To investigate moving MIL in with me?

[CoffeePhoenix]

MIL fell and broke her hip last week. She's in her 80s. If she were to ever be in a position to leave hospital, would I be unreasonable in offering her a place to stay?

She lives with SIL but she is out of her depth with her needs. It seems clear that you would need call in doctors after a bad fall / repeated falls in one evening (pre covid)(especially when she doesn't normally have falls - it was unusual) but if MIL says no, SIL won't do it. (That time MIL was actually very seriously ill with sepsis and the delay to seeking help nearly killed her)

So. I'm thinking of seeing if she can stay with us. But I don't know what support will be offered - she had district nurses around a lot at her house but we're a different area. She's frail, can't walk much and we're worried that the broken hip is going to end what little mobility she had left. Would there be any support available? Any one to help me get her up in the mornings / washed? Actually just washed. That's what I'm really worried about...

Is this a terrible idea? I'm not sure what alternatives there are especially in the time of covid...

The care package comes in two parts: she should be discharged with a 6 week ‘enablement’ package to help her get back home. Up to 4 visits a day to get up, shower, toilet, get into nightwear. This is usually NHS funded. Then , if needed, Adult Social Care can provide Continuing Care. Again, generally up to 4 visits a day. You can start on establishing Continuing Care whilst Enablement is in progress. Age UK are very helpful; read their website about care entitlement and processes.

You don’t get much choice of time of visit: she may be showering at 7.30 am and in nightclothes by 4.30.

Has she applied for Attendance Allowance? I don’t think this is means tested and it can help towards any private provision you put in place.

Don’t underestimate how much work it is , and how wearing, caring for a person with increasing needs. And I wouldn’t put so much blame on your SIL. It is emotionally very hard taking away the independence of someone who does want to lose it, and your MIL is still entitled to make her own choices and decisions.

If you are at home all day with her then you're very unlikely to get a package of care. There are severe shortages in social care, it has to be prioritised to those with critical need. A package for your mil means no package for someone else.

I would suggest you consider very carefully what you are offering. You will be MIL sole carer which costs time and money. It is exhausting and there are no breaks. It is hard and stressful. A POC will be arranged but will be assessed by SW or OT In Hospital with equipment. Carer calls by nature are not always on time and though might be for 30 mins 3x a day you might not get the full time. Trying to increase the POC with social services or get more equipment is very difficult.
Your MIL may be a delightful person but she may find it difficult to adapt as older people often do. She may feel resentment and no longer in control of her own life. Only you know how she may behave if she feels like that. It may be confusing for her and although she needs a lot of support she may prefer to have it in her own home.
I work with people who have a relative home from hospital and very quickly find it difficult to cope. You cannot send them back.
You also cannot promise she will note go into placement to a care or nursing home. Because what is important is MILs needs being met.
It sounds doom And gloom but really it's about the day to day practicalities of being a carer yourself rather than the relationships you have with your MIL as her daughter in law.

I'm sorry this is going on. Its awful to see someone decline this way.
What does your DH think about it all? I assume its his mother if i've read the thread correctly?

Have you considered getting a power of attourney in place incase things decline mentally in future too?

Is your home step free from bathroom, bedroom etc? Is your bathroom accessible for a wheelchair/shower chair? Is the SIL's home set up as such and accessible? Do you have space for a hospital bed which raises up and down? Can she easily get in and out of your car for hospital/Dr's visits?

I agree with others than SIL might be out of her depth in terms of increasing care needs and just exhausted. Did you or any other family members ever provide respite for SIL to give HER a break? Rather than her suddenly moving to yours, could she stay at SIL's, but you and DH provide more support there? Could SIl help at your home?

Assessments for OTs, physios etc can take ages, plus the time needed to order and fit medical equipment. Caring is a full time job and without significant help and support, can be utterly draining. best of luck x

She's not scared of me, she trusts me and we have a different relationship than she had with her children obviously...

thats the key and if that means staying with you is best then do what is in her best interests

With your MIL being in hospital you are likely to find it easier to get the help required for getting MIL home to your home etc than if she wasn't in hospital

care package and equipment etc

I meant to add another question to yourself. WIll DH be helping in providing the care to his mother, or will it ALL be down to you? Would you both be willing to provide intimate, personal care such as washing, toileting, wiping etc? Would he be doing this for his mother if you were out getting food etc???

At the end of the day, if your MIL has mental capacity it’s up to her where she lives. The person to blame for her fall is herself, not your sister in law. It’s terribly hard to watch someone being stubborn and putting themselves at risk, but it’s her choice.

I had a similar situation myself with an elderly friend. It was very hard for us and her family, knowing she was having occasional falls and struggling, but she really didn’t want to leave her home, or have carers coming in to help. We did all we could to support and keep her safe, but ultimately it wasn’t until she recognised for herself that she wasn’t coping (after another fall) that adequate care could be arranged.

How would you feel being railroaded into leaving your home by a “bossy” DIL if you were in her position? I’m not trying to wind you up, I’m just suggesting you give a little more weight to considering her wishes and work out something from there.

Have you really thought this through? You say you will only need help to get her washed and up? Will she be upstairs confined to a bedroom and reliant on you for all of her drinks and food or do you forsee her being able to be self caring during the day? How do you plan to meet her needs as her needs increase going forward? Make sure you have thought this through properly, Who will provide respite if you want to go away? This is a huge decission, how does MIL feel about it, leaving her home?

Olympicsrock, I dont know what field of medicine you work in but clearly not rehab. Go and read up on discharge to assess policies. And to tell the OP to lie about having a bad back and to start insisting on what she wants when she doesn't know what is even available in that area? Awful advice. Please dont do this OP.
Meowmeowlikeacow gives excellent advice.
There are services in place to help you, they do this every day, your MIL will get assessed by OTs and Physios and will get rehab at home provided (usually for up to 6 weeks free).
There is no need to go in all guns blazing. The staff want to help you.

Putting aside the health issues, would you be happy having your MIL living with you for the rest of her life, eating at your table everyday, sitting watching TV with you etc. because whilst I love both my DM and my DMIL no way on earth would I want them with me everyday.

I know someone who said they would take in their elderly FIL thinking it would be for a couple of years. Seven years later she is at breaking point, is fed up of never being able to watch what she wants on TV, he has become quite cantankerous and demanding and her marriage is in trouble partly because her DH (out at work all day) will neither help with any of it or understand how hard it is for her. But she feels she signed up for it so can't back out now.

My MIL has rapidly deteriorating dementia and both DH and I are adamant that she will not move in with us when FIL dies. FIL struggles with her at the moment, there is no way that I will make my DD live with that. Luckily they have money that they can throw at the problem. I think people underestimate how difficult it can be caring for elderly people, especially when you cannot go home at the end of the day and forget about it.

Do not underestimate the commitment you will be taking on here. MIL is only going to get more and more frail as time goes on. If you are 'lucky' enough to get a care package funded do not be surprised when carers don't turn up - I've been through this with DM, DD (who was severely disabled) and also DFIL. In DM's case she lived alone so there was no one to pick up the slack when carers didn't appear (she lived 75+ miles away) including on the day she was discharged from hospital after she broke her hip, when the hospital 'forgot' to initiate the care package and DM was left sitting in a chair exactly where the ambulance crew had left her with no food/drink - which the carers were meant to come in and prepare, and unable to get into bed. Out of sight us very much out of mind where social care is concerned - and that was before Covid.

Just in this situation myself. Dad in hospital trying to sort care package out. But unable to at the moment lack of funds. Transferring him to intermediate care. He unable to walk at the moment.
He also mum carer as well. I looking after my. At the moment until they sort it all out. He didn't want social services involved but they need to be. I only been looking after mum for a few weeks but I am drained already. Able to have a break for 24 hours at weekend.

I actually think you will get care help, we did! DGM had a fall and hurt her back so ended up in hospital who wouldn't discharge her until care was in place as being in the hospital weakened her legs they kept her in that long.

She lived with DM anyway who was home all the time and they knew that and still arranged care. It was put in place by the council but through an external care organisation and the council paid for it. That was two carers, four times a day to come in and get her up and dressed, couple of loo breaks and then got her ready for bed.There was also the option that DM could have been a second carer which would have allowed a lot more flexibility with times but DMs back is bad so two were needed.

This was all very recent but I suppose it depends on where you are and what care is available.

The therapists on the ward should be able to assist with discharge planning. Ultimately if your MIL has capacity the decision will be hers, and people with capacity have the right to make unwise fucking ridiculous choices.

Depends what area you are in but the discharge to assess model is definitely running here - they will try and get her out as soon as possible. They might try and arrange care prior to discharge or they might leave it to a team like ours to do on discharge. We're trying to help everyone but we're inundated and if there's any chance a family can support well grab at that chance.

I'd phone the ward and try and have an open conversation with the discharge coordinator/ward therapists.

@ineedaholidaynow

Is your house set up to cope with someone who has limited mobility and has a history of falling? Would she be able to move around rooms, get to her bedroom/bathroom?

This is an issue. As well as talking to the Ward Sister, you also need to make sure that the hospital's Occupational Health team are involve - BEFORE she is discharged.

DO NOT let them discharge her to your house before a care plan is in place!

A friend had her elderly mother come and live with them after a heart attack as they didn't want to see her in a home. She was in her 90's and her prognosis was not good. Well, 5 years later, she is still there. My friend has had to adapt her home to cope, she cannot leave her mother alone and is now her sole carer (including intimate care) despite her own health not being that brilliant.
It's all very well being kind and doing the right thing, but caring for an elderly relative in your own home will damage relationships and may damage your health. It is unrelenting hard work, and it is very difficult to get help from any services because they are overstretched and underfunded. If they see you are at least half way coping they will leave you to get on with it, and will not assist you.
My advice is don't do it.

This is a big commitment and as local services are stretched and social care poorly funded you might not get as much support as your expect.

What if she gets worse and need more support? how will you cope?

You might get help during the day but what will happen if she needs help at night? are you able to lift a fully grown adult?

If I were you I would not take this on and instead use the time she is in hospital to look at other options.

Also, when someone has unrealistic expectations and doesn't want to accept their loss of independence is it often better to have healthcare professionals involved in making those decisions rather than just the family who might feel guilt and therefore prefer to go what the elderly person wants rather than what they really need to be safe...which might include going into a home.

Good points from @Reedwarbler.

Also, you're now going to be the one she's screaming at that she doesn't want to go to call the doctor/go to hospital.

You would want help with getting her dressed and you’ve repeatedly told your SIL not to let your mil do something, which caused her to fall. You sound very naive tbh and I’d be interested in listening to your Sil’s take on this.

I agree that you sound exceptionally naive. If you aren’t prepared to offer any personal care then she really isn’t likely to be better off living with you. Are you hoping there will be financial help for you and your husband for providing her with a home? It’s easy to criticise your SIL but you likely don’t know the full story. It’s rarely so simple.

@CoffeePhoenix stop blaming Dil for what her DM does.
You've obviously never been a carer and you're coming across as a know it all

My mam was a long time carer for her brother and df.I was a carer for my uncle after my DM died.

You have absolutely no idea what it does to you and your relationship.

I would seriously think about what's best for Mil . Because being a carer is time consuming,thankless job.

As someone who has dealt with various elderly relatives - the reality of state social care since 2010 is that you will get virtually nothing. Care will be prioritised for OAPs living alone, and even there it is scant. She will get a bit of physio after her fall, but that will be that.

She will need a lot of care and you will have to pay privately for it. If she refuses to, or in this case, can’t pay - you will be stuck.

You need to recognise that this will deteriorate further, and it’s not quite as simple as now she needs a nursing home and one is magicked up the next day

Please don’t criticise your sister in law. Until you’ve walked a mile in her shoes then you’ve no understanding of how difficult this is and how determined your mil behaves when she decides she wishes to do something.

Assuming you will be in charge and she will do as you say is in reality highly unlikely. Unless you physically will be with her 24/7 Ie at her side, and wrestling her to the ground to stop her.

@Ffsnosexallowed

If you are at home all day with her then you're very unlikely to get a package of care. There are severe shortages in social care, it has to be prioritised to those with critical need. A package for your mil means no package for someone else.

Yep.