Fil right now is in and out of consciousness. He can only indicate yes and no. He is being fed by ivs. He can’t use the entire right side of his body,
Mil reacted by making the sleep aide a true live in, She wants her husband home. This lady isnt even a cna. She has handled a Hoyer lift zero times. She is in poor health herself.
I don’t think she’s reflected on how it really takes a village to handle cases like fil, but she absolutely won’t consider a home and it sounds like she’s even resistant to rehab.
What to do?
Mil’s first instinct in all 15 hospitalizations was to give aide the next night off, presumably to have her own space. We want to foster that versus a paid friend and her family.
I hope you get the unfortunate complexities sorted.
Sil is paid hourly. Aide is paid based on a contract of 117 hours a week, as it was back in 2020 when she was brought in to care not only for fil after his stroke but mil who was fighting cancer at the time. She has long been in remission.
The things mil needs support with aren’t her adls. It’s more like executive assistant functions that her other dil is tasked with. The immediate task burden is now the financial paperwork that comes with spousal death.
I'm so sorry for your loss.
I'm sorry you and your family inherited the drama of the opportunistic aide.
We also had an opportunistic aide who Dad was very bonded with. After Dad passed it took awhile but the opportunistic aide washed herself out and was replaced with a legit, competent CNA.
I with you strength during these trying times.
The 24/7 scheme is already canceled. Aide is not even supposed to be there until 9 tonight. When dh asked how long that would be going on, mil said for just a little while. Those hours are too late to cook a communal meal to feed the child with or for the child to be coming over. Which the child hasn’t been —thank god—during the gatherings of extended family.
Dh’s brother reinforced this understanding last night when he and dh went over there at 3 am. Aide had been the one keeping vigil. He turned to aide and said, “Welp, thank you for your services.”
It would be decent to pay aide severance. All for that. But when it comes down to it, this aide was mostly there for fil.
200K a year, eh? That should be worth a lot of companionship.
I am so sorry for the loss of your FIL. I’m glad he made it back home since that is where he wanted to be.
No matter how ill they are it is always a shock when they finally pass 💐
He died about five hours after we left. 230 am on tuesday
Dh had planned to spend a few moments privately with dad today, so he’s gone back there by himself.
Dh’s brother was in the driveway having a cigarette. Dad had two full puréed meals after being sent home with doctors saying he had no swallow reflex. Dad can still indicate words. At this point, it looks like we were sold a way worse outcome than presently exists. It definitely looks like he could benefit from rehab.
Aide made a deal of repositioning fil while requesting mil’s assistance. Aide then removed her sandals and put her dirty bare feet on the couch. When the company came, aide finally let us alone.
Will your MIL need to have this aide after FIL passes? Does she need help as well? If so, maybe the aide she knows the longest is the best one to stay there. I don't know how old the child is, and I do think if there is an ambiguous status, that is the aide's problem, not your family's. I think any legal problems would be on the aide, not your family. Everyone should deny all knowledge of the child's origins, and say they figured this child belonged with this woman if anything legal happens as a result. No one is paying the child, right?
These relationships get so tangled, and people who live in the house to take care of people are really walking a fine line with the relationship.
From the time fil is transported home until the time he dies, we all realize aide will have a huge role. She has been the one he’s been comfortable with changing his diaper since his first stroke. We all get it.
i kinda see this as more pernicious than the romance scam, tho. As my own hospice counselor (from dads death) put it, her coming in bearing gifts like lobster from her “church” in the first year and giving us Hawaiian Host chocolates was a calculated and very typical move based on his own personal exp. Btw, they aren’t Hawaiian islander, but use that sympathy. Once they show they’ll take care of elder, elder is expected to take care of them. Thats whst my own hospice counselor said.
I can see putting up with this in the short term, but I don’t want to be part of this for the long term. Tweens sent out to curry favor and profit from clients—even if they don’t fully understand this—are not people I need to deepen relationships with,
It’s not exactly a rally and this is not exactly hope but I don’t see how we can deny him that or ice chips or whatever once he comes home. I get it with hospice, my dad was on it, but we fed and watered him until the end. My sister runs a cancer department. We consulted with her. Whereas the present hospice seems to be pushing the no fluids thing.
Always looking forward, so the next holiday is Easter. If there’s any celebration, I see myself stuck on the couch conversing with mil and aide’s informal foster adopt child seeking attention from the one of eight informal grandma role models existing.
To some, I seem extremely harsh. Whatever. Aide has a husband with an actual horse farm in her country. Aide is here to maximize resources toward that for her own family including the kid I might be tasked to socialize with. I’m not being paid, aide is. The day aides paycheck stop, so do the visits from the child.
Which makes both non family.
Im sorry aide introduced a child. But she’s not my child and we don’t even know what relation there is to aide. Tweens can say all kinds of things to outside people, true or false. We don’t need that risk. As long as she is inserted, I need a gray rock strategy.
For the gray rock, all I can think of is simply being cordial. I would find it very hard, myself! 😬
Aide stated she had observed fil eating a full breakfast. We had all been told he couldn’t swallow, but here he’s doing that just as the hospital has gotten the consent to just hand him off to hospice.
Of course, aide is primed to make bank on this occasion. She has inserted herself as “family”, as MIL even told our pre-hospice meeting she saw her as family. You too can shnooker an old person for what is presently a 200k salary plus free rent and food for you and whatever relation this child is to you. His passing with the child’s “cute” presence sets it all up for MIL to request her son's rehab the upstairs suite for this wonderful tween who held his hand or catheter bag when dying, which could definitely be construed as child labor.
Aide being present for hospice and funeral period is one thing. Us having to adopt aide into the family thereafter is another.
Hate to tell ya grams, there’s a million more grammas for this kid at its home. It’s real home.
He was comfortable throughout.
"Generally, CNAs cannot start, maintain, or administer medication through IVs, nor can they manage, start, or flush feeding tubes (stomach feeding), as these are restricted nursing tasks. While they can assist with oral feeding and monitor for complications, inserting tubes or giving medication via tubes is outside their scope."
CNAs are not medically trained. So here may be a good reason to place FIL in LTC. Him not swallowing is a big thing. I think my RN daughter would say, no stomach tube. Once they place it, only Hospice can remove it. He maybe transitioning. Hospice may be the only choice.
Fawnby said "She has no idea what she's asking for by insisting he come home." I had to laugh at that. Ever since Peggy has posted, her MIL has paid thousands of dollars to have her and her husband cared for. These people she hired, I think, are not even trained. So, MIL doesn't care because she will expect others to do the care. She won't be doing it.
I can imagine MIL must be feeling extremely sad and frightened and hoping to “make things right” and “do her best” but I’m afraid those things will not save him.
Where is your husband in all this? You are amassing as many questions as possible for the “big meeting” but I suspect the real issue is more emotional than practical. Not “how exactly is MIL going to face the 9,254 complex care issues she will be facing” and “how can I convince her that she is not up to it” but more how are they all coming to terms with his likely imminent death. You all have my sympathies.
Ill start. If he’s going home with a tube on pallative care do we just bring him back to the er if and probably when he aspirates? Then what?
If he goes on hospice, it is a matter of arranging with a new provider whether he will continue on the new antiepileptics he is on. Morphine, Ativan and Seroquel aren’t going to fix his seizure problem.
Home for comfort care is more complicated than it sounds. Ask if he could go to LTC rather than home. (Don't let MIL edit your list of questions! This is certainly a legitimate one.) If comfort care lasts only two weeks, then that's one thing, but if it goes on for six months, that's another. In the case of the latter, he'd already be in a nursing home, and MIL would not have to turn her home into one. Which is extremely awful to have to do because her home won't be a home anymore, it'll be a nursing facility, and if she's not in good health herself, the effect on her could be serious. She has no idea what she's asking for by insisting he come home.
Please let us know how it goes!
I am not a cna, and had no prior medical care experience before my husband was in the same condition as your FIL. After several weeks (unsuccessful) in Rehab, then another 9 month in a skilled nursing facility, I was forced to bring my husband home and begin caring for him. I had spent nearly every day with him at the hospital, rehab, and nursing home. I watched, learned, and was even taught by the nurse how to provide the basic daily cares my husband needed. By the time he came home I was fairly proficient in diaper changes, bed-making, transfers, and using a hoyer lift properly.
I guess the point I'm trying to make is the caregiver does not necessarily need to be a cna, but she DOES need training - even informal - to learn how to properly manage this man's care needs.
I can kind of understand his wife's desire to have him back at home. We all just want our life to return to normal.
I'm not going to judge whether she should have him cared for at home, or in a skilled nursing facility. But, I hope you can convince her to have a better trained and more experienced aide to help with the home cares. Both the wife and aide should get some training. He should definitely take advantage of spending weeks in rehab, and try and get him off the IV feeding. They will not be able to do IV feeding at home! She can ask the doctor about a G-tube for feeding, and learn how to use it. (I had to do that as well for my husband for the first 2 years) She and the aide can alternate spending days in his room, if allowed, while at rehab, watching and learning how to manage his care needs. They may even be able to get some informal instruction from cna's and nurses there. That was how I learned.
This has been my only job now for 10 years. I was previously an office assistant.
I love having my husband at home with me, even with all the challenges. I currently am employed by a home health care agency, with my husband as my only client. I have to maintain CPR/First Aid certification, as well as completing several continuing education units every year.