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!
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.
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.
He's deluding himself to think that this kind of care can be done at home.
He should meet with social worker/discharge planner to start talking about options for care. I would suggest that you go with him to make sure they understand he will be alone caring for her. If he does not listen, start packing.
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
You should probably talk to her doctor who can then reinforce the need for rehab over home recovery. Most times a resistant family member will "obey" a doctor over a family member. Your BIL is probably taking to heart that his wife is his responsibility and "sending her away" seems like a failure on his part. He needs to know that she will be coming home when she has recovered.
Seems that the time she is in rehab would be a perfect time to "fix" any problems in their home to make it easier to live in: lever doorknobs, rocker panels for lights, handrails in bathrooms, removing scatter rugs, streamlining decorative items... The general lay-out and design elements should remain, but their home may need adjustments so they can continue to age in place. Maybe your BIL can get onboard with modifications if he knows they will make it easier for them to stay home as they both age.
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.
I'd like to share some insights into a similar situation. The woman fell down a few stairs, broke an ankle, had surgery, followed by more surgeries and adaptations for diabetes. She was younger than your sister, but still required support at home and long healing periods. Her husband had medical experience; her grown daughters helped. Still, it was a long recovery period b/c of the diabetic complications with healing.
Your BIL is good person; he would be an asset to anyone who needs care. But the complications from diabetes may change along the way, and he should prepare for multiple doctor visits, possibly more surgery, and frustration from his wife, especially since she has LBD.
I really think though that the crux of the issue is how best to address her care and healing, for her as well as for her husband, w/o compromising his need to provide care, but at a safe level for all. And, unfortunately, that's unlikely to be with home care at this stage of the journey.
Someone else suggested and I concur that focus be on the long term, the healing, and how each of you can contribute during this challenging journey, w/o providing physical care that will challenge your own physical limitations.
What might work is for you, your husband and BIL after discussion with the surgeon what will be needed, is to create a work division plan - someone does the shopping, someone else the cooking, and the various medical trips, so that each of you participates and can benefit from knowing that you're helping.
Someone can read up on LBD, possibly consider the Alzheimers Creating Confident Caregivers Course, which is excellent, and provides alternative methods of thinking when working with dementia.
Someone can research and arrange for installation of grab bars, etc., as well as arranging the house to avoid any mishaps. If you think she'll need assistance with medical appointments, research, discuss and locate transportation (I used an ambulance w/ non emergency service for transport when I had cataract surgery.)
If you contribute at a level that doesn't challenge your own health, you're really accomplishing your BIL's caregiving goals, but in a different way, and at a safer level.
I hope that each of you is able to find peace with a compromise, and that your sister's healing progresses well, without complication.
I think the family could look toward a positive outcome by frankly discussing how difficult it will be for both of them, but how you each can help in your own ways, and by safely doing so.
"Tell BIL she should live in HIS home and HE should take care of her."
The OP's sister and BIL ARE living in their own home, as is the OP, and her husband, who moved into Sister and BIL's home:
"My husband and I moved in with my Sister (she has Lewy body dementia) and BIL. "
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!
If she isn't suppose to put weight on her legs then she will have to be bed or recliner ridden and use a wheelchair.
If she can't transfer from her bed or recliner to the wheelchair bu use of a walker to stand up on then she'll have to stay in bed.
Her Insurance should pay for her to have therapy at home.
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.
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.
Do you and your husband have the means to move out of their house? If so, you can tell BIL that as much as you love both of them, you can not sit by and watch her put in harms way by not doing what is in her best interests. She may need a wheelchair at first to keep her off of her ankle, will their home accommodate it?
Good luck, I really hope he listens to reason for her sake.