MIL's health has declined. My husband and I aren't even really sure where to start getting help. Any suggestions?

Gosh your Mom-in-law is so very young to be going through hip replacement and falling.

Contact your county agency on aging for programs, such as Case Management, Meals on Wheels, Adult Day Care, housing, care referrals, etc,... go to the website link below.... click on your State.... now click on the city/county. https://www.agingcare.com/local/Area-Agency-on-Aging

I am curious about the "legal limit" on the cats? Never heard of that. Or is your Mom-in-law living in public housing where the lease limits the number of pets to 3?

CanCan,

This could be bad. I don't think it's "as if" she's unrealistic, I'd be very concerned that she has early diabetic encephalopathy that is something like vascular dementia. What happens with that is that people seem OK because they recognize everyone and converse witih them, and memory per se is not so bad; but on the other hand, judgement, reasoning, and problem solving skills may be just about gone. By "very overweight" I am guessing you mean "morbidly obese" and I'm also guessing the liver biopsy is for non-alcoholic fatty liver disease, which is a consequence of the obesity and can lead to the hypoglycemia. This will go nowhere but downhill without some weight loss - but the good news is even a 5-10% weight loss could make a substantial difference, and changes to medication management would tend to help as well.

I would see if a really comprehensive geropsych evaluation can be done to objectively see where she is cognitively and help you feel you are doing the right thing if you need to say NO, you cannot go home until _____ . I am so sorry to see you facing this sort of thing. It can be hard to know how hard a person can fight and how much they can change, and how much you have to accept. Diabetes and obesity are much underestimated enemies of health and well-being; there may be few or no major problems for some years, but the microvascular disease and the wear and tear on the joints catch up with you.

Thanks, Countrymouse. I am trying to stay objective. I understand she's probably scared and lacks basically any control over her situation right now, so she's using any sort of power she has right now as a means to an end. I also think she might be reacting to medication(s) she's been given. There's a long history of strain in this family, and I'm staying at the fringes of this whole thing. We do care about her and want her to get help. I'm also worried and feel responsible for her animals. When we are out of town, they must be taken care of, even if that goes against her wishes of having her sister not be involved right now. There's no guarantee anyone else will step up and help with this issue or any other pertaining to her care right now, as no one has yet. It's really only my husband, his aunt (the sister she'd feuding with) and me. There is also a caseworker from the county that's been really helpful, as well as the paid cleaning crew who is going through her home as we speak and boxing up things and beginning to make it livable.

The irony of this situation is she is mostly worried her sister will "move" things around in her house. Everything is being removed for cleaning, so there is nothing her sister can "move" to a "wrong" place.

I agree patience is going to be needed. It's not something I'm known for (and neither is my husband), but we're working on it. Hopefully she can see we really want the best for her in this situation.

cancankant, with mobility being a problem with your Mom, she would need to hire someone to help her out with her own care, do some house cleaning for her, and help with the care of the cats [mainly litter boxes].

You will need tough love with her, either she hires help or the cats will need to be re-homed with new families. It's not fair to the animals. With 5 cats, experts tell us that she would need to have 6 litter boxes.

Thanks all for the helpful advice. We have some time, as she is still in the hospital and because she is likely to be transferred to a rehab facility sometime next week, as she can't complete the physical therapy sessions in the hospital.

My MIL is 61, not 81. She is very overweight so it does contribute to a lot of problems and does not help her mobility. The first time she went to the ER, they couldn't find anything wrong with her, but the doctor told her losing weight would help (Thank you, Cpt. Obvious). We knew something HAD to be wrong, though, and tried to get her to go back to the hospital. Then she fell again and had to be hauled out by the paramedics.

She is diabetic, but she is being treated. They do believe that her medication stopped working for her, though. When she was admitted to the ER, her blood sugar was extremely low. We are probably lucky that she didn't go into a coma from low blood sugar. She also has some problem with her liver (they did a biopsy today), and she has a UTI. She had a terrible infection that lasted months after her hip replacement surgery. She technically needs revision surgery for her hip, but she's afraid to have it done. I'm not sure I blame her, since the original surgery went so poorly. I think her mobility is worse than it was before the surgery.

We are focusing on trying to get her house clean while she's away. I do think there is at least some depression issues. I don't think it's anything like Alzheimer's or dementia. I think she just got to a point where she gave up on life. I really wish she'd said something to us sooner. She didn't want any other family involved, but her sister is willing to help, so we will be enlisting her services. Hopefully some of her other siblings will help, too. My parents have offered help as well, so we should be able to get through this.

It's all very overwhelming. I agree about the cats, too. It's not fair to them to live in squalid conditions. I have been involved in animal rescue over the years, and it breaks my heart to see them in a cluttered, filthy environment. We definitely will be talking to her about getting help with cleaning (including cat boxes). She does have many boxes (at least 5 or 6), so that was not the problem. She just was not cleaning them at all. They were literally overflowing when we went to "scoop" them after she had to go into the hospital. We were so blindsided by all of this. The house had gotten bad when she was in complete pain before her hip replacement, but she been able to keep it up pretty well until recently it seems.

Cancan, to understand your MIL you have to look at things strictly from her point of view (you don't have to act on it, please note!). Given that she is someone who has actively avoided facing up to her health issues over many years, and has now had the misfortune to have a bad experience with a hip replacement, she is hurt, she is frightened, and her very natural instinct is to run back to her home and bolt the doors.

Natural, but hopeless - I agree with you. It is totally unrealistic. All I'm suggesting is that it is going to be patient, time-consuming work to win her compliance; so meanwhile your poor husband will have a heck of a job on his hands. Somehow you will need to help him find a way of going round her, so that he can accomplish the changes she needs *now* without forcing her to give explicit, detailed agreement to them.

She is in extraordinarily bad shape, unrelated to her age - her condition is the result of a cavalier approach to managing her health and especially her diabetes over many, many years. Am I blaming the victim? :/ It's hard not to; only I wouldn't put it like that, I'd say I'm holding your MIL responsible for her own health, as a competent adult. So don't feel bad for not having done anything about it before: these things pile up gradually, and it's not until the pile topples over that anyone wakes up. It just happens like that. And anyway there's nothing to be gained from wishing.

I think if you and your husband can stop being surprised by her attitude you will perhaps find it a lot less frustrating and stressful. Don't waste your breath reasoning with her: go in there tight-lipped, do what needs doing, make no judgements but stick like glue to matters strictly practical. Here are your options, this is what we recommend, this is what we will do to get things done. You don't like them? So what's your better idea? Ok, this is what will happen if we act on your better idea… And that's why we're not doing that.

You will need the patience of Job. Frankly your MIL is extremely lucky to have you and your husband taking charge. Watch your backs, both of you, and be ready to hand her over to professionals if you're getting overwhelmed: there is nothing wrong with doing that.

But I don't think MIL's situation is hopeless. The CHF is bad news, but it's not necessarily the beginning of the end. I'm sorry for the hard time she is inevitably going to have adjusting after this crisis, but she's young enough to do it. God willing it could turn out to be a new start for her.

What a lovely attitude you have on you, Cancan. I know it's incredibly difficult, but I repeat that she's lucky to have people like you on her side.

Your MIL may be so overwhelmed between the hip surgery and the condition of the house that she blocks it out and refuses to acknowledge it. Several of the comments in your posts make me think that she's still on the side of denial and it will take a while for her to realize that what you're doing is actually life saving for her possible return home. But until she reaches that side of the river, she'll continue to be defensive and in denial.

I suppose it's easily understandable; no one really wants to admit that their life is out of control physically. It's just too much at one time. And I think it's a coping mechanism when life becomes too much and too complex for someone to handle.

It may be that when she eventually arrives home to find the house cleaned, she'll be grateful and recognize how much the help her family has provided will assist her recovery. Hopefully that will be the situation.

And hopefully one by one the various physical issues can be addressed and resolved.

You and your family are gracious and dedicated supporters; your MIL is lucky to have you.

Cancankant, you'll know you've got the hang of this when you're looking at a bag full of elderly undrinkable wine and think "executive decision: garbage." Or recycling centre, if you are civic-minded. The key phrase is "executive decision." On many of the hoarding programmes of which I used to be an avid consumer but now can't stand the sight of them, so many tears over things like mouldy pizza boxes would have been saved by this. If the declutteree later misses said wine or pizza box and kicks up a fuss, you can say, according to how much hypocrisy you are able to enlist:

a. oh my goodness, did that go in the garbage truck? I'm SO sorry, it was a clerical error.
b. Pizza box? Well I'm sure it must be somewhere - let's look for it at the weekend.
c. I'll get you another.
d. Sue me.

I stress that this approach is only ever to be used for things that are definitely, by anyone's standard, garbage; and NEVER for items that you just dislike intensely, however tempting.

Thanks, everyone. This has really become a rollercoaster. We went to the hospital on Friday and Saturday. She is just - flat. No personality at all (except for wanting orange sherbert - I know that's her favorite). We find out more tomorrow.

Countrymouse - No need to apologize at all. No one saw this really bad development coming, and the family is completely shocked. I have used humor throughout (perhaps in bad taste at times, but that is my style) in order to cope.