How do you deal with a non verbal senior?

InvisibleDIL: He needs to see an oncologist.

Does he still have his cognition? Does he remember the date, time, place, person, president? Throat cancer often painful as it spreads up through the mouth. It does not respond well either to all of the other treatments. Does he verbalize his discomfort?

Look at state laws. The state where I live allows next of kin equal power decision making in healthcare. Financial the person has to have durable POA with financial designated. Cancer will never get diagnosed without willingness from someone to go get it diagnosed.

You and your husband qualify as next of kin (NOK). With healthcare decision making depending on the state, NOK may step in, but it means someone will have to get him to some doctor appointments.

My mom's side of the family descended from Buddhist Monks and Nuns who abstain completely from medicine. If my military Dad and sister had not intervened and made my Mom go to the doctors at 59 years old, her stomach cancer never would have gotten discovered and she would have died in excruciating pain. I had to listen to doctors talk about cutting out parts of the organs to treat it, I found it devastating as this person gave me life, they talk to my face about cutting out parts of her organs. But by then it became too late for any of that as it began to spread upwards, and she died 6 months after diagnosis. At least she consumed the comforts of modern medicine, and spent time at home with her husband of 40 years.

I work in Hospice. We have our own doctors that will write orders for hospice and hospice evaluation. But even we have to collect diagnostic records for something like cancer or any terminal illness for our doctors to then write both the orders for hospice evaluation and admission.

About once a year we get a throat or tongue cancer case where the person and family chooses death with dignity once it spreads to the mouth and ears. I don't mean to sound morbid or share opine, I state the facts of the situation.

The person ends up in excruciating pain as the nerves in the mouth and ears really big. Unless they get Novacaine shots every 4-8 hours nothing works not even morphine infusion. They don't get to take oral meds as it becomes so painful to swallow or eat. So the death with dignity involves a rectal tube. The cause of death shown as Hospice. To do that they have to stay in sound mind, get 2 doctors to approve it, then file an affidavit in the state.

I had a case where the lady had throat cancer only 57 years old and still an attorney. She had Kaiser insurance known to allow with Death with Dignity. She could not talk. In front of her family she wrote down on a piece of paper some questions:
1. Will you take me out of my pain and misery and carry out my death with dignity wishes?
2. Will this get covered under my insurance?
3. Will someone deal with the body as my parents don't speak english and afraid of authorities?
4. Will someone insert the rectal tube other than my family as my brother and parents will not do that?
5. Will you allow the death with dignity volunteer insert the meds into the rectal tube?

The pain really that bad. It has to have the clarity of an attorney to get this done.

I would try to get him to communicate in some way either in writing or with a bell that means yes, no response means no. Then try to get him to a doctor to get to the bottom of the issues. NOK has equal decision making power in my state, that means any spouse, sibling, adult child may make decisions. Perhaps the family needs someone to take control of the decision making. I know I would not object if someone tried to get my family help.

This hasn't been discussed, but if your FIL DOES have throat cancer, that is usually a very serious form of cancer. If it has progressed much, the outlook is often grim. I am wondering if he doesn't want to see a doctor because he thinks he'd be better off dead. Hopefully, your guess is wrong, but if not, you may soon all be dealing with worse problems than his not talking to you! I do not know how you could best approach this situation, but perhaps you could find som. material online, print it out, and leave it lying around so he can look at it if he is so inclined without your bringing it up, I was a medical librarian; a good place to go for accurate medical information at a layperson's level is a site called MedlinePlus: www.medlineplus.gov. It's from the National Library of Medicine; thus, .gov. Don't let anyone confuse you; it's not the same as Medline, which has professional information! MedlinePlus is easy to use and the way to use it is self-explanatory once you log on. Let me know if you have any problems!

dry erase board, pen/pencil and paper, writing on telephone... ask questions that can easily be answered yes/no or simple responses.

Get him a dry erase board.
Learn how to interact / communicate with him (go to TEEPA SNOW's website). Learn how to use non-verbal communication, i.e.,
- touch
- eye contact
- tone of voice
- asking open ended questions

If his own family doesn't care (which is very sad to read), I would be alarmed. Perhaps the family needs to be reported to the Adult Protective Services (APS). There is a lot more going on here.
I would be very concerned and appreciate YOU for caring for your father-in-law. It is somewhat shocking that you are concerned more than they are, but perhaps this isn't so unusual. It just hurts to hear / read this.

Sounds like they all have 'thrown in the towel' and simply do not care about him. Perhaps he would be better off in a facility.

I wonder if you are married and if so, how does your husband - the son of your FIL respond? care? if he supports this non-caring behavior which isn't care - it is abuse, they you have some decisions to make - report the situation to authorities (call Senior Dept) at your County City Hall. Find out who to speak to.

You shouldn't 'have to' be the person who steps up ... although I am glad you did. Compassion goes a very long was as a person ages / loses independence / has more -serious medical problems as they decline. Thank GOD your dad in law has you. He is very fortunate.

And DON'T FOR A MOMENT listen to 'pay him no mind' - this is part of the abusive behavior his own family inflicts upon him. Gena / Touch Matters

Quite frankly I was at first shocked at the family's response to pay him no mind. Then I read the thread of your responses, and realized there was so much more to this than in your first question.
Since he is currently in your home, sit down with him on a day you are feeling up to trying to calmly talk things out in the open. Lay it on the line. Let him know you are trying to have a good relationship with him, but it's difficult when he does not want to acknowledge your presence. Let him know you see him as angry. Ask him what in the world he is angry about. If what he tells you is hateful, at least you have your answer.
If he can do yes/no answers with head nod and shake, that is at least a start. Can he read and write still? If he can then a note pad and marker can be a way to communicate.
Since your husband is having him move out, you can still try to talk it out with him, either before or after he moves. You have not said your FIL has dementia, so talk to him.
If your son has any rapport with him, try to find out why he won't go to the doctor. If he's afraid of the diagnosis he may get, your son can remind him that illness doesn't stop progressing just because someone refuses to acknowledge it. If he doesn't want treatment, he can make that decision.

Kind of curious why you seem to care as much as you do, when you say his family doesn't care about him.
Is his family simply avoiding him because they don't know how to communicate with him? It is different if he was the kind of person that his family never really liked.

If the FIL seems to want to communicate, you can create an alphabet board.
I used the computer to print on an 8 1/2" x 11" sheet of paper, then placed in a sheet protector. Use as large a Font as you can and still fit all letters on the page. You can do another one with simple words and numbers; depending on what he is likely to need - Yes, No, Hungry, Thirsty, Hurt,....
Place that page in the same sheet protector, so you can simply turn it over.

My husband has difficulty making words and communicating as a result of a stroke. He manages to grunt single word commands, but when I can't understand him, I get the alphabet board out and he points to the letters to spell what he wants.
Now, that's because my husband doesn't have use of his right hand or the motor skills to write. But if your FIL can write down things he wants to say, keep a notepad and a pen next to him. Or even a pad of post-it notes.

I just want to say,  your story reminds me of my good friend when I was growing up. She and her 4 siblings had a step-dad, who because of his lifestyle, smoking and bad diet, was in a similar condition. The family hated him. He was abusive, demanding, and had molested one of the girls. Their mother didn't see a way out, and when he was dying, and finally died, the family was joyous to have this horrible person out of their lives. What I'm saying is, if your FIL's family truly does not care about him or what happens to him, you might find out why and be sensitive to their feelings about it.

His children have made their decisions and they have their reasons! When you deal with someone that is not a nice person it can cause a great amount of disturbance in your family! It's best to stay away then to be upset and fighting! Why does your husband feel responsible? Was he not damaged by his father's actions too?

OP, Grandma’s idea is really helpful. Check it out!

If it doesn’t check out, another thing to check carefully is FIL’s approach to his son, compared with his approach to you. My reaction is that he may want to see you as a ‘maid servant’, to be ignored as much as possible. He may even dream of getting you out of the house so that he can have his son to himself. This is more usual from MILs to their sons than FILs to sons, but it is possible.

If this checks out, you need to talk to your husband about it. We regularly have situations where H needs to choose between W and M, and this just might be the same thing flipped. Chances are that H can’t manage the house without you. H may have to make this very clear to FIL. What FIL’s other children might do is really not the issue for you to worry about.

Note book
White board
Text him.
These will work if he is cognizant.
My husband was non verbal due to the Alzheimer's and Vascular dementias I learned to read facial cues. He would not have been able to read, write or text.

If this is a man that you care about and you have interaction with him daily just talk to him. If you ask a question make it a yes or no so he can nod or shake his head. Make choices limited to 2 or 3 things so he can m ore easily make his desire known. "George, do you want a tuna sandwich, or a ham sandwich and do you want soup with it?"

I have been told by friends that my FIL acts this way because he likes me but I don't think so. He plays games, he speaks but only if he's spoken to first. He acts like a child.

This sounds like a downward spiral that may not stop unless your FIL will accept medical care. He may be in pain. He may be severely depressed. He may just be a cantankerous old geezer, but I’d try to eliminate the first two before I give in (or give up) to the third.

Easier said than done, I know. Is there anyone outside of the family that can have a heart to heart with him and maybe get him to the doctor? If not, you may have to live with his behavior but it wouldn’t hurt for you to tell him you are worried about him and if he ever wants to talk, you’ll be there to listen. Then, continue as you are, without rancor, if you can. It’s up to your husband to figure out options and make changes. I’m really sorry, it’s a hard situation.

It’s sounds as though FIL is living with you, his son your husband, and your children his grandchildren. Other members of the family are ignoring him, perhaps because he is as unpleasant to them as he is to you.

Your options need to be discussed with your husband, but they include:
1) You don’t provide free care to him. He pays for your time in washing, cleaning and cooking.
2) He pays a share of housing costs.
3) He treats you politely, responds to comments, and acknowledges you as his daughter-in-law and mother of his grandchildren – ie part of the family.
4) Failing 1 to 3, he leaves and finds his own accommodation. The food stops immediately.

You are NOT 'over-stepping boundaries' in setting terms for your own personal interaction with him. You are NOT responsible for his relationship with other family members.

What does your husband think about this?

I think the worst thing you can do is to just ignore him as no one likes to be ignored or made to feel invisible.
Instead just talk to him like you would anyone else and let him respond if he wants to and be ok if he chooses not to. And you don't have to ask him questions that he may feel like he needs to answer, but can just talk about what's going on in your life, his grandkids life or even just the weather.
And if his family "doesn't care about him" you may want to call APS and report a vulnerable adult living in an unhealthy environment, and let them come out and do an assessment.

My late husband couldn't speak at all after he had a massive stroke at the young age of 48, and even after much speech therapy, he still could only say very short sentences and simple words, and we were really never able to have what I would call a conversation up until his death at the age of 72.
But I always talked to him, told him about my day, and included him in whatever was going on in our lives and family. And I know that he appreciated that.

So please don't ignore your FIL just because the rest of his family is. He needs to know that at least one person cares about him don't you think?

Please explain who is “in the house”. Does FIL live with you, or in another house – and with whom? He refuses to speak “even to his own blood”. Does this include your MIL and your husband, his son? Is this just about a sore throat, or is it deliberate with no explanation? And for that matter, why do you feel “invisible”?

It’s hard to understand, and more detail would help.

Hmmmmm.
Interesting family you have married into.

Given you really have nothing to say here, and father in law apparently doesn't wish to have any medical care, and family agrees with that way forward, you simply visit, keep things to a minimum, supply paper and pencils or marker, watch a bit of TV with him, get on with your day. He will function as he does at all other times.

If you suspect abuse or neglect then you have decisions to make as regards speaking with hubby and family, calling in APS if you discuss with FIL and he seems to need help. Or not.
You know the situation. We don't. Clearly you are worried, and knowing what tiny little bit we know that's about all the advice I can give you.

If he loves old books then read him some fun book such as The Call of the Wild.