Mother-in-law loves having diarrhea. How do I handle this?

Royenburg, the fact that you've reached out, shows your concern, when you return home do your best to get her to the ER, for at least an x-ray, cultures and treatment and that may be all that you can do, from the sounds of it. The clean up of your brand new apartment is the other thing that you must find a way to take care of due to the unsanitary living conditions. Your MIL will need to face the facts, that she may die, if she continues to ignore her symptoms. You need to document everything you do, and the call to APS may well take her off your hands if they find her a Vulnerable Adult, who refuses treatment. Thay may recommend an involuntary mental health evaluation and hospitalization, and this too, maybe the best approach, and you may want to ask for it, called BAKER ACT. I hope you are able to find a solution for her. You are doing the right thing!

Thanks! Not sure how much good it will do, but we will try to push the thought of a doctor again when we are home.

Are you going to push the "thought" of a doctor with your MIL? We all know where that is going, don't we?

I think the time has come for someone in the family to contact APS or the Department of Health; don't you think it's unhealthy for your adult children living in the adjacent building to be exposed to her unsanitary and unhygienic conditions?

She actually has a diabetic appointment (only thing we can drag her to) while we are there. We will attempt to see what else can be taken care of while we are there. She will let my husband go in and talk to the doctor with her.

That's HUGE!!!! wonderful news. Safe travels, my friend.

See if you husband will fax or email a letter to the doctor beforehand, outlining the issues.

I actually called and left a message for the nurse asking if we can talk to her today to discuss concerns. Through some finagling (and misdirection) :( we got MIL to tell the doctor that she can talk to my husband so he's now on the list. This just happened yesterday so we'll see if they will talk to him.

No one likes the prospect of dealing with an angry, difficult, elderly loved one. Royneberg - your original post is a clear indication of your frustration and concern over this situation. You clearly communicate that you realize there is a whole lot wrong with your MIL - her health both mentally and physically. Clear thinking people just don't walk around in public actively experiencing diarreha and think nothing of it, right? Yet your recent post "we will try to push the thought of a doctor" indicates hesitancy - backing off. I'm sorry, I'm not trying to be a critical, judgemental a$$. Nothing frustrated me more - prior to getting my mother placed in a nursing home - than when well intentioned friends and relatives of my mom, would call me and say "you need to have her..." Or "you need to..." I wanted to scream "I'd like to see you get her to..." Or "you're certainly welcome to try..." But when a situation gets to the point you originally discribed - you've got to pull up your big girl panties, get your hubby to pull up his and face the fact that decisions and actions need to happen regarding your MIL that she's not going to like or even necessarily agree with. Yes, it's going to be hard - it's going to get ugly(ier), it's going to ruin your time back home. But since no one else is stepping up to take on this fight - it falls to your husband. A year ago my mother was living alone in an Independent Living apartment with help from a part-time hired caregiver - I visited twice a week. I THOUGHT my mom was doing okay in spite of clearly having some dementia - between the caregiver and myself all the hard stuff was being handled. Then mom fell, ended up in the hospital, then rehab and a lot of ugly truths started to surface. Seems mom could not change her own soiled depends without some how mysteriously covering herself and the bathroom in poo. God knows where else it wound up in her apartment as I'm sure it was not properly cleaned off her hands and she probably stepped in it and tracked it everywhere. I mean, all those dark stains on the carpet suddenly took on new meaning. However, in spite of the falling and the poo mom was insisting she could return to her apartment business as usual after rehab. What followed was probably the worst few months of my life. And my mom hated me, she sure told me so often enough! But as a decent human being with a conscience, I could not allow the situation to continue. After trying and failing in Assisted Living my mom was placed in a nursing home - still hating me, btw. Fortunately I was able to get my mother in to see a geriatric psychitrist, who got my mother on the right medications. For a while things with mom - still in the NH - were better than they had been in years. One day mom even said to me she knew she was where she needed to be. Now mom is on hospice care. Looking back at the situation I have no regrets or guilt - I did what had to be done to protect my mother and everyone she came in contact with - if anything, I wish I had acted sooner. You've got a month to accomplish as much as you can to help your MIL - I hope you come to realize floating thoughts in her direction isn't going to change anything. As Oprah says "When you know better - you do better".

Rainmom, so very well said.

I think maybe my idea of push the thought might be different than yours. :) We've tried to force her to go to the doctor and it doesn't work. We have to get imaginative to find reasons, and we got very imaginative to get her to contact the doc this week to allow my husband to talk to her. She doesn't take well at all to threats that hold no meaning to her. "You might have colon cancer and so you need to have a colonoscopy". As far as she knows, she doesn't have it so she has no desire at all to go and find out if she has it. In her mind, the doctor would give her the colon cancer so he can take her money. However, we can drag her to her diabetes appointment because she found out she had diabetes when she had her stroke. The doctor told her that her sugar levels caused the stroke and if she doesn't "manage" them, she will have another. She's had a stroke, she knows it's possible, she knows the doctor didn't cause it. She has a friend that had a stroke and was paralyzed on one side and ended up in a bed in a nursing home for the rest of her life. She agreed to the diabetes doctor because she knows that she will be in a nursing home for the rest of her days if that happens. The doctor just called and was quite happy to talk to hubby. She's been wanting to for quite a while but has not been "allowed" to talk to family. We have an appointment next week and while there, the doctor, my husband and myself will "push" why she needs to see a specialist. The doctor did tell my husband though, that if she says no, there is absolutely nothing we can do to make her go.

So while you say "Yet your recent post "we will try to push the thought of a doctor" indicates hesitancy - backing off." I see that we're actually making some effort, even if y'all don't think we're taking this seriously.

There are ways to make her go - they are extream, unpleasant and often expensive. When it is determined someone is a danger to themselves and others there is emergency guardianship - which can be pushed through during the length of your stay - and there are involuntary psychiatric holds. Let me give you an actual example: several years ago my father was sick and my mother took him to the ER. The doctors advised my dad be admitted but neither parent wanted that and they left. The hospital contacted Adult Protective Services and made a report. APS began pursuing emergency guardianship. I got wind of it two days later at which time APS gave me 48 hours to get back to them with a plan for my fathers care. Luckily I was able to get my father to agree to check into a rehab facility and went from there. I imagine EMTs are manditory reporters - they already picked your MIL up out of a poop slick once, what might happen if they see the same conditions again?

Three things to keep in mind - You have what could be determined as a vulnerable elder living in unsanitary conditions. And - the personal freedom to deny medical treatment can be taken away if a person is determined to be mentally incompetent. Lastly, if a report is made to APS and your son or the POA is determined to be responsible for your MIL in any way they could be in danger of being charge with a crime - being aware of your MILs living conditions and not addressing it or themselves not reporting her as an "at risk" person.

I understand what you are saying, and that has been my concern. That is why we are documenting it with everyone that we think there is a problem. The social worker, her diabetic doctor, the GI doctor, the doctor that did the surgery for the impacted bowels, the nursing home that we tried to have them commit her because of the problem and they said she couldn't stay unless she paid cash, the health aide that comes in twice a week, her boss at the Addus. We send emails and I have copies of every time we've asked for help. I've sent Addus emails saying she is locking the son/dil out of her apartment. We've had the police chief and fire chief (small town) come and see how to get into the house without a key. We've documented ambulance drivers unable to take her because she refuses to get in. We document EVERYTHING. There is no way in God's green earth that we can be accused of not addressing the problem when we talk about it to everyone.

Royenburg, and that is exactly why your husband needs, is to come to some sort of plan with her Dr ahead of time to convince his Mom that she absolutely must have further tests done! Tell her she could have a Great Big Tapeworm with Knarely pictures to show her, or some other Fanstatical description that she can wrap her head around to get her to agree, otherwise make damn sure that she signs some very Legal sort of documents saying that she has refused treatment. This is what we did in the Family Medicine Practice where I worked, if a patient refused a Mammogram, PAP Smear, or other test to diagnose a potentially life threatening illness, when warranted. Hopefully if the information is coming from a Dr she trusts, she will agree to treatment, but understanding the situation, probably not without some sort of coercion, and therapeutic fibbing. This is a Tough one!

In my humble opinion, I would get a health care proxy (or Health Care POA it's called in some states) naming someone LOCAL to deal with this situation. You and your husband live abroad and, unfortunately, it's really impossible to act as a viable Health Care proxy when you are so far away. I know your children probably don't want to do this, but somebody in the U.S. has to step up and protect your MIL from herself. It's time for a "come to Jesus" talk with your MIL. Tell her that having diarrhea spilling out of her wherever and whenever is NOT an option in the apartment your arranged to have her live in. From all you have written, she is clearly not making decisions in her own best interests.

My Mom (with developing dementia at the time) would fight me and say things like, "You're not in charge of me" or "You can't make me." When she "assigned" me as Health Care Proxy, that was my "in". When you take your Mom into her doctor's appt, have the girls at the front desk give you a HIPPA release form and have the DOCTOR explain what it is and have her sign it IN FRONT of the doctor to give you, your husband or whoever will be "watching over" your MIL authority while you live abroad. Have the doctor explain to your MIL that if she doesn't have a health care proxy form filled out AND a HIPPA release form, they SOMEONE ELSE will decide what's best for her health in our healthcare system. Your MIL is being obstinate and unreasonable regarding her health, which I'm sure involves some sort of dementia. Denial and acting in an unsafe manner (pooping all over the place and not caring) are classic signs.

I don't want to sound mean, but tough love is what's needed here. Unfortunately, you have limited time here in the States. I don't know if anything is really possible in 30 short days. Is it possible that you OR your husband can stay longer? The wheels of healthcare in the U.S. move very slow. Again, a health care proxy is needed naming YOU and your HUSBAND and then alternates to oversee your MIL's healthcare decisions.

To those who will say, when the Health Care Proxy doesn't kick in unless she's unable to make decisions for herself. Well, guess what? She IS unable to make decisions for herself. Any health care worker worth his/her salt will figure that out. I don't know of any doctor who will not consult with the children of an elderly parent when the children are concerned about their parent's mental capacity in making appropriate medical decisions. Until the HIPPA is signed by your MIL, a doctor may not discuss their health info with the children but that doesn't preclude YOU from telling your side of the story to the doctor. Then, the doctor can discuss the situation with his patient (i.e. pooping all over herself anytime, anywhere). Under no circumstances should your MIL go into the exam room alone -- either you or your husband (and I would recommend you as a woman) accompany her into the exam room. Again, as others have said, have a conversation with the doctor beforehand addressing ALL your concerns about MIL. Then she (the doctor) can go over these issues with her.

You and your hubby are between a rock and a hard place being so far away from this living situation. I really feel for you but you may have to "threaten" your MIL that if she continues to make bad decisions, then she can no longer live in the apartment you set up for her. Tell her she is just "not allowed" to poop all over the place. Tell her that if APS is called again while you are not available (living overseas), she may not have a choice and OTHERS (non family members) will be making the healthcare decisions for her. "Do you WANT that, Mom?"

I'm sure she's in denial and scared. Most elderly are when they get to this point in their lives when things are getting beyond their control. No one wants to lose their independence. But when push comes to shove, SOMEONE has to step up and force the issue. The alternative is to do nothing and let her lie in her own feces. I can't believe APS is not doing something to get this poor woman help.

My prayers are with you Royneberg. Please keep us informed. We care.

We're there for 3 weeks and we can't stay longer. My husband has to be back to work on Sept. 12th and my mom and her best friend are traveling back with us and we're booked up every single day of the 3 weeks they are here. We've booked travel for 8 countries for them, and a cruise. I am going back sometime in Nov. for the birth of our 6th grandchild. I've not booked that ticket yet but I plan to be there at least through Christmas.

My BIL has a Medical POA for her but he has basically just thrown his hands up and walked away.

When we were there in May, we took her to a Neurologist because she wanted her license back. He asked her all sorts of questions, what day is it, what year, who's president, etc. She answered every single one of them correctly. She appears to be in her right mind about everything except the diarrhea. The doctor did not give her the license back and she insisted that I paid him off to take her car from her. The doc told her that while she has all the right answers, she would have to think about them, and if a child ran in front of the car, it would take her to long to process that and she would run over them before thinking about stopping.

Hubby talked to BIL and said that when their dad asked him to sign it was more for making decisions when she is dying. To agree to DNR, things like that. He doesn't have time to deal with her refusing to go to the doctor.

It's not that I don't think you're taking this seriously - I just think you don't realize how serious this is. I'm not talking - see what's causing the bowel distress and get it treated - I'm talking a much bigger picture.

What the neurologist did is called a "mini mental status exam", I belive. My mom, three years after having a stroke that brought on vascular dementia, still passes them with flying colors.

But a year BEFORE the stroke, the geriatric psychiatrist who was managing her extreme anxity the primary reason that she was unable to continue to live at home) recommended that she have a neuropsych exam. She was diagnosed with Mild Cognitive Impairment, which apparently was the result of a prior, undiagnosed stroke. My mom can't REASON her way out of a paperbag; she things any man walking down the hallway of her NH means that the facility has been sold, that there are floods in the basement all the time ( the facility has no basement) and most recently, that she has "something like leprosy" that we're not telling her about. So yes, superficially, she's competent. Is she able to make decisions about her own health, where she lives, what she needs? No. I think the same is true of your MiL.

That being said, it sounds as though there is a long standing pattern of not trusting doctors ( no prenatal care? My, my, that's a bit extreme, no?). I'm not so concerned that she may be dying. I'm worried about the effects of her problem on the heath of those around her. The fact that she doesn't "get" that seems to be evidence of dementia, and that she needs a different living environment.

She said that she remembers when she was 4 years old, she had to have her tonsils taken out, but it turned out she didn't really need it. She said another doctor told her that. So, all doctors are just out to do as many procedures as possible so they can take your money. We're loading up the car and heading to the airport so we'll see how things are when we get home. Thanks for all the replies!

Royneburg: So sorry. I want nothing but the best for you.

Royneberg: Yes, I definitely do understand how hard it has to be with you in another country. I am sorry if I seemed harsh, but I've just recently had to leave my home and move 400 miles away to live with my Mother, who deceased. It's still difficult on me.and seems pretty fresh even though it was 2 yrs ago. I wish you nothing but the best, though you're going through such difficulty. It's not easy.

Royenberg, safe travels. Your mil sounds like someone who makes up her mind about things and then won't let any new facts interfere with her judgments.

I had to point out to my, when she developed breast cancer in 1988, that what she "knew" about breast cancer treatment was based on knowledge from her time as a medical secretary at Sloan Kettering in the 1940s. There had been some developments in medicine in the ensuing 40 years. At one point i said to her, with regard to the REALLY bad decisions she was making about her treatment, "Mom, you're too smart to do something this stupid".

It took a couple of days, but she decided to let go of her fear-based, illogical treatment decision.

The use of Imodium for 30 yrs . ccan be a tip off.
classic with older woho i.e. took castor oil every evening.
she may have IBS. there are diff. types.
make sure she is consuming adequate foods.
Now. You already have a DX of Dementia. The unsanitary poop filled hous etc what you have said are self care sdefecits. slipping in poop isendangerment. shower poop off clean house. barracading herself in. refusal of meals. safe enviroment are endangerment of self or others having to walk in poop cleaning is dangerous to walk breathe last weeks poop. People have actually died from breathing gas off poop.
she is.a danger to herself and others. I would get all legal done. give her option . guardianship for her when you get bacjk. even though this may have relation to moving . All this puts her at risk and shows her dementia. Which from.ehat you say ais more rhan a little with the.poop involvement issue. Unsanitary conditions, that are a danger to her health and othersis a cause for guardianshipset up v
create a safe envirfusal of meals

unsanitary conditiond endangerment of her health and caregivers, others refusal to use life alert suggest you get automactic one that goes off are cause for guardianship for self abuse. Either she let you all set it up or elder affairs. because if you dont Dept Children and Families.And the Courts Will. You can let her know that.I assume the nurdlsing home didnt want to clean up her poop either . Easier let her refuse everthing ig they cannt help her then they can say she doesnt need to be there and get you to take her. The nursing homes only want the easy cases. Takes more staff for the others anfd staff dont want to clean it up either. Staff gets pd the same easy find healthcare job. Keep that in mind. If there is nNO one to care for her. She cann't Carefor herself. Harp on that. She is prob until you can come back more perm. in nsg home. W ones who want to help , Just come out tell her. Make sure you have POA and go to DCF apply for longterm care as POA and to be her dcf represenative payee on fact that have POA then you have access to her medicare medicaid DCF records as Payee. Then w dr statement mild dementa you can get as dcf payee have dr refer to other for evaluation. make sure you have ducks in a row . She needs guardianship. If you dont do it the State will. Let others wihom want to help visit her. This is way to much to ask for them to put their life on hold for. Not being harsh but her withholding medical care from herself is denial and she is really endangering herself and others with being a poop.hoarder.issue. Let them help visiting her

Royenberg - are you still out there? I've been thinking of you and wondering how your visit is going - if you've been able to get your MIL any help.

Yes! I've been wondering what's happening, also!

I know it's not funny but I had to laugh when I saw the words "loves having diarrhea." I believe my mom is the same that way; she just does not care. I know she can't help it and it really is not funny. I tell her when I'm completely disgusted and tired that I wish she could smell herself sometimes, and of course, that does not help the situation at all; she never believes anything I tell her these days or that I'm doing the best I can and it's for her sake. She could certainly be cleaner. My mom's not completely incontinent, and we were given some really good pads to use (not quite ready for diapers yet) that do the job, but I have to fight to put the pad on her properly and then to get her to keep the pad on. These cut down on my having to clean up after her so much when she can't quite make it to the bathroom, and I have not had to get up with her at night much at all now. I'm sorry, the others here have better advice than I can give, and you definitely have my sympathy in your situation.

Hi everyone. :D We are in the US for another week. What we've ended up doing is getting in touch with her social worker and they are going to make weekly house calls. We were lucky enough to find out that her social worker goes to our church. We've voiced our concerns and she has been in to talk to her and has talked to the family. BIL has said he'll be more active concerning POA but I'm not sure I believe him but at this time, I think this is the best we can do. I will be back in less than 2 months and will be here at that time for almost 8 weeks. We've given the social worker our blessing to call APS if she thinks it is what is needed. Everything has been documented and I have a copy of all the paperwork.