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itbewhatitbe Asked December 2016

What do you do when the person you are caring for is threatening your health, job, life, family, freedom, and sanity?

My mother-in-law has been living with my wife and I for about a year. Prior to her being with us, she was in 3 nursing facilities that left infections repeatedly unaddressed and nearly killed her. Since being with us, she has been infection free, all of her labs are spot on, and she is enjoying a private room and amenities no facility is capable of providing. While she was in the facilities, there was always an "enemy" and always false accusations against staff. Now, she makes accusations against my wife and myself. For example, when I found 4 used catheters stuffed in the seats of a rental car recently used for a Christmas trip, and asked her to please be mindful of discarding her equipment properly, she is threatening to call a lawyer and press charges... not really sure for what, but this is just the tip of the iceberg. A little background, she is 60 years old and was rushed into emergency brain surgery 3 years ago to remove a tumor and over 750ml of cerebral spinal fluid that was blocked and smashing her brain into the sides of her skull. After a successful surgery, she had a stroke, followed by MRSA infections in her skull, and subsequent surgeries to address the issues. She is a T7 paraplegic (since 17 years of age), self-catheter, colostomy, diabetes, sundowners syndrome, and cognitive impairment. The delusions that she conjectures, like everyone is stealing money she doesn't have, every one is out to get her when she is asked not to wash colostomy bags in public toilets or leave dirty equipment in car seats, are very troubling. She was given a phone to make emergency phone calls, and has had to have it taken away after repeatedly harassing random people. We don't wan't her to feel, or to be, isolated, but it is not feasible to allow her unsupervised phone access to harass strangers. She has driven away every other family member, including a mother, sister, and son who won't talk to her due to her years of delusions and abuse predating the surgery, but perhaps partially resultant from the slow growing tumor. We have hired in-home help, and we are all well aware that she is trying to pit the CNA against us, through clearly false accusations. Throughout her time at the nursing homes, we had to address every accusation as if it were true, though someone calmly kneeling down to speak to her at eye level is, to her, "screaming in my face." My wife took the past three years off work to address her mom's medical needs, and is returning to work next week. This has only made her mother's behavior worse, and my wife is concerned that these delusions will inevitably result in trials and tribulations far beyond care giving and more work addressing the accusations that have no basis in reality, but which must be given credence before being disproved. I am 40 years old and my wife is 30. We are hoping to have children, but are scared to bring a young life into this world with the issues facing us with caring for her mother. What do you do when every state-licensed nursing facility (3/3 so far) nearly kills your mother due to neglect, but keeping her in the home is a danger due to her hygiene issues, cognitive impairment, delusions, paranoia, physical issues, etc.? My wife has spent nearly every waking moment for years addressing these needs, while I have worked to support us financially, emotionally, spiritually, and physically. My wife is amazing. My mother-in-law is, often, a wonderful woman. I am at my wits end trying to assuage every issue from all sides and wind up being the enemy of one, and my wife is always subjected to abuse from her mother and is so tired of always teetering on the edge. My mother-in-law does not recognize her deficits, though at times she seems to acknowledge them. She fills notebooks with nonsensical writing of how we have wronged her by trying to create systems for her so she doesn't use the same colostomy and catheter equipment for weeks on end, and lie to her, and don't want her in our home (we worked for years to make her safe and healthy, including opening our home to take better care of her than what has been evidenced at facilities), and how she is going to sue us, sue her sister and mother, press charges, and how we are mad at her for having had a tumor. No one is mad at her, but she is angry about everything and her constant negativity, manipulation, delusions, and unsafe behavior, severely limits her and us. Prayer and an occasional dinner for two keeps my wife and I going, as does our awesome service dog, but we aren't sure how to move forward to enjoy a quality of life, have children, and feel safe in our own home while keeping her mother with us. We aren't sure how we can place my mother-in-law in another facility, when her needs will certainly not be met there, as no facility has yet been a safe place for her. I tell my wife that she deserves a life, a chance to soar, and peace of mind, and she does nothing short of amazing me everyday. I want an amazing life for her.

pamstegma Dec 2016
First, you medicate her anxiety and paranoia. For your own protection, you find suitable placement for her before she destroys both of you.

BarbBrooklyn Dec 2016
The real question here is, is her mental illness being addressed? Is she on psychiatric meds? Has she been admitted to a psychiatric hospital to adjust medications? Have you looked into her being a resident of a psychiatric facility?

Whatever her physical impairments, her MAIN issue appears to be the fact that she is not living in the same reality as the rest of us.

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CarlaCB Dec 2016
Agree with Pamstegma. Get her some psychiatric help. If she won't accept it (or it doesn't help), you will need to recognize that it's either her or you. If you and your wife want a life and a family, you can't have this destructive and negative influence ruling over your home. Put her in the best facility you can find, visit and monitor her care, and move on with your lives.

jeannegibbs Jan 2017
I am so glad you have decided on psychiatric care!

You obviously are a loving family. MIL is only 60? She could live another 20, 30, or even 40 years. You absolutely cannot wait to start a family until she dies. Do what you have to do to protect your own lives. I hope that with psychiatric help things can be worked out for her.

itbewhatitbe Jan 2017
Thank you all very much for your insight and suggestions. It is very helpful to have this support network online and we are very thankful to have found it this weekend. I shared the site with family who are also caregivers (my grandmother has alzheimers). We are seeking psychiatric care for my mil. Today, we sat down with mil and talked with her at length about what she has been writing and the threats she voices. She is so very afraid of going back into a facility, and of so much more. She said she was not aware of her writings and, when showed to her, she cried and expressed how she was so scared and doesn't understand how to stop the thoughts that come into her head. We sat together and blacked out every negative statement written and replaced each with 3 positive statements. She agreed she needs help understanding her thoughts, how to control them, and how to escape from the fearful delusions she suffers from. She is on medicaid, so severely limited in treatment options, but it did us a world of good, today, to talk to her about her fears, encourage her to share them always, discuss the ramifications of the threats she voices, and reinforce with her the love we have for her in our family. We are seeking psychiatric care in earnest.

gladimhere Jan 2017
I am with Vegas, get her out of your house. The behaviors mil is experiencing are only going to get worse. Bring a baby into the picture? MIL would not be able to tolerate that, and the baby would not be safe. Reclaim your lives. It sounds as if a psych hospital will be your best bet.

blannie Jan 2017
I agree that you need to move your MIL out of your house. Get her evaluated psychiatrically and get her on the proper meds. Then get her into a facility and consider extra assistance at the facility.

I have a feeling her issues at the facilities were partially due to her personality disorders that made her difficult to deal with. If you can get her properly medicated, maybe that will make it easier for her to be properly treated in a facility.

Bottom line if nothing changes about her behaviors and you put her in a facility, it's still the right thing to do. You do NOT have to sacrifice your lives and your future happiness (and children for pete's sake) in service to your mother-in-law. Her life is not worth more than yours and your wife's and your future children. She's had some unfortunate circumstances, but that doesn't require you to give up your lives for hers. Good luck and please keep us posted on what you do. We all learn from each other.

BarbBrooklyn Jan 2017
Itbe, I think that you as a family need to be aware of the fact that treatment, whether funded privately or by Medicaid is likely to include medications, possibly antipsychotics to stop the "voices". Many of these medications come with "black box" warnings which make it sound as though you should run in the other direction.

Consider the alternatives, however. Your MIL is obviously in extreme psychic pain; medication may give her some peace of mind and MAY allow you to care for her, or allow her to be cared for WELL in a non-psychiatric facility. In my opinion, meds are worth a trial in a situation such as yours.

JessieBelle Jan 2017
itbewhatitbe, I found myself wondering if there was a place she could stay that you could be involved in her day-to-day care, but she wouldn't be staying with you. I was thinking that a nursing home, or something like that, where you were free to come in and help manage her care. Would your MIL be able to afford a private room in a facility. I wouldn't want to subject another resident to her behavior. I realize the facilities so far have let things go, but if you are there every couple of days to oversee things, it could keep infections from going unnoticed. And you would be able to escape to your own safe abode each evening. You wouldn't need to visit every day, just enough to keep track on her health and well-being. You have a tough situation. You shouldn't give up your own dreams to care for her, and I agree that bringing children into the environment would be traumatic. Good luck! Please let us know what you decide.

M209M209 Jan 2017
As a postscript to all the excellent advice provided...keep in mind you need to have your own lives and in order to do so she will need to be in a facility. Manipulation can be very strong and very purposeful in spite of many other irrational or inappropriate behaviors. You will not have your lives to yourselves until she is placed elsewhere. I was the "responsible" child for mentally ill mother my entire life. I never had children. She was my troubled and needy child. I have not been truly free to live my life until now at age 60 when it feels like far too little and far too late. She passed two months ago.

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