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:
YOU are not POA for MIL. Whenever MIL lands in a new facility (be it the hospital, another rehab, purgatory or elsewhere), DO NOT let them have your cell number. Once SIL goes back to IL and the facility realizes H might not answer his phone, YOU will become the primary contact because you are local and answer your phone consistently. You could end up running interference between the facility, H, SIL...just like SIL used to have you doing from afar.
Remember, NYMNYP (Not Your Mother, Not Your Problem)!!!
How to make them see that, own it. And you're right . ironic that you mention DH won't answer his phone. I was just trying to call him . .related to biz issues .. and no answer, no answer . no answer. Had to call his son in law that works with him (he always answers, without fail" "Son in law, where is your boss, why isn't he answering the phone". Son in law: "I don't know, let me go find him, hold on". Comes back to phone, "you can call him now".
He gets busy and doesn't answer the phone . all the more reason MIL should've been made to stay in IL . where her daughter can be more responsive to need. But oh well, water under the bridge.
Was a bit of light at the end of the tunnel to hear SIL weighing out . .and so forth as to upcoming doctor need.
At discharge they had directed she needs a bone scan .. bone density .. I think that's an enormous waste of time . and said so . but do with it what you will. At this point .. hauling her anywhere . would require a medical transport .. and so .. whether that will get done .. who knows.
But SIL weighing it all, she was to be seen for a bone density scan and an order to see an endocrinologist.
SIL having cornered attending MD the other day, "what is this for? They want her seen by an endocrinologist .. why?"
MD: Probably as a result of what is found with any bone density scan they want her to have .. in case she needs medication or whatever.
SIL telling me: "yea . we'll put that one on the back burner for now .. I don't know . she already has to be seen by the ortho doc .. for the follow up to her broken hip on such and such date . they want her seen in their office .. and so . that one I have to see to .. if she's even able to ambulate to get there . but an endocrinologist ... bone density ...??? .. we'll see. I already cancelled a cardio appt she was to have been hauled to .. and she has an upcoming eye appt that I had to reschedule before . they couldn't dilate her eyes at the time . because she had this infection . and so they wanted that treated . we were working on that with some eye drops .. and so .. I had rescheduled that appt so they could then dilate her eyes . I guess we'll have to see how she's doing . if she had to go today .. that wouldn't happen . she can't ambulate .. her next appt for her steroid shots in her knees is on the radar too . .but maybe I dunno . maybe since she has to be seen at the ortho doc that did her surgery on her hip .. maybe they'll do those knee injections .. I can't see hauling her out again .. for knee injections .. and for a follow up on the hip surgery . two different appts.
Good to hear her . thinking out loud about prioritizing as to doc visits ...
Something she was all too eager in times past .. to run do . .. remember vein ablations ..
And gluten sensitivity issues ..
To remove the stitches. (!)
We elected to have the NH personnel remove the stitches.
So if MIL isn't "able" to ambulate . then maybe med transport has to haul her there .. and SIL can meet them there .. or whatever.
Not mine to see to.
And regarding your “time on the floor” during this meeting. One sentence questions, one sentence answers. Pointed. Focused. Think everything thru. Condense what you want to ask and say. No emotions. Focused and direct. Maybe a lower your chin and raise your eyebrow. Stern. Controlled.
I have been and still am - 25+ years an advocate for Rainman and the services he receives. I advocated for my parents for 6+ years. This I know: They will pat you on the head and get away with doing as little as possible - as long as you let them. Just stop!!!
“You have to play hardball with these folks.” THANK YOU, Barb.
A-frickin’-MEN!!!
POSH has a SW I'm unimpressed with.
I agree with not giving YOUR contact info to wherever MIL lands. DH can be the go-to. I notice it's NEVER the facility that calls with issues, it's MIL.
How SIL can still have the energy to jump up to answer every single call and try to make EVERYTHING just fine for MIL has, for a LONG TIME, been beyond my scope of reasoning. She's not going to change--if she ever returns home, she'll be micromanaging from IL. Or calling DH. Stand your ground on that one!
I hope tomorrow's meeting goes well. I hope you find some answers and I REALLY hope that SIL and DH can land on and accept the dx of a rapidly declining mother and realize she ain't gonna live forever. AND that she is going to be sad, and mad and probably blame them for everything until the day she dies. And to realize that is NOT THEIR FAULT.
I grew up with a mother who blamed us kids for everything that went wrong in her life. Luckily, we all broke free of her and came, at some point, to realize that she was very manipulative and selfish. It took some us MANY years to see that--but we all did. (YB is still kind of in denial, but he's getting there).
Dorker--you are going to have to be the tough one tomorrow (and ongoing, too) I truly think SIL just cannot, cannot accept that her mother will not totally "come back" from the things she's been through.
The "beauty" of this forum is that all of us who have been addicted to it, is that we have a point by point "book" that takes us from day 1 (so to speak) of MIL's decline to now---she is a whole different animal now, and most assuredly not for the better.
There's no one for her to be mad AT...except herself for lousy money planning--sadly, getting old is expensive and not planning for it makes for a depressing end.
Good that a counselor came by. It takes PATIENCE and TIME for people to make this enormous adjustment to living somewhere they don't want to be. And don't expect MIL to retain much of what is told to her--she is not "herself" any more. Nobody's fault, even if it were, what could you do? Poor SIL, trying SO HARD to land on a "diagnosis" for MIL's really rapid decline-when the answer is this: she's old. She's worn out. Her brain is not functioning the way it did 40 years ago.
Did these 2 kids never think their parents would die? I think that is a problem with narc parenting. Once the parent is sick or unhappy--the kid is unable to be happy either.
I personally hated that old saying "If Mama ain't happy, ain't nobody happy". Really?
Good luck tomorrow. I do hope a plan can be set up that is workable. I don't actually KNOW what this whole meeting is about--but you, Dorker, can keep the monkeys off the trapeze and in their seats and paying attention.
Holding my breath for the outcome!!
I love this!!! Dorker, you are the perfect monkey handler! (BTW, what time is the meeting? We'll be anxious to get your report!)
Midkid is right about MIL being the one to make calls. And I've been thinking about that. Some time when you are at POSH, you need to stealthily get her phone and DELETE your cell number from her contacts. Just as the facility will do it if you let them, MIL will be calling YOU nonstop with her complaints once SIL departs for IL. (At least, I think she will...unless she is so out of it that she thinks SIL is still in FL?) Regardless, you need to extricate yourself from their phone loop -- H needs to be inserted into the phone loop. Also consider re-blocking SIL from texting you (I'm assuming you unblocked her while she's in FL and you two have been working together for MIL?).
You do not want YOUR neck in the leash of whatever facility MIL is in once SIL departs from FL. The facility WILL place your neck in the leash, and YOU will be the one they start yanking when they need to get ahold of someone. Even if you are not POA, they could see YOU as the way to reach H. And they always will try to get the local contact first. I guess you could block their phone calls, but in the event it is an actual emergency, maybe you'd better not.
As well - “That’s not really an answer, is it?” and it’s cousin “That’s not really a plan, is it?” When told someone will get back to you - ask “who will that be?” and “By what day can I expect an answer?”
Write down everything. Not for you - but so they see you are documenting.
Lots of good patient advocacy advice floating about. However, as brutal as this sounds, if MIL does have dementia leading to ALZ, as it appears with her rapid decline, perhaps a hands off attitude is ok. If something like pneumonia comes knocking, dehydration will allow her to quickly slip into the cloudas long as she has no antibiotics (Tylenol makes them feel better). Is everyone on board with DNR at the rehab? Can you ask if MIL might qualify for hospice services now that she's had a broken hip?
The doctor wrote in the chart (?) ...supposedly... that all are to push MIL to hydrate.
Sounds like that is in fact occurring. Staff in and out pushing her water cup at her.
She'd already had, night before last, IV fluids through the night. The result, yesterday they had her "up". I don't know if PT was part of having her "up". But even being up period was an improvement. Had her sitting in a chair. That's new. Also yesterday, them helping her to the potty in the bathroom vs bed pan.
These, improvements .. via BEING HYDRATED appropriately.
I know as of today she did succeed in getting taken to PT. Amazing what can improve some with hydration.
I didn't ask but I assume her BP too improved with better hydration ... as that bottoming out BP was preventing the above before.
And as to keeping her from falls. Right now that is self directed as in ... she simply cannot get up (recovering from broken hip) without a lot of assistance, 2 aides.
Unlike before broken hip ... her advised not to get up unassisted.. doing it any way. Fell and broke her hip. She doesn't get up now, that solved that issue.
So, some of it ... sounds like there has been improvement.
Dorker, the thing is, these are all things that YOU guys brought to their attention. Why don't THEY notice these things?
As to hydration, when you first brought it up, they said "we can bring her water, but we can't force her to drink it". Why didn't they say "if the doctor orders it, we can push it"?
(Frankly, if the doctor orders Anything, they can do it--something to remember).
At my mom's NH, they noticed BEFORE we did that things were wrong. I remember once, they ordered a chest xray. Mom had pneumonia! She seemed fine to us. I asked her nurse who said "oh, she just seemed a little off".
That's the kind of care your MIL needs and deserves.
This should NOT be a widget meeting.
Look to law office sw as an ally when you need to get the hard questions answered ( is this the right place for mil to rehab; can you ensure her safety; what are you doi g going forward to ensure that she is safe; can you put away SILS toys?
My unsolicited advice at this point?
Tonight, take a last look at your list of questions - then tuck it into the file folder, go to bed and get a good nights sleep.
If I recall, you’re an early riser... enjoy your coffee routine with dh and have a good breakfast. Even if you’re not a breakfast eater - eat something. Dress in something you know you look great in - it’ll give you confidence.
Walk into the meeting remembering THEY WORK FOR YOU! And, know that you are on the side of right.
I didn't get that one.
Have a lab appt for me in the AM and then will spend some time organizing some thoughts/questions on paper in the hope not to be treated as a widget.
Meeting is at 1:30 ...
Yes I can't wait to bring up the dried up feces on MIL's hands. What possible justification can there be for that glaring lapse in care?
DoNOT let them blow sunshine up your skirt while patting you on the head.
Dorker - if there is one thing I can say about you - having spent nearly two years reading your inner most thoughts - not just about MIL, Sil and dh, but your daughters, your son-in-law, your grands, mental health, church, your parents, your brother, poor electrified teenagers and a whole lot else... is that you are one sharp cookie. Kind hearted as well, for sure. But definitely smart, smart, smart - and tough.
You know you’ve fought bigger fights than this one - and lived to tell the tale.
I suspect sil has the fear that MIL will get 86’d from POSH and wind up back in her tired, old lap. That’s not going to happen, btw. But I do not understand your trepidation. You know POSH is in the wrong. You know what needs to be done. You know you are right.
You’ve got this.
POSH will try to keep on as they have, “encouraging” her to drink, maintaining they are giving good care. She’s fallen, been treated for dehydration, had the incident with her constipation and BP, so they’re in CYOA mode with these mess ups.
SIL and DH will maintain the idea of anesthesia induced confusion, because this theory allows them to continue to believe she’ll be back to herself...it’s temporary. And they don’t have to think she needs NH level care. Everything they say will be with the goal of keeping her out of NH level care.
Your role includes getting POSH to have explanations for their mess ups, a realistic, viable plan for her care, and acknowledgement that she has cognitive issues that must be factored into their plan.
Your role includes getting it in front of SIL and DH that you all know MIL is having cognitive issues, REGARDLESS of which cause one choooses to believe. That she needed a lot of help at SILs house. They need to take the next step, which is listing all the things she’s having problems with, and coming to the acceptance that NH level care gives her the attention she needs.
You’re not a widget. You’re the keystone...you have the clarity and knowledge to move each party to that common place.
If MIL continues to go to outside doctor appointments once SIL is back in IL, H is going to hate it....as in REALLY hate it. I go on the NH's transport with my mother (they told me I had to; perhaps could have argued that, but it doesn't really matter to me). But I do have to get to the NH ahead of time, wheel my mother out to the main entrance when the transport van arrives, etc. The transport van is $65/RT -- I ride for free.The NH gives me an envelope with all of her information. And then of course do it all in reverse.
But, as I said -- it takes HOURS. I get paid, including my travel time to the NH and back (25 minutes each way). But I still try and limit these trips.
Dorker, since MIL hasn't been officially deemed incompetent or dx'd with dementia, do you suppose she will be at the meeting today? Of course you do NOT want her there.
Dorker, you might want to call or have sil call - to tell POSH you DO NOT want them to hauls MILs frail, injured backside to the meeting today. Sure - you could do like last time and stay after sending MIL back to her room but 1. - the time having MIL there will eat into the time you all need to hold POSH’s feet to the flames and 2. - if feeling hydrated and sassy, MIL might kick up a stink with the whole “This is my life your talking about...”. It would make it so awkward and most likely throw a dark cloud over any gumption sil and dh may have worked up towards being truly backboned helpful.
Had to go do my lab work this morning (doctors and their requirements!) .. and then ran back into the house . .for a cup of coffee (how does one start the day with no coffee .. it's horrible). Then off again, . .to go to 5 yo's science project presentation at school. Wow they start early with these kids .. I don't think I had to do a science project til middle school.
So now back home and gathering my thoughts .. as to what are the pertinent points I want to make.
I think probably hydration .. while it does indeed bear mentioning . it's not . not presently as pressing . .as it does seem that staff are reminding her . but not only that, . seems she too has an awareness now (amazing what happens when one is better hydrated). Seems like maybe she was brought to baseline or better perhaps .. via IV .. and from there .. she seems a little more lucid and is definitely better able to be "upright" .. and so that's grand. But not only that .. she herself is reminding staff .. "I need more water, I've finished that one cup".
So that .. at least for the moment, seems to have a better handle on it, thankfully. And that . that one issue . so crucial to it all .. seems to have answered to more .. she can now get "upright" to be able to be participatory in PT .. so crucial. But yes, what are their goals . as to OT and PT .. dressing/grooming, bathing .. ??..... what?
Indeed, . what is their observation/concerns they've noted as to cognitive issues?
I'm sure that one will get spoken to with a (move along widget) .. "We aren't sure at this point, as to her cognitive issues .. how much is residual from the general anesthesia . time will have to answer to that". I will . most definitely . get it on the table, whether MIL is present or not .. I DON'T CARE .. "these cognitive issues, while worse at present, were also present prior to hospitalization.
I'd like to ask the question about what are their "plans" ........... "actionable" plans . . to keep her safe. At one time, . that was seen in the fact, she was getting up out of bed . against their instruction. That resulted in a broken hip .. so on the one hand, you'd like to hang that question on "what are you doing to keep her safe" .. as relates to the getting out bed . .but that's not a factor at present .. she can't get up out of bed . not presently . without 2 aides . so it's kinda senseless to frame it in that context.
But what are you doing to keep her safe .. as in .. digging at her rectum . through the night . and dried feces on her hands?
Of course, with her being better hydrated at present .. the likelihood of being impacted is lessened .. thus .. digging at her rectum . maybe won't be an issue going forward .. I'm sure will be their answer. But I want it on the table, if for no other reason . than we are "AWARE" she had a woeful lack of supervision and care at that point, that she'd be in that predicament . and no one speaking to it.
Just as an aside .. SIL questioning . when I was on the phone with her .. with this whole dehydration thing .. (always feel like I have to reel her back in) ... her question: "Dorker, do you think she dehydrates faster than anyone else, because of her Sjogrens disease?".
Me: "I don't know, but in the end, it doesn't matter . the fact of the matter is .. she dehydrates . we know that, we've seen it 2 x's thus far . and it's a common problem in the elderly . and .. the fact remains . depending upon her . at least when she is dehydrated to answer to that . it's not