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 place is really beginning to sound like Purgatory, minimal care, at best.
Mother is down to 1-2 showers per week and from what I hear, the smell is pretty bad. She has a permanent urinary catheter installed and she doesn't clean it well, not her 'lady areas' and she really smells bad. She'll never live in a NH and there are 5 women living in the house with her and not one of them has the interest to help mother shower. I am not allowed up there, or I would be getting her 4 warm showers per week and clean those da7n cath bags that always have a few ounces of rancid urine in them.
I think that NH's do the minimum they can do until somebody calls them out on it. The lotion is in fact, a medicine and wouldn't be 'charted' unless noted by her doc.
Maybe now with SIL here she can find a better place, but I wouldn't hold out much in the way of hope. Medicaid patients get the care they can afford. Sad, but true, it almost always comes down to money and what can be afforded.
Unless some family member is visiting every day and attending to these daily living needs, she's just going to have to accept this is her new norm.
you don’t mean SIL, do you - accepting this as “the new norm”? Anything less than catering to hers (sil) and MILs every desire?
Hahahahahhahahhahahah Ahahahahah!!!
Sil is kinda funny in that way. While she was in the thick of it she came to understand just how hard it was. But as soon as SIL gets any distance from the situation OR she’s able to do a drive by and give directives...
SIL seems to loose perspective and expects everyone to pile into the family station wagon and be happy about the never ending circling.
Frankly I love the stories here of the ridiculous lengths SIL goes to in order to appease one self-centered old bat. I get a laugh.
As to the daily towel/washcloths .. I don't know that they do or don't .. I'm guessing that SIL's findings are they are not putting a clean towel and wash cloth in her room daily for her use.
But this is all falling much under the same category that seems to have finally .. after all these months . gotten some attention .. and ... seen to, her 2x's weekly bathing.
Wasn't so long ago ... that we couldn't seem to dial down on .. or rather DH and SIL (I wasn't in it) . that MIL wasn't indeed getting her shower on Saturday and on Wednesdays . her designated days . and it was unclear whether she is declining same . .and staff .. lackadaisical staff .. all too happy to turn and walk out if she declines the offer .. or whether . as MIL would have it believed . .they didn't even offer, nor was she able to keep up with an request on her own .. "hey isn't this Wednesday . when do I get my shower?".
Weeks would go by .. and no shower, and no ability to dial down on precisely where is the problem. Staff telling that they offer, she declines . her telling she wasn't even offered.
It wasn't until .. I think .. SIL finally had it put in the chart, if her mom "Declines" a shower, they are to call and let SIL know. I think that finally got things into the right path . and she was now showered on her designated days.
Although .. last weekend .. SIL happened to be there on site, . when they came in on a Sunday to shower her (Sunday is not her day for showers . no one is showered on Sundays) . and the nurse said to MIL in the presence of SIL .. "No . we offered on Wednesday and you declined, we offered yesterday (Saturday) and you declined . you have to have a shower .. c'mon let's get this done".
Don't know what prompted that action and why she wasn't called when MIL was declining on here designated days.
But all this, .. assuming she might ask for her own washcloth on a daily basis and/or attend to her own moisturizing needs .. falls kinda in that category. Her dx was "mild dementia" . but I say it's worse than that, . but I'm not a trained medical professional.
She just isn't gonna remember to attend to such things. And SIL said she asked of her mom . whose face was somewhat dry/scaly .. and she should be washing her face, with some special face soap that SIL gets her .. asked of her mom isn't she washing her face daily .. and her mom said no . asked of her mom . can she not rub on her own lotions .. and her mom's response: "I just don't care anymore".
As SIL put it, talking to me .. I would think it would be uncomfortable to have dry scaly skin .. and .. itchy or whatever . .that one would "want" it dealt with . so as to not experience the uncomfortable dry skin . but .. I guess .. I don't know . maybe not.
And as to visiting the site of another NH .. we did visit that when we were looking . we did visit that site . and we did actually like it .. as opposed to where MIL ultimately landed (Purgatory). Didn't opt for that one only because they didn't take Medicaid Pending .. at the other site. One had to already be approved for Medicaid, at that time she was not, she was pending.
As far as whether it's better than Purgatory .. I really can't say .. we wouldn't have stuck her in Purgatory as a destination if we'd of thought it sub par .. but .. it does seem that is how it has played out . that Purgatory's care . maybe isn't what one would wish for ... but maybe that's what you find in almost any of these places .. who knows.
bottle with the palm of her hand and then use same said palms to apply lotion as she is laying in bed - ie sitting position bending at the waist with the assist of the bed controls or propped pillows if no autobed and then bending leg— perhaps at the knee?
I clearly don’t know MIL but I think it’s fair to say no finger dexterity is require when applying lotion.
BUT this isn’t a spa. It’s a freakin’ nursing home where Mil is being cared for at no cost to her or SIL. If the dry skin is such a dire issue then sil needs to have a doctor assess the problem and prescribe a remedy.
Perhaps SIL can request the staff to apply hot towels as well and perhaps a foot massage...
But in her bed .. legs outstretched in front of her ... certainly she could manage that.
Problem is, lost on her is any scenario of *gee seems I have a problem here, what must I do to remedy said problem".
Nope. Dry skin/to the point its scaly and in some cases skin break and blood requiring antispeptic ointment & bandaids.
It doesnt compute... problem, solution. Lost on her mental capabilities.
That and as she told her daughter "I just dont care anymore"
As SIL said she told her mom "well dry skin isnt going to kill ya ... but it can decrease your comfort level & its easy enough to just make sure lotion is applied"
I agree .. already taxed staff arent going to <absent orders from MD> be clamoring to give her a daily rub down with lotions.
It wont happen even with SIL howling at the moon ... absent MD orders (maybe even with MD orders... it will take some follow through to get it seen to).
Best solution is that jumbo pump bottle bedside and her administer lotion herself
But she wont see it through. Even when she is being doctored by staff with antiseptic ointment & bandaids ... still wont be seen to (preventatively) by her.
But as I get older myself, I see that more and more little things that I have to do are becoming more of an effort. Certainly more effort than they were even 10 years ago, and actually no - I really don't care as much if certain things around the house are spic and span and dusted and mopped, etc. And even washing and styling my hair... I tend to put it off for an extra day or so lately. And I imagine how I will feel about all the daily rigamarole when I am 90. Things that I have done over and over and over for years just start to get real old, I guess.
It’s probably just me. But, the only loose, wrinkled up old lady skin I ever wanna be rubbing lotion on - is my own!
think - if there was a way to make sure she did it - and that providing it was done in a safe spot like her bed, not the wheelchair - that it might actually be good for her - MIL applying her own moisturizer. A bit of gentle stretching, if you will. Hell, it would probably be the closet she comes to exercising all day.
Hopefully they are using a mild non-soap pH neutral wash too.
If it's in the care plan along with *daughter insists* there's a better chance but unless SIL is there to check she will just have to trust. (But that's always been the issue hasn't it? Control & delegate. Not much trust & relax).
She wants me there to attend said meeting, and that is a topic I will raise . .. "how to best achieve that she get lathered up daily . with moisturizer .. yes . we will/can get the doc to substantiate the need for same . and let's get that done . yes .. but outside of that, how do we make sure that MIL . who won't remember to do it herself .. gets reminder .. and it's seen to . .and/or staff does it . without fail.
In a perfect world, .. MIL would be self motivated and there was a day she was .. but that ship has sailed . she simply will not remember, without prompt .. she won't .. take it to the bank .. even though she has broken skin that in some cases requires doctoring with bandaids and such . and it has to be somewhat uncomfortable .. even in the face of that . the whole quotient of .. "gee problem, what's the solution" is lost on her, . that's a given ..
So . how best to achieve that ... to make sure it occurs daily . when you have over worked, taxed staff .. yea easy to say "now don't forget your lotion MIL" off they march to the next soiled Depends on vomit in the floor or assist to lift .. or shower .. or whatever .. and it doesn't happen.
And .. as to leaving it in the bathroom . nothing . and I mean nothing . gets left in the bathroom . stuff there grows legs .. and so nothing gets left in the bathroom . not her toothbrush and toothpaste . not her special face wash . not her special bathing soap . not lotion . nothing .. it's all on her dresser and has to be retrieved and put back at every endeavor.
Otherwise, I honestly don’t think you’re gonna get more than lip-service. I think they’re gonna be thinking “One more thing that daughter from afar is demanding and will nag us about” and “people are dying and we’re to prioritize that old bats moisturizing”.
Don’t get me wrong - my mother developed a nasty case of cellulitis in her lower leg from a scratch that broke the skin - I get that this isn’t just another expectation of royal treatment. But realistically? Just start making a list... of SILs wants and needs as they apply to MIL. Then imagine - realistically - just how this latest need is gonna go over.
My MIL recently spent 6 weeks in the hospital/rehab for a bout of pneumonia and a wicked UTI. She just got meaner, if that's possible. DH saw her a couple of times when she was in the rehab center and he'd come home just shaking his head "She is SO MUCH WORSE!" I didn't weigh in too much on this, as I have zero relationship with her (her choice) and I thought she was pretty bad before, no filter at all--just complain, complain, complain. I don't know how she got the pass to go home to live independently, she's pretty forgetful. Now she's supposed to be walking with a walker AND hauling an oxygen tube along with her. To me, that's an invitation for another serious fall, but it's not my monkey to deal with.
I look at her and wonder how in the WORLD she got okayed to go home. I am sure there was a lot of fabrication on the part of SIL who must have said she was going to live with her.
I expect every day to get the call she has fallen once again and is back in the hospital.
Anyhow--just wondering if MIL ever had any kind of mental acuity test? Just from what you write--every single day with her is a crisis of mammoth proportions. And she's in a CARE FACILITY! She just needs a uptick in the care dept. Like people who actually come when called. IDK, sounds like she's just spinning in place. But at least she seems to have come to terms with losing her dog and home. That really is huge.
You may or may not be familiar with The Talk... but it’s goes kinda like this - as delivered by some administrator - “Well, Mrs MILs daughter - perhaps it’s time for you to move your mother to a different facility. One that is better able to met her needs”.
Which may be what SiL is considering all along. However - I’m afraid at any other facility it’s going to be much the same. Lather, rinse, repeat.
Sil would be wise to do a more discerning job of picking her battles - rather than battling over everything. Things that more than likely are more important to her - what she wants for her mother - than what MIL actually wants for herself.
My mom was in a NH that accepted Medicaid and NOTHING ever walked away except for a Christmas angel, which the facility replaced.
I never assisted my mom with toileting or changing. I'd ring the bell and see how long it took them to respond.
My mother had TED hose put on and taken off each day. Her clothing was put away neatly by the laundry staff.
SIL may be annoying, but I don't think her requests are out of line.
MILs dry skin is a result of a
medical condition. Putting lotion on her is a reasonable request. Although, personally I think it would be good for MIL to do it herself if she could remember to - and care to.
But the expectation to fold and put away her laundry - in matching sets, no less - when their practice is to hang clothing seems a bit much for me. Maybe because when I was unhappy with my mothers closet condition I fixed it myself rather than expecting staff to adapt to my own standard. Maybe it’s just me.
The expectation that MILs special soaps and expensive makeup doesn’t walk away is also reasonable - but not realistic I’m afraid. Especially, when residents and their families are warned to not have items of value in their rooms. It would be great if staff and other residents didn’t take items - but I think that likely happens everywhere to one degree or another.
Sure. Call sil when mil refuses a shower. Reasonable. Providing sil is keeping her replies brief and not grilling staff and moving right along to other topics of concern. Staff will avoid calling her. Unreasonable response from staff. Sure. But definitely realistic.
But I think - and I’m only speaking for myself - that the vast majority of these issues could be resolved in two ways. First - MIL gets the seemingly impossible to achieve cognitive assessment and her chart reflects her lack of executive function - and perhaps she is moved to a wing or facility more appropriate. Second - SIL slows her roll somewhat and sticks to topics and tasks that matter more to her mother and less to sil. MIL likes her matching two piece VS pajamas. Yea - me too. But expecting staff to stop what they’re doing to come button the top up for her... I don’t know. Might a pull over the head style be a better choice - in the real world?
It just feels - to me, at least - that SIL is still trying to generate happiness in her mother by way of micromanaging even the smallest of detail. That and perhaps assuaging her own guilt and sadness over not being able to keep MIL in her home. Regardless of the right or wrong of sil feeling that way. Which on the flip side is probably alienating staff - which will show in their care of MIL. Is that a right staff response? No, of course not. But reclaiming “power” by way of rebellion is a human reaction that goes back to the dawn of man.
If ever in these last two years - Dorker told a story that encapsulates MIL and her children - for me - it was the circling for the perfect MIL approved campsite - a practice that I refer to often. For me - it says it all. And, I have to say - I bet there was probably a time or two when other campers got annoyed at that car - that continued to circle and circle. A reasonable response? Not really. But likely realistic.
How did the care meeting go?
No, I didn't expect the laundry lady to hang or fold things in matched sets, but they did put her clothes away neatly and they didn't expect my mom to dress herself.
Dorker's MIL seems to be in the wrong place, care-level wise. Dorker said a couple of weeks ago that an assessment had been done and the finding was "mild cognitive impairment". At that level, my mom was placed in "Independent Living"; she was mobile, ambulatory and could order from a menu. She didn't "get" stuff that was wrong with the other clients (why doesn't she speak up? why is she bent over her walker?" but she was interested in the activites that were offered and when she had a problem, we said "ring for the staff" and WE refused to come running.
Dorker then said the other day that MIL had been found to have Mild Dementia; there is a WORLD of difference between MCI and Mild Dementia. Mom had mild dementia and we attempted Memory Care; she couldn't remember NOT to get up, fell and broke her hip; that landed her in a NH.
I think that the lack of clarity (and mental health and reasonable expectations) on the part of MIL's "team" (not including Dorker) is largely the problem with MIL's care.
I just wanted to point out that being able to leave special soap and lotion in the bathroom is NOT unreasonable.
Reasonable to leave soap & it be used etc. I had forgotten MIL was a 2x wkly shower.. as is my Mum (a fellow refuser). So 2x moisturising (if done) not enough (also like mine). My Dad is like SIL watching every tiny thing & is has a fine detail focus. It was driving him mad when Mum went into respite care. The care was good but was never going to be what he would do.
Same stuff. Mum's face was dry. Dad complains they need to use the cream.. but Mum can't remember on own & refuses anyway. Eventually he settled down & excepted all the differences - but this was for a 4 week stint - not a life sentence!
Also same that he built Mum up to 'OCD tendncies, a bit of a worrier, some brain changes after a stroke & 2 X assist transfer'.
As soon as he left the staff met her: complete with obsessions, compulsions, demanding, anxious off the scale, wheelchair bound + the very picture of a vascular dementia patient. I got a call from the Nurse Manager...
I suspect similar here. SIL always downgrading the cognition problems or label. Not that the label probably really matters, but a clear picture of what she can do gets her what she needs.
Once staff got a REAL picture of my Mum, they devised behaviour strategies. They then knew she couldn't remember when her last shower was so stop letting her refuse every day & wrote Mon, Wed, Fri showers on her board. Job done.
If SIL continues to block a cognitive eval, then the onus seems to lie on DH.
Yes, Guestshopadmin, there will surely come another challenge to Dorker's boundaries in MIL-land. All's been quiet on the Father Front for a while now, though...it's probably time for him to have a crisis and at least try to get Dorker to come a runnin'...
Do tell how MIL's care plan meeting went yesterday, Dorker!