Grandma is 88 years old, is demential, and diabetic and so requires four insulin shots every day to maintain her levels. The problem is that she also has severe hand tremors and cannot administer the insulin by herself. Ever since her husband died, that burden has fallen on my mother, her daughter-in-law. My father has since passed away as well so it is really only grandmother, mother, and me left in the family. I am away at graduate school.

The four insulin shots a day has wreaked havoc on mother's schedule and grandmother is mad if she doesn't come down at a certain time to give her the shots. We have gently suggested putting her in a nursing home but she refuses and says that we are leaving her to die and that it costs too much money that she can't afford. We suggest paying for a nurse to come in to give her shots and she still refuses saying that it's too costly and she doesn't trust people. We don't know what to do now.

My mother is burnt out and is unable to do what she wants (travel to see her own father, and me). As a widowed daughter-in-law, does she have any obligation to take care of her widowed mother-in-law? What would you do in our situation?

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With diabetes and dementia, grandma's days of living alone in her own home are numbered. My advice is to get her into a comfortable assisted living facility while she is still healthy and cognitive enough to meet the qualifications. With social security and the equity in her home she should be able to pay for several months while you look at other sources of funds such as veterans benefits (if either she or grandpa was a war veteran) or Medicaid.

As for getting grandma to agree to the move - read some of the threads on here about visiting AL facilities and helping her to adjust. Many of us have been through this, and in the vast majority of cases the elder is happier and healthier after the move.
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She really needs to be making plans for her own care. If something happens to your mom, she will have to step up and do something. But, I agree, your mom cannot be over there giving even one shot. It is too bad that she ever started.
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Sometimes elders no longer have a vote regarding their care if they keep refusing others to help or to move to a continuing care facility. Just tell your Mom to tell her Mom-in-law "sorry, I can't possibly do that any longer" and keep it brief.

Either Grandma gives herself her own shots [I know she can't do that] or she allows a Nurse to come in to give her those shots. There are times when tough love is needed, and this is that time. Please note that one out of every three caregivers die leaving behind the love one they were caring... you don't want that to happen to your Mom.

Grandmar can afford an assisted living or nursing home. If she has social security, that can be applied to the cost. If she owns her own home, the equity in the home can be used. If there isn't enough money, then she will need to apply for Medicaid to see if could get a waiver to help pay for assisted living or pay most of the cost of a nursing home.

Also have your Mom contact her 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 her State.... now click on the city/county.
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