Anonymous wrote:

Anonymous wrote:Given how much your FIL has declined, it's possible that he might be eligible for hospice support in their home. Might be worth discussing with his provider. While this won't solve all their caregiver needs, it will mean allot of extra support (nursing visit at least once a week, a CNA to come in and bathe/change linens a couple of times per week, social work support for your MIL, etc). A hospice team might be able to adjust his meds (and recommend some new ones) to help him be more calm and less combative. Sadly, I'm not surprised to hear about the Medicaid aide no-shows. Not typically the cream of the crop that work as CNAs for Medicaid. Good luck--this sounds like a challenging situation.

A lot.

He could be eligible for hospice. He should be re-evaluated. No hospice aide, or any aide, is going to tolerate verbal abuse, unless the client is very close to death- this is probably why his aides call in all the time. At this point, you need to find him a long-term placement that can adjust his meds accordingly to work with staff, or you can keep hiring home aides that don't show up.

Are you seriously quibbling over allot vs a lot? How petty. Gives the rest of your post zero credibility.

Anonymous wrote:Op here. I get that the idea of nursing homes are upsetting to people. I'm Asian, and grew up with grandparents in my home, dying in my home. Same with my own parents. The issue here is that he is just very very sick, cannot walk, toilet or eat on his own, sees 8 specialists, and we've been trying to manage this at home for 5 years now. There is no way to help him without having a 24/7 person assigned to him. We are a small family, and all of us work, to provide for our children. MIL cannot do more, physically. So we get home aides via Medicaid but no show rate is awful. Mil sayx they don't come because fil calls them all sorts of vile thing. Can a home side refuse to come if he's verbally abusive due to dementia? I thought they had to come anyway as dealing with crazy ppl I thought was their job.

Its their job to care for him, but not to be verbally abused. The problem is he will probably get kicked out of nursing homes too.

Op here. I get that the idea of nursing homes are upsetting to people. I'm Asian, and grew up with grandparents in my home, dying in my home. Same with my own parents. The issue here is that he is just very very sick, cannot walk, toilet or eat on his own, sees 8 specialists, and we've been trying to manage this at home for 5 years now. There is no way to help him without having a 24/7 person assigned to him. We are a small family, and all of us work, to provide for our children. MIL cannot do more, physically. So we get home aides via Medicaid but no show rate is awful. Mil sayx they don't come because fil calls them all sorts of vile thing. Can a home side refuse to come if he's verbally abusive due to dementia? I thought they had to come anyway as dealing with crazy ppl I thought was their job.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What a sad statement on our society that we view our elderly as worthless burdens that need to be warehoused so that they don't inconvenience us.

Our society is not set up to enable people to care for the most vulnerable family members.

No. Our society is too selfish to put themselves out to care for their most vulnerable family members. My family has always taken care of our own. Don't tell me it can't be done.

So what have you done?

Anonymous wrote:Given how much your FIL has declined, it's possible that he might be eligible for hospice support in their home. Might be worth discussing with his provider. While this won't solve all their caregiver needs, it will mean allot of extra support (nursing visit at least once a week, a CNA to come in and bathe/change linens a couple of times per week, social work support for your MIL, etc). A hospice team might be able to adjust his meds (and recommend some new ones) to help him be more calm and less combative. Sadly, I'm not surprised to hear about the Medicaid aide no-shows. Not typically the cream of the crop that work as CNAs for Medicaid. Good luck--this sounds like a challenging situation.

A lot.

He could be eligible for hospice. He should be re-evaluated. No hospice aide, or any aide, is going to tolerate verbal abuse, unless the client is very close to death- this is probably why his aides call in all the time. At this point, you need to find him a long-term placement that can adjust his meds accordingly to work with staff, or you can keep hiring home aides that don't show up.

OP - It makes the most sense to have your inlaws remain in the state with good Medicaid services and a circle of friends and cultural supports for you MIL. There are two issues from your post - finding the right level of continual support for FIL and ensuring that MIL is able to remain where she has friends and a lifestyle suited to her so that she can be a support to FIL in a more supervised setting.

One might first contact elder care services or the office of aging where the in-laws live to see if there is an agency or individual senior health navigators that could help DH or SIL if they went out to the area to visit nursing care facilities as it seems like FIL is beyond the level of assisted living. By phone contact alone, one might also be able to find out if most facilities have a waiting list for Medicaid patients or which have openings. In any case time to get out to see what the nursing homes look like and put FIL on the waiting list at least. Also, find out if the nursing home provide rehab services and/or have a dementia unit, too. If there are not in-house rehab services, then when certain things happen like a fall for example, one might be shipped to a rehab place for a time AND then you have the issue of keeping the Medicaid bed.

Also, try and find out if there is an agency or individual that would work with MIL to hire Home Health Aides and oversee the overall care of FIL. If DH and SIL could cover this management cost, perhaps it would relieve MIL of the stress. And she would have a place to turn to help bring in coverage.

One also needs to be sure and go with FIL and MIL to the appropriate doctor dealing with FIL's dementia or general health care. You need to know firsthand what the doctor has been told is happening, that a complete list of all medications and supplements/herbs and OTC meds are given to the doctor to rule out any toxic interactions and to get appropriate medications in place. One would then need to try and simplify the medication distribution for MIL as much as possible.

It really sounds as if FIL does need a placement with 24/7 support as soon as possible. I would also get in touch with the local DSS to get a Social Worker involved again to check in on their overall state if possible and if other senior Case Management can't be afforded. When aides are present, MIL needs to learn to take a break and get some respite. Again, you are quite correct that some states such as Virginia are just horrible in funding all sorts of Medicaid services. Given that SIL is expecting, maybe she could do the phone leg work and DH could go out and do on-site research, get to doctor with FIL/MIL and most likely they would respond more to his suggestions given their background.

Anonymous wrote:Oh, FFS, OP! They can't help getting old and falling apart. Be grateful they've had the ability to stay home as long as they have...and that they not only have public benefits but are willing to use them. Help your ILs find the best possible place for your FIL, and count your blessings.

And how old are you with your little kids? Telling old people to take better care of themselves is like telling you to have had your kids by the time you were 25.

There, does that help?

You completely misread her post. Fuck off.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This is more just a vent.

My FIL has some serious health issues, basically needs help for many activities of daily living. Its not something my MIL can manage on her own, as she has her own health issues. They are on Medicaid in a very Medicaid-generous state, and get the maximum home care allowed (about 40 hours). We pay out of pocket for weekend care. Overall, my MIL likes living in her state, because her own siblings/friends live there. She also likes her town and what is has to offer in terms of cultural outlets (we are Asian).

My husband (their son) and their daughter (my SIL) both live in really Medicaid-stingy states - states that have a huge waitlist or just give 10 hrs/week - and we live in 'whiter' states - cities where they just don't have the same cultural outlets. We each live about 3 hours away by flight from our parents and try to visit a lot - one of us visits every month.

However, despite this, they are struggling to keep home care aides coming. I think my FIL's situation is so far-gone, plus he's undergone a huge personality change that has made him verbally abusive. None of the home aides want to come anymore. There are no-shows all the time, and sometimes my FIL is in bed for 15 hours a day when a situation like that happens. My MIL is starting to feel like she has no choice but to put him in a (Asian) nursing home.

I don't blame her at all; we're not dealing with him on a daily basis, after all. It might be the best for her sanity. But when I think about him in one of those cold nursing homes, it makes me so sad. On the other hand, neither we nor SIL/BIL are actually equipped to take on a disabled parent full time in our homes. We all work full time, we all have very young kids, we're spread thin as it is. Sure, we can manage their medications and doctors appointments and cook meals (though this is all stuff my MIL does on her own, happily), but as for physical care where we stand in as a CNA (ultimately the thing she can't do for him)? We' can't leave work to give him a shower because he had an accident or stop breast feeding to take him to the bathroom.

Ugh.... All I can say is, people, take care of your health when you are in your 30s and 40s!! Try to aim to be healthy in your 60s and 70s, as that is most likely when your own kids are going to be pregnant/having young kids and aren't that available anyway. I know there are some things (actually, many things) which are out of our control, but some things are definitely in our control. Exercise, eat a healthy diet, avoid stress!

All right, I'm done now. go ahead and let me have it where you say something mean, dcum. I'm ready.

Wait...what? THIS is where you were going with this? I actually had compassion for you as I was reading until I got to that. WTF?

Yeah, I was feeling a lot for the OP, but this is her take-away? That her in-laws failed by not being healthy in their 60s and 70s? Diet and exercise are great, but shit happens, you know?

Also, "avoid stress"? What a completely useless piece of advice.

I find it very useful. Avoiding stress is a choice. The more awareness the better.

Anonymous wrote:

Anonymous wrote:This is more just a vent.

My FIL has some serious health issues, basically needs help for many activities of daily living. Its not something my MIL can manage on her own, as she has her own health issues. They are on Medicaid in a very Medicaid-generous state, and get the maximum home care allowed (about 40 hours). We pay out of pocket for weekend care. Overall, my MIL likes living in her state, because her own siblings/friends live there. She also likes her town and what is has to offer in terms of cultural outlets (we are Asian).

My husband (their son) and their daughter (my SIL) both live in really Medicaid-stingy states - states that have a huge waitlist or just give 10 hrs/week - and we live in 'whiter' states - cities where they just don't have the same cultural outlets. We each live about 3 hours away by flight from our parents and try to visit a lot - one of us visits every month.

However, despite this, they are struggling to keep home care aides coming. I think my FIL's situation is so far-gone, plus he's undergone a huge personality change that has made him verbally abusive. None of the home aides want to come anymore. There are no-shows all the time, and sometimes my FIL is in bed for 15 hours a day when a situation like that happens. My MIL is starting to feel like she has no choice but to put him in a (Asian) nursing home.

I don't blame her at all; we're not dealing with him on a daily basis, after all. It might be the best for her sanity. But when I think about him in one of those cold nursing homes, it makes me so sad. On the other hand, neither we nor SIL/BIL are actually equipped to take on a disabled parent full time in our homes. We all work full time, we all have very young kids, we're spread thin as it is. Sure, we can manage their medications and doctors appointments and cook meals (though this is all stuff my MIL does on her own, happily), but as for physical care where we stand in as a CNA (ultimately the thing she can't do for him)? We' can't leave work to give him a shower because he had an accident or stop breast feeding to take him to the bathroom.

Ugh.... All I can say is, people, take care of your health when you are in your 30s and 40s!! Try to aim to be healthy in your 60s and 70s, as that is most likely when your own kids are going to be pregnant/having young kids and aren't that available anyway. I know there are some things (actually, many things) which are out of our control, but some things are definitely in our control. Exercise, eat a healthy diet, avoid stress!

All right, I'm done now. go ahead and let me have it where you say something mean, dcum. I'm ready.

Wait...what? THIS is where you were going with this? I actually had compassion for you as I was reading until I got to that. WTF?

seriously! wtf!

Anonymous wrote:

Anonymous wrote:What a sad statement on our society that we view our elderly as worthless burdens that need to be warehoused so that they don't inconvenience us.

Our society is not set up to enable people to care for the most vulnerable family members.

No. Our society is too selfish to put themselves out to care for their most vulnerable family members. My family has always taken care of our own. Don't tell me it can't be done.

Your FIL's change in behavior can be due to a brain tumor. You should get him a scan. Your MIL will feel relieved with him in a nursing home. She will need to be there frequently so they know there is a loved one. She will need to be his advocate as well as one of you that are out of towners.

Unfortunately life gets in the way of living that perfect life to not burden your children when you age. You always have to remember how much our parents sacrificed to raise us. It is the circle of life. You do sound pissed/annoyed that you have this burden. That is quite understandable especially when you live out of state and feel helpless. You may want to look into your own feelings and deal with those as well.

Given how much your FIL has declined, it's possible that he might be eligible for hospice support in their home. Might be worth discussing with his provider. While this won't solve all their caregiver needs, it will mean allot of extra support (nursing visit at least once a week, a CNA to come in and bathe/change linens a couple of times per week, social work support for your MIL, etc). A hospice team might be able to adjust his meds (and recommend some new ones) to help him be more calm and less combative. Sadly, I'm not surprised to hear about the Medicaid aide no-shows. Not typically the cream of the crop that work as CNAs for Medicaid. Good luck--this sounds like a challenging situation.

Anonymous wrote:What a sad statement on our society that we view our elderly as worthless burdens that need to be warehoused so that they don't inconvenience us.

Our society is not set up to enable people to care for the most vulnerable family members.

Anonymous wrote:

Anonymous wrote:This is more just a vent.

My FIL has some serious health issues, basically needs help for many activities of daily living. Its not something my MIL can manage on her own, as she has her own health issues. They are on Medicaid in a very Medicaid-generous state, and get the maximum home care allowed (about 40 hours). We pay out of pocket for weekend care. Overall, my MIL likes living in her state, because her own siblings/friends live there. She also likes her town and what is has to offer in terms of cultural outlets (we are Asian).

My husband (their son) and their daughter (my SIL) both live in really Medicaid-stingy states - states that have a huge waitlist or just give 10 hrs/week - and we live in 'whiter' states - cities where they just don't have the same cultural outlets. We each live about 3 hours away by flight from our parents and try to visit a lot - one of us visits every month.

However, despite this, they are struggling to keep home care aides coming. I think my FIL's situation is so far-gone, plus he's undergone a huge personality change that has made him verbally abusive. None of the home aides want to come anymore. There are no-shows all the time, and sometimes my FIL is in bed for 15 hours a day when a situation like that happens. My MIL is starting to feel like she has no choice but to put him in a (Asian) nursing home.

I don't blame her at all; we're not dealing with him on a daily basis, after all. It might be the best for her sanity. But when I think about him in one of those cold nursing homes, it makes me so sad. On the other hand, neither we nor SIL/BIL are actually equipped to take on a disabled parent full time in our homes. We all work full time, we all have very young kids, we're spread thin as it is. Sure, we can manage their medications and doctors appointments and cook meals (though this is all stuff my MIL does on her own, happily), but as for physical care where we stand in as a CNA (ultimately the thing she can't do for him)? We' can't leave work to give him a shower because he had an accident or stop breast feeding to take him to the bathroom.

Ugh.... All I can say is, people, take care of your health when you are in your 30s and 40s!! Try to aim to be healthy in your 60s and 70s, as that is most likely when your own kids are going to be pregnant/having young kids and aren't that available anyway. I know there are some things (actually, many things) which are out of our control, but some things are definitely in our control. Exercise, eat a healthy diet, avoid stress!

All right, I'm done now. go ahead and let me have it where you say something mean, dcum. I'm ready.

Wait...what? THIS is where you were going with this? I actually had compassion for you as I was reading until I got to that. WTF?

+1, WTH?

We do not control everything. We just don't.