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Mother-in-law is 81 year old and was diagnosed with Vascular Dementia three months ago and Parkinson’s six months ago. My husband has been taking care of her and it has impacted our relationship significantly. He has to be with her all the time because she takes meds 7 times a day and she always forgets. The Carbidopa-Levodopa is tricky because she takes it 3 times a day and she can’t eat one hour before and 30 minutes after and it’s always a battle – she doesn’t understand why she can’t eat.

We want to take time off – 5 days – but she is very attached to my husband. We have a caregiver come in once a week and she barely tolerates the caregiver and will not take the meds from the caregiver and always wants the caregiver to leave.

If we have the caregiver come for 3 hours in the morning and 3 hours in the afternoon, there’s a possibility that she will not let the caregiver in for either shift. Do we give the caregiver a key? This seems to be the most ideal but giving a caregiver a key is risky. Any thoughts on this?

Thank you in advance.

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Can MIL really be left on her own except for 6 hours a day?

Look for a facility that offers respite care. MIL could go to this nice vacation house while you are away. It is EXPENSIVE, but sometimes they have "scholarships" available. This money should come out of mom's funds.

Absolutely do take that vacation! You both need it.
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The 6 hours a days is a compromise, we can stretch it to longer but when we have a caregiver for 4 hours she tells them to leave over and over and they end up calling us, asking if they should leave.
With regards to the facility, I've thought of that as well but my husband thinks she will never agree to leaving her place, even if it's just 5 days. I am definitely re-thinking this option though.
Thank you!
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Maybe u get her experienced caregivers who knows just how to give her a much needed self time and ehave just like a good old family friend. Its hard I know but I have found myself working with those difficult people with dementia and one need to be very capable abd patient. Eventually she will give in and accept caregivers dont beat yourself through it.
If you trust caregiver give her the keys, if you MIL can still answer the phone make caregiver call and let her know is coming in.
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Is MIL going to accept medication from the Caregiver?

Does her doctor know how resistant she is to anyone other than your Husband? It sounds as though there is some level of anxiety/agitation going on that should be addressed.
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Your husband needs that break, even more than you do.

No matter how much time, devotion and love he puts in to his mother's care, the sad reality is that she is going to get worse. Over the last six months, he has been unconsciously training himself to believe that if only he tries hard enough he can save her, and that only he can comfort her. Neither is true. You need to snap him out of this pattern of thinking or quite apart from current difficulties her eventual, inevitable end is going to lay him waste.

The compromise visits don't sound adequate, though - it would be much better (and less of a worry for the two of you) to find a facility offering respite breaks, if you possibly can.
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Facilities offer "respite care" but usually only at THEIR convenience. I'm saying this because finding one you can use at YOUR convenience in scheduling a vacation will be a QUEST! I agree that she needs to go to the doc; get her meds looked at to get her agitation under control first.
I also agree with those she needs to be in a facility; probably memory care which is the only one with a lock-down policy. Not cheap but she needs to be safe; she needs her meds in a particular order and this will be the only way you can leave town knowing she's going to be fine. Good luck!!
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Take that vacation with MIL in a facility for a respite stay. I would not leave her alone even for a few hours. She could become disoriented and agitated and most anything could happen. Her choices? 24/7 at home or a facility.
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Tell MIL that you are ALL taking a vacation.
You are going to one place and she will be going to an "All Inclusive Resort" then schedule respite at an Assisted Living facility that you MIGHT consider placing her in at some time in the future.
She will get the care that she needs, she will have some socialization, she will get the meds she needs on the schedule that needs to be followed.
When I placed my Husband in a Memory Care facility for respite I think the cost was $150 a day. He had been going to the same place for Day Care so he was used to the routine as well as the staff. He adjusted quite well.
You all need a break.
Take your Vacation and enjoy yourselves.
Don't worry, emergencies rarely happen and most small incidents can be solved by phone.
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Hello Sushi94122
In all honesty you and your husband are in a tough situation here. Keep in mind that "respite care" places are mostly private pay. First time I've heard of a program out there that funds for this type of care, try looking into it if you have time. Okay about your husband and mother-in-law. The medication help your mother-in-law needs is requires a lot of time and believe me he is going to get burned out. He needs a lot more help then once a week. We had a provider come in 5 times a week for 4 hours a day. Our mom was able to qualify for Medicaid and that's how we got the help we had for her. Mom was diagnosed with dementia and we took care of her until we could. We were exhausted (sister and I) and
She required more help then we could give her. We found a senior care place and placed her. It's only been 6 months but our stress level has gone down tremendously. We were so close to our mother, we never did anything without het SO I totally understand how your husband feels about leaving her alone. He wants to make sure she will be okay with the person who cares for her. That's why having a provider come in more often will help her get use the their presence and she can start adjusting. Check with the Department of Aging and Disability to see what type help she qualifies for. Good luck and god bless.
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For the very short time I worked in a nursing/rehab/AL facility, I remember a lady who spent a week there while her son and his wife took a cruise. She wasn't wild about the situation but seemed contented enough when dining with the other AL ladies in the dining room. It may have been a prequel to admission there, not sure (she obviously had memory problems). She always had her cell phone in hand and usually wanted the workers there to dial for her (probably trying to reach her son, lol). Where mom is now, there is a lady over 100, pretty sharp but still seems to resent that her daughter put her in this facility (she'd taken care of this lady for 17 years in her home and actually volunteers at this facility now). Amazes me how people think they'll never end up having to be placed someday, lol.
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If you have time before your break, check out facilities with activities such as gardening, ladies tea, sing alongs, etc., (whatever she is interested in) and take her for day care a few days a week until she is used to it and, hopefully, looking forward to it. Then, leave her for a few overnights. I eased my husband into it that way and I'm getting ready to leave him for a week. The first time since he was diagnosed two and a half years ago. Wish me luck.

For in home care, I introduced caregivers by saying they were coming to help me out with cleaning and cooking, etc., then again gradually eased him into it by running errands and gradually increasing the time I was gone.
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Your MIL already needs more help than one person can provide. Your husband will burn out quickly and this kind of care puts the child in a parental role which is hard on both. Most elders resist the idea of care but with dementia either you will have to hire round the clock care, cost prohibitive unless you are wealthy, or find an appropriate facility. If you are new to elder care, call your Area Agency on Aging and they can explain what benefits your MIL qualify for if any. Respite care will benefit all of you. Most elders adjust fine, even though they may complain afterwards. Some facilities also offer day programs which are a good way to dip your toe in. With your MIL in care your husband can return to the supportive role of son and husband. I know it's hard but you will get through it. Look for a local dementia support group. It helps to be with others who understand as well as build compassion for yourself and others.
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No doubt your husband's mother went away when HE was a child and left him in someone else's care? Thinking of MIL as a "child" which she is, in many ways, and knowing that you have to keep your marriage going--get MIL into a respite care place for the week and go and enjoy yourselves.

My brother has had my mother with "him" for 20+ years. In that time he has taken ONE vacation. Mother had me there everyday for this and that, and though she was still driving at the time, she never went far.

And yes, his wife is VERY angry about this dynamic.

As far as giving the caregiver a key--this is built on many levels of trust. But it sounds like Mom is going to be angry and non-compliant with her--if she is when the caregiver is there, and you are there, she isn't going to act any better. Also there's the problem of nighttime, right? (Maybe the caregiver would enjoy a break too--all my vacations were planned around my client's!!)

I did caregiving in a woman's home. If her "family" went away, another family member came and spent the nights. It soothed my client to know that she was not going to be alone (and she truly could not be left alone, for an hour.)

Best option is probably the "respite care" situation. Having mom in a secure location and maybe lose that cell phone. She'll call you day and night. Let the caregivers at the respite place do their jobs and you go enjoy your time together.
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Thank you everyone for all the insights. I have a lot to think about and digest. All the comments are so astute and the underlying issue here is that my husband is in major denial. He still somehow hopes that his mother will get her memory back. Our first terrible fight was when I said his mom might have dementia.

It is is looking more like we will have to do the overnight facility. We can get someone to come in and stay with her and sleep there -- it's $200 a day. This is expensive but she will not tolerate this. The overnight facility -- might cost as much -- but have to think about how to convince her. Maybe at this point, we have to lie and say the house needs to be fumigated or something like that.

Thank you again to everyone. This has been tremendously helpful.
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I hope you can get respite care. I was so stressed putting my hubby in while my girls took me to England for 2 wks I got shingles 3 wks before. Well he did fine. Has short term memory so was probably a blessing. If he doesn't take breaks he may get sick or die from stress & then no good for you or his mom.
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1 - you both need time off - DO IT
2 - ease her in if possible - if there is time start with day care 1x, 2x, 3x, all week so that there is relief for both of you but also MIL gets into routine then have her stay 1 night then increase - otherwise set yourself up for next opportunity - some day cares will also do showers etc so that will help in long run
3 - you are 2 persons & she is 1 person - I know you think that her age trumps the needs you have but it doesn't because it's 2 people - so ease her into another situation if there is time - be as kind as you can be but you have needs too & don't disreguard them
4 - if you go then her chance of major health and/or death is less than 1 in 73 while you are away [365 divided by 5] & if you precondition her to where she will be that will lessen even more
5 - we are meant to care for our children & then our parents too but that doesn't mean that we need to work ourselves into an earlier death to support our parents - we want to do so much for them BUT that doesn't mean we should put our lives on hold forever because if you sidestep doing things for yourself all that you will feel at their age is 'why didn't I do..xxx..like I wanted to do - - - d*mn mom for taking away my opportunity' - I'll take a 1 week cruise not a 3 week cruise because mom[91] & dad [94] do need help BUT I GO however for maybe a shorter time ...this is my comprimise
6 - you are not obligated to correct any faults of a prior generation excepting sacrificises that where due to educating your generation - so if mom/dad put a mortgage on house to pay for YOU to go to university then you owe them something even if you didn't persue what you went to school for because they paid that $$$ to advance you - this a debt that you can actually calculate however most kids pay part so keep that in mind -
7 - why are you questioning giving a key to someone who you know & have a relationship with? - basically you are trusting them to take care of someone you hold dear so why not give them a key otherwise you don't really trust them to responsible so then get someone who is ... think this out & know that those caregivers know they are being in a trusted position so that if anything happens their 'ass in on the line' so probably the safest time for you mom - however if you haven't done by now all really valuables should be secured but rest is 'small stuff' & don't fixate on whether a figurine is missing/broken [because they are worth diddly squat] rather will mom be taken care of!!
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I'm sorry for all of the difficulties that your family is going through. All of the above comments are very appropriate. One more thing to consider is something that I mention to everyone that has dementia and then is diagnosed with Parkinson's. These two symptoms are significant hallmarks for Lewy Body Disease. Please google it and see if any of the other symptoms apply to your MIL. This is important because LBD is VERY often misdiagnosed. Also, Levodopa can cause more problems for LBD patients than it can solve.
Blessings,
Jamie
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You should look for a facility that covers 24 hours of care. The caregiver is an impossible option because of unreliability and her resistance to the cg'er.
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1) m-i-l is not the boss here. You must do what you must do for her own good, and if that means having her medications adjusted to lessen agitation, or 'easing into' a respite home, you go ahead and do it. Her life as she knew it is over, and you, husband, and m-i-l will have to adjust to a new normal. If she needs someone dancing attendance upon her as far as taking the medications properly, it should not be on the head of some poor caregiver, but administered by experienced people at a facility. 2) when my mother was still at home, we had one super-wonderful lady 3-4 days a week. Though it was 'forbidden' by the agency, we (shhhh!!!) gave her a house key. For other caregivers on other days, I went to meet them at the house and show them around, and told them the house key would be left under the door mat. (This also was 'forbidden' by the agency, I was supposed to leave the key in a lock box, with a top secret secret combination, but the lockbox cost more than the door it was hanging on!) There was nothing of value in mom's house, we cleared out everything of any value whatsoever - knickknacks, jewelry, checkbook, credit cards. All that was left was a little money in an envelope in case the caregiver needed to buy something, and a small flatscreen tv. So, I guess what I'm saying is how much you trust your caregiver, about giving them a key. We had no bad experiences to speak of, but of course there is no guarantee they won't let in friends or strangers off the street to 'case the joint'. Please go on your trip after m-i-l goes into a respite home, even if she doesn't like it, that's too bad. They will call you in an emergency.
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Good Morning, Sushi! Reality can be tough. But MIL is never going to regain any memory. My brother had a real tough time with this, as he and Dad were close!! It was hard for him to see Dad, or Mom for that matter, lose the cognitive ability to make decisions they had been making all their lives!! And yes, a New Normal must be found for all. The double whammy is that the parent knows they are losing some memory, doesn't know why and does not want to lose control of anything!!! Most times it is very hard on them, too, which explains some of the behavior problems!! God Bless you and Hubby as you find a care home, take a vacation for a few days, and then maybe in time be able to leave MIL in a facility as things progress!!
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