How can I talk to my Mother in Law about the decisions being made on her behalf that I disagree with?

A fellow caregiver asked...

My husband has four siblings. His mom is 93 years old and still lives in a condo basically by herself even though one of her sons "lives" there too. He is a worthless person who thinks that the world owes him something. He is 67 years old and is verbally cruel to his mother. My husband is the only one who really takes an active interest in helping his mom . However, his sister is a nurse and has medical power of attorney and has convinced my mother-in-law that she has the right to tell her now what can and can't be done in a medical sense even though she has her faculties she is so intimidated by her and will not listen to anything we try to tell her. Mom lately is so sad and gets extremely argumentative when we try to explain our frustration over how she lets her run things. There are two other sons also and one has a wife that runs the show at their home so he very rarely comes around and the other son uses religion as his "I'm so busy" excuse and the mom is very religious so this becomes a very acceptable reason. My husband is retired and works part time but the family just assumes that he is the one to always take care of these things. But as soon as someone else does appear on the scene she uses all their advice and then cries to us about what they did and we try to help but then she says what they said and won't listen to anything we have to say. She gets herself so upset lately that then she can't go out because she is afraid of having an accident. She has become so concerned about her bowels lately that it is getting out of control. She hardly eats anything and still thinks that she should be going to the bathroom as if she were eating like a truck driver. I want to know what I can try to do to make her life a little easier. How I can try to have a talk with her? Or am I just hoping for something at this stage that is just not going to happen? I am an only child and my mom passed away 25 years ago at 52 years old so I wish I could get these people to take a different path in dealing with her. My dad is in a nursing facility and it has been very hard for me and I have no one to help or get advice from. These folks want any decisions to be only made by them as an individual and not as a group for what is best for her. Any advice after my rambling would be great. Thanks all for listening.

Expert Answer

Maria Basso Lipani writes a popular website on geriatric care topics, where she puts her expertise as a Licensed Clinical Social Worker to good use answering care planning questions. Maria is a graduate of Columbia University School of Social Work and is licensed in California and New York.

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.