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:
A consult with a geriatric psychiatrist and/or a neurologist would also help dial down on the cognitive impairment issue so that MIL's needs can be better accommodated i.e. would a dementia diagnosis then necessitate attended bathroom visits on a schedule per the facility's policy? Would there be a higher level of care be put into place there if they had that official diagnosis in hand? She would most certainly qualify for more accommodations insurance wise if the diagnosis was there to deem them "medically necessary".
I know you've hammered that point to DH over and over again, but I'd keep nudging in that direction, just remind him that if her limitations have an official diagnosis, then it will go a ways toward helping her get the accommodations she truly needs. Remind him that he is the boots on the ground here, so rather than leave it to SIL, who is still in denial about the cognitive deficits, he can pull the trigger to arrange for that consult. He might if he truly sees that it will help his mom.
Right. So don't waste the time trying to get them to do the right thing. This is their mother, remember. You know that you've wasted a lot of time in the past trying to get them to understand things, and it's all for naught.
I'm glad you are going to go on the trip, regardless whether or not H makes it!
I am going to go at this as I lived it.
Mom’s geriatric PCP described it to me much as another poster explained. There are circuits in Moms brain that no longer connect. He told me to stop trying to figure out and becoming SO frustrated trying to solve the problem of WHY she was doing the things she was doing. And I will add that my Mom was VERY good at coming up with cover stories. Just like MIL seems to be doing. “The staff is unpleasant, it takes them too long, etc, etc.
I don’t think think the thought is even crossing MILs mind to use the call button or the thought is not being completed.
Maybe someone here can chime in as to how being incontinent plays out.
Mom first just could not get to the bathroom in time. Even when she was still walking. The circuit still existed but apparently only for a few seconds then it would be broken and her body did what it needed to do. Mom’s excuse...she held it too long.
I wish a toileting schedule would work. I hope it does.
Something you mentioned...MIL was in fact at one point in the bathroom to change her own soiled pull up or adult diaper.
I am wondering if MIL is completely incontinent at this point but still has the ability to attempt to make excuses and try to cover for herself. My Mom did for a LONG time.
I’m kinda disappointed that the NH Administrator talked to MIL (scolded her) trying to convince her to use the call button and wait for help. 1) that person doesn’t know much about Dementia or 2) Dementia is nowhere mentioned in her records and that person thinks they are dealing with a stubborn person that can be convinced.
When my Mom fell in the NH, which was often, if there was the slightest chance she might have hit her head, there were neuro checks every 15 minutes for a designated amount of time. Then say every 30 minutes, and so on for 24 or 48 hours. That may be what you are seeing in the 2 hour checks at this point after the fall.
The falls in the facility are hard for the family accept unless they accept cognitive decline is at play. The family or staff can’t convince the broken brain. Attempting to lessen the risks is about all that can be done.
Moms facility used wheelchair seat alarms. That helped. They used bed alarms. That helped. They lowered her bed. That helped. They put her in a floor level bed. That helped. Finally they put her in a Geri chair. That was like a tiny recliner on wheels. The footrest could be brought up to keep her feet off the floor. That helped. But! Nothing was a complete fix. Mom could still mange to slither and be found on the floor.
As long as my Mom could get to a standing position without assistance, she was going to fall. She forgot she could no longer walk. That circuit was broken.
Again, none of this is your job. I only mention the above if by chance during your conversations with DH you might be able to help him understand.
I do hope you and DH get to make the trip complete with no crisis at home.
Many times my DH would almost physically have to drag me out of our home for a weekend away. Boy does it help to get away. Sure, you may come home tired but a different kind of tired. Kind of a physical tired but emotionally recharged.
Good Luck with the kiddos today 😬
And she's still insistent on wearing pants? When the frustration of getting them on and off is next to impossible.
Cute, casual 'day dresses' that can seqway easily from day to night. And they can be rucked up in the behind so if she has bowel/bladder problems, she isn't as likely to ruin every single thing she's wearing.
With my old client--she HATED going to the bathroom--it really did take 20 minutes or more. She wore more 'protective wear' than I could believe--and still daily peed herself, and her bed.
Got her to wear long culottes, which was a compromise between pants and skirts.
I think the 2 hour toileting schedule is as close to "perfection" as you can hope for. Honestly, I think she is being a real pill and has created a cloud around her of people who do not want to even talk to her---much less clean up after a bowel explosion. Leaving her notes, etc? Worthless as her brain just doesn't 'get it'.
I would hate to think DH would toss off a wedding for a bout of chitapalooza. Even a fall, if it's her typical one, kind of slithering to the floor. Just keep up to date and let the NH you're going to be gone and give them your number.
Glad DH is stepping up. It took enough!
Sorry for your dad's fall. My FIL did that a lot towards the end--I'd go over in the am to run him to his coffee shop and there would be blood everywhere and he'd state he either didn't remember hurting himself, or say it was just a bump. I mean, once I peeled a strip of skin off the wrought iron railing. Puddles of blood. That was the hardest for DH, he'd just start gagging.
I have done so much elder care--when my oncologist asked me what I wanted out of this TX I said "20 good years, and then I'm not treating again". Kids got upset, but I'd rather they remember me happy and strong that sick in bed and miserable. My mother turned 90. There's no joy in that life.
FYI on trip insurance. From a third party such as what was linked above, you have to buy it within 10 days of purchase.
Sounds like DH fussed at her, a bit . later in the day when he stopped in on his way back in from work, and found her describing the following:
MIL: "It's just so painful . it's a deep aching pain . and I can barely move, they've got me in diapers here and I don't even bother them when I have to pee, I just pee in the diaper .. I can't get up". .
DH: "Mom you can't do that, you have to use the button there, and call them .. you have to . you'll get a UTI".
MIL: "What's a UTI?".
DH telling me, "she's so out of it .. she doesn't even remember what a UTI is".
ME: Her brain is broken DH . the circuit doesn't fire right and connect . you can fuss at her all day long about using that button for help .. it's not registering .. you're gonna have to go at it via staff .. not via her".
I guess .. I'm assuming the staff must not think it's anything serious as to the need for xray .. surely it would've been a bit more expedient to transport via ambulance, to the local hospital and have the xray there, and immediate result.
DH said of her, . "I think she must have a pretty low pain threshold".
I disagree .. I've always known her to have a high pain threshold. She does seem to be in pretty bad discomfort. And in her leg/hip area .. and the same one she broke back in March.
Until the two of them (if ever, and that's doubtful) begin to look at the whole picture, and part of that her cognitive impairment .. it's not gonna be dealt with .. it just isn't. Thinking it an option to just continue to chide her . and cajole her into pushing that call button . isn't gonna cut it.
Right now, . they are checking on her every 2 hours ...
But that is, without a doubt, the fall protocol ..
Once that crises is over, it will be SOP .. and .. no one checking on her, unless the two of them get it on the radar . and doesn't sound like that's gonna occur.
Just....wow.
So frustrating to read through this and know that for what, 2 years, you have been banging your head against the wall, telling them they need to get a cog test and it STILL HAS NOT HAPPENED?!!!
And now the very simple solution of a toileting schedule and they are making it so complicated to even bring it up. Of course, the easiest thing would be for you to attend a care planning meeting and discuss all this yourself, but do NOT be tempted to do that!
Is there some REASON why they'll push for one on one nursing care, fussing over MIL getting her hair rolled, but will NOT say "we need you to check for Mom's basic cognitive functions". Do they think it will reflect badly on them?
Actually it would HELP a ton if she had that 'label'. It would put less pressure on her to do things she simply cannot do. It would help the NH to quit expecting something that isn't going to happen (sudden continence, for example, or a better personality!) W/O the actual dx, which will be a surprise to them, they cannot do certain caregiving things. Just....can't.
My mother has not had a baseline cog eval. And she is slippery, that woman. She can pretend to be perky, sweet and upbeat and nice for about 30 minutes, but after that--and many days, not that, she is short tempered and kind of nasty at times. It took me YEARS to figure it out. One big clue should have been that she was not even talking to a couple of my sibs. I thought that was mean, but grew to understand that they had issues and the sibs simply checked out. As YB forced me out of helping to caregiver for her, I saw the sickness that she has. Just a little Narcissist doing her thing.
I truly think at first (of the post) she was doing things because she MEANT TO. Now she can't help it. She's just going to be that way. No asking 'why' b/c she is just inherently unable to control her emotions now.
She's going to have falls, chitapalooza, toileting issues, arguments, late night calls and the Jekyll and Hyde personality switches. Because she can and now she's not wily enough to cover for them. This is just how it is.
Just give up trying.
If she fusses at DH about the hellhole he dumped her in, well, he can sit there and argue that when she got the RM she essentially chose this life. Or he can say "Oh, I have to run. Love you Mom and leave." Arguing with her---pointless.
My DH had a 'dust up' with his mom some months ago. He has not spoken to her since. I don't know what was said or done. I just know he said he was not speaking to her again--yet on all his comments on FB she always plasters this emoji of a little girl hugging a heart. DH doesn't 'get it' and neither do I. I did say "Well, maybe she's happy b/c she's ripped someone's heart out'. Gallows humor sometimes suits us well.
Dorker--just GO to the weddings. And relax and enjoy yourself. Try to, anyway.
July is just beginning and the heat and all you have to deal with--just enjoy family and friends and don't talk about MIL. I hope when you return and SIL is back on the scene, she will have had a chance to man up to the job at hand and be tougher. But that's HER mother, not yours. You have a very sick dad to look after.
Someday you will look back on this and remember it all and think "Wow, that was awful. And you will get all all your affairs in order so your daughters don't have to deal with anything like this.
The YEAR it took my FIL and daddy to die (simultaneously, really) I didn't think it could get worse. It did-- and it didn't. But I learned to roll with the punches and to ask for help and to trust more in the Lord. Still a work in progress.
I hope you have a lovely weekend/week.
Hugs
Liz
Dorker has stated that she is going to stay on the periphery of her dad's life, just where he always placed her.
But OY what a damn day.
DH checking in with his mom on the phone this AM before he went to the doc for himself (laid up temporarily with whatever is done to correct & repair a painful ingrown toenail).
Word from his mom "it just wasn't a good night, I'm laid up in this bed. It hurts too much to move. My head .
Ive had a headache all night and I dont .. cant see, my damned eyesight... I dont know son .. it's just not good ..none of it is good. They came last night and put me in the biggest mess of stuff you ever saw"
DH: "mess of what? What kind of mess?"
MIL: "Diapers or whatever.. the gal came in here last night and loaded all that on me and told me ..now if you need to pee...just pee in your diaper .. so that's what I did. I'm guessing they just didnt want to fool with me thru the night. It's just bad .. this is all so bad".
DH then telling his mom that shes got to call them if she needs to go to the bathroom.
Her saying she knows she'll need to have a BM soon and she doesn't want to mess in her diaper and then wait forever for them to come clean her up.
Him then telling her to go ahead and call them. Her responding that no one will come now ... they're out passing breakfast trays out. No one will come.
Him telling her to eat some breakfast then go ahead and call them.
She told him she would (yea right)...but they needn't worry she'd try to get up ... she cant .. too much pain. And said they've moved her wheelchair to where she cant get to it, thinks they gave her wheelchair to chatty cathy.
DH looking at me cross eyed as if to say .. she's nuts.
They finished their conversation and hung up.
I reminded DH (FWIW)... your mom cant push the call button DH. Her brain is broken. You guys cajole/encourage/admonish .. you might as well tell one of our 2 yo grands .. that's about how it falls continually telling her.
A bit later .. we're in doc office (I drove DH there). Me in the waiting area (too squeamish to be in the midst of toenail whatever they were to do).
A text in that same group thread to DH & me from SIL.
That she'd called & left a mssg st Purgatory looking for results of xray.
I texted her since I didnt know how indisposed DH might be with his toenail procedure. Texted her as to our whereabouts and that likely DH not able to weigh in at the moment.
She asked if DH has talked to their mom. That she called but apparently woke her mom .. so she hung up for her mom to go back to sleep.
I gave her the update as to the phone convo between DH and his mom from earlier.
SIL stating how much she hates all this for their mom. Wishes she could be there to help her.
I responded "you have ... thru so much you have! Remember... it was her most fervent wish she be back in FL ... so ... nothing you can do".
No response until suddenly DH chimes in from his procedural somewhere in the back.
DH: sister, call the desk at Purgatory. Mom just called me and I'm in having minor surgery on my toe .. she says she passed out".
Next thing is a response from her.
SIL: I just talked to so and so. The xray is in. Nothing broken. I asked them to go tell mother, share that with her".
Nothing more.
ME: ... and about her having passed out?"
SIL: I talked to her nurse .. said she'd been in with mom to help her rise up to sitting position to eat and mom got dizzy. She never passed out.
So then DH finally done (not aware of SIL's response above .. maybe hed turned out ... getting his walking papers from the doc) I asked him if he'd seen about the response from his sister. He hadn't. Brought him up to speed.
A bit later SIL texting that it seems shes been forbidden to get out of bed unattended and they're just going to have to make her understand she has to ask for help and if some of them treat her bad shes going to have to remember to tell them so and so (the director) says so ... that she has to ask for help.
I weighed in
Weighed in with my two cents about her broken brain and "remembering" isnt an option .. her brain is broken.
DH then saying to me "yea she called me when the doc was working on my toe, that she'd passed out. I asked her if she pushed the call button and she said no it's not lit up I dont guess I did. I told her to push the help button.
I said "well ... in the end .. she hadnt passed out, just felt dizzy ... and the nurse was in there when that went on. But see! ... she doesnt even remember to do it and you guys keep reminding her, staff reminding her ... her brain is broken DH.
About that time SIL responded to my two cents I'd weighed in with ... as follows:
SIL: for the time being we'll try to get her to remember to use the call button and that if they're mean to her she can tell them so and so says for her to call .. that she has to.
I responded: so the falls will continue then because shes not going to remember... she will right now. Getting up is too painful for right now .. but next week, next month ... the falls continue
SIL: Hope not.
Ate up with stupid these people.
I know you cant prevent all falls. But you can and should mitigate trying to lessen the risk it seems to me.
Guess not.
Just going to tell her to run faster.
Just going to have to tell her what the Chinese characters say.
She CAN'T.
F*** me Dorker I don't know how you didn't swear at SIL. She is really not getting this. Put her onto a vascular dementia website and tell her not to speak again until she's grasped what it is.
I don't like the sound of MIL, to be honest. She's immobile, she could be having TIAs, she's a bit out of it, huh. Mind you, it is important to bear in mind what she'd want, at heart.
Just keep breathing.
Poor old DH, ingrown toenails are very nasty. Plus, for some reason everyone thinks they're funny and makes jokes about "oh sorry did I stand on your foot?" Wish him better.
It sounds like DH does acknowledge and is aware to a degree that his mom's brain is broken, but from what I read, I'm not so sure that he knows that HE can do something to get her properly assessed (or is motivated to). It sounds like he prefers to leave it to SIL, who isn't going to acknowledge the dementia. He's basically going to need it spelled out for him that an assessment is the only way to get an accurate care plan in place for his mom. Hints just don't seem to work for these people.
Mind you, I know it's not your job to keep nudging him about it, but it's got to be frustrating to watch, and to hear about.
SIL on the other hand......I just won’t even go there.
I agree they both need to do some research. And yes it’s hard to not blame “stuff” on MIL being stubborn, hard headed, drama queen, whatever but geez SIL lived under the same roof with MIL for months both in FL and IL.
DH is getting there and apparently the staff are catching on too.
In grown toenail...yikes!
I’ve been thinking for a few minutes.
You know if MIL can’t remember to push the call button it’s downright cruel to keep harping on it.
And I agree those dizzy spells are concerning. She had those at the posh rehab place. I don’t think they ever get to the bottom of it other than plummeting BP.
Yes, TIAs, pain?
I know she had CHF. Does she have AFib as well?
Maybe Purgatory will figure it out.
We’ll see if Purgatory really is better than the Posh Rehab place.
The sub-acute rehab that mom went to next had a geriatric psychiatrist who came in several times a week. When mom started having delusions and became paranoid, he visited her several times, discussed with us the possibility that this might be dementia and recommended she be seen by a nearby neurologist when she was discharged.
(Neuro concurred with the dementia dx). Mom fell in her AL placement, broke her hip. After placement, she was regularly checked on by a psych APRN and the psychiatrist who supervised her.
What is so different about the picture in MIL's places of residence?
I agree they should grab this issue and ride it. They dont though.
Wonder if that's because they envision their mom then on the fast track to residing in a MC unit. Bad enough shes remanded to the setting she loathed and never wanted, slumpers and all. Now let's fast track her to an even worse setting. Not only slumpers but slumpers that dont know who/where they are and no memory at all.
I dont know if that's the origin of their inertia on the whole thing. But perhaps.
I am not saying MC wouldn’t be where MIL would be sent. But that was not my experience.
Mom was a very difficult Dementia patient, combative at times. But, with the support of the visiting psych services, like Barb mentions, she remained in the same NH. She never went to MC.
I was wondering about Rainmom yesterday. Rainmom, you okay?
I dont know that to be their reasoning. I am just guessing.
I think that indent in the sideline bleachers on his part, its seen him actually engage more than used to be the case.
But the actual leg work of digging in and going at it, to get to the powers that be and with any tenacity, that spot on the sidelines still far too enticing.
Its unfortunate because in the end... she is being cajoled and pushed (by staff as well as DH & SIL) to do something that maybe is far more than just her being stubborn. I think my objective view sees that with more clarity than he and his sister do.
Dont know why it's too unsurmountable a task.
More falls, injury, requiring surgery and dreaded anesthesia likely to come. It's all but certain. This too has been vocalized. As well as the fact, if its deemed she simply isnt capable to remember they are going to up the level of care, if for no other reason, to mitigate their liability with a dx that mandates same.
That too been put to audible dialogue.
At some point my words fall much like Bossy Boots and I know how that landed, in my circumstance.
I dont harp at it any longer.
But its maddening to me we can spend countless amounts of energy on pj's and on hair coloring & styling.
I guess she'll look nicely coiffed under the surgeon's scalpel in her stylish Victoria Secret matching pj's sets and styled and colored hair. After all we do have our priorities.
About five weeks in to the 24/7 post-stroke caregiving, when mother was back home from rehab, hemiplegic and bed bound, keeping her clean and comfortable was about all I could do. One particular morning sticks in the memory - around about eleven, with mother in her nice fresh pjs on her newly plumped pillows, and me in my scuzzy dressing gown looking like something the cat dragged in, the visiting District Nurse beamed a smile on her and said: "she's *beautifully* cared for!"
I can laugh about it now. There weren't many highlights going.
Yes, as you wrote, there will most likely be another fall soon, with the possibility of a broken bone, surgery, anesthesia, etc. This is what the HCPOAs are allowing to happen. So be it. I'm glad to know that if a fall/hospitalization/surgery, etc. happens around the time of M's wedding, that you will go and enjoy the time away anyway, even if H isn't able to go.
I also would think (if I was DH or SIL) that surely the staff that are attending her would recognize such need in their charges, as they are much more experienced in this sort of thing. Does it ever happen that a recommendation for evaluation/treatment is made to the family by staff?