Thanks to all who have responded in the past. To sum up, about 3 months or so ago, FIL (86 years old) had a couple of episodes, due to (we think) both his dementia and his psych meds (i.e. not taking them properly), which caused DW and her siblings to get him on Medicaid and into an ALF. At this point, his physical problems and psych meds seem to be under control, and he wants out (MIL, wife of 65 years, has still been in their home, but unable to visit due to Covid-19). It is of course heartbreaking that they have to be apart, but MIL is failing fast (left pot on stove to burn yesterday, also forgets meds, etc.), and there doesn't seem to be any way they could safely still live on their own.
The biggest issue for FIL is that he has never really been reasonable, and has certainly never really managed his own affairs. Now he thinks that he can live on his own and that *he* will help manage MIL. The situation is made more difficult because he can be very articulate at times, and pretty much everyone can imagine being angry for being in his situation.
The crisis came because now he wants the SIL, who lives locally and who has medical POA over him), to sign him out of the facility... oh, and he just "fired" his MD there, apparently officially. He may have become very agitated there... he certainly was with DW and her sister.
The siblings are not in agreement about what to do next. DW thinks that if we can get some type of home Medicaid assistence, that (along with the frequent visits by two local daughters), they should let the chips fall where they may. The other two sisters are more leaning towards more of "we need to get them both in a place where they get help", with the unspoken assumption that they would not be free to leave.
None of the siblings have ever really been able to confront their father, due to his personality and normal parent-child dynamics. So no one *really* wants to be the one to say "Dad, you are not going home", or "Mom, by the way, you also have to leave your home and go somewhere".
While all the siblings *want* to be united, clearly this is a major fork in the road where they are not all in agreement (two others have kept relatively out of it).
The final option that DW and I have thought about sounds reasonable, but her father is *not* reasonable. That would be to try and find a way for her parents to be together, but in some type of ALF. As an outside observer, I can also state that her father would completely reject that as he feels he does not need this, that "I can take care of her and myself".
It is a big mess, and it may just be that this is one of those times in life where you have to make a decision between two horrible alternatives.
I know there is no simple answer to any of this, but as usual, it helps to get it off my (our) chest(s)... DW (who is financial POA) and her sister have been extremely stressed by this, and I even worry about them.
Thanks,
Bood
I'd remind whoever is making the decisions that trying to appease a person with dementia is complicated. And, often neverending. Sometimes, medication can help, but, often, if it's not one thing, it's another. Even if they get what they want, they may continue to show displeasure about something else. As dementia progresses, a person may be insistent that they go home, even when they ARE in their own home. People with dementia may live with no personal hygiene and not even realize it. I'd keep in mind that this phase may fade away, but, it might not. It's unpredictable.
If the siblings just can't agree, I'd remind them that under some circumstances, APS might get involved and then the decisions will not be within the discretion of the family.
Who's providing care for the MIL in the home?
"The two sisters nearby are the ones who do *not* feel that they can live alone, together or not. One works full time, and the other (medical POA) just went part-time."
So there are three sisters total, and your wife has the POA, and one of the sibs local to your in-laws has the HCPOA?
If there are three sibs total, then the two local sibs who want both parents somewhere where they can get the help they both need are the ones who see the most and also are the ones most affected. Does your wife really want the burden on her sisters? What if something happens when the help or they are not there?
Your fil is not going to be happy, but what he wants should absolutely not take precedence over what both he and your mother-in-law NEED.
I encourage you all to get them in a care facility together and if that is not possible to leave dad where he is and stop taking all the phone calls. Try to get mom a needs assessment and get her placed where she will be safe.
If dad is difficult he is only going to get more difficult. He is better now, that is what happens when they get proper care. He will decline at home and the rollercoaster begins, in the hospital to rehab, back home, rinse and repeat.
Please encourage all of them to view this situation as a what NEEDS do they have vs what they WANT. Unfortunately their wants don't really matter, no matter how loud they declare them.
Yep, this is a case of picking between two awful choices, but do the picking on needs and it will make it easier. I am speaking from experience.
Moving MIL with FIL will get them together again and will give him some purpose and take his mind off the fact that he is in ALF.
This would keep MIL safe
The house and assets can be used to provide for her care. Apply for Medicaid now or when needed.
And as he fights this, the "therapeutic lie" of...."you can both come home with the doctor says you can" might settle him down for a while.