In search of some guidance...

No one can be made to do hand's on care for another person.

He needs to read his POA. Is it durable or springing? Is it in effect now or does she need to be declared incompetent for it to go into effect?

Do you live in a "filial obligation" state?

For most of us here, if an elder has not been found incompetent and refuses to go into care, you wait until the illness or fall that puts them in the hospital. You then talk to the discharge planners about getting her into a facility,

Thank you Barb. We live in NJ. It looks like we are a "filial obligation" state. I wonder if this changes anything...

She still has her whitts so I am not sure he is able to make any decisions with her consent.

Would it help to get a care manager? Let them evaluate her and either set up home care or nursing home. I have a relative who looked after her mother in law until it almost killed her. She was also very rude and demanding. They put her in a nursing home finally.

Visit some AL’s near you. Find one or two you really like, take her for a lunch tour. You can eat with her. Sometimes when they see it’s not as bad as they thought it changes their minds. Most of our elderly only knew of NH’s. AL’s are so much different but they need to see for their self. I wouldn’t tell her you are looking at it for her To move you could tell her it’s a senior lunch day & you a ll were invited to eat for free! Free is always good to seniors.

No, you do not have to take her in. POA basically allows your husband to sign documents (financial or property related) on her behalf, and/or if he has medical POA, to make medical decisions on her behalf. He has no legal obligation to take her into your home. In fact, it will likely put him in a much worse situation as the time will come when MIL needs 24/7 care and he and you will not be able to provide safe care for her. I'm sorry you're in this situation, its very hard. Your husband is going to need to convince his mother that AL or NH is really the best place for her. Maybe get a Social worker involved to help, but do not take her into your home, it will only get worse for all involved from there.

If she falls or becomes ill, PLEASE call 911. Do NOT show up at her door and try to argue with her about going to the hospital.

From here on in, let professionals deal with her NOT YOU.

Google the term "grey rock" as a technique for dealing with people with the sorts of personality disorders you mention.

I also told my husband that another option is for him to go and live with her and he can come home a few nights a week if this is something that he would be interested in doing. I don't mind him caring for her.... it's that I don't want her living in my house.

You are lucky that husband agrees with you. She must be hard to live with.

I was a little confused about this paragraph

"She makes too much monthly to qualify for medicad but I know we could apply and they would take all her money less $100 allowance monthly. She did gift someone over 20k 3 years ago and I am sure that would complicate things."

If she makes too much and she has gifted 20k its going to be hard for her to qualify for Medicaid. The income limit is $2349. As of July 2017, the PNA went from $35 to $50 and I don't see where that has changed.

I live in SWJersey and ALs in my area are at least 5k a month. Medicaid may pay after a resident has paid at least privately for 2 years. Then that depends on if the facility hasn't met the % of residents already on Medicaid.

There is a Miller Trust (Qualified Income Trust) Where any money over the $2349 goes into the trust. When Mom passes, the trust reverts back to Medicaid. (I know weird) Its the 20k that will cause a penalty. We have a thread going on now about that. Basically, how the penalty works. Since its been 3 years since the gift, maybe you can keep her in her home for another 2 yrs and the 20k won't be looked at. I think I read its got to be 5 yrs and one month.

Sorry if I have been a downer. Just wanted you to realize how things work.

Here's the thread where the penalty is discussed. Read the replies to my post. The info I posted I got from the internet but looks like it may not be completely right or depends on other things.

No you are not responsible for taking care of her.

Unfortunately we have to wait for the crisis that gets them hospitalized before they get placed into care.

I would stop propping her up and let her see how false her independence is.

I am out of patience with stubborn old people that don't care about anyone but themselves and them not having to make changes while sucking the life out of people around them. They want to do it their way, let them, that doesn't mean you have to participate in their way.

You won't get in trouble, unless you try forcing her to do something against her will. Then you could get in trouble because she has rights ya know.

I would find out about a Miller Trust aka a qualified income trust. That will help her get Medicaid. You can go to www.nelf.org to find a certified elder law attorney in your area. I highly recommend using a certified elder law attorney they do this every day, they know how to get her approved if at all possible.

Just posting my agreement that your husband is not obligated to care for her in your home, not responsible for her happiness, especially since she has a disagreeable personality. One other option is for him to resign his PoA and allow the county to gain guardianship of her when she is truly not able to care for herself. They will control everything, even where she resides, but he can still carry on his relationship with her as long as he wants. The sticky part is the waiting for this time to come about. Much good advice has been given, like calling 911 in an emergency (and if her condition warrants it, have her go directly into a NH and not back to her home). A care manager is usually a good idea but if your MIL is resistant but not incapacitated, it may be wasted time and money.

Perhaps contact the relative to whom she gifted $20K to step in/step up to join in the fun? I wish you all the best as you deal with the situation.

Need some clarity, is your mother n law competent to make her own decisions? If so then let her make her own decisions. Let her live alone in the house. Can she has an aid come in to help her? My mother is 95 and still competent and she won’t go to assisted living or have an aid come in her house. My son goes over twice a week to help her and I have been going over once a week. Needless to say with the corona virus she hasn’t been to the hospital very much. She stays put in her house.Whenever her legs start to swell or she has an infected toe, I take pictures and show her doctor and she prescribes an antibiotic for her and sends a script to her pharmacy. I can’t make my mother do anything and she certainly isn’t going to live with me and I’m not living with her.

You say your MIL has seen a decline. In what? Physical abilities, cognitive issues?

Is your husband's POA a durable healthcare POA or merely a financial? If it is for healthcare, yes, he is responsible for her wellbeing, meaning his healthcare decisions must be in her best interest, but only when she no longer has the capacity to make her own decisions. That doesn't mean moving in with you. You may feel some moral obligation to take her in, but you don't have a legal responsibility to do so. I don't believe there are any legal repercussions in letting her live by herself as long as she still has the capacity to decide that by herself. If the time comes that she no longer can make reasonable decisions for her own wellbeing, especially safety issues in the home, then the HCPOA may kick in.

Great advice here. You and your husband should not feel guilty that you don't want his mother to live with you. Establish your boundaries and provide her the choices, such as in home care, NH, AL, etc. She sounds so much like my mother, who would destroy my husband's and my peace of mind if she were to live with us. She has chosen to live in an apartment, and I have helped her and her sisters (who have all passed) for over 20 years. She is now 93 and won't allow any assistance, other than me taking her out twice a week, my neighbor taking her to Bingo, and the maintenance man in her building. All are trustworthy and working out so far, but there will come a day when she will need more help. I discussed this with her doctor privately and he knows her well and said since she is too stubborn to listen, it could end badly. But it could end badly in my house as surely as it would in her apartment. She is overly demanding living there, so having this separation is the only peace of mind we get. Unfortunately, no matter where she is, my mother is never satisfied. If your mother-in-law is like this, keep her where she is and bring services to her until you have to make other choices. Every time my mother complains, I offer to help her find a cleaning person, in home nurse, etc. and she suddenly backs off and stops complaining. Get advice from doctors, senior social workers, agingcare, etc. and protect yourselves from her dragging you into her life by trying to make choices for you instead of choices for herself. Keep a united front with your husband. I wish everyone the best of luck in dealing with this kind of situation with a loved one.

Caregiving is very stressful and emotionally draining. It was very hard work. After 15 years of it, I'm left an emotional cripple though I love my mom and never regretted it. Still, it was a very stressful harrowing experience--I sacrificed my life for her, and that is exactly what caregiving requires. Nobody can force you to that role, and I would not recommend it to anybody. Ironically mom did not die of Alzheimer's. Her feeding tube kept her body in good shape, though in the end her mind was totally gone. She had liver cancer, but she never suffered. I knew she had it, but at age 90 she was too old to get it treated. She only had physical symptoms for one week--her skin turned orange/yellow and her urine gradually slowed. I knew she was dying because her tube feeding restarted having residuals where the week before she never had any. She assimilated whatever I put in the feeding tube.

The hospice nurse came daily (she was on hospice for 2 years) to make certain she was comfortable and she was totally at peace, and she died peacefully. Not a single narcotic or psychotropic was ever given to her because she simply didn't need it.

She was only bedridden for 2 months. But I used the hoyer lift daily and put her in her favorite chair since that was the routine. She simply forgot how to stand and could not focus on it anymore. but for 5 years I walked her daily in the park and she went 1/4 a mile. I miss taking her to the store. Oh she loved that even though she was on the wheelchair. But God I loved taking her.

It was very painful for me to lose her. I never been apart from her. I don't know she's at a better place and face it we all are going to die. She died before all that coronavirus mess hey at 90 that's good for very very end-stage Alzheimer's. Not to mention her medical management. INSULIN dependent diabetes and all, but her sugars were easy to control because her diet and activity were the same daily. Still I had to check her sugars daily...she was a lot of work. It's something you CANNOT be forced into doing.

In retrospect the most stressful thing was her bowel management. If she did not have a bowel movement in 3 days she was impacted. So I put her on a schedule so every Tuesday, Thursdays and Sundays were bowel movement days. Her feeding tube was great since I could put lactulose (she had stage 3 kidney disease for decades so you can't give magnesium or phosphorus based laxatives) in there the night before and in the morning cold coffee and she would go hours later which was like a "blow out" but hospice supplied me with plenty of diapers and gloves. Her skin was paper thin so I had no shortage of lotrisome cream which I mixed with zinc oxide (half and half) which would clear up any redness overnight. I changed her diapers about 5 times a day, everyday.

Instead of an abdominal binder I bought tube tops from Amazon which would conceal the feeding tube. She never bothered it but it needed protecting because you don't want sheets or covers yanking on it when she is being turned and cleaned. FEEDING TUBES REQUIRE CONSIDERABLE AMOUNT OF CARE. I opted to get one in mom so she would not die of dehydration which is a very slow agonizing process even with hospice. It can take 2 to 3 weeks to die of dehydration. Mom was spared of that! Her needs were met in every way!

The only time she moaned from discomfort was turning and cleaning her up. She hated that..but she could not just lay in her own excrement. When done she was calm as she could be. Still, when she died her skin was in perfect condition. My brothers knew because of my care mom lived years beyond what she would have, and mom had good quality of life right to the end. She knew she was surrounded with love, and familiar surroundings. THAT is something I can take to my grave. I did all of that because love mom and nothing else in this life mattered to me.

I'm carrying on. Living alone, I have a job and getting my Master's degree.

Having children is no guarantee they will care for you during old age.
Nobody can force you to be caregiver

A POA only gives you legal responsibility to make decisions on her behalf once she is unable to do so herself. You have no legal responsibility to "take her in" because of the POA. My advice would be to start looking for AL so you have a place in mind, the cost, etc. and so you have a plan. Start talking to her about what you've found, in other words, bring her along. Can you get some help for her in her home so it's not all on you? Decline will continue and the more all of you know the options, the better.

Your husband is responsible not you. He can sort out what support he can offer her.

As POA he has to do what is right.
That means keeping her safe.
Making sure she is cared for.
Making sure her needs are met.
As a son his "duties/obligation" is the same goal.
It does NOT mean he has to bring his mom into your home.
As a HUSBAND he also has to do what is right for his/your marriage.
You have made yourself crystal clear on the subject and he apparently also agrees with you.
If your husband is acting as POA that also, to me, makes me believe that his mom can no longer make safe decisions for herself. I am guessing she can not manage her finances, is no longer safe to remain alone, WHY allow her to make the decision on where to live?
This is not a decision she can make. Look for a facility that will care for her, meet her needs now and in the future. Assisted Living maybe but, and you do not say in your profile or in your post, I am guessing dementia so Memory Care would be the best option if that is fitting.
Yes she will be angry.
But placing her in a facility would eventually happen IF the scenario you paint came to fruition...
She moves in, you divorce your husband because of it, can he care for her by himself? Answer is probably no. So she would probably go to a facility as an end result
I suppose the other option might be:
With moms vast fortune build an ADA accessible in-law suite and hire 24/7/365 caregivers for mom.
(above said tongue in cheek)

I cared for my Husband for a long time while I was caring for him I decided that I better do something for me so that I NEVER put kids or relatives in the position of having to care for me. I would not want just this type of argument to play out because of me. I made the smart (expensive) decision to buy Long Term Care Insurance. I cringe when I pay the bill but I know I can stay in my house and someone will care for me without having to burden friends or relatives with that task. I would not want to put this on my kids! They have their own lives, their own families to care for.
I would bet if you asked his mom 50 years ago would she want her son to give up his family, give up his marriage to care for her she would have said no.

Keep her safe and healthy. Your options are home health aides in her home (you did not mention any medical needs btw), assisted living, or total care residential facility. You and hubby should spend a little time reviewing resources in her area to see what is available and the cost. Then, sit down with MIL and explain that she needs help and the options available. Neve mention living with you, since you have made it very clear that it is off the table.

I you said you offer to help 'aside' from any medical things (shower, bed pan, or diapers). Are you saying she needs help with those things? And who already helps with those things that you don't do? What are you offering to do for her?
If those personal tasks are required for her, it would seem someone already is doing them (a person needing a bed pan probably can't position it on their own). Why not increase the hours of whoever is helping now?

If I'm way off base on her needs, sorry.

Unless a judge placed your husband in legal charge of his mother your husband can withdraw from being her POA.
He has to send your MIL a letter (preferably certified), and then send letters to any other people or Drs that may have a copy of the POA on file.
The letter can just be short and to the point. I went to an elder law attorney with the same question your asking here, and received this sound legal advice, because I was at my wits end with my sister, and felt trapped. I wrote the letter but I never sent it, and grateful I didn’t because shortly after I wrote it she broke her hip, and ended up on LTC at nursing home. Thankfully the POA was then an asset to have to be able to be an advocate for my sister.

You are not obligated to take your MIL into your home. If she cannot continue alone, her choice (or yours) is NH or a full-time home health care aide

RE ArtMom58's post:

This sums up what I was going to post about POAs - basically they are a way to allow someone to sign documents and make some decisions for a person who can no longer make those decisions or understand what they are signing. The document may/may not specify what those duties/capabilities are, but it does NOT mean you have to provide the actual care, in her home or yours. They are certainly NOT documents that say YOU care for a person. Even having court appointed guardianship doesn't require you to take a person into your home or for you to move into their home - some guardians are not related, just appointed by the court.

Think of it this way - if a person has no family, but needs a POA and/or guardian, someone else, even an attorney, can be nominated by the person to be their POA or guardian. Do you think some unrelated person, esp an atty would take that person into their home? NOPE! So, rest assured being POA does not have this requirement. It is only about stepping in for decisions and/or signing paperwork for someone who no longer can. Temporary POAs are similar but they are generally for one purpose only - for instance, I assigned POA to my atty for closing documents when I sold my previous house. Her Power of Attorney ended when all documents were signed.

Additionally, you say she is "competent", but no real description of her needs. For the most part NHs are for those who need specialized nursing care. Sounds more like she would need AL, if you can get her to consider moving. Specialized care is NURSING care, not just help with ADLs like bathing and toileting. Once the restrictions are lifted, many ALs offer free lunch with a tour. Perhaps hubby can take her to some.

Filial laws - these are rather archaic. For the most part they have only been used in a few cases, to the best of my knowledge, and are generally invoked by a facility that gets stiffed. The case in PA involved a woman who lived there Medicaid pending, but then she left and moved out of the country. The facility used the law to recoup their cost (understandable.) The courts DO take into account how much a child of the person makes and how this might impact them, i.e. they would not impoverish the person. The decision in that case was (not sure if it was appealed/finalized) the son had to cover the costs.

The gifted money will cause issue with Medicaid. Most, if not all, have a 5 year look back, so that 20k would disqualify her until that amount is used for her care. Although hubby *may* consider staying in her home from time to time, wouldn't it make more sense to gradually introduce some CNAs? If she doesn't need assistance, just "company", I'm sure once the virus situation gets better you could hire someone - may take having hubby there initially, until she finds the person "acceptable" and/or gets used to them being there.

One more important note about POAs: Some people will tell you to get and/or use POAs to move someone. These documents do NOT give you the power to force someone to do ANYTHING they refuse to do, unless specifically designed perhaps. We had them in place long before it was needed, but by the time our mother developed dementia, she refused to consider moving ANYWHERE and after a few months of having CNAs sanity check (just check on her, make sure she takes her meds from locked dispenser, etc), she refused to let them in. We, despite having POAs, could NOT force her to allow them in OR move anywhere, per the EC atty. Her plan before dementia was to move to AL when she felt she needed it, but that went out the window! It was the LEAST acceptable choice, although she also refused to consider moving in with us as well. In her mind, she was fine, independent, etc and nothing we said would change that. In the end we had to find a fib to get her to move (atty recommended guardianship, facility we chose would not accept committals, so we had to resort to another method.)

It seems to be a nonstop battle, no matter what you do. My Papa fell yet again (Parkinson’s), hospitalized, to Rehab. We thought Finally, hallelujah! Rehab tells he’s doing a wonderful job, there’s no reason he can’t go home!! It’s enough to drive you insane, I swear. It’s like climbing a sand mountain, one step forward, three steps back.

Your MIL sounds as stubborn as my Papa. Eventually some event at home will put them in the nursing home for good. Till then, it’s a wonder we don’t all drink. Good for you for standing your ground!

Hi, NeedSomeCharity:

I'm very sorry to see your mother-in-law's situation. Her apparent behavior makes it very difficult, if not impossible, to receive help, and COVID-19 just complicates life further. May you get help from her elder care attorney, if she has one? Sorry that a social worker or ombudsman cannot talk with her.

Her behavior and its repercussions is HER responsibility as an adult, if she is still competent. Please don't give in to her nasty demands or let her bully you or your husband. Just leave her alone in her own house. If an injury or illness emergency happens, call 911 and let the experts deal with it!

My Best Concerns, and Good Luck!!

NeedSomeClarity, I know what you mean. My grandparents were this way for a very long time. They refused help that they obviously needed, making up all sort of BS excuses not to do something. It's truly foolish pride on their part, but what can we do? Can't make up their minds for them.

Caregiving is a huge undertaking, and it has changed my life in many ways. I have encountered so many crazy situations and challenges that I never thought would happen: caring for my grandmother during a pandemic, a bedbug problem brought in by the HHA, dealing with my grandmother's anxiety, her pneumonia, eating issues like dysphagia, and countless other things. In my opinion, this is the hardest job on the planet and definitely NOT for everyone. This is a fact.

That being said, you and your husband have already established that hands on, in-home caregiving is not within your capability, and that's fine- you can't do the impossible. So with this in mind, there are two options:

1.) She stays in her home and gets help in. Yes, there's the risk of God forbid something happening that the doctors say "sorry, it's not safe for you to return home", but she made her choice.
2.) Convince her to at least look into assisted living.

Unfortunately, we cannot force our parents to do things they don't want to do. They have to somehow come to that choice on their own, if possible. I can't make my grandmother use a Life Alert button or Stair Lift or shower chair because she refuses to use one. We can't do the impossible. So until then, just continue to closely monitor the situation and take things one step at a time.

My dad was the same. We kept saying something has to happen for him to have no choice. He fell in the kitchen and it took him 4 hours to crawl to a phone. (We had a med alert necklace that he made me return within a week). Luckily there was no terrible damage, but enough to have to be taken by ambulance to the hospital, days of tests, then a rehab diagnosis. That got the foot in the door at an assisted living facility. 11 months later he passed away, but was well cared for And clean(another issue) while there. It was unfortunate that we felt we had to wait for a tragedy - luckily it didn’t come to that, but it was our only option.

Do we also mention "tough love" about how to deal with a very difficult loved family member?? Again, the choice is MIL's if she does or does not accept help, just to only folly with her own stubborn decisions.

If she has not been declared as incompetent by the court, your power of attorney is not in play. Unfortunately, older adults can and do make bad decisions. That's when the situation becomes difficullt. If you're asking about assisted l8ving or nursing home placement, does she have funds? Will she accept in home caregivers? Or would she be willing to participate in a senior shared housing program which matches her with an adult as a roommate who assists with household chores in return for a place to live. I can understand the feel8ng of obligation but if you both know that her residing with you would not be good for any of you, you should trust your inst instincts.