Mixed dementia and demands

Hello,

My mother in law was diagnosed with mixed dementia in February. She is 88. Her husband has gone into hospital with sepsis and other problems (not yet identified) and the consultant has said he will be in hospital for a considerable time.

My parents in law live in a rural setting that is quite isolated, and my husband has moved into the house (temporarily) to look after his mother, whilst F-i-L is in hospital.

Obviously my Mother in Law is anxious and upset, however, her behaviour is a little concerning. She is a clever lady (former deputy head teacher and so on) but she seems to not really be thinking things through. For example, she has told my husband that I do not want to see him, and she has said her nephew ‘hates’ my husband. There is no basis to these claims and my Mother in Law seems not to realise that my husband will actually talk to the people mentioned and find out there is no substance to what she has said.

I realise this is the behaviour of a scared lady who is very worried about her husband, needs to feel in control and may very well be aware that she is deteriorating cognitively. I also realise that my mother in law may be saying these things in a confused attempt to ensure my husband stays with her and gives him her undivided attention.

The problem is that my husband has Asperger syndrome and finds this caring responsibility and mother’s behaviour a bit too much to cope with. The change in environment and routine also upsets him. I am a little stuck because I do not drive, have work commitments and I am looking after our youngest son who has complex mental health needs.

I would like to speak to a dementia nurse or some other health professional who can advise us on how to reassure my mother in law, manage her behaviour, and perhaps arrange for a review of her mental state. However, I am afraid that we will be told that there is nothing we can do because my mother in law has mental capacity and refuses care or intervention from anyone but her son.

I would just like to get some support and advice before a crisis occurs.

Sorry for the ramble.

I think a crisis is actually needed and should be prepared for!

Your husband needs to set an end date for the time he is at his parents house, because he has a wife, child, and home of his own. The longer he stays, the more difficult it will be for him to leave. I would suggest two weeks.

Social Services can do a Needs Assessment for his mum, and arrange care accordingly, wherever she lives.
My mum had sepsis when she was 86, lost the ability to walk, and after a spell in hospital, moved into a nursing home until she died. FIL sounds very ill indeed. Are the hospital being open and honest with your husband about the likely outcome?
Do his parents own or rent their house?
Is mum claiming Attendance Allowance due to her dementia, and also her exemption from Council Tax due to “severe mental impairment”.

The best outcome, if both parents are nearing the end of life, is for them to move into a care home which can meet all their needs, but this will be difficult to find, and expensive. FIL may be entitled to NHS Continuing Healthcare. Read up about this.

Hello,

Thank you for the very prompt and helpful reply. I will answer a few of the questions first. My mother in law is claiming no benefits at all. She refuses to consider a care assessment, claiming that she does not need one, she does not want anyone else involved in her care, and that her husband just needs an operation and then he will walk again. This is his second bout of sepsis and he has been largely immobile for two years. When he went into hospital this weekend, he could not lift his arms to take a drink and the hospital have told my husband that they are managing his pain. I think the prognosis is bleak.

My parents in law own their own house. It is quite a large farmhouse and there is no way they can maintain it.

I think the idea of putting a limit on the amount of time my husband will stay is a good idea.

We have raised the subject of a care assessment, but my MIL refuses to consider one, and so far we have been told that there is nothing we can do if she has mental capacity. However, I am beginning to doubt her ability to make an informed decision about her care.

By definition, if she has dementia her decision making capability is fundamentally flawed!

I’ve had this problem too with my brain damaged son, part of him is 41 year old normal man, part 3 year old. He can light up and drive our 10 ton steam roller, but can’t read write or do any maths. Just because he can do SOME things well doesn’t mean other parts he needs huge amounts of help with.

Does your husband have Power of Attorney?

How is MIL’s money managed on a daily basis? Be careful to make sure her money is protected in some way. Maybe notify the bank manager, they have a duty to protect vulnerable customers.

Does mum in law have any friends visiting regularly?
Long term, the best solution would be for her to move to a care home near your home, to reduce travelling.
Getting her to agree to this is another matter, and then there is the enormous problem of what to do with the farmhouse.
It certainly sounds as if father in law may be entitled to NHS Continuing Healthcare. Maybe you could look this up for your husband?

Hello Janet


This sounds like a frustrating and difficult situation for you. It must be harder if your mother in law isn’t open to any kind of assessment.

Alongside advice from fellow forum members, have a look at our help and advice pages here:

The Alzheimer’s Society also has a support page which could be worth looking at:

Best wishes

Jane

Hello,
This is just a quick update.

My husband walked out of his mother’s house yesterday and is refusing to come back. I have been fielding phone calls from my MIL, but I support my husband’s decision. When I asked what ‘care’ he was providing, it turns out that there was very little practical care going on. My MIL was frightened of being on her own and wanted my husband to stay with her. He put her eye drops in, but apart from that, there was no physical care.

My MIL insisted that my husband only left her house/gardens between noon and 4, and would break down in tears if he wanted to stay out longer. She claimed she was terrified of being alone in the dark. However, over two months of living with her, the arguments between the two have escalated to the point where my MIL would ring me stating that my husband had threatened to kill her. My husband would, in turn relate some of the comments his mother had made and he has been constantly phoning authorities for help and support. Added to that, my MIL has been stating that various people ‘hate’ my husband, that he has no friends and that her step nephew wants to ‘beat him up’ whenever my husband steps out of line. None of this has any substance at all, but it annoys and frightens my husband, who is an individual with autism.

So, yesterday he left. My MIL is demanding that I ask him to return, but I have explained that he is not well (mentally) and other arrangements need to be made. So, last night she rang the hospital for advice about putting in her eye drops and a nurse is coming today to do it. She also slept on her own, and she has asked me for an alarm clock, which I will deliver separately from my husband. She is not as ‘attached’ to me as she is to her son.

It seems my MIL is a lot more capable than she makes out, although I do think she needs some support and will definitely need support when/if her husband comes home.

I do have a lot of sympathy for my MIL, but I think my husband’s decision to move out is probably better for everyone. On reflection, I feel the control that she administered when my husband was a child (before people knew a lot about autism or additional needs) has sort of defined their relationship.

Your husband has made the right decision, just make sure MIL doesn’t keep asking you to do more and more instead.
This is her “Sink or Swim” time.
If she cannot manage on her own, then she must move.
This is a conclusion she must reach for herself. Your husband’s presence would only delay this decision.
Normally I’d suggest that you and your husband go away for a few days, not an option.
All I can suggest for the moment is that you put your answerphone on, and leave it on.

Janet,
sounds like your husband has made the right decision. His mother sounds terribly controlling. If she doesn’t want to live alone then she needs to consider moving to somewhere she is not alone.

How is your FIL?

Melly1

Dementia seems to mellow some people, and make others exaggerate existing character traits. So very difficult.

Hello,
Thank you for the support. My FIL is still very ill. His sepsis seemed to abate, but then, when he moved hospital for rehabilitation and physiotherapy, he caught pneumonia and had to return to the main hospital. He seems to be pulling through, but he has very little movement in his hands, he is heavily medicated and he cannot stand.

My MIL is devoted to him, but this also means she is consumed by her need for him to be home. She phones him at the hospital several times a day and asks him when he is coming home and why he can’t walk. I think she just cannot accept the severity of his illness or the changes this could bring to their relationship and their lives.

I feel really sorry for father in law. When he desperately needs the support of his wife battling pneumonia and other issues his wife’s priority is her own needs.
My mum was the same with me, I know how that feels.