My mother-in-law (88) is becoming increasingly emotionally difficult and not having normal reactions to situations. Any advice?

Can't speak to the dementia but she's more than likely emotionally and physically overwhelmed, in part by the decisions they've made not to accept care. It sounds as if they're locked in a mind set which is self destructive but can't get beyond it.

Can you get her to a doctor for examination to determine if there is some element of dementia, or if there are other physical issues?

This sounds like a tough situation.

We see that she is overwhelmed and struggling but they refuse to have any help of any form. She will vacillate between crying and yelling that she's going to leave her husband & she can't handle it anymore to saying that she's the best person to take care of him - all within the space of a couple of hours. It's sad for us to see their quality of life deteriorate so much - he sleeps most of the time and she is lonely and will complain about how lonely she is and that nobody understands her or her situation, but will not accept any 'interference' by us trying to help or others. We are thinking of going to her Dr to tell her what our concerns are, but if she finds out we did that, it will be even worse!

No direct experience with this, but try calling Adult Protective Services, and just talk to them about what's going on? They will probably be able to help guide you. Good luck, I'm so sorry you're going through this.
There is a huge amount of detaching that we have to do. Realizing what we're unable to change, and accepting the limits. It's extremely difficult and painful, but if you realize what you can and can't change, you'll save your sanity.

She needs to be seen by her physician. Before she goes either call or send email stating your concerns and documenting what is going on to give him a good sense of what you are dealing with. It has been my experience the doctor will not say anything just use the info for his examination. You could even end the note by asking that he not tell her his office received info from a family member.

It is tough, but doing nothing is certainly not going to help their situation. The old say, "It is easier to get forgiveness than permission." Good luck!

I'm wondering if she feels it's her obligation entirely to care for him. Given their ages, caring for each other without outside assistance was a part of that ethos. They probably expected to do that when they married and now she may be struggling with honoring that commitment even though it's physically and emotionally too challenging.

Do you have any other relatives in that age group who could visit and casually direct the conversation to the subject of getting help to supplement, not replace, what your GM is going?

I think the key might be to convince her that this is a different era, there is help, she doesn't have to do it alone and it's better if she doesn't. But I'm not sure how to do it.

That generation is a lot different than contemporary generations. I know - my father is from that era. He'll accept help, but limited help. I'm still working on getting him to accept household assistance.

He'll accept medical assistance though. Perhaps that's what you could try, if you can get either of them to see a doctor who could order home care. That's something that GM can't provide, unless she's a nurse. Sometimes medical people can persuade when family can not.

Authority figures can make the difference.

Sorry - I meant to write MIL, not GM. Apologies.

Thank you all for your quick responses, suggestions and advice for us. Unfortunately there are no other relatives and although my husband has 3 brothers, none of them live here, so we are their only family close by. Every time we think we've had a break through of sorts to have them have home care, visitation or consider alternative living arrangements, nothing is followed through and as she says 'nothing is right for them'. We feel we have no choice but to back off, and then we're accused of having no compassion or understanding. Really hard as we've always had a good relationship with them until now.

I don't know how to advise you, but I am curious to see how this turns out. I have a feeling my parents are going to be in the same situation: living alone in a big house, caring for each other and not really wanting help.

Please keep us posted.

Sharon

At 90, I am guessing He is a WWII vet and would qualify for VA Aid & Attendance to pay for Assisted Living or in home care. They are most likely in need of Assisted Living. Getting them to go there is the hard part. Definitely call APS to check on them. Also make sure 911 has your contact information.

Yes, he is a WWII vet (we're in Canada) and qualifies for all sorts of assistance - but they are unwilling to have either a care-giver come to their home a few times/week or to go to assisted living. They have been independent all their life and do not want to give that up. They both seem to be very un-aware of what their actual limitations are and that their quality of life could actually be better if they were to allow others to help them. Our big concern is my MIL's inability to handle the increased stress of caring for my FIL which is resulting in her emotional break-downs, yelling at everyone, crying and making irrational decisions. We are going to talk to her Dr to let her know our concerns and also to see if we can get any advice.

So it seems the challenge is to address their sense of independence, figure out a way to preserve enough of that while still getting help despite MIL's resistance and lack of insight into their situation.

That's one h*ll of a task. I wish I had some good suggestions but I do know that fierce independence can be a formidable barrier. At 95 my father still believes he can do things he shouldn't be doing and takes risks that send shivers up my spine. But I'm trying to rethink my own approach so that I can find ways to enable him to go forward safely, reassure him that he still can do it but that it's a good idea to have help, or that he can share his acquired wisdom with others who would like to learn how to handle some the tasks he wants to undertake himself.

Wish I had some good answers for these situations.

Could you possibly get MIL away for a nice lunch or dinner, just to give her some relaxation time? Perhaps say that one of the family would like some time with her, and someone else would like to spend time with FIL?

Or possibly think up some approach to her that will ENABLE them to keep their independence but still accept help?

I think pride is one of the main factors here, and somehow MIL has to be convinced that taking action and accepting help will be just as rewarding and a tribute to her stewardship as resisting. In fact, it does take a lot to recognize that someone needs help and accept that help.

Good luck with these efforts.