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I have my mom also living with us and caring for her 24/7 is not easy especially with Corona situation, I can not hire anyone! It's extremely hard. You have siblings but I don't! You need to ask them to step up and take over and let you live or at least contribute to hire someone to live in if you have an extra room (hopefully is tested and screened for Corona).
She has lived her life, you need to live too and have your family. You are lucky to have siblings. Get them to work!
Best of luck...🙏🙏🙏
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Patathome01 Aug 2020
I think MIL requires facility quatantine and placement since even outside family or other help is Corona risk. Yes, what a mess I feel sorry for.
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Try talking with the siblings to create a calendar where everyone does an equal load. It may be falling on hubby because he doesn't say no and other siblings know that.

It sounds like your hubby works remotely to be able to stay 2 weeks at a time. Do any of the other siblings also work remotely? For those who don't, they could fill in for their days off, like from Fri evening to Sunday evening.
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How old is the mother-in-law? You said putting her in a facility is not an option. In that case, pressure needs to be applied to the siblings to help or bring up a nursing home to prod them into helping more. Past that, you are just in a pickle.
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At this stage of her life, I would just ask the doctor to increase her medicine at night. She isn’t going to get better.
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With what you describe, YOU should NOT be the one taking care of her. You must do all you can to take care of yourself before it is too late for you. With her condition, she should be placed where she is cared for. This situation is only going to get worse and if there is a baby, it will be an impossible responsibility. Don't wait - place her and on the baby bit.
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This answer will fall in the minority. It is somewhat appalling the callousness with which people will say "put her in a home now." Sometimes that's necessary, sure, but you're not throwing away an old toy. This is a person, the mother your husband loves so much, and the reason you have him. But you realize that. No shame in wondering how long this could last. You need a good, deep conversation with him about the future, with a good counselor to make sure it doesn't turn into an argument and is productive. You need to do what's best by her and you as a couple. Starting a family means one day we are the elders, and we'd want our kids to do right by us. It's obvious you care, but are stretched thin. There's no one perfect solution but getting more family involved or paid care could help. Best of luck.
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disgustedtoo Aug 2020
Not all of us are being callous when we suggest finding a facility. It becomes ever more difficult, both physically and emotionally, to provide full care for an adult with dementia (any adult really, but dementia adds another whole layer.)

You say "There's no one perfect solution but getting more family involved or paid care could help."

I will agree that there really is no one perfect solution, but we have to weigh those options we DO have and try to select the best of the choices, for everyone involved.

Family help:
As for getting more family involved - AHAHAHAHAHAHA, sure... There are NUMEROUS threads and comments in this forum regarding this topic. While there are a few bright spots, comments from siblings who work together, most of the comments and questions are from those who DON'T get help or support, even when they ask or beg for help. Asking my brothers for help only frustrated and angered me with their lack of support or even understanding. OB just yelled at me to "give it up." Oh, that was useful help from family, eh? The other brother...let's not go there. I will only say that at this point I need him to take mom to 1 appt, 4x/yr, as it is outside the transport area, no other options and I can't support her weight. He doesn't visit, does nothing to help me and tries to get out of these appts! Once she passes on, he will join OB as persona non grata. OB has been there over 2 years and I want nothing to do with this abuser (another reason for not letting him care for mom, like he even could - he couldn't even tolerate a short visit with her the last time he was here!!!) I have no spouse to help and would NOT ask my kids - they have their own lives and issues.

I for one can say WITHOUT hesitation that I knew I would not be able to care for my mother in my home (many reasons, esp access to get in/out and being physically unable to support her weight, but also very small bathrooms that are too small to handicap and renovations being on hold mid-way for several years now. It would NOT be a safe place for her.)

Bringing in help:
Despite trying to introduce aides (1hr M-F) to get her used to them so we could increase the time as needed so she could stay in her own condo, that fell flat in less than 2 months. She refused to let them in. Her place was about 1.5 hr from me, OB lives 2 days away and YB is still working, so it isn't like any of us is near enough to respond quickly to issues or provide daily assistance. NEITHER brother would be a good caregiver, esp OB (I could write a book about those 2.)

So, don't assume that we who advocate for finding a safe place for someone means we are callous. In this person's case, it does sound like it might be the only real solution - trying to live a life, work full-time, start a family and having to spend 2 weeks at a time, often lacking sleep is a recipe for disaster. Sometimes the best we can do is find a GOOD place for them, and then become the child again, advocating for the parent, visiting often, watching over them without the stress-inducing need to provide all the hands-on care. Moving someone to a GOOD (ignore the "STARS" reviews, check them out yourself!) facility and providing all the non-hands-on care and visits will reduce stress and free us up to spend QUALITY time with a LO rather than digging ourselves an early grave.
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I am a self-employed caregiver. My specialty is seniors with Alzheimer's/Dementia. All this is great advice, but let's turn that puppy round. As bad as she "gets on your last nerve," have you stopped to consider how bad you get on hers? The ones with this horrific disease, are still "in there," somewhere. They are also like small children - they act out. Sometimes, the bed-wetting, removing the pads, is a way of "getting even," or the temper tantrums. I know as we age, the bladder, among other stuff, get weaker. Just as a baby, it can't be controlled - they know what happened, just couldn't hold it. Part of all this is the anger they feel - know somethings wrong, and don't have a clue bout how to fix it. There's no way to get them to your mindset - try getting into theirs - watch, observe what sets them off, it could be anything, and prevent it next time. If you feel you can't deal anymore, I would check into a facility somewhere. If she's that bad, she won't even remember being in your home tomorrow. DO NOT FEEL GUILTY FOR HAVING A LIFE. No guilt, no regrets. But sugar, you need help, now.
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disgustedtoo Aug 2020
While some, esp in early stages and highly dependent on what the person was like before dementia, sure, some of what they do could be "acting out", but I really doubt my mothers incontinence, repetition and so forth has anything to do with "acting out." She has dementia and it affects everyone differently. Sure, they often share common symptoms and actions, but each one is unique.

I think in this case, if the MIL is truly stage 7, there really isn't a way to "get into her head" or reality. That suggestion works often to help when the LO gets stuck on anxiety about a family member or has some delusions. Once they get to this stage, there isn't much reality left.

My first suggestion for the night time issue is get her tested for UTI - preferably the urine culture, not just the dip stick test. When I joined this forum, reading suggestions to test for UTI seemed odd... until it happened to mom. She had UTIs often over the years, but the first one after moving to MC resulted in some SERIOUS sun-downing! However, the next 2 showed up as night time bed wetting. She wears disposable panties and has pads inserted at night. She would SOAK herself, the bed, her nightgown, etc. This shows up as extra laundry charges (14 one month! how does a woman in a wheelchair generate that much extra laundry? Bed wetting due to UTI.) Once treated, the wetting stops.
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Dear, Erica1, why is a facility placement not an option?? And, no mention of her age. MIL has a disability and not able to care for herself. Your MIL needs either 24-hour caregivers or be placed in a facility. Get a social worker for assistance. There is an option, Covid or not. MIL's required care is beyond your capable level. She can spend down to Medicaid eligibily.
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I will begin by saying how thankful I am that husband and sister supported me through our journey with my mom. My children and grandchildren came first, but they were all supportive of our care for mom too.
For you, having a family can't wait too much longer so you will need to focus on that. You will also need to be supportive of your husband as he helps mom. You did state that you have support of family and caregivers.... You just may need to pass more of the support their way at certain times. It also sounds like mil doesn't live in your house, so at least that is not an issue. You should support your husband as he cares for his mom.
#1 Luckily my children were adults when I was caring for my mom, but I did homeschool a grandson during that time. I was lucky that my boss allowed me to work almost entirely from home...on my own schedule. I didn't have any physical help from siblings, just my husband and occasionally my children. It was very rewarding...I was blessed to be holding my mom's hand as she took her last breath.
#2 Your mil doesn't sound like she is stage 7 yet. When my mom got to stage 7, no longer talking or walking, has to be hand fed, she still lived 3 years.... 2years on hospice.
#3 Sleep is tough. I tried some of the things others suggested. Keeping her up more during the day, limiting sugar and drinks later in day, setting a schedule.... I didn't want to use meds. Many nights we were up... It is a big part of the disease. Sorry, one of the things that make it the worst on those of us caring for them.
#4 It is best to limit lemonade, tea, coffee, soda. Also looking water close to bedtime. I also invested in more expensive overnight disposable briefs.
#5 Sanity? I am not sure if we keep our sanity ;-) For me, I was luck to have my children and grandchildren around ...for you, with a (hopefully) new baby? Well, you will need to not be doing as much of the care, and you need to be sure that you have help when your husband is taking time to help his mom... But he will need to find a balance too. You will need his support with baby and you will need to support him to care for his mom....balancing act!
#6 This is the tough question. Give yourself a break... You can't be everything for everyone.... And neither can your husband. Stop and think, if you were your mil, what would you feel was fair? How would you want to be cared for? If your parent were in this position, what kind of support would you want from your husband?
Finally, just love your husband and support each other. Much luck
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So sorry for all your problems with this awful disease. In my opinion, the place for your MIL is a healthcare facility. I don't know what the circumstances are that make you say a Nursing Home is out of the question. But, I sincerely would advise it. It is next to impossible to be a wife, then mother, homemaker, nurse, along with loosing sleep at night, and still stay sane.
I do think that, should money be the problem, you should investigate Medicaid. Medicaid is wonderful. Give it a try. If it's because her son, your husband, can't seem to let go, I suggest he visit a couple of N.H. to get a better feel of those kind of places. They are not ALL bad. Start looking into them because, with dementia and disability as your MIL has, things will not get better. You need to keep your sanity and concentrate on your future together.
While in a nursing home or whatever, Mom will get 24 hour care divided among three people. She will be changed often; will be bathe easily with apparatus that you don't have at home; will be fed, if necessary; will have her clothes washed and cleaned. Then there will come a time where Mom, eventually, will not know who you are. But, believe me, I've been there, she will be taken care of so much better than what you can do at home. No matter how much "help" you get.
There are 10 stages of dementia....specifically Alzheimer. Each stage progresses at different speeds for everyone and also different phases cross over to other phases. My mother is in her last stage, however, she can still talk and carry on somewhat of a conversation. There is no telling how long a stage lasts.
And, no.....you are not a bad person to wonder when your MIL will pass on. Anyone who takes care of a relative with dementia wonders the same thing.
I wish you peace and I hope you find a place for your MIL soon so that you can get on with your life and future.
If Mom can afford in home care, at least for a few days a week, that would help a lot. I certainly hope that either you or your husband have POA for healthcare and monetary concerns. Peace be yours and soon.
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Imho, I would have to know the age of your MIL. Based on you and your DH being in your mid 30s to early 40s, MIL may be roughly mid 60s? Since she is otherwise healthy other than the dementia, she may still have quite a few years left. You no doubt will require more help especially since you want to start a family quite soon.
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"Putting her in a home is not an option.'
Can you elaborate on this? Is it a financial issue or family preference?

If it's family, is it all the siblings or just your husband? The toll for 6 years of sharing care (with the bulk landing on him and you) is hard enough, but as this progresses, the stress and strain will only get worse. In answer to your 2nd query - there's no real time line. It varies depending on the underlying health of the person and what type of dementia. Some progress faster, some take much longer. If she is relatively healthy, she could live many more years, becoming more and more dependent and lose mobility. This will take an even bigger toll. Even with sibling help, this is a major undertaking and can impact ALL facets of your lives.

Some promise not to place a parent. Some still think these places are awful. The promises can't always be kept forever and sometimes it reaches a point when it is better to use a facility. Guilt? It happens, but when one can spend time LOVING the parent instead of cleaning up after them, it is better for all! Do take time to visit, when it can be done, places. Mom's place is very nice and I wouldn't object to living there if needed!

If it's financial, there are often ways to mitigate. If someone has POA, her house could be sold and the proceeds used to fund a facility. It would be wise to consult with an EC atty, to know what can and can't be done, what financial restrictions there might be, what options are available.

If in the end either preference or finances preclude a facility, you can hire CNAs to cover care during overnights and other times. It is more expensive for full-time care than a facility, but is an option to provide some relief for those caring.

For your questions:

1. This is difficult at best. Having to tend to emergencies, lack of sleep, etc can take a toll on one's health and could impact employment. Raising a family is stressful in itself, at times, and having to juggle that with full time care for someone else is going to be taxing for everyone!

2. Medical professionals might be able to guess, but there's really no way to know.

3. This should be done with medical advice - doesn't mean medication all the time, but they may have ideas. Sometimes a mild dose can do wonders but not impact much else. I'm not a fan of medications, but the anti-anxiety did help get us through the 1st UTI/sun-downing. It also relaxed her enough that she would go to bed at a normal time, but she wasn't "doped" up.

4. Have urine culture done. Mom's 1st UTI at MC showed up as sun-downing (behavioral), but the last 2 resulted in night time bed wetting. She wears briefs and has a pad insert, but would SOAK everything. Once treated, no soaking!

5. Who says we do??? ;-)

6. At the stage she's at, it's likely hard to set any boundaries. I think some deep conversations between you and your husband, maybe siblings, are in order to discuss and know when anyone has reached their limit. The fact that they are not contributing as much hints at perhaps it has become too much for them. What you describe sounds overwhelming to me (hubby.)

"This illness is the worst." - agreed. Bad enough that it is terminal, but to not know how long or what to expect...

While caring for his mother is important to this man in your life, and you do what you can to support him, I think he needs to really step back and see what this is doing to him and your relationship. While I can understand someone can love enough to want to be there to the end, it would be much better to have her under someone else's care, so that he can spend QUALITY time with her - loving on her, taking her out, if possible, advocating for her - in sum, being her loving son again instead of a care-taker. It relieves the stress of getting all that drudgery done and allows us to give our love as best we can to those who may not fully understand anymore. We know.
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Pepsi46 Aug 2020
I agree with everything you said.
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If she is on a STATIN of any kind stop giving it to her, our brains need cholesterol to survive. Next, We all have guilt in this situation, I pray you have faith and ask the Lord for strength. Not all NH are bad, many are wonderful. The people are trained in this. Good luck and please pray .
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I see several commenters posting about ways to prolong the time in which you can start a family. We have 10 grandkids, 6 great-grands and one more great-grand on the way. Kids are exhausting for everyone, but to me it seems that the one child who had his only child rather late in life, struggles more than the others. I know that I can't play with my younger grandkids the way I did when the older ones were little. In my early 50's, I could crawl in a playhouse, sit in a sandbox, skip down the sidewalk. Not so much anymore. LOL. I can still get down on the floor, but can't stay there too long and watching me get up is not a pretty sight. LOL. How old you will be raising your children is something to consider. And I think your MIL would be well-cared for in the right facility.
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If you think you are over whelmed now with caring and working, just wait until you have a baby.  And WHY is putting her into a home "out of the question"?  Is there anyway you can check into private nurse home care for her.  You would need 2 to divide up the hours in a day (this was done for a man up the road where I live). both would do 12 hour shifts.  Nobody knows how long each stage of dementia lasts.....it could last another 3 or 4 years.......then what, handling a toddler, maybe preschool, etc on top of everything else.  When do YOU sleep?  when do YOU get YOUR house work done?  All of this stress will NOT be good even when going thru other steps to get pregnant........what happens IF the doctor tells you that YOU need 24 hour bed rest, other than to go to the bathroom?  WHO is going to handle everything then?  I think its time to speak with other family members, contact an Elder attorney, and discuss placing your MIL into a home.  (you can make arrangements with the homes to check them out before placing her).  The money will come from HER, and when the money runs down...she can then be placed on Medicaid...........(an elder attorney can help in saving some of her money).  Wishing you luck in both your hopes to start a family and also in placing your MIL.
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Like many others who have posted I am curious as to why care facility is not an option? My mother is 93 and has always been fearful of being "put in a home." Even after working several years as a nurse in one of the best facilities in our city!

Well fast forward 25 years and she is now living in a very good facility due to dementia. My brother and I keep a close watch on her, window visits right now but the staff know we are being observant. She is clean, relatively healthy, and has her medical needs closely monitored.

There are many excellent SNF and AL options out there, staffed by caring nurses and aides. Sure, there will always be the bad eggs but we have found most to be good people. And 3-4 shifts in 24 hours means they are relatively well rested and can go home after a 6-8 hour shift. Can you say that about yourself? Especially with a new baby?

I admire anyone who is willing and able to take on the care of an adult with dementia. But it only took a few weeks of Mom living with me to recognize that I could not do it long term. It would not have been fair to me or my mother and potentially harmful to us both.

Good luck with whatever decision you choose, and best wishes on starting your new family.
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I completely understand the reasons you have for wanting to keep her at home. ESPECIALLY in view of covid-19. I also have a mom with Alzheimer's Dementia and is sounds like she is a little bit more advanced than your mom but not too much.

My mom entered the "wandering at night" stage a few months ago. I give her 10-15 mg of melatonin at bedtime and that helps her get to sleep (sometimes I give her a rx of mertazimine 7.5mg too. It's keeping her asleep that's hard. I've started keeping her up an hour later (abt 11:00 pm) then giving her the sleep meds ith milk and calcium. (also keep daytime napping down to 1 or 2 naps of 1 hour or less).

Most nights, I get some sleep so far by following this. Its hard but you can make it better by finding what works for her.

Best of luck,
you are in our prayers as I know how hard and necessary it is to care for you mom.

Diana
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