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I'm the primary caregiver of my MIL with ALZ(2 yrs now). We have looked in to ALF for her and have decided on one, but she has stated she isn't ready to go there yet. Her children (my hubby) and daughter (who lives out of state) know she needs to go into a place, but at the same time don't want to go against her. She has care come in in the mornings and meals delivered everyday. I go in l afternoons to get night meds ready and get the mail etc. It has gotten where she forgets that meals are coming and will leave with friends that sporadically drop by, who also don't see her often enough, or understand the situation. Therefore I get the calls from places saying she's not answering is everything ok? So, I have to try calling her, (if she answers her cell phone) or going over there. I could go on with more examples, but am I wrong to feel like it is time for the move now?

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After giving this question a bit more attention. I don’t know if any of us can really give you an accurate answer.

If we are judging your experience according to our own experiences, that isn’t fair to you, because we may have totally different situations.

You’re the only person who can really answer this. Sometimes, it really is so hard to determine what is the best way to go. So, we feel like we need guidance from others.

I hope you find help from our individual opinions and figure out what is best for your particular situation.

Best wishes to you.
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Set up a room the the facility placing furniture, pictures, tv, bed in relatively the same place as her home. Take her on a day trip with lunch then when you return take her to the new place and refer to it as home. "I'm so glad we are home" " now that we are home we can relax in our chair"
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Hire a Live In caregiver .
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Have you considered a live-in companion for your MIL as an alternative to going into an AL facility? You might think it's time for her to be moved into AL but maybe she isn't. From how you're describing your MIL here, she doesn't sound ready for AL yet if it's not what she wants. She still needs a higher level of care then she's getting though. Look at hiring a live-in companion. They will cook and clean, make sure she takes her meds, take her to appointments, and basically make sure everything is running safely.
This could be a workable instead of her having to move out of her home. Cheapter too.
Also, if she has care coming in the mornings, meals delivered, and still lives alone in her own home, you are not her primary caregiver. Checking on someone in the evenings and picking up their mail really doesn't count as one.
I have 25 years in homecare so I'm letting you know this as a friend. The time's coming where care facilities AL, MC, NH, rehab... will likely become part of your MIL's life and your family's.
Don't refer to yourself as her 'primary caregiver' to any of the people associated with these places like nurses, administrators, or social workers because they will try to hold you to that and make you literally responsible for her if something happens.
Look into live-in companionship. If you and your family think this would be a good idea, I recommend hiring privately from a site like care.com this way you can negotiate the wages and do your own backround and reference checks.
Also, always hire more than one person. Either they split the week, or you have one who works the weekdays and another on weekends. Or have no one on weekends and family can take turns staying with her.
This way no one can make your MIL's home their residence. Never let a caregiver make someone's home their actual residence and mailing address.
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ventingisback Jul 2023
“Never let a caregiver make someone's home their actual residence and mailing address.”

Burnt, can you please explain to all of us, why that’s so important?
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If you are asking this question , the time is most likely now . Step back , stop doing . This will force her children to take action . Nothing will change if you keep shoring up your MIL . Tell your family you are done running over to MIL’s place . Do not have MIL move in with you .
MIL will never say she’s ready to go to a facility .
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BurntCaregiver Jul 2023
@Way

Not necessarily. A live-in companion may be a good fit for the MIL.
The OP makes no mention of her MIL's home being filthy and unsafe, or that she's not keeping up on her personal hygiene. So either the MIL is still able to look after her own personal needs or her morning help is doing it.
They should float the idea of live-in homemaker/companion to the MIL and include her in the interviewing process. This could be a good fit for her.
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You are not wrong and experiencing the reality of your MILs decline. I wonder if her children were more hands on with mom’s care, would they still not want ‘to go against her’? Maybe they (or at least your husband) can step in for you and care for mom to really see what is involved.

Wishing you the best!
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So the person who is cognitively impaired calls the shots? The next step is to start visiting places without her. Ask the marketing person which doctor forms are needed. You tell her that the doctor feels that she needs to move if she asks. Ask marketing for ideas on how to get her there. Usually it is on the premise that she is going to lunch, but you find the time to disappear.
Some families will gang up and tell the PWD that it is time to move. As far as your DH, start by showing him our answers here.
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Turn everything over to your husband exactly where it should be. Step away, if her children handle everything they will learn how difficult this caregiving thing is.

It is no longer what your MIL wants it is about needs and not just hers.

Stand up, set your boundaries.

Good Luck!
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Just a thought.

Give the caller your SIL or DH number. Let them handle. Give them a heads up one time that you are trying to reduce your stress and will be forwarding the callers. Take your number off all her business give them the sibs numbers.

Also they might try cameras. Sibs can see who comes and goes. Ask sibs to hire someone to take your place in the evenings. They can forward the mail.

MIL not being ready to go is not your responsibility. I assume you are not the decision maker on that so don’t enable it to go on.

It takes a long time to get emotionally healthy after abusing yourself when you know you have to stop. I truly don’t think I’ll ever recover.

Don’t ignore your own health as sibs seem willing to do. Think of them like MIL friends. They don’t know, can’t see the condition you are in. You have most likely trained them that you will take care of things. Take some responsibility on that. You don’t have to fix it. You just have to say, I’m out and mean it.

MIL may not be ready. They don’t want to push her. You understand. They need to do what they need to do. She is not in this alone. You are ready now. They can do what they want to do and should. It’s you that must stop, regardless of their concerns for MIL. You are two different people with different needs. You matter too.

The evening helper could be a permanent fixture for when she goes into care. There will always be something that needs doing until she passes. That doesn’t mean it is you that must do it. Perhaps she could move to her daughters area and it would be more convenient for daughter. They will work it out but not until they see it is up to them and not on you.

Let us know how you are doing. I know you were most likely trying to see it through but truly it can be years yet. If they find the right replacement for you they may be able to keep MIL home a few more years. Win Win.

Turn in your notice and step away. Good luck.
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Do it now. Her children break the news, and she goes ASAP. She isn’t safe.
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BurntCaregiver Jul 2023
@Fawnby

Would you want your own children (if you have them) to make you go ASAP from your home just like that?

Probably not. A person can be 'cognitively impaired' and not require facility placement to live safely. They can remain in their own homes with the right kind of help. If live-in homemakers/companions could work then people should try it.
If it doesn't work then placement in a facility appropriate for their care needs.
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When you, who seems to be the primary caregiver says it is time.
With dementia she has little to say on the matter.
She is doing things that are not safe. (leaving with friends, not answering the phone and forgetting there is someone that she should expect)
What if the person that was going to drop by was you to take her to a doctors appointment?
Her other options would be the caregiver becomes full time. And over night as well. Ya never know when she may wander out.
To drive the point home better back off and let your husband do ALL that you have been doing for mom. Let him field the calls from delivery people, let him go over and get meds ready, get the mail and everything else that you do. (write out all the "etc" items that you ended your list of chores with)
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I bet you do more than go in the afternoons to get her night meds ready and get the mail. Do you? Why not have H go over to get her night meds ready and take in the mail? (It's HIS mother, after all.)

I suspect you will be having more and more "mission creep." It's already happening when she isn't there, YOU get the call, and then YOU have to go over there.

As long as you are the apparent solution, H and SIL will be happy to keep her at home.
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First of all, I am sorry for the additional stress that is going on in your life right now I know that it’s hard on you. I cared for my parents. It’s a tough job!

I toured assisted living facilities and skilled nursing facilities. I specifically asked the question, ‘When is the best time for a person to enter the facility?’

Every place gave me the same answer, “Don’t wait until it is absolutely necessary! It is better to place a person sooner so that they can adjust better to their new surroundings.”

Wishing you and your family all the best.
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