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:
This hearkens back to, but this time I'm not as over wrought . the days when I was trying to point out the finite issues that indicate MIL is "NOT" managing and no one would listen to me. SIL waltzing back to her life in IL to direct from afar, in those days. DH waltzing off to his life . and his "wants and resposibilities" sans the FIXIT stuff .. and all .. not "looking" at the elephant in the room. Refusing to see it.
I do think that time frame . .all of it .. was about enough to drive me off the ledge.
Now . having worn that hat . and worn it out .. along with the holes in the tee shirt to prove it .. I am not as overwrought.
What I see . my perception of what's going on .. they are all whistling into the wind.
MIL will likely not be able to sufficiently rehab back from this broken hip. Does she want to, does have the will? That's debatable. But what I do know is that her peripheral medical issues (ongoing) prevent some of that. She also has more cognitive impairment (Dementia damnit) than either of her offspring wish to recognize/acknowledge.
I point out to SIL . just in passing .. that her mom .. much like other dementia patients . fixates on issues and doesn't relent (the whole heart break of all this going forward), and plays it like a broken record. She does that, yes.
SIL: I know, . she really does .. but ya know, I probably would too if I were in her shoes, it can't be fun sitting in a bed, or a wheelchair and you know you have absolutely zero control over getting up to get what you need . and have to wait for someone to come help you . and it sometimes takes too long for them to come . and sitting in a wet diaper . because they didn't come ... I probably would fixate too if I were her . on how my life isn't worth a chit anymore".
She and I see it differently. Very very much so. What I see, perceive is someone who doesn't have the sequencing ability any longer to even look at the bigger picture . that life is gonna be what you make of it .. that yes . she's gotten old . and yes this is all an enormous struggle, but .. it's what you make of it. She doesn't have that capacity any longer! It's not there, it's gone .. it's absent in her ability to think. What I see, what I perceive is someone who doesn't even have the capability any longer to put the pieces of it all together .. "gee .. ya know Dorker was telling me . the more they have to get me up out of this bed to go to the toilet . at least it's something to help me be stronger . maybe I should buzz those nurses again .. so I can get outta this bed to go pee . no .. I'll just pee right here in the diaper. They keep telling me to drink .. drink drink drink .. that I have to stay hydrated. That doesn't even dawn on her folks . it's said over and over, ,and as quick as it's said, it's gone from the memory bank.
SIL would hang all the above on . ."yea I'd be miserable too .. it must be hard to be stuck in a bed or wheelchair, can't get up to do what you need"
Well damnit SIL . if she doesn't begin to do what is needed to strengthen . she's going to get weaker and weaker . and don't you see it, she can't .. the bouncing ball to follow the points in all this are G.O.N.E. in her brain . they don't exist.
So to keep stringing her along, dehyrating, BP dropping out . .. her unable to PT sufficiently to rehab .. why?!?!??!!? Why do that to her?
I have to .. and mostly I do . find a way to be as *okay* with it as I can be. Because nothing I say changes it.
SIL hasn't told MIL .. "now you musn't say you give up . not here at POSH . you can't say that".
That hasn't been said to MIl . it's been said to me ... as I talk of Hospice .. but not to MIL .. "now you musn't say that til you get to LTC". It would be pointless to say that to her, it'd be gone from her memory as soon
as soon as it's said.
SIL says that to me . as I speak of Hospice. "She can't . not in POSH . it's a straight rehab place . .not an LTC ... if she wants to do that when she gets to LTC .. it's up to her .. there they can call in hospice if that's what she wants . and hospice will engage there with her (I've asked that in our travels visiting sites, that question has come out of my mouth and in her presence .. at each site, "will you guys allow hospice to engage with a patient here if that should be a request").
So SIL hangs it all on .. LTC going forward . hangs it all on . "the doctors, SW, the PT . they all say she can recover".
DH ..???...he does as he always has done .. goes to see her (more frequently than used to be the case) . .. but absolutely zero as to weighing in any direction and/or taking any initiative with any of it, zero.
Her days are numbered there at POSH. A tentative release date had been mentioned of 4/15 .. fluid somewhat . .. ??.....somewhat anyway. But . should LTC come a callin with an open bed . they have to take it . and yes even if before 4/15 ...
I think SIL would like to, . she's made mention of it .. buy a few more days at POSH to the extent her insurance company would sign on for same .. her mentioning the following: "I wonder if the fact that she arrived here, low hemoglobin and had to be carted out for transfusion, then dehydrated .. all negating her ability to participate in rehab for like a week . would that buy her add'l time here ..?".
To my answer to her: "I don't know .. I mean . if they call, the LTC . ya gotta take it . so I guess we'll see what happens as the 15th draws closer".
At some damn point the days at POSH will be over . and at that point LTC will be her setting . and so we will see at that point where MIL's mindset is .. as to "do ya wanna live . then fight to live .. or do you wanna die . and so . .what Dorker has been harping on .. I guess we'll call up the troops on that issue".
That's kinda how it hangs at present.
I just have to be as "okay" as I can be .. w/status quo, that's all I know, and for the most part .. it isn't as maddening to me as it once was when I would've never dreamed I'd of been ignored . for my front line to it all for so long. But ignored I surely was .. and routinely.
I've gotten used to it.
I understand that you love her. And that she was a good grandma.
But right now, her future is in her children's hands. And unless they give you some agency, you really need to step back.
The only thing that I would do in this situation? I would talk to the NH doc about whether hospice was an option. If S/he tells you yes, you have an option to toss into the conversation.
Otherwise, I'd visit and pat her hand and step back.
These folks need to figure this all out for themselves.
Many drs do, they simply don't talk about it. MANY Drs. have "aided" terminally ill patients into a painless death by ODing on morphine and the family doesn't even KNOW. My FIL's oncologist did just that. God bless him for his compassion. Dad was drowning in his own fluid filled lungs. My DH didn't know this for YEARS.
MIL sits in a wet diaper because she doesn't CARE anymore. I don't know why, but the fact she will pee herself several times over and not bother to ask Dorker for help to call the nurse, just sit there and be 'content' with that as staus quo--she is NEVER and I mean NEVER going to rehab past what she already has.
And there is SIL, begging for ANYTHING but the truth "It's a UTI, right? was the first time I thought "this woman is not playing with a full deck".
Now it's "well, when they brought her in she had low hemoglobin so she should get an extra week of rehab"...."I can't have her brought into the NH through the side doors because she'll see slumpers and that will make her unhappy", The drs and SW and PT say she can rehab!" (OH COURSE THEY SAY THAT--THEY ARE PAID TO SAY THAT!!!!")..these crazy thoughts go on and on...
String all of SIL's pronouncements into one long post and you have a woman who is NOT in charge of her mental faculties as far as her mother is concerned.
Truth:
MIL is not going to rehab this broken hip. She may or may not be moved to a LTC facility in a week or two, but her care will be lessened and if she refuses or fails PT, she will be bedbound and that IS a death sentence. She has to want to get better, and honestly? she sure doesn't act like she wants to.
SMH at the whole family. (Not you, Dorker--but I hope you take a couple days off from the depression on visiting MIL.
Somebody has to stay strong and healthy. It's going to get worse, before it's 'better'...and the 'better' they want isn't the 'better' that's likely to happen.
My mom too behaved just like MIL and became rapidly diaper dependent. I was disgusted when she sat there peeing when I was right there, just like you were! And she explained that it was just so much easier. And in mom's view, staff did not care and even expected it... cause it was so much easier. For both mom AND staff. I actually searched AgingCare and read about this rapid diaper dependency as being a serious flaw in some facilities - that it is almost subtly encouraged by staff. And both MIL and my mom are the types that just love being dependent and taking the easiest way. "It's just too much trouble... Just so hard..." They LIKE the diapers. Kind of bratty behavior, and they simply don't believe anyone who tells them about consequences of such things. Some folks are just like that - always choosing the easiest way. (That's the conclusion I've reached, anyway.)
I kind of agree with SIL that hospice can wait til placement. It can't be long now. Funding will run out. And hospice in my experience can start almost instantly, as soon as the word is go. Once mom was moved to family place, the diapers were simply cut off during the day, anyway. They were tougher with her, saying that all are expected to be dressed and go to breakfast every day. And no diapers (they were great with bathroom attending and with clean-ups if accidents did happen.) Mom complained about having to dress and leave the room, and she initially whined about having the diapers, but she did adjust and re-learned at least the dignity of real pottying and dressing. AND she did become a bit more social, and even made a few friends. She cared more about her grooming. The whole thing resulted in a more loving, serene, and dignified end-of-life experience. I pray MIL and your family can experience the same, once MIL leaves POSH.
MIL only one morning bout of Chitapalooza. Now only needs 1 aide to ambulate not 2. Was able to go to PT. Actually ate some of her lunch and even seemed to have some awareness as to that water cup and consuming it's content. Has been switched now from diapers to Depends. The midline IV slated for removal because of prompt via SIL, otherwise it would have been completely overlooked and not addressed so it's said.
Today is another day. We shall see.
Word has it, church lady headed up for a morning visit. That one should begin to prove interesting as MIL has begun to whine some that church lady comes, tells her all these stories of what this one and that one did as to the sagas with each (I'm sure, her attempt to show MIL others and their challenges and how they were dealt with respectively) to MIL now voicing some of the following to all of us as to church lady visits
MIL: She comes here to visit and wants to tell me of this one and that one and how they each dealt with things *I don't give a chit*.
And no we don't put it past her to send the church lady packing ... it could happen with her.
There's reason I only go a couple times a week and don't generally stay very long. That's going to be my involvement. Just a visitor ... nothing more.
I have my limits, though, and won't do that (I did it once and was ordered around to do this, do that, and she gets angry, so no more). I did go out in the hall and got a CNA to come in and help her in the bathroom.
When I'm not there, I'm not sure what happens. I think she wheels herself out into the hall sometimes and gets help. Or (more likely) she just goes in the pullup. She either forgets to push the nurse button, it's too hard to get herself over to where it is, or she just figures it takes so long that it's not worth it.
Just hearing what you encountered yesterday, so similar to what goes on, on this end.
The more things change, the more they stay the same. Yesterday morning, all reports were that it was to be a "good" day .. an "okay" day, so it sounded. Church lady going to visit, .. that meant .. at least to me .. that's the purpose anyway, or one of them, so I would think. Church lady going to visit . that means that SIL and DH . can maybe not rush to get there, she will have a visitor in church lady.
DH and SIL did just that.
DH had gotten up yesterday AM ready to head there to visit his mom, when I let him know church lady was already on her way. That meant, he could utilize his time in other ways . and maybe consider a later visit in the day. Same with SIL . .and she chose to do the same .. she'd go see her mom after lunch .. and visit .. DH planned . he'd maybe go about dinner time and visit for a while.
I went on with my day which included taking the 5 yo g'daughter out shopping with me . and then to a local production of a play.
Was maybe just a bit after lunch time, me and 5 yo . out and about .. and I get a text from SIL . who'd heard from her mom. Instructed to not bother coming to see her at all for the day .. that it hadn't gone well, . her unable to get "up" for PT .. that low BP problematic. She'd done some PT . but not anything that required she be upright .. and .. so .. sounded like .. as SIL put it ... "She sounds so depressed . just doesn't even want me to come see her at all, and said the church lady stayed a long time, and she's tired, wants to lay down and sleep for a while".
I answered that: "Maybe she'll feel differently after she rests ... maybe leave her be and check with her later".
And I went on w/my day.
Took the 5 yo, she and I went to a play for the afternoon . and then I took her home to her mom and dad. Checked in with DH (it was now about dinner time) and he'd gotten the memo that she didn't want anyone to visit her, but he too thought . *maybe she'll feel differently later* . and so planned to keep his agenda that he'd go see her at dinner or thereabout.
I checked in with DH when I dispensed with the 5 yo . and he was at POSH visiting his mom. I asked how she was doing and the answer was "she's doing alright".
SIL somewhere in all that, letting me know DH was at POSH visiting their mom (I already knew that) .. and that she decided she wouldn't go at all, since DH was there, and since she'd requested earlier, to be left alone . wanting to rest.
So once DH got home . I asked him about his mom . how she was . .that she'd said earlier she didn't want anyone to come there . that she was tired, had he found her a little more rested and maybe willing to have a visitor. He said she was "alright" ... yes .. maybe rested a bit more. Said she'd told SIL that, . she tells DH . told SIL not to come . because they both agree .. DH and MIL both . that SIL is too .. far too .. over the top ... enmeshed . has only one sole focus in her myopic world and that is MIL .. and whether she eats or doesn't, . whether she hydrates or doesn't .. whether her BP is too low or isn't , .. on and on and on . that she'd purposely told SIL not to come . hoping . wanting . for SIL to go find something else to do . she and B .. go out to dinner .. go to a movie . go do something besides sit here all the time .. give yourself a break.
I find that to be more lucid in thought than I really see MIL .. I was surprised to hear DH report that was her objective in sending to SIL not to come.
The thought that MIL has enough awareness to think about others' .. and the impact this is all having ... and how much time/attention .. she is requiring (I would debate that SIL needs to back the h377 up myself) ... but the thought that MIL sees that .. and actually had the ability to try to head off any visit by SIL
for the purpose of trying to give SIL a break from her and all her woes .. I was really surprised. Maybe she has moments of more clarity than others.
I asked DH .. "did you shove the water cup at her repeatedly".
DH: "No .. I handed it to her a couple of times .. and she took a couple of baby sips from it . but .. she didn't drink a lot".
I deduce from that .. he is not a minder, . never has been, never will be . and maybe his approach is the healthiest. He's not gonna sit vigil . and shove a water cup at her .. repeatedly . just not gonna do it, even if it means she isn't hydrating appropriately (as we know to be the case)..
He said her dinner tray came and that he helped her a bit with it . but she didn't really eat much . maybe 1/4 of what was there if that. Asked him if he tried to coax her to eat more and no .. he didn't ..
He said she had mentioned needing to go to the bathroom but said something in the same breath I guess . about having a diaper on . and would just use that .. and he scolded on that point .. "Mom you have to call for help . that's not good to sit and use your diaper . you need to have them help you to get UP . and get to the bathroom". I guess her response fell somewhere along the lines of "It just takes them too long, I don't want to be a problem to them, they are short staffed or something". Him scolding again, "that's not your problem, that they don't staff like they should, you need to call them".
I guess in the end, she utilized her diaper.
I questioned .. "SIL said they have her in Depends now, not in diapers".
He didn't have an answer to that, other than to say that no .. she had on a diaper, not Depends. Didn't know why/how. I didn't ask any further. SIL would, she'd be all over that and wanting to know why the Depends have been nixed . .and making sure that's now part of the bigger picture, not diapers . and SIL would've been all over it with the water cup . and SIL would've been all over it with the meal and coaxing her mom to eat more.
DH talking of his and his mom's conversation that both .. clearly see .. that the sister is over the top enmeshed (he didn't use that term I did . and I did define what he was saying, .. with that term, . DH the term is . she is too enmeshed . she doesn't seem to have any clear boundary of where her mom begins and she ends). Him talking of his mom's and his conversation on that topic . though the term they used was that she is there .. "every day" .. and she is too involved" and too the exclusion of anything else.
Sounds like the mom and he both wish she'd back it up a notch . maybe come every other day, not every day. I asked of DH ... "do you plan to talk to her about that?". His answer: "Probably not . can't do anything with her, she's gonna do what she wants".
I pointed out to DH .. "same as it ever was DH .. she always thinks there is gonna be a fix .. always has . always will ... her presence there, she's gonna see to it that IV is taken out .. and question/lament why they didn't address it sans her involvement, . she's gonna try to 2nd guess the docs on the meds . and are they the culprit as to the too low of BP . she's gonna push the water cup incessantly, push the foods incessantly .. she's gonna see to all the finite detail .. making sure her hair is rolled and set . making sure her teeth are brushed . when your mom could care less . it's not on her radar .. same as it ever was".
I told DH . that M and I have had this same conversation that we both also see that SIL is too enmeshed . always has been .. and that I had tried . with M anyway . .since she does seem to "listen/heed" more of what's said coming from M .. that I'd tried to get M on it . to see if maybe she could talk to her mom and get her to back up some. M had basically said she'd try . but no one is gonna be able to do that but her mom . decide whether she can build a life for herself . outside of all this .. and go
And go on with her life .. that M seems to see, as do I .. that her mom . has been too enmeshed . for far too long, but she also has some realization that her mom has to change that for herself, no one else can do it.
DH: "Maybe she feels guilty .. maybe she just feels guilty that poor mom .. this is her lot".
Me: "Guilty for what? She's been a part of her mom's life in large/huge measure for eons here .. to help keep it all propped up .. guilty ..???......she's got nothing to feel guilty about other than . maybe TOO MUCH involvement .. ".
No answer from DH.
The more things change, the more they stay the exact same. SIL .. with all her whirligigs and spinning plates in the air and running the hamster wheel, . it hasn't changed . only the setting has changed. It stays the same.
DH . he goes and visits more now than used to be the case, . which is a good thing ... but he isn't gonna get into the minutia of it all . and maybe that too is a good thing . he isn't one to become too enmeshed . he just isn't gonna do that, not in his makeup.
Me, I go on . and intend to do just that, .. living my life . as I did yesterday. I will go see her a couple of times a week, where I can fit it in .. and I don't get over-the-top involved with trying to hunt down docs and CNA's and PT personnel . and hit them with inquisitions and 2nd guessing.
The green chairs all of us. I don't get mad anymore, . not really .. at SIL's over the top enmeshment . that green chair, .. expecting it to be a red chair. I get mad if it's asked of me to do so . and it isn't . (but she ain't gone back to IL ... not yet ... I'm ready for it, it's coming .. and no .. SIL I won't go up there and be there when the doc comes in to 2nd guess what he's doing and question him, no I won't go up there and hunt down the PT personnel to find out why they didn't do thus and so . and no I won't go question the nursing staff as to why they took away the Depends and opted for diapers again .. not gonna do it).
My approach maybe closer in resemblance to what DH's is .. I just don't get stuck in the mire of it all . as he approaches it.
DH talking of some of their conversation .. he and his mom . that his mom putting voice to . the pondering of what happens next . that she doesn't know what she's supposed to do .. her next going to LTC . at some point in all this . and what does that all entail . etc. He said he told her, .. "You can't look at the bigger picture, you need to focus on the here and now and do what you can here and now to get stronger .. that's all you need to focus on for right now".
I don't know what her response to that was, I didn't ask.
Was glad he was able to visit with his mom . and the sister not there . and that it worked out in such a way that the sister didn't make it there at all yesterday .. having to stand down . at least for that one lone day (rarely happens, if ever).
Found it just a bit interesting that he didn't see any need to (not that I'm aware of anyway) .. call his sister and report, "Gee Sister they have her back in diapers . wonder why that is, do I need to get to the bottom of that, will you call them and find out what's going on with that". Nope . just kinda blase .. to him .. in fact, I was the one that kinda just raised a bit of question in talking to him on it, "thought they'd put her in Depends now . that's what SIL had said". It didn't raise on his radar at all . either way.
Oh well, Sundays are typically very very bad days for MIL . she knows they are short staffed on wknds . she knows there is no PT/OT . on Sundays . and generally she nose dives into pits of despair on Sundays. So .. I'm sure SIL will spend her day there, . in large measure.
SIl wanting me and her to sit down . we have a meeting with the para legal later this week . and need to brainstorm some questions we have, need to figure that out as of today.
MIL being kind of lucid and actually thinking through things is huge. Sad that she has accepted the diaper as "reality" is depressing (BTW, what is the difference between adult diapers and Depends? How much liquid they can hold before they blow up? Are Depends just kind of for 'accidents'? I should know this, but I don't)
How wonderful that DH, slow to the plate as he is--was able to talk to MIL about SIL's over involvement in her care. Seems like MIL is sick and tired of it--I love a lot of people, but I can't imagine ANY of them hanging around me 24/7 and I'd enjoy it.
Has her hip healed? Is that doing better? She can walk, when she can get up? She needs to be much more able bodied to handle the switch to a NH. I know that POSH has been a huge disappointment, and that is sad and frustrating. But I'm thinking that any NH she's in is going to be less hands on--and she can't HANDLE less hands on.
Well--it remains to be seen.
There will be good days and bad ones and nothing you do will change that.
I do have a feeling that the low BP is due to the CHF and the years of mismanaging that. Sadly, that just cannot be made 'well' after so many years of neglecting to control the edema. Now she is basically bedridden and that doesn't help. Do they get her up and into a chair for part of the day, at least? Or is she in bed unless actively doing PT?
Well, you are doing well to maintain boundaries, while still keeping in touch. It's sad, but nor surprising that MIL has not done well in the rehab place. Her personality is such that it would be pretty hard to work with her. Well--this is exactly where most of us thought she'd be...although I have to say, it took a lot longer than I thought it would.
Off topic, but still germane--I saw my MIL last Sunday and she is really becoming frail. I do not speak to her (her choice and mine both)...so I didn't. She was hanging on my niece's arm like grim death. I could tell she was scared to take a step without her. Since I know she lives alone and still drives...makes me think my DH is going to have to go see her and evaluate the situation. She has a home with a STEEP flight of stairs and very slippery carpet. Won't wear a 'fall alert' pendant, so she could fall and no one would know for days on end. She has only tubs as she dislikes showers, and I wonder of she can even get in and out of the tub. Neither DH nor his sis are very involved in her life...and I was thinking how much help I could be to her, if she hadn't hated me so profoundly. SIL works FT and has 2 grandkids to raise, no time there. DH has been off board completely--b/c she drives him insane...but she's still his mother. I see her in a similar situation as MIL with one fall...and there has been NO talk of what they'll do if she needs care.
I do think about her as I read your saga and I think "It will be a fall that does mom in....and DH is going to lose his mind, with guilt".
I think I'll put a bug in his ear about visiting her today. She's 89 and not a spring chicken by any means.
Hope you have a productive week.
Is Posh supplying the incontinence stuff, is that privately arranged for? Did anyone in the family supply Depends? (I don't know the difference, I just recall that after hip surgery, mom was in bed with just chuck under her for a few days, then diapers. I think Depends are able to be pulled up and down, so designed for someone who can assist).
Look, even after my mom was admitted to a SNF, there was LOTS to do.
I visited once a week, 3 hour round
trip, 90 minute visit, meant the better part of a weekend day.
My brother was POA, so he got the business (aka money) related phone calls and I got the medical ones. I was working full time and had a part time gig that I had to give up ( teaching grad school, VERY lucrative) but I was unable to keep up with both jobs, grandchild, housework and just BEING with needing to respond to the various needs. And this was in a place with on site doc, podiatry, dental, audio, psych, and dermatologist. Mom needed to be seen from time to time by pulmonology, derm surgery, GI intervention. Even onsite docs and services needed to be hunted down, recommendations looked into, callbacks. And as you can imagine, these folks ONLY called back either when I was in snowy driving conditions, as my husband was about to be put into an ambulance or when my 4 yo grandson has just announced in a NYC park that he had to poop.
Get ready for a bumpy ride and set up some boundaries NOW. The legal questions ( about paying off her credit cards etc) are just so NOT your job.
When my mother was in the SNF under the rehab classification, everything was covered. But once she transitioned to private pay LTC (same location, same bed), the charges started racking up, and we had to pay for everything. The pullups had a huge markup, so I joined BJ's and bought them there. I'm guessing it's the same for Dorker's MIL -- that since she is classified as rehab, it is all covered by Medicare and her secondary insurance.
Midkid, my MIL lives in an old house with steep stairs, also (not to current code). And she keeps stuff ON the stairs! She has trouble walking, refuses to wear a call button, etc. The only full bathroom is on the second floor. Years ago, an addition was made to the first floor to add a huge dining/living area, a sewing room, 2 bedrooms and a HALF bath. That should have been a full bath added!!!
So this morning, SIL and myself texting (I was getting ready to leave for church, no time to hang on the phone). Trying, the both of us to work out the logistics of trying to get together, she and myself, to brain storm a list of questions for the para-legal this week.
She was firing off questions to me, about when today that might be good for me, vs what's on her radar for today as well as a couple of the questions we've already thought of as to the para-legal and some of that, when she also inserted this statement/question:
SIL: "So I think I'll head up to see mom about lunch time, thinking maybe I can take Poochy for a visit ..???...".
The above was one of a series of other questions in that same conversation.
I answered her questions she'd asked .. all of them .. except the above, .. I purposely didn't weigh in and speak to the above .. a purposeful ignoring on that one, on my part.
Why?
She has tried to take Poochy for a visit a couple of times in the last week or so, but it seemed something always came up that negated the ability to do that, . either she had somewhere to stop on the way or on the way back, or whatever . something coming up it seemed every time.
And in the midst of all that .. MIL had also made noise to SIL .. "don't bring Poochy anymore, it hurts too much to see him, . since I know I won't be seeing him anymore".
MIL has made that statement to SIL, 2 x's that I know of .. maybe more that I don't know of.
So her asking as one of the series of other questions we were covering .. about taking Poochy.
My thoughts . but I purposely didn't weigh in ..
She has told you it's too hurtful to bring poochy for a visit .. just stop it .. she's asked that you not do it . why are you asking MO ... if she's asked you to stop bringing him . .then stop .. he's not one of your famous whirligigs that somehow spins all this in a more positive light, even though maybe that's what you're attempting to do . just stop ..
If I had responded it would've been along that same thought process, but I purposely didn't. I didn't weigh in on that one, I answered other questions we were batting back and forth, but that one I didn't speak to. Until ...
SIL texted a bit later .. "Just spoke to mom on the phone ... told her I'd be heading up that way about lunch time . .offered to bring Poochy and she told me not to . .it's too painful to her to see him. Sad, I feel horrible for separating the two of them, she loves him so much!".
At that point I did weigh in: "Try looking at it from her perspective . she's trying to come to grips with what her life will be going forward from here, and Poochcy . much to her sadness will not be part of that equation. His presence is a stark reminder of what she's loosing in all this . and yes, I can see/understand, that it's too painful for her. Why don't you not offer anymore, to bring Poochy. If she asks . I guess . then yes . but unless she asks . just don't bring him up there anymore, and don't offer".
Her answer: "Yes I can see that, I can understand .. I just feel bad that she will have to part with him . when he goes with us . and not see him anymore .. and she knows that . or not hardly at all .. he's meant so much to her thru the years, she loves him so much".
My response: "She could've chosen .. to stay in IL for placement, where Poochy will reside with you, which would've afforded a better ability for him to be carted in to see her routinely . she didn't want that option. Nothing you can do to change any of it .. just leave it be and don't offer anymore to bring Poochy by at POSH . just leave it be".
SIL: "you're right .. I can understand . I'd probably feel the same if it were me".
I guess another one of SIL's spinning plates that she thought might bring a ray of sunshine/fix to all this, bring Poochy by, even tho MIL has asked her not to.
Yes, MIL is gotten up throughout parts of the day to sit in a chair .. and then put back in bed (at her request . or assisted back and forth) .. she doesn't just lay around in the bed all day long.
She can't walk on her own . .at all. She has a walker . and if she's even able to utilize it (sketchy at best) .. it's with the assistance of someone with a gait belt . and another spotter behind her w/a wheelchair. But her ability to be upright and walking . is sketchy . and usually negated a lot of times, by her low BP.
She has to have assistance, to even get "up" out of the bed and/or "down" back into the bed or a chair .. she can't do that on her own.
Why am I doing the para legal stuff. I guess the best way to define it .. a brain trust if you will . I don't know.
Sometimes it's a matter that questions get asked and answered . but later .. one doesn't remember (that's what notepads are for, but maybe note taking skills aren't where they should be, on both our parts . .??....) .. so maybe later one will say to the other, "what did they say when they asked us about ___________, I don't remember what they answered to that, do you".
And one or the other of us can answer.
Or .. maybe one question asked . begs another that hadn't even been thought of, as seems to happen a lot of times, as she and I tour facilities and ask the appropriate questions.
Why isn't DH the other half of this brain trust if you wanna call it that?
He just isn't all that engaged in that end of things. In fact, I was telling him some of the questions that SIL and myself have already . that we need to be asking and his take on those questions, .. "I don't know .. Good GOD . how do you guys even think of these things to ask .. I hadn't even thought of that".
One of those that we posed .. going forward .. MIL has her checking account, from which all bills have been paid .. all along. What happens to that account going forward ..
At some point . we are in "spend down" mode . as to her reaching that all important "$2k" in assets, no more .. or she doesn't qualify . that's in .. at the moment, . and a trust will be formed ..
So .. ??.....where does that checking account go?
Presently .. it's imperative there be a checking account ...
BECAUSE .......... (of all things high maintenance MIL) ............ she wanted the hospital that does not accept Medicare assignment ............... that's where she's been for hospitalization.
What that equates to in the end . Medicare then sends checks to MIL .. and those checks then get forwarded to the hospital ..
SIL presently fielding all of that .. as the checks come in from Medicare .. seemingly daily . and she has to make copies of them . as Medicaid . ultimately . may be asking .. "I see all these deposits being made and transactions . what's all that" ... all of it the result of MIL having chosen a hospital . that doesn't accept Medicare assignment . and so the nightmare that has ensued in managing all that . and SIL at the helm. Checks still come in, to this day . from all that . and so she's having to make copies of the checks . and then deposit them into MIL's checking account, . and make note of what is paid, etc. So that if .. later in all this .. Medicaid comes along .. as we work to get her qualified for Medicaid .. "what's all these deposits" . she has adequate explanation. But closing that account .. would be really troublesome, at this point. So what to do?
That just 1 question.
Well, he needs to be because theoretically, SIL is leaving in the next month or so. When she does, he’ll expect you to keep things moving because he doesn’t have a clue what’s been said or done. And he’s shown he’s doesn’t want involvement in the nuts and bolts of it all.
The lawyers team deals with this all the time....let them lead the discussion with SIL and DH, and you be conveniently absent.
There are plenty of people in nursing homes who have no one local, and the person in charge is only available via telephone. SIL will remain the person in charge, as Dorker's H is not interested in doing that. So SIL will call the staff and try to activate the whirligigs via remote control. The staff will (or won't) deal with her. They will quickly tire of her.
I see residents in my mother's NH who have at least one family member/friend with them nearly all of the time. One woman spoon feeds her mother all her meals. Another stays at night until her mother falls asleep. The nurse was with my mother yesterday when one of the family members or friends of the resident next door interrupted the nurse. The nurse had to tell her that she was with another resident right then, and couldn't help the other other resident right then. I bet that is what SIL would be like. And of course that is just what SIL is NOT going to be like once she goes back to IL. If she wants to be that kind of person, then she really needs to move to FL. Dorker will no longer be her puppet on a string and her brother will refuse to do it. MIL is just not going to get the kind of care that SIL seems to think she is entitled to with her being in IL. She will have to eventually accept that.
Meanwhile, Dorker is the loving DIL who visits once or twice a week. She has nothing to do with the whirligigs, because she is not the POA and is simply a visitor. If the staff tries to discuss things with her, she can shut that down by saying she is not involved in that decisionmaking because she is not the POA. It is unknown how much her H will step in, because while he is also a POA, his involvement can't be expected to be much more than it already is. After all, he has a job and he will probably be getting back to the churchin', huntin', orphan campin', and missionary lunchin' routine. And of course there is now also the pity partyin' because it is all. Just. So. Sad.
My brother was financial POA. His wife has an MBA and we all implicitly trust her judgement. Ultimately, she was in charge of telling us if mom could afford stuff or not.
All three sibs had Medical POA, so any one of us could make decisions if needed. In fact, we all collaborated if there was a question.
Youngest bro (5 hours away, youngest by far (11 years younger than I and with minor children of his own) was always agreeable to whatever we decided.
POA bro took care of immediate response needs (ER? Bro P will show up --he also had the kind of job where he could say "later" and just leave).
SIL managed the day to day finances, insurance billing, reimbursements. (God bless her.....)
I was 90 minutes away and handled all the medical questions, appointments and stuff like that. In emergencies, bro and SIL would get to the hospital first; I'd show up 2 hours later and try to manage what was going on.
In truth, we were a well honed team by the time mom died, but it was torture while we were doing it. We ABSOLUTELY needed someone local (and that's why we moved mom from her lovely IL near where she had lived to a NH near bro and sil) so that in the case of ER visit, there was family nearby.
Dorker, I'm afeared that's going to be you.
We needed someone to handle the billing, legal, estate, etc. That was Bro. Is SIL going to do that?
We needed someone to visit who was close by. That was SIL.
The thing is, Dorker, my SIL, who loved my mom in a way that my brothers and I didn't (and that relationship was reciprocal) visited all the time and would call me to report of what she saw.
But the thing was, I never took what she saw as "need to do something about it".
There wasn't a directive to "do". It was "mom was like this tonight; wanted to let you know".
You NEED to become the eyes and ears that report TO SIL. And then SHE gets on the horn with the NH and finds out what is going on.
I think that ultimately you need to become the visitor and eyes and ears. If SIL keeps directing you from IL, you need to be able to say "I think you need to talk to the DON about that".
I hope this makes sense.
Although you 'know more' about the stuff the para legal wants to discuss, it's a slow drag back into being one of the chief players.
H is not stupid. He can learn this stuff, and what's more, he is RESPONSIBLE to do it.
I would not weigh in on it and I wouldn't go to any meetings for MIL. This should be SIL and DH.
Atty's have seen it all. You just need to take good notes. Likely the atty will have someone there to TAKE notes and put them in the binder with all salient info.
You're not POA, nobody is at this point, are they?
One more example of MIL's looming shadow overarching all the 'things'.
My Dh didn't want to be involved in his father's trust, and he had no clue what he was doing. BUT, he manned up and did it.
You step back into this....now you'll be involved b/c the legalities from this point on will only be more important. You're once again giving DH a pass.
So, let me translate . "I don't know .. Good GOD . how do you guys even think of these things to ask .. I hadn't even thought of that".
Translation:
”Good. You’re getting deeper and deeper involved in this. I can now claim total ignorance in everything having to do with my mothers care - and it will be true - Thanks to you allowing me to sit comfortably on the periphery again.”
On a positive note - at least for me, is B and Poochy. If ever there was a man in need of the love, companionship and devotion a dog can give - its B. I am ridiculously pleased that they have each other.
And - if sil really wanted to light a fire under mil to get her to show some interest in Poochy again - all as she has to say, the next time mil says it’s just to sad to see Poochy is “Well, that’s okay. Poochy is certainly not starved for love and attention- you should see how he and B have bonded. It’s truly heartwarming!”
You just summed up how I unknowingly became completely responsible for everything Mom.
My sisters words were” this is all over my head” , or “ I just can’t grasp all this” when anything Medicaid or financial came up.
When anything medical or a medical emergency came up she would become an emotional mess. My sister had a background in the medical field!
I was taken and didn’t even know I had been had until years into the mess. Then it was just “easier” to do whatever needed to be done myself rather than her flake on me at the last minute.
Dorker, I too wish DH was more involved in how this all works. Sure, to some of us it comes easier but it all has to be learned. Some family members just do not want to learn the ropes. That leaves someone to pick up all the slack.
I am assisting in the back ground, where asked. Visiting sites, atty meetings, progress reports.
MIL will ultimately land in one of the sites visited. That will be a done deal. If it's determined at that point, somehow .. site isn't sufficient, we've seen just about all there are in the limited selection. My advice to DH or his sister "take it up with staff .. I have no power here .. nor do I want any power".
I reminded SIL just this afternoon .. as we prepare to talk to para legal and a question I have. Will MIL be straight Medicaid as to her health care or keep her Medicare? And if she keeps her Medicare, what about the supplement. That gets funded how? And does she need to be, in the end, Medicaid so as to afford her the ability to be seen by in house docs .. because transporting her to docs that are on her plan, not on site docs, is going to become cumbersome and will be more necessity than as has been in the past...
In other words you better be picking the most expedient route for healthcare. Transport to and fro .. won't be on me.
All the above b'ground stuff will at some point become more resolved and settled.
There won't be any need for me to be in the b'ground or the forefront for that matter.
I'll just be someone who visits a couple of times a week.
Let's say at one of my visits .. I see/view an aspect I find puzzling or troubling in some way. I'll be glad to mention it to her son. Do I think he'll take any ball and run with it. No. He never has. If he doesn't care .. I don't either. Back to the "can't care more than they do" piece in it all.
Let's say SIL is told something from afar by MIL ... somehow she finds it puzzling/disturbing. If she comes to me, I can and will remind her to take it up with staff. I'm not going to be her stepper fetched. I don't have POA and don't want it.
I don't do any of that right now. SIL puzzles and inquisition staff on meds and possible Chitapalooza as result or too low of BP as result. Knock yourself out. I'm not asked to dial down on and track down staff as to inquisition... and if I were asked the answer would be no.
So yes I'm helping at present with b'ground stuff but all that b'ground stuff will one day be resolved/settled.
Where my beef, annoyance, discomfort, disgust - whatever you want to term my opinion - one of more or less both cyber stranger and friend - is dh ONCE AGAIN participating as little as possible. AND GETTING AWAY WITH IT - AGAIN!!! And yes - I do believe he is doing it by design and with purpose. He is KNOWINGLY throwing you under the bus, Dorker.
As usual - just my opinion.
I see why there is so little of her RM left. Guess she was expecting those wealthy kids of hers to fund the next couple of years....
Not to mention the bs nonsense sil goes through with the billing, checks, reimbursement fallout from mil just having to have what she has to have - the perfect campsite...errr...hospital.
Good thing sils been retired so she has lots and lots of time for the residual paperwork, copying and banking.
And - good thing B has Poochy for companionship.
Dorker, I think you are very wise to think ahead to what will be expected of you once SIL in in IL again. Because you can bet there will be expectations. Barb, your SIL had a different relationship with your mother than Dorker has with her MIL. Just curious -- how many days a week did your SIL visit your mother?
Dorker has stated that she doesn't want to visit MIL more than once or twice a week, and that she only wants to stay a short time and only as a social visitor. If she were to become the visitor AND the "eyes and ears" as your SIL was, Dorker's SIL would be trying to have Dorker steppin' and fetchin' once again. Telling H how MIL is is a good idea, BUT he will figure that if you aren't telling SIL, then he doesn't have to, either. And that is perfectly okay, but would you consider not even telling him unless he asked? If there is anything going on medically, the facility WILL notify the POA. Like others have pointed out, H is being primed to going back and doing nothing again. He thinks his pity partyin' exempts him from being involved.
Will MIL call you with her wants/needs? Or will SIL get all of those requests? I assume that SIL will not be able to break her longstanding habit of calling MIL multiple times a day. I sure hope she (SIL) won't then be calling the facility multiple times a day!!!
What will you do if MIL calls you, crying that she's so upset/lonely/scared/whatever? WILL she call you, Dorker? I suppose she will also call your daughters, but after a time or two they won't be running when she calls.
I just wonder how this is all going to pan out. I agree with others here who have said that the really tough parts of this journey haven't happened yet.
Let me tell ya .. she won't go to the one hospital .. Hospital A . which would really kinda be the default of hospitals as to its location .. because:
Her husband, ... had a colonoscopy . routine colonoscopy (Probably shouldn't of, he was 76 yo . and CHF far more severe than MIL's). There, .. the wall of the intestine was perforated, surgical repair, . hospitalized . never recovered. Brought home to *nurse back to health* (HA!) .. and soon . within days . it dawned on all, .. he's not going to recover, Hospice summoned. But he lingered, in that Hospital, Hospital A .. for about a month .. and so Hospital A, is off her list as to any hospitalizations for herself.
Hospital B .. used to be her choice . and she was hospitalized there a few times, until:
The last one ... "they fussed at her". Well I'm sorry but .. damnit .. her brain wasn't right even then .. when you are told not to get out of the bed (bed alarm) .. because you are a "FALL RISK" .. and so . .you need assistance .. and so they come to help you .. to get up out of the bed and onto the potty . and they instruct you .. "now don't get up .. we'll be right outside the door here, call for us . to help you get up" . .and you don't do that . and they peek in because it's taking too long and find you leaned over, prone forward .. as you are "UP" off the potty .. trying to get up . WHEN THEY JUST INSTRUCTED YOU TO NOT GET UP ........... yea, they're gonna fuss at you. IT'S A LIABILITY ISSUE FOR THEM.
As I told her at the time, her complaining that they'd treated her so poorly fussing at her (I wasn't there, I didn't see the indignity she would have you believe it was) .. "They don't really care .. if you fall and break your hip . whatever ... it's you that will live that horror .. but they do care about their jobs .. and if you fall on their watch .. and the liability of it .. they care about that, . they'd just told you not to get up .. without assistance . and you did it any damn way, yea they're gonna fuss at you.
Result, Hospital B now off her short list as to where she'll go if needing hospitalization.
That really only leaves 3 other hospitals here locally.
Hospital C, . not really geographically desirable .. but do-able I guess ..
Hospital D, .. indigent hospital .. every shooting victim or stab victim . or prisoner that has a medical need .. contained there .. along with all the other .. malcontents of the world ..
Hospital E, .. they don't accept Medicare assignment.
Hospital E, . what she's chosen.
So much of what SIL is complicit in, I would not be. Were I in charge, I'm not . I'd of let MIL know a long time ago, that Hospital A .. where her husband was so ill . doesn't mean that she can't get better there, and it suffices. OR .. even if I caved on that one, I'd damn sure not cave on Hospital B ... they fussed at you because you were "WRONG" ............. and they'll do it again, so LISTEN to what you're told.
I wouldn't be chasing my tail around my elbow as SIL is doing .. to try to handle all the b'chit of .. this banking . and insurance assignment . and so forth. I simply would tell her no. Something that has been woefully absent all her life, apparently. The word "no".
SIL has debated .. verbally out loud in convo with me .. as she contemplates leaving in May .. and these checks flying into the mailbox daily . checks from Medicare . that need deposit into MIL's ck'g account . and a check written to then pay the hospital .. and so forth, and record keeping of same.
Her debating out loud .. "what should I do, surely by the time I leave in May . all the checks to pay for all these hospitalizations will have processed through .. but I mean . .do I need to go get DH on the checking account, have him a signor on that account, forward the mail to your address .. so DH can handle it all, .. there isn't