Difficult Father-in-Law with stage 4 chronic kidney disease - how to cope?

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Difficult Father-in-Law with stage 4 chronic kidney disease - how to cope?

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My father-in-law (FIL) has stage 4 chronic kidney disease, and currently lives in assisted living in Seattle, together with mother-in-law (MIL). Both are 80. Recently, MIL fainted from exhaustion of helping FIL with basic duties, such as going to toilet, bathing, which FIL cannot do well anymore. Fortunately, all her tests came out fine. From this incident, they are moving to LA, to be closer to us.

MIL wants to live with us in our home, FIL will need to be relocated to assisted living facility here. I don't mind having the MIL, but I am freaking out about the FIL's close proximity to us. He's a tyrant, and we don't get along. My husband does everything for him, literally, EVERYTHING. FIL was first generation immigrant, and depends heavily on his son. It was a relief that we moved to LA, putting some distance between us. The past few years living apart from my in-laws have been wonderful, and we now also have an 18 month old toddler.

I find myself slipping into depression, I can't sleep nor eat well. In short, I am freaking out. I am seeking counsel from this group, and how best to handle, and re-frame the situation. Also, what is the prognosis for stage 4 kidney failure, without dialysis? Relative to his illness, it will be 2 years come June. FIL contracted pneumonia nearly 2 years ago which triggered kidney disease, he has a host of other chronic conditions, diabetes, high blood pressure, etc. Thank you for your advice in advance.

Stressed in LA.

Assisted Living Family Caregiver Kidney Disease

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I hope that it works out well for you and your mother in law.

I am glad that you are not taking in his dad since he isn’t very nice.

You already have your hands full with a toddler.

I took my mom in when my youngest daughter was a toddler. It is exhausting!

Wishing you and your family all the best.

Please set boundaries before she arrives and discuss her leaving with your husband before she moves in, in case things don’t work out.

I like the suggestion of placing her in the assisted living facility with her husband but in a separate area.

She will not have to care for him but can still be near him and you and hubby have your well deserved privacy.

Then your husband can visit them at the facility.

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Sorry my sister, at times there challenges really hard to get immediate solutions to . For the start, be strong, bear the pain, psychological torture, try hard hard to manage your emotions and thoughts. God will make a way.

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Thank you, Passion! I will try to keep the faith.

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I suggest you and your husband look into facilities that have multiple levels of care at one place -- independent living, assisted living, skilled nursing, and memory care if that's an issue. That way Mom and Dad can live in the same place but with different levels of care as needed. He might be in skilled nursing, while she's in assisted living, but they could have meals together and Mom will still be close enough to be his wife.

(I think it's interesting that Mom is willing to live completely away from Dad at your house. What's that about? Has she had enough of his company, too?)

I think you'll be far less stressed if you have yet another conversation with your husband and make it very clear that the two of you need to be on the same page about this. I'm less concerned about the dad since there's no question he'll be at a facility getting the care he needs, but who'll be caring for Mom all day -- you? At 80, she's not going to be in great health much longer either, so who deals with that while (I assume) your husband is at work and you're dealing with a toddler?

He needs to be realistic. Mom and Dad are a package deal, and just because Dad's sick right now doesn't mean there are other considerations to deal with regarding Mom. Your husband isn't going to be taking his dad to the bathroom or getting him dressed in a facility you don't live in, so I think your biggest concern is the MIL situation, and that needs to be handled up front. You don't want relationships (between you two primarily) to be irreparably damaged because his mom comes between you. His job as a son is to see his parents are cared for, just as he did when they were in Seattle. They were in a facility where they were cared for (though Dad is in the wrong level of care), and that's how it should be when they come to L.A.

I also can't imagine how you plan to get them to L.A....

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Thank you, MJ1929. I know, I have no idea how we're moving them to LA either. :( For starters, FIL is high maintenance, and I am worried whether he'll be happy with the AL we find here.. Husband and I have had a few conversations, all were emotionally charged, and did not end well. If the tables were reversed, and it were my own mother, I'd also feel this is non-negotiable... I am trying to be supportive of him. Thank you.

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Imho, it is IMPERATIVE that you take care of you. I do not advocate that your MIL move in with you.

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Thank you, Llamalover47

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There is a book called "Boundaries" I strongly recommend it for you and then for your husband. I have reread your post 3 times. What I get out of it is your MIL wants to leave her husband. (She wants to live with us, and he will be in AL). Sounds like she has had enough both mentally and physically. Maybe she meant both of them live with you which is an impossible situation.

It sounds like your husband feels trapped into caring for a irritable father. If he came into your home, it WILL negatively affect your child. That is a given. It doesn't mean he won't care for them, he can do it from a distance. It probably won't help because of the strong pull of cultural beliefs. I recommend counseling.

Take care of your self and your baby. If you don't have a career, I strongly you start thinking about it, because I can't see your marriage lasting if your FIL comes into your house. I speak from experience. It was MY mother that moved in with us. I didn't want to but my husband insisted. I finally left both of them and never looked back. I know having her there, even though she had an apartment in the house, put the final straw on this camel's back and I couldn't stand it anymore.

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Thank you, MaryKathleen. Fortunately, I have full time work, and most days, I enjoy what I do. :) So, I am a working mom with a toddler, with little free time to spare, truly, which is why I feel this way. My husband is a gentle sweet man, and I do believe he feels trapped by culture/tradition, by family, and by the situation. His sister, due to her health, simply cannot be the point-of-contact for FIL anymore, as such, he feels he must now carry on..

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If this man is a tyrant, no matter where he is, DO NOT GET INVOLVED WITH HIM OR ALLOW HIM INTO YOUR HOME. He should be placed into a facility since your MIL can't care for him and god forbid, you allow him into your home even if your husband will care for him. It will be sheer hell for you. Your husband owes you first and your child. No matter how or what happens, you must make your husband realize this - NOT in your home under any circumstances. As to being close by you, if your husband wants to care for him and go to his premises, I suppose you can't stop him but he would be alone if your MIL lives with you. You must get this man placed and kept out of direct contact with you or your life will be "lost" and your marriage too possibly. Do NOT give in. Set boundaries at once. Never ever, no matter who or what or why, let someone with abusive behavior and personality come into and affect your life - never.

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Thank you, Riley. Well said, yes, I think limited interaction with FIL is best. If they do move down to LA, I'll only go visit FIL at AL when needed. I can't imagine FIL will need to live in my home, but that's where I draw the line. :/

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"Sister in Seattle now has a medical issue, and cannot look after the parents (before this medical issue, she claimed to need back surgery too..) She's done a lot the past few years, while we are away, so we are grateful. Right now, she's kind of guilt-tripping my husband, "remember dad took care of his mom (now it's your turn)..""

Ummmm, where does this sister get off with this? The parents (your in-laws) were living in AL, NOT with her. Sure, she was involved, but it is NOT the same as saying "dad took care of his mom (now it's your turn)"

Make sure hubby gets THIS point. Yes, it is fine to help out sometimes, but they've been in AL and should move to another AL, together. Ensure the "extra" help he needs is NOT canceled. MIL can either work with them, regardless of what the "tyrant" says or thinks. MIL can excuse herself when the "help" times are scheduled.

Someone needs to help MIL understand that despite what her husband says or demands, SHE has a right to say no as well. At her age, she shouldn't be doing what she's been required to do, by him. Old country or not, it isn't 1800 anymore!

Stand your ground. No is a complete sentence. They will be living close enough for hubby to help out, if that's what he feels is right. There's no mention of any issues MIL might have, but even if there are none, warnings are in order:

1) She isn't getting younger and issues may evolve soon enough
2) Any current issues will progress/get worse.
3) Lack of privacy for you and hubby
4) Potential for interference in child-rearing
5) Potential for demands for help, even when not needed.
6) Once entrenched, how to get a move done when needed?

If possible, make a list of pros and cons. Use information provided here as well as your own thoughts and concerns. Consider how the cons can be addressed, if it's even possible.

I do believe with a young, potentially growing, family that taking in difficult elders is going to be a burden, but can affect everyone negatively. If they were pleasant, not needy, sweet elders, maybe.

My parents and mom's sisters took turns caring for mom's mother. She was easy to care for, the next generation (us kids) were mostly grown, many out of the home, the care-givers were not retired yet and she passed probably late 70s, well before everyone's NICE long retirements! Dad's younger brother never married, and cared for their mother in her home. So, there ARE cases when it works and all is good. Too many have dementia, which can bring a whole other level of "difficult", and then there are the "old school" people like FIL. Wife only does care. Family must do care. Whatever they decide is for THEM, it doesn't mean we have to agree or comply.

My mother's plans included moving to AL when she felt the time was right. In her case, dementia came along early 90s and blew that plan up! Being senior with physical limitations, I couldn't do the care myself, but I could ensure she was in a safe place with good care and manage everything for her. Bros were useless!

Make that list and check it twice. Be ready to push back on hubby and his sister.

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Thank you, disgustedtoo. FIL and MIL canceled the extra help / services offered at AL, and the outcome was MIL fainted. Clearly, they need the extra help! If they truly move to LA, we need to persuade them to keep the extra help, and you are right, MIL needs to step away during those help times, no matter how hard it is for her.

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It is always a terrible problem. In some cultures, it is simply unthinkable to not care for aging parents. There are arguments on both side. I would try the tack, that terrific as your MIL may be, she cannot provide the professional care a very sick man needs. And a very sick man is not in a position to decide this. Sometimes in a marriage, yours in this case, a person has to draw some lines that are difficult and not too sweet. You are no good to your husband, MIL, or child if you take on too much. I would start up front with MIL will have to get professional care when she needs it. If there is money for these things, I wouldn't hesitate. And ignore Dad's annoying comments. My husband is a doctor who managed a dementia inpatient unit, one of the first in the country. He would say that whatever a person's traits were, they became more marked with dementia. Just say thanks, Dad, bye. Don't let him get your goat. Just stop the conversation nicely, and immediately. Apparently, upsetting people is his "thing", deprive of him of the pleasure in your case.

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Thank you, Moxies. I come from a culture where it is required to look after the elderly (although, I'd say all cultures look after their elderly), as such, my guilt for feeling this way. My husband also feels cornered, but he silently bears it. You are right, I'll need to overlook FIL's comments, and try to bring all my compassion. I am trying. thank you!

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Depends how close your husband is to his mother. If he is very close to her, you can expect her to live with you both. It's part of the deal in marriage. I was very close to my mom and I took care of her until she died age 90, and she suffered end-stage Alzheimer's disease, advanced kidney disease, and insulin-dependent diabetes and I took care of her every single day, 24/7. If given the choice between my mom and spouse, I would tell him to hit the road without batting an eyelash. My mom always came FIRST. She was my entire universe.

Think of the advantages. Your MIL can help baby sit your toddler.

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hug, cetude!!
sounds like you’re a wonderful daughter!! :)

and your mother must have been a wonderful person too!!
:)

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Stage 4 chronic kidney disease is right on the border of kidney failure. Your FIL will need to follow a special diet, take his medications correctly, and talk with a nephrologist about dialysis or kidney transplant. He will not need dialysis yet, but it won't be long before he does. Waste products will building up in his system which will make him irritable, swollen, and smell bad (like pee). At his age with diabetes and high blood pressure, he is probably not a good candidate for surgery. If left untreated, he will proceed to kidney failure (stage 5). which only has a 15% chance of surviving for 5 years or more.

Before your in-laws make the move, you and your husband need to discuss how involved your family will be with his care. If he needs help with everything, it might be wisest for FIL to be placed into total care residence (nursing home) where the staff can meet all his needs. Otherwise, your husband can talk with the staff about advising him when FIL would need to move to total care. If MIL will be living in your home, your family also needs to discuss how to meet her needs. She may wish to spend the day with her husband and come home to be with you in the evenings. She may also have health care needs that she needs assistance with. Because you also have a small child in the home, I suggest you write down his/her schedule before talking with your husband. Ask MIL what her usual schedule is and write that down as well. Talk with your husband about if it is possible to mesh the schedules AND create time for just the 2 of you daily and weekly. As a couple, your first priority should be to each other. Your next highest priority is your child (though right now his/her needs are a very high priority). After your child, comes extended family. Express your concerns to your husband and address them together.

Please make sure to take care of yourself and your child. If you find yourself still feeling anxious or depressed, please seek a counsellor to help you with coping techniques. It is not a shameful thing to feel overwhelmed with a difficult situation.

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Thank you, Taarna. I really appreciate your perspective around stage 4 CKD. FIL declined dialysis, he does do shots on a monthly basis (for blood plates(?), I don't really know why this is needed). It's a sad situation all around, and I know it's hard on FIL too. He was relatively self sufficient, before pnemuonia got him. Thank you for your perspective, and I am so glad to have found this site, with everyone's wise comments.

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If it were me, I would want me and my husband to stay ahead of this situation. I would take my husband to meet with a counselor and come up with a plan of BOUNDARIES, so that we could be in agreement with what we (as a couple) are willing to do and not willing to do. It’s very important that you protect your marriage.
I would also be willing (when the time comes) to block my FIL’s cell phone or room calls from my phone and especially at dinner time. Create a safe zone where you can have peace in your home. I could see him calling and demanding numerous times every day, ordering you, his wife and son around.
Im so sorry for your situation. My sister is a nurse who works with dementia patients. She tells me that if a parent was abusive and domineering to begin with...they don’t get a free pass just because they have dementia. It will be up to you and your husband to set the healthy boundaries and protect yourselves.

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Thank you, DILhagen2. We live in LA now, so they don't call as frequently. I agree setting phones on no ring during set dinner or date nights are important. Thank you!

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Take a deep breath. Concentrate on building a nice relationship between your toddler and your mother-in-law. Trust the facility where your father-in-law is to be able to cope with him. Just be grateful that he will not be living with you. And his prognosis is not good, shall we say. If you show maturity in a difficult situation, it will earn you respect from your mother-in-law AND presumably your husband. They ARE his parents.

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Thank you, Octogenarian. You are right. They are my husband's parents, and I need to bring all of my maturity and resilience to the table for this. Thank you for this perspective! I really appreciate it.

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First and foremost, do NOT move your MIL into your home. Trust all of us here on this forum. The stress and anxiety it will cause in your marriage will be overwhelming. You may not think so now but your 80-year old MIL will get older and have her own set of health problems to contend with. You have an 18 month old. That takes all of your energy. I can't stress enough to find another alternative living arrangements for MIL. Assisted living takes couples. Please. Reconsider that life altering decision. MIL could live another 10-15 years. Don't make the mistake so many others on this forum did and lived to regret it.

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Thank you, help2day. I know, I will try to suggest MIL and FIL should be together. This way we can visit often, and it will protect my own home environment. Thank you!

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Talk, talk, talk to your husband about this decision a lot before your FIL comes. This could be the beginning of the greatest blessing ever, or the end of your marriage. You both must be on board with this decision or it will explode in your face.
My dad moved in with my husband and myself a year ago. It has been a very tough year. However, now we are not sorry. My dad is on home Hospice and we love having him here.
You must be a team and be in agreement as we as have many resource already lined up prior to moving him there.
You must have great doctors ready, an adult baby sitting company available, like Visiting Angels, you need time away. Most of all, have support, conversations and plans.
Caregiving is very very tough. It is good to question whether you are up to this. Remember too, this may really be important to your husband. But tell him your concerns in a loving way and listen, then pray.

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Thank you, Lauramay. Yes! Well said, this may be a blessing or will destroy my marriage. :/ I will pray and have faith. Thank you!

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I wonder if MIL might be a positive influence on your household. Would she have an interest in playing silly games/reading to toddler? If she can provide for self-care, she might be able to also help with the smaller household chores. Once she starts to decline, would she be stubborn and insist on staying with you, or would she thrive in assisted living in her later years? Regarding your husband, I would insist that you are doing more than your fair share in caring for toddler & MIL and I WOULD NOT be doing any weekend visits with FIL (he can take MIL to visit, giving you some alone time).

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Thank you, SSAretired. I think MIL will love my son. They do facetime now, and they seem to engage well. FIL doesn't engage my son at all. It may be a blessing in disguise. Thank you for the viewpoint!

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Since they are moving anyway, it's possible that FIL needs more care than current AL will provide. MIL could use a break so she doesn't wear herself out trying to maintain living in AL facility. Find something that offers more care and let MIL continue to live with him. They will probably be better together so that FIL doesn't have to start over in a new place all by himself.

Find the closest facility you can and let hubby visit often. When permitted, you and toddler visit as often as you can, too. They are the grandparents even if one is a little more difficult. Tell hubby managing a kid and an elderly mom is just too much PLUS they would be without each other in the final years.

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Thank you, my2cents. They are indeed the grandparents. :) Thank you.

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Thank you all!

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I had a 20 month old I was babysitting when I took in my Mom who was 86 at the time with Dementia. At 65 there was no way I could care for both. Your child needs your full attention. If u take in MIL, she needs to be able to care for herself.

I also wonder why Mom was doing all the work in an AL? It kind of defeats the purpose. FIL is that much of a tyrant?

Your husband needs to learn boundries with Dad. Look up the meaning of Narcissist.

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Thank you, JoAnn29. Originally, they have all the services set up to support FIL at assisted living; however, FIL "prefers" MIL to do the these things for him, so they scaled back on the services. Well, it overwhelmed her in the end (she fainted). Her solution is she doesn't want to live there, because if she lives there, she will be compelled to help, hence she wants to live with her son :(

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As a nurse I often saw people who refused dialysis live longer than those who accepted it. As everyone's disease is as individual as a fingerprint there is no telling how long FIL will live. There is no reason, with his not living WITH you that you need have much to do with him. Drive the MIL to visit when she wishes within reason, and that's that. However, you are taking on long term care now for an 80 year old. There days she may live another decade and one half and she may do so on a decline, as well. It is almost too late at this point, but I would speak with your husband about the fact that you may not wish to do 24/7 long term care for an unforeseeable time, and that this is good as long as it is good for ALL, meaning YOU, since clearly you will end with a good deal of the care.
Sure do wish you luck. I have long known my limitations prohibit my ever doing LTC for an elder, and I never attempted it.

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Thank you, AlvaDeer. I appreciate your response. You are right! I don't need to have much to do with him, but I think I'll be inadverently pulled in, and I have a feeling our weekends will be going to visit... I honestly don't mind the MIL, it's the FIL who is difficult. For example, over the phone recently, we said, "you'll come with us" (friendly tone), FIL screamed full of ego, "no, you come with us!". I am sure all the meds he is on is influencing his thinking.. He wanted us to find new jobs in Seattle, and uproot from our lives here in LA.

I am trying to exercise compassion. I want the best for my in-laws truly. But I am freaking out. Yes, I've read this situation can drag on...

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The fact that your In Laws are living in ASSISTED living and your MIL is doing the assisting NOT the staff that that should be doing what they are being paid to do and what your In Laws are being charged for.
I doubt that the situation will change with the move. I have the feeling that your FIL will not permit others to help him.
I would not let MIL move in with you. At least begin the conversation like this....
MIL should stay with FIL for the first few months so that he adjusts better to the new facility.
MIL and FIL should allow the staff to do what they are supposed to do, ASSIST both MIL and FIL with daily activities.
You might even want to find out if FIL is eligible for Hospice. That would provide more help for your In Laws.

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Thank you, Grandma1954. Originally, they have all the services set up to support FIL at assisted living; however, FIL "naturally prefers" MIL to do the these things for him, so they scaled back on the services. MIL maybe perfectionist? and thinks her way is better ? Of course, FIL prefers MIL.

I love your suggestion to dialogue, "MIL should stay with FIL...", this is wise. This way everyone will see and adjust a bit. My husband says next step is nursing home, is that the same as hospice?

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Do not have your MIL move in with you. Your immediate family is first priority and your husband needs to be in agreement with this. Choosing this does not mean his mother is not loved. It is a cultural expectation, not a moral obligation, to provide the care...something to which you have not agreed to.

Here is some info about when someone with late state CKD chooses to not have dialysis:
https://bit.ly/3s3CDqc

You really don't need a "reason" to say no to caregiving someone. It's challenging enough to have a toddler! Say "no" and don't consider any other compromises. Your husband needs to put you first. If he doesn't...that's another issue. I wish you much confidence, wisdom and clarity in working through this. May you have peace in your heart.

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Thank you, Geaton777. I appreciate your response, and link, it is very helpful. Unfortunately, my husband cannot in his good conscience say no. It's definitely creating strain on us, and we've fought a couple times. Now, I am trying to hold back (and seeking support groups, today's comments have really lifted me a bit), I find my wanting to "resolve" or "dialogue" only creates more stress on dear husband.

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Difficult Father-in-Law with stage 4 chronic kidney disease - how to cope?

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