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minue8 Asked April 2021

Difficult Father-in-Law with stage 4 chronic kidney disease - how to cope?

My father-in-law (FIL) has stage 4 chronic kidney disease, and currently lives in assisted living in Seattle, together with mother-in-law (MIL). Both are 80. Recently, MIL fainted from exhaustion of helping FIL with basic duties, such as going to toilet, bathing, which FIL cannot do well anymore. Fortunately, all her tests came out fine. From this incident, they are moving to LA, to be closer to us.


MIL wants to live with us in our home, FIL will need to be relocated to assisted living facility here. I don't mind having the MIL, but I am freaking out about the FIL's close proximity to us. He's a tyrant, and we don't get along. My husband does everything for him, literally, EVERYTHING. FIL was first generation immigrant, and depends heavily on his son. It was a relief that we moved to LA, putting some distance between us. The past few years living apart from my in-laws have been wonderful, and we now also have an 18 month old toddler.


I find myself slipping into depression, I can't sleep nor eat well. In short, I am freaking out. I am seeking counsel from this group, and how best to handle, and re-frame the situation. Also, what is the prognosis for stage 4 kidney failure, without dialysis? Relative to his illness, it will be 2 years come June. FIL contracted pneumonia nearly 2 years ago which triggered kidney disease, he has a host of other chronic conditions, diabetes, high blood pressure, etc. Thank you for your advice in advance.


Stressed in LA.

help2day Apr 2021
First and foremost, do NOT move your MIL into your home. Trust all of us here on this forum. The stress and anxiety it will cause in your marriage will be overwhelming. You may not think so now but your 80-year old MIL will get older and have her own set of health problems to contend with. You have an 18 month old. That takes all of your energy. I can't stress enough to find another alternative living arrangements for MIL. Assisted living takes couples. Please. Reconsider that life altering decision. MIL could live another 10-15 years. Don't make the mistake so many others on this forum did and lived to regret it.
minue8 Apr 2021
Thank you, help2day. I know, I will try to suggest MIL and FIL should be together. This way we can visit often, and it will protect my own home environment. Thank you!
Geaton777 Apr 2021
Do not have your MIL move in with you. Your immediate family is first priority and your husband needs to be in agreement with this. Choosing this does not mean his mother is not loved. It is a cultural expectation, not a moral obligation, to provide the care...something to which you have not agreed to.

Here is some info about when someone with late state CKD chooses to not have dialysis:
https://bit.ly/3s3CDqc

You really don't need a "reason" to say no to caregiving someone. It's challenging enough to have a toddler! Say "no" and don't consider any other compromises. Your husband needs to put you first. If he doesn't...that's another issue. I wish you much confidence, wisdom and clarity in working through this. May you have peace in your heart.
minue8 Apr 2021
Thank you, Geaton777. I appreciate your response, and link, it is very helpful. Unfortunately, my husband cannot in his good conscience say no. It's definitely creating strain on us, and we've fought a couple times. Now, I am trying to hold back (and seeking support groups, today's comments have really lifted me a bit), I find my wanting to "resolve" or "dialogue" only creates more stress on dear husband.

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AlvaDeer Apr 2021
As a nurse I often saw people who refused dialysis live longer than those who accepted it. As everyone's disease is as individual as a fingerprint there is no telling how long FIL will live. There is no reason, with his not living WITH you that you need have much to do with him. Drive the MIL to visit when she wishes within reason, and that's that. However, you are taking on long term care now for an 80 year old. There days she may live another decade and one half and she may do so on a decline, as well. It is almost too late at this point, but I would speak with your husband about the fact that you may not wish to do 24/7 long term care for an unforeseeable time, and that this is good as long as it is good for ALL, meaning YOU, since clearly you will end with a good deal of the care.
Sure do wish you luck. I have long known my limitations prohibit my ever doing LTC for an elder, and I never attempted it.
minue8 Apr 2021
Thank you, AlvaDeer. I appreciate your response. You are right! I don't need to have much to do with him, but I think I'll be inadverently pulled in, and I have a feeling our weekends will be going to visit... I honestly don't mind the MIL, it's the FIL who is difficult. For example, over the phone recently, we said, "you'll come with us" (friendly tone), FIL screamed full of ego, "no, you come with us!". I am sure all the meds he is on is influencing his thinking.. He wanted us to find new jobs in Seattle, and uproot from our lives here in LA.

I am trying to exercise compassion. I want the best for my in-laws truly. But I am freaking out. Yes, I've read this situation can drag on...
Grandma1954 Apr 2021
The fact that your In Laws are living in ASSISTED living and your MIL is doing the assisting NOT the staff that that should be doing what they are being paid to do and what your In Laws are being charged for.
I doubt that the situation will change with the move. I have the feeling that your FIL will not permit others to help him.
I would not let MIL move in with you. At least begin the conversation like this....
MIL should stay with FIL for the first few months so that he adjusts better to the new facility.
MIL and FIL should allow the staff to do what they are supposed to do, ASSIST both MIL and FIL with daily activities.
You might even want to find out if FIL is eligible for Hospice. That would provide more help for your In Laws.
minue8 Apr 2021
Thank you, Grandma1954. Originally, they have all the services set up to support FIL at assisted living; however, FIL "naturally prefers" MIL to do the these things for him, so they scaled back on the services. MIL maybe perfectionist? and thinks her way is better ? Of course, FIL prefers MIL.

I love your suggestion to dialogue, "MIL should stay with FIL...", this is wise. This way everyone will see and adjust a bit. My husband says next step is nursing home, is that the same as hospice?
JoAnn29 Apr 2021
I had a 20 month old I was babysitting when I took in my Mom who was 86 at the time with Dementia. At 65 there was no way I could care for both. Your child needs your full attention. If u take in MIL, she needs to be able to care for herself.

I also wonder why Mom was doing all the work in an AL? It kind of defeats the purpose. FIL is that much of a tyrant?

Your husband needs to learn boundries with Dad. Look up the meaning of Narcissist.
minue8 Apr 2021
Thank you, JoAnn29. Originally, they have all the services set up to support FIL at assisted living; however, FIL "prefers" MIL to do the these things for him, so they scaled back on the services. Well, it overwhelmed her in the end (she fainted). Her solution is she doesn't want to live there, because if she lives there, she will be compelled to help, hence she wants to live with her son :(
SSAretired Apr 2021
I wonder if MIL might be a positive influence on your household. Would she have an interest in playing silly games/reading to toddler? If she can provide for self-care, she might be able to also help with the smaller household chores. Once she starts to decline, would she be stubborn and insist on staying with you, or would she thrive in assisted living in her later years? Regarding your husband, I would insist that you are doing more than your fair share in caring for toddler & MIL and I WOULD NOT be doing any weekend visits with FIL (he can take MIL to visit, giving you some alone time).
minue8 Apr 2021
Thank you, SSAretired. I think MIL will love my son. They do facetime now, and they seem to engage well. FIL doesn't engage my son at all. It may be a blessing in disguise. Thank you for the viewpoint!
DILhagen2 Apr 2021
If it were me, I would want me and my husband to stay ahead of this situation. I would take my husband to meet with a counselor and come up with a plan of BOUNDARIES, so that we could be in agreement with what we (as a couple) are willing to do and not willing to do. It’s very important that you protect your marriage.
I would also be willing (when the time comes) to block my FIL’s cell phone or room calls from my phone and especially at dinner time. Create a safe zone where you can have peace in your home. I could see him calling and demanding numerous times every day, ordering you, his wife and son around.
Im so sorry for your situation. My sister is a nurse who works with dementia patients. She tells me that if a parent was abusive and domineering to begin with...they don’t get a free pass just because they have dementia. It will be up to you and your husband to set the healthy boundaries and protect yourselves.
minue8 Apr 2021
Thank you, DILhagen2. We live in LA now, so they don't call as frequently. I agree setting phones on no ring during set dinner or date nights are important. Thank you!
my2cents Apr 2021
Since they are moving anyway, it's possible that FIL needs more care than current AL will provide. MIL could use a break so she doesn't wear herself out trying to maintain living in AL facility. Find something that offers more care and let MIL continue to live with him. They will probably be better together so that FIL doesn't have to start over in a new place all by himself.

Find the closest facility you can and let hubby visit often. When permitted, you and toddler visit as often as you can, too. They are the grandparents even if one is a little more difficult. Tell hubby managing a kid and an elderly mom is just too much PLUS they would be without each other in the final years.
minue8 Apr 2021
Thank you, my2cents. They are indeed the grandparents. :) Thank you.
lauramay Apr 2021
Talk, talk, talk to your husband about this decision a lot before your FIL comes. This could be the beginning of the greatest blessing ever, or the end of your marriage. You both must be on board with this decision or it will explode in your face.
My dad moved in with my husband and myself a year ago. It has been a very tough year. However, now we are not sorry. My dad is on home Hospice and we love having him here.
You must be a team and be in agreement as we as have many resource already lined up prior to moving him there.
You must have great doctors ready, an adult baby sitting company available, like Visiting Angels, you need time away. Most of all, have support, conversations and plans.
Caregiving is very very tough. It is good to question whether you are up to this. Remember too, this may really be important to your husband. But tell him your concerns in a loving way and listen, then pray.
minue8 Apr 2021
Thank you, Lauramay. Yes! Well said, this may be a blessing or will destroy my marriage. :/ I will pray and have faith. Thank you!
Moxies Apr 2021
It is always a terrible problem. In some cultures, it is simply unthinkable to not care for aging parents. There are arguments on both side. I would try the tack, that terrific as your MIL may be, she cannot provide the professional care a very sick man needs. And a very sick man is not in a position to decide this. Sometimes in a marriage, yours in this case, a person has to draw some lines that are difficult and not too sweet. You are no good to your husband, MIL, or child if you take on too much. I would start up front with MIL will have to get professional care when she needs it. If there is money for these things, I wouldn't hesitate. And ignore Dad's annoying comments. My husband is a doctor who managed a dementia inpatient unit, one of the first in the country. He would say that whatever a person's traits were, they became more marked with dementia. Just say thanks, Dad, bye. Don't let him get your goat. Just stop the conversation nicely, and immediately. Apparently, upsetting people is his "thing", deprive of him of the pleasure in your case.
minue8 Apr 2021
Thank you, Moxies. I come from a culture where it is required to look after the elderly (although, I'd say all cultures look after their elderly), as such, my guilt for feeling this way. My husband also feels cornered, but he silently bears it. You are right, I'll need to overlook FIL's comments, and try to bring all my compassion. I am trying. thank you!
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