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:
He has the paid c'giver there, also as an option.
The way it was explained to us in the cancer doc office, .. was that he'd go the day before, (given a stack of standing orders, to be handed to the lab) .. he'd go the day before (c'giver will facilitate same, it's just up the road from him) .. and get his lab work done . and that way it would be available to the doc for the next day visit, infusion.
To do it same day is to have to go the lab on site (not in the cancer doc's office, . in a whole other bldg, requiring different parking if you're someone that can't walk long distances, and he isn't anyone that can walk long distances). So go the day before, . and get the lab work, .. preferably only one day in advance.
To do otherwise, is to have to go to that other bldg, .. and park elsewhere, then go get back in the car, . and go to another parking garage, to now go to the oncology doc . and wait for lab results . and then see the doc ... wait for that . and then .. wait for the doc to order up the chemo mix and that to be delivered from on site pharmacy and the infusion to then transpire.
Said it would save time to do it that way . go a day ahead of time for the lab work.
I still haven't heard back from my dad on the gauntlet of sorts that I laid out, that I don't intend to continue being a party to the whole marital squabble of who drives him . if he wants her driving and doesn't intend to do anything to negate the possibility of same, . fine by me . that I wouldn't be comfortable as a passenger w/her driving, wouldn't do it . but will defer to his decision on that . and that I won't continue to be a party to her consternation about it all.
Did hear from him just a brief little snippet of an email that he'd seen a good pic of me on social media .. that DD had taken . commented in his email that it was a good pic. I thanked him and that was that.
But he hasn't chosen to respond to the other prior memo ..
So I can see what will transpire (and it likely would any damn way, cuz in all honesty what do you do with someone w/dementia who doesn't know .. unable to process . your cheese had slid off your cracker, you are batt chit crazy .. we already talked about this . and you just don't remember it so get off my daughter's azz) . what do you do? She doesn't remember, 5 mins what was said 5 mins ago.
So .. what will likely happen is that I will likely be there in the throes of more marital squabbles on all that .. and will have to speak up .. at that point. I don't know how that will play out, but imagine it will be something akin to: "Look .. I'm not interested in being a perceived threat to you .. I am merely trying to help my dad as he has asked of me . I suggest you guys get on the same page as to how you want this handled, dad as I've said to you, if you want her to drive you, have at it ... I'm out .. if you don't, then get that point across to her .. and get her and her consternation out of my azz I don't need or want it .. I'm outta here, you guys let me know what conclusion you come to".
As to the MIL front, all is quiet there, . for a change. Other than .. DH had gone to see her the other day and I don't even know how it came up .. but .. something to do with .. that CNA months back that had been pretty gruff with MIL . and MIL complained .. and the woman was moved . outta there, to a different wing. Somehow that whole convo came up again (DH found church lady there, when he arrived, there visiting with MIL) and I guess she was telling that tale of woe. Only it was being related to church lady as in a male that had done this, a male CNA. DH corrected his mom .. "no mom it wasn't a man, it was a woman .. you said it was a woman that did this, .. " She was insistent that no it was a man CNA. DH, "No mom, you remember you said you asked HER for HER name and she refused to give you her name . and you
you reported it to management and they asked you to describe her . and you said she was a black woman .. tall .. and thin . and middle age . that helped them zero down on who it was . and so they transferred HER out of this wing . remember.
No, it was a man that did that, not a woman.
He let it go. Batt chit crazy! Why even listen to her. But whatever ... He let it go, doesn't matter . the woman . was xfer'd outta that wing, it's a done deal, over.
If she now perceives it was a male . whatever. Go with it.
That and then later in that same day when DH was on the phone w/his mom she then went on to say to him .. I guess in complaint about not being attended to, not sure why it even came up, . went on to tell him on the phone . that the whole time she sat there talking to him and to church lady she had a mess in her diaper . that the whole time .. she'd chat upon herself, . and sat there talking to them .. w/chit in her diaper ..
He asked her, .. "no you didn't mom . when that happens usually I smell it .. I didn't smell anything".
Her: "Well I guess it just didn't stink".
Him: "Why didn't you say anything, buzz them to come help you?".
I don't know, I walked away . don't know .. Batt chit crazy.
yet you've already e-mailed him this:
"If you want my help, I will do my best, .. my schedule allowing . to support you in that .. but I won't continue to tolerate her".
He didn't reply, and so nothing has changed. You are going to go and take him to chemo with K along, so you will be dealing with all of it. You say you are going to have to "speak up," but you already have in the email.
You gave him an ultimatum, and he ignored it because he knows he can. You are going to be doing exactly what you said you would not be doing.
Why do you give him so many chances? You are falling down that slippery slope...
?
Stuff just keeps on happening and it's not good stuff. I really as sorry for you.
Sounds like dad is playing you. Does he normally not answer emails? My sis doesn't. She doesn't return phone calls either. It's annoying, but she is about the happiest person I know. Must be the lack of social media! She takes texts on her phone and answers those when/if she wants. She rarely wants.
If your dad won't grace you with a response, you don't grace him with help. He's a grown man, he knows what he has for support and until he figures it out...let it go. He'll either make his lab appt and chemo or he won't. (I find that way of doing it all VERY poorly set up!) I go in for blood work at 9 am, a drs visit at 10:30 and then chemo as soon as the infusion is mixed up. They are nothing if not extremely EFFICIENT! Plus I have a 4 star restaurant upstairs from me and valet parking. Other than the fact they pumping me full of poison, I can't complain.
DAD has to figure this out. Step out unless you hear from him and you WANT to help out. Maybe he has to have some awful days with K before he realizes that 4 hours in an infusion room with her will be flat out miserable.
AS far as MIL---you still don't have that cog eval, and probably won't ever have it. As long as the facility has he classified as being 'capable' she will be treated as such. Give up trying to figure out what she's thinking. It's scrambled eggs in there, trust me.
SIL will be here soon and hopefully with a fresh set of eyes and some energy to get something moving for MIL. Minimally to start emptying that house. And getting MIL placed in the WAF place--although--wow, is she qualified for that?
I don't see that there will be any issue . the doc . not aware of cognitive issues and it doesn't seem it's on anyone's radar to inform doc ... she'll likely get clearance to drive, would be my guess.
Giving my dad benefit of the doubt, I suppose .. that he was to go to said appt accompanying his wife.
There, .. it'll be mentioned I'm quite sure, and either clearance will be granted (I suppose it likely will be) .. and/or denied. Perhaps my dad was waiting in the wings (since he doesn't seem to want to inform the doc of any issues underlying there, not that I'm aware of .. even though I've pointed out to him and to her daughter that's always an option .. have the doc be the heavy in it). Perhaps . that clearance will be granted and he will acquiesce to her wish .. path of least resistance/kick the can down the road .. and climb in as passenger in the car she drives to get him to and fro.
I stand on what I said to him . that's his decision .. I am not getting into that quagmire. I don't think she should be driving . if not for his sake, . then certainly for the innocents out there that may run afoul of her . and their justification of same .. "well she only really drives in about a six block radius . none of it any highway or expressway driving". Oh okay .. so accidents don't ever happen in neighborhoods. Gotcha!
I've said all that . and then some. Not going there a.n.y.m.o.r.e.
So as I said to him, I'll defer to his decision on whether he feels safe as passenger in a car driven by her, and I stand by that.
If she gets clearance to drive, . and he wants to take the path of least resistance and let her, .. fine by me. I'll back right on out of it, .. go visit him . as he enters the chemo scene .. and maybe bring along some soft foods . .and so forth . and then resume normalcy in my world.
So I guess, the reason that the hammer hasn't come down . as far as my creating a ruckus . is that I'm aware there is to be a follow up appt .. that I think was to transpire today . and at said appt, I can well imagine .. all other issues will be shelved, until the driving issue is front and center and answered to.
Yes, my dad could've answered that email .. "Dorker, I'm awaiting the doc's decision on whether she is allowed to drive, before forging those waters". Or something similar. He hasn't chosen to answer it at all.
I will go, this Friday absent any further word, as I said I'd do . .and cart him .. but if the uproar begins ... and marital spats .. and so forth . they will both found out that I'm done taking it.
I don't enjoy being a party to anyone's marital squabbles, even whether it's a neighbor and they argue over whether someone was to take the trash out or not .. and especially don't relish the thought of being part of that scene . at my dad's . where it's evident . my participation . is "wanted" by him ............. "n.o.t wanted" by her .
So am I holding my breath awaiting word from my dad, .. especially since he didn't see fit to even answer to the prior email. No, I'm not. I may reach out . underhandedly .. this afternoon to her daughter .. (though whether she's grabbed a bunch of gone .. and not even party to any of this . as to today's visit . is not known to me . and/or I may reach out, underhandedly to the c'giver to see what her knowledge is . as to whether those driving privileges were restored) or maybe even another email to my dad this evening .. as to the results of that visit.
My dad has expressed to me in the past, as I've walked this journey .. how helpful it is to have me a part of the scene . as I ask intelligent questions and have valuable input as things are discussed. So my participation, thus far, hasn't just been solely that of a driver/transport, never has, in all of it. I listen/and process what is said, . and ask questions if I have any . and note that which I find needs noting and inform him after the fact, so as to keep him on task also. He has expressed an appreciation for the fact that my mind is a helpful asset . (hasn't said as much but I would just about presume that to be the case .. he sure doesn't have a sharp mind in his wife, as attendant in these settings).
That's yet one more reason .. at least in my belief, . that he would like my involvement. I don't mind being that part of the equation .. and accompanying him, listening to what's said .. and so forth and asking pertinent questions if any arise.
There's a lot I do mind and have said as much .. I won't be the daily errand gal .. and off I go to pick up rx's . and/or the hardware store, .. and so forth .. I won't be the daily wipe the brow and hold the puke bucket ..
I will transport and participate in the setting of doc visits and I've been clear about those boundaries. I also was "clear" in my expectations as to their marital squabbles over the topic and what I am not willing to be participatory in. He hasn't chosen to answer to that, see prior post on what I surmise might be the reason(s) thus far.
As to MIL .. no I don't expect that there will ever be any cognitive eval. So be it.
As to WAF and placement in that setting, . that is . at the moment on hold as to any progress. It's debatable whether she is suitable. In the end, it comes out to a gamble of sorts. It is truly an AL . not a SNF .. although they stake claim to the fact they move with the resident as they grow more frail and feeble and not have them transition out to a higher level of care, thus the "We are Family" label.
And by the looks of the populace there, that is accurate . it looks .. by the look of the residents there . it looks just like a SNF, not at all like an AL.
It's a gamble somewhat .. in that .. it may or may not to be all it touts itself to be, we don't know. We do know a woman from our church who had her aunt in that setting years back (not recently) and was happy with it, .. we know Medicaid Betty's FIL was there, and she was happy w/it. So maybe what they say is true . they are a "family" and treat their residents as such and move with their growing frailties.
Then why not have a label of SNF? I dunno.
Not mine to sort thru.
It's been put on hold as to any visit by MIL there to view the site . as there has been a brainstorm session of sorts, between SIL and DH . and my participation in same sought.
Many questions arose.
Being this is an AL .. to name a few . the funding is different as to Medicaid . will they await A&A approval . and retroactive pay once approved? Don't know, have to find out.
If not . how to fund it . there is a short fall of approximately $1200 monthly .. DH nor SIL in a position to fund that, not even splitting it.
Answer given by WAF ........... "yes we will await A&A .. IF they application for same is in process and approved by us as valid".
But that also begged another question that remains unanswered. The para legal at the atty office informed, that should MIL pass away . mid-stream as to A&A app and we know that takes months and months and months to wind it's way thru
The way it works, with the A&A process .. that application processes commences, taking months upon months to get approval .. and should MIL pass away midstream while this is all in the works. A&A becomes null and void . no it doesn't then clock back to when it was originally applied for and "oh gee, we're so sorry your mom didn't live to see this come to fruition . and so here's the 4 months that it sat in pending . we owe you that much at least".
Nope . it goes away entirely and the whole A&A funding piece of it all, .. is nixed.
So those dollars that WAF has sat waiting for . for the 3 or 4 months or 6 or 9 months whatever it takes, and that bill wracking up . awaiting the retroactive A&A funding .. if she should die . it goes away . and that funding will not be forthcoming.
So the bill that got wracked up gets paid how? Does WAF just eat that? Do we then become liable? How?
Don't know the answer there, .. many questions.
What we do know is that MIL has a small amount of $ left from her RM and it was pulled out and put into a pooled trust account on her behalf. Those $'s an be used . if they so wish . to try to fund that $1200 or so shortfall every month and that will buy several months . if they wish to go that route .. but that remains unanswered to, as to whether DH and SIL want that as a path forward.
SIL is busy at this point, preparing for out of town guests and for her daughter's wedding . so the whole MIL piece has been shelved.
What we also know is those $'s that sit in the pooled trust .. if MIl should die, .. if there is any $ anywhere .. Medicaid reaches in and grabs at her demise . as reimbursement . such that it would be .. for covering her. If there are no dollars to grab then Medicaid is just out .. but if that $ sits in the pooled trust .. and not used .. if MIL should pass on . it won't be available to satisfy the debt wracked up at WAF . Medicaid will have taken it.
So how to fund it, as to WAF remains a big piece of the whole thing.
What of WAF is ala carte? I mean .. this isn't a SNF.. this is an AL.
We already know that if one wishes to have a "call button" .. that is $15 monthly. We already know if one wishes to have a telephone, that is also $15 monthly.
Does it cost extra for help with showers? Don't know, needs to be asked.
Does it cost extra for extra bed changes in the event of soiled bed sheets due to incontinence? Needs to be asked.
Does it cost extra for help with dressing daily? Needs to be asked.
The rx drugs is a big piece that needs answering to. The way it was explained by the atty office, . in a SNF .. resident participates in whatever drug plan the SNF has . and drugs are delivered as such. And better yet .. the setting of SNF . if the drug costs exceed that which the plan covers, SNF facility covers it that's the way it works.
Not so in AL, not always. Needs to be asked about.
For instance, in AL . it was explained . sometimes the drugs . .and retrieval of same .. and pay for same . up to the family of resident .. need to ask. I do know that at WAF they partner w/some company that delivers the drugs there . we asked that when we visited . but .. that drug company only delivers . they don't pay for it .. what is that cost. And so .. one would need to be a participant in whatever drug coverage (much as she was a participant when living alone . and that was an AARP Walgreens plan) .. she'd need a drug plan . and does that drug plan work in conjunction with who they use for delivery or does it now depend upon family to go retrieve said drugs . as that particular company doesn't partner with "x" drug plan.
Does any drug plan she chooses have a cap on monthly allotment of cost(s) .. ??... don't know .. has to be dialed down and answered to. We know she takes Elliquis and that is very expensive . and in fact, when she lived alone at home . she was on a patient assistance program to get it, her drug plan
her drug plan she had when she lived alone at home . didn't cover Ellisquis . so SIL had it worked out thru the manufacturer of that drug .. as some do who have no drug plan .. and it was provided at no cost to MIL via her cardio doc .. and so she'd have to routinely go there to receive her free supply on that specific drug.
So any plan she chooses were she to wind up in WAF . does it cover Elliquis .. and if so, do they also work with the company that delivers drugs to WAF. If not . how to get Elliquis.
Do they charge for transport to doc visits .. Purgatory does not . or if they do, they are billing it to Medicaid . we arent' having to pay it, we're unclear on all that .. but how does WAF handle that, what is their fee? Do they charge for someone to accompany her, what is the fee for that?
Lots of questions that arose . about placement at WAF in a brainstorming session.
As the paralegal put it, .. some AL's are wonderful, but you always have to be mindful and weigh your own budget .. as sometimes in the end, with all the ala carte services that your LO needs, it ends up being more cost effective to have them in a SNF . and all of that has to be weighed . and so .. get yourselves a list of questions and figure out your budget.
So . before MIL is transported to WAF for viewing it herself, . it's kinda imperative that we find out .. they find out . is this even viable at all, budget wise, and logistics wise .. as to all that will be different in an AL vs a SNF.
So it's been put on hold temporarily ...
SIL would have you believe that MIl has really stopped asking, . that now that Medicaid has been approved (recent) .. and that's the only reason she was in Purgatory to begin with . we had to choose a site that would take "Medicaid Pending" and Purgatory did. Medicaid is now approved. And so as SIL would have you believe .. MIL has stopped asking about moving elsewhere. SIL's words, "it's almost as if .. psychologically the feeling of knowing you DON'T have to be there, . has alleviated in her . the strong strident desire to get the h377 outta there . she's quit asking all the time".
Not so in DH's case, she asks him every time he goes there, when can she be put somewhere else.
Maybe she doesn't ask SIL because she knows SIL isn't local . and .. WAF is close proximity to us. She still asks . SIL would have you believe . she doesn't ask anymore. Not true.
If K gets her driving privileges restored by the MD, will your father even let you know?
Confusing indeed about Medicaid and waiver for AL, and what happens with different scenarios. Sounds like no decisions (or even exploration as in a site visit with MIL) will happen until SIL returns to FL next month.
EVERYTHING was a'la'carte.
I saw the final bill for a month's living. $4000 a month to simply procure an apartment. 1-3 meals a day were added in. Pill storage, and dispensing were extra. Dressing, showering were extra. On and on. I think her final bill was close to $7K a month and this was 12 years ago. She was stinkin' rich and the family didn't even blink an eye at the cost. She lived out her life at this lovely facility. Going to visit her was like going to the Ritz. Warm cookies at the front door. Games and activities and PT going on all day, She was a VERY chatty and frieny lady, and although her kids had made their dad that 'golden promise' she understood the options and was actually very, very happy there.
The secret to this is no secret: Money. It can pave the roughest road and make things so much more palatable.
When you're counting pennies, you wind up in a sub par over worked, over booked placed, where, try as they might, 12 clients to one patient? It's impossible.
I believe it was four weeks after arrival at Mom's first AL, that she was reevaluated and found to be at a higher care (and price) level. The cost also went up as Mom required more meds to be dispensed and to be dispensed more frequently. Regular CNAs weren't allowed to do this job -- only med techs who had special certification, thus these separate charges.
Mom's pharmacy bills rose quite a bit when she moved into AL from IL (where family had obtained the prescriptions.) She was required to use the AL's pharmacy, even for OTC meds and vitamins, which could only be ordered by the month with everything in an individual blister pack. Mom was on Medicare Part D, but could still have a monthly pharmacy bill in the hundreds of dollars for her dozen or so medications plus the OTC ones.
One month I thought there was a mistake on the pharmacy statement -- a charge for $313 for bandages! I called and learned no, not a mistake. At this point Mom was in MC and they were ordered by the facility's dr. for a bed sore. When I later spoke to the nurse there, she told me there were cheaper alternatives that could have been ordered. Lesson learned: inform the pharmacy not to fill any medication over a certain dollar amount without checking first with me (as POA.)
The bandages, btw, were duoderm hydroactive sterile 4" x 4" -- maybe someone with a medical background would know why they were so costly.
Oh, and be sure to ask WAF what their average annual rate increase is. It will be higher than Social Security's yearly increase.
Once she gets past the above, . then she can set her sights on when she'd like to return here. And .. I wish it had been a matter that we could've systematically taken the house apart, in her absence. But it was a decision made in unison . that she wants to go thru things . while there, herself, .. and see what she might want. So we'll do it when she comes . whenever that is, in the coming weeks/months.
SIL got word today that the course (Saw this coming) . of PT will end in 4 weeks. I guess these things . once insurance runs the gamut .. I guess that's how these things work . then that's the end of that! She'll be assigned someone that will do what is known as "restorative" (?) .. and that person will visit her room . and she will no longer be carted to the PT room of the site at Purgatory.
I didn't ask. Was this a decision born out of .. insurance is done paying for it . or was it a decision born out of "lack of progress" or both. I don't know.
I do know SIL has her lined up to be carted back to the surgeon who did her hip repair back in March. When she fell several weeks back, . and one would've thought she re-injured that same hip .. but the mobile xray brought to bear there at Purgatory didn't find that to be the case. MIL has complained the hip is sore .. even still. So SIL has her lined up to see that same surgeon for them to give it a once over . and I guess the hope is also that will then order up another course of PT. Don't know if that will be successful.
No word on anything from my dad's front . but I've been preoccupied this evening and didn't reach out to try to ascertain any news on that front. Perhaps tomorrow I will.
And yes, excellent suggestion to make sure it gets added to the list of numerous questions. What is their annual rate increase.
As it all stands at present .. it's gonna be nip and tuck . for her to be able to afford to be at WAF .. and that assumes all lines up without a bunch of expense ala carte .. and if that expense isn't too great . .then absorbed, if need be, by us .. SIL and DH .. if it's not too big a shortfall in the broad scheme of it all.
Sounds like there is some debate as to whether WAF as an AL is at all suitable, vs the SNF . not Purgatory but another one, a separate site of a SNF that isn't Purgatory.
No one seems hands-down sold that WAF will be the answer to it all. Other than MIL . who hasn't seen it.
In the end, if the budgeting shows it viable, . and if MIL visits and likes it . it's gonna be a gamble .. a gamble that WAF is what they say they are . a loving family oriented environment that moves with the resident and their increasing need, rather than transitioning them out .. (and the populace there bears out that notion). But . how attentive are they really . and they don't have to be, they are an AL .. they could easily sell a bill of goods only to turn around at some point and cite she's too needy for what they provide there, . and insist on transition . the very transition they stake claim to not forcing a resident into. We don't know.
Or ...............
On the opposite end of that debate . it's being bandied about ... maybe moving her from Purgatory but to another SNF. This is one we toured . and it's a little farther away than Purgatory is. But is, .. in every sense of the word a SNF.
Is it smaller than Purgatory. No, not really. Is it better than Purgatory? It seemed to be . sort of . when I went to visit it months back as we looked for sites that would take Medicaid Pending and this SNF did take Medicaid Pending and we would've opted for it . but they nixed taking
the nixed taking Medicaid Pending while we were all in the process of touring sites and making a decision. Their higher ups . made a command decision they would no longer take Medicaid Pending. That crossed them off our list of possibilities as to where to place MIL. At least until Medicaid is approved (which it is now, approved).
Hard to know w/any of these places .. they can all sell you their line of how loving and attentive and caring they are . but in the end .. you don't know . until your LO is there .. and .. then it's too late.
Remains to be seen as to whether WAF will come to fruition for MIL. Loads of questions that need to be answered before MIL can even tour there. No need for her to go see it, only for us to find out in the end, . budget-wise and other factors are going to make it not the most suitable setting . and then nix it. We'll wait until DH .. or SIL can talk with WAF about all the questions that need answering.
One of them that I brought to the forefront that I would like spoken to, but I may be barking up a tree with no limbs. The whole shower issue w/MIL. She goes weeks without a shower . at Purgatory.
That, .. depending on who you listen to .. can vary as to the origin of it ..
SIL would have you believe the staff are lax/lazy and don't bother asking her.
DH would report he's been there (as have I) and they've come to ask .. and she declines.
So which is it? Who knows.
But a question that comes to my mind . how persuasive is WAF as to showers? Or do they try to persuade? I know no one can "make" her, and it's not like she's afraid of showers . it's just . it's an awful lot of hullabaloo for her to shower, . and if given the opportunity to decline it . she does so, she declines. Staff then don't have to bother (at Purgatory) and so another week goes by, no bathing.
Given that issue at WAF what is their approach . do they chart these things and try to persuade her "Now Ms. ___________we've asked you now, this is the 2nd week . and we ask you and you keep declining . you really can't keep doing that . you need to bathe and get cleaned up, we'll help you .. let's get this done".
Or do they even do that?
Staff not having to bother, all too happy to wash their hands of it all, in her declining the whole thing . staff waltzes away (if they even ask, who knows) ..
Is a bed/chair alarm extra? We already know that WAF deploys that measure as to residents who fail to use the call button (a call button that comes at an extra charge at WAF). Does it now cost extra to utilize a chair/bed alarm? Questions, a lot of them.
Plus, moving her "upstairs" might be less traumatic and less of an adjustment than having to get used to a whole new, but similar, environment.
You are so very good-hearted and caring, to your own detriment. There is a concept called "locus of control". None of this stuff (along with how to achieve peace in the Mideast) is in YOUR locus of control.
Dear lady, I spent years thinking that so much was my "fault" and that I needed a solution to everything. Please try to let go and let God or whomever solve the problems of these folks. It is simply not your issue.
I so remember the day I let go of the war in Bosnia....and I'm NOT kidding about that, folks. Us over responsible types take on everything.
Dorker, please let it all go. MIL, your dad, K....just let them figure it out.
If someone asks you for help, you do a specific job. No global responsibility unless you are given authority.
Making it all work for WAF seems time-intensive (and more $ than if she just stayed in a SNF). SIL and H will probably agree to additional monies from them to make WAF possible; H in particular will do it to assuage his guilt. I guess you don't have a say in this, unfortunately.
Wherever MIL goes, she's going to have a roommate. And it seems as if Chatty Cathy is a pretty good one. The next one in the next place may not be as good! NOWHERE will be good enough, as far as MIL is concerned.
When you have so much of our daily existence, .. in some cases hourly .... that is impacted by the latest hiccup there, .. it's almost impossible to be oblivious to it all. It really really is.
The showers for instance.
Obviously .. that is an issue that is important that it's seen to. It really isn't healthy for someone to go on indefinitely without bathing. Particularly that someone who is so impacted routinely with chitapalooza. Hygiene is gonna be a really important piece of the bigger picture.
I guess .. the fact that no one has been able to dial down on where the discrepancy really exists in that whole saga .. leaves it hanging to arise as the latest hiccup ..
There are many hiccups. One of them .. a day that MIL had gotten up .. and I don't know . w/assistance, no assistance, don't know . .. got ready for her PT session . and waited and waited and waited .. and no one came. She finally wheeled herself down to the nurse desk to inquire and was told there would be no PT that day. The PT personnel assigned to her, had called out .. car troubles.
SIL all up in arms that no one had told her mom ..
And my remark to DH on the side, .. "Maybe they DID TELL HER, and she didn't remember, thought of that perhaps?".
Or .. as is the case, routinely when DH goes to visit his mom . usually no more than 3 days go by and he has been to visit her. He comes home sad, forlorn . and he himself, inquiring ... "when can she get out of there, she hates it there". To my response .. "when you guys figure out what/where/when you want to do it". Him sad, forlorn, .. who knows . guilty .. whatever ... and that goes on . and it ebbs a bit, and then he goes to see her again.
All the while, some other hiccup is occurring, routinely.
The latest minor little skirmish .. that chatty cathy had kinda bit at MIL . and hurt her feelings. I guess it goes like this. Chatty cathy complaining that some of her clothes are missing. MIL responding to Chatty cathy's complaints .. "do you have your label in all your clothes?, you need to get them to label all your clothing". Chatty cathy biting at MIL: "You're sounding just like all of them, .. .I'm disappointed in you, you're becoming one of them".
The little "upset" this caused, yet another hiccup.
The never ending complaint from MIL they help her to the toilet (when she asks, and even that is a complaint all of it's own, as they don't come timely enough to suit her), and then leave. At least in that case, DH and SIL both have a clear understanding and try to impart that to her, to no avail. Of course they leave .. that's why you have a chord by the toilet, use it, .. when you're finished, use that chord to let them know you're ready for assistance to get up and back into your wheelchair . they aren't going to stay with you the 15/20 mins it takes for you to toilet, they can go do something else while that's ongoing.
So it's really nearly impossible to leave all this that goes on routinely . on the periphery of my existence, and not be impacted. It's part/parcel of my daily life. As MIL's life goes, so goes everyone else's it seems.
Inquired in an email to my dad earlier this morning, awaiting response . as to what yesterday's doc visit entailed as to restoration of driving privileges, and how that is going to impact his travels to and fro chemo. Will wait for his response.
As to how it will be handled with stepmom at his elbow and creating upheaval. It's more likely dad will be the one to create upheaval. Dad gets a belly full of the incessant non stop line of questions he's already diverted and/or spoken to .. (she forgets, she has dementia remember) .. and keeps asking .. and hounding . and he is the one who snaps. She isn't a loud talker, she isn't a yeller, . she just keeps on and keeps on and keeps on . until he snaps and responds loudly.
On a funny note my nearly 6 year old granddaughter was shown a picture of me from over 40 years ago by my husband. She looked at it and said "that was when Grandma was new". We, I imagine would all like to be new or newer. Accepting we are not is part of aging. No one can force this acceptance on MIL. However she should not hold her family hostage to this lack of acceptance,at least not any longer.
She STATES she showers everyday, but there is no way that's true. I am not in charge of her, nor even involved in her life one iota, but I did check her towels one day and they not only were DRY, they were that 'stiff' that dusty, dry towels will get when they've hung for weeks. She sort of washes her hair...she washes her face, but that's it. I know that she needs help with showering and dressing, but YB will NOT allow her to have outside help.
Ironically, Other YB (these two share POA's...a terrible, terrible plan) and this guy is a sweet Dr No-shot and won't get involved in anything.
He came by to see me last night and we talked extensively about mother for the first time in 20+ years. He's aware he needs to step up and insist on better care for her, but he is just too 'nice' to do it. I cannot be around her or her birds or her filthy apartment for 6 months. Told him it was on him, he could step it up or continue to ignore the elephant in the room.
He'll just ignore her. It's so much easier.
How do you KNOW MIL has been offered a shower? In the CH's I am accustomed to, showers are MANDATORY.....you don't get to waffle around about whether you 'feel like a shower today' or not. You are gotten up and washed. MIL is hardly to go to on the 'truth'.
Well, SIL will be back in a couple weeks and she'll get a shower. I can't imagine that with her chitapalooza record and just being old and sick that she smells OK. She will get skin break down and then, wow, you do not want to deal with skin infections.
I kind of call her on the 'no shower' mantra. I think she IS getting showered but she revels in making y'all mad. Just my opinion.
As to my dad, the only epiphany from yesterday's follow up appt as to stepmom was a lowering of her BP med. Cleared for driving (as expected) .. so forth.
My dad's answering to my concerns went about like this.
She really does do alright with driving .. sans avoiding heavy traffic and/or highways/freeways.
As to her .. what appears to me to be .. some pushback on involvement on my behalf . his answer goes about like this.
She is looking forward to your arrival here, . anticipating that you will be doing the transport and values your participation in realizing she isn't able to capture and hold onto all the minutia that gets delivered in the way of instruction and so we both appreciate your participation in that aspect.
Further he goes on to say:
It's my read that the caustic demeanor you've witnessed is really one born out of protectionism . and a feeling of being left out. She will be attending . and so that will alleviate the "being left out". I think as we go forward here, she will begin to see, particularly if the chemo tx's become troublesome as to side effects, . she will see that having support .. is going to be necessary, absolutely critical . and grateful for same.
So ........as I said I'd do, I will cart him this Friday for the first of his chemo tx's. I won't be able to do so next Friday and he knows that. I will be in IL . out of town. But going forward, . will do the best I can to make myself available for that endeavor.
But .. should she become a problem . I reserve the right to side step the whole shooting match and leave it at that doorstep to navigate. That's a boundary .. and I'm firm in it.
I agreed all along to help him (w/limits) and I'll do so. As long as I'm not subject to the consternation that was evident in the prior setting. We shall see.
and
"It's my read that the caustic demeanor you've witnessed is really one born out of protectionism, and a feeling of being left out. She will be attending, and so that will alleviate the 'being left out.' I think as we go forward here, she will begin to see, particularly if the chemo tx's become troublesome as to side effects, . she will see that having support .. is going to be necessary, absolutely critical, and grateful for same."
I think your father is trying to sell you a bill of goods. You've witnessed K numerous times, and now he's explaining her behavior by the above two paragraphs?!?! Do you believe what he's written?
I also think your father is hinting that he's going to expect even more "support" from you if the side-effects become bad. More support than just driving him to and from chemo appointments. Keep those boundaries!
So you'll be taking him and K on Friday, and that will be the experiment to see if you will continue to do so from that point on. He'll be on his own the following week. Are you going to stay for the whole time on Friday? You will be expected to wrangle/herd/supervise K. Oboy...I think you may be one-and-done for taking him to the chemo appointments. After this Friday, it might be the caregiver who takes him and K. Or, who knows, just K, since she can now drive the two of them there, and she doesn't like the caregiver either, does she?
I think DH would be less forlorn if he didn't hang his hopes on "when can she get out of there" and instead found new ways to bring some diversion into his mom's life NOW. Maybe take her out for a leisurely drive around your nicest neighborhoods to admire the homes and attractive lawns. Pick up some Arby's or other takeout and have a car picnic parked in a scenic spot. (Then straight back to Purgatory in time for the bathroom!) Or the outing could be to the mall where he could push her in a wheelchair to pick out some new slippers or just window shop or people watch. I bet MIL could use a change of scenery about now.
The aides have a list and if you say no one time, you're crossed off their list for the day. They have plenty of duties elsewhere. Each time she's asked, the aide is being paid whether MIL says yes or no, so she might as well get her money's worth.
This worked for mthr, but she was a pemny pincher.
As far as your dad and boundaries, you had set your boundaries earlier when you said you wouldn’t provide transport if K attended the appointments. Your dad just stepped over that boundary and TOLD YOU she will be attending. I’m with CTTN, I think (and hope) you will be one and done after Friday’s appointment. If she couldn’t hold it together at the last one, what makes him or you think she will hold it together on Friday? I mean I hope for everyone’s sake she does but I really don’t think your dad has a right to disrespect your boundary. It’s not like it’s a control issue on your part. It’s that she has already shown she is disruptive and unstable in that environment. It’s not mean or cruel to leave her at own. Would it be appropriate to bring a couple toddlers to this kind of appointment? Absolutely not! I see this as being no different. I hope Friday’s appointment goes well & is calm and peaceful for all.
I'd forgotten that Dorker had already established the boundary of NOT having K coming along to the chemo appointments. And so her father did indeed ignore her boundary, expecting she would acquiesce (as she did). He keeps pushing, doesn't he? Because he knows he can. Careful, Dorker, you're starting to pick up speed going down that slippery slope!
K might be arrested. Wow, what a mess THAT would be!
I am so annoyed for Dorker that her negligent father keeps ignoring her boundaries. HE put her on the periphery of his life long ago, after all. And now he wants her in his life, because he sees a use for her, What a selfish man!