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Dorker, she has congestive heart failure, right?

Not enough oxygen is being pumped anywhere in her body. That's why she's tired.
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Oh, I'm aware that's the CHF at play .. with her fatigue .. that and being 88 years old. Noticed that her ankles were swollen .. but I didn't say a word. I used to would harung her, about her Lasix and her ankles and make a fuss over it. Don't do that now.

I still say ... she's just a hiccup away from another calmity.
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That sounds like a fantastic visit, Dorker. Pleasant and productive.
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Yes, Dorker. The “theme” and limits of your most recent visit are spot-on. Good foundation for managing MIL — and your own sanity— going forward. 👍🏼
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Is PT helpful in these kinds of situations?

Had a text from SIL last night, thanking me for going to visit their mom and helping her, asked me how did she seem to me.

I answered her text: "per her words ........." and proceeded to answer that querry .. in the format that MIL had complained of, her own words.

SIL then responded: "you know she had all that PT before I left .. and even the two weeks out outpatient PT that seemed like it was helping".

I didn't respond any further.

My feeling ......(but I could be barking up a tree I know nothing about) ..., I wanted to say to her, .. NO SIL ......what was helpful is that she has someone in attendance to see to all that she needs to attend to on her own, absent any more structured setting, it's not about PT .. it's about . she's got a myriad of chronic conditions that render her unable to adequately care for herself.

I didn't say any of the above, .. not going up that road frought with all it's frustrations.

I simply didn't respond at all.

I think she was leaning towards, if I'd of taken the bait .. that perhaps MIL would benefit from more PT .. (and of course she has exhausted the home PT .. and it isn't as good .. so SIL says .. as what can be obtained going to the site for same). I think that's where SIL would've liked to have taken that dialogue. But I didn't respond any further .. not going there.

But what is the general consensus ... more PT would prove beneficial in a case like this .. or no ....

She's got CHF (I don't know the extent anymore, the ejection fraction, etc., the severity .. used to .. but I don't know it anymore).

She's got balance issues as a result of a long ago stroke .. (balance issues she's been thru PT numerous times to try to improve .. and maybe it has helped .. maybe absent any PT at all, she'd not even be able to be upright, what do I know). But balance issues that seem to worsen as she ages.

She's got bad knees .. both of them .. they both need TKR .. but she is no candidate for the rehab it would take .. and so that's not on the table for discussion .. she just gets steroid shots to ease the inflammation and discomfort .. and seemingly .. the knee pain wasn't alleviated this time, not as much as in previous sessions of steroid injections.

Do you throw in the towel and say (like I'm inclined to approach it all) ........ "no .. PT isn't going to be helpful .. she is aging and the myriad of chronic conditions she has .. surpass what PT can do to improve her quality of life".

Or am I barking up the wrong tree that I don't have a clue about.

Not that I'm going to respond to SIL or anyone else, "oh absolutely .. let's get her signed up .. I'll go pick her up 3 x's weekly to make sure that's seen to".

Even if PT was something that would be beneficial.. she truly has no way .. (other than enlisting all the gray area left as to her support) .. to get to and fro. 

(((Oh and I didn't even mention the edema that appears to be building in MIL's feet/ankles, when responding to SIL, what's the point, . not gonna argue with her about taking her Lasix)))
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Let it be Dorker. I don’t think any more PT is worth it. To truly benefit from PT one has to actually continue at least some of the exercises at home. If she won’t do that consistently it won’t really benefit her.

You do worry a lot about your MIL, & you get an “atta girl” for that. But, and I say this respectfully, it does seem like you do dwell on MIL too much. Now SIL plants an idea in your head about more PT & you are at least thinking of any benefit she may get, when, again, SIL should be discussing this with DH. 

Either you are all in or not; adhere to your once weekly plan and let it go. 
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What MIL needs at this point is a wheelchair. Let it go, Dorker.
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I think you did a great job not engaging in the ailments conversation. Stay strong. Your own health is on the line. Yes, let it go. It will be what it will be.
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You're still receiving daily texts from SIL? She really doesn't get that you have pretty much divested yourself from MIL, aside from THURSDAY am.

Maybe you need to text SIL with a kind, but firm "I am taking care of MIL on Thursdays. I don't call her everyday, that's DH's responsibility. I have a lot on my plate with my grands, my job, helping to run DH's business. In future, please just text DH with your concerns". Then, if you must, block her number. As long as you receive texts--SIL will continue to believe you are still 100% in this mess.

Yep, the legs are swelling--you're waiting for the big boom. Sorry about that, but when she has the emergency, then you can make some progress towards placing her.

As far as PT, forget about it. Also those steroid shots. At some point, they simply cease to work, actually begin to cause damage to the joints. And of course, NO WAY is she going to qualify for TKR. Not at her age in her condition.

Bravo for not mentioning the swelling to SIL. Did anybody think MIL was actually going to be compliant in taking her meds??

These are DH's concerns, not yours. Let them go. (Ah, I know, easier said than done!)
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I think Dorker was asking in general about PT not for MIL
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Exercise is good. OR would help IF MIL (or whomever) keeps doing the required routines several times a day.

She doesn't have the energy to do that. She has balance issues and is a fall risk. Which is why I think it might be time to consider a wheelchair. Not Dorker's problem.
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I think Dorker was indeed asking about MIL needing PT to continue.

She will *probably* go if someone made the appts and took her and took her to lunch afterwards and then to shop for poochy poo and then to.....it's a snowball effect.

ALL in home PT and ALL clinic PT's leave their patients with a list of exercises to be done once PT is over for that specific "need".

The compliant, comply. We never hear about them. The non-compliant only exercise when the PT is standing there.

Not Dorker's problem. Even IF SIL arranges from afar for MIL to get more PT, it would probably have to be paid for in full, no insurance after x many sessions, which she already did. In home PT would require MIL to let someone strange into her home. I'm pretty sure they've been to that rodeo.
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Midkid has it right. If someone would set it up as to outpatient, on site, PT .. and someone would come get MIL and then stop off to get poochy treats and lunch out .. it'd be on the radar tomorrow. I'm sure if SIL could get this arranged, .. it would be on the radar tomorrow.

That's why I was asking whether it's even beneficial .. in a case like her's.

Like what Barb says .. she's too tired, too compromised to do the at home exercises they recommend. So how beneficial would it all be anyway.

Not very much, IMO.
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Yes. When my mom, post stroke, post broken hip, chf, and entered the nursing home, she had lots of PT. Even after rehab ended, they would get her recertified periodically for PT to keep her strong. As she became weaker, the put a
" walking protocol " in place where a staff member would walk mom, with a gait belt up and down the hallway.

MIL would benefit from PT. She's at the point now where she can't do exercises on her own due to her balance issues; she needs a " spotter". All of these, dear Dorker, are reasons she neds to be in a facility, OR have significant amounts of home health.

It's not just a matter of someone taking her to PT.
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The issue of whether MIL should be in a facility is kind of a moot point at this juncture. MIL has stated over and over she will never leave her house. She also won't be compliant with any kind of in home PT unless someone is there with her making sure she's doing the exercises correctly. That isn't going to happen.

NOBODY thinks she should be living alone. NOBODY except for the person to whom it means the most--MIL. And, being competent, she has every right to do as she chooses. She just doesn't get to "choose" the outcome of that bad decision.

OF COURSE she needs PT. We ALL do. It's called "exercise"...everyone who is remotely capable of moving should be making some efforts to stay functional.

How beneficial to MIL would any PT be at this point? It might keep her more stable and able to ambulate. It might help with walker skills--but if she refuses it, then the family has to accept that.

Dorker has accepted that. DH has too. At some level, so has SIL.

I think everyone in this family is just holding their collective breaths, waiting for that fall, the tumble or crash or medication mishap that changes MIL's life forever. And not in a good way.
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And that's what Dorker needs to do. Sit tight and not worry.

What will happen will happen.
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But worry she will, especially with those swollen ankles brewing.
I know I would worry. 
That’s what makes this entire situation so sad. Dorker has a lot of feelings involved here, and I am sure she will worry about those ankles as well.
We all think we know what should happen as far as MIL’s living arrangements etc. But it’s not so easy.
I don’t know why this thread gets to me so & in thinking about it I confess I don’t know if I would be able to limit myself & not swoop in to help.
That’s why I am not at all questioning Dorker’s reasons for stepping back after 15 long arduous years. I understand & do not think it is fair that Dorker was taken advantage of especially after she began asking for a plan/more help 2 years ago. My “beef” so to speak is with MIL’s children but we’ve been there before, no need to rehash. 
I am really sorry DH & SIL didn’t opt for the agency help. Even if it was only 8 hours - it would have been better than nothing. 
It’s still early - meaning MIL has been alone what, a week and a half? It remains to be seen if DH steps up and visits his mother or checks in more frequently. I do see an “event” in the near future where MIL will be in distress due to CHF, cellulitis or something. I sincerely hope that if and when it occurs MIL’s kids will finally make the difficult decision to get her more supervision. 
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I think that all of us here are natural born fixers. We step up, lean in, do our research and do what needs to be done.

Those of us with functional families? We get listened to, and our elderly parents and siblings agree to the plan we've created.

If you are living in dysffuction junction, you have stubborn parents, a sib in denial and at least one sib who is jonesing for the inheritance.

You, the fixer, are painted as the bully and the ruiner of parent's dream of eternal independence.

It's hard to step back. But that's what needs to happen.
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Absolutely Barb.
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Hey, I've benefited from seeing these situations from both sides. My DH's husband's family is a LOT like Dorker's. In fact, my DH is a lot like Dorker's DH. His mother used to threaten to disinherit him on a weekly basis. When he told her she should stop smoking due to her worsening COPD, she said she was going to call APS and report him for elder abuse.

He walked away. We offered no assistance after that.

At some point, the only sane thing to do is to step off the speeding train.
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The swelling in her ankles, feet, it is a concern. But not enough that I felt it imperative to push the agenda with MIL when on site the other day. In fact, I saw the ever increasing edema (and even noted she hadn't once gone to the restroom, not that I noted anyway), but I never mentioned it to her.

To do so would only meet the same mantra heard time and time again, ... "I just hate taking that medication .. I have enough trouble just trying to remain upright .. then to have to go back and forth to the bathroom .........".

I've heard it all, .. the above and other excuses, far too many times. So go report it to one of her offspring? Doesn't do any good.

I didn't even mention it to MIL .. nor SIL .. or DH, in fact.

It's concerning to me, as I know the result .. if she doesn't get it under control .. and it won't be good.

But so should she, know the result, if she is "of sound mind", and that's the page we're all on .. so I better get on board also and realize she is "CHOOSING" to not take her Lasix .. and fully aware of the end result.

I suspect what will happen, is what has happened previously .. countless times. She will see the ever increasing edema .. and either just before cellulitis becomes an issue, .. she will double up on the Lasix and then create a situation where she is now dehydrating .. from ridding herself of too much fluid .. too rapidly.

But that too, .. should that bring on a need for doc visit .. and/or ER or whatever the case may be .. she should be fully able to "mange" being of sound mind. Am I right?

I remain, encouraged and grateful that she is finally reaching out for 3rd parties to engage in it all. How much, in the end, that will prove viable .. doesn't look promising to me. But .. at least there is recognition that additional help is needed.

In fact, I even feel somewhat encouraged .. when I was there the other day .. and her wanting me to sort thru and dispose of (donate) some books. Maybe that's a sign she has some recognition that she will need to be moving along .. and some of the contents of her home . need to be aptly sent in whatever direction she deems appropriate.

I didn't ask her if that's why she was having me sort thru some books .. so .. maybe I'm wrong.

I do remain resentful ..

I resent it that I was so on the front .. for so long .. and when the water hit the wheel as to her need, I wasn't heard .. by any party involved here.

But I have no one to thank for that, but me. I didn't ever do anything I did for her, out of coersion or any other force.

I think I have indeed stepped off of the speeding train .. in as much as I'm no longer mired in it all, and running hither and yon and have severely limited my involvement in it all. Grateful I've reached that point.

But now if I could find the switch that turns off any worry/concern .. that'd be great.

Have no idea if DH is checking in routinely with his mom .. haven't asked, don't intend to do so. If he doesn't, .. they can take that up with him .. or not. Fine by me, either way.

But at least I'm no longer handling 3rd party requests from that direction .. as to the minutia that goes on rotuinely.
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Pole vaulting right into narcissistic expectation that the world live to serve MIL.

Today was the meeting of the church women (Stephen Ministry) and MIL.

I didn't stay long .. (reason .. I have had enough of the drama of it all) .. I stopped and brought some sandwiches and we sat and ate lunch and visited for a bit .. all of us (including DH).

MIL holding court, .. telling her nostalgic history .. and no one else allowed to enter a word edgewise.

Until I asked, "So L .. why don't you tell us a little about yourself, you said you're originally from the NE area .. I'd like to know how you ended up living in FL?".

That gave SOMEONE ELSE a chance to hold the floor for a bit, thankfully.

We visited a while longer, and I said my g'byes .. left all of them there to finish their visit. I felt that they were probably looking for an "out" .. as they'd been there a while . . and that would've been as good an opportunity as any for them to also exit if they wished.

I went ahead and left.

DH came in later, having stayed longer .. and he said those poor women, .. they tried to keep saying their g'byes .. nice to meet you, so forth .. we'll be in touch .. but then MIL with her, "well one more thing I'd like to tell you", .. and this went on and on.

Finally I guess .. all culminating in MIL having gotten out her calendar and having mentioned to them that she'd like to get re-signed up for on-site PT .. and she has no way to get there. That the recommendation had been for 2x's weekly and would they be able to help with that (this I hear from DH after he returned home).

Yes, they said, between the two of them, they could possibly work that out.

I told DH .. (not that it matters) .. "that really disappoints me .. those poor women, this .. it was explained to me that this is a set up wherein they get to know their person they minister to .. and visit with them .. build a rapport and then .. yes occasionally .. perhaps if there is a doc visit .. an errand, etc. .. but boy she just pole vaulted right into it didn't she .. 2 x's weekly .. what about those MOW drivers .. any word on whether they're going to step in .. or maybe the local city bus service .. or the GOGOGRANDPARENT thing .. . nah .. didn't think so .. nah .. it's all about the whole world lives to serve her .. and her wants .. and how she wants it".

I dropped it after that.

Oh well, .. not my ship to captain ..

I don't think that's what these women had in mind in stepping forth, .. that they'd pole vault right into .. 2x's weekly (one or the other . in the road now .. at least once a week for each of them) .. but they are grown women .. and if this isn't what they had in mind, that will have to be resolved how ever they see fit to do so.

Good grief!
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I bet SIL indirectly has some part in the pole vaulting. She probably more than once told MIL to make sure to ask the church ladies to help her with the transportation to/from PT.
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I wouldn't doubt it. I hate it for them, . .. and I truly don't think that's what they had in mind .. initially.. for all this set up.

When I mentioned my displeasure about it, to DH .. he agreed .. I guess it didn't dawn on him .. not in the moment .. when he was witness to this request .. and he said the following:

"If you want to give them a call and let them know .. talk to them .. that they don't have to do this .. ".

I responded, "nope .. won't be doing that .. you can do so, or they can figure out how to navigate around it, not getting into it".

He then expressed some misgivings about the gas expense of hauling her .. do we need to compensate them for their gas .. and I told him when I used to do this, I'd drive MIL's car and her ride in her own car as a passenger . .. and if she needed gas, I'd stop and take care of that for her, .. her money.

The good news in it all, is that I was once the one who would've been facilitating the above, 2x's a week, no longer is that the case.

So that's a good thing. Hard fought emancipation from it all.

The bad news is that I don't think those folks had this in mind .. but they will have to navigate the set up for what it is they wanted to achieve in it all, or not.

SIL sent a group text last night, to both DH and myself: "Sounds like mom really enjoyed meeting those nice ladies from your church".

I wanted so badly to mention to her, that I think it's just inappropriate that MIL pole vaulted right to having them haul her hither and yon, right out of the gate. But I didn't say anything at all. I just responded, "yes they are nice folks". Left it at that.

DH only responded: "Yes, she likes them".

Interesting that DH says that when he walked them to their cars for them to leave .. he'd said to them, "Now you guys this isn't gonna be about dogging you guys and having you meet all her needs, .. you're just part of a team .. your help will be appreciated, but it's not gonna be on just you guys".

I thought to myself, "what team?".

But didn't say anything.

This is gonna be one of those wait til the other shoe drops sorta things. I'm sure there will be a time .. sooner rather than later .. more than likely .. that one or both are unavailable for whatever the reasons .. and her with a PT appointment .. and the dial will swing in my direction (absent any team) .. and I will simply state, "I see her on Thursday mornings, . is this a Thursday morning appt?, sure .. I can handle that" .. "wait no .. it's not .. no .. I won't be doing it then .. maybe her MOW drivers .. or maybe the city bus system or the GOGO GRANDPARENT thing .. nope".
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Oh yes, Dorker. Staying out of it is very wise. Or else anything you say to help the church ladies will eventually get back to SIL and will be viewed as you trying to undermine MIL's support network.
Then you will hear from her directly...
Then the church ladies will come to you...
It's a minefield.
Not one foot or even a toe in it.
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Dorker, it sounds to me like MIL would be amenable to paid help if it could be afforded. I know she was reluctant before but seems like she is opening that door some. She might even like it - more people to tell her story to. Stay strong! You're doing great. Maybe as these ladies get more involved they will realize the situation and have some influence on DH and SIL that more needs to be done. Step by step - maybe there is progress. I hope. 
I agree with polarbear - hold your ground! Not one toe!
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Dorker, take a breath. These are adult ladies, yes? The Stephen ministry does offer to HELP. The 2x per week PT may work for a short time. You know MIL is a narcissist? That she always had something for you to do if you went to her house? That she has a servant mentality for new people in her orbit? The ladies will figure it out. Let the church ladies be the ones who say no. You are letting yourself slide back into enabling mode and trying to manage the situation that DH and SIL and MIL need to manage.
Please please please let MIL and SIL blow the situation up. Don't get further involved in an opinion - you are just getting yourself more into the fixer mode and giving DH an excuse to think that you are willing to get back into the muck and mire.
Take this with love from someone WHO DID THE SAME AS YOU and wore the bad guy hat with NO GOOD OUTCOME WITH HUBS.
Let it go. Let it be someone else's burden. You have no control - my mother's favorite saying in this situation "let go and let God".
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Dorker,
I agree. Don’t be the drama here.

Check with MIL on Wednesday’s to see if MIL has a “need” for you to handle on Thursday. If someone has arranged for church ladies to do something on Thursday, IMO, you are off the hook.

As stated above, let MIL and SIL turn this into a circus, blow it up. Then it will be up to DH and SIL to figure out the next step.

As hard as this unorganized mess is to watch, keep yourself distanced from the fray!

Don’t become the scheduler, organizer!
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These sweet ladies are in their 70's right??

Um, I am only 61, but with a bad back, I have to be pretty careful about the hauling of wheelchairs, old people who think it's great someone is hauling them in and out of cars....by 72 or 73, I will be happy if I can still take care of my house and walk w/o too much pain!!

Having been "used" many times by people who found a willing ear, or driver, or babysitter, I have had to learn to set boundaries and not feel guilt over saying "no".

MIL looked at the sweet women and went "Wow--a whole new set of go-fers". They'll figure it our pretty quickly, trust me.

I imagine they will burn out pretty quickly--but that's just me seeing the worst. If MIL is going to use them for 4-5 hours per day ( as well we know that one grocery shopping day is pure-d awful)....they'll realize they are being "used". And they do have other people to minister to.


Don't get drawn into the drama and DO NOT organize their times. Other than letting them know that they are NOT obligated to do anything, I wouldn't get involved.

I laughed at the "team" concept. 2 older women and one distant SIL and one clueless son do NOT a "team" make.
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Oh but lest we forget the MOW drivers who were, more than likely, put on the spot (deer in the headlights look on their faces) and DD .. who also has volunteered her services. Thus a "team" approach .. accd'g to DH who is yes, clueless.

No I don't in any way intend to get in the middle of organizing who does what/when .. nope.

I only reported the findings of yesterday's frustration of having met with the Stephens Ministry folks there at MIL's house. The "frustration" that she pole vaults right over the line .. of what the intended purpose of all this was to be about .. and onto her target of go-fers .. to do her running for her, two more .. willing/able bodied. Yes, women in their early 70's.

I guess, frustrating to me, .. from the respect that I thought everyone would play nice .. as in .. let's take this on the terms of those who are nice enough to offer their services.

Should have known, "play nice" a term lost on narcissists.

Just as another frustration from yesterday's event.

First off (as I said, I exit the scene there pretty quickly) .. if you don't have anything nice to say, say nothing ..as I was taught. And I'm pretty much in that former category.

As MIL sat there .. telling her tale of woe .. and she said the words she always says:

"Now you'll find that I'm not someone that is running to doctors all the time, in fact, .. they have a hard time here getting me to go to doctors if the truth be known .. I really am not one of those that is constantly at a doctor's office. I really don't even have that many doctors".

At that point I interrupted, .. on purpose, .. "ahem ... uhm .. don't know if you're aware of it, but you have 14 different doctors you see, and usually that's more than once per year, per doctor".

MIL with a confused/bewildered look: "Oh now don't say that Dorker ... that can't be true .. how do you ...??......".

MIL then saying: "Well undoubtedly thats, .. that's that daughter of mine, .. she'd have me going to every doctor this side of the Mississippi if I let her".

Subject dropped.

I don't have the stomach anymore to sit and watch her wax and wane on and on .. about how "this isn't her, this isn't what she's about", .. "this isn't her to run to doctors all the time", .. all of that nonsense. No patience for it.

This is her! At the direction .. yes .. of her daughter .. for sure .. but THIS IS her!

Then, as I was leaving .. I said my g'byes and begged off staying any longer, because as I'd stopped to grab some sandwiches to bring, I'd also run thru the grocery store for some things for my house, at the same time and thrown the things into the cooler I keep in the back of my SUV .. so I needed to get on home, to get those things put away at home, and said so.

This then prompted MIL (see earlier posts where I mentioned it's well known, . this is where everyone will come when the Apocolypse happens .. there will be ample food here for an army, it gets joked about at my expense). This them prompted MIL to say: "You can't possibly have a square inch anywhere in your house to put another thing .. this gal here .. I tell ya ... I've never seen anything like it ..... her cupboards .. there's not another square inch to squeeze another thing into .. or her freezer .. what can you possibly have needed at the grocery store?!?!?".

I answered at that point: "Oh I just grabbed a few things I'll need in the next few days, need to go get it put away".

MIL: "I don't know, I've just never seen anything like it .. I don't know how you could even need to go to the store for a year!"

DH then chiming in: "Well .. she grew up with some lean times and I guess .. she wants to make sure we always have food in our house:

MIL: "Well you have that and then some!".

MIL: "I don't know how you even use all that food you buy".

DH: "Well seems like they all land at our house to eat ... when she cooks, the kids are welcome to come .. if they want to .. and they do .. they come by ...".

MIL: "If you don't fix it, they won't come .. " (as if that's a problem that I'm trying to solve, to get rid of kids that show up here ......it's not .. it's not a problem for me).

The two ladies: "Well she is also a wonderful cook for our church family .. she fixes things to bring to the sick .. the homebound and we are so grateful for it".

At that I said my g'byes and I left ...

Felt like a criticism .. coming from MIL ..

Just wanna say, "what the hades is it to you?, I'm not asking you to pay for it, or go get it, .. or even show up to put any of it away .. what the hades difference does it make to you".

Just ... uggh ... I find it really hard to be in her presence anymore.

Glad that little set up is behind me now .. and what happens going forward, not on me.

I will make my requisite call on Wednesday to see if there's any need for my Thursday morning visit and keep that visit short and sweet and be done with it.
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