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Helping Mom accept and make decisions
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SmartCat posted:
A little quick history.

My husband's father has Alzheimers, he received a preliminary diagnosis over a year ago (probably closer to 2 1/2 years ago). His wife (my MIL) is still living and is taking care of him. He received his diagnosis, when he was already fairly advanced (having severe short term memory issues, losing his way, focus, etc). His wife is having an incredibly hard time accepting this (which doesn't surprise me, and I can't imagine what she is going through). We live about 1/2 hour away from them. She has not taken him to the recommended specialist for followup diagnosis, appointment or meds, even though we consistently offered to go with her, support her, etc.

Dad has been getting progressively worse and is now to the point where he can not dress himself or do other things for himself, without her standing over him, 'helping' him do it. He has gotten lost once and since then, we have changed door locks and other things to keep him in the house. We are doing everything possible to keep him safe. So his safety is not my main concern.

My main reason for posting here, is: how do we help my MIL accept this and the fact that she needs to think about assisted living or getting help or whatever? Every time my husband or I broach the subject she becomes extremely defensive and refuses to talk about those issues. She doesn't want to discuss their finances with us and has told my husband to keep his nose out of their business. She is less defensive with me, but I also try not to push too hard, as I know that taking any of these steps means that she isn't able to take care of her husband, her love, the man she pledged to stick with through sickness and health, etc.

I go in at least once a week to help her and this time was originally for her to go out and run errands, see friends without having to take her husband with her. But for the last 6 months, she seldom leaves me alone with him. I believe this is because she treasures my company over more than going out on her own, but I worry about her not getting away ever to have a break. Occasionally she will go out to get her hair done or dentist appointment and leave him with me, but these are the rare exception. We are lost at how to help her through this and worry that she won't be able to make the decision of when it is no longer practical or safe for her to be his sole care provider (keep him in the house with her).

I'm not sure that she would accept a 'stranger' in her home to help care for him, as this is her 'job', her responsibility, and perhaps thinks she is failing him, if she can't do it. I see a lot of posts about caring for your parent with Alzheimer's, but little about caring for the other parent as they deal with a spouse with Alzheimer's.

Any suggestions and advice is welcome. Thank you.
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cjh1203 responded:
Hi SmartCat,

Your in-laws are lucky to have someone so caring and concerned for them.

My uncle had Alzheimer's and, although my aunt was never in denial about it, she absolutely refused help of any kind until just a couple of months before he died. My mother and I offered every single week to stay with my uncle so my aunt could go out and do some things on her own. (The four of us did go out for breakfast every Sunday.) She did get her hair done one a week, but would leave him home alone despite our offers, which wasn't a good thing.

When we broached the subject of assisted living or getting someone in to help, they both were adamantly against it. My aunt thought that it would be a betrayal of him not to do everything herself. Her own health suffered greatly for it.

What finally turned things around was getting her in touch with a case manager who specialized in Alzheimer's patients. She talked to my aunt and told her that what often happens is that the caregiver will refuse help, become ill and end up in the hospital, leaving the Alzheimer's patient home, and everyone scrambling to figure out what to do.

She said that 100% of families she's dealt with thought it would be cruel to put their Alzheimer's patient in any kind of facility, but almost all of the patients actually improved and thrived once they were over the transition to the new location. She had an answer for every argument my aunt could come up with. After that, she oversaw every aspect of my uncle's care and was a great source of support for my aunt.

My uncle was quite upset at first at the prospect of strangers coming in to help him, but after the first visit, he just loved it when the nurses and aides came over. He liked talking to them about things that had happened in his life, and thoroughly enjoyed the attention. It was such a help to my aunt and gave her a little breathing room.

That's a long route to my suggestion, which is to get in touch with your local Alzheimer's Association and explain to them what's going on with your mother-in-law. They probably know of someone like my uncle's case manager who could talk to your mother-in-law and address her fears and concerns. I think that, a lot of times, it's easier for people like your mother-in-law to talk about things like this with someone outside the family.

Another possibility is to enlist the help of your father-in-law's family doctor, or whoever diagnosed him. Maybe you could ask the doctor to call your mother on the pretext of following up on the recommendations given at the time of his diagnosis, and he or she can impress on her how important it is for him to get treatment and the appropriate medication. Does she know that Alzheimer's medications can slow the progression of the disease for a lot of people?

I can't think of any other suggestions offhand, but maybe someone else can offer some ideas. I hope you're able to get through to your mother-in-law. I know how frustrating it is to see her in such a tough situation and refusing the help she needs.

Best wishes.

Carol
 
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Judith L London, PhD responded:
Hi SmartCat,

Along with Carol's great suggestions, I would add that if you and your husband visit, one of you could take out your mother-in-law while the other stays home with your father-in-law. You could also have your husband tell his mother how worried about her he is about her and that getting in some help would make him feel relieved. Statistics sadly show that when the caregiver never gets relief, emotional stress and physical breakdown soar.

Meanwhile, you are one attentive daughter-in-law.

Judy
 
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2010guardian responded:
Dear smartcat,

While reading about the care your MIL is giving your FIL, I'm thinking about how I help my husband, who was diagnosed with moderate AD about 2 years ago. I assist my husband in dressing also by 'standing over him' and helping where needed.
I'm wondering if maybe your FIL needs assistance in the bathroom, and maybe MIL doesn't want to have outside help in that area. Just a thought. It's really great that you are able to help your in-laws the way that you do. Just thinking.......

Kathy


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