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She is currently in a respite care/assisted living facility nearby, as she recently fell on her knee, which aggravated her osteoarthritis in both knees. She is using wheelchair/walker. Our house is not handicap accessible and has steps/no grab bars in bathrooms but only the handles on the sides of the toilet. Her bedroom and bathroom for a shower is upstairs. Also, she gets up multiple times per night to go to the bathroom so if she ever came home, we would never sleep for fear of her falling.
I have been the primary caregiver for the last three years doing everything for her as there are other health issues (I.e., diabetic/insulin shots, Macular degeneration, Dr appts, etc.). So yes, I have created a monster (expectation of immediate dedicated care). She is a strong willed, independent person and we are approaching the idea that it is safer, and she may need to stay there, but she is very resistant. What is the best approach to get her on board? My next step will be to bring the doctor/physical therapist into the conversation and let them be the bad guys to say she cannot come home safely, and then we can make her feel better by saying she can come home for the day during holidays or other family events if she is on the walker.

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You are never going to get her to change her mind so you cannot present this as a CHOICE. She needs to be told that you are no longer physically and mentally able to care for her at your home. Her needs are more than you can handle. If you have to be the bad guy, own it. So many people on this site are afraid of upsetting the elder. Yet it is ok for the elder to work them into an early grave without giving it a thought. She isn't going to get better. She will only eventually get worse. You can't do this anymore. You gave her three years, how much more does she expect?
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Isthisrealyreal Nov 2022
Yep, being the bad Guy and owning it is actually pretty awesome.

I found that once I was labeled, I didn't get calls for assistance.

For me, win-win. Get your home back and no more manipulation, who can ask for anything more?
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Cindy, here's the deal.

She won't be safe at home and you and your dear husband (dh) can no longer be adequate caregivers.

There's no "convincing" her. YOU say "no, we can't do this anymore" and accept that she won't be happy with you.

You have to steel yourselves to not be afraid of her anger, her displeasure and her sadness.
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TouchMatters Nov 2022
and ... if she isn't safe in their home, she won't be safe there during the holidays so not a good strategy to use. It doesn't make sense - and mother (IL) won't be in a mental / psychological / emotional place to hear 'home for the holidays.'
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Welcome to the forum. I'm sorry you are new here and had to find such a foul, guilt inducing comment from someone who has no profile themselves, just a history of leaving foul comments for others.

Assisted Living is not some house of horrors that an elder is being "dumped off at", for petesake! It's a luxury environment where an elder gets care, meals, activities, entertainment, outings, and all sorts of other amenities too numerous to mention. We should ALL be so fortunate to be able to afford AL in our old age. Your MIL, at her age and in her level of need, is no longer capable of living with you and needs more care than one person can safely provide. She needs a team of caregivers working 24/7 to care for her now. Those that don't understand this need have a Superman complex or an extreme level of ego combined with ignorance blinding them to the reality that they're simply incapable of being All Things To All People At All Times. Fortunately, you have the intelligence and presence of mind to realize the need for AL for your loved one.

Get her doctor on board to explain the need to your mil and that at 94, it's simply too dangerous for her to live anywhere else but AL. Let her know you'll visit frequently, too, and then be sure you do. Before mom went into a wheelchair, I'd bring her to my house for Sunday dinners and holidays, then it got too difficult and she was too high strung when she did come over, and wanted to get back to her apartment almost immediately. By then her dementia had gotten pretty bad and she'd segued into Memory Care. So we'd bring the festivities to her instead in the library which was nice. You'll figure out what works.

Wishing you the best of luck.
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Cover999 Nov 2022
Where are these ALs that are "luxury" environments? They sure aren't in Cleveland Oh?
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Why do you have to get her 'on board'? Do not allow her to move back into your home. Whether she is on board or not doesn't really matter. Cruel? Do you want your life back, do you want your marriage back, your home back - if yes to these things then it is time to release her hold on you and your husband and give her to care, physical therapy, recreation, and nearby doctors, nurses, and social workers she will benefit from.

I realize some people think we 'owe' our parents, but now they live to 100 but lost their brain at 85. Bones are brittle, sight and hearing are gone, mobility is gone, bodily functions are not reliable and multiple aging diseases have to be managed - YOU cannot give your life up. So don't.
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You are already on the right track, but attempting to do a “carrot on the stick” of coming home for any reason may very well not be the helpful tool that you think it is. NEVER make any promise that you aren’t 100% positive you’ll be able to keep.

Her proposed residential care site NEEDS to BECOME HER HOME.

How did you become the “designated caregiver”? Did you offer?

Does anyone in this care giving process have POA?

Does “age related decline” mean symptoms of forgetfulness, overt hostility, refusal to participate in therapies? All or any of those may be symptoms that the “independence” at home that she says she wants are reachable goals for her.

Then there’s this- YOU have cared for her for three years in a set up in your home that was less than ideal for her VERY COMPLEX NEEDS.

You soldiered on, and you are weary and afraid that if you continue to be her primary source of care and attention, your situation AND HERS, could quickly become much worse. She is NOT an “independent person”. She may once have been, but no longer. And that means that her ability to participate in decision making is no longer appropriate to leave in the thoughts of “the monster” BECAUSE YOU AND YOUR FAMILY COUNT TOO.

You have reached a point that many of us ultimately reach. I gained 60 VERY UNWANTED POUNDS and added a sleep disorder before I placed my mother, the most stubborn woman who ever walked the earth, in a very good SNF, where she lived over 5 happy and contented years before her death at 95.

SO- stop trying to figure out how to continue to let her rule your household, and allow her to be placed in the very best near by facility you can find.

Allow HER to adjust to her “new life”, STAY AWAY from the facility if they ask you to do so, until she realizes that this is now her “HOME”, and NEVER AGREE to any or visits or treats.

“We’ll see what ‘they’ think…” works. Blame doctors, therapists, whoever, but don’t commit to ANYTHING that you can’t or won’t be able to do.

BE STRONG. You’ve paid your dues for THREE YEARS. It’s time for a change. Make one.
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Cover999 Nov 2022
Can't blame her for being resistant. These places tend to be depressing.
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Your husband needs to tell her that returning to your home is no longer an option. The house is not safe for her anymore and you can no longer care for her. Your are Seniors too. She needs more care than you are capable of giving her. She really has no option since she cannot live alone. If he can't say this, then u have to.

It does not matter what she wants, its what she needs. You should be enjoying your retirement years. She still has her independence. She will have her room. She can walk around the AL. She will have a social life, activities and entertainment. There is no talking her into it. She has no choice. This is how it has to be.

What you need to do is allow her to adjust. When u visit u do not need to stay long. I stayed no more than an hr. She needs to get used to the staff caring for her. If she calIs numerous times a day, put a stop to it. Tell her to take advantage of what the AL has to offer. Use the aides. If she gets mad, oh well.
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Cover999 Nov 2022
From her point of view she would be in this place while daughter and law can leave and/or not visit at all.
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Isthisrealyreal makes an excellent point about being the "bad guy" and it's true. Sometimes being the "bad guy" can be a good thing. When people see that you don't have a problem saying no they soon understand that you're not a pushover and they stop trying to take advantage of you.
@Cover999
The OP and her husband do not want the MIL coming back to live with them and they should not take her back.
How many loving and caring parent/adult child or SIL/DIL relationships with in-laws that were totally wrecked and devastated because they took on caregiving?
People get fooled when they hear the word "caregiving". It sounds wonderful, doesn't it?
I've seen so many families over the years destroyed by caregiving for an elderly parent or in-law. Loving marriages that broken beyond repair because of caregiving. Brothers and sisters at each other's throats over preserving inheritances or resentment going too deep for healing because one sibling gets saddled with all of it and the others don't get any.
CindyAL and her husband should keep the MIL in assisted living for their sake as well as hers.
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Cover999 Nov 2022
Maybe the key is finding a good one.
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She needs more care than you can provide, and you need to keep telling her that. Also, bringing her home for a holiday isn’t a good idea because then you’ll face the weeping and wailing when it’s time to take her back to her new home. Maybe next year…..
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This is really on your husband to tell his Mom, not you.
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Your question: "What is the best approach to gt her on board?" is really asking:
"How do I get myself on board?"

* You need to realize you/your husband are in control.
* Set your boundaries
* Expect 'kicking and screaming" - OF COURSE she'll be resistant... why wouldn't you expect this response?

* UNTIL and UNLESS you change your mindset, she will continue to do what she always does - she won't change.

THE BEST APPROACH:
1. Be clear
2. Be concise (don't make excuses)
2a. DO NOT give too many examples of 'why' (give one: it isn't safe for you to be in our home due to no wheel chair accessibility" - that's enough). Long explanations = feeling guilty or out of control of the situation, if not intimated).
3. Be firm
4. Do not argue.
5. Walk away as needed (as she'll want to engage / scream / argue - give her time to cool off / cool down.)
6. Make needed arrangements.

GOOD TO BRING IN THE PROFESSIONALS...
Realize there is NO easy answer to what she needs as she won't accept what she needs. DON'T MENTION THE HOLIDAYS YET. That won't register and she'll think why "JUST" the holidays. And . . .

If she can come home for the holidays, why can't she be there all the time?
Be very very careful what can of worms you open.

Gena / Touch Matters
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