Where can I to find help for 93-year-old mother-in-law who refuses outside help?

Alot of this really truly depends on both your personalities and what mom needs.
For me, my mom was absolute on NOT moving and all you can't make me.

This is what we went thru, it will be a bit long........
I basically forced my 90++ yr old mom to move from her house of 50+ years to IL
in Fall 2007. None of it was pretty. It had come down to issues of her immediate safety and security. At spring break and that summer, we would come into the house and the gas would be left on; the front door would be left open; medicine would not be taken; frig would be filled with spoiled, moldy food....Whatever the case there was always an excuse.....the dials on the stove got stuck, the mailman tried to break in, the pharmacy switched the medicine to poison, the food is fine and that's just a type of cheese! Had 3 home health agencies that spring and summer & after a few weeks would refuse to let them in. Sound like your MIL?

I'm an only child and live states away. Fortuanately, back in 2002, she did DPOA, MPOA, and "Guardianship in case of incapacity", banking co-accounts, etc. naming me for all. With this I could make her move and did. If you don't have this capability, it will be harder to make her move. You will need to get guardianship or conservatorship (depending on her state) and it is complicated legally. IMHO you will need an elder care attorney to represent you as you have to go thru a court hearing to be appointed as the G/C. If this is the situation you are in, I would get an attorney first then contact Social Services for an home safety check.

For us,it came to a head in Fall, 2007 after I paid a last minute visit to her -...bathrooms filthy, clothes in standing water in the washer and the refrigerator dial @ "1", raw food in kitchen; past due on utilities. She was not there when I got there (was at senior center). I took lots of pictures. However, the yard was manicured and overall the other rooms were tidy.

When she got home, she became all it's not my fault and called the police because someone came in and did this to her. The police came and did a report which stated "elderly resident, confused and agitated, stated neighbors kids broke in and stole clothes and food". This was good because I could use this to show her incapacity from an outside source.

Up until that day, we had always let her know in advance we were coming. Apparently she would show-time for our visits.

The interesting thing about all this was that to the outside world she seemed just amazing - she still would drive to grocery, went to twice a week senior center (got dressed appropriately & the van picked her up); went to mass and vigils every week (got picked up by altar society ladies); hairdresser every week, was big on sending every type of holiday cards to family & friends. I cannot tell you how many time, we would be out and run into family and old friends and they would say OMG your mom is fabulous...where is that Dorian Grey picture...she can't be that age...

Before this, I had tried to get her to move closer to us in the late 1990's. Took her to see places on her visits here, even did a week-long mini stay at one. She refused to move as she couldn't leave her family and friends. In 2005 we stayed with her post Katrina for a while & got alot of work done on the house to make things easier for her...put in a ramp, more and better lighting, grab rails in the bathrooms, a walk in tub, fixed up the garage apt so she could have a live-in (but apart) caregiver. With weeks of our leaving in 2006, my aunt went into an Alz unit and her long-time caregiver was set to help my mom out. How perfect! That lasted about 4 months as my mom would lock her out. But the house & her are still looking all nice and tidy, she seemed cognitive and competent & is ambulatory.

I had looked at IL & AL's in 2006 while were were there and had it narrowed down to 2. She went with me on all these visits and was nice but not interested. The ones who had a tiered system (IL to AL to NH to Hospice) all thought she was good to go into IL as she was day to day functional and did not need AL.

Back to Fall 2007, found the IL paperwork and went to both that afternoon after the police left and got her on their lists. The next morning I went to see the elder care attorney who did the paperwork in 2002. I'm pretty good with legal stuff as I have been executrix for a couple of my "aunts" estates and had been through getting my MIL in a NH and Medicaid but wanted to see what's what on a forced move.

What he told me is that because of the advance paperwork I could make her move, we did a request for emergency guardianship form that I could file if needed (& use the police report to show cause) but the key to getting her moved would be having her move into a private pay situation BEFORE she was diagnosed with dementia. He also gave me a list of gerontology specialists.

Got her moved - she was crying and grabbing onto the furniture as the guys were trying to shrink wrap it. Lots of drama. Then the day after she moved in, she called all PO'd that if only I HAD moved her in a day earlier she could have gone on the shopping trip to SteinMart as she was too late for the sign-in sheet.

Turns out she has Lewy Body Dementia - for her it's really episodic. On retrospect my mom had LBD related paranoia, issues with language and difficulty with familiar tasks since 2005. To this very day she appears lucid, knows who people are, can seem to carry on conversations, can mostly get dressed & potty on her own, walk with just a cane. But if you talk with her past the 2 – 3 minute conversation most people do with the elderly, it is totally scary... animals who appear in the corner, gypsy children live in the building, someone stole her TV cable, they are trying to poison her. She constantly was getting "robbed" and was "stealing" from other residents. Finally moved from IL to LTC in Jan of this year.

In speaking with other LTC residents kids,most of them had make mom move into LTC as is just got to be too, too much for them to do at home. They all mention that they wished they had moved mom/dad while they still could have enjoyed living in IL or an active AL setting. I am totally glad I forced her to move when I did.
None of this is easy but you have to remind yourself you are doing it for their best safety, security and health. Good luck.

My Dad is 85 and has back and leg problems,stomach hernias, walks real slow and an addiction to pain meds. Lives with our Mother whom is in a wheel chair because of Gillian Barre Syndrome and other past surgeries and now has disease of her bladder etc...My sister through State Help(Medicare) comes over to clean house, wash clothes, cook 2 meals, call for appts and takes them to appts and doesn't make much more than $7.65 perhour and can only get 38 hours as they don't pay for overtime. My other sister comes over every other Saturday as she has two grandchildren and helpless grown son living with her. I live out of town and come over on rotating Saturdays to help out also. Anyways our Dad refuses for any one (nurse) to come over at least once a week to check him over. He thinks he needs no-one to help him. Let him do it alone without "All of Us"... What to do !!!!!

For a lot of people of any age, refusing help is a way of maintaining pride. If she's so far gone that Social Services has to come in to mandate protection, that will do the job.... but it will do the job by absolutely breaking down any possibility she has of maintaining the fiction that she's still strong. First try to reframe the conversation from "YOU need help" to "this is a favor to ME -- I can't sleep unless I know you have someone coming in to do the things I'd like to do if I could." If that doesn't fly, try the frame "Yes, you're still strong and you don't need very much help, isn't that great. But we don't have any choice about this any more -- if anything happens to you, I'll be liable and I have to be able to say that there was someone helping you." It's the tiniest fudge -- you may not have legal liability, but you feel an ethical liability. The point is to find ways of getting help in there WITHOUT her having to admit she needs or wants it.

Many of those who are care givers and even have durable power of attorney and all the legal papers that are needed to help their loved ones, are hit by the same door way you are trying to go throough. I went through elder care social service. its was until protection services got envolved. you see I weent inot a bathroom near by it was summer time and she but ona pot of water, the gas piol blew out and the place wa filled with gas. I smelt it ran, shut off gas, got mom outside, called 911 and then open all doors and windows. They came, but they had to call protective services. She was ok, but she could have blown up the whole house. That is when even the docotrs listen to me that something was wrong, I knew. By the up keep of the house and the smell. She had alztimers/dementia. She was tested. However when social services says they will help if you are not there you do not know what is going on. I finally had to move my mom to Florida and then something I did not want to do place her in a beatuiful asssiting living near by so I could watch and visit regular. Take care, and do seek extra outside help and quidance. My mother did fight with the nurses and people that came in to help her, and I got the back draft from all. It is a diffcult thing to go through and watch to everyone.

This is one stubborn lady! I would suggest that you leave the moldy food, etc. and schedule a welfare check by Social Services. They may be able to get her to move, since they aren't family members. It's sounds like an obvious case of an elder unable to care for herself, so Social Services may be able to help. You've done about everything else that can be done, so let's hope they can!
Take care and good luck,
Carol