voice—they just don’t know it. Putting a loved one in a facility with all their health issues is best solution.

The nursing facility is exactly where she belongs. You can’t provide the extensive care she needs 24/7—caregivers get tired and can make mistakes. My overarching priority for my brother has always been for him to be safe and comfortable, if not happy. Keeping your MIL safe is an act of love. She will be in a safer place. Visit her often. Nursing homes take notice when the family is involved. Contrary to popular opinion, there are good nursing facilities out there.

Consider bringing in hospice as they can provide comfort measures and it doesn’t have to be at the end. My brother has been in hospice for almost nine months and the care has been incredible. Again, they’re another set of eyes. Medicare covers hospice care. Check out Medicare’s website for nursing facility ratings to help you find a good one. Sometimes one that’s a little farther away is much better than a local one. Finding the best place possible can help abate the guilty.
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Honeybee0409 Feb 2022
Thank you for your advice!
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The 'armchair critics' are the absolute WORST! The ones who have All The Answers while doing nothing to help us with our loved one! I have 2 cousins who act like Debbie. In fact, cousin #1 sent me an email the other day (an email, mind you, she lives 5 miles away & also has a PHONE, hello?) asking what she could do for me while my DH and I are in AZ for several months so he can get a liver transplant at the Mayo Clinic while my 95 y/o mother is here in Colo in a Memory Care ALF on hospice. I told her that she could go SEE my mother as I'm an only child so there will be nobody else to go see her while I'm gone but these two cousins. She emailed me back totally IGNORING what I asked of her, and wishing me good luck on our trip! Why ask when you have no intention to DO a blasted thing, that's my question? Yet, if the day comes (this summer) when mom's $$ runs out and I have to place her in a SNF on Medicaid, boy howdy I WILL hear from these two fabulous cousins how I 'shouldn't be doing such a thing', I'll betcha $100 on that!

Don't bother HAVING a conversation with this armchair critic, she doesn't deserve your time or the stress you're suffering over it. Do what you feel is necessary and IF she contacts YOU, then you tell her where MIL has moved to, IF you feel like it. We owe these cousins precisely what they've given US over the years: BUPKUS.

Wishing you the best of luck with the upcoming move. I hope your MIL adjusts well to new accommodations.
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Honeybee0409 Feb 2022
"Armchair critic" is hilarious!!
Thank you for your advice!
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I forgot to tell my brother that I had moved Mom from an AL to LTC. He stopped by my house and said "Where's Mom". Good thing he is easy going. And really, if he had called and visited he would have been told then. He only visited a couple if times in the 2 yrs she lived with me. Not sure if he ever visited the AL. The only time he visited the LTC was the day he stopped here and when she was dying. I know this because the regular nurse did not know him. Just said a big guy came to visit ur Mom. Thats parr for him.

This is a cousin. Her opinion does not matter and you don't need to give her excuses. Your DH does not need to hear any negativity on her part. A number of us are not in the position to be judgemental. We have had to make the hard decision to place a parent. For me, I was not a Caregiver. It was a Senior taking care of a Senior. Our LOs care is just beyond our capability. So, place your MIL. Take time to allow her to adjust and allow you both to adjust. I guess cousin will see you in Church and ask where MIL is. Hopefully its after the service or say "will talk to you after the service". Or don't go and then she will call. Then u can explain that MIL had to be placed and that you are both upset and adjusting but it had to be done. If she starts, tell her sorry but you are hanging up.

My Mom adjusted well to both an AL and LTC but she was in the last stages of her Dementia. We just told her she was going to a new apt with new friends. The staff was good to her.
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Honeybee0409 Feb 2022
Thank you!
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Have a "casual chat" with Debbie after MIL is already moved and settled in. When she asks say, "MIL is doing so well in her new home. We are so glad she can get the professional help she needs." Let it go at that.
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Honeybee0409 Feb 2022
This is a great idea; thanks!
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Move Mom and don't worry about notifying Debbie with any great haste.

When she says "Why didn't you tell me??" you can smile sweetly and say, "We were going to tell you when we saw you, but we just never see you anymore."
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Honeybee0409 Feb 2022
Lol nice! Thank you!
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I agree with others not to say anything until placement is done and she is settled in. At any point prior to that, those who oppose your decision still think there is wiggle room for them to insert their opinion. Please don't let them do that to you after all you've already been through. And I mean that.

In my case, I was primary caregiver in an impossible situation. I had *very* limited help and my LO's condition rapidly became something that I could not keep up with at home anymore. My lady went from a rehab setting directly into the nursing home wing of the same facility, so I did tell some therapeutic fibs along the way because I simply could not take any more of the wrath and criticism from the lady's family. I still had a lot to do on the lady's behalf, and I had to find a way to keep going. I would refer to the "new room" and worded it that way. I didn't come right out and tell anyone until it was official.

In a way, people were somewhat relieved that I made the decision and told them after the fact. It absolved them of having to do the grandstanding of why a nursing home is terrible or why the nursing home THEY like is better than the one I like. Regardless of what they verbalize, a lot of people know deep down what the right thing is - they really don't want to be involved in the decision or wonder if they are being asked to get involved. But then once you involve them, they don't back off.

Tie up the loose ends. Then inform the onlookers.
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Honeybee0409 Feb 2022
Thats a really good point about people not wanting to be the one responsible for making the "nursing home" decision. Thank you!
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Next time she calls, tell her she can reach MIL at this number and what the visiting hours are. I would also only allow Debbie supervised visits. She could cause all kinds of problems for you at the facility.
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Honeybee0409 Feb 2022
Yeach my husband and I are trying to figure out how often we should allow visits because again, she only visited my MIL at our home 3 times in 6 months. We think she's just going to put on a big act about being concerned when her actions have proven otherwise.
Thanks for the advice!
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Why do you care who’s going to be angry, if you and DH are the legitimate responsible parties?

Don’t talk to ANYONE about the details of your MIL’s situation until she has moved to her new residence. Her facility will probably suggest that visitors be limited during her adjustment period, so if Debbie (Downer) throws a fit, shrug your shoulders, state simply that you’re dealing with the facility’s rules and say you’ll let Debbie know as soon as MIL is strong enough to enjoy guests (never).

You and DH are in control, you have done the hard work of the last several months, you owe apologies nor explanations to ANYONE.
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Honeybee0409 Feb 2022
Thank you! You're right; we just have to stay focused on taking care of my MIL and not worry about other's opinions.
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Please tell your husband that he isn't an evildoer or a felon; he doesn't need to do "guilt". He is grieving. You have both done what you could and I congratulate you both on making a decision together. I am so sorry for the GRIEF, but it will be there for all of you. You aren't gods. You are human beings with limitations and you are likely smack up against your own for more time than you even realize.
Tell Cousin Debbie as nicely as you can. When she has more to say than you want to hear tell her that you are sorry for her grief over this, that you are ALL grieving it. That this isn't open for opinion or discussion. That there is quite enough on your plates now. Do tell her you hope she will visit, and to be a positive presence in your Mom's life; that she is WELCOME TO VISIT as long as she can stay within that boundary. Wish her well. And that is the end. Tell her that you do not wish to argue or even discuss this with her. Wish her well and hang up.
Again, I am thankful you understand your limitations. Not everything can be happy all the time at ANY point in life, and certainly not at this point. Some of it is going to bring tears. Is this loss after loss after loss not worth the grieving? Allow the tears to come; they will wash everything out.
My best to you. My heart goes out to you both. To ALL of you.
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Honeybee0409 Feb 2022
Thank you so much!
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First off I want to say, Great big warm hug! I know how difficult it is to make this decision and the last thing you need is family butting in.

I think that I would not tell her until it is a done deal and I would wait several months before I told her where she was.

If she questions you at church, tell her you got a professional to help your MIL. Period! You don't owe her any explanations or justifications for what you both feel is the best care situation for your MIL/his mom. Sometimes just looking at someone with her audacity and not saying a word is most effective.

I guess I am ornery, because I would call her out for never helping her best friend, especially since she offered and you couldn't continue to do it alone, if she pushed the issue.

At the end of the day, her son is her legal next of kin and that gives him the authority. A niece is far down the legal succession, she has no authority and has chosen to not be involved, so she's not involved.

Best of luck with an easy transition.
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Honeybee0409 Feb 2022
It has taken everything within me not to lash out at her when she makes comments and yet hasn't lifted a finger to help ease this burden. I like your approach with just simply stating there is now a professional taking care of my MIL. Thank you!
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You tell people AFTER you have done it.
And you can limit who is allowed to see your MIL.
Allow "Debbie" but not a gaggle of people.
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Honeybee0409 Feb 2022
Absolutely! Thank you!
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