How do we get Mom to see the need for longterm care?
My Mother-in-law is suffering from dementia, and the time has come for her to go into a home, as her husband is terminally ill with lung cancer and can no longer care for her. We are all finding it difficult, and do not know how to tell her, or how we will get her to agree. She has a caregiver in daily to help, but she thinks she manages quite well on her own- which she does not. Can you give any advice on the best way of dealing with this situation?
Expert Answer
Depending upon whether your mother-in-law has early or middle stage dementia, moving her at this time could prove challenging. Not because it is her choice or something that she needs to necessarily agree to, but because in her mind she is quite capable of caring for herself and perhaps even capable enough to care for her dying husband. No amount of reasoning with her or outlining what she can't do anymore will advance your cause and may even lead her to dig her heels in further.
That said, I'm wondering if you've considered the alternative. One thought would be to bring in home hospice for your father-in-law (a covered benefit under Medicare) and supplement the home care provided through hospice with private home care as needed to fill in the gaps until his death. Unless your mother-in-law is able to pay for assisted living or a nursing home out of her own pocket, or she already has Medicaid to do so, managing the care of both of your in-laws at their home may be your only option for the time being.
If you do decide to move forward with plans to transition your mother-in-law now, I would suggest keeping the conversation very simple and having the person whom she has the best relationship with take the lead. It's also critical to plan the transition with the staff at the facility you choose. One thing I've seen work in similar situations is a gradual admission whereby a new resident begins by visiting for longer periods of time over the course of a few days before spending the night.