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Just popping by to report, nothing new. Trying to get something on the radar as to a sit down chat with SIL, she .... a busy week again, w/PT for her mom (outpatient) Mon, Wed and Fri, as well as her DH .. who has arrived on the scene with a pinched nerve (?). Schedule to meet with the HHC agency and get that initiated. Meet with the yard guy about entry/exit to the b'yard (that's a whole issue that I had harped on hard .. for forever .. let him enter via the garage and use the key to unlock the b'door, wahlaa .. he's in the backyard .. no need for her to go out there, to unlock a gate .. just let him enter via the garage .. and she keeps the entry door to her house locked, .. thus no worry this sinister yard man will enter her home. NO NO NO . she could never do that! I guess MIL has now acquiesced on that point also, as well as a HHC agency. Wow, the changes! And .. SIL lots on the schedule for the week .. guy coming to power wash the d/w .. at MIL's house. So ... she's having to figure/when how to meet with me.

But nothing else to report at this point.
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So with all the medical drama, MIL's debts, and a reverse mortgage, SIL is spending somebody's money on pressure washing the driveway, not even the house? These people!!
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I posted the following here about six months ago:

”... I can't help but think this doesn't have to be an "all or nothing" relationship. I think it's important to consider how Dorkers husband may feel towards her should MIL find her cloud tomorrow. Will he be resentful? Will Dorker herself begin to feel regret and guilt? God knows there are people here on AC that did everything. but breath for their passed-on loved one - and they even struggle with guilt - needlessly. And, while one never knows - it can be assumed that SIL will still be around long after MIL is gone. Will the relationship between Sil and Dorker ever be able to be warm and sisterly again? 
So, while it's important for Dorker to find balance in her own life as it relates to the care and comfort of her MIL - I think it's important to always be mindful of a bigger picture.“


I reprint this not to say “I told you so” but to say I saw this coming - all the anger and hurt feelings, damaged relationships and a marital strain.

Cause heres the thing - more of what I see coming: should MIL pass away before a sincere attempt is made by everyone involved to mend some fences, I do believe the damage will be irreparable. Particularly, if that cloud is anything less than a fluffy, pure white and accompanied by cherubs and angels. Could dh ever get past it? At times dh says the right things but at times he spews a whole lot of resentment and anger.

Dorker, don’t stand by waiting for SIL to lame excuse her way - again and still - out of the talk you need to have. You know where they are. Take a picnic dinner for two and drive over there. Give the food to BIL - for him and MIL and then get SILs purse, take her by the hand and drive her to a nice place for dinner and a glass of wine - or two - and TALK!


How is important is this - to you? What are you prepared to do?
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To piggyback on to what RM is saying, there HAS been a big change here. SIL has somehow gotten her mom to see that she needs outside help. HHC is scheduled and the yard guy can now come in ? Those are both huge. MIL seems to be accepting some of her frailties.

There needs to be flexibility on both sides. This started out being about your daughter and the babies. Don't turn it into something else. Yes, go talk with SIL.
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"I understand there is hurt and anger here at my departure in the whole thing .. "

Here is a more accurate version:

I understand there is hurt and anger here at the whole thing ..

There is hurt and anger, plus there is also fear and anxiety and frustration. But remember that you are the one who is setting the example of how to face up to MIL's situation rationally and proportionately. If DH and SIL and MIL appear to be resentful of you, it's because you're showing them up. Not because you're letting them down.
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A bit of re-framing here, Dorker. It sounds like perhaps SIL is setting some boundaries. She CAN'T make her mother move. Her mother is technically competent can't be forced to do something she doesn't agree to. So she's going home to look after her own health and family.

You can meet with her write to her, but let it be known that you are not going to respond to her directives if you don't agree with them. You are not doing dog duty, you need the transport service to take MIL grocery shopping, you'll visit, chat and have lunch one day a week.

Dorker, you don't have to be anyone's go-fer. Learn to say " no" and mean it.

I mentioned this long ago in a previous post. Another person on this board was being asked by her parents who were in their 90s to change light bulbs, do grocery shopping, etc. They wanted her to quit her job! She refused. Still visited, etc, but would no longer put herself in danger doing tasks they should have been hiring help to do. But the mom refused any " outsiders". The mom fell, wouldn't go to rehab. Fell again and sustained a head injury that killed her. Pure, simple stubbornness.

You can't change what MIL will do. Neither can DH or SIL. You can only change your own actions.

But if you truly love MIL and SIL as you say you do, clear the air. And go back to visiting MIL as a friend, not a caregiver.
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Some things are obvious to me:

1. SIL doesn't want to meet with Dorker, and since she's put off any talk this long with anyone about MIL's needs, it probably won't happen before she flies off to IL in a few weeks.

2. H will accept nothing less than Dorker jumping back in and being the step and fetchit for MIL. Now we know that is what he expects her to do. All this talk of dividing up the duties...how is THAT going to work? D is already whining that her sisters aren't being expected to help. If D agrees to be on dog duty, you know she not going to be able to do all that's required. The only way this will work is if Dorker is available to be the on-call babysitter for D.

3. HHC is coming in 8 hours a week? Is Dorker willing to pay ~$320/month (and $320 for SIL) for this? What if the needs increase? And who's going to force the meds down her throat every day and see that she's hydrating properly? Who's going to be there when she gets up multiple times per night to let Precious Doggy out? (I see these as NEEDS that won't be met with anyone's plan.) And then isn't there the chance that MIL will cancel the help after SIL leaves, as always happens? Haven't there been many things that were in place that were cancelled by MIL in the past? What's different now?

4. I think if Dorker jumps back in, even if just for, say, 1 day a week, that she will be the one the rest of it falls back on. I don't see anyone doing the extensive planning to take care of MIL's many many needs (and wants!) for the other 6 days of the week. H refuses to plan in advance, so who will be doing it? SIL will not be able to schedule others from afar for the rest of MIL's needs/wants. Everyone will end up being just as hurt with Dorker (even if she does 1 day/week MIL duty) as they are now with her totally out of the picture.

5. I'm not so impressed with the preacher. Nice that he can comment on how well his elderly mother is doing, especially since HE is the one that's out of state. And what has he suggested that hasn't been suggested HERE many many times? Maybe I'll get to eat my words if he gets H to step up. But why would the preacher try to get H to help more, since H is such a vital part of the church (in essence making the preacher's job much easier)? Is he really going to suggest that H cut down on the churching?
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I'm assuming MIL has had an evaluation by HTC and found to be in need of 8 hours a week of HHC.

It has always been interesting to me the difference between the way Mil's needs are reported here and what her needs seem to be evaluated as. When she had home health coming in, last time she had been in the hospital, those folks ( including visiting nurse) didn't seem to think that MIL was unsafe living alone.

If she is non compliant with Meds/hydration and walker, she'll end up in the hospital. That's an opportunity for Dorker to call the in house professionals to evaluate her living situation
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Posted twice. Sorry
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It has always disturbed me that some on this thread gleefully paint MIL as Satan on a broomstick and SIL and DH as malevolent dupes. I agree 100% that Dorker needs to keep her boundaries firmly in place but IMO turning this into an epic battle of good vs evil is just stirring the pot. Dorker is part of a family that she loves and that got along well previous to this, I don't see why trying to find a compromise and getting past the animosity is not something of value worth working for.
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I'm glad you said that CW because it's been bothering me too.
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MIL has been selfishly insisting that she stay home "I'll manage" when it should have been clear to her at least for the past four months (not to mention 15 years) that she has a ton of help to stay in her home. It reminds me of my dad - refusing any and all help - but my poor stepmom "i need the help to take care of you!!!" She might not be Satana but she certainly is Narcissa.

Dorker has expressed on this thread that MIL was a great grandmother to her kids and that she wants a relationship. She can do that. Although it seems as if MIL is a great grudge holder - she'll never go to Dorker's again after the way she was treated during the hurricane - but doesn't respect/care for Dorker enough to try to discuss/clear the air.

Dorker's biggest battles are not going to be with MIL. It is going to be with her DH. SIL will continue to direct from afar, DH will ignore her as he sees fit. Eventually DD will tire of it all (especially as siblings not tapped to help). DH will be exasperated with Dorker as he seems to be "for chrissakes..... can't you just......." and if Dorker is not strong - she will be sucked in again.

Many things can be outsourced - grocery delivery, dog grooming come in, senior transport to doctor. Dorker can say "no" to the urgent non important issues (dog treats etc)

In all of this - is no one talking about MIL's biggest risks? That she is easily a fall risk - and that she does not take her meds right unless someone gives them to her. Will she at least wear a lifeline? If someone puts her meds in pill packs - will she take them on time and religiously?

What happens if during SIL's daily call - she can't reach MIL? Now she is worried about her having fallen - DH too busy, DD with babies, will this be the Dorker show again? Or should SIL call police for a welfare check?

Good luck Dorker - keep us posted.
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Having been out of the loop over on that end, I don't know the set up for the whole Home Health Care thing. Is that, since it's self-pay obviously .. is it an eval by their med team ... and service rendered accordingly. Or is it a matter that one can go ... I could if I wanted to pay for it I guess .. hire them and have them drive me hither and yon and show up here for light housework, and pet duty .. and any other of assorted things .. as long as I wanna fork over the $.

Not sure how it all falls.

I can tell you, as to her getting up all hours of the night to let poochy out, ... as to her lack of med compliance, .. as to her lack of seeing to her own nutrition/hydration (when left on her own) .. those items wouldn't even rise to the top as to any "need" assessment.

As has been my observation, on the scene there, countless times ... and I'd strived to get it done differently, to no avail. When I say to you, that SIL does EVERYTHING but breathe for her, when in attendance here .. that's the absolute truth .. that's how it goes. The pattern had been, .. when I was part of that scene .. MIL up all hours of the night (that's likely to continue) with an aging dog that needs to relive himself frequently, even in the night hours when one would presumably rest. All thru the night. SIL arrives here, .. she stays up later than MIL is able to. She lets the dog out, late at night .. before she goes to bed .. and ... the dog seems to do better with that set up, but if the dog does arise in the middle of the night, in need to exit to the b'yard .. SIL hears this, and takes it on herself, and goes and does it.

As to the meds .. SIL on the scene .. she hounds her mom, .. until it's done .. and on time. MIL left to her own, .. I've seen it, countless times ... she waxes and wanes on .. and dillies and dallies and it can be lunch time before those morning pills ever get on board and by then, another set of something needs to be taken. SIL on site,.. she lays them out for her mom, along with the b'fast she has out .. and then SIL, relentless, doesn't let up until it's done.

As to the hydration/nutrition. MIL's pattern had been, at least when I was a part of all this, to not take her Lasix .. "Oh I hate those things .. ya know .. I just can hardly get one foot in front of the other to get any damn where, .. and that makes me have to get up and go all the time .. ", and she'd not take them. The result ... she'd get edema ongoing . and then she'd double up .. and now .. she would begin to dehydrate .. and then weaker/fall. Yes, counseled, by docs, .. by me, by SIL .. everyone .. "not taking them isn't ian option, ya know the docs have advised if you really don't want to take them we can try support hose .. to see if that will help". That would be met with, "I'm not doing that, ... I can't do that .. I have arthritic fingers I can't do anything with". Well let's go to the medical store and see what assistive device might help with that, .. or maybe we hire a home health aid to come in and help with it ... No, she'd hear of nothing, and the above pattern, lather/rinse/repeat, over and over. WHEN SIL is on site ... see above, .. pills get administered.

When/if MIL would get sick, . which seemed to happen with more frequency than normal ... (diverticulitis). NONE of us want to take anything of sustenance, fluids and/or anything else, when we don't feel good. I get it. But we all know, what will happen if we don't .. at least hydrate .. we all know that. Her, left on her own .... she would languish in the bed (of course, not feeling well). Mother have you gotten some Pedialyte and drank it, or at least some water, you know you have to be pushing the fluids back in .. you know that. Answer, "oh no .. I just don't feel like it, I don't want anything". Mother you know what's going to happen .. you're going to get weaker and weaker .. it's not good, you have to drink .. you have to. This over the phone as her "I can manage" plays out, absent anyone in attendance. So you go out there, on site, and make sure to push fluids and .. try to get her to rally. And eventually, until the next time .. there ya have it. SIL on the scene .. none of the above is an issue, because SIL is there pushing the above .. "and here mom, you can have a small banana ... go ahead and see if you can just eat that, or here's a piece of dry toast if you would .. just try and eat some of it, .. and go ahead and drink some of that water I have there for you, just a few sips. MIL sits there, hanging her head, not proceeding, SIL harranges .. eventually it gets done.

Now why does none of this rise to the top as to "need" which is evident. Because, as I said .. when SIL is here .. she runs like a race horse. I think SIL .. needs to be busy .. to her, this doesn't smack of, "gee what the hell happens when I'm not here to be struggling with her to meet all this demand". To her, because she has to be busy, all the time, it's just life as we know it.

Why isn't SIL herself, saying to any evaluation team, "Ya know, when I"m here with her, ... staying with her, it's really a struggle for me to get her to take her pills in the morning .. and it's ... its' really hard to get her to keep herself hyrated well, .. and so forth". Why isn't SIl pointing those out as issues that need to be addressed. I would presume, because SIL .. being in attendance there, .. doesn't "see" it as an issue, she is able to achieve it. What she is failing to recognize is that it gets achieved, yes it does, but only because someone is there .. physically/audibly .. staying after it.

If you had any idea how many times I've been on the scene there .. as I watch SIL fix the dog's lunch .. (has to be warmed in the microwave and smashed up and pebbles of dry this or that in it, and this pill stirred in and so forth) .. and I've said to SIL, "let her do it, who do you think does it when you aren't here". If you had any idea of how many times I've been present, as SIL harrangs her mom, to take her pills, and I've pointed out to both of them, "Gee how does this get done when you aren't here to bug the crap outta her". If you had any idea how many times I've been there on the scene, her pushing her mom, "Ma, you really need to work on that glass of water .. you need to take a few more sips .. you need to at least try to eat that banana there .. or a few bites of that toast", and on and on it would go, and me saying, "gee, .. you really need to show your daughter that you do these things without having your hand held to get it done ...".

I've tried countless times, when I was part of the scene, to get SIL to understand/comprehend . those things .. all those things .. that she stays after her mother about . and does for her, .. letting the dog in and out .. all of it ... these are all things that MIL has to do on her own, being left alone to manage. That she needs to LET HER DO IT ... on her own .. without prompt and harranging .. so she herself, can get an accurate picture of how it all goes in her absence. SIL's response to my assertions was generally, "well that's why I'm here I want to help her".

So yes, there is need that is not being addressed in a mere, .. 8 hours a week home health aid coming to the scene. But that too, will have to surface, .. I suppose .. if/when it does.

WHEN I exited the scene .. you had all the above as issues, and so much more.

She had been advised countless times by all involved, .. cane is no longer sufficient .. you need to be using a walker 100% of the time. She wouldn't do it. I had even been with her at one particular visit .. to the PCP .. where I brought to the forefront, that she fails to use her walker 100% of the time, and still uses the cane .. and is (hold onto your socks) going out to walk her dog, cane in hand .. on occasion .. and falls into the shrubs there on the side of the road ,.. and some hapless passerby has helped her to her feet again. PCP .. cautioning, "you really .. you have to use the walker, .. that cane just doesn't provide the support you need .. it really does not .. it's not safe ... you realize what it will look like if you take a nasty horrible fall, do you realize that ... and the dog walking, .. you really just cannot be doing that any longer, .. if you feel your dog needs to be walked, maybe there is a neighborhood kid that would like to make a few bucks .. or there are services for that .. but it's just not safe for you to be doing that any longer".

You would leave there, me with her .. and I'd talk with her .. "you know, they are so right, you really have got to use that walker .. all the time .. not just some of the time, all the time . you have to keep yourself safe and .. one way to try to do that, is to use that walker like they want you to do . and walking the dog .. you have a wonderful backyard that's completely privacy fenced, .. the dog can wander at will out there, out of harm's way .. you falling in the shrugs out there on the sidewalk, and then waiting for some passer by to come get you to your feet, .. one of these days the dog is going to get loose from you doing that as you get perhaps .. seriously injured . and then the dog will be off and gone, and you laying there unable to get up, you need to listen to them and do as your advised".

She would either agree (to shut me up) or she would argue with a stance of, "I'm going to do what I damn well please".

And then fast forward to a day or two later, DH maybe calling to check in with her, .. just a check in. "Hey ma, how are ya .. how are you doing?". Her: "Oh I'm doing alright, I have had a good day today .. ya know I took the dog out for a little walk, and I almost fell ... I really had to grab myself there, I got unsteady .. you know this isn't me, this isn't what I'm about, ... you know .. I just want to get back to where I can do those sorts of things .. it's really upsetting". You would hear this phone conversation, and then DH cautioning, "Mom Dorker says that you guys talked about all that at the doc and they told you that it's not something you should be doing any longer .. remember the time you fell into the bushes there and someone drove by and saw you and stopped and helped you to get up .. one of these days .. a driver may not see you .. to help you get up .. or you may get hurt so bad .. that they can't help you, .. you can't be doing that .. you aren't supposed to be doing that, it's not safe". Her with (rinse/lather/repeat) .. same as above .. agreeing (to shut him up and/or .. the stance of I'm going to do as I damn well please).

This kinda thing was going on ALL THE TIME, before I exited. And .. what this means to me, how this all lands on me .. as to my view/perception . she is going to fall and get hurt and need convalescing and a whole lot of support, ... for something that is so so so very preventable. Heed as you've been advised. It's not just you and your wants .. there is a whole lot more that factors into your refusal to do as you should.

And we all know where that "support" would've come in. Certainly not DH .. he is far too busy. Certainly not SIL .. she's in IL dog sitting .. who who? Me. And it did, for various and sundry issues .. .repeatedly.

And .. my trying to appeal to her son and her daughter, .. that she needs to be, I don't know, take the damn dog leashes .. so she CAN'T take the dog out for a walk, .. I don't know .. would be met with the patt answers too often cited, "she's so stubborn", .. "we'll just have to take it as it comes, do the best we can" .. and MIL's, "Now I will manage".

Things like, what arose in conversation with SIL .. that she is to meet with the yard guy .. as to advising, I suppose . on his entering the code to enter the garage . and from there .. he can then get the key that unlocks the entry/exit door to the b'yard .. and he is now in the b'yard and can open the big huge privacy gate on his own. That's an issue that I rode hard .. for a long long time. What had been occuring .. MIL .. knowledgeable that it was yard day .. was making her way out that same back door, and down two steps to get to the sidewalk below on her back pathway .. and then on that sidewalk (no walker) .. she'd hold onto the wall/corner of the house and make her way over to the gate/fence .. to use the key to unlock the little lock that secures it. A HUGE HUGE ENORMOUS FALL RISK to be taking. I had questioned and rode it hard .. "why are we doing this .. it's so senseless, putting her at risk for fall, .. ya know, give the guy the code to the garage .. he can enter that and the garage door rises .. and then from there, show him where the key is, the key that you need to unlock that back door that then allows you access to the b'yard .. he can then use the other key to unlock the little padlock on the gate and open it, .. and wahlaa .. he has entry to the b'yard for his riding mower, .. he does the same when he leaves .. and uses the code to close the garage door and he's gone .. and MIL can lock the entry/exit door in the garage that leads into her house .. so she doesn't have to worry that he will come in and do her harm .. for that matter, the guy is riding the mower around in her b'yard for 45 mins . if he wanted to do her harm .. he could do it, just bust some glass along those huge picture windows she sits at daily and he's in .. I don't think he means anyone any harm . why can't we solve that issue in this manner'.

Oh she'd never do that .. no ... she's too afraid the guy would come in her house, doesn't want anyone to have access to her garage .. no .. she'd never do that .. MIL why won't you do that .. "oh I'm not going to have someone coming and going here, with a code to enter my garage .. you don't know what it feels like to be alone and old and unable to defend yourself, no I'm not going to do that".

Seems there's been a change to that approach .. as of my recent short conversation when SIL indicates she has that also on her radar upcoming, to meet with the yard guy and go over how he will now enter and exit the b'yard. GOOD. GREAT .. however that got achieved, I'm all for it.

At the time I exited all of this thing .. there were so many factors at play, the above and so much, .. SO SO MUCH more ... and at the root of it all, the base of it all, .. no lack of compromise on the part of ANYONE involved. She was not consistently using her walker as had been advised countless times .. taking her dog for walks, with a mere cane as support .. she wasn't doing her meds .. wasn't hydrating well in the event of illness, .. I recall one particular time . she was on an antibiotic (diverticulitis flare up) and she'd been left there to take her meds, and do the BRAT diet .. as she nursed back to health .. called her .. I had some other conflict in my schedule and couldn't be there on site ..called her, "did you manage to eat some dry toast this morning, and get your antibiotic in?". Her answer, "I haven't taken my pills yet .. I wanted a bowl of cereal and some OJ so that's what I had .. ". Me: "MIL what ?!?!?!?!? OJ?!??!!? Cereal/fiber .. you haven't even taken in anything solid for two days . and you start with that, .. you can't do that .. you are going to now be sicker again". And sure enough .. that was the case ..

And at that time, as we all know, I was helping my daughter with a multiples pregnancy and she'd been put on rest .. and so I was taking the 4 yo .. a LOT .. to help her with that . and helping daughter where possible/where needed .. and also expecting the birth of twins .. and .. I could see the writing on the wall, I can't keep doing this .. we need more help.

And we all know how that went .

And so I exited.

Maybe someone of more fortitude .. maybe someone more strong willed than me, would've stayed in the fight and just said, "welp can't help with that, can't help with this .. that'll have to get answered elsewhere, I'm busy" but stayed engaged. I didn't. I stopped and exited and that's that.

So now, fast forward to 9 months later or whatever it is, .. and a couple more visits from SIL for calamities that have befallen the situations .. calamities that have required SIL be front and center, on site/in attendance, for longer than the requisite 2 or 3 week stint she would attend here .. a couple of times that has now occurred in the 9 months or so I've exited the scene.

And now suddenly .. there is recognition for the fact that add'l help is needed, and a HHC agency in the works .. as to (mere) 8 hours a week, .. (and I don't have the inner workings/particulars on how it was arrived at that 8 hours a week suffices). It has also, apparently, occurred .. that the yard guy can indeed enter and exit the b'yard without having mother at great risk for fall to facilitate that event.

Mother also now uses the walker, ALL THE TIME ..................... ALL THE TIME ..........!!!!!! I don't know if the canes have been thrown away or stuffed in a closet somewhere .. don't know. But I know she uses the walker now consistently as her means of ambulating. This .. subsequent to the hospital stay that occurred right about the time the twins were born .. and I'd exited the scene there .. she hospitalized .. and (UTI hospitalization where some cognitive impairment screening was done and deficits found, but never addressed). In that setting .. she'd been complaining that they won't let her get up out of bed and go to the bathroom on her own. And so here came the PT team .. to assess whether she truly is a fall risk .. and let's look at and evaluate that, if you do alright .. sure .. we don't wanna have to come help you, we can go help someone else ... let's see how you do. Her .. being evaluted in that setting (remember this was at the time, I'd left the front with the newborn twins and mommy recooping from a C-section) to go to the front at the hospital. And was bitter/resentful for having been called to that front as I'd said all along ............. she needs more help this isn't working. But to no avail. So I was there, when that evaluation was ongoing .. and the staff said to her . (as if she hadn't been told this countless times before) .. that the cane doesn't suffice as support for her .. she needs to be using the walker, .. all the time, 100% of the time. That's when I spoke up and said to the staff in her presence, "this isn't the first time she's heard that is it MIL .. what do you do when they refuse", .. that brought about some conversation about why we do what we're advised to do, and what can happen when we don't .. along the lines of, "you hate being here right ??.. you've told all of us how much you want out of here .. well if you fall and break a hip and you know that's really very common in the elderly .. if you fall and break a hip .. it won't be an in and out visit to the hospital .. you will be confined to a hospital for a long long time .. you really need to not be using that cane .. the walker needs to be your means to get around".

And I got a look shot at me, that she could kill me (for speaking up) and told, after staff left, that I can just leave .. as she put it, "you know, I"m going to do as I damn well please, these people can tell me all they want .. but when I get home, I'm going to do just as I please .. you know that right".

This is all when I'd left the front with newborn twins and my daughter, to attend to the above, and had already all but exited the whole scene that is all things MIL and her care and well being.

Somewhere in these last 9 months or so, .. the walker is now the *go to* as a means of ambulating. Maybe she the falls she has taken (none damaging) .. maybe this last fall, at xmas .. the one that did so much damage (no broken bones, but might as well have been, for the damage done). I don't know, but I do know the walker is now the go to .. as to her getting from point A to B.

Yes, I exited the scene in part because I needed to be on the front helping with DD and newborns .. and that has been answered to, and then some. DD takes care of those kids like a pro .. she doesn't need me. SHE LIKES to have my support and has it, quite often, even still .. but .. point being, that hurdle has been crossed and then some.

I exited the scene .. absent any willingness from any corner in it, . for recognition of the very real problems faced in supporting it and compromise.

Some of that appears to have been spoken to, at this point, .. at least rudimentarily.

Look, I realize .. NOBODY can make her do anything she doesn't wanna do. I've known that all along, throughout all of it ... I think it's reckless and irresponsible to continue to leave her to manage .. in her own home. But my thoughts on that topic .. immaterial. That's the fact. But .. of the remains of what is to be. The support it takes .. that .. pinpoints where my issues were in it all. Some of that is now getting addressed, it would appear. Some of it (mere 8 hours a week of support from HHC).

Hooray! Pleased with that.

And as things stand presently, the soonest SIL can pencil me in .. Tuesday a week from tomorrow. And as a means to show .. that it's not about me, and my (as I've been accused of) "it has to be all your way Dorker, or the highway" .. I haven't balked at the above. Should SIL be more motivated to maybe move things around and make it possible this sit down discussion occur sooner than a week from tomorrow. Absolutely, IMO .. and could she? Probably. But .. it's not about me .. it's not about .. "my way or the highway" never has been. So if that's what works for her schedule, then so be it. Set for Tuesday a week from tomorrow . and she and I will sit down just one on one . and talk over some of this.
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I don't think people here are painting MIL as evil, nor painting H and SIL as malevolent. But MIL is narcissistic, and H and SIL selfishly used Dorker as a way to avoid confronting MIL's selfish lifestyle. H wants Dorker to keep steppin' and a fetchin' to enable his workin'/churchin'/huntin' lifestyle. There appears to be no compromise for him.

As Dorker writes, she has tried to compromise for years. And none of them will have any part of it.

Dorker, I am very curious...does SIL wipe Precious Doggy's butt after he does his business?
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Yes, SIL lives and breathes for her mom, when present on site. She does wipe poochy's backside .. as he enters from having done his biz. As MIL does, when SIL isn't present.

MIL has had her pills sorted in pills packs .. all along. SIL does that for her, when here .. and that too, had been questioned by me, ... "what happens when you're gone, who does that?".

MIL would then take it on to do .. and .. she'd play with her meds, .. "Well I don't like taking this at supper so I'll put it in the lunch time slot .. and I don't wanna take this at all, so I'm not gonna put it in there .. and it would get all screwed up".

And it didn't matter, because she wouldn't take them anyway .. unless someone is there pushing that.

As to being back to square one with it all, as an eventuality. I plan to, going forward .. and anybody that wants to add some input, PLEASE PLEASE DO ....

Put some parameters around what I'm willing to do .. I don't intend to, in any way/shape/form, get into the management of who does what/when. Nope. Not going to insist that DH is the one to go over and wash the dog, that leaves it open for me and he to argue because he puts church/hunting in front of it. Nope, not my waggon to pull. I don't intend to push an agenda (as I've done in the past .. DH you really need to just go spend some time with your mom, go spend the night with her just because .. she's lonely .. go do that .. scoot out of here in the morning before work and go sit with her and have breakfast .. she'd love to have your company .. DH set it in stone .. that every other Sunday, after church, belongs to your mom, you take her to lunch without fail .. put that in stone). As I've done/harped in the past. Nope .. not doing that. That too, sets up contention between he and I, when he finds the church need, or this or that opening of whatever it is with hunting .. more pressing. Nope .. not going to argue that. I find fault with him for his failure to sit up and take notice and at least meet somewhere in the middle of the above. But .. not mine to argue with him about.

I plan to present to SIL (and I need suggestions from you kind folks, boy do I need it) .. "take me out of the equation as to pet need .. I can recall a time in your mom's life when she had a family pet gassed, simply because she was at a station in her life she didn't want to be responsible to anyone/anything. I'm there .. I have a 24 yo daughter that moved back home dog in tow with her, and I'd of rather she not bring a dog with her .. but .. so be it. But to take on someone else's pet in this point in my life, no thanks. So put that in someone else's corner to manage.

SIL I also need to speak to you about the texting business. When you are trying to reach your brother .. and you aren't getting any response. I need that you refrain going forward from the thought process that putting it on my radar then will get it addressed. That which you need your brother to see to, that's between you two .. I don't know, get with him and make some other plan that works better .. I don't have the answers .. but putting it on my radar to get with him, no longer an option that works for me. You need his attention to some matter, .. and he isn't being responsive .. you know where he lays his head at night, to sleep ... we have a landline .. call it .. I will hand him the phone if I'm the one that answers it. Short of that, .. it stops .. with triangulating me into the equation when you can't get his response.

Further, SIL .. there are some things I refer to as rabbit holes and wild goose chases that have gone on and that too changes going forward. Examples .. doggie diapers .. doggie gate that wouldn't fit the walls .. gluten tolerance testing .. exercise bike that sits to this day unused. If you recall SIL .. when these items were on the screen for addressing, all of them, and more, there was pushback, seen as superfluous and a ridiculous waste of time. Going forward, ............ when/if you present some need, .. gonna need you to be more mindful that if it's a need I don't agree with, and say so, then you will need to get that need met elsewhere and take me at my word on that, and don't push/persuade/cajole/justify and all other means of achieving that end goal. That only serves, in the end, .. to pi&S me off .. and in the end, when it turns out, it was a fruitless effort, I'm even more Pi&Sed. So .. let's going forward have some clearer boundaries around that issue. If you come up with some need you think needs addressing, you are welcome to bounce it off of me, .. if it's something I think useful/helpful and I'm able to help .. be glad to do it .. but if I say to you that no . I won't be doing that .. then take me at my word, .. and if you still feel it needs to be satisfied, whatever that need is .. take the ball and run with it, .. but run in another direction, not mine.

And on another note SIL .. there needs to be some clearer boundaries around what MIL needs as to her needs landing in our lap, via you. MIL .. if she is to be left on her own to manage .. my assumption is she is of clear enough mind to delineate for herself what her needs are and ask for same. In the past, that kinda looked like this ... I might've been with MIL the last two days in service to whatever the problem was .. and dealing with it, and have now returned to my own responsibilities and my life, only to then get texts from you that since MIL isn't feeling well, .. she can't seem t get to the lab for her appointment tomorrow .. for her blood work, .. and while we're out .. an we pick up the dog treats that need to be picked up, they've been there a week and she can't seem to get there to get it, ..

Let's put some clearer parameters around that .. if she is to be left alone to manage .. then my presumption is she is able to do so. She can speak up for herself. If she has these needs .. then, she can ask .. this business that it comes to us 3rd party via you .. and then I phone her, and ask and she then feigns the whole, "I wish she'd leave you guys alone, now I told her I will manage, I will take care of it, why does she bother you guys ... ". Nope . not gonna work for me. If MIL needs out help .. she can presumably ask for it. And I will weigh, whether or not I can or can't.

So the above ...... maybe addresses some of where my gripes have been (I may have forgotten some, remind me if I have .. and let's figure that out .. all of you that have weathered this with me here). It addresses some of what has gone on, and parameters going forward.

What I also need help with, from the fine folks here .. I'm speaking above to how I won't do this and that .. what is it I WILL DO. What can be said in conversation about that.

What has been forgotten left out, or left to open ended .. help me, critique please.
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Dorker - first of all decide what ARE you willing to do for MIL? One afternoon a week visiting? Take her to a doctor or to get her hair done? Pick up some groceries when you go shopping? Decide that first.

Conversation with SIL might look like - and remember - your job is not to problem solve. That is MIL, SIL and DH - your job is to outline what you WILL do.

"MIL's increasing needs over the past 15 years coupled with DD's needs after her twins' birth had way too much landing on me and i can no longer do what i had been doing.

I know you and DH and MIL are the ones to make decisions for her living arrangements and needs, that is not my role. But i know you will need some help and wanted to set out what I'm able to do.

I will do XXXX on YYYY day.

Please work with DH on anything outside of these items. When you call or text him - and he doesn't respond right away - please don't loop me in. All it does is gets DH to blow up at me for nagging him. He sees your texts, he will respond."

This kind of boils everything down. Don't tell her "please don't send me down rabbit holes" because if it is anything other than what you have outlined - and you consider it - maybe yes or maybe no. If it is no "i can't do that please work with DH"

You are exactly in the situation a former co-worker of mine is in. She works part time now (retired from my company) and her DH is the only child, MIL stubborn and wants to stay home, refuses any assistance other than DIL or DH and she is burned out. She finally said that Wednesday afternoons she would help MIL and that is it. DH is insisting she quit her part time job and basically be MIL's full time go-fer and fetcher as it gets her off his back with her needs. Good luck!!!
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Dorker,

You need to explain to SIL that you have essentially been operating an AL in MIL's house for the last 15 years. If SIL must be there around the clock to provide all sorts of assistance, MIL NOW requires services that are more than the average real AL facility typically can provide.

The idea that 8 hours of outside help is the bandaid for this is delusional at best.

It sounds to me that SIL is intentionally procrastinating your face to face meeting so that she can just cut and run. If BIL is there, surely she can meet you for half an hour. This just shows she really is not invested in the meeting.

Let them chase the rabbits down the holes. Stay strong.
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Mincemeat: Agreed.

Her schedule this week looks about like this:

Monday - AM-yardman coming for discussion on new entry/exit, 1 PM - PT for both her husband and MIL (she drives to same for them, MIL scared to death of BIL's driving).

Tuesday - DD and kids are visiting for lunch and DD is doing MIL's hair

Wednesday - 1 PM appointment again for PT, for her husband and MIL, cable tv coming in the AM to address some issue

Thursday - 11 AM appointment for gel injections in MIL's bad knees, PM-guy coming to power wash the driveway

Friday - HHC agency folks coming to initiate the set up for services, and another 1 PM appt for PT services for both husband and MIL.   

In the background of all this, I am the one that wishes to meet face-to-face with SIL. DH .. if I insist will accompany .. I don't insist .. in fact, don't want him there. I don't want any naysayers .. and dismissal of my points I wish to make, and he would act in that capacity most certainly. Don't wish to have MIL front and center as she would put on the whole "Now I will manage" hat and worse. So it's ME that is the one motivated in all this to make a time that SHE is available, as well as myself.

I am committed to something else tomorrow afternoon, but other than that, I'm wide available, and said so, she said the above as her schedule for this week.

Could she ask DD to put off her Tuesday visit with MIL .. and hair appointment with MIL .. would DD agree to same. Probably, yes.

MIL would absolutely refuse any set up where "hey let's have BIL drive you for your appointments" then freeing her up to have some time. She is terrified of his driving. Could she leave some of those chores, the cable tv guy, the power washing guy .. some of it .. could she say to her husband, "now the power wash guy is coming, here's his payment, I want him to do this area out here, come look at it .. all up and down this area .. and then free herself to see to said sit down with Dorker.

I think so.

But obviously she isn't motivated to do that. For whatever her reasons.

Now for me, to sit on this topic and "see .. see what I mean .. !!!... I try .. I try to get with her, but she's so busy making work for herself in every corner, that she can't make a time that works".

That would be seen (and maybe justifiably so) that Dorker is just ridiculous.

Thus, I step back and tell myself, "that's the best she is willing to do", and go with it. As to any sit down face to face meeting of the minds.

I do know (comical almost) that with her husband .. and his different frailties .. and his mind .. she does (as a for instance) send him to the grocery store, .. and say she puts on there .. on the list .. I want "x" kind of cereal, and then the list goes on and on. If that kinda cereal is out .. let's say they don't have "x" brand. He doesn't then use his brain and say, "Well gee, . let me call and ask if there is some other kind they'd like .. he just comes home with no cereal.

Thus,.. she .. of the ilk, to do it herself, rather than deal with the fallout of his shortcomings .. in so many arenas. She might send him to the library to pick up so and so books .. and he comes back with several more that no one cares to even read and forgets the ones that were asked for. That's kinda how he operates.

So maybe in her view .. it's better she stay there to deal with the cable tv guy, the power washer guy, etc etc etc.
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So, SIL can "pencil you in" for a WEEK FROM TOMORROW? How very, very accommodating of her! She's just showing how busy and powerful she is. That's crazy!! I'd probably say "Oh, gee that's not going to work for me--how about TOMORROW and let's get this show on the road ASAP" (But then, nothing happens ASAP in MIL's world, does it?) BIL is here now. Can't he babysit MIL for a couple hours?

I like the idea of explaining to SIL that you have BEEN functioning as MIL's ALF coordinator and primary CG for 15 years. Maybe that's not even a part of SIL's mindset. She's very trapped in the here and now and plastering band aids all over the little cuts and scrapes and ignoring the compound fracture that is MIL's life.

(SIGH)

I think what you plan to say is good. I'd actually type it up and give SIL a copy to keep. She can refer back to it when she goes home and suddenly remembers that doggy needs something and she goes to call you--and then you can remind her that doggy care is not under your purview. Also, having an "agenda" written out will keep you on task and not begin wandering all over. You state what you have to say and be firm, but loving.

After all--you guys really are a loving family--I think that gets lost as you vent. But it's there, underlying all the junk on top. You've been steadfast in that regard--that this whole thing is really coming from a place of love, and I for one, give you kudos for that. To still care so much about someone after what she's put(ting) you through is amazing.

Realistically? When SIL leaves this time, MIL is going to have a fall, an illness, whatever, and she will be back in the hospital again. It's not me being negative...it's just what's going to happen.

8 hrs of care a week will ensure that eats once, maybe twice and gets her meds on time, 2 days a week. IF she keeps the CG, which is unlikely.

Make sure SIL knows you are NOT replying to texts like a trained monkey. DH can handle that. (He won't, but you need not even be in the triangle here).

I wish you the best of luck...don't let SIL put you down or guilt you. You've done enough for a lifetime. That can be your takeaway. SIL hasn't been in the trenches like you and she really cannot speak for/about you. Don't let DH guilt you.

Hang tough. Don't let ANYONE run you down and try to make you feel guilty.

But, wow, MIL has a clean driveway!! 'cause THAT matters!
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Can't she be left alone with DD while her hair is being done? Can't SIL miss lunch with the kids and let BIL be the "adult" there? That schedule is beyond-beyond. She's putting you off!!! Manipulating you, as always.

And NO, DH should not be there. Absolutely NOT. And he probably doesn't want.

I'm so frustrated by this all---and you're 3000 miles away. I can hear your gnashing teeth from here!!
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"I am the one that wishes to meet face-to-face with SIL. DH .. if I insist will accompany .. I don't insist .. in fact, don't want him there. I don't want any naysayers .. and dismissal of my points I wish to make, and he would act in that capacity most certainly."

H would do that to you? He wouldn't stand up for you to his sister?
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Midkid: DD and crew are going there for lunch/visit and to do MIL's hair (DD is a former cosmetologist BTW). "crew" is going. Somebody needs to watch, at leasts the 2 babies .. and keep them from eating electrical cords and the like .. in MIL's house. BIL now operating on a pinched nerve (?) in his back. Not that he'd of been someone even I would really (overly vigilant can we say) trust to be attentive enough to that setting. SIL .. will likely run circles in caring for babies .. and DD and MIL will do their thing as to the hair fixing. And the 4 yo will likely go entertain BIL with her antics. That's about how that will all play out. So no, she can't really leave BIL for that and come this way.

She could move the visit by DD .. if she so cared to do. She could .. direct her husband as to instructions via the cable tv guy .. or the power wash guy .. she COULD do that. But I'm not in the business of directing how other people do things.

I'm just hanging back with a "uh .. okay .. pencil me in for Tuesday a week from tomorrow then".

CTTN: Let me give you a bird's eye view of about how all that would play out, with DH in attendance (and let's remember, he has NEVER walked in these shoes, not a mile, not even a foot .. ever, and he never will).

So we're all gathered, me and DH and SIL.

ME: "SIL as you know, there were some problematic issues in it all, as to the well being of MIL and it took up, for me, .. at least for my world .. too large a chunk of my time/effort/energies and my own well being, so of course, what we'll do from this forward .. let's work to see what we can do to address some of those concerns.

First and foremost, let's talk about when you can't get a response via texting DH .. as to some need that has cropped up. Here's what will work for me going forward .. if he doesn't respond to you .. I don't know, .. we have a home phone/old fashioned land line, call it .. you know where he sleeps nightly .. you can sure call the home phone .. and I'll be sure and hand him the phone .. or .. I dunno .. you two get together and figure out what works better .. but .. as to bringing me into the loop .. and texting me when it's been two days and you haven't heard back from DH ... I'd really prefer we not go that way any longer, that creates friction in my world when I'm seen as nagging him .. and .. so let's do things different going forward, and take me out of that loop.

DH: "What .. friction ..??...what are you talking about Dorker .. ??..... poor SIL .. she's just doing what she can to manage this situation from afar .. and .. yea maybe I didn't text her back .. but I get it, .. I know .. I know to go there, don't put that on her, that she's somehow now FORBIDDEN to loop you into it .. that isn't fair, she's just trying to get a resolution, you know me, you know my world, in some cases you can actually speak on my behalf as to what's in my orbit to be done, and can maybe even address it with SIL to let her know that you know I have thus and so to take care of, but that it looks like "x" day might work .. that you'll pass it on to me .. don't do that to her".

ME: (now pretty hot under the collar, .. see above .. he hasn't walked in these shoes) "Dear hubby ... that approach has been tried .. countless times .. and what the result has been, in my experience, .. so I speak up and I say to her, "Oh yea, looks like on Wednesday he might have some time for that .. I'll be sure and pass this along to him"., and I do so .. only to learn that you have signed yourself up for thus and so at church on Wednesday and I didn't know it .. and then I say .. oh gee .. you better let SIL know that Wednesday wasn't so good after all .. and I leave it alone. Then, .. I get another text from SIL .. say a day or two later, "I talked to mom she said she never heard from DH yesterday (Wednesday) do you know if he forgot, or did he get busy ..". I now go to you, .. "DH did you not get back with your sister that Wednesday didn't turn out to be so good afterall, but that you'd do it on "x" day. And you then blast me, .. "No I didn't get back with her, there just gonna have to understand dear Dorker that I will get there when I can .. just tell them that". And that meets with, me saying to you, "well be sure and pass that on to them then, let them know that". Why all this circuitous conversation .. just let's cut me out of it .. I don't even need to be in it . if there is some issue that needs your attention, let's go ahead and cut to the chase, and figure a way that gets the two of YOU on that page and I don't even need to be in it, .. that's what I'm trying to achieve here".

DH: "You act like I'm some damned unapproachable monster that you can't even remind me of something without me snapping your head off, when have I acted like that, .. when?"

ME: "I didn't know I needed to get out my daytimer and mark each occurence with it's date/time and the specific situation that caused it .. but .. nonetheless .. back to my point.

DH: (body language indicative that he is pizzed at having been thrown under the bus on his lack of responsiveness and the fact that Dorker will no longer run interference on that front).

We proceed ahead.

The above being only one of infinite different scenarios that need to be tabled for discussion.

With the above .. I don't see why he'd have ANY problem with that as a proposal .. gets me out of his ear on it .. and it also alleviates me from having to own that which is now in my lap to address. And I would say that to him in the above dialogue.

Let's move on to another scenario that might be on the table for discussion.

Me: "So SIL what I'd propose as to my time/efforts going forward .. I'd like to propose that maybe Tuesday mornings.. (for instance, haven't decided yet) . I can be in service to MIL .. and whether that means a doc visit/lunch out .. just visit . pick up things .. whatever .. I'll be happy to do it .. how does that sound.

DH: (interjecting) "Dorker you can't just put everything in stone .. and hope that all goes well, all days except Tuesdays .. it doesn't work that way, what if it's a Thursday and mom is sick .. I mean stuff happens on other days of the week, you can't CONTROL every situation .. you wanna lay it all at a "TUESDAY" or whatever .. what if there is "NEED" on other days of the week .. and I'm not available.

Me: (now even more aggravated at having what works for me, in my world presented and efforts there thwarted or used as point of argument). "Well Dear Hubby .. as you're well aware .. I had some real problems and for quite a long time, with how much I was unable to manage my own life in service to the need on that front .. and so that's why we're where we are with all of this .. my trying to come to the table with a semblance of what will work for me, so as to not be someone seen as being mean spirited and controlling and because I do love all of you, and want to help . but .. you have to remember in it all, just as you are busy and can't be there .. I too am subject ot the same perimeters as I walk my daily life .. so .. what I'm trying to do . is to put out there a semblance of what will work for me .. so that my life doesn't again get consumed with all things MIL's well being, which I"m sure you agree isn't fair".

DH: "I just think, for you to carve out one day a week and set that in stone .. and then .. what ..??... the rest of the days of the week if there's any problem, .. oh well .. dorker doesn't do Saturdays or Thursdays .. JUST ONLY TUESDAYS".

The above is about a picture of how it would go, .. and that's just covering a couple of topics. Him wanting me to be flexible (i.e. dump it all on me again) .. wanting to say that I'm trying to "control" it all, when in reality all I'm trying to do is control what goes on in my circumference, as any normal human would like for their daily existence.

No, absolutely not .. he doesn't need to be a part of it, and no I can't expect he will defend my position in it all, unfortunately. It wouldn't be his sister that would "argue" any of the above .. she's smart enough to know .. I can just turn and walk away from ALL OF IT. It would be HIM that I have an argument with .. and the above is about how it would look.

He has been so very inconsistent with his stance on it all, as pertains to my involvement. On the one hand, he says things like, "I hear ya dorker .. I'm right there with you, I understand ... you act like I don't understand"

But then will, in another moment say things like: "You can't control everything that goes on, some of it we just have to wing it, do the best we can (i.e., dump it on Dorker).

What you would hope he would say is .. stay silent .. and/or add in to the mix: "Ya know sister, it really was a lot we were leaving her to deal with, so I think it's great we can all sit and work thru some of this".

Nah, that ain't gonna happen.
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"DH: "I just think, for you to carve out one day a week and set that in stone .. and then .. what ..??... the rest of the days of the week if there's any problem, .. oh well .. dorker doesn't do Saturdays or Thursdays .. JUST ONLY TUESDAYS". "

This example really says it all, don't you think? He expects you to be steppin' and fetchin' just like you used to do. SIL probably knows this. She'd like that, too! It keeps Narcissa happy and both of them out of the actual caregiving.

I would refuse to help at all. Not even "Tuesdays." If you limited yourself, they would be just as hurt and angry as they are now when you aren't helping out at all. So why help at all?

(A future way to help out would be to go visit MIL in the ALF/SNF one day a week.)

Narcissa is more important than anyone else. Well, of course she feels that way, but isn't it hurtful that they think she is more important than you are? Because that is what their actions over these past months is saying to me, loud and clear.
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Have key talking points. Keep it concise. Know beforehand what you are willing to do. List all the things that can be outsourced - grocery shopping, dog grooming, all home maintenance items, dog walker. SIL can do the ordering of things online, especially pet items (Amazon Prime), even medicine can be mailed.

On the texting, stress that it's more efficient and less subject to mix ups if the texts are directly between SIL and DH.
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Dorker

I’m sure you will get lots of ideas about what you can do or not do before next Tuesday.

I think I would keep it simple.

“I will do anything MIL asks of me that is not dog related and can be done in the four hour window I have on Tuesdays.”

“The request must come from MIL. She can have her list ready. What I can’t accomplish that day will have to wait until the next week.”

“I’m not sure if this will trigger too much anxiety. I plan to go slow and see how it goes. “

“If I feel I am being asked to do things that aren’t necessary, I will tell MIL no. No direction is needed from afar.”

These things you will do could include the hair dresser, picking up meds, a visit, a lunch out. Helping her with wardrobe. Paying the hired help. Helping her make her shopping list.
Help her with her mail...whatever she needs. This allows you to adjust as you feel like it. 

She still has her housekeeper right?

Dorker, since you and DH are helping to pay for the private pay assistant then I would also question paying someone for taking her to therapy when that can be done in her own home. My mother had OT and PT several times a week for years. It kept her going. My aunt has it the same way now.
I know MIL has had it in home before and SIL changed it. She can change it back now that it’s going to cost $40 or more to take her out for it. 

No need to pay for Needless trips for blood work etc as that could be done by HH. I don’t think she is on warfarin but if she were they will even do the PT/INR blood test in her home.

Also UTI test can be done by HH. If I suspect aunt has a UTI I call HH and request they check it. They get their order from the dr, do the test and when the results arrive they let me and the dr know. If a prescription is needed it’s called in. No trip necessary. No extra charges.

Her insurance pays for HH and therapy. They keep their eye on the CHF. They will help her with her shower.
They can change her sheets.
They will sometimes even come more often if she is sick and it’s needed.

When my mom had to have her lasik increased or decreased or her warfarin adjusted they would come redo her pills. The key is to communicate.

Now that it’s private pay it’s time to utilize the benefits already paid for. HH can do the pills and reorder as needed.

They are a terrific resource for the lucky ones like MIL who qualify for ongoing care and want to live at home alone. I know about the services because I have used them for years, first with my mother and now with my aunt. I know you don’t want to get too involved and I appreciate that but I sure hope you guys don’t end up paying someone else to do what her insurance already covers.

If for some reason they didn’t like the one company there are many available. I think we changed once in at least 10 years of service and that was early on.

The private pay for transportation to a dr visit  is ok but even that was limited to once a year per doctor for my mom.  

We did up to four drs in one day sometimes and that was after a three hour drive. Once you get it organized, it works. And she was on a walker or I was pushing a wheel chair. The attitude has to be right. We are all in it together is the one I look for.

When edema is being managed by HH, steps are taken to correct weekly and not quarterly or after it’s gotten so bad it’s a crisis.

I just want you to know about this resource in case you find yourself paying for services to get care that is already covered by her insurance.

One of your volunteer jobs could be to check the logs weekly looking for anything unusual or out of bounds.

Don’t over commit. See first if SIL can reign in all the unnecessary direction.   Let the tone of your meeting be that you are counting on her being able to keep her end of the bargain and stay off the texts. Let her get it that that seemed to be what was causing you the most anxiety. 

I’m excited for you and MIL getting to enjoy one another’s company again. 
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At this point, I only see three possibilities. 1. Hold the current course. 2. Kick DH out of the house and tell him to go live with MIL. 3. Go live with daughter and help her with the children.
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Re: HH, won’t she have to be deemed home bound? Patients  determined to be “Home bound”, in my experience, could go out for Doctor appts, or therapy appts, but not much leeway was given for other excursions. Grocery shopping isn’t included. I did home health nursing for 3 years & if there was no acute medical need we were out. Same for PT/OT. Once she has reached her potential for home PT, she would need to go out-patient for more effective therapy  as home PT would stop. OT is assistance with ADL’s - dressing, bathing, making easy meals. They don’t stay in long if the patient is able to ambulated with an assist device.  97y/o, you are very lucky to have that service. We required medical justification & could not stay in the home if we couldn’t justify it and weren’t doing anything considered skilled. We were expected to teach the family and patient how to do their own med management. In my experience, Medicare is not going to continue to pay an RN to fill a med planner. That’s not skilled nursing. Home care staff goals are to stabilize, educate and discharge. I worked for a huge agency out of Baltimore. Also, anything done needs a doctor’s order - lab work, etc. Doctors have to justify a need for continued homecare as well as pre certification & Medical justification for payment from the patient’s insurance company.

When my MIL visited last year, we had Visiting Angels in for 6 hrs a day as we both work. They were pretty expensive! I think once MIL has her evaluation on Friday, they are going to recommend more than 8 hours a week. I’m thinking SIL thinks that’s all she needs. 8 hours is not a lot at all. Plus MIL will dismiss them, guaranteed, once SIL leaves. 

I do know there are pharmacies that pre-fill blister packs with individual doses and different daily intervals to make medication management easier. A few of my patients have this and it’s great. But it still won’t guarantee compliance.

In order for this “plan” for MIL’s future care and well being to work if she remains in her home, others have to commit to doing their part as well. The only other people around MIL are DH, DD, YD & Dorker. Who else will commit? Who can? YD has her job and friends, DD has 3 small kids, & DH has his own business. Who is going to give anything up? I think no one. The only one with the most flexibility is Dorker. That’s not fair to her. I have a creepy feeling that care will again fall to her. I don’t know how this can be avoided unless MIL goes into AL or more home aide hours. I just don’t see it. MIL as well needs to be on board and make a few compromises. She is making consessions for the lawn guy, but that’s one small thing. 

I can’t believe SIL won’t (can’t) see Dorker for a week. Really? 
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Dorker - if you just do Tuesdays, what possible urgency is going to come up? If MIL is sick, dial 911 for hospital. If she is not sick enough for 911, she can wait until DH can stop by after work.

If she is out of groceries - they deliver. If she needs dog treats - they deliver.

I can't truly fathom what DH expects from you except that you drop everything any time he wants for MIL. NO!!!!!!!! it got to be too much.

AND there is no point for you to be in the middle of the text mess. Just say - "it no longer works for me to be in the middle"

Good luck - your DH is really getting on my bad list. It seems as if everyone feels their chit is more important than yours. As this gets going - SIL will be managing from afar, DH will have his business, DD will get sick of it as she has her kids and hands full - so everyone is going to decide that Dorker should do it because after all she has the most time and her stuff isn't as important as theirs. DH will come along with "I keep food on the table, I don't have time for this chit - for chrissakes... can't you just.................." and Dorker will be the bad guy in all of this if she says "NO". I certainly hope she does - this hamster run is going nowhere.
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Yes Shane. She had OT in home, but that's come and gone. Sounded like their purpose was to eval the home and what best suitable as to MIL's travels around her home and that was dispensed with pretty quickly. PT also assigned, in home .. that too, has run it's course and has now been ordered for outpatient. Visiting nurse .. that was to .. I suppose, .. check her vitals .. and report in .. (post hospitalization). That has long since also, run it's course.

SIL is now engaging some HHC agency .. and I don't know the inner workings of how this all lines up. Someone lay like myself, .. just presumes there are two paths to that end. One of those paths being, ordered by physician and justification for same, and then whatever your insurance limits .. you work within those parameters. The other option .. #2 .. that layperson like myself would presume. I, myself, .. I guess, if I felt so inclined, .. could call up such agency and as long as I wanna write them the payment, they will do any and all things I wish done .. drive me here and there, daily, pick up whatever incidentals I can conjure up that I might need .. do some light housework, wipe my dog's backside as he comes in, you name it.

The above would be about my layperson presumption of how that all works. Maybe I'm wrong.

I know that SIL is working to get in place (which, my own reading on it, tells me it will be months and months and months) VA Aid and Attendance, .. as to payment for above services. In the interim this will all be self-pay.

i haven't questioned (because I have been out of the loop on the whole scene), but I will be asking .. "okay so we're paying how much of what this will come to monthly?, and we're looking for this to address what needs specifically". Oh you want them to haul her to the vet .. you want them to haul her to doc appointments .. you want them to pick up her rx's . you want them to take the dog to the groomer . you want them to x, y and z". I don't know, I haven't asked. I don't know what they will do for the monies they are paid nor do I know what the intentions are on SIL's behalf of what they will satisfy as to need. But I intend to ask.

One thing that comes immediately to mind .. for me anyway .. that I don't know the answer to, and I suppose some research on my part might answer my own question. Okay .. so we're going to pay HHC .. and part of what they will be doing is a monthly trip to the groomer at "$" amount per hour .. are we sure that it wouldn't be more cost effective to have a groomer pull into her driveway .. shouldn't we weigh out which is more cost effective?

You want them to haul her to the grocery store, at the slow slow pace she move .. wouldn't it be better, more cost effective to have those groceries delivered? Yes, there is a fee associated with same, but what's that fee vs what the HHC charges per hour as she ambles around the store.

I presume the answer might look a little like, "Well she doesn't want to give up trips to the grocery store .. she likes to go .. it's like a social outlet for her, she can look at things there, and decide if she sees something new she might like to try .. she doesn't wanna give that up". "and we're paying how much ...??!!!??!! ... when we could pay "x" amount less and have those items delivered?!!?!?!?

I haven't done the cost vs benefit myself, because I don't even know at this point, what SIL has intended as to what they will provide in this said *8 hour allotment* she is mentioning. Don't even have any real knowledge on the topic of what they will and won't do for her .. I just am ignorant to all this.

Maybe she intends that someone come weekly to re-organize her med packet for her ... maybe they take her in that setting, to her dog groomer, .. I don't really know .. not in on it, as to what the intentions are.
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It still makes me laugh that MIL wipes the dog's backside every time the beast comes in.
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