I’m not sure if my FIL is tired or in denial. Should we do more?

First of all the MIL is not going to get better. She is not going to suddenly be back to driving her self, making dinner etc. Unfortunatly it will ONLY get worse. It is just the circle of life.

What her husband is doing is admirable but he is only going to be able to handle this for so long. The three of you Husband FIL and you need to come to some agreement as to what is enough and too much and when you get to that line you need to already have the plan in place as to what your going to do with the MIL, IE a facility. I will tell you my wife dragged out moving her Mother to a facility WAYTTOO LONG. It took our marriage and our family being demolished and her finally getting to where she could no longer do it alone ( No one would help her because her Mother had become so difficult to deal with)to move her to a home. Her Mom fought it but after about 2 weeks at the facility her Mother was sooo much happier. She was around care givers that knew how to handle her situation, She had other people in the facility to talk to and create friendships with. She was no longer isolated at home.

Imho, I do not know why your FIL would try "to talk some sense into" his spouse with a broken brain. Prayers sent.

Someone needs to discuss the future with your FIL. Ask him what would happen to his wife if he should get ill or have an accident. What happens to her if he isn’t there to care for her? He needs to organize all critical care information, doctors, medications, insurance, etc. in case someone else has to take over.

My grandmother did an excellent job of caring for grandpa because they didn’t want to bother their 6 children or 19 grandchildren! Then grandma broke her hip and went to rehab. Grandpa, age 91, was left home alone until my mom discovered him lining his pills up on the counter trying to figure out what to take. Oh yeah, and wearing his underwear outside his pants.

I have to mention something if it hasn't already been mentioned before: dementia/ALZ is probably THE most frustrating thing on EARTH for a care giver to deal with, bar none. The repetitive talk, saying the same thing 100x, asking the same questions over and OVER again, forgetting what day it is, having SUCH a one-track mind that absolutely NOTHING gets through.........it's terrible. I often say that once my mother gets a thought stuck in her head, even an irrational thought, nothing can chop it out of there with a CHISEL. I can tell her 1000x it isn't true, or whatever, and still she will say the same irrational thing 1001x afterward. There is no dealing with dementia/ALZ, there is no rationalizing with it, no arguing with it, no winning. EVERYONE loses.

It's also very hard for a loved one like your FIL who's known his wife for 50 years (or whatever) to see her change like this. To say something to her and have it not register, after speaking to her in the same way he's spoken to her for 50 years, but now, all of a sudden, she doesn't get it. WHY? What the heck is going on, he's shouting in his own mind? While he may realize she has Alzheimer's, it's likely he doesn't understand what all Alzheimer's involves. The details of what's going on, or not going on, in her mind. He gets frustrated b/c he can't get through to her. It feels seriously annoying at times to be saying the same thing over and over............and you think to yourself, OH COME ON, this can't be REAL! NOBODY is that dense!

So that's the other side of caring for someone who's suffering from ALZ/dementia. Their perception of what's going on. It makes no sense.............b/c it really doesn't make any sense. And THAT is the frustration in and of itself. Trying to create 'normal' from 'abnormal'. Applying HIS sense of logic to something that's totally illogical. Expecting A but getting B, you know what I mean? Expecting her to be the wife he's known and loved all these years, yet getting a stranger a lot of the time, and someone he can no longer relate to.

And it seems to me, from experience, that men tend to stay in denial about this situation a lot longer than women do. If he brushes things off or under the rug, maybe it will all go away and he'll wake up tomorrow to 'normal' again. Except that's not going to happen as the disease progresses, and acceptance is the key to getting help and figuring out the next course of action.

Here is a link to a useful article about AD and the stages and what to expect during each:

https://www.healthline.com/health/stages-progression-alzheimers

You can also go to alzheimers.org for lots of good info and for their 800 number for someone to talk to about all of this. Lots of resources are also available on their website.

Finally, your FIL needs help with daily care for his wife. Nobody can do this alone. AD reaches a point where most people can no longer handle it at home anymore, and placement becomes necessary. Keep all these things in mind as you yourself learn more about AD and what your FIL and the rest of your family face with the care of your MIL.

Good luck!

I am sure he is aware of the situation but he is scared. scared that she will forget him, and other stuff.  Maybe he afraid to ask for additional help. most older people don't want to leave their homes, or put their "other half" in a home because then they will be along by themselves, at least she is still in the house even if they have words.  Explain to him that IF she was to go into a place, that he could visit every day.  My mom did this when we had to put dad in a NH due to dementia and she could no longer handle his outburst, etc.  She would drive in every day.....then after a couple months, she would only go in maybe 3 or 4 times a week........but she knew that he was being taken care of better than she could do.  It will be a big adjustment for your FIL but maybe you and hubby sit down with him and let him know that he might be scared, etc.  and ask if maybe he would like some help in caring for her.  wishing you luck with this.

Just a note on leaving her alone. Can she still use the phone? Would she know how to call for help or get out if there were a fire? If someone knocked at the door would she automatically let them in?

The time when someone with dementia shouldn't be left home alone comes on pretty fast in my experience. If you are dealing with a caregiver who is having trouble accepting the diagnosis, be extra careful on letting him be the only one deciding that is is safe to leave her alone in the house.

I agree with others that he needs some help. Depending on finances, would he allow someone to come in during the day to 'help' mom with some house cleaning - but really to give mom some one on one attention so that he gets a break-. It might even help him to have another person to have conversations with. The only thing to pay close attention to is how your mom view's this person coming in. It's common to see another woman as a threat to her marriage or having an affair with the hubby.

If dr can help with a med to keep her a little calmer at night, it may avoid some of the bigger issues happening in the evenings.

It is very common to try and 'talk sense' into the dementia patient. Break it down to dad that her brain believes what it believes because it is broken. You can't fix it. There may come a time that she will become physical. If dad is doing this 24/7 think on his own, he may be wearing out. Breaks are going to be important for him. Perhaps you could make the appt and talk to her doctor. Many are doing it online now. I would send a letter in advance to describe the evening behavior so he understands what is going on prior to the appt. Mom and/or dad may tell him everything is fine if you leave them to their own doing in the appt.

Your FIL needs help.
He may not say this. He probably would deny it. He probably would refuse help.
I can tell you from first hand experience that it is not easy being a sole caregiver.
The first time I had a caregiver some in and I had time to do some things myself I thought I won the lottery. I got shopping done in half the time. But I did miss him by my side. I loved the quiet ride. But I did miss the noises he would make. (I know sounds odd but you get used to things like that.)
As long a MIL now understands some things it might be good to have someone come in so that she will be used to someone helping out.
Introduce a caregiver as a friend. Or say you are getting someone in to help with cleaning, the laundry, meals. Whatever works. You can start out with 1 day a week or 2 half days to ease into it. As she declines he will need the help for longer periods of time.
The time may shortly come when she should not be left alone for even a short period of time. You just never know what may happen.
Another option might be Adult Day Care if there is one open in your area. That can be a great help. My Husband was in one 3 days a week and it was great for both of us. (until I was asked not to bring him back because he kept trying to leave)
If you or your husband could come be with her for a few hours a day once or twice a week that might help him as well. And the longer you stay with her you can get a better idea as to how her decline is. (although a few hours does not give a true picture it can help)
A few suggestions for him.
*If he gets very frustrated with what she is doing or not doing, if it is safe leave the room. This will give both a chance to change the focus of what is going on.
*Redirect a behavior if possible. Give hands something to do. Fold towels, color , get a magazine and ask her to cut out recipes, clean out the "junk drawer" in the kitchen (everyone has one!)
* LAUGH. When you want to yell, laugh instead. Totally catches them off guard and they end up forgetting what the focus was and they laugh. Easy to redirect then. (found this out by accident once when the situation was so ridiculous that I wanted to scream but I just burst out laughing, changed my Husbands manner)
*Learn to accept help. People WANT to help they just don't know what you need. so tell them. Have a list of things that you need from the store. When someone calls and wants to visit say "sure tomorrow at 11:30 would be great, you can join us for lunch and "Betty" is much better in the mornings, but would you mind stopping and getting a gallon of milk and a loaf of bread for me".

People want to help and by refusing the help that is offered you deny them the pleasure and satisfaction they get from helping. (does that make sense?)

Your FIL might have memory issues too and that will become clear. But really, the thing they most feared, not aging but losing their minds, has now happened. So denial would not be surprising. He might think he is taking care of her but he likely is not.

My inlaws were a very devoted couple. She developed ALZ which progressed slowly so she was able to do her ADL's. She slept at night as well. They lived in their own house where they had been since 1957. They moved to IL in October 2018 and we sold the house. My husband is the local child, his sisters live in California so they were rarely here. Everyone thought that my FIL was doing a wonderful job and he had prided himself for years, that people thought he was much younger than his 90+ years. But it caught up to him. I am a nurse and because he is not my father, I saw his decline first. They had their POA and trusts already set up. He kept saying everything was fine and of course, everyone wanted it to be fine. I read Being Mortal and that prompted me to approach him differently, by asking questions about how he picture the future and what he wanted to happen. He had not progressed deeply in vascular dementia yet so he was able to think and make the initial decision to move to IL with her. They really needed to be in AL but she resisted and he felt his job was to care for her. They argued all the time because he tried to modify her behavior which could not be done. And she went from a sweet, agreeable woman to someone who was not agreeable at all. Really so sad but the reality is the reality.

I would start by talking to your father about what he wants, what is hard for him and how he sees the future enfolding. One thing I also learned is that my FIL could not figure out HOW to move. He said, "we can't move". I asked him why and he said, "because we have so much stuff". Not stuff he was attached to in some cases, just stuff he could not wrap his head around getting rid of. No one had thought to ask him that. I was able to get him thru figuring out what to move to IL.

When they are at the point your LO is at, it is overwhelming that the fate they feared is happening. There may be good years ahead still but they will need to make changes to make that happen. It is scary and depressing. And I can understand the resistance.

3rd sentence in your post points to the problem your dad is having. I know with COVID, that everybody is trying to be careful. He needs more people interacting in their lives since the burden of caring for mom has become a little too much for him alone. Talk with him about allowing family, close friends, community of faith to "visit" and help in small ways: cleaning home, sitting with mom so he can get out a bit, delivering groceries, share a meal, play games.... With other "normal" people coming in more often, he may feel less burdened with a woman who lacks "sense."

I think you may have also pinpointed that MIL has Sundowner's Syndrome, Print out an article or 2 about it that includes suggestions for dealing with her increased anxiety/frustration, anger in the evenings. Next time he vents about this, talk about how this will not "get better" without changing something: either evening routine or MIL starting a new medication to help her relax more. Give him the articles to read and make a "date" to check back with him to see what he is doing differently and the results.

Please be aware that 75% of people 75 years old and older have some form of dementia. Monitor FIL for dementia symptoms as well as MIL.

I apologize if I missed it but what specifically are you looking for— are you mainly asking for advice about listening to your dad vent?

Keep in mind that an old man is trying to care for an old woman. That right there says he needs help. He has his own aches and pains and limitations, so don't expect him to be able to handle the care your MIL needs by himself.

Broach the subject with him, because he definitely needs help. My dad finally relaxed and let me take over when he was given a terminal cancer diagnosis, but until then he bravely struggled on and refused most help. I took care of him and my mother for eight weeks, and it darn near killed me.

Get help for him in the most loving way possible.

One family in my extended clan : the Mrs was so frustrated/getting angry with her DH (Alz) & his behaviour. Through an Alz organisation, some counselling was arranged by her children - for her. She was reluctant at first but then found it extremely useful. Yes there had been denial, but also lack of knowledge. She
had not really understood the disease, the symptoms beyond forgetting some things or how it would change their lives in such a huge way.

After counselling she understood better. She looked for the positives too eg that currently he could still shower himself. She now understood it was progressive & that skills would be lost. She also accepted the care needs would become too much for her in their home, even with aides.

I hope your Father can gain similar help & understanding.

I think it's important to recognise that FIL is not alone in not appreciating how communication and comprehension skills decline in Alzheimer's disease, and that it will take him time and support to adjust to MIL's changing needs.

You see it all the time - families buy gadgets and gizmos and dot signs around the house "remember to take your meds!" "Sit down to pee!" thinking these will assist their loved one's memory, and then become frustrated when the meds pile up and there are still puddles all round the toilet.

I have just spent four mornings with a lovely lady who, sadly, is struggling with vascular dementia. Four mornings running she has been distressed because "I didn't know if you were coming" - it has been comparatively easy to reassure her and redirect her, but it's heartbreaking to think that every morning between seven and eight she is alone in the house and afraid that she will have to manage by herself. She is certainly not able to call our office number to check that we're on our way.

I asked her if she had a calendar (thinking I could display our call time on it), and she enthusiastically showed me the talking clock her daughter bought for her - you press a button, and it announces the day, date and time. Wonderful! But unprompted, it doesn't even occur to her to use it. Of course not. She has vascular dementia.

Then (different client) there is the door alarm which plays back a loved one's recorded message, e.g. "Mum, it's too late to go out now. Please get back into bed." I'm sure this is very reassuring for the lady when she approaches her front door at two in the morning. But at midday, when she's letting a worker in to help with her lunch call? - it's just baffling.

EVERYONE finds learning to negotiate dementia a challenge. Not just elderly husbands.

Re Geaton's "sh!tshow that would land in our laps anyway".

A friend is living this right now. (FIL Parkinson's, cog decline, MIL afib, poor mobility). Both in/out hospital & unsafe discharges. Both lack of insight, judgement & planning. Have crossed that line from real thinking to magical thinking. *I WANT her to look after me - so it will be possible*

FIL stating his wife will do everything for him, including showering. One Doctor quipped "That wife who just left? Or do you have another one - a lot younger who is physically able to?"

If she is at stage 3 and her husband does not have a good knowledge of the condition, I’d insist that he either be evaluated to see what’s wrong with him or he immediately read and view material that explains what he needs to know. If he’s arguing with her, he may not have the temperament to be a hands on caregiver for a PWD. I’d explore options for care to discuss with him. It can be stressful. He may not know how to ask for help.

Ditto to what Alva stated. Also, you WILL be doing more, the question is: should you wait until there's some sort of trainwreck, or try to manage it before it comes completely off the rails?

We knew my step FIL had Parkinsons and was starting to have issues. He was in denial and was insistent that his wife was going to care for him and she "seemed" to be doing it except, upon a closer look, she wasn't. We soon realized she was having her own issues with short-term memory loss and cognitive decline, as well as physical decline. Her sons (my hubs included) seemed to be content to wait until (in my opinion) things descended into total chaos. Since we lived 6 miles from them I could see the writing on the wall. I worked full-time in our business, still had 2 kids in high school and a small grandson, helped my own elderly mom who lived next door to us, plus managed care for my mom's 2 older sisters out of state. I KNEW if no one started taking control and making critical decisions, it would become a sh!tshow that would land in our laps anyway. I worked (daily, almost another full-time job) for 1-1/2 yrs getting MIL to assign PoA (step FIL wouldn't do it), got them involved with social services and was talking to social workers almost daily, helped MIL apply for Medicaid (step FIL wouldn't do it), stopped them from driving, got MIL into a nice facility, helped the county get guardianship of my step FIL, liquidated their remaining possessions while their house went into foreclosure, and more. This is the short version of things and it may sound like a lot of effort and I'm not suggesting this is what it's going to be like for you BUT I can't even begin to imagine how much more work with much less desirable outcomes there would have been if we'd have hung back until the roof collapsed on us all.

My recommendation is to start doing more now because I don't think you'll regret it and it will be in the best interests of both of them. I hope you or someone has durable PoA for both of them. If not, this is the starting point. I wish you much wisdom and success in helping them.

alz.org will have some good, clear, basic information leaflets which will help him to understand what is (or may be) happening. I should have a trawl through their website, especially the sections for family caregivers, and print off a few selected pages for him to read.

A person can understand quite a lot about the disease and yet not have taken to heart some of the key points. It's a horribly frustrating and frightening (and, yes, exhausting) stage of caregiving, but with your support your FIL will get through, and may be quicker to recognise when he needs more help with her care.

"Try and talk sense to her???????" Your FIL is seriously lacking in understanding about dementia, or he is in serious denial. Another possibility is that he himself is not entirely well. In any case, and whatever the screnario, none of this is good. You and the rest of the family, whatever that consists of, now need to sit with your FIL and find out how much he understands. That will decide what the path forward might be.

I would say you are absolutely correct that he is in denial. If her care is really good he can continue to be in that state. But I think that you recognize, and your message to us indicates that you DO recognize, that this cannot long go on. You are on this. I trust you to know when you need to step in.