How can I help when they won’t accept the help we can give?

Who are "we" and who is "she"?

The nature of the relationship between parties makes a big difference to what is appropriate, and to what kind of leverage might be available to you.

You leave her to her own devices, and stop providing help. When an emergency occurs (and it will) and she ends up in the hospital, you work with the social workers there to get her placed.

Take a giant step back and wait for the inevitable.

Hello!

You speak about “being put in situations”. At this point, friend, you are ALLOWING this. Your LO cannot put you anywhere, without your consent.

Your only choice, in order to have boundaries, is to keep those boundaries, which are for YOU.

Yes. Step back. You know this, deep down.

Best wishes to you.

Often a "combative, stubborn elderly" = dementia

I agree with ZippyZee that you need to stop being the only solution for her.

Who is her medical PoA? This is the only person who has the legal ability to manage her care in her best interests if she is no longer competent to do so. The only other option is to pursue guardianship through the courts (IF she is deemed incompetent to care for herself).

If no one is her medical PoA and no family member steps up to pursue guardianship then you will need to step back and let the chips fall where they may until the inevitable crisis allows APS or the EMTs to step in and get her the care she needs going forward.

Thank you everyone! This is the advice my family has given me as well. This is my MIL and my husband is POA.

We have stopped tending to emergencies and told her to call the ambulance, which she refused. She then proceeded to get very nasty and berate my husband about how he is not the person she thought he was. Leading to disruption of peace in my house for days.

I could go on and on about her behavior but the main point is we need to get her the help we cannot provide. My maternal family has agreed we need to let something happen and have APS get involved

Just read your reply. Please stop listening to all nasty and berating comments. Each and every time this happens either leave immediately or get off the phone saying you’ll talk later. Neither you or your husband deserves to be talked to like this not matter her situation. Something that actually worked with my dad when he desperately needed help in his home—we told him he had to hire someone or he’d have to move out, to some kind of assisted living. He had a sound mind, we couldn’t actually force him to do either, but somehow he believed us, and was desperate to stay in his home. He decided to hire help, which I found and put in place. He’d been beyond hesitant but when it actually happened, the helper became a cherished friend to him. I give her a lot of credit for her skill at winning him over. Sometimes it works to state without reservation that this is the way it has to be and not talk about it over and over

No no no, hold on.

The OP described how the peace of the household is disrupted for days after MIL has given vent to her feelings of betrayal and abandonment. But MIL is not - may it remain so! - part of the household. So the *conflict* is between..? Where's it coming from?

Guess: husband comes under pressure from MIL for MIL to move in with him and you, you thus becoming her primary hands-on personal caregiver. Husband relays this to you. You issue a nolle prosequi. DH relays that refusal to MIL, but without fully grasping himself what the problem is. MIL rebukes him for his lack of filial devotion. He comes back to you...

Has MIL *ever* received hands-on care from suitably trained and qualified persons? - not including very short-term crises e.g. stays in hospital.

You may want to tell her if she doesn't go along with your suggestions that the following will happen.

You will not do more than ur comfortable with

If she won't except help from the outside and she ends up in the hospital, the state may take over her care. At that point the State makes all the decisions. Where she would be placed and it could be miles from her son. Her SS and any pension will be used for her care. Any assets she has will be used for her care. Her son will have no say it what happens to her. Now don't take this verbatim, but most of what I wrote is true, the rest a little drama. I am not beyond using some scare tactics with people like this. When they see that a stranger may be in charge of the rest of their lives, their thinking may change. Also, losing controll over their money.

"cleaning, laundry, food shopping, companionship and assisting with medical appointments." Is she really not able to do light cleaning and her laundry? Or are u "disabling" her. As one member calls it. How old is she? If she craves companionship, maybe an Assisted Living would be better for her.

I too do not like doing the more intimate things. Toileting is the worst. Even my RN daughter, who has worked in NHs, has told me not to expect her to help me with toileting. No, she did not say it exactly like that.😊

There is a terrific book called "Boundaries" by Townsend and Cloud.

You set boundaries about what you are willing to do. And then, you stop explaining and you don't budge.

"I can't possible do that" is a very useful phrase.

If is IS an emergency, then call 911 and send the EMTs to her home. Let HER send them away if she wants to.

Let her be as mad a wet hen. Don't answer her calls and STOP picking up the guilt care.

When things are not in an uproar, have POA contact her doctor and explain how things are not going well. Let her doctor get the ball rolling on more in-home support if that is what she desires.

Thank you all for taking the time to respond. I should have mentioned that I am not on her beckoning call but DH has been in the past and is getting better at saying no and not offering.

When things get bad and ugly, he mainly deals with it. I am just there as support to him and offering the level of care and help I am comfortable with to her.

I have spent many years untangling her web of deceit and manipulation and no longer break or bend to her heinous requests. DH is getting better at being able to recognize what is happening and saying no but it is coming in forms of rage and anger of years of not appropriately handling or communicating expectations on both his end and his mother’s end.

I sit back and watch as an outsider with no real input and keeping my mouth shut (as I have learned is best to do with in laws) and keeping my own internal peace.

Thank you for all of your suggestions on where to turn next as I do feel bad that her health is declining rapidly and she is having difficulty taking care of herself but I do not feel bad for the bad mistakes she has made her entire life, continues to make and the levels of manipulation and narcissism she will stoop to get what she wants.

Its taken years of mindfulness to get to this point, but I am happy I am finally here. Thank you all again!

Continue to do what you are willing to do and nothing more. In fact, back off on things she is capable of doing herself but has managed to get you to do. My aunt would get mad at me for not cleaning my father's apartment. This was not the 1950s and I had a job and my own home to tend to. Plus he was perfectly capable to clean himself He just chose not to. Not my problem.

If she gets nasty, end the visit right then and there. Don't care if you are in the middle of something. Just brought the groceries in and she gets nasty....leave them for her to put away. (my aunt did that to my grandmother once)

And wait for that emergency. Tell the ER she lives alone and shouldn't be. And no you cannot take her. Let them be the bad guys.

I've said this before and I'll say it again. Does she have a weapon she is holding on you or is this just a guilt cruise? I imagine the latter, and in that case, you don't have to go. I believe people are obligated to see that their parents are cared for in their old age, but they are not required to completely turn their lives upside down to do it. And nobody should ever put up with any kind of abuse, physical or verbal.
The crappy part about getting old is that you don't always get to make choices about your life. That is your mother's case. It's sad, but she will have to accept it.

If she doesn't want to accept the help you're willing to give, then so be it. She will be in over her head in no time. Then maybe she will be brought to a teachable moment and realize it would be in her best interest to be more cooperative.

As said before, boundaries. I totally agree on the "no bathroom help". That's a line I am NOT willing to cross. My nose and head can not/will not do it.

I also agree that being so stubborn, etc could be indicative of her actually having a problem, like dementia or at least cognitive decline.

As long as your loved one is mentally competent, you can not have to force her to accept help. Consider having a series of long talks and write down "agreements" afterwards: what you will do, what you will not do, and consequences. Continue reinforcing your boundaries with the types of care you are willing to provide and what will never be an option.

You may need powers of attorney for medical and financial when she is deemed mentally incompetent to conduct affairs in her name. Please consider obtaining an appointment with a lawyer to get those POAs, a will, and any other legal documents required for her location.

Many seniors with dementia have agnosomia, an inablility to recognize their need for help or resistance to help. Please consult her family doctor for an evaluation. Her primary care doctor may make referrals to a neurologist and/or a geriatric psychiatrist to pinpoint causes for her behavior. If she is deemed "mentally incompetent" then you may set up care for her, even if she denies the need for outside help. Anti-anxiety medications may help her to relax and accept help with less anxiety, agitation, controlling behavior, or outbursts.

If husband is POA, is he actively using this to manage her finances? If so, can he hire someone to be there at the times that one of you is there doing other agreeable tasks (laundry, cleaning, etc)? If the person comes in with one of you, then you don't have to rely on her letting them in. Let her scream and yell. Do what you came to do. If she asks for help with bathroom anything, aide is there, if she's any good, she'll work it out!

NOTE: Medicare does sometimes pay for a limited number of hours for help with personal care, if someone is house-bound. Not much, but take what you can get! They can likely help with bathing and some toileting.

(for others, this was NOT a question about legit activation, just IS it happening? POAs CAN be activated without someone being declared incompetent - all depends on the documents. IF he's already managing her finances, he can hire aides.)

The only other real option is to present the ONLY options available to her. Your choice mom/MIL!

First, present the list, in writing, of those things you ARE willing to do:
1) cleaning
2) laundry
3) shopping
4) appts

The first 3 items should have a scheduling restraint, like weekly.
Appts happen whenever, so no real way to "schedule" those.

Then the ultimatum, ALSO in writing:

1) hire help for any other needs
2) move to AL
3) wait for emergency, state takes over, none of us have any say in how or where you live or get treated.

Give her both of these, in writing so she can't say she doesn't remember or didn't hear you. Have copies available if/when she throws them out.

Discussion can be limited to accept or not. If you do not accept the help we are offering in list #1, then you are left with 3+ choices. Hire ALL the help you need, move to AL or let the state take care of you.

(I realize limiting outside help to the times one of you would be there wouldn't be enough if she needs toileting help all day, but cross that bridge later IF you can get someone IN the door AND helping her. Once you have someone there, on a regular basis, maybe she'd get used to the person? Heavens to Murgatroyd, what if she actually likes the person!?!?

But, those should be your lines in the sand. She crosses them, all bets are off. She starts nonsense, either in person or on the phone, leave or hang up (you'll have to work on hubby with this! My daughter was 5yo when she taught this to me!!!) If you leave mid-clean, mid-laundry, mid-grocery delivery, I would leave it ALL as is at that moment (maybe put away fridge/freezer items, but the rest stays where it is at that moment.) Stay away until the next scheduled trip to clean, food shop, do laundry, but repeat the Exit, Stage Left if she starts again.

It sounds rude to hang up or walk out on someone, but if they are haranguing you/him and upsetting both of you, then it is no longer rude, it is self-preservation. Just cut her off or talk over her saying something like Sorry mom, gotta go and just hang up (don't slam it down) or leave, without slamming the door. DON'T take any calls from her. Turn off the cell phone, get out of your own house if you have a home phone, then you don't even hear it ring!

Stand tough. If she really doesn't have dementia, at some point it should sink in that she's NOT going to get her way. If it doesn't, maybe cutback on the schedule, go every 2 weeks instead of weekly.

It's good not to try to get in the middle between him and her, but DO be extra supportive of him, while he navigates these uncharted waters.

You say no.
You mean no.
Your actions support that no.

Sounds easy right?

The problems is when you say no but end up doing it anyway. Sending the message you WILL do it.

Then your LO will keep at you because *They know you will do it*.

Maybe it would help to find out what the roadblocks are?

1. Only trust you - distrust others
2. Unable to plan alternatives
3. Hate or fearful of change
4. Denial of their needs
5. Lack of insight

In my lot are a mixed bag. MIL only trusts family so warnings there. Mother hates change. Sis OK with change & trust but limited planning & lack of insight. The sum of all that is they all expect us to be at their beck & call.

This site, counselling & boundaries! Three cheers for those!

They built up my NO muscle to an effective size to be of use.

I say no.
I offer an alternative.
The consequences are theirs.

Need advice, I might add, if I may, that it sounds like you have quite clear limits to what you will/won't do.

Is the issue more that DH doesn't like to say No to his Mother?

If so, tell him he is not alone. Many have been conditioned to avoid confrontations.

Personally, I was trained my whole life to never upset my disabled sister. She cannot look after herself, will not move & lacks insight how her needs affect the wider family. She would not arrange other transport until I stopped driving her. She would not get a weekend aide until I refused to come & she was left filthy. She would not call EMS for falls until I refused to come & she was left on the floor.

But now she loves her aides like friends & jokes with EMS. I think she does realise now that without their help, she could not stay in her home. She just didn't know how to plan all the help she needed.

Your MIL doesn't want to get old. That maybe the jist of it. But she did get old & now has to deal with it. It's certainly not your DH's fault, nor can he fix that. Tell him that if you think it will help.

Thank you again everyone!

I am at a place of solace with the situation. I try to mind my own business for the most part of let my husband be on her beckon call if he so chooses. After years of resentment, I have learned to let it go and am grateful my immediate family does not operate in this manner. There is only so much say and leverage you have when it’s not your family. I know marriage is supposed to integrate you together as a family but let’s get real, my in laws will not receive the same amount of attention and care from me that my mother and father will. I don’t expect my husband to pitch in and help in the same degree as he does for his mother either.

You are all wonderful. Thank you for your advice from experience! I am glad to know I am not alone in this crazy, messy life.

Sounds like DH is a little afraid of mama.

We have that going on.

DH will (well, used to, we're trying a new tack, which is we don't talk to or see MIL AT ALL anymore and it's working nicely)--tell his Sis that 'we'd' be happy to do this and such for MIL. We show up to do said job and MIL at some point throws a high holy fit. Screaming, crying, slapping at me---b/c I am there in her actual HOUSE--how dare I?? But DH wanted me there for that quick trip to Home Depot for some piece of pipe or something, or to hold something while he nailed it, or just to drown out the sounds of his mother. Mostly so he could have an 'escape'.

ONCE I had to go alone and fix her sprinkle system and every time I went outside (the turn on/off valve was IN the house) she'd lock me out. I mean, I was doing her a HUGE favor, I am not a sprinkler repair person by trade! I was on the phone with DH as he guided me through fixing the problem. The sprinklers were nothing compared to his crazy mother who would lock me out and then refuse to answer the door. So DH had to call her, over and over to PLEASE open the door for me.

At first it was funny, really. But then I needed to use the bathroom and she refused to let me in. I drove 2 blocks to my sister's house to use her bathroom.

Then the job became her against me. No longer funny, or amusing. I fixed the problem, wrote her a note on the receipt and added $300 to the total and wrote "amt now due". (No, of course I didn't charge her, I was just sooooo mad.)

That was the LAST job I helped with. Slowly I backed completely out of her life in every way imaginable and DH finally did too. Without me as a buffer, he found he could not deal with her crazy.

Sad it's all on SIL now, but she insists she's fine, and I imagine she will be. MIL is kind to one person and that's SIL. Thank goodness for that.

It's OK to say no. It's hard after 40+ years of ALWAYS saying 'ok'.

There is no easy solution - there is no solution that will stop you being at least verbally attacked, made to feel guilty, put in the wrong. You have your limits you have explained those - they seem very reasonable and very sensible to have put the line down early on - stick to it. Don't do any more that you know you are able to without it harming your health or the relationship and feelings you have for your LOs. Leave things even if it is difficult and you feel bad doing so, ignore the talk, they have to make decisions for themselves or get to a point where the decision has to be made for them - you cannot bend further and further without harming you and your relationship, but you are NOT guilty, in the wrong, uncaring - they have to come to the realisation that you cannot manage and are not going to and how their lives and comfort are rests entirely in their hands if they will not allow you to get some additional help.

The best thing to do is make a list and tape it to her refrigerator door of things you're willing to do and stick to it.

If you can't handle helping her to the bathroom then don't.

Once she sees that you aren't going to help with physical care, she will have to accept the fact when she can't manage them herself.

You can't time when you're going to need to go to the bathroom so that would mean she would need 24 7 Care and that cost lots of money like minimum $12 an hour.

Let her know she can't move in with ya'll so once she can't do for herself. Her only options are to get outside help or move in to a Retirement Center.

If she lives in her own home, she may consider hiring a Live In which you can get for about $2,000 a month plus Room and Board.

That would be 1/3 the cost of hiring 24 7 Caregivers.

The key here is to not do anything for her that is not on your comfort list because if you do it once, she'll think you'll do it again.

You can have help bars put up in the bathroom to help her and keep her safe using the shower, tub and toilet.

She could also wear an Alert necklace or watch in case of an emergency.

Unfortunately the answer has to be - since she is past doing for herself - you are going to hire a caregiver or move to assisted living - which do you prefer? Clear cut - no other choices. (If living with you is not an option - My Mom lived with me her last 7 years - was truly a blessing but she had no problems until the last 6 months - was even a help to me). You know what you are comfortable with . That's it. If someone can do for themselves fine - but if not and they are asking others to do for them - then the "doing" in this case is hire caregiver or assisted living? Someone should have POA - if not get it done. Then make the decision for her based on need and financials.

Good for you to know what you are and are not willing to do as far as caretaking tasks. You are wise to be clear about this from the beginning.

If your parents are still making their own decisions, they will have to choose between hired help and a care facility. Your mother may feel hurt, but that's the way it is. Her expectations of you are unrealistic.

Would it help if their doctor confirmed that these are the4ir choices?

Options:
1. Do what you can 'anyway.'
2. If they say "NO" as 99.9% do, they you need to:
3. LET GO.
4. If you are a POA or have any legal authority, do what you can legally.
#3 is a tough one - a very hard lesson that many of us face with loved ones.

5. Realize you are NOT responsible.
6. Accept how you feel (sad, bad, grief stricken) - don't stuff in the feelings, let them out.
7. I've had to override my friend (of 19 years) of his "No, No, No's" and his anger and do what is in his best interest. Usually, later on he thanks me. However, I realize this is not possible for many.
8. PUT their care needs and well being first over their inability to make decisions in their best interest. Realize their cognitive functioning is compromised. You can only do so much.
9. Say the Serenity prayer often.
10. As I always say, set clear boundaries. Caring for an elder loved one is a lot of letting goes.

Gena.

Have the local Pastor intercede? Sometimes a spiritual leader may have the right amount of influence, after all the many helpful chores you are willing to provide are nothing to sneeze at. Dementia and stubbornness are like cousins as far as I am concerned. Your family’s heart is in the right place, and the guilt trip being dispensed by mama has no merit. You can lead a horse to the water but you can not make the horse drink, an old saying. Personal hygiene is a very touchy subject, and offering general help, other than certain areas, is a true sign of a kind person. God Bless you for caring, you sound like a nice person.

You describe a catch-22 paradoxical situation, since "every time [you] mention getting outside help, your MIL "gets very argumentative saying she *has a plan and that she * "doesn't need help."
*WHAT IS THAT PLAN?
If MIL *"doesn't need help, then WHY is MIL having anyone "help her with toileting and other things."

Technically the, "level of care you are willing to provide and are comfortable offering," 100% is a comprehensive list of ADLs (Assistance with Daily Living) that qualify your MIL for Long Term Care.

Based on your post it sounds like your MIL has made "it very clear that you will be [guilt-tripped] into helping with hands-on care taking needs."
Which means that perhaps it's time for a semi-retreat and re-evaluation, which includes:
1. only having your Darling Husband ANSWER, her phone calls, since MIL says she "*doesn't need help."
2. Obtaining a Neurology referral to get MIL ar least one series of MRI and/or CT scans.
3. Researching Assisted Living and LTC Nursing Homes.

Arrange to have someone be there at the same time you are there to do errands, cleaning, etc. This person is your 'helper'. Maybe they will meet the person and be more agreeable.

If you have started helping with things you said you wouldn't help with - they already have the collar on your neck. It's hard to un-do what you started doing and you have shown them that you may not be pleased, you will do it if they persist. Better to ease a little help into the house - maybe housecleaning 1 full day a week by a stranger. Then change it up with several hours a day for different tasks.

If they need help with toileting, what happens when you aren't there? If you are called about the problem, then get this hired person to respond when you get the phone call. Prior to the situation, if you have had this person be there at same time when you've been there, it won't be a stranger coming to tend to needs.

Nobody can force you to do something you don't want to do. (unless they are armed, then all bets are off) Do not allow someone else to run your life. Ultimately, it is not up to her. If you really don't want to do it, then don't. She can yell, scream, threaten to disinherit, etc., but she does not have power over you unless you give it to her.

Imho, since the aforementioned she does not have a plan apparently, when a crisis arises, YOU should not go running to it,

I'm guessing these are your parents? Sorry you can't apparently accommodate their needs, though they took care of your primary ones for a long time. My personal experience with outside help is that it's very difficult to find and trust, and I don't blame your parents resistance for some intelligent reasons. For your situation, I empathize with more with them then you, though I hear your position loud and clear. No one likes the nasty part of the life journey, especially when it means apparent self-sacrifice to do the distasteful. A difficult situation for all.