Need guidance. Mother in law not accepting any help

Am2022

Hello. This is my first post on this website and I’m hoping anyone going through this can offer some guidance. My mother-in-law has started showing signs of cognitive decline and dementia. Over the past few weeks we’ve received calls from several people who are concerned. We discovered that she is not paying her bills or her property taxes, and has gotten lost while driving several times. She refuses to go to the doctor or to allow us to help in anyway. She refuses to see the lawyer and set up estate planning . She has always been extremely stubborn and independent, however it is clear that she is not thinking clearly and needs help.We are at a loss. What are our options? She is refusing to participate in her own care and actively denying any help. We are afraid that she will get hurt or hurt someone else, also that she will default on her mortgage and lose her house. What can we do?? Anyone with a similar experience? Thank you.

MN Chickadee

Keep reading the threads on this forum. You will learn a lot about what is to come and how to handle it. Also read threads on (or google) anosognosia. When a person's brain reaches a certain point in the disease is simply unable to recognize its own deficits and never will. It is important for you to understand that reason and logic will not work on her. You will need to do all logistics. Make online accounts for what you can in order to set up payment or at least view what is going on, set up appointments etc. It's a good idea to start with a primary care doc for bloodwork and an overview and then get referred to neurology for further testing. Not everyone can or will make it that far, some run with that the PCP finds. Having some clue what is causing it is helpful, as there are different types of dementia and the care and treatment can differ. A neurological work up is best for this but you aren't the first to run into serious road blocks with your LO.  Take what you can get. 

Consult an attorney practicing elder law in the state MIL resides in. The attorney will be important no matter what happens or what route this takes. They can advise you on what guardianship would entail in her state as well as other things like planning financially for her care long term based on her personal finances. If guardianship is necessary they will tell you what to start documenting and how things might play out with the taxes and other things. 

Embrace "therapeutic fibs." Fibs and workarounds become pretty essential for most families dealing with dementia. Working behind the scenes. Using whatever words or explanations bring comfort to the person with dementia (PWD.) Stop talkingto her  about her memory or dementia or doctors or a problem. Find the right buttons to push. Maybe you and your spouse are doing your own legal documents and the lawyer is offering a discount, she can come and do hers for free. Some lawyers are particularly skilled at finessing these situations. Maybe it's to "protect her assets." Or make sure you can see her at the hospital in a medical emergency. Maybe a doctors appointment is a simple blood pressure check or some annual assessment Medicare or insurance is requiring now. Maybe it's an appointment for you and she is along for the ride. Bribe if you have to. We're going to have the quick appointment and then go to your favorite restaurant or do whatever activity makes her happy. Maybe you tell her that pill she is supposed to take is a vitamin.  Maybe you take your meds casually together and yours is a tic-tac. Maybe you secretly disabled the car and it's broken, the mechanic is waiting on a part that is taking a long time. Maybe you want her to come stay with you for the summer to experience ______ and that gets extended. Maybe this facility you are suddenly in is a temporary rehab, the doctor wants you to stay here for a few days. Or it's a hotel you can stay at due to a problem at the house. These are all things we've had to say and do in order to protect our loved one. This is the mindset (for you and your spouse) that may get you to where you need to go. There are many resources online on communication techniques. Teepa Snow videos are especially great for understanding the disease and how to work with it. 

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SusanB-dil

Hi Am2022 - welcome to 'here'...  so much good advice and a very welcoming place we wish we didn't need, but so glad it is here.

agree with what has been posted - do look up 'anosognosia'... it is not denial, but the firm belief that nothing is wrong, despite hard evidence to the contrary.

If she will not sign over any papers, you may have to look into guardianship. You really need DPOA and HIPAA access in place  Since she is not cooperating, the papers and getting her off the road will not be easy, but she has already "gotten lost several times" - that you know of... Need to disable the car so she does not get hurt nor hurt someone else.

It is time for someone to take the reins and step in ASAP.  From what you are already seeing and have heard, you know that this is serious.  

Iris L.

You need to take time off work and go in person to investigate and make arrangements.  Reports from your mom or neighbors won't give you the full picture.  Look into family medical leave.  Anosognosia is real, please familiarize yourself.

Iris L.

Paris20

Sometimes you cannot convince a person with AD of anything that you know is true. Anasognosia means the person with it cannot understand or accept the diagnosis. My husband was diagnosed seven years ago but still thinks he’s fine. Therefore, you have to work around everything. That means fiblets, making up stories to account for what you’re doing, e.g., bringing an attorney to your MinL’s home, or just doing what’s right and keeping her unaware, e.g., making the car unworkable or setting up automatic bill payments. She will forget each event anyway.  To ignore her behavior is not an option, just as trying to convince her with rational understanding is impossible. The sooner you deal with these problems, the better off you’ll all be. Trying to put off very unpleasant tasks only makes them worse.