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I retired early to move to Oklahoma so my wife can care for her mom. My wife said her mom's health was declining fast and maybe had a year left. That was over three years ago. Her mom became bed ridden four months ago. She has no control over her bladder or bowel movements and my wife changes her three to seven times a day. It has become physically and mentally overwhelming for my wife of 53. She tore a ligament in her knee a few months ago and still limps around. My wife has also had a breakdown and her doctor put her on HBP meds and anxiety meds. My wife reached out to the Hospice nurse who contacted her mom's doctor. He referred her to a nursing home. My wife explained to every family member that she cannot do it anymore. They all agreed a nursing home is the answer because none of them are in any position to take over mom's care. Then the day came we ( Hospice nurse, wife and I ), told mom. She became very standoffish and said she will not go and she would rather die first. She said she used to work in a nursing home ( back in the 80s) and she knows how " those people" can be. We explained that there are Quality Control and certain protocols now. She wasn't trying to hear that. She still refuses. My questions: At what point does my wife's health override her moms well being? What can/will the state do to help us? The nurse said that mom cannot be forced into care. I almost called 911 a few weeks ago because I thought my wife was having a stroke. Her BP was off the charts. I swore if that happened again, we would just quit. Then what? It is so sad for their relationship to end that way but my wife's life is more important. It is also sad that after my wife had her breakdown, her mom is so selfish, that she will not go willingly into a home. What are our options? I am almost to the point of calling 911 for mom and having her hospitalized, then rejecting her upon discharge. We don't want to do it that way. Please, any advice.
Lee

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“Showing signs” of burnout? No. She IS burnt out. I feel for her. She will die before her mother if she keeps this up. 53 is not old and she seems already broken down.

MIL can refuse and argue all she wants, but MIL needs to understand how this is killing her daughter.

Better to take MIL in an ambulance to a facility than taking your wife out of your home in a hearse.
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BurntCaregiver Jun 2021
You're right about that, LoopyLoo.

Many caregivers who are decades younger than the person they're caring for and start off in fine health often end up dying before the person they are caregivers to.
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The time has past that your wife's health should come first. She needs to tell mom - I'm done. Either MIL moves out or wife moves out. Oh, wait, it's your house. So MIL must go. Your wife needs to tell her that she NEEDS to go to a NH. That no one WANTS to go to one but no one at your home can care for her extreme needs. Changing her so many times a day? Ugh, no way, that is just not OK.

Good luck reclaiming your lives!
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BurntCaregiver Jun 2021
againx100,

That's the way it has to be.
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The way I see it, MIL has a choice between admission to the NH for respite for two weeks, or permanent admission when her daughter has a fatal or debilitating stroke or heart attack. Can you put it to her that way, unsmilingly? It is seriously on the cards.

This is a first stage. From there, you and your wife will at least have a breathing space to make longer term decisions.
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The time has come for sure. Would it be possible to take your MIL on a tour of a NH or two? If not, how about virtually? Her imagination's probably running wild, maybe if she had real images to replace the imagined ones it would calm her down.

My grandmother had the same phobia about nursing homes because she'd heard of abuses. A favorite relative, whom she trusted above everyone, selected one for her and so she reluctantly went---and ended up loving it there.
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Wolfman24, Medicare and every other insurance I am aware of will provide for Respite for a Hospice patient. This is a benefit that you should be able to take advantage of this. You are not dumping mom off you are using a benefit just like any other that Medicare provides.
It is also pretty easy to contact another Hospice and see if they would be of more help.
I hate to even mention this option but…..
you could drop Hospice and get MIL to the hospital for some reason and then tell the social worker there that it is unsafe for her to be released to home and you need help placing her. This is also known as an “ER Dump” and I personally don’t think much of it but if that is the only way to get her placed safely.
And the social worker for Hospice or the hospital can help in application for Medicaid if it is needed.
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I agree, you need to do what needs to be done for your wife before she dies of caregiving for her mom. It is not uncommon for caregivers to die before the ones they care for. Mom and dad were in AL but dad insisted on having mom care for him - by this time he was on hospice. Dad was getting weaker and so the decision was to move him next door to SNC. It was probably as much for mom as for him - mom was getting really worn down.

In no uncertain terms tell MIL that your wife is no longer able to care for her because her health is in serious decline and whether or not she likes it she needs to move.

If the only option is to get her to ER and refuse to take her home, then do it. It's not the best option, but you may have no choice.

If other options are available, then pursue them, but while you're getting MIL out of home - you and wife need to hire in home aids to care for your MIL and MIL pays for those services.

Unless you and wife have signed as the responsible payer for your MIL - there is no way Medicaid can ding you for your MIL's debts. - I agree dump the current hospice and find another (the one we had for dad was super). When dad went into SN my worst fears were realized - I was afraid dad would eat up so much of their income and mom would be left destitute and homeless. However, after running my tuckus off getting all the paperwork together and getting dad on medicaid (he died a couple of days before it was approved) mom was left with enough income to continue her life as before. Mom ended up with a medicaid approved annuity that paid out over 2 years; if she had died before the annuity paid out - the state would get the they're share first then any balance would have gone to beneficiaries. Your mother's debts should be your mother's debts and no one should come after you, your wife or other family members for recompense.

I wish you and your wife the best and pray that you all be blessed with peace, grace, love and a swift resolution to your troubles.
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cweissp Jun 2021
PS - another thought move out of MIL house and call adult protective services that MIL is living in unsafe conditions and you and wife are no longer able to care for her.
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So sorry to hear your wife's health as become so damaged and I appreciate you working to accommodate her and to protect her.

While it's true a person can refuse to go to a facility, if there is no safe place for them otherwise, preference has to yield to safety. A friend's uncle, who routinely fired in-home carers but couldn't manage on own, was kept at the VA hospital when he went for a health event. He'd run out of options, for his safety, he had to stay.

I can imagine MIL is terrified at the lost control of her body and is grabbing at safety - her daughter - with the desperation of a drowning person. A drowning person rarely has the presence of mind to consider they may be harming the one trying to rescue them.

Are there converted house-type assisted living facilities nearby? Perhaps a smaller setting would ease MIL's fears. When we were touring ALs 10 years ago, many were increasing the level of care provided; one had a completely bedridden 91-year old...

The biggest setback with these facilities is that most are private pay; although I did encounter a couple that took VA vouchers.

The Find Care section of this site is a good place to start searching. Best wishes to your family and for a speedy resolution that's best for the health of you all.
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notgoodenough Jun 2021
"I can imagine MIL is terrified at the lost control of her body and is grabbing at safety - her daughter - with the desperation of a drowning person. A drowning person rarely has the presence of mind to consider they may be harming the one trying to rescue them."

That is probably one of the most spot-on descriptions I have ever read! Very, very well put!
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Your wife is already burnt out. Her mother's care is beyond the ability of 1 person 24/7/365. Your MIL needs another living situation - now. Here are a few ideas:

1 - Research all options that your MIL qualifies for: adult day program (usually at a nursing home or personal care home), home health aides, nursing home (assisted living is out of the question with MIL's degree of needs), and hospice.

2 - Tell MIL that she needs a new home since her daughter can not care for her anymore. Give MIL choice of top 3 options she qualifies for. Remember to tell MIL when she needs to move out.
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rovana Jun 2021
I think they are in MIL's home - so the aim should be for OP and wife to move out and away themselves. Like husband gets a job in another state. Now they have to figure out how to do this without risking abandonment charges and how to deal with wife's guilt. But I don't think MIL will see reason and humanity while her daughter keeps doing. Very selfish.
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What happened to the all the family support who said mil needed to go?. They don't seem to be around anymore. Join your wife at your mil bed and tell her you are losing your wife. You are her husband and protecting your wife is the most important thing in the world to you. Mil needs to let your wife be a wife to you and not a caregiver for herself. Invite the entire family to her bedside! Then tell them to find a place for mil in the next week or you will do it for them. Before she has a stroke. No one seems to care about their sister except for you.
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GOOD CAREGIVING REQUIRES BALANCE.

Your MIL is living a WELL CARED FOR, COMFORTABLE LIFE.
Your wife is living IN HELL.

This is NOT a BALANCED CARING RELATIONSHIP.

If you LOVE your WIFE you will assist her to do WHATEVER MUST BE DONE to save her own life and PRESERVER HER OWN HEALTH.

Her mother is an important part of her life, but not important enough to be allowed to become the cause of your wife’s death.

Since Mom appears to be cognitively intact, TELL HER that she must design HER OWN CARE PLAN, and that your wife CANNOT be involved in her physical care, but WILL continue to be a loving, concerned daughter.

BALANCE. Your wife needs a life, and the time to get well. Nothing less!
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