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:
I asked here yesterday .. "do they have access to any of her previous scans here on this end, .. CT's, MRI'S, MRA's .. so they can compare".
Her answer: "Yes, I'd sent for all her medical records back when I was working with the gastro doc on this end .. and .. I shared all those records with them last week when she was inpatient at that point".
Shared the records, eh.
I have before now had cause to wonder if the only way to get a house physician to look at notes might be to staple them to his eyeballs.
I personally like the summary format. This includes:
current px
known allergies and contraindicating reactions
presenting condition
recent or latest available test results.
If it goes over one page it's less likely to get read, is the trouble, and with MIL... crikey. Imagine. You definitely wouldn't want to drop her file on your foot, would you?
If you don't think she would, then all you can do is watch from afar the dominoes fall which could end up in SIL's death or permanent disability and DH going to IL to do the necessary paperwork to get MIL into a facility.
That may be how this all plays out.
You are correct. Just because the info is in front of the nurses and physicians DOES NOT mean it is being read. It is very common here for Doctors and Nurses to enter a hospital room and expect the patient and/or a family member to recite any and all important information.
Just makes you want to scream “It’s in my chart”! Which is no longer a chart, it is on a computer.
DON'T YOU DARE blame yourself for one single thing that has transpired!!!! Goodness, woman, you were holding up this circus for years whilst yelling "HEY, this cannot go on much longer!!!" and nobody paid any mind. Now SIL has stepped in and sadly, she's getting to witness the final act in MIL's life. Whether she "gets' better" from these TIA's (and people of her age, simply DON'T) she still will be left with serious deficits. Does she WANT to spend the next months of her life following MIL around like a crazy person, wiping, feeding, fussing? If she does, then, fine, let her.
MIL is YEARS past being able to effectively care for herself. She isn't going to "get better". She's going to have more and more ER runs with no conclusions. (I did this with my FIL the last 6 months of his life. It was EXHAUSTING).
One thing that seems very unlikely to happen is for MIL to ever return to FL. She barely made it to IL as it was---trying to return her "home" would require massive planning and then what? She has nowhere to safely live.
And can I ask WHY? WHY? in the name of all that's holy, does NO ONE know about her finances?????? IS she still waiting for the prodigal son to show up? She trusts her other 2 kids to do everything for her, WHY is she so weird about the money thing?? She ever gets placed in a NH and this will all be a moot point. They will force the family to get that info.
Here in Utah, if your children (those you have designated as "inheritors") are 100% in agreement that you are "demented" then your POA kicks in. My daughter would step in an run my life. I have 5 kids. I know that they hope to never have to do that for me, but they could. Is this also a "law" in FL? Dh and SIL can simply check this out by calling any attorney who does wills & trusts. Once granted that power, they can finally figure out the money end of stuff. Not knowing just makes it impossible to know what you are working with.
Sadly, I think once those TIA's are becoming a daily event, she does not have a lot more time. Brain tissue is affected by each small bleed. Eventually, she won't even be able to walk or talk. She won't know who people are. Does SIL have a home set up for that?
Wow---trying to take a urine specimen, when the ER nurses can swiftly cath a patient for one---tell sil to quit trying to get a clean catch. Ugh. That sounded nasty.
Well, as I often say, and will continue to say People can outlive their "sell by" dates.
And MIL have like 5 too many docs weighing in on her care.
So glad this isn't happening in your neck of the woods. It would be nice for DH to make a quick trip to IL to spell SIL for a couple days but we know that ain't gonna happen.
You are good to listen to SIL, I personally would have blocked her calls and texts by now, but you remain firmly still lovingly involved. I think that's amazing.
Everyday is new dilemma--but take heart, it will not last forever.
I know myself, for me, I am allergic to codeine .. and so anytime (it's been eons) that I've been confined to a hospital I have a nice little paper bracelet on my wrist that indicates same.
MIL is a Fall Risk .. it's noted on her door in a big (or here it has been) neon yellow sign .. and she also has a bed alarm .. she also has a neon something or other bracelet along with her hospital ID bracelet .. indicating that.
Would be a matter, I would think, .. if anyone is able to review the chart enough and Good gracious with her, .. it'd have to be the week's reading for any attending physician ... not anything that would be seen to thoroughly and expedient like. If someone, family member there, and informing of same .. I'd think there'd be some bracelet .. to accompany her hospital ID bracelet, informing of just that .. allergy to whatever it is in the Lidocane patch .. and thus .. not administered.
Nonetheless, no worse for the wear .. rash on her back that is presently being treated with whatever they do to treat such things and noted accordingly not to do that henceforth.
Do I think SIL would EVER place her mom?
I think we were there, or maybe almost there ..
Post this last hospital stay .. ending in discharge on Friday. At least to begin the dialogue to the path forward from here. Although .......... SIL did say things that lead you to believe her head is still stuck up her backside, .. when she said things like, "Oh I don't think med compliance is going to be an issue going forward .. the docs scared the bejeebers out of her with the Eliquis and her not having taken it .. she won't be forgetting that again".
I wanted to say (but as you all know, I no longer argue my points) .. "uhm .. it's not necessarily that she is forgetting them or doing that in any way out of malice, .. she simply isn't cognitively aware enough to stay on top of it all SIL!". I wanted to say that, along with "Oh I'm sure it did get her attention .. at least in that moment .. but I have not a doubt in my mind ... it will be as fleeting as many other things that she is incapable of managing .. in one ear and out the other".
I didn't say it, .. does no good, save my breath and use it for a more worthy cause. I just nodded my head in affirmation of what was said.
That kinda thing leads one to believe, SIL maybe at least partly on the train at that point, of thought .... "maybe now that she'll be med compliant we can get her back on the road to strengthening and this whole ALF biz can be thrown out the window".
The last I'd talked to SIL .. and on the ALF biz .. was before MIL was discharged, which occurred this past Friday late afternoon .. it was before then .. that there was any ALF discussion.
Then .. MIL discharged on Friday afternoon .. and I talked to her on Friday night, but the concern at that point .. was merely ... that SIL was so worn .. just so worn out herself .. and she was pondering maybe just ordering a simple cheese pizza delivery .. for dinner, and did I think that would in any way foul up the digestive tract of MIL's so sensitive gut. That she was going to, now that she has her mom home .. work on getting herself back on track .. as to her own eating and sleeping, and so forth.
Then, on Saturday I got the kiddos here and I went underground so to speak, as to kid care .. and hadn't talked to SIL.
On Sunday is when I did put in a call to her .. because the last we'd spoken, at least on that issue .. it was said that .. SIL herself .. prefers her mom in ALF in IL .... and that would be better so she can keep an eye out on things and be a part of her mom's life there .. and further .. that she is willing to keep the dog .. since we all know MIL can't take a dog to any ALF .. she can't adequately care for the dog to do so. But that MIL
But that MIL is firmly in the camp that ALF it will be, .. how to get there, the path forward .. will have to be navigated .. but she wants it to be in FL.
As was said by MIL: "FL is my home, not IL, I don't want to be in IL". Her firmly in the camp .. that she wants .. ALF if it is to be .. to be in FL.
SIL having not argued that point with her mom who, at that point, had been laid up in a hospital bed, undergoing a withering amount of testing as to why she'd been blabbering her speech.
SIL's assertion had been that can be approached more incrementally going forward. That she'd like to, if she can, convince her mom . that IL is the better option .. she can keep the dog and bring the dog for visits .. and she can keep a finger on the pulse of the goings on and be a part of helping her mom.
So .. it was .. at least .. for a minute .. on the table, as to SIL and any consideration thereof.
But then .. I put in a phone call to SIL on Sunday .. since the last we'd talked on the topic there was a "up in the air" and no clear direction .. is this gonna be IL or FL? But that's when I found out .. all this latest.
So .. ALF .. at least for this moment ... probably not a direction to look at ... by SIL or anyone else. Gotta now figure out why she can't even tell you what year it is right now, .. even if you tell her what year it is.
And see if this is gonna be a new normal for MIL, that hand sanitizer appears to her as hair gel .. and that she doesn't need TP to wipe herself . just her hand .. and Lysol wipes are appropriate for same .. and jello is to be drank from a bowl ....
If this is her new normal, ALF is off the table.
SIL is in the know on the above .. but you have to remember .. it was only as recent as a week or so ago .. that SIL has had the light of a thousand suns shine in her eyes as to the true reality of the whole thing.
Remember .. remember remember ....SIL was going to bring her to IL .. restore youth and vitality .. and all would be right with the world of the aging and infirm MIL.
So discussing with her, routes to ALF and so forth .. not even on the table.
And since then, crises mode of course is the order of the day as SIL is now meeting herself coming and going .. trying to keep a lid on all things her household, between herself and her predicament .. the dog and his bleeding rectum .. the husband having gone manic and now MIL and all this latest saga .. crises mode is in full blown glory. So getting her .. and getting any info as to whether that .. ."are there funds available?, how much .. is that something that should be looked at, as you work with discharge planning?",......... right now .. she's too busy putting out fires to see the forest is a raging inferno.
She is also on MIL's title for her car, so that if/when the day comes, the car is to be sold, MIL no longer among the living .. that can be done. She's also on MIL's checking account, should she need to go in there to talk to them, and/or write checks for MIL.
So ................ it's not ALL COMPLETELY IN THE DARK HERE ... as to anyone and any capability to handle a damn thing. SIL can .. she is on her important accounts.
Tests and so forth today, nothing thus far has been found. CT, EEG .. I don't know what else, results .. if they are in .. nothing earth shattering has been reported.
I know there is talk of another MRI (I think it should be an MRA) .. but ... she can't tolerate laying on her back .. it's too painful. So .. SIL asked if she can get something for pain and the doc felt concerned about doing that, .. with an elderly presenting with confusion/disorientation .. and sedating her can cause more of that. So I don't know if there is progress on another MRI (MRA) .. or if they've shelved it.
In the meantime .. MIL is conversing with anyone that talks to her, .. she has eaten .. and knows what her utensils are for. She is using the bedside potty with assistance, appropriately. She doesn't seem to be disoriented/confused. Still doesn't know what year it is .. doc doesn't seem real concerned about that.
SIL hasn't been able to get that all important "inpatient" label .. says she's tried to plead the case to anyone who will listen .. so that her mom can be discharged to a rehab site. To no avail, thus far. With no dx of anything .. not so far .... and at this point I'm convinced the person has to have something GOD AWFUL as their dx, to get that all important "inpatient" label. Absent that .. she will be discharged (I don't know this, I'm guessing) probably tomorrow or the next day to go home.
SIL asked about home health care .. which really .. that amounts to a nurse to come and check vitals and then the nurse is gone .. (her vitals have never been a problem). She was told that needs to be ordered by her PCP. So SIL is trying to get it set up to have her seen at the PCP that she sees, to get that HHC ordered.
So, she isn't really disoriented/confused at this point .. whatever that was .. it was transient .. as was the babbling .. as was the episode when she was still here in FL and summoning DH to come .. her hands don't work. Transient/fleeting.
I just don't know ....
Handy-dandy little chart on Admission vs Observation under Medicare. How many hours has she been on Observation status?
She's either taking a run-up to the big one, or she'll settle down again now and they'll find a balance. Gosh, this is hard.
I think what year it is comes under the heading of what my mother dismissed as 'trivial questions.' I.e. the ones she couldn't be arsed to make any effort to remember. Like the name of the current Prime Minister. Or her address.
What's this back pain all about, then?
She was admitted I would guess about 9 PM CT last night.
Accdg to the powers that be there, there's nothing they can do as to labeling her as "inpatient". Medicare will come in and change it in the end.
As a side note I had urged her to see about another cog screen... especially since they will likely be ready to bounce her outta there and no clear answers as to why this has happened.
They won't do it. Said that needs to be done outpatient, results in the hospital are unreliable. So I then told SIL If it were me I'd argue that point before they basically do what I consider an unsafe discharge.
She said the doc said they can order a cog screen and do but it's based also on their interactions with the patient and witnessing confusion and disorientation, which they aren't seeing.
I am stumped.
These fleeting transient episodes and then her normal resumes or there about.
Stumped.
I'm not completely sure the brain scans are worth the money, either. What are we looking for? If the clot's already there, too late. If it's not, or it's been and gone, it won't tell them anything.
In a perfect world I wouldn't mind getting a cardiac physiologist in there to do a full echo, now this minute. If there's a big fat blood clot developing that really could be handy to know.
Hospital is not a good place for little old ladies to be unless they're there for something useful. SIL should plan to bring her home and get support lined up ready for that.
How is the lady herself? Spirits bearing up?
I recall once that they tried to discharge my mom after a couple of hours; they hadn't figured out what was wrong. I turned into a banshee, screaming and yelling and weeping and carrying on. I kept harping on the fact that they hadn't figured out what was wrong (I honestly don't recall what the issue was, but I was determined NOT to let them send her back to Independent Living without a fix or a diagnosis of what was causing the issue she was having. They finally kept her and did a more thorough workup.
I'm sure the rules were somewhat different then (this was probably in 2010 or so), but this is a frail old lady with intractable unexplained pain, intermittent confusion as well as mobility and balance issues.
MIL's spirits .. (I haven't called her .. may do so tonight) .. accdg to SIL .. she's seemingly as okay as she always is. She's worried/concerned about herself and what must be wrong with her .. she's worried/concerned as to her future .. and placement, realization that she cannot live alone any longer. But doesn't seem overwrought with any of the above, and is as fine as she normally is.
Don’t discount the HHC. With that she can get another pair of eyes. She can get an aide to bathe her, she can have someone else to listen to her. She can also get PT and OT. I know she’s had it before but not when she could really appreciate it. SIL needs all the help she can get. The nurse will weigh her. If the bathing aide comes they can also weigh her. They can set up her meds. My aunts changes her linens and also shampoos her hair. Sometimes she heats her lunch. An able bodied person can do these things quickly but as tired as SIL is these small things really help. Regardless of how long it lasts, it helps.
You have been given some poor advice on that subject on this site in the past.
I know it’s not all the help that is needed but it has worked very well for my loved ones who fall into that sweet spot of being a home bound elder who doesn’t need 24/7 care but does need skilled nursing oversight.
If SIL has a HH she wants to use, she can call them and they will help her get it set up. I would look for one that also has hospice as she can transition to that group if and when it becomes necessary.
The fact that she is a resident of Florida might require some extra steps. I haven’t had that experience but if I were SIL I would call a well established National HH and discuss this.
They would have to do an evaluation but the worst thing they can say is no.
Thanks for keeping us informed. I hope she qualifies for rehab.
Dorker, this must be so, SO very hard for you. I am fortunate to be the least functional member of a pretty functional family. My SILs and my Brothers and I work together in a fairly functional way. You are an amazing human being and in NO WAY responsible for the mess that MIL is in right now.
That is ALL on her and her kids' heads. She groomed them to be afraid of her anger.
Remember - the insurance companies have been experimenting with doing away with the “three nights”rule because that rule came in when it took a lot longer to get test results. Many insurance companies no longer require the three days, trying to cut unnecessary hospital days. This is a really significant change. SIL should be able to find out if MILs insurance has done this.
The way I understand it with this whole Medicare thing and the "outpatient" thing. It was done, .. a tightening of the whole process, .. the purpose there, . .to prevent unnecessary admits, which was apparently a problem of huge proportions. I can see that would be the case, .. at one time perhaps. Things that can be treated outside of that setting (less expensive) were landing in the hospital .. and then all the various specialists tagging in for their cut of the pie.
I understand the reasons for why this was all enacted. But as with a lot of things, even the best of intentions have gone awry.
My understanding of it, .. Medicare has auditors if you will, .. maybe akin to Utilization and Review .. and any "admit" that isn't deemed something that "qualifies" as such .. it can be ......1) a huge/hefty fine for a hospital .. and worse ....2) denial of payment to the hospital because the stay wasn't one that was considered something necessary for "admit".
I don't know what this secret list is, of what qualifies .. other than some vague .. gray area of what is deemed treatable within 24 hours of "outpatient" observation and/or .. deemed to be something that can be seen to outside of that setting.
What seems to be a gray area, not addressed (and maybe there's wiggle room .. at least in a tiny amount .. for docs that care to try to find it .. not all do it seems) .. is this .. it doesn't seem there is much factored into the equation as to folks who have many issues. So, for instance, someone presents with what turns out to be a UTI .. yes, . normally very treatable outside of a confinement in a hospital bed. But that very same person may be someone who also suffers from balance issues/confusion/disorientation .. and is a risk to themselves for those very issues.
Seems UTI would be something that falls under the radius of "outpatient for observation" if not flat out . send em on home with an rx.
Seems like there is some very very tight criteria for what qualifies one for an inpatient stay. What that is, .. I guess .. I'd have to have an inside line into how Medicare works .. and I don't really care to comb thru the catacombs of that bureaucracy.
Not only that, in order for Medicare to pay for any stint in a rehab site .. there is the rule that the hospital stay has to have been 3 days .. inpatient, NOT "outpatient for observation" .. automatic dis-qualifier .. that "outpatient" label, if you want Medicare to pick up the tab.
So I do kinda have a rudimentary understanding of why/how .. etc. But it seems like it's iron-clad and can't be cut through .. to find any gray area, that will then loop things into the direction it needs to go.
There are horror stories out there by the gazillions, of folks who've been caught in the above loop and need more care, but get bounced out of hospitals and/or find out that rehab stint they were sent to .. guess what .. Medicare isn't paying it .. because you were actually "outpatient".
There's some group that has brought forth a class action lawsuit . and .. thus far, the only thing that has come of it, is that the hospital now is bound to have you sign a paper that says you are aware you are "outpatient", or the hospital will be fined for that too. And no, one refusing to sign it, doesn't then negate the whole thing . it's just noted that the patient refused to sign it. And on it goes, the whole big huge behemoth of it all.
On another front that is better news, at least thus far (these things seem to be so fluid with this family of complete and utter dysfunction) .. SIL talking that she sees it, going forward, . her mom cannot continue to live alone .. just can't.. it's not safe
the fact SIL would be at that fork in the road, .. is HUGE. Will it stick or will she stick her head back into that beautiful river of Denial .. and float along enjoying the lovely current? Wouldn't surprise me in the least.
SIL also saying that she feels firmly that her mom needs to be in whatever setting, nearer her .. not here in FL. I concur ..
I don't necessarily want her here in FL for that setting, whatever it turns out to be .. in that .. she will still need attention and I am no longer in the biz of doing SIL's bidding. Place her here in FL . in a site .. and then something is awry .. and it will be us called to the front lines continually to address it.
Also .. her precious doggie .. (and yes I seem to be the only one with any awareness that doggies don't live forever, and hinging these things on where the doggie resides, is really kinda a fools errand . but whatever). MIL and her precious poochie. She does seem to now have some awareness, .. MIL does .... that she will have to give up Poochie when she enters whatever site .. her unable to care for him. But this dog is more important to her than the air she breathes.
SIL has agreed to take on the doggie care. Does MIL really want to land in FL in a site somewhere and then .. never see Poochie again .. if he should live another 2 or 3 years and her also ... because SIL visiting here to see her mom .. is she going to bring Poochie on any kind of regular basis .. to FL .. to visit? I dunno .. doesn't sound real practical .. but SIL .. known for not looking at what is "practical" .. so who knows.
As SIL put it, .. asserting that she really wants to try to urge her mom .. bit by bit .. not with a sledge hammer . that the better option is there in IL .. she will keep poochie and bring poochie for visits ..
That takes care of that little roadblock .. (or ostensibly).
Selling her mom on a stay there in IL . in whatever site .. ???....is this even possible???.... Good question .. I don't know.
Dorker, throughout it all, you never lost your sense of humor!
On a more serious note, does SIL know that it’s OK to give up??
I’m not being snarky or obtuse. I ask this because SIL seems to believe that changing course would be a failure on her part.
It’s tempting to call SIL’s tunnel vision “self destructive.” But SIL’s tunnel vision is also destroying others.
Now for some truth: SIL’s near-and-dear people in IL — and her kin in FL — would not think less of her if she partially or fully outsourced MIL’s care.
Yet SIL is stuck in her “project mentality.”
Whatever SIL once promised her mother or herself or the devil himself......the deal is off. When the heck is SIL going to ACCEPT that?
**And honestly who knows at this juncture if she's even a candidate for ALF**
Heretofore, .. it's always been about, honestly, .. the next gadget, pill, procedure, test, whirligig .. whatever.
As her cousin said, .. "she really thought she was going to bring her to IL and breathe new life into the whole thing .. and the realization that isn't going to be the path .. is a whole new concept to her".
DUH. Ya think?
Just once I'd like to hear it (won't ever likely) from these folks, "Man oh man, dorker .. I see now .. you've been saying this for how long?, I see it now".
Not gonna happen.
SIL talks of, at this point, .. that it is a struggle for her mom. In general .. her mom's mood/well being .. is one of just concern/worry .. as to what's wrong with her, .. and .. what the future holds. But her mom does slip into a darker space, at times, .. with more despondency .. as to "why did I live long enough that this all has to go this way .. I'm not even supposed to be here among the living anymore".
That part,.. I struggle with. Only because I wanna crack each of em on the noggin .. and say to them: "Hey folks, been sounding this alarm for how long now, ???.. the fact you've all been in DENIAL .. and this is JUST NOW DAWNING ON YOU ... !!!!".
As I told her, 'your mom spent far too long with the whole "this isn't me, this isn't what I'm about' .. as her mantra .. when she should've been accepting that this is aging .. and it "IS" what she's about ..
...and SIL leading the charge of the next gadget, whirligig .. or pill or test or procedure .. fortifying her mom's "this isn't me, this isn't what I'm about".
Seems to be a ruder awakening for their mom .. and even SIL .. than they ever even contemplated. That part puzzles and befuddles me.
But alas, .. in SIL's home, .. in her charge now, for six weeks .. and the story has now turned, to the fact SIL sees .. and MIL also apparently .. this isn't viable .. and ... she needs more supervised care.
Can it be that much different .. what used to go on? That she'd come here for 2 or 3 weeks and literally dance on her head .. while spinning plates at the same time . .and then waltz off back to IL . and direct from afar .. even daily .. numerous times a day at times .. as to the need on this end. Was it not *see-able* at that point .. that this doesn't work . is not viable. Was that not clear from that vantage point? Does living that scenario make it possible that it's not seen .. just how bad it is.
No, I'm pretty sure it's all dawning on her, on both of them, finally.
Now, SIL will handle the latter years of MIL's life - with all the heart-breaking but inevitable ups and down of the decline. It is what it is... And to tell the truth, even the best planning still has tons of variable and monkey-wrenches thrown in. The decline just happens no matter where MIL might be.
My guess is that SIL will hang in there a while longer being caretaker to MIL in SIL's home. It ain't easy! And she will need to mellow and re-design her life to one of caretaker. It does seem the reality of that is finally hitting her.
As caretaker, she will need to learn to take care of herself first, as she won't be any good for anyone if she loses her own health. Respite, HH helpers, outings with "sitters", and rules for mom are all needed things. MIL will have to learn to adhere to SIL's schedule. (and perhaps a lift chair and TV in MIL's bedroom would be a good set-up?)
ER visits will probably be a given. It would help to have a card in SIL's purse with vital info like allergies and current meds to just hand to admissions or ambulance crew. In my experience the hospital will just keep sending MIL back to SIL with "bandaids" until something really major happens. And only then will they consider "rehab" (which also often results in discharge back home after insurance runs out). I think SIL will have to learn to roll with the punches.
It is a good thing though that SIL is fairly up on MIL's finances and is co-owner of the accts. For my mom, I was assured that when mom's funds ran out, they would quickly help arrange for Medicaid at the NH, but my mom wasn't in long enough for that to happen before she died. I was also lucky enough to find a lovely caring home that supported Hospice during mom's stay and was fairly inexpensive. (not much more than her ss check) They even let me bring doggy in for visits.
But you are right - even when my mom was in, there were still daily "needs" and calls and many things to attend to, so if MIL came back to a placement in Florida, you guys would still have your hands full, as SIL will one way of the other. Do your best to support SIL, so you will all be in a loving space when the inevitable happens. Remind her to take care of herself first.
So, suppose everyone had listened, and agreed, and thought the same. What about it? Where would we be now?
The only alternative that would have prevented there ever being some point at which MIL's health did this to her would have been her death earlier on. Even if she had had optimum care - let's say one to one care, in her home, provided by a silent spirit who never, ever intruded on her privacy and was qualified to the gills - time still rolls on and bodies decline and unpleasant, frightening effects result.
Or say she'd been a considerate and co-operative little soul and had obligingly moved into a facility ten years ago. Knowing all of you as you do, can you imagine that you wouldn't all be racked with guilt and anxiety wondering if you shouldn't have cared for her yourself?
You can only deal with what's in front of you, and it's certainly the only useful way to spend your energy.
I've tried it both ways. One parent dropped dead out of the blue - ?possibly preventably? - at 71. One declined over a period of twenty years, the last three of which were no fun at all, and died in my care at 90.
The point is that whichever way up you look at it and whatever format it takes, there are aspects to life that just suck. All you can do is be kind to one another and plod through it.
And, by the bye, if SIL hadn't presented the IL visit as a way to get MIL back on her feet, do you think MIL would have agreed to get on the plane?
And EmilySue, that was comforting .. hadn't really thought of it that way. That yes, me and my family did afford her the ability to stay in her home with her precious doggie .. many years.
Hopefully SIL will find a better balance going forward. Maybe made harder in her world by the fact her husband has a tendency to go manic (and more so if stressed, and Lord knows that household is *STRESSED*). And we know that MIL doesn't tolerate his mania.
In fact, SIL had asked of me yesterday to call MIL's 92 yo sister and update her on the latest. Did so. The 92 yo sister, btw, sounds more lucid than MIL ever does. She mentioned the following: "You know, when I last talked to "S" (SIL) she said they'd come to the conclusion there, that it's not working .. it's just not going to work and that MIL is going to need to go to an ALF or something .. I think that's really the right decision . from what I understand .. "S" said that MIL has been mean to B (SIL's husband), and that's not fair to "S" or "B" .. ya know, he is walking her dog 3 x's a day there, and feeding the dog and doing anything else he can do to help, .. I just hated hearing that, that she'd been mean to "S's" husband".
Indeed, I hope SIL can find a better balance somehow. She's right, it's not fair to any of them. But we've known .. for a long long time that MIL doesn't tolerate SIL's husband very well, and not at all, when he's manic.
**Also of note, .. this 92 yo sister (a former nurse), she asked .. "If nothing is found medically, has anyone thought to call for a psych consult ...???.....you know, she was so overwrought and so pent up about this whole thing .. having to leave "HER" house .. and "HER" things and just so anxious and upset about it .. and she doesn't want to be there, she wants to be home .. but of course, we all know that's not possible, she can't live alone anymore, .. I just wonder, you know stress and anxiety can do all sorts of weird things to us old folks .. has anyone thought to call for a psych consult .. maybe she could benefit from some anti anxiety med or some counseling".
Good suggestion. One I forwarded to SIL, who then also found it a good suggestion and asked the nurse to see it through.
I like that suggestion, to get a wallet card or something and keep it handy, as to all the meds, allergies . and hand it off where appropriate. I'll pass that on.
Sounds as though, they aren't going to find anything specific and as CM put it earlier .. what's the point. If there was a nasty clot that caused some of this transient issue .. it's long gone. What's the point really. Other than to ascertain if there is permanent damage and damage that isn't sustainable as to her living with SIL. It doesn't appear so, at this point .. as the confusion/delirium that brought this one, seems to have waned. Other than "what year is it", which apparently isn't all that big an issue.
So, she'll be bounced outta there, to SIL's care, .. and from there .. we'll have whatever the next episode brings and I'm sure that will be shortly, unfortunately. SIL's new norm, .. living in crises mode.
I guess maybe I should .. and I will .. begin thinking about what our xmas plans are, and maybe a flight to IL for the holidays .. to visit MIL. I love to go there in the winter anyway .. (we don't get snow in FL ya know ..). Would love a "white xmas". Maybe, since it doesn't appear she'll land back here at xmas . as had been the set in stone .. marker that MIL has lived by .. maybe we go there, and visit. Something to think about anyway.
I saw the comment by someone that MIL should be set up in her room at SIL's to watch TV, and not force B to be banished to the basement to watch TV in HIS home. YES! What's going to happen when the basement repairs start?
MIL's 92 y/o sister is really on the ball!
I am really going to be reading to see what the daily crises are if MIL goes to a facility. Because that would be what will happen if my own mother (92 y/o) ever agrees to go to a facility (which she can afford). I have told my brothers (all out of state) that I will NOT be the contact person for issues. But of course I (as the only local sib) WILL be that person.
I was wondering what you were going to do about Christmas. I figured you wouldn't leave your daughters and granddaughters. But you would consider it? Or maybe have Christmas with your girls and THEN fly to IL? After my FIL died, we traveled to see my MIL after Christmas for a few years (she wasn't alone; she has local children). Of course there were no young children then to consider. I traveled to MIL and FIL at Christmas once or twice with young children. It's a long trip to snow country, and upon my insistence we didn't do it again.
Keep us updated, Dorker! I am most happy that you are permanently OUT of the caregiving loop for MIL! Your H is, too, but then he was never going to really be in that loop anyway, was he?
Hadn't gotten as far as xmas truthfully. Will consider an IL trip perhaps.
All of my family slated to go glamping (cabins, no tents for this old gal) for the New Year's holiday. DD & crew participating in this trek.
MIL isn't on anything for anxiety. MO, it would benefit her to do so.
Don't know yet that FL is off anyone's radar. This is SIL's assertion (I agree with her) that her mom's placement needs to be in IL not in FL.
Will MIL buy into that? I guess we'll see.
If MIL digs in her heels that she DOES NOT want to remain in IL, I can foresee that SIL will acquiesce to her mom's demands.
That's going to mean though, but ado to poochie. Poochie's new home will be SIL's. Is she willing to leave the one living being that's more important to her than life itself? We'll see.