FMIL is going to have a stem-cell transplant and will lose all acquired immunity plus will have numerous blood derangements from the treatment, let alone the disease. Docs don't want her to be left alone for even one minute for at least a month after the month she comes home from the hospital.
FFIL is also significantly disabled (recent stroke victim, just had two brain operations and a heart operation is coming up).
Their day caregiver is SO's Brother's Wife. From what we hear from Dad, she can spend half her day out "doing errands" (and going home to feed her cats and take a smoke break) and kinda dawdling around the ILs unless there is an appointment.
Even then, this $65,000 caregiver's priorities are out of whack: She cares about pointing out bumblebees in the yard. Making sure Mom has her favorite hot dog. Covid vaccinations, that's just optional. Mom's radiation treatments? Well SO is off Tuesdays and Wednesdays, why don't you just call him while I entertain my sister for a month-long visit?
The caregiver already has itchy feet (or nicotine withdrawal) that makes her go out along with other factors. She is already burning out. For the past two weeks, SO has been enlisted to "go help" because that paid caregiver's priorities were to spend time with a sister here for a leisure trip. Nor has she, when she is on duty, had to deal beyond occasional urinary incontinence and she didn't like that. Both her clients held it, and both came down with UTIs.
More of this is inevitable. The family is rich enough to bring a CNA or maybe an LPN on deck given the immediate medical need here. They've gone through with clients the imminent stage that at least MIL and probably both of them will need, thus being able to educate this "family" caregiver.
But the mom is shrieking and is abusive toward us. She thinks that our reminding her of what her doctors said and put in a binder in bold italic is just an excuse so that we don't "take care" of her which proves we don't care.
She needs at least a CNA. This family can afford, private pay, even an RN. We care about inheritance (it is substantial) less than Brother's Wife, who seems to be gaslighting the MIL into her grave by going against medical advice.
How can we get her to accept medical advice?
If no one steps up, she will have no choice but to hire several aides, or her doctor will have to recommend that she go to a rehab facility for however long it takes for her to be healthy enough to return home. Those should be her only 2 options.
I can't help but wonder if the reason you or her family are afraid to upset the applecart with her is because of the "substantial" inheritance, that you/they may all risk losing if you/they don't give in to what she wants. If in fact that is the case, then you all may as well just suck it up and get your caregiving schedules in place with her, if you believe she will hold that over all your heads for the rest of her life.
These are good questions so I'll try to answer them.
I can say for myself that I really don't care about the inheritance, because whether married or not, it only goes to the person designated. Whereas this woman got everything from the ILs, has no education in providing care nor any job in the 21st century, and has to date not done so sufficiently even to proactively get them to covid shots, and who dissolves absolutely around concerns such as incontinence.
I read the stem cell transplant manual eight times. They're really serious. This is going to be a bigger thing than chemo. And unfortunately the odds are it won't work ideally. This person if they survive a year could be at least incontinent. Behaviorally, they are already borderline abusive, hence DIL's attitude around it..
We as a family need help. Seriously. Odds are she's incontinent and in a lift within a year. OK, and none of us know how to do that. Brother's Wife has expressed she's so grossed out that she didn't change them. SO, well, he loves his mother but wiping her a****** and vagina is just a solid no for him.
I'd do it. I don't really care that there's a vagina there. Moving the person around and so forth, yeah, I need help from someone who's done it before in a professional capacity.
But looking at this situation realistically. It's like a 20 percent chance this treatment will render a two-year remission. The other 4 in 5 times, the person typically has 6 months to a year before the cancer comes back, and then an equivalent period after that.
If those months can be as event-free (not in the cancer sense, but in the infection sense) she'll have more quality days regardless. Plus the effects of the treatment itself on her, plus what is going on with Dad.
Such a person, even if "just" a CNA, could educate us into what are routine parts of her job. Such as incontinence. This has come up already and will probably be part of the care plan eventually. Shouldn't we all know how to deal with it?
You refer to "doctors", which I assume includes the doctor who will perform the stem cell transplant.
Any doctor who doesn't want a patient alone at any time for a month would to me be recommending rehab, where the patient can get the rest she needs (and away from apparently bickering family), medical attention, meals, and generally peace and quiet, which doesn't seem to be apparent in this family.
It's not my specific intent to criticize your family, but the impression I'm getting is that they're not working together to create a positive response. Someone needs to take charge, and at this point, I think a doctor would be the person to do so.
The doctor needs to explain and emphasize that she needs professional, not family care, at least for the month after surgery.
That's not meant to be a deliberate criticism, but rather a summation of what I read in your post.
If your MIL doesn't want monitored recovery in a place more suited for it, someone should contact the doctor and ask him/her to explain why this is needed. A letter would be appropriate, detailing all the concerns, and probably would be better support for keeping the relatives out of the picture.
From your description, it doesn't appear as though the SIL is suited to provide intense care.
How you get your MIL to accept medical advice is to have it provided by a medical person, the surgeon performing the surgery, or someone in his office or on his recovery team. In writing is probably the best, couched in terms of confirming the appointment times, surgery, and emphasizing correct and necessary post-op care.
And I leave it at that. I tell Janet what to do, and sometimes it’s a bit of a dance getting my MIL to accept help, but it definitely makes things a lot easier if we approach it this way.
In November with her in chemo and him just having had his stroke, she was still saying family could do it all. At that point I'd broken up a fight between SO and Brother's Wife because even that early, she was telling him that he'd have to work a straight 36 hours since she needed a day off.
Brother found this indy, said she took care of Mrs. So and So who you used to know when they lived near you in the 1970s. They pressed upon the ILs that they needed Saturdays and Sundays off, so the aide takes care of that as well as the overnights.
SO, meanwhile, is indebted full-time to go around on commission doing extremely arduous and unpleasant work. Think toilets and what's in them. This is just for starters. Just because his weekends are actually on weekdays doesn't mean that they are not weekends to him and to us. Plus for the record, he's totally on a volunteer basis for this. Baby Jane is the only one getting paid, and as I said, it's about 25 percent more than the indy.
SO reiterated to Brother what the actual doctors said. She needs her own person for medical reasons.
One person to do the shopping and "errands" (with infinite opportunity for two-hour smoke breaks and what have you) as is currently the situation. They would be in charge of doing any incidental gardening (like picking tomatoes) and dealing with pet litter and pet waste. Dad isn't as acute as mom at the moment, certainly not as immunocompromised.
One person to deal with mom. Now if SIL is the trusted person, then she can get a nicotine withdrawal method, or for that matter get a Juul e-cigarette. But that's not all there is. She just doesn't have the wherewithal physically to spend a full 50 hours dealing with the two of them. She is already snapping (according to them) and now we're supposed to be doing more of it. The transplant hasn't even happened yet, yet this "S" IL is still representing that she'll take care of both of them, no problem, and they believe her because she's very attuned to the "can you get me a sandwich" requests. The emotional requests. It's like it's her first priority.
SO finally went to the Brother about it. Reiterated what he heard in the meeting with the docs. Brother said he would talk to his wife, Baby Jane about it.
If Baby Jane gets her way, could be less time and less quality time with mom. Dad too. How could this Baby Jane not get herself vaccinated, not get the FFIL vaccinated in the appropriate time frame? Let alone what happened with the mom's covid schedule. (She got it, prob from baby jane). Not that it will matter anymore.
Who is the caregiver here? Are you or your spouse being asked to step into this role?
Do any of the parties suffer from dementia or significant mental illness? In particular, MIL's equating rehab with "giving up" seems nonsensical and should be challenged by professionals, unless she is so deep into dementia that you are quite sure she won't "get" it.
Are you certain that FIL is an accurate reporter of events?
Is someone PPA for finances and healthcare?
She gets her wsy when she shreiks? That will only reinforce she demandingness. Someone needs to say "no, mom, this is what the doc says you need" and mean it. Can anyone do that?