Advice:Family member not fit for caring duties

[Annier25]

The situation involves my mother in law 

caring for her husband which has vascular dementia, mobility issue slow walking and has higher care needs. Has been approved for the top level aged care package with respite and approved residential living for the future. Her mental health has declined a lot when family approach her about seek professional help of counselling she denies it and ask for my anti depressant as the solution. She had been using his aged care approved package the for her benefit such as provide meal on wheel or cleaning non important areas of the house like a patio mostly for her needs not her husband who need it.  However, when approached be friend or healthcare  provide a spill about her non existent or minimal health issues like muscle sprain which seem to be all for attention and pity. Sometime there been occasions where she doesn’t want to deal with him and say it too hard and would leave him dirty and unhygienic due to lack of shower this cause issue where he has reoccurring medical issue on his buttocks area. But he can listen to instructions and can do the task. 
They live in small bedroom apartment where he sleeps on a sofa bed and lately she been hoarding item inside the house where there heaps of fall risk for him. Aged care have come to do an assessment and I’m upset they never indicated that this living arrangement is not appropriate for him.

when she complained about caring for him the family have suggested it time to transition him to residential living where he can be taken care of by professionals but she always say no he not ready and she want him with her. There relationship wasn’t great where they were seperate for over 10 years before he became unwell. She make say comments to him about being stinky.

 At this time I feel like she may not fit to care for him and has mental health issues where she can be very nasty when trying to help. She has tried to palm him off to us but we can’t as we have full time jobs and she had no job.
 I’m sorry for the rant, I feel helpless as I cannot talk openly with anyone as it will affect my relationship.

[Summer Rose]

Hi and welcome to the forum.

I hope that it helped you to vent and share your story. It sounds like a really challenging situation for you and the entire family. I could feel your sadness and frustration as I read your words. 

I really feel for both your mother-in-law (MIL) and father-in-law (FIL), as they are both struggling—although in different ways.

I’m wondering if it might help both of them if you could persuade your MIL to allow your FIL to visit a nursing home for respite care. This would give them both a break and if your MIL sees that he’s receiving good care she might be ready to let go.

We took this approach with my MIL and FIL. My FIL had dementia and it got to the point where my MIL wasn’t coping (or providing necessary care) but she couldn’t see it.

The family persuaded her to select a care facility for “the future”. This took a lot of effort and for her son (my husband) to take a firm approach.

Then we convinced her that she needed a break and my FIL went in for a weekend, then a week and then he moved in.

It’s just a thought because I agree with you that a change is required, for both their sakes.

Kind thoughts to you 

[indigo22]

Hello,

Welcome and thank you for reaching out to us.

I have a good understanding of what you are going through, my mother and I co-cared for my father, and later I was carer for my mother. Dad had vascular dementia, mum had a different kind of dementia.

The slow walking and mobility issues are very common to vascular dementia as the signals from the brain are not working efficiently like they once did. Depending on your mother-in-laws age, it is possible that she now has some early signs of age dementia or other type of mental illness, but the only way to determine that is through a GP. 

One of the important things in a case like this is to be sure that there is a person who has Power of Attorney, along with Medical Power of Attorney and Guardianship. In my family, that was me. The papers were signed by both my parents while still sound of mind and it gave me the ability to do what was best for them in any given situation. If your mother-in-law has these papers, there is little you can do other than having her checked out by her GP to make sure she is able to make good decisions. If on the other hand, she does not have these papers, then this should be a priority for your partner to sort out. This does not require a lawyer (at least it didn't when I did this about 25 years ago). It is best to have all 3 sets of papers as then it covers all care needs.

Given that he is accessed for high care needs, I would think that he would be eligible for personal care. By this I mean, a nurse (or similar) to visit and assist him with his daily shower etc. This is also something you could look into.

I hope this is of some help and I am happy to talk further and answer any other questions you may have to the best of my ability.

Take good care of yourself and your partner,

indigo

[therising]

A warm and deeply caring welcome to you ❤️

I'm wondering whether you've been able to get to the bottom of the reasons for why you MIL thinks and acts in the way she does. Gaining some insight might help with navigating the way forward. For example

• Some older people may fear living on their own and prefer to live with pretty much anyone rather than face living on their own. So, they won't want the person their currently living with to leave
• Some people may have the attitude 'I couldn't care less about my partner', based on their partner having been a careless person toward them over past years. So years of past mental or emotional abuse or neglect may play a part in the current relationship. Resentment, when it comes to feeling like they have to take care of their partner, may also come into play
• Mental health may also play a part in a person's thoughts and behaviour. For example, if your MIL's suffering through depression and the patio is the only place where she feels happy in life, it could explain why she may want all the cleaning to involve her 'happy place'. If she experiences the lack of energy and motivation that can come with depression, it could explain her not wanting to cook for herself (hence ordering meals for herself). If the meals also lead her to feel happy, that's an added bonus in her mind
• Another mental health issue can involve dementia. As indigo touched on, is there a possibility that your MIL could be facing early onset dementia and is not able to make the best decisions or be led to see good reason for certain things?
• Financial stress could be another factor. Does your MIL fear not being able to afford to live on her own? Could she also be concerned about having to find somewhere more affordable to live?

I know that's a lot to consider but sometimes it can take a lot of detective work in order to get to the bottom of what seems like a bit of a mystery (the mystery of why people won't or can't listen to reason). With so much focus and care being directed towards her husband, I'm also wondering about whether the sore ankle is about her wanting people to care about her too.

Something else to consider is whether your MIL is also eligible for a 'My Aged Care' package, for example. Could the services be increased to cover both their needs? With my mum receiving this package (level 3, verging on level 4), a lot of the money goes toward admin fees, which leaves less money in the fund to cover day to day expenses/services. If your MIL's eligible, there would be more in the fund to cover her needs and therefor it would free up funds for someone to come in and help your FIL with showering and other hygiene related expenses as well as them receiving meals for the both of them. If she fears not being able to set this up, this is something you could help her with.

Your in-laws are blessed to have you in their life, someone so caring. I think sometimes our partners may appear as uncaring but it can be a matter of them having the attitude 'If I don't see a problem, I don't have to face or feel any problems'. In other words, they'd prefer to feel the easy stuff in life. We can be left to face and feel the problems on our own. Sometimes it can take a bit of a wake up call for them to feel the need to finally address what is obviously a problem or challenge.

[Annier25]

1. Thank you for your reply. 
   I do agree that convincing her to see the facility would make her become adjust to the idea. Unfortunately I cannot really talk to my MIL lately as she doesn’t receive well feedback from me (see me as an outsider to decision). However, they have the approval already for a nursing home but it cause my FIL say to her I won’t go there/ if you take me there I will leave - this was play to her own feeling and emotion as he left her previously. Also because my FIL is vocal they belief he still has a rational mind however the doctor have deemed him without  the rational ability to make decisions for himself. My partner can speak to his mother and convince her but it gotten to the point where he becomes too sensitive and very stressed if I raise the issue to him and he can see she not coping but has a difficult time taking a firm approach as he doesn’t want to upset his mum and let it be. Also he expressed that nursing home would cost a lot to have his father in there. 
   My MIL has said she need a break but when it come to taking him to respite is difficult and feel like an inconvenience and FIL get push into our home so she can have a break. She has asked us if we can take care of him. But they not wanting to seek the appropriate help. I don’t know what to do but to pull myself away from it which is not me.

[Summer Rose]

Hi Annier25

Thanks for sharing more of your story.

It’s certainly a tough situation, as your MIL really seems to want you and your husband to provide care for your FIL.
The key to resolving this is how your husband really feels (he may be more worried about costs than you think) and if he can find the strength to use his voice.
He really seems to be the only person with the power to deal with them.
I think all you can do is gently continue to try to talk to your husband. I think showing him that you only have the best interests of your MIL and FIL at heart will help. As will providing him with reassurance about costs.

I would also be firm with your husband that you cannot provide care for your FIL yourself. You do have the power to make this decision.

Kind thoughts to you