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She is incontinent and won't change pads and depends regularly, doesn't bathe (just a washcloth that she doesn't wash regularly), has a hard time remembering to take her meds. Husband and I work full-time and live 15 minutes away. It's becoming overwhelming with her demands. Gentle hints at "Mom, can I come assist you with a bath sometime" or hiring someone to just come in (who's already in the facility) to make sure she's got her meds for the day, compression sox on, and a bath on occasion has her fuming! "I don't need help!" Yes, Mom, you do. Please let us! What can I/we do?

I agree with cwillie. It is time to have the "talk" with MIL. Other than that, you have little legal power if there is no POA and if your MIL at 93 has no diagnosis of incompetency due to dementia.
The important thing now is safety checks. This WILL, of course, come to a head, often enough with a broken hip or other bone. There will then be transit to the ER and there will be a diagnosis. Get the Social Worker to assist you in getting emergency temporary guardianship and work with him or her on placement from hospital or rehab.
I wish you good luck. We have had people on Forum with elders they struggled to get diagnosed or place, and were unable to. I hope a few are reading now. One of our frequent contributors did all she could to protect/place/assist a stubborn Mom who ended dying at home. That of course, is an option, and there is little upside to losing all control of your life and your faculties and your body, and ending with your rights taken from you as well.
I am so sorry. I recognize you spend so much of your time in fear and pain worrying; but there is little you can do ultimately.
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Reply to AlvaDeer
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My first thought was to get the IL involved. Have them do an evaluation and "they" tell her she can no longer stay in the IL living section. She must transition to an AL. And I don't mean by letter. The representative sits down in front of MIL and looks her in the eye and tells her they can no longer allow her to live independently that she needs to now go the next step, an AL.

Your husbands POA must read that he can take over once she is found incompetent. She is now incompetent and if his POA reads he needs that confirmed by a doctor or two, then he needs to get it done. DH needs to realize that Mom can no longer make decisions when it comes to her care. That is now his job.

My Mom had lost her sense odpf smell so I did bluntly tell her she stank. She needed to at least have her underarms washed and deodorant on.
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Reply to JoAnn29
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We went thru this with my 93 year old MIL. She finally told my husband to stay out of her business. So he did. There is not much more we can legally do. The crisis did come...falls, stroke then Covid. She also had cancer but it was slow growing. She beat the Covid but died because her body was too weak to recover. We were also waiting for her independent living community to tell us she could no longer stay there and it was almost to that point when she took ill.
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Reply to Monica19815
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I would step back and wait for the facility to tell her she can no longer reside there unless she hires extra help.
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Reply to BarbBrooklyn
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I've never understood all the people who pussy foot around a problem and then complain that nothing changes, stop with the gentle hints and come right out with it. "Mom, you stink, your spit bath isn't sufficient. Either I'm coming over on Saturday to help you or we're bringing in a bath aide, which shall it be?"
And the one of the reasons people don't change their incontinence products is because they are expensive, grab her CC and stock up, an over abundance may make her more apt to change.
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Beatty May 12, 2021
Yes! I told my Mother she stunk once & she did have a shower (that week) 😂. And the worries over money...you got it!!

The other one.. just can't physically manage. Says can. (But can't).
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Good answers so far, on legal, social & practical matters.

I can't add but to say I am living similar... so sympathise.

Mine is hanging onto her independence firmly (understandable) despite have dreadful mobility, lack of bathing or pad changes too. Plus poor diet. Plus frequent falls.

Physio said best for her to stay on her feet - until she can't. Then things WILL change.

Her Doctor said I am in the club: 'awaiting a crises' club.

You too. Welcome.
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WifeOfMike May 25, 2021
This is exactly how we feel. When she refuses to use the walker when I take her somewhere ("I'll just hang onto you"), I explain to her that when she falls, I'm going down with her, probably on top of her. I've got osteoarthritis and have had many surgeries that I won't undo due to her vanity. She uses it then. The crisis will come, and she'll be more embarrassed when they have to call the fire/rescue team to pick her up, because independent living isn't equipped for that.
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You do not mention if there is dementia involved? Or if there is POA or guardianship? Without those being certainties you really have very little to no control. I am afraid only memory care or long term care placement will answer all these problems for you. Not everything has a "fix it" and this aging thing certainly doesn't. If your Mom has no dementia then I think you may need to let nature take its course here; as seniors lose more and more control they are ever more desperate to keep control of those few issues remaining.
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Reply to AlvaDeer
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Her demands are overwhelming? What, her demand that you butt out and leave her to get on with it, or is she asking you and DH to do things that would be better handled by somebody else?

I came home from a client today having overheard her daughter say on the phone to a respite care provider "... she can't get out of bed or walk to the bathroom on her own." Ha! - au contraire, the problem is that she not only can but DOES go walkabout all on her own. She is a broken hip waiting to happen.

Could anyone at the ILF arrange a needs and/or risk assessment, and explain to MIL in a professional manner that a regular service review is part of their contractual responsibility? She may take suggestions with more grace if they come from someone with a uniform and an ID lanyard (won't necessarily accept them, mind...).
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Reply to Countrymouse
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Need to start with answering the question: Does she have a Power of Attorney assigned? If so, this person needs to review the document to see when their authority is activated (some PoAs say 1 or 2 diagnosis of dementia need to be had, some none). If she needs a diagnosis you can tell her a "therapeutic fib" to get her to go (like, "Social security now requires a physical in order to keep receiving benefits" Or Medicare, whatever). Once there pass the doc a pre-written note asking her to get tested for a UTI and have a cognitive exam. Then the PoA can move forward with this info in hand.

If no one is her PoA, you can attempt to take her to an attorney to do this. The attorney will interview her privately to see if she is capable of understanding what a PoA is and does. Sounds like she probably won't go but you can create a therapeutic fib to get her there (anything you tell her to motivate her to go. Once at the office she might be more amenable to creating the documents if it's explained to her by someone other than family.

If she ends up without a PoA you won't be able to easily manage her affairs legally and may end up reporting her to APS as a vulnerable adult. They will move to attain guardianship of her (if family doesn't choose to do this). They will assume management of all her affairs and make all decisions in her best interests going forward, including transitioning her into a facility.
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