This issue has had me tearing my hair out for a couple of weeks. Here's the story.
My 85 y/o MIL has lived in the same rent-controlled apartment in Chicago for ~40 years - first rented by her late husband, for the past 6 her - then later my SIL moved in with her.
About 2 weeks ago, she fell and broke her hip. She spent a few days in the acute care hospital, then they called my SIL at work two days after the surgery that "she has to get out." They said they couldn't arrange a room in rehab. The SIL got this message about 6 pm, took the next day off (Friday) to talk to them. Early in their talk, she listened to voicemail from me in Nebraska. They gaslit, saying "We'd NEVER just throw her out on the street." I told SIL on her voicemail, using my stern (retired) librarian voice "Do not allow them to bring her home. If they do, send her back, calling 911 if necessary. It's an UNSAFE DISCHARGE." Suddenly, they found her a room.
Now, supposedly the "insurance" who initially said "up to 20 days" is saying she needs to leave by THIS Friday. Supposedly, there is a report from her physical therapist that she can walk 300 feet, and climb 100 stairs. According to my MIL, THAT IS A LIE. She needs help getting to the bathroom with her walker. Now, I know that falsifying a medical record is a felony. Told MIL and SIL to report him to the facility.
Now, there's no way we can afford to pay for all of this stuff that she needs. My husband (DH) and I each have our own medical issues, and are set up here, in Nebraska, ~1000 miles away, for our care. SIL says she's "one paycheck away from bankruptcy" living with their mother. There's no way we can afford Chicago at all! We're not going hungry soon in our paid-for house, but this is a small town.
There are several options available for MIL near us. With us.... nobody wants that for more than a few days. There is a senior care center, with everything from assisted living to skilled nursing. They cost about 1/3 what they do in the Chicago area. She doesn't want to live "in a small town". Cheyenne is the biggest city nearby - where we end up going about monthly anyway. They offer a furnished, elevator-accessible apartment, walking distance from many things, other things can be delivered, for about 1/3 of what she's paying for this 3rd-floor walk-up
There seems to be a lot of denial involved. Her stepson, in his 60s, has offered to carry her up to the apartment once. She's only about 115 lbs. If she's there, she'll be a shut-in. He simply cannot be there everyday or even every week to get her in and out.
My SIL insists that she cannot move (her job - needs it for healthcare). She doesn't HAVE TO move with her! (Can anyone say "codependent"?) She wants to move to S. California - but.... MIL could move without her, but she's insisting not to leave Chicago.
I relayed the message to DH that he's got to "let the disaster happen". He's worried that his Mom is shut in to a 3rd floor apartment, there's an emergency, they don't have a landline and cell service is... well... it can go out too in an emergency.
He's suggesting going out to Chicago, cancelling all of our upcoming medical appointments. That will cost us a minimum of $120 per day in hotel, plus meals. I simply cannot get in and out of that apartment! I have mobility problems plus a healing broken arm/shoulder now.
DH is listed as a contact, but no one from the facility has called here or talked to us.
Any ideas on how to get over this objection? Besides leaving her on the street? We cannot afford to move there, nor can I be of any help in her 3rd floor apartment. There are options in our local area, from independent living (perhaps within a block of our house), to assisted living, to SNF.
Objections "I don't know anyone there! I don't have any friends!" (I know several very friendly women close to her age who would be here in 5 minutes - plus there's a senior women's group here (I go sometimes). "It's a small town. (Okay...)
Can SIL remain in the rent controlled apartment without MIL being there?
If so can you convince mom that SIL will stay and hold the apartment and she should come to the AL close to you until she is well enough to do the stairs to be able to safely remain in her apartment?
One of two things will happen...ok maybe 3 things.
1. She does regain her strength and can move back to her apartment.
2. She does not regain strength and remains in the facility close to you.
3. She does regain strength but decides she likes the amenities that the AL offers and she wants to stay.
It's a good idea to frame it as "a little while, until..." at least at first. Then, one of the 3 things you list will happen.
Does MIL have any cognitive or memory decline?
If no to both above, then family has very little power to force a resistant adult to do things against their will, or to pay for any of it.
I agree that people need to stop orbiting around her so that she sees she will have to make a decision.
Early signs of dementia are stubbornness, irrationality and lack of empathy as to what their decisions and actions are doing to others.
If anyone does think they still want to step into this thankless fray, they need to insist that they be asigned her DPoA for medical and financial first.
Moving her to whoever is willing to manage her care and oversee her affairs is the logical solution. Transitioning her into IL or AL in a continuum of care facility is the wisest thing to do -- not an apartment where she'll just need more hovering.
Caregiving needs to accommodate the care givers or burnout will happen. She needs to afford to pay for her own care, since it would be unsustainable for anyone who isn't extremely well-off.
Also realize two things: elders often don't recover to their pre-fall level of functionality, and; this won't be her last fall. Once falling starts, it's usually considered "the beginning of the end".
Wishing you wisdom and peace in your heart as you sort through this situation.
The apartment we're looking at is in a beautifully restored hotel in a downtown area. There are all sorts of things she could walk to, and suitable transportation is available at the curb. We go there about monthly; we are not close enough to "hover", but close enough to do something in case of emergency and visit ~monthly. Moreover, she can leave it at any time, to go to a more "supportive" care environment.
Money is a problem for her.
Thank you even more about your note about "elders don't often recover to their pre-fall level...". *sigh* I took a bad fall myself in May, breaking my arm and shoulder. I'm realizing I cannot do things I could just a few months ago. Things are improving, but I doubt I'll get back to doing everything I used to.
Your m-i-l thinks she has lots of friends in her area, yet she doesn't see any of them. She could be remembering a past social life without realising that's not her current reality. It may well be that her perception is skewed and untrustworthy.
I completely understand your s-i-l. I didn't want to be enmeshed in my mum's life, yet I would have found it extremely difficult if she had been moved 20 miles away from me, let alone hundreds of miles away. I don't drive and would have been very sad to not be there for her.
Nevertheless, it would be better for your m-i-l to be in a suitable facility that she can afford. Yours is the last voice to be heard in this matter, though, so there's not much you can do except wait and see.
But stop talking about paying for your m-i-l's care - you will need to pay for your own care soon enough and can't afford to use your money for someone else, especially when that person doesn't want your intervention.
The SIL's refusal to live in reality is more concerning.
I have all but vetoed the notion of going to Chicago in a few days, as among other things, I don't want to walk into a war zone! Between the National Guard and SIL... If husband wants to go, he's on his own. I'll tell him I'll stay home ready to do what I can to get him out of the situation if I can.
Dealing with this with my BIL. He lives 2 hours from everyone which is too far for us to just pick up and run down there. We have all asked he move a bit closer so we can help but he refuses. OK, then he has to deal with it.
Your SIL's problems are not yours to worry about. She loses a place to live if her mother moves. So, she is loudly objecting, and probably convincing her mother not to move. Yes, they may have a co-dependent relationship, but you can not change that.
Here's how I see getting over your MIL's objections; regarding having no friends if she moves, how does she plan to see friends when she is a shut-in in her 3rd floor apartment in Chicago? No one will help her to get out of there once she is in! It is NOT SAFE for her 60-something stepson to be Carrying her up 3 flights of stairs!!!! Please don't let them attempt that!
You say you can not afford to pay for all the stuff she needs. What stuff does she need, and why do you feel any responsibility for paying for any of it? Your MIL will have to pay for her own medical care. She may qualify for Medicaid, the SIL should help her apply for that NOW!
If she still refuses to leave Chicago - I understand, that is where she has a life and feels comfortable - then it is time to look at assisted living or skilled nursing facility. She can not live in an apartment she can not access! She's Not going to enjoy a skilled nursing facility, but she likely can't afford the assisted living.
Let her fail, if she stubbornly makes bad choices. Do not help her to pay for anything. Do not go to Chicago. She will have to experience hardship before she will agree to make a change in her living arrangement.