So I created a post several years ago, and wanted to look for help based on the current situation. My father-in-law had a debilitating stroke a few years ago. He can't walk on his own, barely talks and has a feeding tube for nutrition. He has been in a nursing home the past few years, and recently he ended up in the hospital with a UTI. My wife now wants him out of this nursing home, and wants to move him into our home to take care of him. Here are a couple things to keep in mind.
Our house is not wheelchair accessible, bathrooms/hallways are a bit tight.
We have 2 small children that live in the house, she wants to put them into one room so he can have his own room. Or put him into the oldest one's room, he's not pleased with that idea as you can imagine.
No one in his family cares much about him, including his estranged wife and 3 other kids. He has a sister who wishes he was dead. My wife is the only one who wants to take care of him.
My wife is a nurse, and she is under the impression that she'll be able to handle his care 24-7. I know it's going to take 2 people to get him to the bathroom or to change his diaper.
He has no income besides Medicare, about $800 a month, and the nursing home has been using that for the past few years.
Now I've expressed my opinion on the situation, but I don't think she is taking anyone else into consideration. She has already closed his account at the nursing home, and he will soon be release from the hospital. I'm pretty sure she is just going to bring him home. She does not discuss any details with me. I told her that this decision could possibly break apart our family, and she is willing to go that route, BUT we are living on a combined income so I don't see how she would be able to do it on her own, much less with both of us on board. Me personally, I think he has had no quality of life in the past few years. No one has gone to visit him, including my wife. I don't see any way for his condition to improve as it has gotten much worse over the past year. If it was my father, I would have a talk with the immediate family about removing the feeding tube and let him pass. I know that is a hard decision, but lying in bed all day and not seeing anyone ever is awful. I've asked other family members on her side if they would be able to take him in, and of course no one will, they all have excuses. I've asked if they would like to move him to a different facility in their area/states, where he can be closer to them, and no one has stepped up. The facility he was at was a good hour or so from us, it was the closest one available.
Does anyone have any knowledge of what Medicare/Medicaid would cover for caregiving at home? What I saw was 35 hours a week, but not for long term. My wife said that she could be his caregiver, and they would pay her X amount of money, but I didn't hear any other details with that option so I don't know if we could afford that route. My wife would have to quit her current job, so we would be losing half of our income, and with the way everything is costing right now, we can't afford to do that. So I guess, my question is a couple parts. 1, how do I convince her that this isn't an option? Even if money wasn't an issue, I honestly don't think she could handle it. She brought him home for a holiday last year, took care of him for 2 days. After the 2nd day she had to take 2 days off of work because of the exhaustion. 2nd question, does anyone have any real life experience dealing with Medicare/Medicaid for home health care, at home care giving, so I have those facts ready when I try to have a discussion with her? Also note, this has been a very hostile topic, and has caused some knock down drag out fights, some occurring in front of our youngest child. I have told her numerous times, that I do not want this to cause these fights in front of the kids as it's harming them mentally. We've had some issues now with our youngest at school. Please help!
Marybost - my daughter is an RN and is almost making 6 figures. Sometimes she has made more than her husband. When he went back to school to get certification, she supported them for 2 years. So, it is very likely that OPs wife makes half of their yearly income. Losing it would be a big thing.
The best thing you can do is to get your ducks in a row of what to do and where to send FIL when this happens. I strongly feel that she WILL see the light when she has been sleep deprived for a week or more.
Work on identifying several LTC medicaid NHs because he WILL be going back to one eventually.
I like how you've handled most of this so far. However, a lot of your foredrawn conclusions are based on incorrect logic. For instance, you are not losing "half your income". First of all, I seriously doubt she contributes half although I could be wrong. Second, you would be losing "her part of our income but gaining whatever the insurance pays us for care giving." Like someone said, there is too much fluidity in your facts, meaning that you angle facts to frame your point-of-the-day, sometimes using the same facts for several different, mutually exclusive reasons.
You said you lost income when she was too sick from working double time, but you failed to present all the double time she earned! C'MON. We aren't stupid readers, man.
You can't stop the feeding tube because it wouldn't be in place unless he expressly asked for life-saving end-of-life measures. That is HIS choice, not the family's. When you are 90, you'll be grateful that YOU got to decide in advance with your directive or POLST document, what your end-of-life wishes are.
If your wife is an Aries, it's best for her do it. It's the only way she'll sort this out.
If her dad is not obese, or is thin, his care should not be too exerting.
Wherever he ends up, he won't get UTIs if someone puts cranberry medicine in his food, if that is possible. Cranberries prevent bacteria from attaching in the urinary region.
There are a lot of things wrong with most of the responses you got. A lot of the reasoning in the responses is myopic, fear-based, racist (one), and mysogynistic. Many responses violated the whole spirit of marriage, of teamwork.
Being a nurse is very hard work. If she's had it, she's had it. Let her be. Maybe her capacity is not the same as before Covid. Tell her if she wants to change careers, you would support it if it's financially possible. Tell her she wouldn't have to use her dad as the rationale to get out of her job, if that's important to her.
Return the puppy and kitten. Those were mistakes. What were you thinking. They should have waited until after this crisis settles down.
Can't you enlist any niece or nephew as a backup plan? I've never known anyone cared for by their siblings. It's usually by the grandchildren or nieces/nephews.
Don't worry about your bathroom. I've dealt with some really small bathrooms. It can be done. However, it sounds to me like he'll be on piddle pads and disposable briefs. You can order a "commode" for bedside. It is basically a toilet with frame bars to hold onto, & no plumbing. The container is lined (most people do) and emptied. He can urinate into a urinal in bed, and some modified clothing detergent bottles work best.
Feeding tubes I worked with were very easy. I don't know who routes them up the nose and into the whatever. Some people have one that goes directly into the stomach. Anyhow, hopefully your wife can set it up and keep it clean. But the actual use of it is very simple. The food is ultra-purified and kept at room temperature forever. All you do is plug a new sack on, and usually the flow button stays at the same slow flow.
Check with Volunteers of America, Catholic Community Services, Lutheran Family Services and 211 to see if you can get volunteer care givers. Some people give back.
You & she should control yourself around your 5-year old. The issue on that, is not her dad. The issue is that , is y'all haven't been disciplined to argue behind closed doors in a civil manner with a radio on and laundry going. Do it when the child is asleep or out of the house. Or take a drive. It is up to the parents to see it coming, & take precautions as a team. Whatever the issue. The is
Your plans sound very good -
increasing communication & maintaining the children as the priority.
Your wish may well be to talk your wife around... but the first goal, done with honesty, may be for you BOTH to have a say. This should avoid her feeling 'ganged up on' as you say.
Then for her to really HEAR your view.
The next aim may be for her to realise if she continues with her current wish, there will be consequences - ones she will NOT like.
Once she GETS that - she will free herself to make new wishes!
Best of luck 🤞
If I would have known that she would be taking care of her invalid father, i would not have married her..I'm sorry..I'm all for helping your parents as they age..but her dad is in bad shape..there is NO ONE person that can take care of him..and she is being down right selfish as she will be neglecting our 5 year old during his early years of child hood.
And I agree with MJ that if she cant do her job how does she expect to take care if her father 24/7.
I hope you refuse when she asks for help toileting and caring for dad. Because you know that's going to happen.
She doesnt even have the energy to take care of her own kids.
Whether you acknowledge it or not this thing with her father will forever change your marriage. Especially when you refuse to help her with dad. She sounds like the type of person that will blame you and resent you for not helping her.
I hope you stay single after this is all said and done.
And yes, unfortunately you are 100% correct..our relationship is forever damaged..it's unrepairable, and there is resentment on both sides now.. is it fixable? i dont know...she would have to change in a major way...what happens when dad passes? heck she blames me when he gets a UTI...
But here is the thing..and I learned this from the therapist I was talking to..she probably isn't thinking clearly because she is grieving..before all of this mess..we never had any issues..we worked hard together renovating a house..started a family together...laughed together, loved each other...its really a bummer, and im truly heart broken over the whole situation..i want it to work out, because I do love her.
Also, I haven't read the entire thread, but I think it's only fair that at the very least you demand she have a concrete back-up plan for when this fiasco fails. She can't just go down one day and expect someone else (read: you) to pick up the pieces until another nursing home has an opening for him.
First off, I want to say THANK YOU to everyone who has posted, whether it's advice or criticism or just well wishes, I truly appreciate. It has helped me tremendously with dealing with this situation. So thank you!
Next, I have my first online counseling appointment today. I think this was really needed for myself, as I've been experiencing quite a bit of anxiety and depression from this. I would like to get my wife involved, and possibly the kids, but I felt that this was the first step.
This is a busy time of year for us, with 4 kids all in different grades and schools, you can only imagine how much stuff is going on. Homecoming, plays, school projects, after school activities...you name it, there is always something going on. Even though we only have 2 of the kids living with us, I'm involved with my other two as much as I can be. I am the one who does the school projects, transportation to and from school, etc...so if I'm not working, I'm doing what a dad is supposed to do.
Update on my wife, and this is sort of a big one. So her work is understaffed like a lot of places are now a days. Well, they have been working her about 7 days in a row, with maybe a day or two off after. She ended up getting completely exhausted, got sick and ended up going to the Dr. where she was treated and is now feeling better. Down side to this is, she has missed work, and is now behind on her charting. So then her work grounds here, so she can catch up on the charting. This impacts us financially as he paycheck will probably less than half of what it normally is. I can't get frustrated with her, as I witnessed how much she had to work, and I wasn't surprised when she got sick. Her work HAS hired on some new nurses to help with the load, and has promised that they won't load up my wife as much as they have (they can't really). Now, there is a small part of my brain that thinks the timing of all of this could be intentional. Meaning, is my wife not catching up in a quick manner, attempting to get fired? Making it where she is at home, and available to take care of her Dad? Not a good option, considering we rely on her income, and if she thinks that Medicare/Medicaid is going to pay her to take care of him, she is wrong. We've all agreed on that on this forum.
So if I was to guess, I'd say FIL has about 2-3 weeks left at short term NH before he gets discharged. My goal is to get some help through therapy and then involve my wife so that everything is out on the table, open communication, full transparency. I'm hoping that the therapist that I was assigned can understand this situation and has some help for the both of us. What I want to avoid, is having my wife think that I am just trying to have this counselor change her mind, or feel like we are ganging up on her. I honestly don't think that anyone is going to be able to convince her, and that the only way she is going to realize that this is going to work is to actually live it out. And while my main concern is the kids, I've talked to them and have been prepping them for this scenario, and I know they won't have to go through much of it as it will fail quickly. I know there will be resentment for her making this decision without considering myself or the kids, and that will need to be addressed as well. I ultimately want to work together to work through this, as I know it's a tough situation, but I'm confident we can get by it. I really wish I had the support of her own family, I'm really disappointed in the fact that they aren't disagreeing with her decision, and I don't know if I'll be able to respect them in the future because of it. Well, I think that's it for now..I'm running out of characters, and it's time to get to work. Thanks again everyone, I promise to keep you all updated.
So should this happen, it’s when a definite decision has to be made:
- he stays at the facility and goes from rehab patient (MediCARE) and segueways to become a LTC resident (LTC Medicaid or private pay or LTC insurance). If he was on LTC Medicaid before, it may make the paperwork easier OR he could face having to have a new LTC Medicaid application done.
if this is a new facility for him, they may want your wf to sign off financial responsibility on him. Y’all are married so should things go bad, it’s joint debt.
OR
- he exits the facility to live at a family member’s home.
Your bride is not acting reasonably. I’d be real concerned that she will sabotage his rehab stay; that she become even more hyper on the “only I know what’s best” mantra. When the patient or family gets like this, the staff isn’t going to try to change their minds. Staff isn’t going to coddle a patient; they’ll be nice but if your not making an effort to participate in the care plan, well in my experience your toast on staying in rehab. They can’t as Medicare is really strict on having to have in detail just how the patient is progressing. MediCARE will cover up to 100 days in rehab but pt has to, HAS TO, be measurably progressing.
Try to have a word with the SW & PT regularly at the rehab / NH as to how things are going so that you and the kids are not gobsmacked to find out that grandpa moving in manana. Good luck.
hugs…hope she realizes family impact.
The fact that she is a nurse also doesn't automatically give her any advantage - by that I mean it might give her a skill set but not an advantage to really do the job - because at the end of the day - she's not anymore able to remove herself emotionally than the rest of us. And the biggest advantage a nurse has usually is the fact that they aren't treating their own family members when they are applying that skill set. And when they are working - there are multiple nurses on duty in shifts. She is ONE person on ALL shifts - permanently. In her mind I'm sure she is thinking "I've taken care of multiple patients, I can take care of just my dad". But that's the unrealistic thinking that is going to be her downfall. She was never doing anything alone.
And that's what she has to be here. Because she isn't giving you any choice. It sounds like to me she intends to move her father in and expects the entire house to become a nursing home. Has she discussed her plan for AFTER he is there? Does she expect you and your 14 year old step son to assist in his care? Does she expect your children to give up activities so that she can be home with her father?
The way I see this breaking down is that she will take care of her father 24/7 and you will do...everything else - work, home, take care of the children. And you notice what is missing. Her relationship with you and your children.
Additionally- I have said this before on the forum. Unless you live in some massive home - which based on the fact that the kids will need to bunk together or grandpa is moving in with the 14 year old (ABSOLUTELY NOT) this is HUGELY disruptive to everyone. Does she even know what he is like round the clock? You mention that the last time you saw him he was basically unresponsive. Is he physically catatonic? Does he talk or make noises? Moan or groan? Is he physically able to move about on his own at all? How close are the bedrooms - would she have to be up all hours of the night or day changing him or feeding him? When does she intend to sleep? Is this going to be so disruptive that the kids aren't getting what they need - sleep at night? Could this potentially impact their education or health (mental or physical)? Could the fighting between you and mom escalate and be misunderstood by the 5 year old and become something else that he mentions at school? Not physical but it doesn't have to be for your child to misinterpret and say something at school. Children at that age don't always understand what is happening and can say things in such a way that teachers and school administrators are required by law to report it to Child Protective Services - things that in reality are totally innocent but that can be misinterpreted and then you have to go through the process of the added stress of a CPS and even an APS investigation to prove everything is actually ok.
Additionally - he has been in this state for how many years. Does she really think that is ALL the fault of nature vs nurture? She really believes that she can bring him into your home and reverse the damages to his health? She is willing to do that much damage to her life and her family and her marriage on a "what if" for someone that she didn't even have a great relationship with in the first place. The guilt is strong in this one.
I don't have an answer. But it doesn't sound like she can hear you through the FOG (fear, obligation, guilt)
Make a plan for how you can manage without her or her income. You need this fall back to feel more secure yourself while the world spins out of control. (Smaller 2 bedroom apartment, find before and after school programs to allow you to work, etc.) If you own your home, do not hesitate to force a sale. She and Dad can also move into a 2 bedroom apartment.
If you need to implement your emergency plan, go after part of her (reduced) income for child support. You might need to let her sink before she realizes the actual situation she has created. She has the resources to dig herself out if she wants to. Remember, the kids come first.
Best case scenario, she actually gets Dad a little better; then what? Where does he go from there? Does he live with you forever? She really doesn't appreciate what she is doing with her unilateral decision: you are on the brink of losing your wife and your kids their mother. This is damage that cannot be undone. You are the kids lifeline. That is your first priority, because there is no one else.
With prayers that she will realize the impossibility of her plan having a good outcome, and be willing to listen to a counselor for the good of all of you.
The OP never mentioned that his wife doesn't care about the kids.
She's making a terrible mistake insisting that her father be taken from the NH and moved in with them. She's also being very stubborn about it and the price of that stubbornness may be the loss of her marriage and family.
So be it.
There's still no reason to play dirty and try to set her up.
If it comes down to divorce I cannot see how a judge could possibly allow the kids to live with their mother. Not when she is caregiving for an elderly invalid with dementia in house. She cannot care for the kids too.
Then the OP will not have to worry about getting by without her income because then she's paying court-orderd alimony and child support as she should in such an instance.
The OP should not try to set her up though because he still has live with himself.
If the nursing facility is not satisfactory, in your wife's opinion, then she could work on locating a better one by calling "A Place for Mom" or the Care Advisor on this site. If not successful with that, please get Adult Protective Services involved to get him to a good place that appeases your wife's fears.
The FIL the has been living in the nursing home for years. The wife didn't have a problem with it and did not insist on moving him into their home until now.
Kryptoid even said that his wife really wasn't all that close with her father and didn't even visit him in the nursing home. The rest of the family doesn't care much for him either because he wasn't a good person.
The sudden need to take the guy out of the nursing home and being him into the house and become his 24/7 caregiver seems fishy to me. It seems like the father is being used to push the husband away.
And how does she think she will feel when he dies in your home because she couldn't keep up with his needs? Someone else mentioned this....how do you think a kid is going to react to moving back into a room where someone died?
People get sick or old and they die. As sad as it is, there is no getting around that. Blowing up your life to give someone an extra few weeks/months of living 'miserably' does not seem worth it.
"I’m not sure how long he’ll be at the short term NH, but I believe it’s 30 days."
A lot can happen in 30 days...
FIL himself may even decide on his path... (After the trials of a hospital stay, many are happy enough to get a warm bed, a hot meal & kindly staff - they are willing to settle).
You wife could visit. She could advocate for Dad's care needs, gain confidence in the staff, have a change of mind & work with the discharge planner/social worker towards the right permanent care accom.
Or you could visit Dad & let him know that although you care for him he cannot move in with you. Then arrange to speak up to the social worker & advise under no circumstances will FIL be discharged to your address. You live at this address & are saying no. If your wife says otherwise, then mediation with the social worker will be required. They may call this a Family Meeting, a Care Plan Meeting or by another name.
Although you are not a blood relative, not NOK, if your home is noted as the discharge destination it is basic common sense you must be OK with this.
I really applauded your decision for online counselling. Hopefully your wife can join in too.
You do have power here & can play that tough card above if needed but it will have consequences on your relationship. It would be ideal if your wife could understand WHY you are saying no. Why her ignoring your no could break your family.
I setup some online counseling. I’ll probably start that this week. I signed up for the both of us, but I may have the first meeting by myself. I thought for a bit that this would help change her mind, but honestly I don’t think anything is going to change her mind at this point. She let it slip that FIL is being discharged from the hospital to the short term nursing home in about 5 days. I’m not sure how long he’ll be at the short term NH, but I believe it’s 30 days. Honestly, I’m so burned out just thinking about all of this it’s really exhausting. I’m seeing no plans being made with her or her family..so that just leaves one option and that’s her bringing him into our home. While I’m afraid of having yet another fight over the issue, I am going to bring it up this week and start with a discussion and then go from there. Thanks again to everyone who gave advice, I’ve read everyone’s posts and they have all helped out in one way or another. I’ll try to post another update before the weekend.
How about taking the rest of the family and go on vacation the first full week she brings him home? I’m not kidding. Take the kids and go stay at someone’s house some friends house. Let her feel the reality of the full brunt of caring for him alone at home. Also leave her a piece of paper that outlines the loss of income and how you will cut your living style in half to accommodate this.
i don’t know, I said it was a crazy idea.
I went on a deployment one time and when calling home they acted like they could care less so I stopped. It took about 10 days for them to “miss me” and show proper appreciation.
Gee, maybe stay away until she cries “uncle!”
hang in there, big hugs, and good luck to you.
On your ? Re:Medicaid paying. Hang with me on this…. Medicaid is a huge set of programs, from Happy Teeth Vans for kids to LTC in a SNF / skilled nursing facility. Each State determines what Medicaid program they will do but under federal guidelines. E.g. most States Medicaid do not ever pay for AL. For IHHS aka inhome health those can pay a family member as a caregiver - if your State does this program - but it’s at slightly above states minimum wage, like $10 hr in $7.50 min wage state. # of hours interdependent on FILs needs assessment. HOWEVER if his assessment goes over 32 or so hrs per week, most IHHS will not pay for inhome as care plan is too involved, too rigorous and needs 24/7 oversight which means in a facility. State (unless in NY or AK) are not going to pay for 24/7 inhome. Assessment team can look at his old NH chart along with recent hospitalization and if it seems he’s way way beyond what avg inhome can reasonably do, he will be over the hours max. The assessment will be he needs to move out of home and go back into a 24/7 facility.
Which if that happens, snowballs probably to the need to do a fresh application for LTC Medicaid as he has exited the NH & moved into a home. (It sounds like he was on LTC Medicaid to pay his NH bill - the $800 SS went to NH - so I’m assuming he was on LTC Medicaid LTC). If y’all’s State wants a new LTC application done, that means all new paperwork on him with its 3-5 yr financial look back, which falls on his POA to do. If Wf has not kept up with her dads banking, SSA annual payment notices, his life or burial insurance policies, etc having to get all this together in very short order to do a fresh LTC Application plus managing FIL care and marriage / house / kids will be beyond challenging. If her LC flairs up, who’s picking up the slack?
That you can do the majority of kiddos and your family’s household stuff and still work is amazing. But it can only go on for so long. If FIL moves in, kids will be secondary to her dad. Your somewhere on page 3 of her list. Resentment all around. Kids too young to express their concerns but it will effect them. Living with someone incontinent, with feeding tubes, smelly, frail, bedfast does not lend itself to happy childhood drawings. Forget any play dates or sleepovers happening. Health & welfare of y’all’s children should be her first priority. If she cannot do this, I think you should look into divorce with full custody; & get a good divorce attorney, no “mediation” bs. I’m guessing you were too nice last divorce….. get a pit bullie divorce atty this time. Good luck.
I just had my mother in short term rehab & wanted her to transfer to long term when it ended..the NH wanted her out & asked me to find another facility for her. I wanted her to just stay there but I gave them 2 choices & they both declined her. I also got laid off from my part time job the same day!!! So being emotional, I just said I’ll take her home again. I paid Atty & signed retainer when she entered facility..figuring she just go to long term after short term rehab! The NH also couldn’t manage her at times. I came after work to help feed her & found her in dining room screaming 😱 “my tushie hurts…I want to go home 🏡 “. I asked Nurse if she took her meds & she said my mother refused…so I asked if she tried again…I ended up giving meds to my mother with Nurse ok. Also, they were leaving her in wheelchair for 12 hours without changing diaper! No wonder pressure sore came back! But Social Worker kept telling me to find another facility & that they’re mostly just short term & have no long term beds . Coincidentally, the other facilities gave same lying excuse…BS …I don’t believe..because they want to pick & choose not so difficult patients. Not like my mother…dementia & needs help with everything. 2 person assist. However, at home we can get her into wheelchair with just one person. I did it today when Aide had day off. I could have left her there & say it would be unsafe discharge but they would try other ways to get her out, I believe. I could see they couldn’t manage her..& I couldn’t do tours of different facilities in a rushed fashion..I knew about the 2 others..close & convenient to my house..but these nursing homes are so corrupt & they don’t care about anything but $$$$$ , sadly. You have to go there every day to check on your loved ones. What I want to say is that if your wife takes him home permanently, he’ll have trouble getting back in another one. A trial period to see how ugly this could be at home I’d recommend before discharging him. I believe after a trial period, wife will be glad to take him back when trial period over! I hope my advice helps prevent this inevitable disaster. Hugs 🤗
however, a bed is a bed is a bed - from the director of the ombudsman program in my state.
so you can push back on that one...
care just isn't great in nursing homes anymore.....
Wife doesn't just want to take care of her dad, does she. She wants to rescue him, to provide gold standard care along the guidelines that we all know should be achieved but almost never are even in fully-staffed and fully-equipped healthcare settings, and at the same time to compensate for all that went wrong in his relationships not only with her but with his own wife and the rest of her family. If she puts him in a nursing home "they will kill him" and she couldn't live with that. But actually he is heading for an ugly end-of-life and death, has been on that course for some years now, and she has shouldered all responsibility for it. Because no one else will. Because heaven knows why.
What does he want? Where does he think he should live once he's discharged from hospital?
Taking the lead on his care isn't a bad idea, given that she is a qualified and currently practising nurse. But the idea of providing all of it, in a family home with a busy young family in it, is... nuts. Which she must know full well.
How long have you got before his proposed discharge date?
But I see something that caught my eye...
K's Wife is unhappy & burnt out at work! A'Ha!
So. Here is part 2 of her motivation (part 1 being no-NH-ever).
Is she thinking a nursing job, for just 1 patient, a family member, will be a cakewalk?
Is she thinking the benefits of private nursing, for this one patient (Dad), will be more financially & emotionally rewarding?
Is she sick if working for the 'system' & the thought of appointing herself as In Charge in her own home a far superior deal?
If I put my 'black thinking hat' on here.. But.. what about the children? Who will cover the other shifts so she can sleep & eat?
And the BIG question.. is this FAIR to her family?? To Dad, Spouse, children?