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:
As to DH, I commend your restraint. He has had so much opportunity and didn’t even want to then. “If only x, then I would y” is so easy to say. When people make comments like that, they FEEL like they are doing something, making a sacrifice, etc. But “woulds” do nothing to execute a plan and get ‘er done.
It is ironic because I think he would be telling you that very thing if the shoe was on the other foot;)
This is just dread talking. He doesn’t want to do this. If fairies magically made all of this happen overnight, and MIL was where she needs to be and all paperwork, etc done, his sadness would dissipate rapidly, lol.
You responded well... not letting him sink to far into la la land, but preserving your relationship.
As far as being an infant in the Medicaid/LTC world, I get that feeling. It is like fighting through sticky muck to get to a goal and then being told to turn around and go to another location... rinse and repeat til you reach the end or die trying. And the muck is so deep that even with all of the experiences we have personally had, I am still a toddler, even though I FEEL like an old lady, lol. But, Betty... She’s a grown up in that world:)
”Yes, we do have Medicaid beds. Two, actually. We save them for very special circumstances- it’s kind of a secret, no-no thing that 99.9% of the population won’t be considered for - but we have to SAY they might... since it would be discriminatory and illegal to do otherwise”.
Fancy Pants site takes NO "Medicaid Pending" at all. Not in LTC or otherwise. Just to name one.
There are some that do .. few and far between.
The site that we have cited as to where she'll land, .. I've taken to calling it her "Purgatory", short stay (LTC) .. it also houses an AL arm in that same setting. We weren't . all that impressed with it .. not as a whole . all in all. But it is what it is.
It has to go this route .. she can go home . if someone wants to take this one for the year or more it will take for her name to come up on some waiting list. . No one wants that. Thus, it has to go this way.
The site we've selected for her Purgatory .. that's the one where there are any number congregated around in the .. I guess one would refer to it as the "commons" area .. watching tv .. sprawled out in wheelchairs . recliners . and most of them seen there, in states of .. don't know who/where they are .. some dozing .. some awake .. but . pretty apparent they're out of it ..
It is what it is.
Then you walk over to the other area . and there are AL apartments . no private rooms (this will displease her .. she will NOT get a private room there for her Purgatory). And were she to stay there, as the site for AL .. she won't have a private room.
This will displease her GREATLY.
(might displease whoever has to room with her, .. to quote DH).
She very well could end up remanded to this place . if Fancy Pants comes along to assess her at some point .. and they will, it's part of their admission process ..
If they refuse her
It could be this place or the "we're all family here" place . about 5 mins from us (no private rooms there either) .. or . let me take that back . there are private rooms there, but one has to share a bathroom with 4 others .. not a bathroom for each room, in what is their section where there are private rooms.
But should Fancy Pants deny her coming there.
Her choices (unless we land on somewhere that we find more likable .. that hasn't happened yet) .. her choices will be .. .the Purgatory where she next is landing .. . or the land "We're all family here" site about 5 mins from here. And both of them Slumperville, full bore Slumperville.
And yes .. it's gonna take for DH .. a few more phone calls .. of "I need ____________" . .. inconveniencing him . .yes even in whatever setting she lands in . before he begins to again see .. "she needs to be in these places" ..
Takes a lot of restraint ..
I just wanna say a saying that my mom is famous for .. ."Ya know .. chit in one hand and wish in the other, . see which one fills up the fastest".
Here here!
Wish all ya want .. it is what it is .. she's been de-railing on this track for a long time ... what did you people think would be the end result here .. seriously?!?!?!
SERIOUSLY?!?!?!?
Yes, we all "wish" that cloud would come for her, .. afterall, it's what she wants.
Yes, we all "wish" it didn't have to be this way .. she never wanted to live long enough to have to face this path.
Yes, . we "wish" we were all made of $ .. and could hire around the clock c'givers.
Yes, we "wish" we could put her in the finest of country club settings .. her hob-nobing with the higher echolant she fancies herself to be.
Wish in one hand, chit in the other ....................
It is what it is.
Restraint
Every day could bring huge changes in her condition at this point. Glad SIL might be reined in a little, by you and M, Dorker, in order to shift her focus to what is needed NOW. POA, medicaid, and prep for the move to LTC. Perhaps working on the list of what will be immediately needed there at the LTC could occupy SIL. That move will be coming up soon, right?
SIL talking to the powers that be, in the present setting (Rehab) .. her stay there extended at this point .. til 3/20.
Was to have been discharged 3/13. One week extension .. .
This because some of her PT got sidelined due to gout (which is improving) . .
And so that buys us a bit more time to get into that atty .. and get the ball rolling . slated for 3/15.
Good news there.
Fancy pants sounds like more IL and when I went looking at IL for my mom, I was told the Residents were on their own when ill with Flu, gastrointestinal issues, etc, up to the Resident to get to the doctor. FP place sounds like someone will still have to run MIL to appointments.
To quote her ... why would you pay for AL and not get it ... that's about what it comes to there.
Her words
I suspect they didn’t think too many people would actually last that long.
But when things weren't perfect, NONE of us had any trouble saying "Mom, suck it up". We'd been told this SO many times as kids that sort it of came naturally.
MIL did NOTHING to prepare for her old age; her "plan" if you can call it that, consists of "the cloud" coming to get her on HER schedule (she thinks even G-d follows her directions, right?).
I wonder if someone would be brave or audacious enough to say "Mom, you didn't make a plan, so this is how it's going to HAVE to be; just deal with it, for Chrissakes and stop bellyaching".
I don't think she can do it, dress daily ... manage her time appropriately to get to the dining room, dressed and ready ... I don't. Tell ya what ... have her start now ... in Rehab. She dressed today you said ..but assisted by an aide. If she's capable ... and suited for a site that requires her to do it ... have her go ahead and try ... daily, now. See how she does. She's living in PJ's where she is presently ... I see others there rehabbing, they're dressed..... have her start showing you now, she can do it, daily. It won't hurt her for sure, and you'll get a better read on her willingness/ability to do it.
The other day .. and the testy conversation between she and her mom . and her mom insistent that she is going home . now this is my life and I will live it the way I say .. and I don't care about all that .. you guys go on and go back to IL . and I will be just fine . her digging in her heels.
SIL then countering that .. no .. that's not gonna be possible . and then explaining to her mom some of what we're doing . .trying to put all this together . as to sites to look at, affordability, etc. Her words were about like this:
"Mom we're having to sort thru all this and try to find some place that's safe/clean .. that kinda thing, but affordable . you know you don't have any resources really . you don't have a home to sell . you don't have any assets . it has to be Medicaid . because we can't .. you can't afford anything .. so .. we're trying to sort thru that process and find a place . one that's safe/clean, affordable".
She kinda did go there, and tell her.
It needs to be a relentless drum. Not the mollycoddling backpedaling of "oh we'll find you a lovely place if only you can dress yourself" thing that is going on now.
Can M come back? She seems to be the only one who can talk turkey to her gma.
Remember back when I had suggested more than once .. get MIL on a low dose of anti-depressant . get her some counseling .. get the doctor behind all this .. and have them reiterate the need for placement
Went nowhere.
What has happened now .. SIL has gotten behind that issue . talked to doc on the phone .. "would you request an anti-depressant for her as she grapples with all this . and would you speak to her about the need for her to reside in a setting with help she needs available to her . and why .. and could you refer her for some counseling .. do they do that . can they do that".
Enter stage left, MD: "This is some really tough stuff you're having to come to terms with her, . how bout I rx an anti depressant for you . .as you work through this transition . going to be just for a little while, how does that sound"
MIL: "I don't want an anti depressant . I don't need that, I don't want to have to do this . but I guess that's what I have to do . so I'll do it, but I don't want an anti depressant".
Doc: "Well it's just for a little while . and it will help you to feel a little better and not so down/depressed about the circumstances, and that's going to be important as you work to come to terms with it all, it's a lot of adjustment . and ya know, you really do need to be in an AL . you need someone to help you with your meds . that you forget to take . they can help you with that . you need more socialization . I mean you live at home just you and your dog . and you aren't able to get out and visit and socialize . that isn't healthy for anyone . .this is going to be best for you . .to be able to visit with people .. and have friends .. and it's going to be a huge adjustment . but it's really necessary . someone to help you with bathing .. nutritious foods available . you won't be alone . if you fall . and it's really . it is necessary . but let's get you started on an anti-depressant to start with . and go from there, how does that sound?".
MIL: Okay
DING DING DING!
Tried to tell ya!
But nope . what do I know. This could've been several months back in the works, but NOOOOO.
Sheesh.
Lesson in shutting your mouth . and don't say it, 'TOLD YA SO'
I'm talking about a united family front that that says to MIL "Mom, the time for YOU to plan your old age was 30 years ago. You didnt do it then. Now, we have to do it as best we can with public resources. There are not a lot of choices. We're going to do the best we can, but you don't have have options. Just stop complaining, there's nothing more WE can do."
It would probably be best that she actually Not have too many visitors in the next couple of weeks, allowing her to come to terms that this is her lot in life, that she either buck up and face getting as strong as possible, or become a slumper and end up in a facility that is less than she feels she deserves, but she should have been being encouraged all along, and she should have known that this is what would happen. Sadly. SIL led her to believe that she would care for her at home and at all costs, a very sad and costly mistake, although I am sure SIL thought she was doing the best that she could, lesson learned.
I would say keep MIL out of the searching for now. You guys tour as many Medicaid Pending facilities as possible, and find the lesser of evils, and pursue placement there. There must be more decent facilities out there. Or again, perhaps a smaller private Adult Family Home, where the ratio of patient to attendants is about 10 to one or two. I know they are out there, as there are many, many in my area when we looked into it for my FIL, but what I am not aware of is if they accept Medicaid when the money runs out. I say put the "FP" out of the running, and keep looking!
I'll say it .. but I don't count.
If we can pull DH out of the doldrums of despair that his poor mom has now been handed the fate she set out for herself .. that's another matter, to be able to form that united front needed.
No . not even with the help of an aide .. apparently it's a non-issue there .. as no one comes to assist her to dress, . .she stays in PJ's all day, every day .. and no . she hasn't attempted to do it herself.
No better time than now, to get started .. show that you can do it .. .dress yourself daily ..
If you can't . let's get an aide involved and find out where the problem is and maybe some OT involved. Great time to start it.
That will also document whether it's possible to do so .. as well as document any improvement or lack thereof . .and/or willingness to try.
To paraphrase what what someone said earlier, "he needs to put the guilt and emotions in a box and visit those later."
I had reached out, and spoken to M last night late. Asking of her, to try to reel her mom back in .. Fancy Pants site .. SIL seems sold, hook/line and sinker, . .we don't even know if they'll accept her .. but for her to be selling that as an option to MIL .. when MIL .. we don't even know if she can successfully dress herself . and that is a strident requirement there, and expectation, . no exceptions.
Told M, .. I can't seem to get her to recognize that .. let's get her to dressing daily right where she is .. .can she do it .. tell her the relevance of that task . and let's see if she can do it .. that will tell the story ..
So, M reached out to her mom this afternoon and they had some dialogue on it.
Next thing ya know Dorker is brought into the loop . .and SIL informing me that once again .. M .. .has brought her back down to earth and reality .. that it may be that if MIL lands at FP .. and their AL arm of things .. and found not suitable .. . it would be that much harder as to placement in an AL anywhere . having failed the criteria for that set up .. and why put her through all that .. she's already going to be moved from Rehab to a short-stay in an LTC and from there to AL . and if you're dead set on this as her AL . .and she fails there . .then it'll be another move .. why not set her up with what you know she can and cannot do successfully and comfort and care .. and safety .. and leave it be at that.
SIL saying she thanked her daughter for bringing her back to reality on it all . that she supposes that she is just wishing/focusing on the other population there and not on her mom and her specifics as to her capabilities . .. what she wants for her mom . what she imagines her mom wants for herself in the way of the folks she is in a setting with (FP is definitely more functional folks . for sure . up and about on walkers, dressed, etc.).
I just reiterated to SIL in response: "Well .. AL is on down the road a bit and doesn't have to be decided on at this point . .she has her short-stay in an LTC to get through .. and so .. let's focus on whether she can indeed dress herself. No better time than now . .while in Rehab .. she hasn't been doing so .. let's see if she can do that here and now . and if she can't, let's find out what is the impediment . maybe OT can work on it some . and bring that capability around .. and if not . then we know the path is not Fancy Pants site . they won't allow her to be there if she doesn't have the capability to dress herself daily . so let's just see if she can do it now . or if not . see if OT can help her to get there, as to that task.
Seemed to have really burst SIL's balloon .. the notion that the reality of it is .. she very possibly is not a good fit for Fancy Pants site . for that very reason . failure to be able to dress herself daily (she also has time management problems).
But reality .. is dawning .. at least in this issue, at this moment .. for now.
M .. seems to have the capacity to get her mom to "LISTEN" where I cannot.
SIL doesn't really engage on the topic of "let's get her to doing it now, and see if that's something she can do".
I suspect . SIL knows .she cannot . and has been helping her to dress while in her residence . in IL. She damn sure didn't dress before she left here, even offered opportunities to go out to lunch or dinner .. she refused . she'd have to get dressed . .she'd tell you . .and it's too much . .just can't do it, and would decline to do so.
She surely didn't have some miraculous recovery as to her capabilities in SIL's care that SIL can now report .. "No . she dresses every day here". Nope.
I think SIL . by way of M . has had to face the reality that her mom doesn't indeed dress . not without assistance .. and that won't be the setting for her, if that's the case.
Good job helping to get things back on course. Hopefully the transition to the LTC will go smoothly and then they can assess her further and get all of the Medicaid stuff processed and approved in the meantime.
Youve already indicated that the LTC site is pretty dismal and chuck full of slumpers. If you can find an AL that is even marginally better than the LTC site - mil might not be so put off.
Its all kind of relative - if you know what I mean. Mil not having seen Fancy Pants - won’t know what she’s missing. Mil will only know the AL is better than were she was.
My mom hated rehab so much - HATED it - when she left to go to AL instead of back to her IL apartment she was actually quite happy. To be honest I think she would have accepted moving into a tool shed if it meant getting out of rehab!
So, get her clothes that are as easy to manage as pjs.
For the last 6 years, I've been driving my husband to work, getting up at 4 and in the car by 5 am. I'd leave my previous days pullup pants and pullover top on the bed and slip into them for the drive. If mil has easy to manage clothes, the task will be easier.
Has anyone observed an OT session? What is it working on if not dressing.?
Dressing - there is a reason elderly women LOVE to wear a muumuu, house dress or duster- EASY on and off. That is what she needs. She could probably handle getting in and out of one of those. I cannot believe OT is not helping her with dressing.
I'm so glad that M is steering her mother back on track. But I've been wondering this, Dorker. You are now more involved in MIL's care than you have been since June 2017 (the beginning of this thread). You and SIL are communicating and working well as a team to find/facilitate a facility placement for MIL. But...team. Team MIL? You are more involved than H (which is the way he's always liked it, yes?).
At what point will SIL depart the scene for IL? Don't expect H to suddenly step up and fill her void (I know you won't expect that). What will happen then? Who will communicate with the various people at the facilities?
I know, I know; these are still early days. But I am just a bit concerned that SIL will expect you to be the stepper and fetcher once she departs the state since you appear to have stepped back in now. Do you think she will stay in FL until MIL is at her final destination? Will SIL stick around during the "short stay" at an LTC?
Perhaps at least be thinking of what you will agree to do once she departs. MIL's laundry? And what about those MD appointments? When the facility goes a callin', will you go a runnin'? (I'm referring to the calls I get from my mother's NH, which necessitate sometimes that I have to get out there.) You will have to be very clear with your boundaries at some point.