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The psych Dr. wrote up a rx for HHA from medicare. I made a few calls to, at home nursing facilities, and they are saying that medicare will not cover bathing MIL because it's not medically needed. I'm not sure if I'm talking to them properly to get MIL what she needs. The bottom line is she needs help at home. My health is quickly going to hell in a handbasket, and no one else seems to think she needs help (she is an exceptional showtimer) I tried every coy way to get someone in to help, including but not limited to paying the home health aide to go to family parties to introduce her as a family friend (not once but 3 times) Mil still won't let her in the house. Yesterday, I mentioned to MIL that the Dr. wants her to bath at least 2 times a week, and that's why I need help (once a week has been her life long bathing schedule but now that she is over weight she needs more) She had a melt down... her blood sugar reading was 279 (with out additional food) so the stress knocked the number out of wack. I am in the process of calming her down...walking her and givng her water. This has been the most significant change in her health in 3 years. I'm in need of advise because I know it's only going to get worse...but I need help. I don't know what to do. It's easier to just let thing be but I need help. It's a vicous circle.

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Things are not that bad, yet. Tomorrow is bath day let's see what happens.
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Oh, yes. The wiping down with a diaper wipe or a wet rag, is supposed to be good enough. How about the not changing out of her nightgown, for 2 weeks. And then, we had the just hang the towels, that she had wet on, out on the railing!

Long story short, the bath lady called 911 and from the hospital to rehab to AL to NH, in a few weeks and she is clean and healthy as can be. Why? Because everyone else is and the aides don't take no for an answer.

I never would have believed it.

My sister and I stayed out of the placing her in the NH, and let a grandson handle it. Can you try to get her the help that she needs?
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You do it anyway. My daughter didn't want to be bathed. I let the aide in and I left her alone with the aide. She didn't want a hospital bed, and stamped her little feet on the floor while I rolled her to the bedroom. You don't offer options. You become Nurse Ratchet. Tantrums be dammed.
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I had a "temporary suicide" and slept 14 hours. I think I really needed to sleep cause I'm feeling a little better. MIL blood sugar is still spiking but I have the doctors figuring it out. It ends up it's not the end of the world. Not being so accessible might be the answer. Thanks for all your input .
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Where is your husband??????????

Get the help or refuse to participate in MIL's care anymore. You can do this. It's allowed. This old lady thinks that all she has to do is refuse and she gets her way. You're taking care of her and if you deem it necessary that she need more assistance then you are obligated to get more assistance.

And your husband should be helping you with this. He should be in charge of managing this situation. This is his mother. If he sees you suffering at the hands of this old bat he needs to step in and not leave it to you to figure out all on your own.

If you want to leave, leave. You can stay in a motel overnight or with a friend. You need a break and no one is going to care if you get one or not so you're going to have to get what you need on your own. Inform hubby that you are leaving for 24 hours and he can stay and take care of his mother.
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You need a shrink, a therapist. One who will teach you how to set boundaries, and enforce them. Stop worring about your MIL's feelings and think about your own. If you don't take care of MIL who will ? No one, your all she's got. That is real power.
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Love, if your MIL's sons can in unison harden their hearts, why can't you? Take this as your consolation: that if MIL keeps up her nolle prosequi, and they continue with their blithe indifference to her welfare, the issue will very soon be forced without further effort from you.

Seriously, DON'T keep banging your head against the wall. Fold your arms, sit back and wait - it won't be for long, and God willing it won't be anything she can't recover from.

You say this is a significant change after 3 reasonably stable years? What does her doctor make of it?

And the next time she turns up a blood sugar reading like that, DON'T nurse her back to health. Call her doctor, or take her to the ER, and let her health care team deal with it. Her health care team, by the way, should not mean "you."

As long as you're carrying this, everyone else will be content to let you. So you have to stop, for her sake as well as your own, or she won't get the level of support she needs. Come on, work on those boundaries. Best of luck.
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This is so difficult. I have no support (except for you guys). No one in the family will take part in a family meeting. Last time, it was like an upper middle class Jerry Springer show. There is so much hate between the brothers. MIL is so good at show timing that I get confused. All I know is that I can't continue at this pace. The Dr. is insisting on me getting help. Yesterday I had to spend my only day "off", actually the only day I have to clean my house, nursing MIL back to "health" with a blood sugar level of 274 I wasn't sure if I should have done more, but last night the number was 137 what I did worked. I am despondent. I tried to make my stand and get her help and ended up doing double time. I wish I could just walk away. Did any of you try to get help and had it go bad? I think that's the part that worries me the most. I you had to do it again what would you have done different.
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My Dad Parkinson's has worsened, and he starting early dementia. I hired my sister to get two days a week off. She quit after 2 weeks. I have hired a wonderful women who does the laundry and takes care of me and Dad. Dad was giving me the same guff. he is worried about money, when he is rich. After a week of him moaning I set a boundary. I told him if he fires the caregiver, I will have to leave and he can make other arrangements. I heard all the guilt, the pie in the sky, thinking one of my siblings would step in to help him. I stood firm for my health and sanity. I say what I mean, and mean what I say, so he knew I meant it. Good luck. Be clear and unemotional. It is wonderful having someone who cares for me also. Th two days of the week is pure freedom. I am so much healthier mentally and emotional. Do it for you.
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It is difficult when the situation reaches this level! As hard as it is, you have to be the adult and just get the help you need. MIL will adjust, it may take time, but once she knows you aren't going to play her games things will settle down.

Family meeting is in order and MIL has to understand everyone is on the same page and want the best care for her. Sometimes you just have to not give them any options. It is what it is and we move forward. It really is not a matter of what she "will let you do" but rather what you need for your own health and wellbeing! That could be finding other living arrangements for MIL.
Best of luck!
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Just to make sure I understand the issues...

1. Home nursing facilities advise Medicare won't pay for in-home bathing assistance.

a. I'm wondering if a script from a medical doctor instead of the psych doctor might make the difference? The former would be in a better condition to advise what is medically necessary.

b. Do you have the Medicare and You 2014 Guidebook? It does help in defining what Medicare will and won't pay for. Sometimes there are little hidden clauses that reveal a way to accomplish getting Medicare's payment.

c. Bathing, whether by bath, shower or sponge bathing, is in fact medically necessary to avoid build-up of dead skin cells, keep skin supple, avoid odor accumulation, etc.

I wouldn't give up just yet - keep trying. You might ask nurses/staff at your MIL's primary care or other medical doctors HOW to get Medicare approved home bathing assistance.

2. Even if Medicare would pay, MIL won't cooperate.

It sounds like she's really being obstinate, but from reading your profile it sounds as if her now deceased husband did everything for her and she's faced with a change now that she doesn't like.

Sounds also like she's created a non-negotiable standoff by refusing to cooperate with you to get help for her. Has she always been this stubborn and uncooperative with you? Do you think she resents you caring for her instead of her husband?

Given her obstinacy, I think I would back off on the bathing issue for a while, and do the same with other things that she resists. She may be trying to re-establish some kind of control over her life now that her husband is gone and may feel "adift". Preventing you from moving into a surrogate place might be her way of creating some control.

I'm wondering if her husband did all the care, bathing, etc. voluntarily or did she manipulate him into doing it?

Sadly, though, she won't cooperate so you're beating your head against a brick wall as she apparently isn't going to change. Rather than stress yourself, I'd back off on anything that she resists.

I take it she's diabetic as well?

3. You're caring for your MIL, but apparently w/o help from your husband? As Eyerishlass asked, where is he? It's his mother, he should be running interference if nothing else to get her to cooperate.

If he doesn't, how can he expect you to bear the burden all by yourself?

Speaking again to the issue of control, I find this comment telling:

"she would rather be dead then let me have help ( I even cried) or go somewhere other then her home."

I think this woman is not just uncooperative but also manipulative, perhaps manipulating you if that was her practice with her husband. But I would also try to think in terms other than that she won't "let me have help." You're doing this voluntarily; you don't need to "let" her dictate the terms of your caregiving. And at this point, it sounds like it's become a thankless and stressful task.

So from now on, think of what you'll "let" her do, and that includes manipulating the situation.

If you are to care for her, you need help. Period. If you don't get it, some other arrangement needs to be made. She'll probably "pitch a fit", become upset, spike a glucose reading, then blame it on you. Be firm and don't give in; if she ends up in the ER, that's a good time to remind your husband you can't do this alone.

I think a family discussion is in order to make sure he knows he's going to have to pitch in and help or some other arrangement will be required.

You can't continue to absorb so much stress when your MIL won't cooperate and your DH isn't helping.
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When you're crying where is your husband? Is he talking to his mother, telling her that he won't allow you to be her only caregiver anymore and that she will accept help or she'll have to go into a nursing home where she'll get the kind of care that you can no longer provide? What is your husband doing to help?
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Yup, that's the cause of the melt down....she would rather be dead then let me have help ( I even cried) or go somewhere other then her home. She won't even go to her other sons homes (Not that I blame her, they are all awful sons)
I love my husband ..."we don't have it all together, but together we have it all".... if this is a prediction of how he will be with me in the golden years....I'm in trouble.
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This sounds very frustrating for you.

Have you told your MIL that in-home help is Dr.'s orders? Has she heard it right from the Dr.? She's more likely to listen to the Dr. than to you.

What about telling her that you need help in caring for her, that you can't do it alone anymore and if you can't do it then the next step is a nursing home. So it's either in-home part-time help or skilled care, her choice. But one way or another she is accepting help. I realize this is a heavy-handed way to go about this but you said you've tried and tried to get someone in there and MIL blocks you at every turn.

Is your husband doing anything to help?
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