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She has dementia and cannot be left alone. My husband is an only child so there are no siblings to help. My husband is a firefighter so he leaves for 24 hours at a time and then I am left to care for her. I am a social worker and I work from home and see clients on days when my husband is at work. Prior to her moving in with us my mil and I did not like one another but we tolerated each other. She was widowed a few years before moving in with us. She is only here because I love my husband. She does not have enough income to live in an assisted living facility so we are stuck with her. My husband has a strained relationship with her because she talked so bad about his father and as a child he hated that. As an adult he asked her to stop and she never did and it really scarred my husband. She presented to the world as this sweet religious woman but she was so nasty to me and we have had some truthful conversations about how we felt about one another. She even was happy my father in law was suffering right before he died. I saw her laughing and joking while he was in pain. She said well sometimes people have pain because of the things they have done. She laughed and I was like you stayed married to him and your son is devastated. I was very close to my father-in-law. He was truly loved by me and I really miss him. She was mean and nasty and never thought I was good enough for her son. Well we have been together for almost 30 years. She is the most critical person I have ever met along with my sister. She has criticized me in so many ways but I have always responded to her directly. She then uses tears for sympathy but I was never moved by her crocodile tears. I would tell her I knew who she was and she was a fake Christian then the tears. I watched her talk about people and then act like she liked them when she was with them. That was very telling to me. Sorry for the long rant... I just needed to get this off my chest because I feel like I am losing my mind. I just don't know what to do. I take antidepressants and after having a total hysterectomy in April 2023, I was thrown into surgical menopause. Dealing with that on top of her has me so derailed.

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I love my husband too, which is precisely why I never took my mother into our home! She'd have ruined our lives AND our marriage with her dementia and her toxic behavior which was just like your MILs. I had her in Memory Care Assisted Living with the plan to get her into a Skilled Nursing facility on Medicaid after her personal funds ran out. She lived to over 95 and passed right before I had to apply for Medicaid.

I suggest you save your marriage and your sanity by having an honest conversation with dh now about getting his mother placed. It's time.

Best of luck to you.
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I hate to be this blunt, but I am not much interested in your MIL's personality.
It's really beside the point. When she starts "talking about" others, tell her it's not a "Christian " thing to do.

You and hubby work full time.
Neither of you much likes his mother, and with good reasons.
You are dealing with your own illness.

You are exceptionally articulate and well written, and I would imagine an excellent Social Worker. I hope you are in private practice doing some counseling work, as I always recommend LSW in private practice to folks on our site. As a retired RN I have great respect for the profession.

That said, what would tell someone visiting your practice with this problem?
Would you say "You're in trouble, and I haven't a CLUE?
Because the following is what I, as a lay person. would tell them.

I would start with my second paragraph about "This is YOU and your hubby". About work, illness, dislike of MIL.
I would then say that their supposition that MIL cannot enter care in ALF may be correct, but there are other options: 1) enter nursing home 2) if cannot qualify because too well mentally and physically, a small nearby efficiency apartment until she CAN qualify.
I would recommend a visit to--wait for it--a LSW or elder law attorney for options.

I would tell my client that it was a mistake to take in a woman that neither one of you much care for, despite a sharing of genetic material. And that, even if you DID love her, it's a mistake to take in someone when you are still working and have your own challenges otherwise. You aren't gods. You aren't Saints, you aren't omnipotent, and you are putting your lives literally at risk.

I would tell my client that they did not create MIL's problems and they cannot fix them and they should seek marriage counseling before throwing themselves on the funeral pyre of this woman; it may be a slow burn.

That would be my advice and is likely why I am NOT a Social Worker.

You have painted yourself into a corner.
Time for your own counseling with your own husband to try to save YOUR OWN LIVES.
You need first honesty with yourselves. If caregiving doesn't work for ONE partner it is out for both.

You need then to be HONEST with MIL.
You need then to explore with her the options for her living OUTSIDE your home, which presently you have made HER home with slave labor included.

I am sorry. I understand this is blunt to the point of unpleasantness, but often there is no option save brutal honesty. This isn't working. This could KILL you, your husband, or kill you BOTH. If not it most certainly will challenge your mental health and likely destroy your marriage.

I think taking her in was a dreadful decision.
I think that you have to address it as the dire situation it is.
I wish you the best and hope you'll update us. Moreover hope you will stay on Forum and help OTHERS because your expertise is sorely needed. That's if you can squeeze a moment out of your day, which likely right now you cannot.
Truly my heart goes out to you, even if it doesn't sound like it right now.
The talk should start now. It should start with your husband.
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There is Medicaid. With my Mom, she had 20k. That 20k got her in the door of a Long-term care facility. During that 2 months, I applied for Medicaid, spent down her money and got them info needed. She paid privately May and June. June I proved Mom had no money and July 1st Medicaid started.

If you don't have POA, maybe you can find a way to get temporary POA or guardianship. Just long enough to get her in a facility. If her monthly income is over the Medicaid income cap, see if your State Medicaid allows for Qualifying Income Trusts. Its not fair that this is your husbands mother and you seem to be doing most of the caring.

Yes, if she is ever hospitalized this would be the time to place her. Have her transferred from the hospital to a facility. Rehab is even better because they are usually in the same building as a LTC facility. She can go right from Rehab to the NH section.
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First of all, and let me make myself plain and clear. YOU ARE NOT STUCK WITH HER!

There are other options. If her dementia is so advanced that she cannot be left alone as you say, assisted living cannot provide the level of care and supervision she needs to live safely. AL will not accept a person that bad off.

She belongs in a memory care facility. Here's how this gets paid for.

After a facility has been found, her assets will have to be spent down on her paying cash pay until they are gone. The facility will take her monthly income too. After her money and assets have been spent down on her care, she gets on Medicaid and they start paying the bill.

You being a social worker yourself would know this already of course. I'm sure I don't have to explain to you what a 'Social Admit' is. Take her to a hospital ER and ask for one.

You don't need advice from the people here. You already know what to do and how to do it. Whatever is preventing you is between you and your husband.
I would strongly suggest you have a serious sit-down conversation with him and not with his mother there.
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JoAnn29 Jan 11, 2024
Where I live, Medicaid will not pay for a MC unless you have paid privately for at least 2 yrs. If MIL does not have 2 yrs of money, better she go to a LTC, pay privately and then apply for Medicaid when money runs out.
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Is she not a candidate for Medicaid? If not, then she has "enough income" to pay for some hours worth of caregivers for herself. Spend her money on her and give yourself some breathing room. And in the event she needs to go to the hospital, do not accept discharge back into your home.

Please have a candid conversation with your husband and let him know that you do not want to continue having her living with you. You and your husband should sit down with her finances and start working on a plan. Use your social worker skills to help yourself. Her needs are only going to increase.
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You are a Social Worker...
What advice would you give if a client came in and presented this very same situation?
Have you explored other options, other services that might help ?
Was her husband a Veteran? if so she may qualify for some services through the VA. Is she a Veteran?
You mention she does not have the funds for AL...does she have funds that will pay for a caregiver so you do not have to care for her .Employ the caregiver ONLY when you husband is working his shifts and when he is off duty HE provides ALL her care. I bet he will find a better solution
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So you say you've had "truthful conversations" with your MIL, but have you had them with your husband? About how he is prioritizing his Mother over you? And how it is on its way to wrecking both you and your marriage?

As a social worker surely you have explored options, like working through APS and allowing the county to become her guardian instead of your husband (and this is assuming she assigned him as her PoA -- if this didn't happen then county guardianship should be a possibility). What have you found out about this, if anything?

In the end, you are allowing this situation to persist since you are viewing it as a loving act for your husband. Instead you need to view removing her as a loving act for your marriage. He's grown somewhat immune to her horrible personality. And dementia robs people of their filters and their empathy for others, so MIL is only going to say and do worse things.

Start researching options for alternate care for her. Consult with a Medicaid Planner for your state. Most states' Medicaid only covers LTC (which means a person is bed-bound or profoundly ill) but there may be different coverage in your home state.

Otherwise consider Adult Day Care or paying for a companion aid to stay with her during the day in your home. But please let your husband know the extent of emotional and mental damage that you are experiencing.

Maybe consider other help for yourself, like BetterHelp.com which is online therapy services. I wish you success in helping yourself and your marriage, and gaining peace in your heart.
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Apply for Medicaid and look for a section 8 senior apartment for her. Yes, you do have options, start exploring them. This will not get better.
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BurntCaregiver Jan 11, 2024
MeDolly,

The MIL cannot be left alone. She is too far gone with dementia to be in an apartment on her own.
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HOME CARE DOESN'T WORK

Get her into a facility. Medicaid will pick up the tab once her money runs out.
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Welcome!

What a sad situation.

What are MIL's resources like? Is she Medicaid-eligible?

Does she have all her EOL paperwork (durable POA, healthcare proxy, etc,) completed?

Is there Adult Day Care, perhaps part of the PACE program available in your area?

Make sure there is no co-mingling of assets; a visit to an Elder Law attorney might be in order. Is she paying for in-home caregivers?

It looks like the Douglas County Senior Center has daily meals, activities and transportation. Have you looked into that?
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BurntCaregiver Jan 11, 2024
@Barb

The MIL needs to be placed in memory care. The OP does not want this woman around and there is no love loss with them.
She even says that her husband has had a strained relationship at best with her since he was a child because of the abusive hatred she had towards his father.

When there is history like this, under no circumstances should the needy, abusive, demented elder me moved into the home. Family caregiving should not even be considered as a possibility.

They need to get her placed in memory care.
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