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:
We all know that this didn't need to ever be the drama that it has become. Personally, I look at this whole "column" to be a dire warning of what can happen when elders DON'T plan and WON'T plan--but have very difficult and challenging age-relayed issues. They just think they'll never get old and need more care and they cannot or will not see the pressure and stress they put on everyone around them.
My heart does go out to SIL who sounds as if she has finally seen the light. She CANNOT FIX MIL, nobody can. Getting outside help for MIL's care is not as admission of failure, it's common sense. In 6 weeks her health (SIL's) has bottomed out, poor BIL has gone manic and will do so again and again (NOT a pleasant thing to feel!!) as long as the Toxic One lives with them.
HHC would be VERY helpful. Takes a lot of pressure off MIL. And yes, get a nice recliner for MIL'S room and TV in there. Let BIL out of the basement and let him have his home back. Poor guy.
Yep, MIL is a pill of massive proportions. Her sister even sees it. A cog eval would be nice, to be assured that what you think is actually what's happening. Something to calm her down a little wouldn't go wrong either. Trouble is, she's so used to having herself as center of attention for so long, she doesn't KNOW how to be decent to others.
Better still, placement in a NH up there in IL. With visits from her dog. Again, the TIA's are going to continue and she will slowly deteriorate mentally. Nothing can be done about those, no pills or magic potions. We age, our body starts to "go".
We keep reading the same old, same old stuff about MIL. I really hope that all this pushed SIL to MOVE into a healthier direction. She's been amazing, but she's going to kill herself with this "care". And you, Dorker, you've just BEEN THERE for so long. Screaming into the wind, yes, but you've been there.
Hopes today for a fairly quick decision about SOMETHING to help all involved.
Is it? A neurologist mentioned anti-anxiety meds for my mother, but then her PCP said she didn't like to use those meds on her elderly patients.
I think my mother would greatly benefit from sort of antidepressive/antianxiety med, but she would never agree to it.
So be it. I don't have to be around her any more than is absolutely necessary, though, either.
Dorker - continued Prayers and thank you for sharing all of these latest developments. Very informative.
If it is totally up to her, I know my mother will NEVER take anything like that. She is very anti-medication. You can barely get her to take even an aspirin.
MIL sounds like a prime candidate. She needs something to help her calm down and quit picking on SIL's hubby.
AMEN!
Wiser words have never been spoken - as an approach to this situation and to all the other goodies that life throws ones way.
My mother takes other medications, no problem. But, as she preached to me the other day, she majored in psychology and knows all about this stuff. (Ha!)
Since she's so difficult to be around, I avoid it as much as possible. I'm her Dummy Daughter Driver, and dread my driving duty days. I've set strict limits, and she'd like to get out more.
What the heck does HE know about mental health treatments?
I'm not even sure that I understand how that happened, and how it will be justified as to Medicare.
They've already done a CT and an EEG and nothing was found there. Not even aware of anything further they intend to look at in the way of tests .. .so what do they do now .. just let her lay there and hang out for the 3 day stay (no the prior two nights do not become retroactive as to satisfying that all important 3 day requirement). So she has another 3 days in front of her .. (and no she's not at all pleased) .. and .. for what? I don't know.
But the goal there, by all involved, is to direct this to the rehab site and a stay there.
SIL says of her mom .. "They haven't found anything wrong really, .. is it like old age .. is it the TIA stuff .. who knows .. but something is wrong with her short term memory .. she doesn't remember what year it is .. no matter how frequently she's told .. not that it matters all that much really .. if she knows that .. but .. even with her Elliqiuis .. every time they bring that she wants to know what it's for .. and I explain it .. or the nurse does .. and she asks when she started taking that (years ago).
They were, .. as I was talking to SIL, .. SIL had stepped outside to talk to me and DH .. they were doing a cognitive assessment on MIL. (shocked) she had asked about that and was told they don't do that in the hospital .. has to be outpatient, results not reliable. I guess that changed too.
They are moving her, at present, at SIL's request .. to try to get her to be more amiable to stay put .. (not like she has the capacity to get up and walk out, she doesn't .. but she can beg/plead/cry .. and that she is doing, wants out of there) .. they are presently moving her to another area. Where she is, for whatever reason . .there are some patients that are hollering and screaming .. and there's no peace to be had.
There's some good cop (SIL), bad cop (SIL's daughter M), ongoing. MIL having said to DH that M was mean to her ..
DH having asked SIL about this, here was her explanation and she's not wrong: "Look M is different than me, .. she's just matter of fact, cut to the chase, realist .. me .. I'm one to coddle and so forth as you know, she's cut from a different cloth .. she wasn't "mean" to mom .. she was matter-of-fact .. in telling mom that she needs more care than I can provide . that I'm getting on in years myself and that I simply can't do it ... I'm not strong enough .. that she needs to be where she can get more care".
She was matter-of-fact and not coddling .. a realist.
A side note, MIL asked of DH: "If I can just get out of here and I want to go to my house, .. just me and my little dog and ya'll shut the door and leave me be .. I'm just in the way .. I need to go on and die .. I don't know why I'm still here, I don't even need to be among the living any longer .. I just want you to get me and take me to my house, .. just me and my dog .. and then leave me be".
((Of course DH said the right things as in .. now mom .. we can't do that .. it's not safe .. yadda yadda)).
She does seem awfully focused on wanting to go back to "her house". Hyper focused.
SIL: "Well I mean ... I get it, this is hard .. this is terribly hard .. hell she has fought aging every inch of the way .. she didn't even want to turn 40 . eons ago .. this is hard stuff .. she's not gonna be happy and all *oh joy and happiness, yes cart me off to an AL* ......... she's mad .. she's sad .. I get it .. ".
Hooray for that all important label getting slapped on this thing. However or why ever ...just hooray.
Interesting .. I think that hard fought label on all this .. and even still .. MIL's wails and laments were working on SIL .. and on DH ... both.
Both of them were going to .. at least beginning to .. on their speaker phone convo .. go down the path of .. "just get her outta there, .. why bother with anymore tests or anything .. she's miserable .. she's let them release her to go home (to SIL's).
That's when I interjected .. "can you ask if they will move her, .. seems a simple enough solution if they'll do it .. I mean she's still not gonna be happy .. she wants outta there for sure .. but .. she won't be subject to those other patients screaming and carrying on, at least".
SIL asked, they will move her. Simple.
Kudos to you for suggesting the simple expedient of moving her room.
That is so much better than being carted off from doctor to doctor then ER then hospital to get prodded, poked, tested, etc. To what end? A prolonged painful ugly one?
The way things are going, she'll end up with dementia and become a shell of what she was, then dies piece by piece slowly as her brain shrinks and dies, if her other diseases don't claim her first.
Anyway, I'm so glad that you've managed to get her made more comfortable. The waiting and seeing is hard enough without bedlam going on around you.
Is MIL under the care of a hospitalist? In my experiences with my mom, the only way to get the "whole picture" was to find out from the nurses WHEN the hospitalist rounded and physically be there when s/he was there to examine my mom. Then I'd corner her/him in the hallway and write down everything that was said. The times when I couldn't do that, I was able to get the nursing staff to get the doc's phone number for me and I'd place a call and ask for a callback to query what was going on.
Since SIL seems inclined to take your advise, you might pass that on. Or, perhaps young M (sounds like an eminently sensible young woman) could be pressed to do that--she sounds a bit more clear headed and less prone to wringing of hands than her mom.
What the heck does HE know about mental health treatments?"
When the dr. said that to me, I just looked at her. I'm sure the expression on my face said plenty! Then the dr. said, "She needs socialization. She needs someone to check in with her every day to see what she needs."
Again, I just looked at her. Just because HER culture took elders in (she's from and went to med school in Nepal), she is not ordering ME what to do. A daily call to my mother to see what she "needs" would turn into a long phone call and/or requests for what she "wants." Ummm...NO WAY.
This was the last time I went to the examining room with my mother. When I told my mother the doctor said she needed socialization, she was angry that the dr. spoke to me and not her (not true; she just didn't hear it), and that from that point on, I was not to go back with her to the examining room.
My mother is deemed to be mentally competent, and I am tired of trying to convince her to do things she doesn't want to do. She has all the say, so why bother?
I am just trying to keep my distance, other than my required Dummy Daughter Driver duties.
In point of fact, my mom's docs DID say that she needed socialization. She moved, first to AL (disaster--it was too much of one kind of help and not enough of others). She ended up in the hospital and the very wise geri psych there pointed out that what she needed was a place with very little "care" but lots of enthusiastic staff and good activities. We looked more carefully and found a nice Independent Living place.
But she was still very, very, VERY anxious. Fortunately, the PCP whose office was on site referred her to the lovely geri psych who was ALSO on site. Having someone who could see mom in her own element was really crucial. Geri psych adjusted anti anxiety meds and send mom for a cognitive evaluation--because it was obvious to this trained mental health professional that the SOURCE of my mom's angst was that her brain wasn't working properly any more.
I understand that your mom now forbids you to come in to her appointments. But I would take a shot at explaining, in writing, to mom's doctor what you are observing about her ability to manage her life and her moods.
I understand what you mean about "the look" you gave her. But looks often don't translate between cultures.
Yes, I have full HIPAA access and could write to her doctor about my concerns, BUT I greatly fear the explosion by my mother if the doctor told her what I'd written ("Your daughter says..."). I'm just not willing to risk that.
My three brothers know the situation. They aren't willing to risk her explosion if they went behind her back and talked/wrote to her doctor, either. And they would be in a far better position, since the explosion would occur farther away from them, since they live states away. The fallout wouldn't be as bad for them. They have less to lose. Since we all have a HIPAA release signed by my mother, I have given them the username and password for her online chart. I don't believe any of them have ever even looked at it.
I asked her a few weeks ago if she'd told her dr. at her recent physical that she's only showering once a week now, and she replied, "No! I'm not going to tell her THAT!" So she must be doing a great deal of showtiming with the dr. I also asked her if the dr. knows her legs are without feeling from the knees down (we'd thought it was just her feet). She doesn't know/doesn't remember if the dr. knows that (so I'm thinking she doesn't know it). She is so proud when she tells me, "The doctor says I'm in better shape than people younger than I am!"
What would it hurt if your mom got angry at you?
You want the best for her. She no longer knows what's best for her. You do.
And as CTTN so aptly put it .. what's the point of continuing to try to persuade them to do thus and so when they aren't gonna do it. Wasting your time/energy.
As to that EF #, yes puzzling to me also. I'd love to know w/that kinda reading .. where did the CHF dx come into all this, . what was the EF# at that point ... I'd love to know. I know that SIL .. and yes she said 60 .. was the # .. and she even said the docs remarks were, something akin to, .. "if she has CHF it's not bad, not with that as her EF#".
I know that SIL has her mom's medical records, sent for them. I would love for her to comb through that and get some prior EF readings that have been done. For instance, when she was hospitalized back in June of 2017, I know for a fact one was done at that point.
SIL kinda has a handful to deal w/the moment, so .. not sure she has time to comb thru and find that info. But yes, definitely very puzzled by that, you bet I am. And yes I am certain she said "60".
Yes there are hospitalists as the MD's on all this, and for the most part, SIL is there, from about 9 AM .. on thru and into the evening, .. on-site .. daily (absent her own doc appts she's had to see to, a couple of afternoons). So, for the most part, she is there, on site .. to talk to the docs that make their rounds.
Interesting that one of the Neuro docs said this (or something like it): "What she needs is to get out of here ... this place is enough to make anyone depressed and anxious" (referring to the screaming ongoing from other patients), .. and SIL I think was buying into that, yes .. let's take her on outta this place ... even though she's told everyone including the janitor .. she wants them to switch her to "inpatient" .. and finally got that all important label .. but her mom's .. discomfort .. with listening to screaming from other patients .. was enough that she was actually contemplating .. "yea let's' just get her outta here".
Interesting also to note .. that SIL had told her mom in an effort to push this whole AL thing .. that she is so very isolated at home (and she is) .. that she watches her mom interact and have conversation (she does do that) with each and every person that comes in the room, even the people who come in simply to empty the trash .. she wants to talk to everyone .. and hear their story ... everybody has a story .. where'd you come from .. what's your story ... she engages each and every person she encounters .. SIL telling her, .. I see how you interact with all the people here coming and going .. you're so isolated at home .. it's not good .. wouldn't you rather be in an AL where there are people to talk to.
And on Polarbear's points .. go crawl in bed with a handful of sleeping pills rather than all this poking and prodding. Let's don't forget that I tried to approach with (cognitively impaired, can't string a thought process together and follow it) MIL with the whole Palliative Care thing .. and even talked of Hospice as an option. Talked with SIL about it, .. SIL who has been firmly riding the train of, .. "oh we can just do vein ablation and PT .. and we can get this and that gadget and pill and so on ... and I can breathe new life into her when I get her here in IL", .. so .... that topic has been attempted ..
To no avail.
There is also the concern that she could stroke out (she has had TIAs, as a-fib, an aneurysm).
And, as Dorker said, she will do (or not do) as she wants.
I am not going to be the one to cause the explosion. It can be one of my brothers. She's their mother, too, and as the local one, I'm going to catch way more fallout if I do it.
When your mom begins to emotionally abuse you, then walk out of the room. Don't just stand there and take it.
I know a LOT of elders. Some are on AD meds, some aren't. My mother, who should have been treated for chronic depression/anxiety since 1954...never took a thing but Valium. LOTS of it. Consequently, she wasn't much of a "mother". Hated having kids, hated being tied down and wow, did we feel it. Now, at 88, she's on about 15 meds, but NOT an antianxiety med. Is SO proud of the fact she isn't on AD meds and how she never had a depressed day in her life. (5 out of 6 of her kids are on something for depression, have been or currently are in therapy) Not germane to the discussion at hand, but telling nevertheless.
MIL has now run out of steam. Her words and whining falls on deaf ears (I HOPE). No, she's not going to be happy, and that's too bad. She's had a good 88 year run of manipulating people into doing her will--the end will not be of her liking, but it's far better she get one on one care from people who can handle her and her many woes--people who come in fresh every shift and won't take her crap. SIL will feel guilty, but then, once her life goes back to "normal" she'll be OK. Staying on that hamster wheel is going to kill her. And let's not forget sweet BIL whose life is difficult on the best day!! HE deserves a medal!
As far as poochy not being in the picture--well, we don't get what we want, most of the time. Isn't this the same woman who once upon a time had a "inconvenient dog" put to sleep, simply b/c she didn't want it? Sorry, not sorry to bring that up.
She can opt for Hospice. She's that bad. Truly. She won't, b/c she still has some fight in her. Even palliative care which simply keeps her out of pain wouldn't be bad. I have to wonder if her constant pains (for which she will take NOTHING) were under control, she'd have a better QOL and maybe not be so nasty. Chronic pain is a bugger to live with!
Dorker--I pray that this path continues. That she can be placed in a NH in IL and never returns to FL.
Your role now is now to be the constant support to DH and SIL. Just reassuring them the right thing is happening. Maybe SIL thinks it's temporary, but the TIA's coming fast and leaving deficits behind--that's not going to suddenly stop.
Hopefully SIL can look at this a good thing, and deal with it by not feeding into MIL's "This isn't what I am about, this isn't me" mantra. It IS what she is about, now.
88 is a good, long life. I honestly wondered what she thought aging was going to be like. I'm only 62 and I hurt all over in the mornings. No, I can't do backflips on the tramp with the gkids. I am probably not going to be able to hike to any mountain over 11,000 feet again as I don't do the thin air well---but I DID do those things and you can't take that away from me.
It might be nice (though likely impossible) to get that prodigal son to show up before MIL passes. He won't and that will be on him.
It'd be nice is MIL would bend an inch and appoint a POA, which I bet she never does.
Really so sad, her failure to plan has resulted in the upsetting of so many lives. So not necessary. So very, very selfish.
Can you give her back the car? Tell her that you aren't going to participate in this charade any longer?
I think the most subtle form of abuse is the "I'll die if you upset me" sort. I've been subjected to that. It really sucks.
Just a couple of weeks ago I had a flare of diverticulitis and the first thing the the PCP said was that she did not want to send me to the ER because they just admit all geriatrics.
We assured her that between my caregiver and DD a Vet we could handle things like IVs perfectly well at home.
The two of them have decided that I am not going to the hospital again which is fine by me.
I do feel for MIL in many ways and completely understand how she just wants to go home and pull the blankets over her head. Everyone of us wants to creep into our cave and hide when life gets out of hand. My hope for MIL would be that she has a sudden big stroke and it will be all over for her.
I was so thankful that my DH went that way. It was what he always wanted but don't think he expected it quite so soon.
MIL will never willingly agree to anything so SIL will have to stand firm and refuse to take her back to her house or her own home.
It is not going to be easy and Dorker you and DH may have to go to IL to support SIL.
As for my mother, if I'm in her condo, I do leave when she becomes abusive (actually, I try to leave as soon as possible most of the time, anyway). It's a little harder when we're in the car. I can't in good conscience turn the car around and take her back to her condo instead of to church, nor can I do that for a coumadin appointment or doctor appointment. If we're on the way back from somewhere, I just clam up, unload and dump her groceries on the counter (while she's creeping around holding onto the car until she gets to her walker and then walks up the sidewalk and up the one step into the condo) and leave as quickly as possible, double-locking her in behind me. Actually, I do that most times even if she's not been abusive.
If I gave the car back to her, it would be me doing all the footwork to get it registered in her name again. And then I would have to handle the sale, as she is incapable of advertising it, etc. So, no. She owes ME (money I'll never collect) for all the time I've given her, gas money, etc. I'm not going to go further in the hole by having to buy another car for myself.
I've been her Dummy Daughter Driver for two years now. The amount of driving has not increased in that time, because I set strict boundaries from the start. If the doctor visits were to increase, I'd ponder requiring payment. I don't even get gas money from her now.
I just really wish she lived near one of my brothers, because she is so negative and unappreciative. There is no mother-daughter bond between us. I've always been a disappointment to her, and I can't stand being around her. I can't get over how my brothers don't have to do what I do. She should be near one of her beloved sons (especially Sonny-No-Show).
Fast forward to 5 years ago -- I was on the phone with my mom, my DH had just been dx'd with PD, and she was complaining that I hadn't been getting her out lately. While we were on the phone, she had a TIA, became incoherent. I called the AL to get someone up to her, then went in to DH, in tears, to fill him in. And the first words out of my mouth were "Dad always said I'd give her a stroke and I just did". My sister and I laugh about the reaction now, but how sad that it was so ingrained in me.