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My mother-in-law suffered 7 strokes in the span of 72 hours which caused damage to approximately 75% of her brain. She was almost 50 when this happened. My wife decided that she wanted to try to take care of her and move her in with us about 5-6 months after the strokes. It has been 2 years now, and my wife is pregnant with our third boy... I know... However my wife is on bedrest from the doctor, so I am now taking care of her and my family. She can get around enough with a walker to go the the bathroom or get something from the kitchen, but literally not much more. She gets confused a lot, which I suppose is to be expected, but she has been becoming more mentally unstable as the time goes by. Is there anything I can do or a place I can take her that will get her taken care of... because I sure as heck can't afford to... Especially being the only one with an income at this point. Or can I just take her to a hospital and drop her at the front door with her medical cards and ID? I know it's kinda jacked up, but im running low on time and options. Please help.


Thank you.

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That was pursue, not persuade. Dang spell check
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I agree with others here that being a full-time caregiver and raising a young family is probably not feasible. You and your wife have done a great job. Do persuade help in placement....that said, It sounds like something in your MIL's behavior has become worse recently. She may need to be checked for a UTI. They can cause crazy behaviors and confusion to surface. You could also see if the doctor could prescribe something to help with the behaviors while you are waiting for placement. Good luck on your journey...and with your new baby!
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One thing you might look into is respite care. It is just a short term solution but sometimes assisted living or nursing home facilities will take a patient for a few days or longer when they have an empty bed available. I would at the very least try to arrange something like that for when the baby is due.

Adult day care might help as well as hired caregivers. It would get your MIL out of the house during the day.

What is your MIL's financial situation like? Also if you can share what state you are in, it might mean more specific advice.

In SE Michigan, our hired caregivers are about $20-25 an hour if you go through an agency, assisted living is about $2200-3000/month, nursing homes are about $9000/month. I can't remember what adult day care runs now. Many people end up needing Medicaid to cover the cost of nursing homes. Some states have Medicaid vouchers for assisted living or for in-home caregivers for needy elderly who live in the community. (The requirements for NH Medicaid and then community Medicaid for seniors are a little different, at least in Michigan, and there tends to be a waitlist for the latter but that depends on your region.) In Michigan we have a program called PACE. It's in many states now and it can be very helpful if your MIL were to stay with you or in a senior/assisted living arrangement. They basically help take care of everything but overnight care.

I also really recommend calling the Area Agency on Aging; stress the time urgency and your wife's change in health status (i.e. that she was put on bedrest and can no longer provide care for your mom, 2 little kids, etc.) and I wonder if they'd be able to help you more quickly?

Also if your MIL sees a good geriatrician, there might be a social worker in the office who can help (social workers are often not helpful, in my experience, but when you get a good one they are a huge help!)

It is smart that you are looking for alternatives. This is a happy but really stressful time, I'm sure, and you guys will need to be able to focus on the new baby, your little ones, and also on your wife's recovery! Best of luck!
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Dear usmc,

I'm sorry to hear what you are going through. Its a lot to take care of young family, be the breadwinner and manager the care of an elderly parent.

Please consider talking to a social worker. Calling Adult Protective Services. There are resources in the community. Talk to your wife about possibly moving her into assisted living, memory care or nursing home. There are options. I wish I had explored my options before the anger and resentment snowballed. I know we all want to do the right thing, but sometimes its hard to know where to begin. I hope a family meeting with a family therapist or social worker will help put into a plan that will work for everyone.
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As always, jeannegibbs has given good advice.

I am going to add what I usually add, when people are going to wait it out for the crisis that will require a trip - preferably by ambulance- to the hospital. And unfortunately, that is often the only workable course of action - but if the opportunity presents itself - beware the hospital employee, usually a social worker.

This person all to often will tell you - you have to take the person home and be responsible for their care. Some will make it sound like there is no choice or alternative by implication, others will outright lie about it. Don't let them bully or bluff you. It's not true - not unless you are the persons legal guardian. Just keep repeating that it is impossible for you to take MIL home and provide her with the care she needs/requires.

I know I'm a broken record on this point - but boy - I wish someone had told me this little tip at the beginning of my caregiver journey.
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Actually, on this site we often recommend the "leave her at the hospital door" approach, but in a way that won't get you in trouble. If your MIL has a medical need (for example, she has fallen and needs to be checked out) call for an ambulance to take her to ER. Find someone to stay with your wife and boys and go there yourself. Explain that she absolutely cannot be discharged back to your house. If she is admitted to the hospital explain the same thing to the discharge coordinator, the social worker, and her doctor. If MIL is in good health except for the dementia, you may never get a chance to use this approach.

It sounds like assisted living might be suitable for MIL. With your third son on the way you certainly cannot afford that, unless you are printing money in your basement. Does MIL have assets and income that could cover this expense? If so she could be self-pay in an ALF. If not, she probably qualifies for Medicaid. Get that application process started NOW. If she has no assets it should be pretty simple. Also start looking for a suitable ALF and check out local Memory Care units. That may not be necessary if MIL's behavior is just confused and not a danger to herself or others -- but check one out just to know the options. Inquire if the places accept Medicaid residents -- do that by phone before you visit it.

Now, how are you going to do all this research and applications, etc. with a bed-bound wife and two young children? Do you work out of the home? Who takes care of care of the household while you are gone? You may have to take some time off work to do these things. And you may have make arrangements for the care of the household while you investigate things.

Another approach, and the one we used for my mother, is to call the county's Human Services (formerly known as welfare) and ask for a needs assessment for MIL. If the appointment is not soon, start the application for Medicaid while you are waiting. The person doing the needs assessment will know what resources are available both from the county and other sources. They may be able to tell you what local facilities accept Medicaid. They may be able to offer some immediate respite by placing MIL in a temporary care situation until the more permanent solution is arranged (don't count on this, but do ask!)

You and your wife have provided a remarkable gift to MIL. You have given her two years of a normal family setting. That is awesome, and you should feel good about it. But your responsibility to her is to see that she gets the best care available, and that is no longer in your home.

My sister, retired, supportive husband, no kids in the home, took our mother in. That lasted about a year. The dementia became worse and mobility issues worsened. Mom had to go to a nursing home. It was my sister who made this decision and the rest of us arranged for it to happen. Even though she knew this was how to get the best care for Mom, my sister was devastated. She second-guessed her decision. She went through the "maybe I should have done something different so she could stay here," and the sadness of this milestone. She could not help us with the search for a facility or the actual move. And this distressed state lasted a few months. But as it became clearer and clearer that Mom was in the right place she lost the guilt and the dismay.

You and your wife may know perfectly well that something has to change, but still be very distressed when it does. That is natural. It will pass.
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Actually, her words were... "she is losing it, im ready to have her committed"
now keep in mind my wife is almost 32 weeks pregnant so i take everything with a grain of salt at this point, but it has gotten extremely difficult to take care of my MIL not to mention her mental state... im not a doctor but i would probably put at least a 72 hour hold on her... but thats just me. thank you for the response, i kinda knew that, but i was trying to show somewhat of the predicament i am in.


thanks,
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I'm sure someone will answer your questions better than I can.

But I know one thing for sure - DO NOT just drop your MIL off at the hospital. In most states this is a crime in an assessment of catagories - elder abuse, endangerment, abandonment of an "at risk" person etc.

Just wanted to get that out there before you did something you'd surely come to regret.  What does your wife say - I can't imagine she'd like that idea much herself. 
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