My MIL lives in her own home on her own. She is 89 and dealing with some cognitive decline. She frequently crawls due to back issues. She is not falling as far as we can tell. My husband took a picture and sent it to me and my sister-in-law. I am a teacher and therefore a mandated reporter. I don't think this is ok. My sister-in-law, who is the medical POA, thinks it's ok due to it not being a result of a fall, but instead because of back issues. She is really entrenched. If we do anything, there is a strong likelihood that the relationship will be damaged beyond repair. She does a lot for her mom. She is the primary caregiver.
So, is it ever ok to let the elderly crawl?
You, being a mandated reporter, think you should report it so someone ELSE can help MIL. How about YOU and your husband take turns to come and stay with MIL to make sure she does not crawl on the floor? Or take her to doctor to get help for her mobility? Too busy to do that? But you think SIL who according to you "does a lot for her mom" should do even more? Any wonder why doing that might result in "the relationship damaged beyond repair" ?
You said "if we do anything... wil! result in relationships damaged...." I seriously doubt your "anything" includes actual hands on help that SIL needs for her mom.
So instead of making an easy phone call to report to someone body, go ask SIL what you and MIL's son can do to help so his mom does not have to crawl on the floor.
I'm answering your comment from below. My friend I have no faith in humanity. I have faith in my humanity though.
Do what's right for the sake of doing what's right.
Sure, it might piss people off. You might make enemies or lose a job like I did. If you can help a senior with dementia, or a child, or an animal to get out of an unsafe living situation, do it anyway.
Sometimes a person has to put some time in and do some legwork. No one is going to thank you or appreciate any of it. Do it anyway. It's a mitzvah (good deed) which makes a person better and elevates their soul.
I'm not a particularly nice person or even a friendly one. I'll always do right by somebody though. Not just for them but for myself.
At the OP it is okay to turn a blind eye if you are not going to do the leg work, let your MIL be and avoid the added headaches that come with APS being involved. My sample size with APS is small just this forum and another one, but they seem like they are kinda useless in most cases. If one does not do their due diligence and pesters them nothing will get done. I hope you do not expect your SIL to be calling for updates and what have you. As a teacher I doubt you have time, unless you are one of those teachers that just uses teachers pay teachers, to reduce your work load. (Dated a teacher once.)
Either way glad you are willing to piss people off, burn bridges with families, loose jobs etc… most are not. My old man once told me he was a whistle blower that reported a bank for discriminating against POC when it came to mortgages especially in affluent areas.
”Pride does not pay the bills.” Doing good at the expense of oneself personally makes no sense cause end of the day as you said only you really will be the only one to notice and in a sense putting in all that effort so you can sleep well at night or some do to bank chips so the wizard or whatever they believe in the sky views them favorably, or it just boils down to virtue signaling.
Either way if the OP is willing to do the leg work awesome, I am will the SIL would love the break. Though if the OP is just going to call and expect APS to sweep in a address the issue, or expect the SIL to field the phone calls, sudden visits with the case worker, and the doctor if they need a need to do a psych assessment in home. Then honestly, please do not be a busy body and leave well enough alone.
I don't think a nursing home would be able to solve the issue. Maybe a pain management place has a solution for MIL.
But I agree with Burnt Caregiver that the family memembers should all sit down and talk about what is going on with MIL.
Though if SIL is like my mother the talk wont actually go over well and will just create more problems than solutions.
Any elder who's 89 with COGNITIVE DECLINE should not be living alone. She should either be placed or have help coming into the house 24/7 or something close to that. Living alone with cognitive decline AND crawling on the floor due to 'back issues' doesn't sound like a safe or healthy idea to me, so I wanted to change my original comment. While I wouldn't get up in your SILs face about this and ruin your relationship, nor would I involve APS, I WOULD speak to your SIL about your concerns. Your concerns being that she lives alone with no help and nobody to oversee her activities and help her with her showers, meals, everyday life happenings. THAT is really the crux of the matter, and when the crawling is thrown into the mix, it's a different kettle of fish IMO.
Is your DH her son? If so, HE is the one who needs to speak with the SIL who's medical POA about a solution to this entire situation. She can move into Assisted Living with a Memory Care annex so she can move in there if needed. But be forewarned: the crawling may not STOP in managed care, either! If she's a stubborn woman and that's how she likes to get around, then that's what she is likely to continue doing! So don't move her JUST b/c she's crawling.......consider the whole picture that she's an elder of 89 with cognitive impairment AND she has mobility issues BOTH. Perhaps a physical therapist can help her learn to use a walker, or a wheelchair may be the safest option for her. You don't say if your SIL takes her to the doctor regularly and what sort of medical equipment has been suggested for her? My mother used a walker with wheels and then wound up wheelchair bound when her balance issues became severe.
I hope you can interject your concern here w/o wrecking the relationship with your SIL. I also hope there's a better answer (medically speaking) for your MIL than crawling around, like physical therapy for instance. My mother who lived in Assisted Living for years did get PT and OT on a regular basis, which was available inside the AL building. There's a lot of services on site in AL, including docs that come in to see the residents. It may be a good answer for your MIL.
Good luck.
1. Should your MIL be crawling? The clear answer is NO, and all physical, cognitive, and psychological evaluations should be done to determine why she is crawling, and to create a treatment plan to stop it.
The second question is more complex: WHO is the responsible party to ensure the first issue is addressed?
In the eyes of the law, your SIL has that legal authority as picked by her mother and agreed to by her through the Medical POA.
I am not sure of the exact laws for mandatory reporting in your state, but in some states simply being a teacher for children does NOT make you a mandatory reporter. The reasoning is that child educators are not elder care specialists. Here is the wording I pulled from a quick Google search on elder care mandatory reporting "A mandated reporter is anyone who is responsible for the care or custody of an elder or dependent adult. These include caregivers, health practitioners, clergy, social services staff, and those who work in financial institutions."
IMO, your SIL is the person responsible for your MIL. Then, your husband is responsible. As an in-law, I do not see you having much personal responsibility such that it makes you a mandatory reporter using the wording above.
THAT SAID, it does seem you are passionate about reporting this. Perhaps passionate to a fault given how many other adults bear much more legal responsibility here.
As you stated, you will destroy family relationships with even a threat of mandatory reporting, so I would get crystal clear on the law in your state. If the wording is similar to what I quoted above, I would get crystal clear on your boundaries and your interactions with your MIL. Personally, I would make it clear that I do not enter the house, receive pictures, or over hear any stories about her care in any way as long as she is not receiving the care she needs (clarified in question 1 above).
This situation is not acceptable.
But, it is not your mother nor are you the POA.
The boundaries are yours on what you will and will not be privy to given you have little to no legal interest here. Beyond that, you will destroy a family and may risk your marriage over what you perceive to be mandatory reporting, but may not be mandatory at all in your state as a teacher.
If I followed professional opinions I would have given up my entire life to care for my mother instead of having her placed in a SNF for her own safety. I would have listened to many professionals that told me I should do what I can to keep her home since AL is out of the question only viable placement is SNF and that is not where she belongs yet.
OP do not put your noise in this situation unless you are 100% ready to do the leg work and field all the phone calls. If not turn a blind eye and ignore it, it is easy to make a phone call, and be whelp I did my good deed. While you let the caregiver deal with the actions of your choice.
No one should ever turn a blind eye when a person is mentally incompetent be it from dementia, mental illness, retarded (I'm sorry I don't know what the current PC term is for that, and living in a dangerous situation.
The OP is a teacher and cannot just turn a blind eye. She's required by law to report any kind of abusive or dangerous situations. The same way a doctor, nurse, social worker, cop, officer of the court, or licensed caregiver is. Someone should of course use their own discretion too. Many times a situation can be handled and corrected without reporting upon it.
Would you turn a blind eye to a child or animal living in danger or abuse?
So yes. You do the leg work and field the phone calls. Especially when the person living in danger is family and you care about them. Even when they're not, do it anyway. That's just plain human decency.
I've made my share of enemies over the years and lost positions with care agencies and a few private ones for reporting to the state on an abusive or dangerous situation. My conscience would not let me do otherwise. When the state, the police, or APS have questions they must be answered truthfully. I've had to deal with the phone calls and paperwork too. It doesn't always come to that though.
The OP should not just call APS or the cops and leave her SIL to deal with the consequences. That's a d*ck move and you don't do that to family even if you hate them. She should have a talk with her SIL and husband and tell them she's going to do it. The MIL cannot continue living alone and crawling on the floor like an insect because it's dangerous. The OP, her husband, and the SIL are adults. I'm sure the three of them together can find a solution for the MIL.
Your MIL cannot be left living alone in her house anymore.
Sorry, but your SIL is not her primary caregiver. If your MIL had one of those she wouldn't be crawling around her house to get from one area to another.
Your SIL probably does think her mother crawling around the house alone is fine because it means mom's staying out of a care facility hence preserving future potential inheritance. Or because the crawling keeps mom from having to possibly be moved into her house.
I think you would do well to not worry about potentially damaging family relationships by reporting to APS what's going on here. Your worry would be better placed in some thought about what happens if there's a fire in the house and your MIL can't crawl to an exit to get out. I'd worry more about that.
You know, I've been a homecare caregiver for almost 25 years. I have been in every situation that can possibly happen in a person's home. I have seen and heard it all. I've been on this forum for a long time too and have seen every manner of story here.
I can't believe that someone, a teacher, would ask such a question as "Is it okay to let the elderly crawl?" I am truly shocked and that is no easy thing to accomplish.
So, I will answer your question in the plainest possible language.
NO! IT IS NOT FREAKING OKAY TO LET THE ELDERLY CRAWL AROUND ON THE FLOOR LIKE INSECTS TO GET FROM ROOM TO ROOM!
IT IS NOT OKAY FOR AN ELDERLY PERSON WITH DEMENTIA WHO CRAWLS TO GET AROUND TO BE LIVING ALONE UNSUPERVISED!
None of this is okay.
Maybe your MIL is worried about the cost of a wheelchair or modifications to the home.
Never tolerate stubbornness. If they have access to her money, get the modifications to her home done and hire a live-in caregiver/companion.
If the elder won't go for this, the other option is a nursing home.
They tend to be more cooperative and less worried about spending when a nursing home is brought into the equation.
If so with the cognitive decline that might not be a good idea.
Does she have a walker that is sized for her and does she know how to PROPERLY use it?
Maybe an assessment by a Physical or Occupational Therapist might be a good idea.
It actually sounds like she needs more help, assistance than she or the rest of the family wants to admit.
I would suggest to Sis that there might actually be a remedy for Mom, but you won't know unless you get her to the doctor. She might benefit from a Cortizone shot, or some painkillers or physical therapy. You won’t know until you have her evaluated. I would really question Sis as to why she’s so adamant about not getting Mom any help. Back pain is excruciating, and even if her problem is spinal stenosis and nothing can be done, at least you'd know.
I would hope reporting it to APS would be a last resort, and a conversation with your sister would be the more effective route to take.
Can the back pain be treated?
There are exercises and treatment programs online that recommend crawling as beneficial, and state that crawling can rewire the brain. Maybe that is what is happening?
So maybe, don't panic. Be part of the solution by getting more information and talking to your husband.
I’m surprised that the lady can crawl comfortably (my MIL’s knees would never have allowed it), but if she can I wish her luck! It’s safe, falling is not an issue, no-one’s forcing her. Let her choose.
However, an elderly person should never be crawling around! Their skin is paper thin and prone to tearing.
The muscles are generally weak, the fat pack is gone at the joints (even if they are fat around the stomach) and a pressure sore can be developed very quickly.
Back pain that forces an elder to crawl around isn't about what "doesn't look right". It is an incredibly dangerous situation.
P.S. I've found that I cannot go to restaurants because of my need to stand and not sit upright, except Japanese sushi bars. Standing is ok there without waitstaff freaking out.
If Mom is seeing a neurologist I may say to SIL "thats weird, have you asked her doctor about it?" I say this because crawling is something we ALL have to do. If we don't we need to be made to. It has something to do with the development of the brain. You literally must crawl before you walk. My nephew did not crawl but was shown how to. He made fists with his hands and his Mom was told she had to make him keep his hands flat.
Me, I have a bad lower back. Arthritis but I do think some pinched nerve. The last thing I would do is crawl around on the floor. I would question this. It may be a neurological problem. Dr may say don't worry but I would at least ask.
Busy bodies are the worse, mind your life and let other mind theirs. Unless some abuse is taking place do not make your SIL life harder by getting APS involved. Caregiving is hard enough as is, no need to do it with a agency looking over your shoulder, having to do month checks and what have you. Please.
Your husband should ask APS for a welfare check and recommendations for her care. Have him show them the photo, and/or send it to her doctor.
You can advise him, but do not do it yourself.
It does not need to be an adversarial action between your husband and his sister.
It is just not right for Mil to be crawling because there are so many less harmful modes of mobility available. Be sure she has been offered the durable medical equipment her doctor suggested, and that she has the means and ability to acquire it.
There is also a cognitive decline or mental condition that may be causing this behavior, so get her evaluated a.s.a.p.