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My husband and I moved in with my Sister (she has Lewy body dementia) and BIL. I am helping to take care of my sister and her husband..they are both 74. I am 58 and have had 3 back surgeries. I am really not supposed to lift more than 20 lbs. That was ok until this weekend when she broke her ankle in 2 places. He cannot lift her anymore because of his knees when he fell. The Dr. said the only way was surgery. When the temp cast came off she had an ulcer and it is not healing (she has diabetes too!)
So.. Dr. said there is 30% chance it will need to be amputated.
My BIL thinks we can still take care of her after her surgery on ankle on Thursday. She will have 3 pins sticking out of her ankle and can not put ANY pressure on her foot for 3 full months..Her dementia is getting much worse and she will not do what we ask/tell her to do. I think she should be in rehabilitation but BIL disagrees. Advice desperately needed!
I pray I can convince him and he changes his mind!

You need to tell BIL that you CANNOT do this; you physically CANNOT take care of a sister with Lewy Body Dementia *LBD* in addition to a serious situation with her ankle. Period. Does he not realize how diabetes can complicate her situation to the degree where it's not unrealistic to have her foot amputated??? My SIL is going thru the same thing withOUT LBD to further complicate an already complicated situation!! Sores & ulcers do NOT like to heal when diabetes is involved. I think you're in way over your head, personally, and aren't qualified to take care of someone in THIS condition. Honestly. Your sister won't be able to follow ANY directions either, so things will be even MORE difficult than they would be under ordinary circumstances, you know?

Tell your BIL you will have to move out if he doesn't agree to rehab, and then to getting extra in home care afterward. It's not unreasonable to think your sister may require full time care in a Skilled Nursing Facility at some point, either. Perhaps you can appeal to your sister's doctor to get your BIL on board here and to make him understand the seriousness of the situation you're faced with.

Wishing you the very best of luck dealing with a very difficult situation. My heart goes out to you in a big way.
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Reply to lealonnie1
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If BIL insists on "bringing her home" you are going to need to vote with your feet and leave HIM to take care of her.

He's deluding himself to think that this kind of care can be done at home.
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Reply to BarbBrooklyn
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Hi As a nurse and psychotherapist, I have had experience with families with similar problems and sometimes you have to make a stand to make your point especially since it appears you provide the majority of care.
The writer who suggested that you move out has one approach. I know someone who went to a hotel for a few days and got a positive response from the rest of the family.
I have had my husband age 80 in a Rehab 3 times for a stroke , serious infection and after 2 major surgeries. He did not want to be there but the PT in rehab was necessary. Medicare usually pays some of the cost and some insurances pay the copay. A skilled rehab provides 5 or 6 days of therapy per week which may help her become more mobile.
With 2 broken ankles dementia, diabetes, she requires skilled inpatient rehab, followed by home PT and outside help with her care unless the whole family is then able to care for her. It is really in your SIL's best interests .
Good luck!
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Reply to nurseMPB
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IMHO, BIL has zero say in this.

IS he, by chance, worried that a rehab facility may likely lead to a permanent move and that will eat up any inheritance? My BIL was adamant we not move my FIL to a NH at his EOL and was more than happy to run me ragged caring for him. (Your sister could require a very high level of care that will be expensive. Too many people look at family members as being 'free' or 'cheap' labor. )

When it became apparent that my 3xs a day runs to FIL's for meals, etc, was eating me alive and FIL's Dr. said he could no longer live at home---BIL was furious. Dad passed away 2 days after the news that he couldn't go home. BIL swooped in and vultured everything of value before a funeral was even planned. He also listed and sold dad's rental property, took the commission and 'allowed me' to flip dad's condo to make it sell faster (I was allowed a $5K budget and NOT allowed to take any payment for my hundreds of hours of work) The condo, BIL sold and took the commission. MY DH was executor...and did not stick up for. It's been 18 years and I still have some residual anger.

That's just MY story---but I know I am not alone nor unusual in this.

I do not weigh in on my MIL's life. It's NONE of my business. I support DH in dealing with her, but her life is none of my business. Sounds like you are in the position of obeying BIL---is he by chance a bit of a bully, to boot?

Families are so great...until they aren't.

I, too have a bad back and cannot lift more than 30 lbs. I am slowly trying to reclaim my life and take care of ME for a change.
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Reply to Midkid58
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Time to put your foot down...not so hard as to break it though.
YOU can not care for her.
BIL can not care for her.
There really is no other option but to have her go to rehab for however long it takes to heal.
If that means going to AL for a time if necessary then that is the way it has to be.
The problem with any dementia and rehab is how participatory will the person be. If she is cognizant enough and willing enough to participate and retain what is done then she may fare well. But if not the doctor may be right and she may face amputation. If this is the case you truly will not be in a position to help her.
If he is insistent on bringing her home I think you and your husband need to move out, look for another place to call home. You can not remain there as it will be a danger to your health if you try to do more than you can or should
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Reply to Grandma1954
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We have been down this road with my mother who refused to go into rehab after fractures. It was a huge mistake. She could not get around and we were simply not able to care for her in the way she needed. My advice is to insist on rehab where she will have the care she needs. BIL can spend his days and evenings at the rehab with her so together. She needs special care now which she will get. Also this might enable you to get visiting services to transition her when home which might include visiting nurse PT/OT and an aide to help with bathing and such. You and he will see this as giving her the best care if you select a good rehab facility. That’s very important. Good luck.
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Reply to janlee
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worriedinCali Dec 19, 2020
Let’s not assume BIL will allowed to spend his days and evenings with her. In a lot of places, visitors are still banned entirely. Or limited to brief in-person visits.
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For your own safety, and as a nurse I will be frank here, FOR HER OWN SAFETY, she should be in rehab. I think also that soon you will have to face your own limitations in general before you do yourself a permanent injury. I am so sorry. I wish we could all just "fix it" in these situations, but that is not the case. We cannot. I hate to sound so tough in this one, but if your family will not protect you, then you MUST protect yourself. So the answer is a simple "No. She must go to rehab. I couldn't be more sorry, but she must".
That is just one more "personal opinion" for you to weigh, adding to the confusion, but I think you know the answer. I think you must tell ALL that you will be unable to participate in care now other than to do the cooking, carry in meals, do easy housekeeping; the rest is on them. I am so sorry.
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Reply to AlvaDeer
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You will need to let him know that bringing her home means he will have to hire full time help because you cannot manage her care. Be firm. It’s not safe for your sister or you. It’s likely that rehab will be covered by Medicare for a certain period of time. And truthfully, it doesn’t sound as if your sister will be able to return home without ongoing outside help, between an amputation, her dementia and her other chronic conditions. It may be time for a new plan. Having her discharged to rehab after surgery will allow for an assessment of her future care needs. So sorry you are going through this.
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Reply to Mepowers
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OK, so firstly, if you & your DH were NOT living there what would BIL's choices be?

Since HE can't provide the physical care for his wife in her current condition;

1. Hire round the clock in-home care, or
2. Arrange for residential care (whether it be called respite or rehab). This may be in a skilled nursing facility.

Since you & your DH have said no, these are the only choices I see.

Anything else is denial.
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Reply to Beatty
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If he won't put her in rehab where she belongs, you and your husband need to move out.

You're not physically capable of the caregiving she will require. Trying will likely severely injure you and you'll end up in the same position she is.
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Reply to ZippyZee
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