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My MIL has only one living relative, my husband, so we are solely responsible for her. At age 94, she is declining in health. The biggest issue is how uncooperative she is. She won't take her meds, she rarely wears her hearing aids, she won't use a shower chair or walk-in tub (even after getting stuck in her tub and having to be fished out completely naked and then passing out after being fished out). She only uses her walker when I put it in front of her and she has severe arthritis in her toes. Last week she fell and was lucky as she only bruised her face. We use nanny cams to monitor her during the day. We have decided to take a vacation and we would like to have her in respite care, but she refuses it even though it will only be for 10 days. We can't live tied to her 24/7, and she is likely to live to be 100. I explained this to her, how she is hurting her 68 year old son's health, but she won't listen. Her doctor even ordered her to do respite care while we are gone and she pretended she didn't hear by giving him her sweet old lady smile and assuring him that, as a nurse, she could take care of herself. This was after he determined she said she was on no meds, then that she took it sometimes, then that it gave her headaches, then that she tried it again and it didn't give her headaches and that an alternate drug he tried made her dizzy (which she complains about whether she takes it or not). She is still mad we took away her car keys last year after 2 known major blackouts and a call from the police about a confused driver. We do not have guardianship for her as she has some cognitive ability left, but we need her to cooperate. I said we should just go and leave her to her own devices, which sounds cruel, but that feeling abandoned might be what makes her rethink her stance. Our backup plan exists only because our son lost his job a few days ago. That is for him to check her cameras on occasion and only call 911 for an emergency. She no longer cooks, but can do microwave meals. Most of her day is spend sleeping or staring blankly out her window. We have thought that assisted living would help with her lack of socialization and boredom as well as meals and oversight, but she will probably have to be forced out and into memory care within a few years.

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Please get her doctor to write whatever document is needed in your location to declare her mentally incompetent. Check with a local lawyer to see if "next-of-kin" (which is your husband) is enough to make decisions on her behalf from a legal perspective. If not, do whatever you need to get that covered.

Then, you nay have her in respite care whether or not she agrees. When you come back from your vacation (now would be better) get her cared for 24/7/365 since she can not care for herself alone.
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There is some really good advice on this post. I would put a key somewhere so if while monitoring her while you are away, you can call 911 if you see her on the floor. Leave a portopotty near by, food for the microwave in the freezer, and bath wipes so she can wash up. Let her know that you will not be reachable for 10 days or whatever you choose. Maybe you could contact the local church/police/neighbors to let them know your situation so that they could check on her. You’re not legally obligated to her. That is what she wants. I would think about keeping it that way. Have fun on your vacation. Don’t worry, be happy!
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Your situation is almost exactly like ours with my 96 year old mother who lives in her own home alone. She fights our help every step of the way. The most important information I have been able to find is by watching Teepa Snow videos on YouTube. The insight I gained gave me, for the first time, successful communication with my Mother. Hang in there
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MargieRKB: You and your husband are not responsible for your MIL. She is responsible for herself.
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Tell her that you are going on vacation. Period.

Tell her that while you are on vacation that you will not be available to handle her emergencies.

Tell her that while you are on vacation that you will not be calling to check on her.

Tell her that if, as a nurse, she feels confident and competent to take care of herself that you will not second guess her.

Do not ask your son to watch her - that is unfair.

Remind her that she should call 911 for emergencies.
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"Legally we cannot force her to do this unless we have guardianship and we do not." As someone else said, the next time she falls and can't get up, hae the ambulance take her to the ER to check her over. Then tell the hospital she is no longer safe at home because you are unable to care for her. A social worker will get involved. She cannot be left alone.
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Please call Adult Protective Services for a placement evaluation and let them know that she no longer has someone to care for her. That information should cause them to take action that is enforceable.
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You described my mother and our situation for several years. I pushed her into respite care so I could have a break and get my knee fixed. Packed her bag and put her in the car. At that point she was so angry and so demanding and so criticizing, blaming and shaming, I figured I had nothing to lose.

What have you got to lose?

Turned out my mother showtimed for the staff. Her rage and rudeness were all for me.

I knew she was slipping cognitively, and was shocked when her assessment revealed that she couldn’t name the town in which she’d lived for almost 20 years. She didn’t know her age or date of birth. She thought her parents were alive.

She is now in permanent care, as of spring 2022, and is content there.

You may find your MIL is already at the stage for MC.

Save yourselves. Don’t wait.
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I completely understand your situation. While the scenario isn’t what my sister and I have experienced, I resonate with many of the replies and advice you’ve been given. Mom moved to AL 3 years ago, after my dad passed away. She had been in declining physical health, falls, anger issues, and mild cognitive issues were getting worse. While mom blames the move on us (we forced it) she forgets that she agreed to it and also agreed to sell the house. Just seeing the shape she is in now, even falling more, first refusing a cane, then her walker, to now completely relying on her walker, I am so glad we made the move to AL where she has everything she needs. She is more active than she would have been in a house by herself. So getting back to the topic of taking trips with my husband (we are both retired), is always an issue with her. Jealousy abounds with her (always has), we are abandoning her, the verbal digs she makes to us, etc. I now either do not tell her or inform her 1-2 days before we leave of our trip. But she also forgets that she and dad cruised the world in their retirement years. We have to live our lives and know that she is in good hands where she is at. So my message to you is, travel! You need the break from her behavior, and control over you. Take control of your lives. I do believe she needs to be in AL for everyone’s sake and sanity. Best of luck and enjoy your trip!
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Does she qualify to have in-home aides to check in on her? Connect with a local social worker to find out what her options are. You need to take breaks from being a caregiver! Some facilities have assisted living / memory care / skilled nursing. It involves a move, but is within the same facility, and in my mother's facility they did the move for us (after I helped downsize her stuff). If your mother would be willing to move to a facility, it would be a good thing to look into. Some facilities are well run and provide amenities that she might like. If she can afford it, in-home aides are the other option. You'd have to help with finding, hiring and overseeing / paying hired aides. All the best to you both.
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@MargieRKB, I’m sorry you and your husband are being thwarted at every turn by MIL.

You cannot continue beating your heads against a brick wall on this. You’ve tried every loving thing you could think of, for naught.

MIL has apparently stated she wants to die in her home, and it sounds like she firmly means it.

It’s time you accept what she is saying, and let her go to her death her own way. It may not be the way 99% of us wish to shuffle off this mortal coil, but she has stated her wishes, and you two aren’t HEARING her. I think she will continue to block all of your efforts.

You aren’t being harsh to accept her wish to die at home, you are realizing there is nothing more you can do to help her since she thwarts every helpful effort.

It sounds like your husband might benefit from a therapy session (or more) to help him realize he must back away with love and understanding that she chooses to live her own life and not acquiesce to the comfortable care home (AL or MC) that you all wish for her.

I hope you have a wonderful trip, and I’ll be thinking good thoughts that your dear son soon finds a great job.
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BurntCaregiver Aug 2022
If MIL wants to live her life and die on her terms in her house as she wishes that's fine. If she is of sound mind, then that is her right to do so. On the flip side of that coin is that she has no right to expect her family to also live their lives on her terms.
Her son and DIL should not be centering their lives around propping up the MIL's stubbornness and delusion that she's living independently because she isn't.
People have a right to live and die on their own terms. Don't refuse any ideas about AL or outside help from the family, then call hysterical in the middle of the night because there's no pudding.
Nobody gets it both ways.
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First of all, you two are not responsible for her. Unless the two of you named her conservators/guardians, you are not responsible for her. She is responsible for herself.
I've been an in-home caregivier for almost 25 years. I have told many, many elders who were suffering from ESS (Extra Stubborn Syndrome) with an underlining case of stupidity that there's no better and faster way to get themselves a one-way ticket to a nursing home than an acute case of ESS.
So you tell your MIL this.
Assisted Living would be better for her physically and mentally. Don't worry about memry care being needed down the line. There are AL facilities that also have a locked memory care facility.
Leave her to her own devices. That's not cruelty. It's tough love and your MIL is in serious need of some. Going on your vacation is the best thing you could do for her. Many elders have to learn the hard way that their stubbornness will not be tolerated from their families and no one will be playing their games.
If your MIL wants help from you and her son then you will help her but it will be on your terms, not hers. If she means to control your lives through her 'stubbornness' and thinks everyone will dance like puppets while she holds the strings, she is mistaken.
Make your language plain when explaining this to her so that she doesn't misunderstannd. Then go on your vacation. Don't play her game.
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TriedandTrue Aug 2022
This is sound advice. My father is in assisted living and has ESS (I love this). My sister and i make sure he has cookies and protein drinks. My dad refuses to go to the dining room, refuses to shower, refuses to shave, refuses to change the batteries to his hearing aids, and refuses to use his walker. So, because he won’t eat and no one can make him, he’s very weak and because he refuses to use his walker, he has been falling, literally every other day. His skin is like crepe paper so he bleeds profusely and gets very deep cuts. He is cognizant about 90% of the time. For four years, i have nagged him and to no avail. He wants independence so I finally saw the light snd i’m no longer nagging him or the caregivers to get him to do what we are paying for. They have tried. I have tried. Now its time for my dad to learn for himself. I will visit as a daughter only. I will still get his supplies but that’s it. I 100% agree with this answer. Live your life and stop letting this parent control you. Once she sees, she is responsible for her well-being maybe she will rise to the occasion. I would place her in AL though. My dad wears a button to push if he needs anything. He pushes it every time he fslls. The nurse comes and cleans and wraps the cut and calls his doctor snd then he gets wound care from another facility that will come to him. I also wouldn’t worry about memory care. If she’s pretty alert now, she probably will never need it. For now, before your vacation, get respite care for her. After your vacation, investigate good AL facilities. Sell her house to pay for it. Its a lot of work, but worth it for all of you. Don’t let this parent control you any longer. I let my dad manipulate me for his every want and neither of us is better for it.
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It sounds like you need to hire a caregiver if only part time. She may refuse so tell her its for housekeeping, laundry and a little cooking. MIL will think she can still be able to care for herself.
Tell her it is to help her son with the many responsibilities.
If she refuses then she is on her own.
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BurntCaregiver Aug 2022
The OP's husband does not have conservator/guardianship over his mother. No one one does.
No one can force her to accept help coming into her house unless someone else is making her decisions.
They should not support her delusion that she's still fully independent and totally taking care of herself because she isn't. This only encourages stubbornness.
There's no shame in someone needing some help around the house or with self-care. Especially when they are elderly. Take the shame out of needing help without supporting delusional stubbornness.
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You’ve done everything under the sun to help her. Enjoy your vacation, you certainly deserved it.
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We have one of those too. My BIL/SIL are live in caregivers and we are the only backup option. My nephew (their son) was getting married at a destination 6-8 hours away depending on traffic. FIL was invited but logistically it was just impossible.(he's mostly homebound and travel is a nightmare, plus they were getting married on the beach and he wouldn't have been able to attend that anyway with a mobility scooter and the only beach access over the dunes)

So, we decided to book respite care. Thankfully we had some help from the VA. But it wasn't fully covered, so he was hot under the collar about having to pay for his own care (the horror). He decided that he could take care of himself. Spoiler alert - he cannot.

We got his reluctant permission to book home care and went ahead and booked it, working with the provider and the VA and scheduled everything - with him insisting that he didn't need it. We were going to be gone for a week. He kept saying he didn't need them and that once we were gone he was just going to send them home anyway because he didn't have the money to pay for them (he did) and that if he needed help we could just come home.

Some little voice in my head told me to cover all of the bases so I called APS. Not to report anything but just to get advice. I just said that I had a question and explained that we had a vulnerable senior who was competent but physically incapable of taking care of himself. That we were traveling and has scheduled 24/7 care for him for the duration of the trip and he was strongly suggesting that once we were at our destination he intended to fire them. The person chuckled and said they heard that a lot. They said that all we could do from our end was strongly remind him that if he did do that, he'd better be prepared to sit alone for a week with no prepared food or REALLY be able to take care of himself, because we have done everything we can to make sure he is taken care of for the time we are gone and HE would be the one that is removing that help. BUT no, we would not be legally responsible for that - we left him with care - he removed the care.

So we spent a lot of time really reminding him that if he fired them we wouldn't be coming home (I think he thought at the last minute one of us would stay home). We left for our trip and stayed up to date with the caregivers. Ironically - HE didn't call one time - which is unusual. We had to call him to check in. He didn't fire them. He actually enjoyed having someone new to tell his stories to. He was kind of sad to see them go. We started off with three shifts of three but they whittled it down to two shifts of two before it was over with. He sleeps a lot so they had plenty of down time. And it was the same two for most of the week.

I never in a million years would have thought it would go so smoothly with him. He is a dyed in the wool narcissist so I was 100% waiting for the call that he fired them and that he was expecting us to make the 6-8 hour drive home.
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BurntCaregiver Aug 2022
ESS (Extra Stubborn Syndrome) and there's no quicker way for an elder to get a one-way ticket to a nursing home. You did the right thing calling APS to be covered.
BIL and SIL should by no means be providing care for free.
The lot of you should sit down with a few spread sheets and show him how much a nursing home costs and how much 24-hour live-in care would cost if BIL and SIL left.
Then negotiate a price on what he will start paying them. Room and board is not considered sufficient payment for service.
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I totally understand what you are saying. It is so frustrating when they are spritely as an OAP but do your head in like a naughty unruly two year old. Your right to not want to live every breathing living moment of your lives watching and doing everything for her. You need to visit her and tell her you all care about her, you have arranged carers for the weeks of your holiday, god knows you need it! One thing you need is a key safe which you can get from argos or on line , and a number easily to yourselves remembered, if you don't have one already outside of her front door, and carers can use it to get in twice or three times a day, to help bathe and prepare meals etc. She is entitled to six weeks free care , if you have not already called social services for advice and help. Respite might be arranged so you all know she is safe while your away.My mother in law is spritely but riddled with arthirtius so she has carers in to assist her. She does have a lift in her home and all the gadgets . She as been in and out of hospital alot due to blood probs etc but she never expects us to do everything for her. My mom is independant and it is on my inssistance , as I tried to live with her last year, god what a mistake my health and well being declined , and she did less for herself , even though she was capable. She had used blackmail almost to con me into nearly selling my property so I would have no choice to stay living at hers. I soon told her no, that she needed to still be independant as she as no dementia problems and can still get around her home , as a stair lift and is quite capable of boiling an egg, and opening a tin. Using a mircowave and even ordering in those pre prepared meals you see in the ads. So it is loneliness and the fear of it, that is making your mother in law act out, it is also still having a voice importancy in your lives, however selfish it is, Yes if she passes away soon it will be a relief and she would be out of any discomfort , heaven easing it . I pray for my dad to come fetch my mom as even though she still is okay she is not great health wise and it will get worse as she as terrible mirgraines and leg ulcers to cope with, but since she as lived alone again our relationship as improved. She as realised I am independant individual who was not born to be her carer in elderly years. None of us set out to have our kids become our slaves , mentally this destroys our souls and only causes us to become ill and die sooner. So please take care of you, be selfish . The old gal is amazing for 94 but is not 4 and needs constant guidance and attention. She is clever and knows like many elderly to play the I cannot hear you, what you say? and the losing of the plot. Your not horrid people in reclaiming your lives, we as I say are not born to be elders carers despite what past history in humanity tells us. We won't if we refuse an aging love on fulfillment of all their woes and happiness, wants etc , go to hell be condemned because we put our lives and needs first. We all get old but in this modern age of tech and employed carers , support in elderly needs etc, we can love and support from a quiet close but be it a distance for our own sakes. I even threatened care homes, living carers when my mom tried to guilt trip me before I left her home, to live apart again. I have my own health issues which will get increasingly worse and quicker if I had continued to enable her. So stick to your decisions and guns.. Say no , love you but.. no mom to her.
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BurntCaregiver Aug 2022
You are absolutely right, kazryan. Family members all too often get pulled into being unwilling players in their elderly LO's games. Many times they aren't even aware that they are being pulled into it. Then one day it hits them that the elder's needs and demands are the center of their lives.
Families have to learn what to avoid in order to not get trapped.

1) Ignore guilt-tripping and manipulation. If you're willing to help an elderly LO, it has to be on your terms not theirs. You are not responsible to be your elderly LO's social life.

2) Do not prop up an elder by supporting them in the delusion that they are still fully independent and calling the shots when they aren't. All this does is encourage them to be on a power trip to control the lives of their family.

3) If there is stubbornness to accept help, encourage them to. If they refuse wishe them luck and ignore them. Unless there's dementia and they will have to have others managing their lives. If some senior has to learn the hard way (and many do) that's how it has to be. It is not their family member's fault if they refuse help.

4) Always remember that YOU are not the only person on earth that can help or provide for their care needs. The elder may demand that only YOU will do and will refuse anyone else. Then you refuse them. Offer nothing. Caregiving is only successful if it's done on the caregiver's terms. Not the care recipient.

5) BOUDARIES! This is the most important one of all. Do not take every call. Do not allow abusive or negative behavior when you're talking to or visiting your elderly LO. You are not one of their doctors or a therapist. Therefore you do not want to hear their health complaints or a detailed description of their latest BM. You will walk away and the visit ends when gaslighting and fight instigating start. Treat actual emergencies like emergencies. Running out of pudding is not a reason to go rushing over.

People follow these things and they will not get caught up in the drama and games that come with elder care.
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I left my live in fiancé mamas boy last week because he devotes most of our time to his mother who will not accept care in her home, can’t do a thing for herself and she refuses to go to a home where she should be. I’m so angry and disappointed that he actually said I’m not the fiancé for him because I wouldn’t move in to care for his selfish miserable stubborn mother who never thanks just orders us around. So glad to be away from them both!
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CTTN55 Aug 2022
I'm glad you left your fiance last week! I hope you didn't waste too much time on the relationship.
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Lol
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I could have written your post, I swear! And we, too, are about to head off for 7 days with a short 2 day trip to follow. We do intend to interview a home care outfit later this month but for this trip, we will do what many here have suggested. A call 2x a day and my brother will come see her twice. She lives on a cul de sac with some amazing neighbors so if, god forbid, she does not pick up her paper one day, that's their signal to check. One neighbor has a key to our house.

It's a fine line that I struggle with everyday. She is adamant about not going to AL even though I think she would do well there. She is adamant about "not being treated like an invalid." She is adamant that she can take care of herself while ignoring the many things I help her with. I really appreciate the response about her choosing and living with the consequences even if I also have big time FOG.

Good luck and try to enjoy your break. You NEED it!
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I never say this but this one belongs in a nursing home
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To add on to CM's theme..

Family is family, yes, but made up of individuals. Who can make decisions *for themselves* not for others.

A Social Worker told me this:
1. Give advice
2. The person makes a decision - 'good' or 'bad'
3. The consequences are theirs

But I get why you just don't sail off & wish her luck.. you feel a great obligation. Fear (to leave her), Obligation (only family) & Guilt (forcing the respite care). This is F.O.G. (Google this term of you like, it blew my mind when I did!)

So MIL is dependant on you & your DH but refuses to be looked after by others when you are away? I am wondering about her problem solving & planning ability 🤔

Does she understand but taking a stubborn stance as a gamble she will win & you will not go? (ie manipulation)

Or does she NOT understand her care needs (ie lack of insight?)

MIL's Doctor's opinion on this aspect could be a good idea.

For people being stubborn as a rock.. not going etc, using a firm stance back that you WILL be going may work. Try explaining they will be home ALL ALONE. Not to be cruel, but to break through.

For those lacking insight, tricks may be required.

The last resort may be go but build as much safety around as you can. This may inc;
- ensure she has a phone
- her Doctor's number preset
- ask neighbours to check-in
- wellness check from local Police/Fire
- easy open snacks/drinks

Call the Doctor to advise MIL is a vulnerable elder home alone.

Then tell MIL to call her Doctor for any problem & go.

You may only need to inform MIL of this plan with assertiveness for her to back down. Best of luck & Bon Voyage 😄
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MargieRKB Aug 2022
This is such good adivce. DH talked to her yesterday and she said she was not going to leave her house. I believe she has a wish to die in her own home regardless of how that happens. He told her she was being selfish (she prides herself on being generous.) NOTHING would budge her. She doesn't remember our phone numbers, won't understand presets if her phone has them, refuses or can't realize she is a danger to herself. We installed 2 more nanny cams, our son will check them several times a day and we are telling her neighbors that we tried to get respite care for her but she refused and we don't want them to step in and care for her. We are leaving her mostly to her own devices, with prepared food, the numbers for senior transportation, but not giving her some things she really likes, hoping that talks to her louder than our words. Our son is under directions to call 911 if he sees her on the floor or something seems off.
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Margie, you and your husband get to decide whether or not you go away for ten days.

Your MIL gets to decide whether or not she stays in respite care while you're away.

You see the difference? You and DH are responsible for what you do. MIL is responsible for what she does. The error lies in believing that DH is responsible for her choices. He isn't.

You already have a system in place to catch any emergencies. Check she has all the supplies she'll need for those ten days - medications, groceries, disposables - and off you go.
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Margie,
I would tell mil that her son is seeing a specialist wherever you are going. He needs to for his own health, you say, and you two will not be having your phones on.

If she is in your dwelling, tell her the only way to stay in it is to go to respite so that you don’t have to worry about her burning the house down or etc. And if she’s by herself in her own place, she follows your sons instructions or he gets the authorities involved.
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I'd make a video of you asking her one more time to go to respite care and her refusal. Then tell her (also on video) that you're having your son check on her, you'll call her every morning, and so forth. That way you have solid proof that she is making the decision to fight you.

Then go on vacation.

If her doctor doesn't say she is incompetent, then you have to let her make her own bad decisions for herself.
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The first thing is that you ought to go on your vacation. You aren’t slaves, and she isn’t your slave-master. If you wrote the heading ‘How to get co-operation’, come on now, wake up. Next comes what to do while you are away. Kidnapping her and taking her to respite care isn’t a great option.

Suggestions:
1) Phone her every morning and evening to check. Very brief phone call, not one to dominate your mind and time.

2) Talk to Respite Care, tell them the situation, and ask if she will be able to go in at short notice if necessary. Keep their contact details, and leave them in MIL’s house with a written explanation for 911 if necessary.

3) Get her an alarm pendant, with it set to contact you and/or 911. If she won’t wear it, leave it in the most likely place for falls – probably on the floor in either the bathroom or next to her bed.

4) If your son is willing, ask him to visit Grandma, and lay it on the line to her that she is a pain in the but. It's not fair to his mom and dad. He has a lot less to lose, and young people have a good vocabulary about these things!

I hope that there are more useful suggestions. Your, Margaret
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MargieRKB Jul 2022
1. We could phone her two times a day, but she is very hard of hearing and might not answer.
2. The assisted living facilities need a solid yes or no.
3. We got her an alarm pendant and she refused to wear it.
4. I'm not sure she would listen to anyone.
Great responses for Grandma Bulldozer (our kids nickname for her)
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I would not give her a choice. Her doctor agrees she should do it. I would tell her that you r going on this trip and she has no choice because she cannot be left alone that long.

Maybe while ur away, she may find she likes the AL.
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MargieRKB Jul 2022
Legally we cannot force her to do this unless we have guardianship and we do not. We would have to physcially pick her up and carry her in kicking and screaming.
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Some people on this forum have employed "therapeutic fibs" to get their uncooperative or fearful LOs into facility care. You seem to think that your MIL still is very mentally "functional" but I beg to differ. Just being a refusenik doesn't make her lucid. Stubbornness is a hallmark of dementia.

She is probably beyond AL but not quite ready to MC or LTC, since she is still mobile but a very high fall risk. I think the back-up plan for your son to call 911 if she falls or has a problem is what I would do. Make sure your son knows to not pick her up -- call 911 even if she doesn't seem injured or insists she isn't hurt. From the ER to the inevitable rehab she can be transitioned to a permanent facility but have tempered expectations that she won't care about the socialization. I'm sorry for this distressing situation. It's hard on everyone in the family.
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MargieRKB Jul 2022
Her problem is more prideful stubbornness than anything else. I think she would prefer to die her way than be in an "institution." She has always been impossibly stubborn. The funny part is she said these same things about her parents when they got old and swore she would not do this to us... nope, she is worse.
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