I’m very glad you took the time to write in. My hunch is that many readers can relate to the myriad of family dynamics you describe and I have several
thoughts on things you might try:
First, consider having your mother-in-law assessed by a doctor, preferrably a geriatrician, with three specific goals in mind: 1) to get a written opinion on her cognitive status; 2) to make certain that her diminished appetite is not due to some undiagnosed medical condition; and 3) to determine if medication for anxiety and/or depression may be appropriate. Assessing your mother-in-law’s cognitive abilities is essential. Either the results will validate the role your sister-in-law has assumed as the decision maker, or prove that she has assumed this role prematurely.
If your mother-in-law is found to be impaired and you feel that your sister-in-law and brother-in-law are behaving abusively, I would encourage you to consider anonymously contacting Adult Protective Services (APS) in your area: the number can be found in most phone books under “Abuse” or by calling 411. Keep in mind however, that APS cannot assist if the older adult is not cognitively impaired. In this instance, the abuse is not likely to end unless your mother-in-law begins to set some very clear limits with her children, which I would agree is much less likely to happen at this point.
One very direct way to help your mother-in-law is to see that she gets some relief from her physical symptoms. Her fear of an embarrassing accident is clearly distressing and is significantly impacting her quality of life. If the doctor can find no underlying cause, perhaps some medication or a special diet can be tried. If she is cognitively intact she may also benefit from counseling - perhaps through a local church - to help her sort through the tremendous stress that is most likely contributing to her ailments.
If she does not improve in a few months, consider arranging a follow-up appointment with the doctor to discuss other suggestions. If she does improve, try using yours and your husband’s visits to get her out of the house whenever possible. It is important to create opportunities for her to get a break from the environment in which she lives, particularly if it involves socializing with peers such as at a senior center. This should help to improve her mood a great deal.
Last, but by all means not least, take care of yourself by figuring out what helps you to relax and make a commitment to do more of those things. You have a tremendously full plate between your mother-in-law and your father. Perhaps talking to someone would be helpful to you as well. Free counseling for family caregivers is available through the National Family Caregiver Support Program and you can find a center near you by contacting the Elder Care Locator at: 1-800-677-1116.