What is the next step?

GoldenRetrieverGirl · 12-30-2003, 10:15 PM

I posted a thread in October regarding my inlaws. This is a recap: My MIL has dementia (she is 59). They live next door. My FIL (he is 60) has gone back to work to get away from her and she attends adult day care, grudgingly, two days per week. A dear friend takes her one day per week out to lunch. I fill in when my FIL asks, where ever he needs me (next door or pick up/drop off, Dr.'s appointments, etc.).

Problem: My FIL is nearing his wits end. He phoned the week before Christmas to say that he could no longer live with her. He wanted to kill her and he just could not take it any longer. A couple of days later he explained that he was venting and that he was "insane" that night. My husband and I decided that our 3 year old son is no longer allowed next door without us. Anyway, my FIL is scheduled for neck surgery next week and will be home for two weeks and then maybe working part time until he is out of the neck brace (6± weeks). He also needs to have both knees replaced (sometime soon) and has diabetes.

My MIL is not a well woman, but we all know that she is not at the stage where you would put her in a residential facility. We don't know at what point her health will warrant an institution, but the situation next door is not good. My husband and I both help out as much as we can, but I am 29 and hubby is 33. I run my own consulting company (part time) and hubby works full time. We have a 3 year old son and I am in my last trimester of pregnancy with son #2. We just don't know what to do. Any advice would be appreciated. We are scared and sad.

Jennifer

Bettyhere · 12-30-2003, 11:22 PM

What, exactly, do you mean that your MIL is not at the stage where you'd put her in a residential facility? There will never be a point where her health will warrant an institution--the time for placement is when the caregiver/s can no longer do it. It's for the caregivers, not the patient. AD patients are usually fine no matter who cares for them or wherever they are, so long as there's no abuse or neglect. Your FIL is hanging on by a thread, no telling what he may do and his health is every bit as important as hers. Your boy needs his g'father, and you won't be able to do much with the new baby on top of everything. The entire family is putting their health and well-being behind what your MIL needs, and her needs will increase endlessly, her illness is sucking all of you dry. Either get a full-time caregiver in the home or find placement--nothing is going to get better. Sorry to be so blunt, but if things are as you say, there's nothing I know of that anyone can advise you to do otherwise. You have to come to grips w/the illness and determine if your marriage, your boys, and your FIL are going to always come in 2nd to your MIL's disease.

GoldenRetrieverGirl · 12-31-2003, 09:36 AM

When I say that she is not ready, I mean that she is still cognizant of her surroundings and some of her behaviors. If my FIL were not in the picture, there is no way that she would be living in that house at this point. At the same time, how can the family explain to her and the rest of our family/friends that the current situation cannot remain as is, warranting her placement? She would freak. She doesn't even like going to adult day care two days per week. She tries to get out of it every chance she can. She tells me that she just wants to be at home.

I just don't know. There is no question that she is taking a tremendous toll on my FIL's health. He has felt trapped and frustrated for a long time. She is so argumentative and antagonistic at times. I would not be able to take it if I were him. My husband called her Dr. last night to talk about a medicine change. Her Dr. is putting her on a low dose of Risperdal. I am going to look it up this morning to see what it is.

We all, the three of us, just don't know what to do. I understand what you are saying and a large part of me is in agreement with you. I just can't imagine telling her that she needs to live somewhere else. Not yet. At the same time, she is taking him with her at this point...

I appreciate your honesty. We need to hear it. I just don't know what to do with it...

camachinist · 12-31-2003, 12:18 PM

If my FIL were not in the picture, there is no way that she would be living in that house at this point

You explained exactly why you should consider placement. FIL's had it and MIL can't live alone.

Her Dr. is putting her on a low dose of Risperdal. I am going to look it up this morning to see what it is.

Antipsychotic.....just approved for bi-polar mania, IIRC. You might search this site for more information and practical experience.

I just can't imagine telling her that she needs to live somewhere else. Not yet.

What Betty does know (and has told me a few times

) and may not have said clearly enough is that there is no "right" time or "yet". It is not a decision the patient makes (MIL is no longer competent to make such decisions).

Do your legwork (both regarding placement and planning for the financial end of care) now and, when the time is right for you (not for her), take action. A trip to the new "day care" is all it will take. In that regard, you've at least got that habit grudgingly instilled. She just won't get picked up. Remember, she's mentally ill, not a bad person.

Keep us updated on your progress.

Best wishes!

Pat

Bettyhere · 12-31-2003, 03:53 PM

Dear Girl: When I asked what do you 'mean', it was retortical, because I mean there is no 'time' she will ever be willing to leave her home. She may always appear aware of her surroundings, and I don't mean to be harsh, I had to place my husband for my own well-being and he still had awareness. And if you think that was easy---. Your MIL can stay in her home for years if there is someone willing and able to take care of her full time--so who is willing and able, your FIL, your husband, you?

You are under no obligation to explain anything to anyone. If someone challenges you about placement being too soon, then let them take care of her. No one has the right to criticize your decision unless it's one of abuse and neglect. Most people don't understand jack about AD, just do what has to be done. And your MIL won't understand, and it is so hard--yes, she'll freak, she'll cry, all those things, but you have to weigh all sides and do what's best for those of you who still have a future--especially your boys. All of this turmoil in the family about their g'parents is not good for small children. They need to feel safety and serenity, and what do you tell them when they can' visit their g'parents just next door? If you need a reason for placement, for heaven's sake, your boys are it. You are describing a very bad environment for adults, little children should not be part of it. Your FIL no doubt wants her placed, his health depends on it. I'm surprised his doctors don't tell him he can't have this ongoing trauma. You don't say how your husband feels, and you still seem ambivalent. Others are reading this and I ask them to join in with their opinions. I could be missing something.