I've posted before about in-law care-giving. Aged mother in law, lives in same town.
We are at the tail end of a visit from sister in law from several states away. Sister in law has been here for 3 weeks caring for her mother. A much welcome respite.
It had been discussed, prior to her arrival here on the scene, she would be talking it over with her mother, to try and get her mom to come up to her home, for a stay of maybe a few months.
This, in my opinion, is absolutely essential, as I am expecting twin grand-children, due in about 1 month (if they don't come sooner, as is the case a lot of times with multiples pregnancies). The expectant mother also lives locally here, and has a 4 year old daughter. I will be on that front, helping .. as much as is needed. And not on the front with mother in law and care-giving, and have made that as obvious and apparent as I know how to make it. It would be great if mother in law would agree to go to her daughter's home (several states away) for a period of a few months .. and allow me the latitude to put my energies where I want them to be, on my daughter who will have had a c-section .. and my grand-daughter (4 years old) and new twin babies.
Nothing doing. Mother in law has dug in her heels, and will not hear of it, going to stay with her daughter for any period of time.
What are her reasons?
In mother in law's defense ... her daughter ... I don't even know how to describe it. I will say that when her daughter comes here to visit, she all but breathes for her mother and if she could find a way to do that, she'd do that too. She is the most nervous nelly, never sit down - ever ... worry wart, do everything, all the time .. person that I've ever encountered.
A great example, as I was taking her to the airport yesterday for her departure, . I reached into the fridge to grab myself a bottled water and shut the fridge and turned to walk away, as I've done for all of my 50 plus years living on this earth .. and she said to me, "Oh make sure that fridge shut". WTH???? Like I don't know how to shut a fridge? That's just a small, very small slice of what she is ... how she is.
She is so very hyper-vigilant, seeing to every minute details down to it's finest most minuscule point, fine tooth comb, questioning every point along the way, "should we do thus and so, but maybe if we do thus and so, then such and such will happen, maybe we should do it thus and so .. but then so and so might happen, maybe we shouldn't do thus and so, but do "x" "y" and "z" instead, but if we don't do it that way then ..........", on and on and on and on it goes. And usually in hyper warp speed, as to every single friggin thing.
If her mother moans .. "what's wrong mother?, why did you moan, are you alright?".
Mother: "Yes, I'm fine, I was just sighing out loud".
Sister: "Why did you sigh? Are you hurting, are you sure you're alright, why are you sighing what's the matter?"
Mother: "For God's sake __________________, I was just sighing, .. calm down, I'm fine".
Sister: "Are you sure, .. because if something is wrong you need to tell me".
Mother: "Everything is fine, I'm fine".
Sister: "Are you sure, we did a lot yesterday, did we do too much, maybe we shouldn't of gone to two doctors in one day .. was that too much for you, are you too tired now, maybe we need to move those other doctor appointments so we won't have two in one day, is that too much for you, for one day .. is that why you were sighing .. what's wrong, are you sure you're alright".
Hopefully that kinda gives a little bit of a snapshot of what goes on when sister is in the ring directing things.
So in mother in law's defense.. I do get it, why she wouldn't be chomping at the bit to go to her daughter's home.
BUT ....
The only experience she has with her daughter, in the last years as mother in law has aged and been unable to go anywhere much, has been the daughter coming here, periodically, for periods of about 3 weeks at a stretch. When her daughter comes here, she moves heaven and earth for her mother and then some, and doesn't sit down, doesn't stop .. the WHOLE ENTIRE TIME.
Is there a possibility maybe (as I said to mother in law, when she expressed that isn't happening - talking to me - her going to her daughters .. ever) .. could it be possible that maybe if you would go to where she lives .. she'd be more busy managing her own life in that setting than your's and she would get out of your backside .. and not be as hyper-drive-vigilant as you experience in her, when she's here, could that be possible.
The daughter is retired, lives several states away. Does come here, generally, every few months .. and stays for a period of about 3 weeks at a stretch. I wish I could make a list of everything the daughter did when here this last time, but it would take up the whole character allotment:
Talking to MIL, her carrying on about how bad it is. She defines a couple of things in that conversation. One of them being, the husband to SIL .. and how he is almost like a child .. that he doesn't "anticipate" need and so forth .. has to be told what to do. She's right. He doesn't. To a fault. The garbage can, it can be overflowing for instance, and spilling out onto the floor to the point you're having to step around the overflow and he will do so, unless told to bag up the kitchen garbage and take it out, which he will dutiful see to, promptly, if told to do so.
The sink might be piled with dishes .. and same thing. He will go grab another cup or plate for whatever he needs and the dishes piling up there in the sink, .. nothing that he notices and takes care of on his own. If told to do it, .. asked ... yes, will do so promptly.
That kinda thing. So .. I think there is some resentment on MIL's part, that SIL .. as a mate for her life partner, is child-like and has to be told even the simplest most rudimentary things to do .. even down to "Go get dressed for the day, remember B we have to go that appointment at 11, I laid out your jeans and that plaid shirt and be sure to wear those _______shoes, don't wear your sneakers".
Kind of .. well in truth .. like you'd do a kid. He is .. she's right, .. kinda like a kid.
She also complains that her daughter, .. n-e-v-e-r ... stops. She's right about that. She will say to her daughter .. maybe she just finished folding a load of clothes and going to put them away after the millions of other things she's been doing .. and then she will say to her daughter, "Well come sit down and talk to me, .. let's watch that movie we recorded". Her daughter will come, and sit down .. but only for a NY second, and she then realizes she forgot to do thus and so, and she's up and gone again, to do this that and the other millions of things she finds to do.
What's different for SIL and for BIL?, .. how is this setting different in that they too are worn to a nub .. both of them?
I think, like was mentioned here, .. maybe it's a wholly different when one breezes into town for a few weeks .. knowing full well they will be on full-alert and seeing to every nook and cranny and then some, ..and then will be on the plane back to "their life". I think that may be part of it also.
I do find it interesting that's one of the very things I complained mightily about, .. I can't live my own life and manage my own life and her's too .. and nobody heard me. But here we have SIL in her own setting now, not having left her setting .. to come here as has been the case for the last umpteen years .. no .. she is at home, in her own setting .. and MIL has been there actually 6 weeks .. to be exact .. and it has come apart at the seams there. SIL finding it woefully difficult, if not impossible, to manage her own life .. and that of her mom too.
When I talked to her yesterday (SIL) .... she sounds shell shocked, worn .. not at all the energetic .. gonna go to point A to solve this, and then point B to solve that, and then onto point C .. and work on .. blah blah .. and then point D ... to get so and so taken care of and on and on and on it usually goes with her. She sounds bewildered .. and beaten down. In fact, she said .. (this would've been the 2nd morning now, MIL not present
But SIL said this: "I was just sitting having a bowl of cereal here with B .. and we're both looking at each other, we feel like we've been in a war .. like we're battle worn .. both of us ... we feel like .. *what has happened here, to our lives .. * .. we're both just so worn out .. so past going".
And her cadence to her tone spoke to just that demeanor. She's tired.
I think, as MIL put it, when I talked to her (River of Denial runs deep in SIL) .. MIL said to me that when she and SIL began to put on the table, some discussion on the AL setting, that SIL's words had been that she had wanted to bring her there, work on getting her stronger and PT .. and "enjoy" her .. and that had been her goal .. but it doesn't look to be possible. This is what SIL had said to MIL.
As I told DH (I didn't say it to MIL) ..... "This is where I want to shake the chit out of your sister .. .. what the he77 part of ........... your mom is far too compromised at this point, to be living alone, she can't manage on her own anymore, .. she needs far too much help, she's always sick with something or other, or has fallen and each and every thing that happens to her, knocks her down another notch and another notch and another .. she can't get dressed even on a normal day .. she can't take care of her dog ..she doesn't eat ... she doesn't take her meds .. what the he77 do you think I've been saying .. do you not listen to what I've said".
I think this has been a situation that has knocked SIL off her axis, in truth. She, who lives in the river of denial ... and she who is always gonna find the next gadget, the next pill, the next procedure, .. on and on it goes .. and she truly did think she was going to, as I've said so often, bring her up there and restore her mom to the youth and vitality of a 40 yo.
You have to realize that when her mom got there, .. she'd stabilized .. before they left here .. the chitapalooza scene that had been ongoing for a few weeks by that time, strict diet .. and so forth and got that wrangled into control, and on the plane they went. They got there, and chitapalooza returned. So then it was (per normal SIL mode of operation) off to the gastro doc .. to get this fixed, one more pill, one more gadget, one more whatever. And so tests, .. so forth .. to try to hone in on what's going on there .. that she keeps getting diarrhea all the time. This is something MIL has been plagued with for YEARS AND YEARS. This isn't new.
Got her there .. and of course .. now working to wrangle the chitapalooza scene into control again, inclusive of even sleeping with her mom for the first couple of weeks, lest she have a middle of the night episode and struggling to get a move on to get to the bathroom.
Then .. her husband went manic .. and of course, when that occurs .. she has to police him (that's their normal anyway .. but it ramps up to a higher level when he's manic) .. and what he eats .. and so forth, where he's going .. has to take his debit card/credit cards from him (he is compliant to a fault) ... he talks, non-stop .. not characteristic of him for his usual .. and so he never shuts up .. and so she was dealing w/that, until that could be wrangled under control.
Then .. somewhere in all that the dog, bleeding from the rectum and so having to deal with that also . and vet appt .. and meds .. and such.
And then she got sick .. strep throat .. and I don't know why . maybe that's the nature of strep .. the fever wouldn't abate .. not for at least 3 or 4 days .. in spite of the antibiotic she was on .. and her lymph nodes/swollen and inflamed and painful .. this sidelined her .. not something she easily copes with. And of course, .. she then went back to the doc .. got a different rx
SIL is tired, physically ill, the spinning of the top has slowed and she’s realizing there is no magic pill, device, she’s finally having to wrap her head around it all.
Went back to the doc, different rx .. and as we know, bad reaction, gut/intestinal issues resulted, and her landing now for hospital confinement.
She'd no sooner gotten home from the hospital and was back at it, .. as best she could, not yet really on the mend . hauling her mom for knee injections . when her mom was then babbling as she tried to talk .. so now .. ER via paramedics and a hospital confinement for her mom.
As an aside that's neither here nor there, .. that's why I was so insistent, .. "When is your daughter due back from vacation .. maybe she could cart MIL for her knee injections and let you stay home and rest".
Doesn't matter, people are gonna do what they do ..
And in the end, she'd of been summoned to the hospital .. with MIL now babbling her words. But .. that would've been .. ostensibly .. the perfect time to reach out for some assistance.
Generally speaking, for the most part, .. the norm here has been SIL breeze into town .. spend a few weeks here standing on her head .. to do every living/breathing thing possible .. and then some .. and SIL healthy while doing so, and also having left her home/responsibilities there, as well as her husband and overseeing him .. and here to do all things MIL and then some .. and then she's back on that plane and gone again.
This is a whole different animal. Having MIL and her needs right there in your home, where your responsibilities are also .. that and them having had the book thrown at them the last several weeks with one ailment after another between all of them.
MIL has never been in B's presence for more than a few weeks .. all of SIL's and B's married life .. even back when MIL was healthy and would go and visit and stay there. It was never more than a few weeks at most .. even in more recent times.
The only time that has occurred previous to now, it didn't end well. The supposition had been .. a few years back .. that the whole set up would be that they'd spend some months here, and vice versa .. in the care of MIL. That began .. and here they came for what was to be about a 3 month visit .. this was a few years back. He went manic .. and it was more than MIL could tolerate ... that's the time that I cited here, when he was then leaving .. and she told him to take a good look around, that he was not welcome there anymore, that he'd not see this place again. SIL having decided after that .. the whole "plan" of spending a few months here, and a few months there, not gonna be viable .. that she can't have her mom being mean and unkind to her husband .. and he can't help it .. he just goes manic at times .. but that she understands .. hell she herself, as she puts it, wants to strangle him at times, .. he's so obnoxious when he's manic .... but that her mom is too old to be around it and tolerate it.
When they came this past xmas .. it was to be about a two/three week visit. B did go home at that marker .. without SIL. SIL stayed behind for what turned out to be about 3 or 4 months .. to take care of her mom who had taken a nasty fall. B didn't stay . he went on home.
So, MIL hasn't had to be exposed to him for longer than 2 or 3 weeks mostly . in her entire life.
Hard for me to grasp and find any sympathy. But I do realize .. I see him fleetingly ... I have been around him when he's manic .. and he's more fun than is normal .. he's more talkative (for sure) .. but I'm not in charge of policing him (nor is MIL for that matter). I look at it from the prism, there are so many things that could be so much worse .. he could be beligerent and abusive .. and/or any other number of things .. when manic or otherwise .. he is far from it. The worst of it ..God's honest truth .. is that he tries to eat all the wrong things (he's diabetic) and he talks too much . that's it .. that's all. But God help her, she can't be around it. Too much for her.
Don't get it.
•Does Florida even have Medicaid-funded Assisted Living?? In my state, Medicaid only partners with Nursing Homes. ***And no biggie if that’s the case in Florida. Or Illinois. Let’s face it, MIL is one blunder away from being NH material. If she isn’t already.***
•That chunk of change that MIL has stashed away (from her reverse mortgage payout) puts her well above the asset limit for Medicaid eligibility. Fear not - this is not a deal-breaker.
•This is where the Medicaid spend-down comes into play. However, there are Very Specific Rules around the spend-down. MIL can’t piss it all away on vegan dog food and pizza delivery til she’s down to 2K (or whatever it is in FL). It’s a defined process. It cannot be fudged or short-cut like the ESA paperwork. Dorker, I hate to say it, but this is where your brain will come into play. If you have the energy for a brief “discovery period” or a fact-finding trip to your county office, you’ll be able to deflect the “yes but”s and outright denials with productive advice.
•All this horsepuckey, and MIL still won’t do paperwork for DPOA/HCPOA and Representative Payee for Social Security. This needs to be revisited. Pronto. It’s quite possible that MIL’s next TIA will leave her incapacitated. Or her next fall will be on her head. And no one in the family is authorized to access her bank accounts; deal with the reverse mortgage lender; direct her medical care; cancel her car insurance; sell her useless car; so on.
•Last but not least, the lighting rod known as The Yellow Bedroom. Dorker, if it were feasible for you to fill that room with cement and nail 2x4s across the door, I’d say go for it. Yesssss, in a fit of pique, MIL declared that she’ll never again set foot in your home. She’ll change her tune when her only other option is a Medicaid facility.
Be vigilant, Dorker. It’s not your job to think ahead for these people. But it is your job to protect yourself. Keep your radar up. (((big hugs))))
As such - feeling involved- I find myself doing what I call “charting and graphing”. It’s what I’ve had to do with Rainman due to him being autistic and completely non-verbal. Not to mention individuals with autism tend to interrupt and process stimuli- from pain to a change in lighting differently than typical folks.
So when Rainman tries to scratch one of his companions or has a diarrhea episode out of the blue - I immediately start the charting and graphing which always begins with “what is the same and what is different?” Compare and contrast.
When everything went to hell in a hand basket there in Illinois- when technically it should have worked - at least for a while - I thought back to Christmas and that extended visit.
I was sure B was there longer. Didn’t he arrive about a week before Christmas and return to Illinois around Valentine’s Day? Well - no matter in the bigger picture.
After reading the replies to my questions I believe some points brought up are very valid.
SIL finally perhaps realizing that NOTHING is going to bring her mother back to the point where she can return to Florida and live alone again - thus preventing SIL the ability to put it all on her mental back burner, leave the grunt work to you and SIL to return to her own life.
Diahrrea. It’s one thing to deal with this on a temporary basis and a complete whole other thing when it’s day in and day out - goes away for a week and then returns with a vengeance. For lack of a better term - it begins to taint everything in your living environment, leaving the feeling that everything is ugly, dirty and smelly. And now that’s SILs home turf.
Lastly - do you suppose that part of this disaster could be MIL herself and her attitude towards this situation. I mean, whether MIL verbalizes it to SIL or not - her negative attitude and opinions has to be thick enough to be palpable. Could be that MIL is behaving like a spoiled, wet duck in a thunderstorm- extra miserable, actually - thinking this is the direct route to getting her home? At Christmas SIL was with MIL exactly where MIL wanted to be. And SIL was making it all easy and
possible to MIL - doctor visits aside. MIL was likely has happy and content as a pig in mud. Likely MIL would have liked that situation to go on indefinitely.
Over all - this is really background noise in the situation that has more pressing matters. Although it does tell me one thing - that this situation will never, ever work and the sooner the plug gets pulled - the better.
“Well, duh” some may be saying as they read this. But one thing I’ll say about me and my caring for my mother. I can say without hesitation that EVERY decision I made on her behalf I made with her best interest in mind. More - I gave her every opportunity to show she could live and function in the least restrictive environment. That’s another special ed term, btw. When it came down to the final choice of having to put my mother in a nursing home I was able to do it with a clear conscience- absolutely zero guilt. Sure, I was sad about it - but never guilty.
Maybe SIL is having to go through that same process.
The bugaboo of refusing to name a POA of any kind is really a pain now, isn't it? I don't think having her declared incapable of making her own decisions now would be much of a sticking issue, but I know she will go to her grave not allowing her kids to make those life altering decisions.
No way can she live alone, ever. The TIA's, while seemingly fleeting, are leaving in their wake, more and more cognitive decline. My mother is also ahving them, and since I only see or speak to her once a month or so, it's very evident she can only "hold it together" for a few minutes, then she's garbling words or simply unable to keep a coherent thought. Very sad, but that's life. She'll never go into a home, brother won't allow it, he also won't allow any outside help, so, he's made his bed.
I am so sorry for the slow decline that is all too evident. SIL is seeing upfront what you have been shouting from the rooftops for ages. MIL cannot live alone. Period.
I imagine a lot more handwringing and fussing will continue on until MIL either A: has a terrible fall/illness that lands her permanently in a facility in IL or B: she manuevers her way back to FL to dump on Dorker and Co. And Dorker--don't you get caught in ANY CG!!! You can run yourself silly finding a place for MIL to live, but as long as it's not with you or even back to her own home---hang tough. You have done enough.
I do feel for SIL, who has thought, until now, that she was the magical wonder woman. She's not, she's sick now and not likely to totally recover until MIL is gone, either out of her house or has passed away. This stress can kill....we've heard and seen it over and over.
One thing I am happy about--my MIL hates me with such a passion that there is zero chance I will ever be in your shoes. I'm sorry for the "lost" potential friendship we could have had, but she refused.
Funny,isn't it? We so infrequently get what we "want".
Hope your Sunday is blessed and calm.
Liz
And Dorker, I overlooked it until just now, but if MIL's ejection fraction really is 60% then that is not far short of normal for a healthy adult, and whatever is wrong with her it's not heart failure. Who came up with that figure, and based on what echo done when?
If she and DH decide that returning her to FL is a good idea,
I'd be in the "That's so nice for you all" camp. I'd not lift a finger to help.
If she ends up at her home without significant help, I'd call APS to step on.
I've had my g'kids since yesterday afternoon .. so have been quite occupied.
Just talked to SIL, just wanted to talk to her .. on the point .. is there any clearer discussion between you and your mom at this point, as to AL in FL or IL .. and the dog and .. ya know, there is this little dilemma about "spend down" assets and the parameters there .. that are pretty tight, but she's not gonna qualify for Medicaid if she has any (or so I think) .. assets left .. as to her reverse mortgage and cash she has access to thereof.
That was the whole reason I reached out to SIL, to at least begin some discussion on the above .. and I thought .. maybe if given some clearer direction . I'd make some phone calls tomorrow.
Little did I know, MIL just carted off via ambulance, AGAIN .. this afternoon.
Goes like this. She was discharged Friday ..
From there forward she has slept a LOT ... and has had a headache in the front of her forehead (different than her normal headache that is by her left temple .. a headache that hangs for days generally).
But .. the bigger picture, .. she has been very confused/disoriented . since she got home.
For instance; "She threw a whole roll of toilet paper into the toilet". No I don't know why.
Further: She had the hand sanitizer in her hand and was trying to squirt it into her hair .. I guess she thought it was a hair gel of some sort ..??.....
She didn't know what the wet wipes were for, I guess along the lines of Lysol wet wipes ..and was trying to use those to wipe herself, and another time, didn't use anything . just her hand, thought she had TP in her hand.
SIL having reminded her this morning to take her Eliquis (you have to know that SIL was convinced that this latest episode where she was babbling her words, and ended up in the hospital .. and the docs there strongly admonishing her . that may be why a TIA occurred .. and she dodged a huge bullet .. that it's important she take that, .. SIL's assertion there, one that they scared the bejeebers out of her .. and so .. SIL's thought process .. that won't be a problem now .. MIL has had the bejeebers scared out of her on that issue). Fast forward to this morning, SIL reminding her to take her Eliquis.
MIL didn't know which pill that was. SIL: "It's the little pink one".
MIL: "Now what's that for?".
SIL: "It's the pill the doc talked to you about remember, you have to take it to not have a stroke".
MIL: "How long have I been taking that, .. what's it for?".
All of this together, .. this and the fact she has had to pretty much, accd'g to SIL . had to have one on one supervision since she got home, because she's so confused ..and disoriented .. prompted SIL to reach out to the Neuro doc that was treating in the hospital, to ask "Is this normal behind a TIA?".
Answer given .. "no not really", .. from there, it was decided that maybe it should be ruled out that UTI isn't at work here. And so SIL talking of what a feat that was, for her .. to try to catch the urine .. down between her mom's legs .. her mom unable to do it .. SIL using a flashlight . and so forth .. got that done .. off to the Urgent Care .. SIL and MIL and the vial of urine.
There, the determination was inconclusive . but it was thought .. considering her history .. an ER visit is in order .. time to cart her off again.
Thus, taken by ambulance, again this afternoon .. to the hospital.
The points I wanted to cover .. nope. Not done. SIL now on her way to the hospital .. states that she has to get in there to the ER .. that MIL .. she's not even sure if she's able to provide them acccurate info as to her med history and meds, and symptoms, etc.
So no talking to SIL at this point on above points.
SIL .. (I hate to say it, and wouldn't wish this kinda stuff on my worst enemy) .. has had her arse handed to her, as to her living in the River of Denial .. with her mom's stay up there. I think maybe Karma had to come
Karma had to come and hit her with a sledge hammer, right in the face, .. for her to be able to finally grasp just how bad off her mom is and cannot care for herself.
I mean .. look no further than the discharge from the hospital the other day and SIL's words: "Oh I don't think that'll be a problem anymore, .. the doc scared the bejeebers out of her, on that Eliquis issue .. she's gonna take it now".
Yea right! Was my thought .. been there/done that ...
Maybe that sledge hammer is gonna have to keep falling on her head .. for it to finally dawn on her for good . that her mom .. cannot take care of herself.
So, anyway .. as it is right now, . maybe it's just a UTI .............????..................maybe not .. don't know.
??
We'll see what happens.
I know if the dx turns out to be UTI . they will slap that "outpatient for observation" label on the whole thing .. and there ya have it, discharge for home, .. likely tomorrow, with a script for an antibiotic in hand.
We'll see...
And your MIL - what a mess. It seems like systems are really beginning to fail.
I really(!!) hope that she becomes an in-patient and then is discharged to rehab. That might give everyone some breathing room to figure out what comes next. Although knowing your SIL, she will probably figure that rehab will fix everything and MIL will come home as good as new.
Admitted her. Says the disorientation seems better but she doesn't know what year it is.
I asked SIL, does she now....????......now that she's been told? Answer, no. You can tell her and then ask her in a few minutes and she doesn't know.
I asked if she knows other stuff, her Bday, the year she was born, who is our president. Answer, yes.
Very odd.
And FWIW SIL did ask ER doc upon admittance for label of "inpatient" vs "outpatient for observation".
She was told by ER doc to talk with the case mgr and admitting doc.
Case mgr visited and label is "outpatient for observation". Told SIL they can't label it "inpatient", Medicare would over rule that as the designation.
So it doesn't look like, this early in, things can be directed to a rehab site.
cognitive skills assessment? For MIL, that is - not her. Might be worth trying to suggest it to SIL- to ask the attending physician.
I cant recall - was a Catscan of MILs brain don’t during her ER and hospital overnight, last week? I’m assuming yes - as a stroke was ruled out...
And it's not realistic, appropriate or not, to expect someone who's carting her mother back and forth to and from the ER to be weighing up the pros and cons of ALFs.
MIL is definitely known to experience AFib, yes? If this level of stress goes on she'll be in a nursing home, if not a funeral home, before the end of the year. But what low-stress environment is currently available to her? None: she didn't elect to secure one.
It is not anybody's fault that all of this is currently happening. MIL refused to shift her life to a more easily manageable plane. SIL and DH refused to strong-arm her into doing it. And Dorker has been sending out warning signals for heaven knows how long. All of those positions were reasonable viewed from each person's perspective.
So although these goings-on are nightmarish, particularly for poor old SIL, they are natural developments. The best thing to do is offer sympathy and counsel patience.
I know it's hard on everyone involved - you, I know you love MIL (even though she aggravates the heck out of you sometimes) and worry about what will happen in the coming weeks/months, DH, SIL, BIL and definitely MIL, who has to be scared and confused with how she is feeling right now.
Right now, I guess, it's just waiting and seeing what the docs say.
I'm sorry for all going through this - thinking of you and your family. Hope the docs are able to give some answers and direction.
I'm wondering if the attendant dehydration could have thrown MIL's electrolytes out of balance.
I also wonder what DH's plan is if his sister has a heart attack in the midst of all this.
SIL's household is in crisis mode. MIL is sick, and SIL is still recovering from an illness, and will make herself sick again if something doesn't change.
BarbBrooklyn has a really good point...just what IS DH's plan if SIL has a heart attack in the midst of all this? Or any kind of illness that puts her out of commission?
This family is rapidly headed for a crisis. Dorker's best action is to plan and protect herself.
She did have CT and MRI last week during her stay at that point.
From what I understand, she was also to have had an MRA and MRV .. but can't withstand laying flat on her back. Ever since the fall from last xmas .. her back/ribs have been intermittently problematic .. (as I detailed here before, the doc offered to do further investigation as to why it's still an issue, .. MRI ... standing order, whenever she wants .. she declined, too much for her, to just get dressed most days .. and didn't want to do it). So we don't know why her back/ribs are still so painful .. at times. But laying flat on her back for the MRI was apparently excruciating. To the point, she'd been hollering out in so much pain.
They'd been unable to proceed with MRA or MRV .. for that very reason. And also interesting to note .. they'd administered a Lidocane patch for pain relief. She can't tolerate those, is allergic .. and she never told them. Not surprising . this is a woman who is so impaired .. she likely didn't remember. And so now has a rash on her back from the patch they'd put on her. SIL wasn't present when they came with the Lidocane patch .. SIL had left to go to her own follow up doc appt as to her gastro issues that had landed HER in the hospital, and left her daughter there.
Only 2 people know the intricacies to all of her care .. SIL and myself. Had SIL been there, she'd of told them not to do so (one can't count on MIL to know) .. or had I been there, I'd of said the same.
I did ask SIL: "When they are admitting you and charting your med history and they ask for allergies .. did you not tell them about the Lidocane thing?".
SIL's answer: "I don't know, I probably didn't .. I am so frazzled myself and not even thinking straight .. my whole existence has been turned upside down here, .. I don't eat normally ... I don't sleep normally anymore .. nothing ... I can't even think MYSELF anymore". Understandable. I told her, .. "ya might wanna note that, .. at least .. in your memory bank, .. like for instance, people who are allergic to penicillin .. and that gets noted when you are reviewing medical history and allergies .. might wanna just put that one in the forefront of your brain .. ".
I'd of probably failed to mention it too, if I were living what she is. Frazzled and completely off her axis with all this.
I did ask DH .. "So .. what's the plan here, when SIL finally falls out and has a heart attack or whatever .. at the pace she's going?". He doesn't know. I don't know either.
I mean .. for one thing .. that damned "outpatient for observation" label. At least a this juncture, if that sticks as the classification . you can count on her being bounced out of there, today .. tomorrow .. maybe. And .. who knows .. is this her new normal ... this bizarre stuff? I can't see that they'd just bounce her outta there, with this as her normal now. Unless it's dehydration .. we know it's not UTI .. so .. unless it was just chalked up to confusion/delirium resulting from dehydration .. they hydrate her, send her on her way and this bizarre behavior isn't the new norm.
If on the other hand, it's deemed to have been stroke related, .. they would have to, I would think, change her to "inpatient" and them from there, she can be sent, .. one would hope .. to a rehab or something. One would hope. I guess we'll know more as they work to figure it out.
Talking to SIL on it all. It's so very strange, all of it. MIL doesn't have any recollection of the bizarre things she was doing .. nor .. seemingly ... does she find it in all, any bewilderment and worry .. so it seems.
SIL said that her mom says, "I didn't do all that, you're making that up". I don't think it's said in anger, but more in humor .. her mom thinking it's all kinda funny ..
SIL talking of the bizarre things ....
Her mom had complained of chapped lips. SIL got for her, her medicated lip balm .. and then MIL put it to her lips and began to suck on it, like you would a baby bottle. She had to correct her mom .. "no .. you take the cap on and apply it to your lips, like lipstick".
Said at one point she'd gotten her mom a bowl of jello .. and her mom picked up the bowl and tried to drink it .. had to tell her mom "No .. you don't drink it, here use this spoon".
Said she'd been standing at the bathroom sink .. (no I don't know why) .. deciding I guess to wash her backside .. and at the bathroom sink .. no not the bathtub or shower .. the bathroom sink (which wouldn't be usual/typical) and was doing so with no wash rag ...
SIL now feels worried that maybe it's all stroke related and her having waited, .. wasted time .. pondering UTI .. maybe has caused further problems .. maybe if she'd of recognized it as just that and gotten her right away to the ER rather than pondering it all, rather than going the UTI route ..
Who knows.
No, I am not, at this point, looking to discuss ALF's and the route there and so forth. Yes, I'd put in a call to her yesterday to begin some dialogue on that .. and direction, as it had been my thought process that I can begin with at least some phone calls on some things today .. as to that route .. from this end, .. but let's first decide whether this is truly gonna be IL or FL .. that was my motivation.
But I'd been mired in kid care since Saturday and hadn't come up for air at all.
I didn't know, .. til I put in that phone call to SIL that she'd gotten MIL home from the hospital .. on Friday afternoon/evening .. (I knew that much) but since then, MIL has done a LOT of sleeping .. but when she wasn't sleeping . it was requiring 1 on 1 supervision to watch and stay after every move MIL made, and resulting in another ambulance trip .. to the ER .. didn't know all that.
I do now .. I know it now. So no .. won't be talking of ALF's and such at this point. Crises mode in that household for sure right now. It's my guess that if this is her new normal .. then ALF is off the table, and SNF is more the order of the day.
I'm wondering at this point .. I do know that MIL has access to "some" cash as a reserve from her reverse mortgage. I have no idea, no earthly idea what that sum would be, .. is it $4k ..is it $14K .. is it somewhere in between .. I don't know.
Would it be maybe a matter that MIL get ck'd into an SNF .. at this point, on her own dime .. and yes I realize .. that isn't gonna last .. any time at all .. that sum of money as compared to what the cost is .. but is that a route to go .. something I ponder .. and then of course from there, .. when the funds are running up the route to the Medicaid is then run .. by the powers that be?
Is that something I should maybe focus on ...???
Input?
It is safest and in MIL's best interest for SIL to require the team to check the history and not attempt to give details herself; the other side of that coin is that any medic who relies on information provided by a stressed-out relative is fat-headed. SIL can be as much of a broken record about that as she needs to be. "I don't know, you will need to check her file" is the mantra to learn.
Caring does not equal knowing. It's a classic caregiver's trap.
MIL is away with the fairies. I expect her brain is too busy keeping breathing to worry about anything else. And this is actually good, you know? - better she should seem semi-detached than start panicking.
Speaking of keeping breathing, how are you doing? Take some deep ones :)
Are you the hospital discharge worker? Are you an elder care planner? Are you SIL or DH?
No. You are not.
Your job is to say kind, sympathetic things (I should start with reminding SIL that she is neither a neurologist nor a psychic, but just a loving daughter doing her very best) and love them all. End of.
I had begun to ponder (why do these little nuggets burrow into your psyche and dig away). "Gee, maybe this is .. at least in part, .. my fault".
Why?
We all know, you uproot an elderly person who is so very compromised .. it's a known fact .. that can cause them to falter greatly.
"Maybe this is all my fault, .. maybe I should've left well enough alone .. and not had her uproot for IL .. maybe it's my fault this has all happened .. maybe .. as she kept saying .. before she went .. this is all too much for me .. it's going to be more than I can do .. *I'll never see this place again .. I won't make it back here, I'll die up there* .. maybe .. maybe she WAS too compromised to have to do this and it's all my fault".
These nuggets that dig their way into your existence and eat away at your thought process.
Ahh . but then I look no further than the utter devastation that the panhandle of FL is living at this moment .. many thousand without a home .. or even a job ... the place is like ruins .. damage of historical/biblical proportion in that area.
That could be us. If one ever comes in our direction of that veracity .. it could be us. The whole premise for why she needed to be outta here .. is that very thing. It's bigger than that .. in reality .. but the one premise is hurricane potential.
No it didn't land here .. and yes .. we've been very very fortunate that we haven't had to deal with that .. for decades .. but it doesn't mean it won't ever happen. It very well could.
I do ponder, .. "what if I hadn't been so insistent and dug in my heels that she cannot be here during hurricane season .. and that kinda thing took aim at us .. what would we have done .. her camped out here .. and utter destruction in every direction (as has been well established here, she is no one who can travel to evacuate the area, .. she's just not able, .. so DH would be stuck here with her, I wouldn't be here .. he'd be stuck here .. with no way for water/power/communication .. and maybe even our house in total ruins .. and this old feeble woman ).
So I do weigh the above psyche nuggets against that picture. Along with the fact .. "ya know .. maybe this was in her cards any damn way . it was just gonna happen irregardless of having been uprooted .. whether she was here in FL or in IL .. or wherever .. this is her path to her cloud maybe .. so .. what would you have been doing were this the case .. and her here, firmly entrenched in her home with her things and her precious memories .. and yet the scene that is ongoing in IL .. if it were ongoing here".
I do weigh all that, .. and the conclusion I come to ..
She is THAT compromised that .. doesn't matter .. whether she was uprooted or not .. and whether that was any cause for all this .. she is THAT compromised .. and so . she needed to be where she had more care ...
Of course I had no idea that she would get to SIL's and that it would turn this far south on SIL .. and her now loosing her own mind with it all, literally.
So .. mixed bag for me.
But I did ponder maybe that's something that SIL needs to note and take consideration of .. as SHE works with the case manager there on site .. and it's apparent SIL in all her frazzled state .. she is not thinking clearly herself, .. worn to a nub.
Maybe that's a little food for thought that should be planted in SIL's ear .. "hey ya know, .. maybe you need to talk to them there .. the case manager or whoever .. I don't know what your mom has at this point, at her disposal as to any funds at all, left from her reverse mortgage .. but .. ya know .. maybe that needs to be utilized at this point, for placement .. and from there .. maybe the powers that be, get that switched from self-pay (which will happen awful quickly) to Medicaid".
That as my thought process. Nope, not calling the hospital myself, or the state of IL to navigate these waters for SIL .. or the docs on that end . none of the above.
You are not in charge of MIL.
God knows you did not make a single one of MIL's recent decisions.
Even if you HAD been put in charge, and been able to make different decisions, there is not a shred of evidence that there would have been different, let alone better, outcomes. At home, in independent living, moving earlier on to SIL's house - in any of these situations, MIL's health would still at some point have given way. And besides, the fat lady isn't singing just yet. Be calm, wait and see. Everybody is doing their best and that includes you.
Dorker, you have scurried about for months and months on end giving help and succour to your elderly mother in law. You have contributed sensible suggestions, and you have been supportive to the entire family. You have also known where to draw the line.
You have not a thing to reproach yourself for.
This really saddens me to hear of the events that have taken place during the last couple of days.
I am sure MILs behavior is disturbing to witness. Given SILs high strung demeanor, exhaustion, probably still ill, I am sure she is completely and utterly overwhelmed.
I agree, MILs Medical records need to be made available to whoever is treating her in IL.
I really do hope they keep MIL long enough to figure out what is causing these lastest developments.
We have one site locally that does upright MRIs. They are not done in our local hospitals. Is this what you guys ran into in FL? No upright MRI available in hospital?
I also agree, no need to be doing research on FL facility placement at this point. This situation looks to remain in IL at this point. Let the hospital discharge planner do their job when the time comes. I would assume there are a lot of questions that need to be answered regarding MILs health before that comes into play.
Given SILs frazzledness she might need help getting MILs records electronically sent to IL. That should only require a signature but sometimes follow up calls are required. You might be able to assist with that since you are familiar with MILs physicians.