I posted about my situation on Reddit, and got some DM's to seek help from this site.

Long and short of it my MIL is a difficult patient, and her Medcaid PRI does not make it easier to place her via her MLTC, she has been rejected.

We have exhausted all of our options, her issues are triggered based general medications have proven not effective.

She does suffer from some bouts of dementia related psychosis but it triggered based. Her doctors also are against the idea of putting some medications on her file as PRN.

Since I use to be an RN I offered to help with her care which was a horrible mistake. I have told my husband he will need to do the hospital method, but he refuses cause he does not want them to just place her anywhere.

I am at a loss, even her doctors are in favor of not placing her yet. We are well past the ideal I tried to explain we cannot do much we are already I debt paying for care since she does not qualify for much via medicaid yet. Which is another issue.

Yet we all knew she cannot be left alone but safety and supervision is not a covered need, or is wandering prevention.

My husband is getting caught with the ideal, and does not help his mother's medical team are filling his head with all the horror stories regarding nursing homes when it comes to difficult patients..

I use to work on the memory care ward before I got my ED position so I also have horror stories but issue is I am done, and we cannot force placement outside of taking her to the ER and letting them do their thing.

My husband is also not ready to navigate the emotional woes of placement and visiting. He cannot handle her asking to go home, he also dislikes getting phone calls constantly which is most likely what would happen. She is fine with us caring for her, but I am just burnt out and we cannot afford private pay, and medicaid is well medicaid.

I am done, we have a child also.

"Sadly, his mom was the type that would say never put me in a home, kill me before doing so...that being said 100% she is the type that does not want to be a burden but would not want to go into a nursing home. She would rather die before that."

My mother has said you can shoot me first if you are going to put me in a nursing home. Or you can push me off a bridge. At the same time she says she doesn't want to be a burden. What a stinking heap of emotional blackmail! I've heard so many people here say their LO's said the same.

What are we supposed to do with this? It's a lose/ lose. We have no choice but to be the "bad guy" and be the person who places our LO. And then suffer their sense of betrayal and wrath for the rest of their lives...After we have given so much time, energy, emotional and mental anguish, and money to do everything we could for them. I'm getting so very angry about this, both for myself and for everyone else who posts the same on here.
Helpful Answer (12)
Reply to LilyLavalle
Helpneeded8972 Feb 5, 2024
I do not fault her for feeling the way she does. I wish I could end her life and not be punished for it. I would give her that gift.

That is not dangerous slope to go down though that can easily be abused by many and I understand why it is not possible.

I do not think it is emotional black mail just someone being honest how they feel.
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I have a couple of reactions to your issues:

1) What’s with this ‘medical team’? How many, what qualifications, and what practical experience? You are blaming a lot of this on what the ‘medical team’ is telling DH. Hire a new doctor! Object strongly to their faces about their lack of reality! Blow up in their faces! Tell them to keep their mouths shut unless they are willing to come and provide a week’s REAL help. You don’t have to be their victim, forget about ‘politeness’. Call in APS and get a second opinion from them – after making it clear that you are at breaking point.

2) “I know if I divorce him that will break him”. M’s behavior will break him, ignoring these unrealistic medicos is unacceptable, going along these lines will ruin you both financially …. The poor bloke is in for a hard time, whatever choices he makes, isn’t he? Time for you to make sensible decisions? Or does “I love and care for him too much to let him go down this path alone” mean that you are determined to share the hard time?

3) MIL “does not want to be a burden but would not want to go into a nursing home. She would rather die before that”. Funny thing is that they usually have the means to die, but they actually choose NOT. It’s all just words to put on pressure and guilt.

4) The current situation is only working because of your support, as well as DH’s care work. DH “does not feel someone should have to be put in danger to get help”. In fact someone may need to ‘in danger’ before they accept help. They are responsible for the dangers, which come from their own needs and mindset, not from artificial dangers ‘put’ there by you. Being stubborn gives them their ‘best option’. You can withdraw your help. This will make DH change what he does to support MIL, and when he changes MIL may find that it is no longer her best option.

5) You don’t want to divorce, but there are other ways to tip the balance on what’s happening. Take a holiday, go away for a month, visit the old home, find an ‘oldies’ tour to visit somewhere you have always wanted to see. You are ALLOWED to do this. You don’t need permission from MIL or from DH. It’s called living your own life. Then you can find out how things change, without any irreversible marriage problems. If you think it’s too expensive, just trust me – divorce is a lot more expensive!

You have options that you can take yourself. Don’t think that you are stuck, with no options. It’s not true – any more than the argument that these care arrangements can’t change.
Yours, Margaret
Helpful Answer (12)
Reply to MargaretMcKen

Honestly? You probably can't.

I talked myself blue in the face trying to get my DH to see how bad his mom's QOL was and how she would probably flourish in a group setting. He never believed me and it became a real issue between us. He thought I was cruel and heartless. I thought he and his sibs were trying to support an un-supportable situation.

Finally, OB crashed, hard, and said he would no longer be hands on with MIL. From there it was only 2 weeks and she was moved to an ALF.

And she's FINE.

DH said the other night that they should have done this 5 years ago. I said "So, maybe I was right?" VERY begrudgingly, he said "Yeah, kind of, I guess."

Bottom line, she's safer and better cared for and hopefully she will not be awful about her new living arrangements.

And yes, my DH is going through some horrible guilt pains. when the guilt should be that he neglected ME through all of this and our marriage has suffered some real blows.
Helpful Answer (12)
Reply to Midkid58

Add on , do not allow his mother to move in with you .
If your husband doesn’t come around he can go move in with his mother .
You and your child stay in your home .
Helpful Answer (11)
Reply to waytomisery
Beatty Feb 5, 2024
Correct. I have had this discussion with my DH as I see the writing on the wall. I see the FOG. I see his sib deep in the FOG.

I hear the constant rewarding messages of *Good Children*. I hear the undercurrant of *A Good Child Obeys*
I sense the FEAR that underrides this guilt evoking manipulation.

I love my MIL. She is a wonderful person. Yet if she needs fulltime care - she needs to change HER life - it's that simple.

So I keep MY message simple too.
I will live here. With any children still at home.

HE is free to move. Into her sspare room/garage/tent in her garden - whatever. He laughs & says it will never happen.
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If your husband continues to insist your funds go toward his mother’s care, please separate your finances from his, your own financial future is important and needs guarding. No way you should be paying for her care.
And FYI, my mother went from private pay to Medicaid in the best nursing home in her city, receiving the same competent, kind care throughout, in the same bed, same room, same caregivers. No one outside the business director knew or cared how she was paying. The only way to become Medicaid qualified is to spend mom’s money, spending yours will never help toward that
Helpful Answer (11)
Reply to Daughterof1930
BurntCaregiver Feb 5, 2024

A lot of good places will accept Medicaid after a person has cash-paid for a certain amount of time.
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I felt pressure from family members to provide care. To enable a LO to stay home.

The LO had long lost sight of the big picture. Went about their day & concluded they lived alone therefore were independant.

#1 Untruth : Independant.
The Social Worker re-phrased this as "Living alone, DEPENDANTLY".

I sought much advice.
I was told to have HONEST discusions to what I could/would do going forward.
To expect PUSH BACK.
To HOLD my position firm.

To follow up my WORDS of NO with ACTIONS.

The best way was to BE BUSY.

A good sensible Councillor/Coach advised people in this position to get a job. A part-time.job, a volunteer job at their children's school, start a study course, anything. Just no longer be available. Quit.

I had to. I had to actually quit & leave it all on others for them to SEE the FULL level of dependance.

HelpNeeded, I think you may need to consider this too.

Be honest & clear. Tell your DH:
I will not continue to prop this up.
I am starting a new job/study/something & will no longer be available.

If your Husband talks of reducing his paid work hours or funding aides to replace you he will need marriage councelling. To see how his actions will financially DAMAGE his own family unit.

I DO very much understand not wanting to leave MIL unsupervised & in an unsafe way. (No-one would suggest leaving her to burn the home down or fall & suffer a head wound). So he needs to ADD what safety measures he can; eg
Falls alarm
Easy heat meals (no cooking)
Food & medicones delivered.
Regular aid visits (MIL pays).

Could MIL be OK with that?

If not, he needs to get a NEW plan.

Withdrawing your assistance will force him to hurry up with that new plan.

Tough love.
Helpful Answer (11)
Reply to Beatty

HelpNeeded8972. I read your replies . Sounds as if your mother in law should not be living alone . She is already in danger . Your husband does not realize that one to one is impossible unless someone is wealthy. It’s the reality of the situation . No Medicaid facility is going to give her a one on one or promise to not medicate . His mother will be rejected for admission if that is what your husband is requesting when he tours facilities .

It’s not ethical of him to put yourselves in debt . His first responsibility is to his spouse and child. His mother can get Medicaid . Life is full of danger and harsh reality , he can’t stop it all. Whether it’s ethical or not to let something bad happen , unfortunately it does happen .

He needs to man up and go the ER route . He needs to put his own family first and get off his high moral ground. Have your husband read this thread .

He could also be sticking to his “ ethical “ reasons because he does not want to deal with the emotional woes of placing his mother and subsequent phone calls and visits . It’s called avoidance .

You tell him you do not want to get in many more debt over his mother . You have a child to support who may want to go to college one day. You also need to save for your own retirement years. His mother can get Medicaid .
Helpful Answer (8)
Reply to waytomisery
Helpneeded8972 Feb 5, 2024
Medicaid assessments are dumb, cause they state dumb s**t like cannot be left alone for safety and supervision, requires a one-to-one blah blah people like my husband clinch on those words.

In his eyes if that is what he assessment states this is what she needs then why not provide it? To a degree I get the stance, and even with her doctors I get it also. Why medicate someone that is perfectly fine with a non chemical intervention.

Giver her a one to one she is fine they are not wrong, problem we poor we cannot afford that.

In an ideal world everyone would get the ideal treatment but that is not realistic. F**k this disease, that is where I am at now.

Eeverything you said is on the money, but he has others in his ear telling him he is a good son, he is doing what is best for his mother, so rare find someone willing to do what is right everyone often take the easy road.

I wish I could beat her doctors tbh.
There is no ideal on Medicaid.
I will be so honest as to say with the mental issues and medications there is no ideal in even the most wonderful memory care with all the financial assets in the world, and it is memory care she needs or a nursing home and medication, as she cannot be cared for easily and as you have seen as regards Medicaid, EVERY PLACE out there cherry picks patients.

You MIL has needs that you cannot fulfill and needs that no one ELSE wants to fulfill. Period. End of sentence. And the facts.
It doesn't get worse than this, and from my own view over time, you pegged it exactly. I am also a retired RN. I think we both know that the "hospital method" as you call it, and what we here admit is the ER DUMP is the only way. And no, the placement won't be pretty and may not even be in your area.

It is time for an honest sit down with hubby. It is time that the marital disagreement is addressed. This is his Mom. I understand that. Now I need you to tell me that he is on board with at LEAST 50% of the care of her and of the rest of the household. If you can tell me that, I won't be as tough on him as I would like to.

The truth is that I would be telling any husband of mine that I understand I stepped into this myself, and that it was likely the biggest mistake I ever made, that I should have known better as an RN. But that I cannot go on either mentally or physically, and that it is literally destroying me. I am going to admit right off that MIL is a placement problem. And that of course doctors don't want her placed as it is basically losing a patient who will likely have to be in and out of neuro-psyc rehabs for medication titration for the rest of her life, and who will likely be over medicated to non responsiveness of undermedicated so that she is shown the exit of any facility out there. I would tell that husband that in the most ideal of circumstances (say she has lots of money) her mental situation is going to make placement almost impossible.
AFTER I said ALL OF THAT I would say that I know this is painful, that not everything can be fixed, that we didn't create her circumstance and cannot fix it, but that I personally can no longer endure it.
I would tell husband he has a few days to think on this but that it has come down to you or her. That if she stays you will have to leave. You will see an attorney for legal separation and try to find a nearby small efficiency room or apartment, that you will attempt to help with some things such as shopping and etc., that you love him, but that you cannot go on.

I don't see another way.
I know you don't either and that's why you are here.
Know that you are not alone.
I am so dreadfully sorry. I just finished a memoir by a daughter whose mother, even IN CARE lived way way too long. Called Requiem for my Mother her own very talented musician mother was reduced to being someone her family longed to see go to her peace. This is what so many of us are reduced to. People praying that our elders can pass.
Helpful Answer (8)
Reply to AlvaDeer
Helpneeded8972 Feb 5, 2024
Thank you. Know the funny thing as am RN I use to dread and hate when families would dump their loved ones off. I remember all of us on the floor would bad mouth such people. Living this I understand how tough it really is.

It is nice to be around people that do get it. I do feel for him and I have tried to tell him many times that this diease has no real good options just a bunch of crap ones.

I feel for him, and my MIL. I wish I could take away her pain and suffering. Sadly that is not option.

I will speak to an attorney to see what my options are.

Edit: While he cannot always do 50% given work he does do all he can when it comes to both our child and his mother. Would say it is more 60:40.

I was able to stop working when our kid was born due to some smart / lucky investments and his income.

I will be looking to get back to work going forward though.
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Helpneeded, there is no "one to one" in any world. I formerly heard this from parents of children in need of special services: "He would do fine if he had a "one to one" academic helper. There is no "one to one" help except for someone of the wealth of Elon Musk or Warren Buffet. Your husband "means well' but good intentions pretty much pave the road to Hell. This is situation of "counseling needed for husband", presenting problems are 1) will not tolerate idea of medication to improve Mom's countenance, 2) feels a difficult elder is entitled to one to one personal assistance, and 3) feels OK with decimating his family's finances (including a child) and ruining his marriage by failing to listen to his spouse who has "health risks" (stroke or heart attack) due to his inability (or unwillingness?) to function in what I would call Reality. You love your husband dearly but he is not willing to face reality. Speak with an attorney about "separating finances" before filing for divorce.
Helpful Answer (8)
Reply to fluffy1966

Your husband is using the fact that you stepped up to help, now he doesn't have to make many hard decisions or put in the work to care for his mother that he brought into the home.
Helpful Answer (7)
Reply to RealtorD
Beatty Feb 12, 2024
I read this several times over & it is so clear when put this way.
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