Advice for future-proofing MIL

[PerformativeBewilderment]

I’m a recent arrival in these parts and would love to get some advice from the wise folk who’ve travelled the road ahead.

FIL recently passed away after a long illness, and MIL is now living alone. She’s late 70s, definitely showing signs of cognitive decline, drinks pretty heavily, physically frail with a few minor falls yet somehow no major ailments or regular medication.

FIL was the practical one who handled all admin, finances, planning, driving, etc and MIL basically wants DH to step into his shoes. He has LPOA for finance, which MIL wants him to enact and manage all the finances. She’ll be self funding any care, if / when that is needed.

Her home is large and old, requiring a lot of maintenance. She currently pays for a weekly cleaner and monthly gardener. She lives in a village with close community ties, although she’s reluctant to do much beyond host visitors for wine a cuppa.

She doesn’t drive but has access to a bus into town and her village shop is excellent.
She can’t use any technology - she has a landline with a few pre-programmed important numbers, handwrites letters instead of emails, watches repeats on ITV4 rather than using BBC iPlayer - and has a card for a ‘day-to-day kitty’ bank account.

DH has a tricky relationship with her, and is grieving his Dad while trying to manage his Mum. We’re an hours drive away and have kept pretty good boundaries so far, but we haven’t had any crises yet.

Based on the hard-won expertise on these boards, what should we be doing now while the going is still relatively good?

It sounds to me like the biggest problem might be the house. Is it somewhere that could be adapted to ground-floor living if necessary, or is it completely unsuitable for wheelchairs/limited mobility? And how bad is the 'high maintenance' - is it just of the level of ''needs a lick of paint and a lot of cleaning, or more 'leaking roof, windows that won't shut, and a boiler installed in 1973'?

Is there anywhere in the village that might be suitable for her to downsize to in due course, or are you going to have to wait for things to become impossible then move her to a care home nearer to you?

Do you think she would accept carer visits when they become necessary, or is she going to insist on her independence, ie that you and DH do everything for her?

@PerformativeBewilderment there is an excellent group on here called the cockroach cafe....its for people who are dealing with elderly relatives and all the associated problems.
As @exexpat said how bad is the house??
This will be the main stumbling block and how accepting your mil is for having help.

I'm about 6 years ahead of you.

The technology issue is the most annoying, but the post office still accepts debit card payment for bills.
I tried to get her to set up direct debits, but that was frowned at.
I have to investigate and look things up for her online but generally it's fine.

Well, you said she has definite signs of cognitive decline. Along with the other issues you mentioned, it seems like it is time for changes.

I would first gather info. from people who are knowledgeable about the details of what an appropriate setting would be for her at this point, what's available in your area, the costs, and getting her to comply. Then you'll be ready to make a solid plan. I hope it goes smoothly.

Thanks all - I’ve been lurking quietly in the cafe already but selfishly wanted my own post. I’ll be sure to check in and get settled with a hot drink.

The house is a Georgian coachhouse and totally unsuited to ground-floor living - thick walls, no downstairs bathroom, potential to install a stairlift but we foresee regular technical user-issues. Currently it’s somewhere in between exexpat‘s extremes - now it ‘just’ needs a lot of cleaning, regular maintenance to windows, woodwork, chimneys, etc. FIL was too ill to do the little jobs for the past few years, and they have become much bigger jobs that are going to need some professional input.

MIL might just about consider downsizing in order to stay in the village but the smaller options are limited. We’re also concerned that the cognitive decline would be more pronounced in an unfamiliar home and she’d end up needing a lot more care.

Info gathering sounds like a good place to start - do we need some kind of authorisation to discuss her with the GP or local services?

You can speak to her GP if you're worried.
I just filled out the form online and they set up an appointment to discuss.

I have noticed that nothing seems to be linked, so the hospital tells the GP stuff, but doesn't seem to then say 'you should check everything is ok in 3 months'.
And the hospital says, contact the council about falls prevention, which you do, but it's a black hole, who can't see her notes and don't answer the phone

My advice would be to start ‘networking’ with the community, her friends, neighbours. You’ll need support and people on the ground to report back when things go downhill.

Can you join any local Facebook groups then use these as a good way to learn about other services that might be helpful? Also line up handymen and trades this way via recommendations.

I’m afraid I would bite the bullet re taking on the finances, because so much depends on how much cash she has. I don’t blame your Dh for not wanting to do it, but contacting the bank and getting set up with whatever they will offer (ideally full access and a PoA debit card) means that he can manage things at a distance and set things up tbh to be as convenient for him as possible. The sooner he finds out whether she can actually afford the life she has, and what kinds of resources she has for the future, the better. She may not be a fan of online banking but I doubt she would actually prevent your Dh from setting it up (if I’m honest I set up my own online access without telling my mum, even though she had capacity then - the things she wanted me to do were infinitely easier online and I was not going to spend every Saturday morning queuing up at the bank for her, even if the bank branch itself were still available.)

If she has any random little bank accounts and shareholdings, start getting those rationalised into fewer accounts asap, it takes FOREVER.

As far as the practicalities of where she is living, I would say don’t panic. TBH very little is selling right now so downsizing is much less accessible anyway. It is amazing what people will put up with to stay at home - sleeping on a chair, strip wash at the sink etc etc. The importance of familiar local routines and contacts becomes exponentially greater with cognitive decline.

Could have written a lot of this myself - my DM is wilfully helpless and expects men to sort out her life for her in DF’s absence. The main issue with mine is that she simply doesn’t see it as her responsibility and that people are being mean if they don’t do everything for her. All her friends’ husbands avoid her like the plague as she shamelessly presents lists of jobs she needs doing from tech-related to DIY, investment advice to calling utility companies. She just refuses to do things for herself. My advice is don’t do everything - it’s a slippery slope. Make her retain some level of responsibility. I really wish I had. DM just bleats and cries if she has to do life admin of her own now, even things she’s arguably totally capable of.

Make sure she gets her steps in every day and talks to people. Being at home too often can lead to loss of mobility and confidence quite quickly and the more human interaction she can muster, the better.
DH having POA is vital, even if you don’t need it for a decade.
I’d echo what PP have said about rationalising finances and getting your DH to maybe be a signatory on her current a/c or be able to do internet banking on her behalf. Yes it’s a chore but believe me it’s a million times worse if your DM loses capacity and you have no means to assist in the paying of her bills.
The big house needs careful thought - Selling houses is so brutal right now. I’d brainstorm all the options for her house and try to work
out the least worse options . Maybe be aware of the rental market for a little one bed near her or near you.
Keysafe for her house should also be on your list.
Hats off to you getting on the front foot now.

Her wanting the finances taken over is a huge plus. Yes, it's a pain to do - but being able to audit and rationalise it all now is far easier than having to plunge into a total mess in a few years time when she doesn't have capacity to answer questions about it.

Unlike the finance one, the health LPA only takes effect after she loses capacity. Before then you can give information to GP, social services etc; but unless she gives them permission they won't give you any info in response (whether they act on info you give them is variable).

If possible, get her to make an advance decision/statement of wishes about what health care she does or doesn't want in various circumstances. DNAs only cover cardiopulmonary resuscitation, there are a lot of less drastic treatments she may have views on. There are templates online that can take you through the various If-Thens.

Start researching care homes, extra care housing etc in her area and yours (and think about whether near you or near any existig social network she has would be best). She may not need it, and places do change so if she does need to move into one you'll always need to do some last minute work to confirm decisions, but it helps to have at least a longlist rather than starting from scratch if there's an emergency.