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Hi everyone. I just joined the forum and apologize in advance if I'm doing things wrong with the posting. I'm not really a caregiver at this point, but my husband and I are trying to figure out what to do for his mother. She lives in the house she's been in for 60+ years and is adamantly opposed to living anywhere else. She has been getting by with some help from my husband and his brother, but we are concerned about her safety there. Also we live two hours away, and my husband has been six hours away much of the time lately because of having to go out of town for work. One of our concerns is that she has left pans of food on the stove and then gone to sleep. My husband is considering disconnecting or removing the stove, leaving her with the microwave for heating food. She has always been a rather stubborn and cantankerous individual and seems to be becoming more so with age. This is making it difficult for her sons to help her. Her latest crisis seems to have begun with dental problems. Her remaining teeth are in very bad shape and causing her pain. She has been refusing to see a dentist because "they put their hands in my mouth." None of us know how a dentist can work on her teeth without doing that, but that is her argument. Because of the dental problems she hasn't been eating much and because she doesn't eat she hasn't been taking her medicines. (Some of them need to be taken with food.) She has diabetes and heart problems. A few weeks ago she called my husband saying she needed him to take her to the doctor right away, but wouldn't say what was wrong. By the time he made the two hour drive, she had driven herself to her heart doctor wanting him to do something about her toothache. The heart doctor refused to treat her and told her to see a dentist. A week or so later she called my husband to say she had called an ambulance to take her to the emergency room, again refusing to tell him what was wrong. As he was in route, she called to tell him the hospital would not admit her, and that he needed to come get her because they were going to throw her out. He said he was on his way and would be there as soon as possible, but that wasn't good enough for her. He asked her to let him speak to someone at the hospital to explain that he was on the way, but she refused. By the time he got there she had left. He didn't know where she had gone or with whom, and the hospital couldn't tell him, either because they didn't know or because of privacy concerns, I'm not sure which. She was mad at him for not coming soon enough and was refusing to answer her cell phone. He called various relatives and finally learned that his cousin had picked her up and taken her to his aunt's house after she called the aunt telling her that she was at the hospital about to be thrown out and her son wouldn't come. The problem again was the toothache, and the er doctor told her to see a dentist. Not long after that, my husband got her admitted to the hospital after she called to say she was very weak and couldn't even get up. She had not been eating right or taking her medicine and her blood sugar was very high. She has improved somewhat and has gone from the hospital to rehab, where she is uncooperative, unhappy, and wants to go home. When my husband refused to do as she wished, she got mad and stopped taking his calls. She called her other DIL wanting to be taken from rehab to the ER to get her toothache treated. Rehab has a van to take patients to non-emergency medical appointments, and they have arranged to get her to an appointment with an oral surgeon. It remains to be seen whether she will cooperate. If she doesn't, I don't think she can be forced. In the meantime she is on antibiotics for the infections caused by the bad teeth, and on pain-killers. This will be the third attempt to get her to a dental appointment for this problem. Previously after a few days of antibiotics and pain-killers she has decided she is better and cancelled appointments. This was before trying to get the heart doctor and the ER to treat the problem. Ok, this is horribly long. I'm sorry and thank you to anyone with the patience to read it. I'm wondering if anyone has any advice. From what I've read, she can't be forced to do anything she won't agree to, and she won't listen to her sons, her doctors, or anyone else. It looks like we have to wait until things are bad enough that she can be declared mentally incompetent and have a guardian appointed or adult protective services steps in to save her from her own bad decisions. At this point, I really don't think she's mentally incompetent, just incredibly stubborn and ornery. I am, of course, very glad to be living in a time and place where the individual's right to self-determination is protected, but it looks like we can't help my MIL until things get a whole lot worse. Looks to me like we have to wait for her to crash and burn, and hope she survives long enough to get help. Any suggestions? Thanks.

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Thanks, Veronica91 and Countrymouse. I didn't mean to sound whiny in my last post. It's just frustrating dealing with all the paperwork. But we are getting there. From what I've read it seems like we're following some master script: something bad happens leading to hospitalization, then to rehab, then to nursing home. And I feel bad for MIL. Of course she wants to be able to go home, but it just isn't realistic. Growing old sucks, even if it does beat the alternative. At least MIL's something bad wasn't as bad as it might have been, and, as you say, she is in a safe place now. We don't have to worry that she'll start a fire by leaving something on the stove. I hate that she's so unhappy, but of course it's a big adjustment for her.

Veronica91, you are an inspiration. My husband and I are 61 (well, I'm almost 62), and we have been thinking about our own old age and how to manage. We just bought a riding lawn mower last year, something I had always considered frivolous and completely unnecessary. I am still amazed at how much easier it made grass cutting. Of course we aren't cutting grass right now because it's winter. In previous years, although I looked forward to spring and warmer weather, I dreaded the fact that the grass would have to be cut every week. Now I don't feel that way. Of course I know that someday I won't be able to do it even with the riding mower, but we are thinking about possibilities for that time. I hope I will be able to age as gracefully as you are doing.
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DP, there's nothing wrong at all with the "stay and be looked after until you're well enough" approach - it worked for my great aunt for three years. Gets a little more problematic if you need to sell her home (we didn't, it wasn't an issue); but even then you can get creative about "keeping our eyes open for a nice apartment" or something like that.

And, yes, she might surprise you. ?!?

And even if she is going to be there for the duration, as a matter of fact, that doesn't mean she has to or even can change what she honestly wants, which is not to need to be there. It is fair enough, really, from her point of view.

You've done well in getting her this far out of harm's way, especially when you look back to only a few weeks ago. Hope there's more progress very soon.
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Dogperson as a older person myself and fully aware of my limitations I continue to plan projects that rationally i know i will never be able to do. It is a form of denial,but it allows you to still dream.
I very much doubt that at 79 I am ever going to be able to return my 5 year ago health.

Hopefully MIL will come to the realization that with her disabilities she is never going to be independent again.

I manage by focusing on the positives and plan things that I can do mainly downsizing hobbies and making use of all the help I can get. I enjoy having a house cleaner and have no desire to do housework again.

We have installed a stair lift for both of us to easily navigate the basement stairs.

I was always a cook from scratch person but right now enjoy the ease of frozen entrees. if they were
not so expensive I would sign up for one of those meals services. Well on second thoughts scrap that idea because you still have to cook them.

I used to iron everything and dry the laundry outside. Not any more.

Maybe you can help MIL see the benefits of having others care for her every need and not have to worry about going out at all unless she wants to. The only thing she has to think about food is what time the meals are served.
I will leave out socialization and activities because those are things I hate. I personally would rather persue my own interests, but I would probably go to church services and try to not think about the long NYS snowy winters as I wheeled myself through the warm corridors.
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I wanted to update, even though there really isn't much new to report. MIL is still very weak and needs assistance to stand, get in and out of bed, and get to the bathroom. The rehab people say she needs 24/7 care. They noted that she repeats herself often in conversation, but said she had "good cognitive awareness." If that's true, why does she still insist that she wants to go home? If her cognitive awareness is so good, why can't she understand that she is in no physical condition to go home and take care of herself?

My husband and I are, like the rest of you, learning to navigate the maze that is elder care. Since MIL has no assets, we are applying for Medicaid for her, and I think we've finally tracked down all the necessary documents. One elusive one was a copy of the letter she got years ago from Social Security approving her for benefits. My understanding is that Medicaid and Social Security have both run by the federal government -- the same government that sent that letter in the first place and has been sending MIL her Social Security payments ever since. So why don't they know she's on Social Security and how much she's getting? Oh well, never mind that, my husband went to the Social Security office to get a copy of the letter. Of course, it was the day the federal government was "shut down" due to budget disagreements. My husband was told that although the Social Security office was open and they had computers, paper, ink, and printers, they could not print any documents due to the shut down. They could look up information, but not print it. So he went back the next week. After waiting an hour and a half, he was told that although they could now print a copy of the letter, they could not give it to him. They could only give it to MIL, who is in no condition to go the office to get it. Finally they said they could send it to her at her address of record. Fortunately my husband has been picking up MIL's mail at her home twice a week, so he has finally been able to get the document.

I'm just venting, and I realize that in the grand scheme of things, this is a minor annoyance, not a major problem. Still, it's very irritating. It's like they're going out of their way to make a difficult situation even harder to manage.

MIL has run out of rehab time, and the rehab people have pretty much acknowledged that there is little if anything they can do to help her. She is now in the same facility but as a nursing home patient rather than a rehab one, with the status "Medicaid pending."

We are hoping that once Medicaid approves her we will be able to get her transferred to a nursing home closer to us so we can visit more often. We are also hoping she will agree to it. I don't understand why she can't see that she is unable to care for herself at home, but she's still insisting that's where she wants to go. We are hoping to sell her on the idea that she needs to be in a nursing home until she gets strong enough to take care of herself at home. I guess it isn't a complete lie. I suppose it could happen, although it doesn't seem too likely.

Thank you everyone on the forum for all your advice. You have been a tremendous help.
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Hopefully her son has POA over her— that does help a lot.
Having a geriatric Dr look over her health & mental issues
will tell if she is capable of taking care of herself.Make sure to jot down all the things she does out of the ordinary.Also make sure to mention leaving the stove on & falling asleep. Hope all works out for you.
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BarbBrooklyn The comment was not meant to be a joke, but that the mom seems to still be in partially her right mind to express her wishes.
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That's good to know, surprise. Sounds like a good argument to use if we need it. Thanks.
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If things get too much for you and your husband, the state can take over her care/finances through a public guardianship. You will lose all say so in where she lives - it could be hours away depending on where an opening is for this type patient. You can still visit, but that's it. You would not be the "bad guy", the state would be.

You might want to use this worst case scenario/threat to get her to comply with your wishes. If you all were not around, this is what would happen to her.
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Yes, I'm bracing for a bumpy ride. We're in the early stages of trying to figure out how medicaid and nursing home placement works, plus wondering what to do if she flat out refuses to go.

I think you're right about denial and pride, Sue. It must be hard to admit that your health has failed to the point that you just can't take care of yourself anymore and can no longer live the way you would choose.

I've told my husband we will likely have to get very hard-nosed. We may not be able to force her to go to a nursing home, but we can refuse to take her anywhere else. We will try pushing the nursing home as a temporary thing until she can regain her strength. Maybe she'll accept that. If not we will have to stand firm, and it will no doubt get ugly.
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Good outcome, dog person!
These "forced" situations are the worst. So many bad and hurt feelings. You're doing it right.

If they still have their mind, why can't they acknowledge that they are in bad shape and willingly take the offers of help? Denial, I guess. Pride too. The only one that accepted assisted living gracefully was my dad. Never had a complaint from him. I'll be forever grateful for that.

Keep us posted on her "progress."
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good for you, dogperson. This is the best route for all. You are doing the right things. Your hub will have to humor her on those kinds of phone calls. She isn't able to comprehend how sick and disabled she is . It may be a bumpy ride for a while yet, but at least you know where you are going and that is good news. (((((hugs))))
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This morning she called my husband from rehab wanting him to take her home so she can do laundry. She can't stand up without help, but she thinks she can go home and do laundry. It's sad. He told her no. She is already mad because other son won't take her calls.

They did have that teleconference yesterday. The recommendation is that she needs 24/7 care. We have made it clear that neither son can provide that.We have applied for Medicaid as she has no assets, and we are looking into nursing homes.
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Thanks, surprise. Maybe emergency guardianship is the way to go. We will try to figure it out. My husband did get home before the roads got bad from the snow. He is asleep now. I'll talk to him and we'll work on a plan for dealing with things.

At this point I don't see MIL being released to anywhere but a nursing home. She was unable to walk or even stand when taken to the oral surgeon. I hope at least she will be more comfortable now that the dental problem has finally been addressed as it should have been. Maybe she will have to admit she cannot live alone anymore. If not, I guess we will have to consult APS. We will see what happens at the meeting on Friday.
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We were able to get emergency guardianship for mthr for 8 weeks when she was in distress and needed care. Combined with a dr assessment, we were able to have her placed in memory care where they administered the meds, kept her clean, and managed her anger at being "locked in." After she settled down and was on the road to recovery, she did give us POA. She's still in the same MC and happy as can be.

APS did help because they had several calls on her from the community. They were in favor of us becoming the guardian. You might call your APS and see if they have advice for you or any reports about her that you could use in applying for emergency guardianship if you find you need to force her to comply medically.
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Thanks everyone for the responses, the good wishes, and the welcomes. I appreciate it.

MIL is back at rehab from the oral surgeon with new antibiotics, new pain-killers, and new diet rules (liquid diet for awhile). I hope this will at least resolve her mouth issues eventually and relieve her pain. Husband is on the way home and hoping to make it before the weather gets worse. Snow is predicted for today which is why my place of employment is closed and I am home.

Hi Martinaa. Nice to meet another dog person. I also would like to die in my home surrounded by my dogs. It depresses me to realize that probably isn't realistic, but I can't focus on that now. Just have to hope some version of the Rainbow Bridge is true and we'll all be together again someday.

I do think this is the crisis that will force a change in living situation. We will add this to our list of reasons MIL can't live alone or with either of her sons.
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Just because you haven’t had to physically care for someone in their home does not mean you aren’t a caregiver. Your concern for her and just by seeking out answers means it weighs on your Heart and mind and makes you a caregiver!
Unfortunately My mom had a quick decline and I’d come back to visit and take her to doctors. Even though I got her the medical alert, called every night, registered her with the police department, paid her bills online for her (after I learned she couldn’t handle the finances) and got her in home nurse and PT, it wasn’t until the home PT found her on the floor and she went to the hospital that i was able to step in and do something. She also wouldn’t give me POA, she is stubbor! But one day i kept asking and talking and she gave me POA!! So don’t underestimate, keep trying! I let some of my moms forgetfulness and stubbornness go before I realized it was dementia or brain injury from the fall (brain bleed). Try try try to get POA while in the rehab where they usually have a notary available! It makes things a lot easier. Make sure doctor and social worker know her living situation! If all else fails and she declines...Last and probably hardest decision will be to get CPS involved. My prayers are with you as the worry becomes unimaginable at times.
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Dogperson,
Welcome!
You are a caregiver.
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Hi dogperson (I'm a dog person too. ) I can certainly relate to your stressful predicament. I went through that with my parents. I would go home to help and get things sort of straightened out and as soon as I left they would go back to their old ways.
One thing came to mind is: If she is in rehab the Dr. can order a nurse or home health care as well as physical therapy to make some house calls when she goes home. It is paid for by medicare if written by a Dr. Just ask the Dr for it. We did that with mom after a hospital stay and because the Dr ordered it she went along with it. Also, it got her used to having people come over to the house and she actually started to enjoy the visits. Later on we hired caregivers and they were angels! You know its scary losing your freedom. I myself plan to go out kickin and screaming. I want to die in my house, in my bed with all my dogs and my cat piled on top,lol. We tried assisted living for my parents and it was terrible. It was a very expensive place and after being there 4 months mom had big sores all over her rear because they didn't change her or clean her often enough. It was very cliquey and my Dad was very loney and not part of the clique. We moved them back home and hired a service which was about the same cost as the assisted living. Let me know how it goes, Martinaa
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Praying for you and your family, Dogperson. This is definitely a crisis situation but one that may endure for some time until she gets the help she needs. Take one day at a time (or even one hour or minute!). Try to practice good self-care during this time, and Breathe! I have seen this advice many times on this site. We forget to breathe deeply and end up causing ourselves more stress with short shallow breaths. Your MIL must have been in awful pain with her broken jaw. I think she has been suffering from mental illness or dementia for a while.
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I am so glad that she is getting her dental issues dealt with. From what you write she has had mental illness for a long time. if she would agree to an assessment that would be ideal and I am sure it would show deficits. A geri psych eval would be a good way to go while she is in rehab. Pots left on stoves are dangerous. Surely things are bad enough now to contact APS. Mother has life long mental illness which, to some degree, masked the onset of dementia. She was also very bright, so her MMSE score was high, but we all agreed she had deficits and was making decisions that were not in her best interests. Treatment with meds may make mil able to adjust to life in a facility. It calmed my mother down considerably and her behaviour was not that much of a problem once she was on it. Keep us updated.
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Hi Dog Person and welcome,
I was living in Puerto Vallarta, Mexico and was talking to my mom in San Francisco every day (thank God for Vonage phone service!).
We chit chated and she seemed fine. I ordered her groceries on line and had them delivered to her apt. She'd tell me what she wanted. I saw over the course of time, she was ordering less.
I visited at Christmas and realized she had dementia. OMG! How did I not know that? She couldn't write a check, she was completely confused in the grocery store, etc.

I took her to a neurologist and it was apparent. Either I was in denial about some questionable behavior or I just was ignorant of how the disease manifested itself.
They told me she should not be living alone. Her primary doc and the neurologist wrote letters stating that she was incompetent to handle finances and needed to be placed in a memory care facility.
She went there a few months later.

What I want to stress here is that I chalked up some unusual behavior to old age, being a grumpy old lady, etc. when, in reality, she had Alzheimer's. They can "fake it" pretty well, even into the more advanced stages. Family members don't ask their loved ones what year it is or who's president. So how would we know?

Can you have a geriatric neurologist visit her at the rehab? She won't even have to know that it's a psychiatric evaluation. Then you can go from there.
Good luck to your whole family.
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Dogperson—I doubted my mom would be found incompetent but we had her assessed in a Geri Psych unit (in a psychiatric hospital). She thought it was 1984. Case closed.

My mom got a new medication and a diagnosis while she was there. She has depression and moderate dementia! She is a good actress, playing straight on the phone.

You and your hubby are about to fall down the rabbit hole. That’s how it’s been for me! God bless all of you!
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Oh DP it never rains but it pours!!
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Thank you, Veronica91. Nobody has POA and I can't imagine her signing it now or ever.
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Katiekate, you are right that it will continue to get worse, It is, in fact, doing so even as we speak. I just got another text from my husband. MIL has a broken jaw. It did not show up on the x-rays. The oral surgeon found it while preparing to put in the denture attachment studs. Oral surgeon says it is probably the result of tooth root infection. He is now working on a bone graft. He will use artificial bone to try to glue everything back together. The heal time will be 6 to 8 weeks. If it doesn't heal, she will need further surgery for a plate and screws.
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This seems to be a no win situation for this family so i would call in some "big guns' if you can find any like Adult Protective Services and explain that she is definitely a danger to herself and others.
Does anyone have POA? If not i doubt she will sign it now so you may have to go the psychiatric assessment route. She will talk herself into Memory Care if she is unable nad I stress unable to co-operate rationally. Very important that no one pick her up from rehab or anywhere else. if she discharges herself and calls a cab which of course she can call APS immediately.
By the way dementia can start well before a person becomes elderly and of course there is also mental illness.
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More people were posting at the same time I was typing. She has been to three dentists, two of whom have told her not to come back. I don't blame them a bit. I just got a text from my husband that MIL is in oral surgery now, thank heaven. She will get the bad teeth removed and will get studs to snap her lower dentures onto. (This was supposed to happen yesterday, but it turned out the van service rehab uses didn't run because of the Martin Luther King holiday.) MIL has dentures but has been refusing to wear them because they aren't comfortable. Part of this is the bad teeth, but part is her refusal to go back to the dentist for adjustments because if she does that the dentist will put his hands in her mouth. We will see how this works out.
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The one thing you really need to be sure of....do not let the rehab discharge her to her home or to the home of one of you.

Everyone is right. And this is going to keep getting worse.

If any sibling allows her to be discharged into their home...then you need to make it quite clear that they and they alone are signing up for this ride. It won't end well. The worse thing that happens is the family meeting has a well meaning family member that says they will take dear Mom into their home...then all the rest chime in with how they will be there to help. The result is anger, frustration, guilt, and often the dissolution of the family over it all. Don't go there
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I guess maybe there really is some dark humor in the whole situation, but I'm having trouble appreciating it. I know her going to the cardiologist for her teeth sounds like age-related dementia to people who don't know her. I can certainly see why people would think that, and they may be right, but I'm not sure.

As an example of what I'm saying, my husband should have had his teeth straightened when he was a child. He wound up having it done several decades ago as a young adult after he developed TMJ. I had just assumed his family couldn't afford orthodontia when he was a kid, but it turned out that wasn't it. MIL told me the story of trying to get the problem taken care of. She had decided that one of his canine teeth, which stuck out at an odd angle, needed to be pulled so the other teeth would fit better, and that is what she wanted the dentist to do. He wouldn't do that, and tried to explain the approach he (and professional dentistry in general) considered appropriate. The dentist wouldn't do it the "right" way (i.e., her way), so she didn't get her son's teeth straightened. MIL was in her 30's at that time and in her 50's when she told me about it. Her decision strikes me as crazy, but it wasn't age-related dementia.

This is part of what we're up against now. How much of her craziness might be dementia, and how much is just her craziness. It's obvious to everyone but her that she is making bad decisions, but mentally competent adults have a right to make their own decisions, even if they make bad ones that are not in their own best interest. So it looks to me like the question will come down to whether or not she is mentally competent.

My husband will be in a teleconference on Friday with the rehab people to discuss how his mother is doing. He and I have been making a list of our concerns about her living situation, including things like leaving pans on the stove and not taking her medicines. We'll see how that goes.

I am also concerned that she will "raise hell" even if we get her into an AL or SNF. I've been googling to find out more about how to deal with this situation (that's how I found this site) and have read horror stories about facilities refusing to take or keep patients because of their bad behavior. I have also read that mentally competent patients can leave if they so choose. There is certainly a lot to worry about. Thanks for the advice about the geriatric psychiatrist. Sounds like we'll need one at some point.

Someone posted that MIL's situation reminded them of Dorker's situation, so I found that thread and have been reading (or at least skimming) that long and painful saga. I don't believe I'm even halfway through yet, but I hope I have learned enough from it to avoid the trap Dorker has had to fight so hard to extricate herself from. I'm glad I found this forum, and heaven help us all and our relatives.
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I like this bit: "When my husband refused to do as she wished, she got mad and stopped taking his calls."

Sounds good to me! Peaceful, like. But sadly only temporary, it seems.

Dogperson seems pretty sure that MIL would not be assessed as incompetent. And it is certainly true that there is a huge difference between being demented and being idiotic and foul-tempered and making unreasonable demands (especially when in pain. As you might well be when you've let your teeth rot in your head, for example).

Has anyone tried a different dentist before now? I'd wait and see what happens with the next appointment. Could be the change in surroundings and personnel will help.

Poor family, I do feel for them. And I think DP herself is right, that all she can really do is rub her husband's shoulder blades and wait for MIL to crash.
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