Fairly complex question about division of responsibilities; how do we best approach mom with dementia in nursing home?

My mom was real good at NOT saying a word to her professional caregivers when she needed something or had pain - I'd have to do that for her. It went as far as her calling me up in the middle of the workday (when she could still use the phone - God, I missed that when she couldn't call anymore, as annoying and stressful as it could be...) to tell me she needed me to order more Depends because her closet was empty. You guys have a good system. it can be hard to know what complaints are meaningful ones that need attention, but you may not be able to get Mom to change her ways and tell the right people during the day when something can actually get done.

All of the above are great answers, and I agree with all of them. After a year in a nursing home my mom was able to go to ALF. Even with her in these facilities caretaking can still be a full time job always making sure the caretakers are taking proper care of your loved one. It's very hard to turn the care over to someone else. In the beginning I drove myself crazy trying to take care of every need and complaint my mom expressed. How do you ever know if what they are telling you is true or exagerated, or misconception. Especially when someone with dementia. A lot of times they're not able to express their pain or needs. I have now learned when my mom has a complaint or ailment I wait a day or two to see if she still has the same problem. 9 times out of 10 she never mentions it again. If I were in your position, I'd let her know you hear and understand her concern, and you'll see that she's taken care of. Then, I'd wait it out for a day or so. (unless of course it's obvious that she has a valid complaint) Just my thoughts, and it has worked pretty good for me. Even so I do keep on top of her caretakers, and I'm sure at times they are sick of me. :-)

Yes, my family rocks! Part of the issue is that mom has some aphasia due to stroke. She can't always communicate to staff what is going on. She mostly can't talk on the phone, although she got staff to call me for her the other day, amazingly. Thanks for the great advice, all!

When my dad was in a NH I learned to pick my battles. I learned that by trying to follow up on all of his complaints and issues it became a full-time job and I was on the phone much of the day trying to put out fires. For example, my dad falling and getting a huge shiner = big deal. My dad eating in his room as opposed to the dining room because he said the staff never came to get him = not a big deal. Had I chased down that issue, about not eating in the dining room, I would have discovered that when staff came to get my dad, my dad told the staff that he preferred eating in his room. My dad just didn't remember. It took me a while to discover that my dad's perceptions were not always accurate and I discovered this by trying to manage every little thing. It's impossible and almost drove me crazy.

And even though I learned to pick my battles, having my dad in a nursing home was a full-time job. My brother and I coordinated care for him and I talked with my brother everyday. Most of the time we just leaned on eachother for support. I too feel bad for families who have back biting and gossip and complete disrespect for eachother all because of one elderly person. It was so hard for us when our dad was in a NH, all the things that needed to be done and all the issues we had to deal with that I can't imagine what it would have been like had my brother and I not been there to support eachother.

I wonder if SIL (and mom) are focusing on mom's medical situation because she doesn't have other things to talk about? It's an easy habit to get into. Daily visits are a lot! My mom lives five minutes from me and I talk to her twice a day for a few minutes and am over there 2-3 times a week. I'd go batty if I was there daily. Folks in that situation don't have much going on, so they will naturally focus on their aches and pains if not directed another way. I'd recommend SIL visit every other day and call on the alternate days and not focus on mom's health - as Jeanne says, try to direct her to the nursing home staff for that if possible. If she's visiting every other day, she can keep an eye out for any physical changes or concerns with mom's behavior. I watch my mom like a hawk when I'm around her, because she doesn't always remember to tell me things that are going on.

And of course I agree with everything else Jeanne says. Your family rocks! Most threads on this site are about slacker siblings or siblings in constant fights over the care of their loved one(s). You guys should start classes on how you manage to do it as a coordinated unit!

Dear Jeanne; As always, you are so helpful in answering these questions. I wish you well and thank you for your wisdom! Hugs!

You are right; it is frustrating trying to fix the unfixable.

I don't know if less frequent visits would mean more frequent and timely interaction with the facility staff. This is perhaps a question you could ask of your contact there.

Maybe SIL could demonstrate that the staff is there to help her. When she says "I have a headache," SIL could reply, "press the nurse call button, Mom." When someone comes in, encourage Mom to tell about her headache. Then let the staff deal with it. I think I'd try to get Mom out of the habit of thinking only her family can take care of her.

It might be kind of a fine line between "only my family can take care of me" and "my family has abandoned me." Discuss this with the visiting SIL and see if together you can come up with a plan that cuts out all the middleman delays. Instead of from Mom to SIL to You to Staff, encourage more things to go directly from Mom to Staff.

Even if you can work out this particular challenge, medical liaison is a labor-intensive role. It can be time-consuming, especially in times of acute illness or flareup, and especially doing it long distance.

You mother is very lucky to have her entire family supporting her, each in his/her own way. I congratulate you all. If there are grandchildren they are getting a great set of role models.