How to tell wife

In Scotland you are entitled to an assessment of your needs as carers

I think this is the same all over the UK but the actual help you get is a bit hit and miss. Three years ago my mother was in hospital and we received a whole lot of bumf as her carers. One thing we were told was that my mum would not be released from hospital before my needs as her carer were assessed. Three years later I am still waiting for that assessment! (No longer needed of course but that is the sort of gap you may find between what you are entitled to and what you are actually offered).

You need to get adult social care involved. In Scotland you are entitled to an assessment of your needs as carers so that might be a route to suggest to your wife that yours and her needs have to be considered as well as her mother's.

I would also frame it around getting assistance to look after MIL rather than jumping straight to a care home even if that would be better.

You definitely need to share the load! Depending on your MIL's financial situation, get SS in to do a financial/social assessment. As a first port of call, you might be entitled to daily carers and also respite care. It's clear this is draining all the energy from your lives and you desperately need support.

That’s a great idea. Hope you both have a wonderful holiday.

That sounds like a good plan, you sound like a very supportive husband.
Does your MIL have capacity i.e. able to make her own decisions? Also, do either have Power of Attorney? My husband and I found this to be a godsend to have POA, especially the finance one. My MIL is in a care home and is self funding, she has capacity, but he can access her bank account etc. to pay her care home fares.
Depending on where you live in the UK, there is a shortage of carers, hence why some vulnerable people remain in hospital longer than necessary.
I second what others have said, to get a care assessment undertaken ASAP, as your current situation is un sustainable.

It is impossible for one or two individuals to provide round the clock total care for one person for any length of time.....especially not in a private home that is not set up for it. I am a retired professional and seen it fail many times and have done it myself twice for family end of life care, bith times with external support and of course a close endpoint. Firm gentle conversation with your wife and then start involving social services. You have done your best now its time to stop.

Your post could have been written by my husband 12 months ago. I feel for both of you. You both need help and, as you say, this is not how you expected to be living. The crunch came for us when mum went into hospital following a fall and I ended up there the following day after losing my memory and remembering nothing about the previous 48 hours!

My husband, like you, was very patient, willing to do any practical jobs required but he was not as emotionally involved in the situation. Along with the frustrations you feel your wife is probably guilt ridden and distressed to see her mum suffering no matter how badly her mum treats her.

Unless you are able to pay the care home fees there isn't a quick fix but I would recommend getting your GP's surgery and Social Services involved as soon as you can. My mum was assessed for care in the October and we heard nothing more until a carer arrived at the door one morning in March - even though it was agreed that help was needed that was how long it took for there to be a space with an agency. But even knowing that help is coming can make it easier to get through the day.

With my mum we framed it as "this is not our choice - it is what you need" and the decision for her to go into a home was taken out of our hands anyway. I hope you both get the help you need very soon.

I have been thinking that I should have said this in my previous post.

What you are doing is dangerous, and you risk injuries such as damaging your own back. Then that would be both you and your MIL down at once and the injury could last a lifetime.

Tell your wife that you feel the strain in your back every time you have to lift MIL, so you really don't feel you can go on like this. If you do then you will destroy your own health. Whenever she falls call for an ambulance, even if it might take a while to come. Do this every time.

Possibly it is largely your MIL who has the expectation that you can and will continue to get her up, and that is unrealistic. Perhaps she has you and your wife down in her head a youngsters who will just bounce back. My parents had a neighbour like that. She kept calling them whenever there was a problem and they eventually had to start saying that they could no longer go round and help as their own health failed (they were in their eighties by then with fast delining mobility, respiratory and other issues).

It sounds brutal, and it is, but it may be the only way. Something has to give here, and it can't be you or your wife.

Care in care homes is very expensive and will eat up all but substantial savings in a year or two.

The sensible approach would be to proceed via Social Services. They will do a care assessment, and in most cases will recommend home carers before they recommend care homes. However, the frequent falling might push your MIL’s needs over the threshold for needing a care home. Don’t dismiss the usefulness of home carers, though: two visits a day from someone who will deal with the incontinence issues can be an absolute godsend.

If your MIL has savings above £23,500, Social Services will require those to be spent first. Once they drop below this figure, Social Services will part-fund the care, whether that is at home or in a home, and once the savings are gone, they will fully fund. That’s why it’s better to go through them than do this independently.

The other service useful for a faller is a pendant or wrist alarm linked to a helpline. This would enable you to go out knowing that you’ll be contacted if she falls.

I know this doesn’t answer your initial question but it’s important to have proper information before broaching the subject.

I would start with “I think this is getting too much for us to cope with on our own” and then see what reaction you get. If your wife isn’t ready to discuss it yet, give her a bit more time. You’ll have planted the seed and she might need some time to work it through in her head. Meantime, do some research about how the care system works. On the other hand, your wife may feel exactly the same as you do and just needs you to start the conversation.

Good luck.

I came on to say don’t lift her too, call 999 instead. I know it sounds cruel but my family’s mostly healthcare and one of the nurses has lifelong back injuries from moving patients at work. The first rule of manual handling is don’t! Use a hoist or get the patient to mobilise eg wheelchair transfer etc.

Never risk your health for another, it can be a lifelong souvenir.

Is your wife waiting for you to say it’s untenable do you think? No one who works in healthcare/care has to do 24/7 the way you two are. We get to go home and rest.

Maybe rather than saying 'I', say "I don't think this is right for us, we're both doing our best but struggling, it would probably be better for all of us of MIL moved into a care home"

I had a recent conversation along similar lines with DH. MIL had a hospital stay for an op and she needed care following discharge. The idea was mooted that she would stay with us.

I did my best to be kind, but honest, that no way was that an option for me. She’s currently in a facility that specialises in geriatric rehabilitation and assessment.

So my advice is to be honest, but gentle. The idea of respite is a good one as it would allow your wife to assess how she feels without that responsibility

I don't think you're being unfair or harsh to tell her you can't carry on like this. It all sounds very difficult. I went through this slightly differently as I was going over to my parents to sort out my mum and she just got worse each day in front of my eyes. My father couldn't cope on his own, he put his back out helping her and was suffering as a result of that on top of all the stress and worry. She was falling all the time and breaking bones due to osteoporosis. she fell again, we couldn't get her up and we got the ambulance out. They took her off to hospital and after 6 weeks in there she was discharged to a nursing home of our choice. A tough decision. Frankly it was the best thing we ever did, it was a pleasure to go and visit and spend quality time with her rather than constantly being stressed exhausted and in crisis management mode or waiting for the next thing to kick off.

I would have an honest discussion with her, at the very least daily carer visits would take some off the load off her but there's still the in between times. My mum really thrived in the home with others to talk to and activities organised, that was a very nice and unexpected outcome which took away a lot of the guilt involved when dad and I made that very difficult decision and my brother was dead against it. Even he came round once he saw how much happier she was there.
Have you involved social services for mobility type aids and so on?

Your wife sounds like she needs a week or two away from it all and mum in a home, you could take it from there?

You really shouldn't be lifting her. Does she have a hoist. It's much safer.

I think just saying you can't do it any more is fine. It's honest, clear and you're explaining your own feelings. There's no way to misunderstand it.

Quite clearly your MIL needs to be in residential care, probably permanently though I agree about starting with a temporary setup.

I hope that you can get emergency respite care arranged and go from there. Try your local Adult Social Services.

This is so tough for you but I also understand anyone's decision to care for parents at home. I have done it for my Mum and now for my Dad and it is not easy.

However, from what you say about your MIL it is time to look to get some help that you deserve. Firstly speak to Adult Social Care and her GP about her entitlement for care. Also, speak to them about Continuing Health Care. This is notoriously hard to get but it doesn't mean that your MIL is not entitled to it.

Speak to Beacon with regards to Continuing Health Care and also read the CHC framework because lots of social care services avoid trying to go through the assessment process but don't be swayed if you read the framework and you think your Mother fits the criteria then fight for it. We managed to get for my parent and it made a massive difference to have help for her and for me.

Good luck it is such a hard time for you both.

I work for an aged care provider. Incontinence is a major factor in many people moving into residential aged care. It is 24-7 care and can’t be managed with visiting carers as you can’t allow people to sit around in soiled clothes or sanitary products until the carer arrives. And many people feel unable to manage such personal care for a relative. I couldn’t do it for my mother.

I agree that respite care would be a good first step. A couple of weeks so you can rest and have time to speak openly to one another. I think you are well within your rights to be honest about what you can and cannot manage in your own home. The current situation is clearly untenable.

It's fine to say you are close to finding it unbearable, and that you are concerned the strain is getting too much for DW too. Also fine to say that something needs to change before you both burn out.

Then listen to DW and work out a way ahead together (there are some very sensible suggestions on this thread).

It might be that a home is the best option, but let that come from discussion, rather than you presenting a solution before you've both aired what you each think right now

You have my sympathies. It's incredibly hard looking after our older family in our own homes. I've done it for a few months for my Mum (terminally ill) and for a few weeks for my MIL (waiting for care home space)
I think once incontinence is an issue you really need outside help. Be it carers or residential care.
This will make you both ill and you should talk to your wife. There are compromises that will give you all better quality of life.

You can get home visits from carers. It is subsidised for low income families. I think up to four visits a day so help with washing/dressing/toileting/medication/feeding. I am sure she would not want to be dehumanised.

ps, you are NOT selfish not to want this.

I don't know what's so bad about saying ''I cannot do this any more''. Your wife is exhausted too and it's her mother, she must be able to understand that you feel you have reached the wall?

This is a common problem , the decision to put an elderly parent in to a home. But god almighty, she's doubly incontinent, nobody's going to judge you.

Good luck with this conversation. PS, i see what people are saying with the don't tell your wife, discuss it. But in this instance, a forceful position on your part, a firm stance so to speak, that could assuage any guilt she might feel?? Like, well, I had to, in the end, my husband told me no more.

I agree with the suggestion of getting her into respite care for a week or two.
it will be hard for your wife to think clearly whilst she is in the thick of caring for her mother.

How about you tell her you see how exhausted she is and would like her to have a break for a week. Suggest putting MIL into a respite home for a week so that you both get a break, then after a few days of being free, maybe suggest looking into more long term solutions so that you all get the best of both worlds. You and your wife get free time apart and together and MIL gets more people to care for her that means she has more freedom too, as a lot of care homes have activities on during the day that will help occupy her.