My father in law is a great man. He has been unquestionably the leader of the family, a warm, loving, and generous person whose decisions have led to a prosperous life for him and his children. He is now 90, and his great mind, the true person that he is, is only around a quarter to a third of the time. It is impossible to gauge when the real person will show up, although when he is around more than a couple of people he seems to try harder. The rest of the time, he can be confused, angry, combative and abusive. He lives with my mother in law, who has taken on almost all of his care. Both of their children live in different cities than they do. A few years ago, my wife started regularly flying down to help out every couple of months. Her brother goes down a few times a year as well. My mother in law is a dozen years younger than her husband, but his needs are taking a toll. Everyone agrees she needs help, but my father in law refuses. He doesn’t even want the cleaning person to come for more than once a week. I am very concerned about her health. If she catches the flu, she will likely be down for a minimum of two weeks, which would be a disaster. If something worse happens to her then all choice goes out the window. Either he will need a full time nurse or they will both have to move to an assisted living facility. Because of my father in law’s success in life, money is not an issue. My mother in law realizes there is probably not much time left so she wants to keep him happy and comfortable. She cannot say ‘No’ to him. He will be around longer, and the quality of the time remaining will be better if we can just convince him to let her have some help. Do we fight him and hope he tires of the battle? Do we lie to him (tell him he already agreed to having someone come in for a few hours a day)? Do we try to have his doctor be the one who tells him that he has needs that are beyond his wife’s abilities? I would appreciate hearing from others with similar situations. What can work? What is unlikely to help?