How to Handle/safeguard Mother in Law?

Sounds like she needs a geriatric dr. who specializes in memory loss issues. She could be tested for dementia or Alzheimer's, but she probably needs to change her living situation.

1) Full Med Check with Pharmacist.
- The elderly often have so many doctors that they end up on meds that are contraindicated because the providers don't know what else they're on and the patient can't remember. Go to her house (or have someone do it) and round up ALL her pills and make an appt with the pharmacist to do a full med check. Sometimes patients are even on double doses (2 heart meds prescribed by 2 different doctors).
- One of the most common causes of dementia is this very problem. Fix the meds, fix the dementia and physical problems.

2) Someone needs a limited power of attorney (probably the executor of her will... and that needs to be checked as well... sometimes executors end up being the brother who passed 4 years ago). This circumvents the competency hearing for a few years (hopefully). They have their name on bank accounts and need their signiture before funds over x amount are spent.

3) The aide DOES need to go if they aren't making sure she eats regularly

3.5) If she's not eating well, i reeeeeeally doubt she's taking her meds as rx'd. ((see #1 !!!))

4) 2 choices: residential assisted living or an aide. Keep the brochure f the residential facility on the fridge.

5) ATTORNEY. I'm impressed by the $2500 a month. My grandmother's facility was $9,000 a month. No long term care insurance. My grandmother was wealthy when she went in, and completely broke by her death. If a small portion of her wealth hadn't been in trust, there would have been nothing left (including the house). My uncle-in-law was on disability when he went in... and the facility went after his mom's house, since he had lived in it for some time, although his name wasn't on it. They got the house. These places do not play, and they have whole teams of lawyers to go after whatever assets their patients possess.

Wow, you are one aware family member.

Everything you describe is classic with aging parents.

I just want to recommend the Home Instead website. It has been very helpful with our family decision making. It helped me get the conversation going in the right direction. I am discussing these exact stories you clearly describe above almost daily with my girlfriends now.

Please check their information page:

http://www.homeinstead.com/Pages/home.aspx

There is not much time left given the decline you are witnessing.

Basically it comes down to "which would make you feel more guilty" because you will second-guess whatever choice you make. Are you more concerned about her physical safety (gotta get her into a situation with oversight, so she doesn't cause an awful accident) or with her mental and emotional health (gotta respect her choices and her need for independence so she isn't miserable for however many years she has left)? It totally sucks, but you have to sacrifice one.

As for memory issues, I would ask about Aricept (not sure if that's how you spell it). It did wonders for my MIL until she stopped taking it, when the dementia took over immediately. It's my understanding that many of the meds are the same way - as soon as you miss a few doses, you deteriorate quite rapidly (which is another reason why regular oversight is so important). I feel for your plight and pray that you're able to reach a compromise that brings you some peace...

Contact Meals on Wheels. They will deliver 2 meals a day and spend time with the your MIL. Look into elder day care centers but the cost is almost as much as Assisted Living ($2500/month).

Does she have heart failure? My Mom did and as her heart grew weaker she needed her meds adjusted. Her blood pressure would drop suddenly causing a dizzy spell and falling. Because her heart pumped so ineffenciently she would not always get enough oxygen to her brain and would get dizzy and fall. She also would not get enough fluids she simply did not understand that a person needs about 2 quarts of water daily. Most of the time she only drank an quart or less including decaf coffee. So she would get dehydrated get dizzy and fall. And she never told her doctor she had dizzy spells and fainted on and off most of her life.

You MIl needs to set up a power of attorney for everything -- medical --financial ect and she needs to have a current will and if she chooses a DNR.

Before you decide anything. Talk to an attorney who specializes in will, trusts and estate planning. You are in Wisconsin as am I. I went through this with my Mom. Look into long term care insurance for her, NOW -- RIGHT NOW. If she needs to go into a nursing home or assisted living facility and has no long term care insurance; the facility will attach everything she has. In order to protect her assets she would need to transfer the title of the house 7 yrs before she enters a facility. If she has any investments, bank accounts, ect it will all be attached to pay her expenses at a nursing home or assisted living. Rent for one month in an assisted living apartment is $2500/month + fees for any time they have to help her with something. If she needs help with showering, dispensing or taking her meds, making meals each thing is an extra charge. A nursing home is $5000/month. If she has $100,000 in the bank the home withdraws $5000/month -- in 20 months her money is gone--so then they go after investments -- then the house--it's like a reverse mortgage. When she dies the home owns her house and sells it to pay her expenses. Before she enters the home she has to sign documents handing everything over to them.

You need to decide how to best take care of Mom and her life savings. My Mom refused to take out long term care insurance so I took care of her (shared a home) for the better part of 10 yrs. The last 8 months I was housebound with her until she died.

I agree with Victoria C.

She is no longer safe on her own. Your hubby's attitude is probably somewhat correct....but being independent is also pushing her toward the grave. Balancing this is emotionally difficult & challenging. Who's right? & who wins the battle?

My heart goes out to you.

Hi! I recently went through this with my mother. You are so blessed to have family members on the same page. I'm sure you realize there are no good answers. Okay, I don't think I can do this, I've deleted three times already, I'll only make you more upset. I will tell you to make use of your local office of elder affairs, I always found them a good ear with great ideas. But, you can't make her do anything she doesn't want to do. they will tell you that too. Good luck---

I am so sorry, but she should not be living alone. And I am seriously surprised that a social worker did not get involved in her care when she was found on the floor after 48 hours and required hospitalization and rehab, here in CA we have to literally convince them we can handle the situation. Because one didn't get involved you are between a rock and a hard place. Had a social worker gotten involved they would have assessed your MIL's physical condition, mental ability, etc., and possibly required certain things, i.e., that she return home only with a live-in attendant/aide, one she couldn't get rid of, or that she live with relatives or be placed in a nursing home, etc.

I say this because of my experience with my father, who passed three weeks ago tomorrow, and my mother who we care for. Dad developed what is called "Sudden Onset Dementia," from a stroke last year. He had been having problems prior to that and was beginning to make unwise decisions regarding his money and his life, however, we could do nothing about it at the time until he was diagnosed as having dementia. He had named my sister as power of attorney about 7 years ago, and once there was a diagnosis of dementia she was allowed to make decisions regarding his care, as he was no longer of sound mind and had lost the ability to. We (she, her husband, myself and a brother who live together) chose to care for him at home, even during hospice, as that had been his wish. But, had we decided he should be placed in a nursing home my sister would have been allowed to do so, even if Dad had resisted. Our mother has a type of dementia caused by her 2 heart attacks, her brain was deprived of oxygen for a greater length of time during the last one and because of this she will forget things she's been told over and over. It has been a problem since Dad's death, her doctor is hoping she can get some closure, instead of reliving it over and over.

Since your MIL doesn't want to move but there are clear indications she should not be left alone you need to gather as much information as possible to assist her and if she lives in Wisconsin this is a good place to start:

http://www.dhs.wisconsin.gov/ltcare/adrc/

The site seems to be able to direct you to an Aging Resource Center that appears to offer a wealth of information to assist you in decision making. Also, do consider requesting assistance from a social worker who deals with the elderly, to find out what you can and need to do for your MIL, as if she is found to be "neglected" they CAN move in and remove her from her home, and you, her family, will lose all say-so. It can get ugly so you need to be proactive now. And, if no one has been granted power of attorney you need to try and get that done (she has to cooperate, you can't force her) BEFORE she is diagnosed with dementia, as she can not legally do it after that. Having it makes things tremendously easier.

And having been in your shoes I know how hard it is, hang in there as it will only get rougher for awhile. God bless.

I suggest that you either go along with her wishes and allow natural consequences or give her the choice of keeping the live in aid or going to an assisted living home. Sometimes tough love is all we've got.

I agree that forcing her to do something is also not good and could result in her giving up and dying. But the alternative of allowing her to live alone is also not good and could be endangering others as well as herself. What would a house fire do to the neighborhood? What would knowing that she died because she fell and was alone do to her family?

On the opposite side, she may do well in assisted living because she will be getting nutritious meals and supervision.

You have to weigh the alternatives and decide upon the lesser of two evils. Then go slowly in getting her co-operation.

My neighbors were elderly and their son took about a month to convince them that they had to go into assisted living and then made the arrangements quickly. No long drawn out "battle." The couple reluctantly agreed to move. I felt really sad for them but knew this was the best thing for them. She is now living in memory care and doing OK. It did turn out for the best.

My brother moved my father into a foster home. A friend did the same with her father. Both of those decisions worked out really well. Of course the fathers agreed to make the move. My father lived another several years. My friends father who was over 100 lived for a few months. A foster home provides supervision and a more home like setting.

I suggest finding a geriatric counselor to help your mother make a reasonable decision. The counselor can help you make a decision if she doesn't.

such a tough choice. and because no answer is perfect, you do have to gird your loins for second-guessing yourself. don't allow yourself to make yourself crazy over it.
i sympathize with your MIL's fierce desire to remain independent. but clearly that's no longer an option. she MUST allow (or your husband must bite the bullet and insist) that she allow him power of attorney. it's just too dangerous to risk an elderly woman living alone with dementia to have no-oversight access to her money. yes, it's her money. but it falls on the rest of you if she withdraws it all and leaves it on the sink in a public restroom.
if you're really not ready to face the wrenching, painful decision (that is often completely necessary) to have her move to assisted living against her will, then someone has to check in with her every single evening. if it can't be you, then you need to hire a nurse. someone has got to make sure she's eating, that the stove is off, that she's not collapsed somewhere.
i'm so sorry you're facing this. i know it's a lot easier to say than to do. i'm not too far off from your situation myself. my parents have long-term disability insurance and have been completely clear that when they can't cope on their own any more, they want professional assistance from people who are trained. my in-laws are like yours, they are not willing to give up an iota of independence even when it causes endless worry and anguish for their kids.
i understand both POVs. i hope you find a livable solution.
khairete
S.

Went thru this with my aunt. I did nothing but run back and forth every
time she would not answer door, phone. This went on for two years. She
fell, she got stuck in bathtub, she smoked, took pills and drank. I told her
she could not smoke in bed. She tells me" it is OK when the ashes hit
the blanket, they go out.!!!!!!" Had an aide, the "fallen" button everything
to assist her. The last straw was she went out after the aide left, and
managed to literally fall flat on her face (never even put hands out to break
fall). She was taken to the hospital and was OK except for all the bruising.
Docs told her as I did she could not return to her apartment. Brought her
up to nursing home close to me. That is where she stayed and where she
is today. She is now 81. Now the transition was not easy but at least I
could sleep at night. She still says I killed her dog, and on and on. There
was nothing else I could do. Could not bring her home with me. Stairs
and her smoking. She would not be able to be left alone!!!! I think that is
what you are facing. Your MIL is not safe. Good luck and I really know what you are going thru.

You have to be very careful about having someone live with her. My friend just had a horrible experience with that. She could not even evict the person because she live there!
I am sorry you have to make such a hard decision, but she has to be moved somewhere safe.

What's causing the falls and memory lapses?

This is something that is becoming more and more common.
I went through this myself. The most ideal choice is to hire someone to come in a few hours a day, or live there if you have long term health insurance. One of hte most important things is to get good food into her
THere is an organiztion in areas called Meals on Wheels. GOOD FOOD is VERY important. I have seen many regain their health with someone preparing good food. Unfortunately, in my case we had to put her in a nursing home and go through ALL of her savings, Her imporvement came when she was getting 3 "reasonably good" meals a day, and even though there was a lot of sugar in what they provided,, it was far better than what she had been eating. Depending on your location, I know someon who loves to go into homes and help with things like this.