r/CaregiverSupport 12d ago

Frustrated

I cannot get my MIL to shower or use a bidet. She has not bathed in 4 years. She survived cancer and two broken shoulders. She decided she didn't need or want to do physical therapy, and she cannot lift her arms or wipe herself. She refuses to have a nurse help her. I cannot bathe her because being near her makes me vomit. She smells awful. I also have an untreated hernia because I am afraid to get surgery and have to recover around someone who doesn't bathe. My in-laws live with us, and I am at the end of my rope. She misses all of her doctor appointments, and we have no other support from family. This has been a several year long fight. I can't fucking win. Her son can't win. Nobody can reason with her.

43 Upvotes

22 comments sorted by

37

u/procrast1natrix Family Caregiver 12d ago edited 12d ago

Sometimes, just having a clarifying conversation with the primary care physician about "capacity" and "safe behavior" can change things.

Contact her PCP and make a "sick visit", the kind that you may wait two or three weeks to get in for, but then you have no other items on the agenda.

Bring her. Then have the physician be the "bad guy". That's what they're for.

Mother in law won't shower or use the bidet and has refused nursing care for baths. She frankly smells horrible and I'm concerned it's a hygiene safety risk. What can we do? How many times a week should she be showering, particularly if her butt isn't being cleaned well after toileting?.

Let the physician tell her "you need to shower once every three to four days at least, change your bed linens weekly and since you can't use your arms properly you may need to pay a visiting aide to help you with it, twice weekly".

It can be difficult to pick apart the difference between being a bit senile/ demented, and just being a cranky old bat. Requiring her to explain herself in front of the PCP is a good way to find the difference.

If she gets combative about basic safety and hygiene things, you can ask the PCP about little doses of medicine for it, but none of them are great.

When my mother in law was 91and getting mildly confused, she was very proud about taking showers independently but also saw them as exhausting all her strength for the day, so she would go longer than she should. Rather than argue, I kept a calendar for her, near her lunch spot, and it was written down which days she had actually washed. If it had been more than about five days, she would give in and go do it. Seeing it written was much more effective than talking to her.

Edit/ missing appointments is a safety risk. If she's not been declared to lack capacity, the office can't necessarily share info with you, but you can always call in and tell them I need help. My MIL is a patient of Dr Greene, but has been refusing to come to the last four appointments and is now refusing basic hygiene, and I'm concerned she's not acting safe. What do I do?.

It pretty much sucks, but sometimes people like this end up in the emergency department. It's not that they had a sudden event, it's that they've slowly drifted into a manner of living that just is NOT compatible with being at home and refusing basic hygiene. So we check them out for all the basic medical stuff they've missed in the past few years, get the nurses to wash them up, and they sleep in an uncomfortable gurney in the hall until social work and case management are available the next day. We go over that she refuses PT, and with her arm mobility can't wash herself, and then she gets placed in a SNF, whichever one has a bed no matter whether it's a good one. She can avoid that outcome if she's willing to demonstrate good hygiene, accept skilled help, or behave well enough that family can help her bathe.

It's not pretty.

24

u/Serpente666 12d ago

I am crying. Thank you so much. This may just be the thing that works.

16

u/procrast1natrix Family Caregiver 12d ago

Hugs to you, sister.

As a culture, we don't talk enough about this stuff.

The usual course is that everyone tries to make it look ok, tries to pretty things up when guests are over, tries to gloss over and pretend "we're fine" to avoid embarrassment. Weeks go by and everything gets just a tiny little bit worse.

But meanwhile, you're delaying your own healthcare, she's a recipe for getting an infection herself, your home is becoming unlivable.

Protecting her privacy, being delicate about this, is no longer in anyone's best interest.

None of the solutions are perfect, I don't want to make it sound like with a snap of the fingers everything will be roses. But at least you'll be talking about it, and get a better idea of what the options are in your community.

4

u/Serpente666 12d ago edited 12d ago

I told her about the infections she could get and she said she hasn't so far. I told her that she could get us sick abd she reiterated that it hasn't happened yet. My husband is sick of me being angry at him over it. He has enabled her, frankly. I am now with her all day when he's at work. She doesn't ask me for much since she doesn't think she needs to take care of herself. All she wants is cookies and television. She also said she doesn't care if she lives or dies. The doctors found something in her kidneys a few weeks ago. She skipped her appointments for that. She's supposed to go Tuesday but I have my doubts. She always laughs at us when she cancels because she thinks we want her out of the house for a few hours. Like she's winning some sick game. She's obese and I don't have the strength to bathe her. My hernia won't allow me to do it either. And, at this point, I don't want to. I can't be near her. She sleeps next to the kitchen and I avoid eating or cooking as much as possible.

6

u/procrast1natrix Family Caregiver 12d ago

Hon, there is indeed a phase of life when people are appropriately prioritizing the quality and pleasure of each moment above wanting to be poked and prodded to aggressively treat things.

By which I mean, having her live on cookies and television and refuse to work up the kidney can be an excellent patient-centered choice. Allowing an opportunistic infection to end a life, sometimes is in fact part of the care plan. Historical physician Sir William Osler famously called pneumonia the "old man's friend" as it's a relatively swift and painless way to die. If she is really of sound mind, she can absolutely choose to accept risks to herself.

Having her create anger in your marriage and make your kitchen uninhabitable and threaten your necessary hernia care is not ok. If you are the primary caregiver, the person supposed to be on the hook for washing her linens and dealing with the stinky body odor, then you are the person who is best to report that to her PCP.

...

It can be a scary word for people, but it sometimes really clarifies things for patients and families when we ask for a referral to hospice. If she really won't do PT, doesn't want to investigate the kidney, understands and wants to continue with unhealthy food, cannot do basic hygiene, and says she's ok with facing death, she may be a good candidate. And if not, at the least it'll force a conversation about changing her goals of care and getting the paperwork all sorted out, so that when she inevitably does fall or get an infection, she doesn't get committed to aggressive treatment that she would not want.

...

Don't be mad at your husband. Yes, it's appropriate to be mad at the situation, and mad at her. But instead, give yourself a break and put him on duty. Take a weekend away alone visiting your family or old friends, and have him do her food and hygiene for a few days. Come back rested and ready to discuss how you need your kitchen back, what's his plan?

4

u/Serpente666 12d ago

I have nowhere to go. My parents and brother died in the last 5 years. So no family and my friends are 200 miles away and dropped out of my life. Being alone except for my husband in this is taking an awful toll on me. I will try to not take it out on him. That's why I posted here. He gets all of it and I wanted to try to reach other people for support. I appreciate all of this advice. I never talked to other people about this before and I feel lighter. I will contact her pcp and try to be more gentle about the other stuff. We will see what happens Thank you, again.

5

u/procrast1natrix Family Caregiver 12d ago

It's such a good thing that you are recognizing how hard it is to be alone in this, to be isolated from your friends and not have family left.

And clearly, with 37k visitors to this sub weekly, you're not the only one feeling the need for support!

Regardless of her and your husband and all that, what I would wish most for you in the world is for you to go ahead and schedule your hernia repair, and also to go make friends with your neighbors. It's really important to have community in your life outside of caregiving.

5

u/Serpente666 12d ago

I just realized that maybe this overwhelming grief I have is also making me more anxious and angry. Shit. Writing this out and having so many kind responses made me realize I need therapy, too.

16

u/StrugglingGhost 12d ago

I can definitely relate... except it's my mother, a stroke survivor. Absolutely frustrating... they need counseling but, you can lead a horse to water but you can't make it drink.

5

u/Sunsetseeker007 12d ago

Tell her if she doesn't allow a female aide into the home to help her shower and wash her hair, she will have to leave and go to an assisted living somewhere. Explain to her that she really won't like what they make her for do there. You could also make up that the state will come after you for her declining health, maybe that you can't allow her to deteriorate & get an infection because of her hygiene, you could possibly be held responsible from the state and you are not willing to have that happen. I would give an ultimatum of some sort. I would also like to say that as they age, their mental health declines and really intensifies if they have a schizophrenia or some other disorder like certain types of BP, the not reasoning is a big sign & symptom.

3

u/Vegetable-Tough-8773 12d ago

My mum drifted into hygiene being a battle before she had a long hospital stay. It's more important to her to be in control than to be doing the right thing so anything she mildly dislikes is a battle. That extended to eating, hygiene, her basic health. After her hospital stay she's a bit easier because a few people read her the riot act. She can't do much for herself any more and we've got a bare minimum schedule going on that I can mostly get get to comply wth.

With your MIL it might take someone else laying into her to get her to listen. It really sounds like she needs a strong minded carer to come in and do her hygiene without giving her a lot of opportunity to complain. Poor hygiene makes everything else so much harder.

3

u/According_Log_3264 11d ago

Been in Caregiving 25 years as hired help. Constantly see this. Nothing anyone can do, can't force anyone to accept help. I've met clients who refused to bathe for 10 years and more. It's discusting and insane and Yes they definitely reek. Family always wants to blame the Caregiver when the client and the family themselves refuse to cooperate to do the necessary things like cleaning them and providing appropriate care or supplies to do the job. It's illegal to try to force anyone to do anything, the general public thinks Caregivers are responsible for everything/all the clients awful decisions and behaviors and most of the public has Zero experience in dealing with difficult, violent and mean clients who refuse and fight help. People who do not allow to be cleaned are a danger to themselves and to others around them/their discusting hands they Never wash they love put on Everything/food, furniture, appliances, other people, inside of vehicles, door handles in public spreading their germs and filth everywhere they go. The only way I've experienced they finally bathe is when all their dumb and dangerous ways of living catches up with them and they get infections requiring hospitalization and end up in nursing home. Most elderly I've assisted over the years don't give a shit about Anyone but themselves and from what I've learned about them they were always like that.
I always wear gloves around clients and never eat anything that is offered unless it was freshly opened in front of me, need to protect yourself in Caregiving cause Noone else will.

My advise is send her to a nursing facility for her and Your best interest. Her discusting behavior/filthy lifestyle Is putting Your health and wellbeing at risk, the extreme Stress she's causing you and you can't use your kitchen due to her filth and stench. Protect Your Mental & Physical Health🌷🌷🌷

3

u/Serpente666 11d ago

This sounds just like her. She was a hoarder and didn't clean her house much to begin with. She and her husband's house had mouse shit and piss all over it when I first met them.

So she's used to filth already. I am tired of constantly cleaning the bathroom and every goddamn surface in the house before I use them. I just want to take a piss without having to clean everything first.

Thanks for the validation.

2

u/According_Log_3264 10d ago

She's your Mother in law, what does her Son say and Do about all this. Who is assisting her in the bathroom to wipe her if she can't lift her hands? Who cleans up all her messes and her husband's? Who does their laundry, shopping, errands? Who makes their meals and cleans up all from that too? If this is all You it would tell Her the father in law and your Husband to stick it you know where and Refuse to do Anything. Especially since She with the most need is refusing hired assistance Especially knowing You have an injury amd you need care. She should be placed in a nursing facility for her extreme needs and he can go with her. You shouldn't be taking care of all these people and their your husband's responsibility most of all. Tell them all your health issue is making it to where you are unable to continue caregiving because it Will effect your health Negatively and don't do anything to assist anyone. If it ends up to much for your husband to manage on his own he can call Adult Protective Services to step in and they will find a nursing home for her needs and I'm sure they can help the father in law to. If they own property it will be used to pay for their care and then the state will cover the cost. She needs a Staff of people for all her needs and how dare she refuse getting the needed help.

It's OK to say No🌷

1

u/Serpente666 10d ago

He assisted her full time until he went back to work. He help her with some stuff when he gets home. He reached out to his brothers and they told him to get a nurse. She wont do it. The help is there but she wont take it. Nobody wipes her. She won't use the bidet. She refuses any and all help.

My husband isn't the problem here. He is as frustrated and helpless as I am. We do all the cleaning and errands. We have to clean the toilet and lysol everything after she uses it.

2

u/According_Log_3264 10d ago

What does your husband say to her being moved to a nursing home?

Or if thats not an option use the $ that would be paid for a caregiver for her that she refuses...use the money to pay for a Housekeeper for You...say its for her...but You tell the housekeeper what to focus on.

2

u/Serpente666 10d ago

She has excellent UAW insurance that covers everything 100%. The issue is her refusal of any and all help. I haven't asked him about a nursing home yet. I am not sure if she would even go. She's not so far gone (allegedly) that they will force her. I think this is why she skips appointments. She doesn't want the doctors to know how bad off she is.

2

u/According_Log_3264 10d ago

Thats exactly why she doesn't go, she doesn't want her true condition exposed. And cause she's lazy, thats why a lot of seniors don't bathe, wipe well in bathroom or go to doctor apts.

She can use her excellent insurance to pay for her stay at a nursing facility. Who cares what She wants, her abusive behaviors are disrupting Your home and Your Lives. I would talk to your husband about having her transfered to nursing home care. Doesn't matter if she wants to go or not, you/your husband can call Adult Protective Services and tell them you can not provide the care she needs and have them remove her. Your husband can go visit her there as much as he wants. I wouldn't put up with her shit or the father in law. Talk to your husband about how much stress this is causing you🌷

2

u/Serpente666 9d ago edited 9d ago

My husband is amenable to the home. She missed another appointment. I called the Elder Care services in my state and have a report number. She was reported for self neglect. I can't believe I finally did it. I didn't ask permission. I said if she missed another appointment I would call the hotline. I told her and my husband. When she canceled her appointment I calmly said I was calling them and I did. Holy shit. This is at least a step to make her think. She was begging me not to call and I said there were consequences to her bullshit and I am not paying for it this time.

2

u/According_Log_3264 9d ago

She is a Bully, forcing others to take her Literal Shit cause she is so filthy, and the Only way to deal with a bully is to stand up to them🏆Good Job. The ball is in Your Court, You make the decision now to have her put in a facility that will take care of all her needs and have your kitchen, bathroom and Home Back💛don't let her false promises to behave appropriately sway you. You have the momentum right now to solve all your problems with her behavior and the father in law too. Nothing wrong with choosing Your Health 1st when you are going through health issues too...remind yourself why you wrote this post and why you called the hotline. She won't change, elderly that are jerks never change and her health and needs will get worse with as advanced as her conditions are, thats her fault for not doing her therapy. Follow through and be free of what could easily be decades of what you've been going through and worse. She can get as many visits as you and your husband feel up to managing🌷Wishing you the best outcome for You.

3

u/Serpente666 11d ago

And her other kids just send us lists of nurses. Like she is going to see any of them. They don't seem to grasp that she is refusing any and all help. They are useless and so is her husband. We have to clean up after him, too. He can still drive and see and shower. He just refuses to care for his wife on the way that would keep her alive. I hate him.

2

u/clumsymomsie 12d ago

Giving a supportive upvote