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The Dreaded Call


Jean in Newcastle
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Your spate of threads makes it appear that you aren't really speechless.

 

 

 

This thread and others have addressed that home health aids were insufficient. Turnover, quality, reliability are all huge factors. I think it's safe to say, reading this thread, that Jean has done all she can do and armchair caregiving it after the fact just isn't really helpful.

 

I cared for my mother through cancer, at her apartment, then at my home and finally at a hospice for the last few weeks of her life when she needed more than we could provide at home. I did the last year old this while sick with hypermesis gradivarium and then with a tiny newborn and infant for 6 months. I am sympathetic to home care advocates. It is thankfully what worked for my mom but it doesn't work for all people. And the time to advocate for it isn't on this thread. It's just not. Be thankful that home care was a viable option for your mother. Don't assume that it is a viable option for others.

I'm not sure what the little dig about my "spate of threads" is about.  I don't post here often, actually, anymore.  ??

 

I don't need to be lectured by you as to the viability of home care when I have assumed nothing.   Like you, I know a little bit about this topic.   I simply responded because of the harsh beat-down on the poster who made the response that our parents took care of us and maybe we should take care of them. She is entitled to her opinion too, though I stated quite clearly that perhaps a new thread would be a better venue. 

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When dh's grandmother starting the 2 am calls to us, we had it written into her care plan that the phone be unplugged from 10 pm to 8 am. She continued to call a lot during the day and I encouraged him to stop answering every time because her dementia prevented her from remembering that she had just called five minutes earlier. It was very hard for him to manage all of this emotionally.

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I would put a limit on it, honestly.  This was before we moved her to assisted living but when we had caregivers in her home, she would call us 10 times a day.  She would forget that she called.  That was when my dad was living with us and I was taking care of him.  I don't think there would be anything wrong with limiting calls to 2 a day.  They are going to have to get used to it. Period.

 

But I didn't respond to someone who thought calls should be limited to 2 a day.  The poster to whom I responded thought the nursing home should block the parents from calling at all for weeks.  Not right. 

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I'm not sure what the little dig about my "spate of threads" is about. I don't post here often, actually, anymore. ??

 

I don't need to be lectured by you as to the viability of home care when I have assumed nothing. Like you, I know a little bit about this topic. I simply responded because of the harsh beat-down on the poster who made the response that our parents took care of us and maybe we should take care of them. She is entitled to her opinion too, though I stated quite clearly that perhaps a new thread would be a better venue.

We are all entitled to an opinion. We also all should be responsible and kind enough to know when those opinions really don't need to be voiced.

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But I didn't respond to someone who thought calls should be limited to 2 a day.  The poster to whom I responded thought the nursing home should block the parents from calling at all for weeks.  Not right. 

 

I'm not a fan of leaving them alone for weeks with no communication, because people with dementia have no concept of time PLUS you need to be able to assess how it's going by seeing and speaking with them. Even the best facilities make errors with meds or diet, you might need to make small adjustments with clothing, how their room is set up, etc. This is not the time to stop contact.

 

Of course, people with dementia can't keep track of how many times they have called someone. Jean can put her phone on silent and not answer their calls more than twice a day. 

 

I don't believe that a nursing home can prevent someone from making a phone call. That would violate their civil rights. However, my experience was that by the time my mother entered a facility, she was no longer able to figure out how an unfamiliar phone worked. Hopefully too many phone calls will not become a huge problem for Jean's family.

 

:grouphug:  :grouphug:  :grouphug:

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Sounds like you have really had a lot on your plate.

 

Maybe it would have been easier to sell the rental properties and with the proceeds, hire someone to be with them in their home?   Anyway, you did a lot, moving them five times!  Goodness. 

The five moves involved less than five houses and is too difficult to explain here!  Anyway. . . there were financial reasons behind some of the moves back and forth, though the ultimate goal was getting them into a home that had been remodeled to be elderly friendly.  Their rentals are their income now that pays for their care and will continue to pay for their care as long as they need it.  

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Not the person you are addressing, but I have done it, albeit for only 1 parent, as the other one was already gone.    And I had very young children at the time (age 4 and under - I'm old).   I feel somewhat qualified to address it. 

 

Sometimes there isn't anything else that can be done, such as where the elderly person is violent, hooked up to machines that need to be maintained by medical personnel, routinely escapes into traffic, and other such safety matters.

 

But sometimes - often, I'd say,  that isn't the case at all.  Other people are entitled to have different opinions from the OP, although I would certainly agree that maybe a new thread is the better place to introduce them in highly emotional situations like this. 

I thought I started a thread about my very specific situation?  Where I already stated that we've had multiple Silver Alerts involving the police despite having a gps system and care to stop escapes?  Perhaps another thread might indeed be the place because I honestly was asking for help from people who would take the time to understand my situation.  

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No one has suggested dropping them and going dark. The poster who suggested a moratorium on calls went daily and was supervising the care. No solution is going to work for everyone. Some dementia patients have serious anxiety and get fixations. If the phone is a fixation, removing and distracting can be a solution.

 

Instead of a mommy drive-by, we have a DIL drive by? Superiorority complex much? Do y'all go to funerals and tell people how much better you would have handled their loved ones' illnesses? Yuck.

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I thought I started a thread about my very specific situation? Where I already stated that we've had multiple Silver Alerts involving the police despite having a gps system and care to stop escapes? Perhaps another thread might indeed be the place because I honestly was asking for help from people who would take the time to understand my situation.

Jean, you don't have to defend yourself to internet armchair quarterbacks. :grouphug:

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What I was implying was that some people will quickly call others to come rescue them out of situations they don't like. I know Jean. I know she has done so much for them. They are in a good place for them now. The staff needs to help them adjust, not Jean. The staff needs to help these people get used to their new situation, not Jean. By all means call and ask how they are. Offer to speak to the Dr if they beg to leave. But emotionally,a week of just waiting might be good for Jean. Let the staff help them adjust so when they come visit in person it's a time to ask about their week and not just a rescue mission. Everyone needs to adjust to this. And let the center manage the difficulties these people are struggling with. The family is just as upset and they also need to let the staff do their job. In a few weeks hopefully everyone can handle the occasional begging to leave comment. The people will be better adjusted and the family will be equipped with better phrases to say like I will talk to the dr .

 

As moms we have all had to listen to our kids beg something to change(or cry/scream), but its harder when it's parents. Jean knows this is best for them. I hope the family sticks together and utilizes the staff who have helped other people through this. If they rush in every phone call they won't ever adjust.

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Just another thought - by giving everybody time adjust to the new normal - you send a message to the staff (particularly the caregivers) that you trust them; that you consider them key team members; and that, for the great majority of the time, you will be relying on (and deferring to) them to make decisions regarding your loved ones' day to day care.  

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Dh and I had a long talk last night.  He did shed some light on some of his parent's fears and fixations.  He's on the same page with SIL and I, which as someone else pointed out way up thread, is a good thing.  Despite being on the same page it is a bit of a complex dance, isn't it!  We all care about MIL and FIL very much.  

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Awwww, you did the right thing.  I've worked in nursing and I plan on keeping my family at home too, unless they get dementia.  In that case, a locked memory ward really is the best and safest option. If I or my family had dementia I'd do the exact same thing.  It's very normal for them to object strenuously for several weeks, even a month, but they will get used to it.  And as their caregivers get to know them and their routines, the caregivers will adjust and do things the way they want more, so everyone will be happier.

 

There's an amazing book called The 36-Hour Day that you really should read.  It will tell you the phases of dementia and what is normal and what you can expect in the future.

 

Also, those with dementia might not remember what happened two minutes ago, but their moods are more persistent than their memories.  So doing little things that make them happy will make them more happy.  One nursing home found that giving dementia patients chocolate improved mood and behavior for everyone to such a degree that they started charting it like a medicine. Now obviously that doesn't work so well if someone has brittle diabetes, but the concept holds true whether it's wrapping a cold person with one of those microwave grain heating pads and a blanket, putting up mementos on their walls so it feels more like home and they have something to think about besides being in a new place, having their favorite music or TV show play in the background, etc.

 

I know the rules are different in different areas too, but in the couple states I've worked at nursing homes in, unit routines could be changed based on family request.  For example, if they want to be able to sleep in, skip breakfast, and have a snack at 9:30 or 10 instead of a full meal, a nursing home might be able to do that. For most of them we had to give them certain snacks to make up for the calories lost in breakfast, but it's doable.  You might give them a few weeks to adjust before changing anything though.  It might turn out that they'll get used to it and even like a new routine.

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When my great-grandma had to go into a locked ward nursing home (Parkinsons and dementia) we were blessed with being able to create a schedule for family to go visit that first month.  Since there are so many of us, Great-grandma had someone new to pop in for a visit every single day.  At the nursing home's suggestion, we arranged for visits just before bedtime.  The family would come in visit for awhile. A nurse would come to put her in her PJ's and the family would head out to the waiting room.  Then the eldest woman would come back in to tuck her into bed and say prayers.  Saying bedtime prayers was very important to great-grandma, she never lost that habit.  Sometimes, she would forget who she was praying too! LOL  Those made for fun stories, but I think having someone there every night made it easier for her to emotionally transfer from her home to the nursing home.  Great-grandma's sons would pop in every day or so to see her, but everyday one of the boys would stop in to talk to the staff and see how she was doing.

 

Hugs for you as you and your family go through this transition.  One comment my Aunt made was that she was so grateful to be just a Daughter-in-law again and not the one who had to make Great-granny take a bath.  Relish being just family together and let the staff do their jobs.

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Awwww, you did the right thing.  I've worked in nursing and I plan on keeping my family at home too, unless they get dementia.  In that case, a locked memory ward really is the best and safest option. (snip)

Not all people "with dementia" even have dementia - often, it is undetected infection in the elderly - but even so, it is only the "best and safest" option for runners/escape artists who regularly endanger themselves, because you find them out on the highway or something like that.  Many, many older people never have any inclination to do anything or go anywhere at all.  They just stay at home.  I think it is important to point out that critical distinction, lest people reading this thread think all people with dementia automatically need to be in a locked, memory ward.  Nothing could be further from the truth. 

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 One comment my Aunt made was that she was so grateful to be just a Daughter-in-law again and not the one who had to make Great-granny take a bath.  Relish being just family together and let the staff do their jobs.

This really spoke to me, Amy, since I've been the one the family has always called on when MIL would refuse to do anything.  MIL won't take her pills?  Call Jean.  MIL won't bathe for five days?  Call Jean.  I was always gentle with her but also the bad guy who had to stand firm and not take no for an answer.  It was always so stressful for me.  

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Not all people "with dementia" even have dementia - often, it is undetected infection in the elderly - but even so, it is only the "best and safest" option for runners/escape artists who regularly endanger themselves, because you find them out on the highway or something like that.  Many, many older people never have any inclination to do anything or go anywhere at all.  They just stay at home.  I think it is important to point out that critical distinction, lest people reading this thread think all people with dementia automatically need to be in a locked, memory ward.  Nothing could be further from the truth. 

 

I've never seen a doctor diagnose dementia unless simple things such as infection had already been ruled out.  Also, many times when something dangerous happens such as leaving a stove on, or wandering away and getting lost for three days, it happens with little warning.   It takes time, proper diagnosis, and a lot of arrangement to get someone in a locked ward.  It is never done lightly.

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I've never seen a doctor diagnose dementia unless simple things such as infection had already been ruled out.  Also, many times when something dangerous happens such as leaving a stove on, or wandering away and getting lost for three days, it happens with little warning.   It takes time, proper diagnosis, and a lot of arrangement to get someone in a locked ward.  It is never done lightly.

I have, and that is most definitely not true everywhere.  It happened to us.   Thankfully, we didn't simply accept it at face value, and a GOOD doctor pursued it to the end.  It happened to extended family as well.  They were more than happy to just slap another old lady or man "with dementia" in a home, trust me.  I was there. 

 

I don't believe that assertion that most people will just suddenly begin doing dangerous things.    Most people are very much creatures of habit.  What they did before, they will do again.  If they are sedentary creatures who watch TV all day, that isn't changing.  If they are on the go, go, go, all the time, that isn't likely to change either.  

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What in the world?  MIL and FIL have both been thoroughly checked out.  We've always had MIL checked for hidden infections whenever symptoms have gotten worse.  This isn't about them being diagnosed.  This is about finding appropriate care for them in light of their diagnoses and their current stage within that diagnosis - which by the way, didn't just happen yesterday but years ago.  

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Jean, I am sorry that one poster doesn't know when to quit. Don't let such little insinuations second guess yourself. You are doing all you can, utilizing the resources available to you. It sounds to me that your ILs are very much loved and looked after.

If you mean me, I'm not even addressing the OP.  I was addressing misinformation - or what could be construed as misinformation - in another post by someone else, which stated that the best option for people with dementia is a locked ward.  This has no relevance to the OP, but I'm not simply going to leave something like that unaddressed, lest someone else have the faulty idea that a locked ward is automatically the route to go for someone with dementia.

 

Not so, except in some cases. 

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I have, and that is most definitely not true everywhere.  It happened to us.   Thankfully, we didn't simply accept it at face value, and a GOOD doctor pursued it to the end.  It happened to extended family as well.  They were more than happy to just slap another old lady or man "with dementia" in a home, trust me.  I was there. 

 

I don't believe that assertion that most people will just suddenly begin doing dangerous things.    Most people are very much creatures of habit.  What they did before, they will do again.  If they are sedentary creatures who watch TV all day, that isn't changing.  If they are on the go, go, go, all the time, that isn't likely to change either.  

 

nm

Edited by Susan Wise Bauer
Engaging without name calling is a better way to advance the discussion.
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Jean, if you feel relief and your in-laws are safe, then you did the right thing.  Period.  Some other posters on the thread seem to be having a pissing contest at your expense, but you still did the right thing.

What in the world?  MIL and FIL have both been thoroughly checked out.  We've always had MIL checked for hidden infections whenever symptoms have gotten worse.  This isn't about them being diagnosed.  This is about finding appropriate care for them in light of their diagnoses and their current stage within that diagnosis - which by the way, didn't just happen yesterday but years ago.  

 

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Fair enough for a discussion, but maybe another thread?

If you mean me, I'm not even addressing the OP.  I was addressing misinformation - or what could be construed as misinformation - in another post by someone else, which stated that the best option for people with dementia is a locked ward.  This has no relevance to the OP, but I'm not simply going to leave something like that unaddressed, lest someone else have the faulty idea that a locked ward is automatically the route to go for someone with dementia.

 

Not so, except in some cases. 

 

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Jean,

Oh hon, so many hugs to you and your family. I will be praying for you all.

I worked as a CNA while I was going to school for my RN in a nursing home's memory unit. I vividly remember the heartbroken sons and daughters that left in tears - they hated the dementia that had stolen their family members's memory and the intense pain of realizing "I'm at the end of what I can do" is dreadful. Many times I hugged those sons and daughters. It still makes me tear up thinking of it. I wish with all my heart that dementia never happened to anyone. You and your family have been true heroes and we can see that. Be gentle with yourself, you are my hero.

 

Michele

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I don't believe that assertion that most people will just suddenly begin doing dangerous things.    Most people are very much creatures of habit.  What they did before, they will do again.  If they are sedentary creatures who watch TV all day, that isn't changing.  If they are on the go, go, go, all the time, that isn't likely to change either.  

 

That is just plain wrong.

 

People with dementia can lose their personalities. It's not just that they become forgetful. Their entire personality changes so the idea that they stick to previous habits or patterns of behavior is completely false.

Previously calm, lovely gentle people can become violent, swearing, hugely offensive.

 

 

Jean  :grouphug:  You're doing the right thing.

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I have, and that is most definitely not true everywhere.  It happened to us.   Thankfully, we didn't simply accept it at face value, and a GOOD doctor pursued it to the end.  It happened to extended family as well.  They were more than happy to just slap another old lady or man "with dementia" in a home, trust me.  I was there. 

 

I don't believe that assertion that most people will just suddenly begin doing dangerous things.    Most people are very much creatures of habit.  What they did before, they will do again.  If they are sedentary creatures who watch TV all day, that isn't changing.  If they are on the go, go, go, all the time, that isn't likely to change either.  

 

This thread has been started to give support to a woman that has jumped through every hoop to try and keep her IL's happy and at home. The decision to have them in memory care was made after making sure all avenues of diagnosis have been evaluated. They are where they need to be.

 

Jean needs support as they begin this new leg of their families journey not statements that stir up the guilt and doubt that is inevitable when making this large of a decision.

 

You are are absolutelly entitled to believe in and have the opinions you have expressed in this thread. However, I would suggest that if you want to have a dicussion about the diagnosis of dementia and the merits of in home elder care you start a new thread to do so and let the rest of us support Jean.

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my friend cared for her beloved mil as she developed dementia.  my friend also had a son with a catastrophic brain injury suffered at birth.    her mil was rude, she was nasty, etc. etc.  friend's comment was - if she ever directs that nastiness to her disabled son (who was in a hospital bed in the same room.), she would be sent to a nursing home.  he was the ONLY person she wasn't nasty to.

 

dd's best friend is working with TBI patients - damage in particular areas of the brain can completely change a personality.  the sweetest person in the world - can become a nasty, vile and hateful person - due to changes in the brain beyond their control.

 

 

That is just plain wrong.

People with dementia can lose their personalities. It's not just that they become forgetful. Their entire personality changes so the idea that they stick to previous habits or patterns of behavior is completely false.

Previously calm, lovely gentle people can become violent, swearing, hugely offensive.


Jean  :grouphug:  You're doing the right thing.

 

 

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such a lame excuse.  ;)

 

we love you jean - and we're here for you.

I know, right?  It's the kind of excuse that Heels makes!  

 

Thank you all for the support.  

 

You know what is really funny in a very nice way?  Dementia has changed MIL's personality from being very strong and boundary stomping to very sweet  now that she is unable to make decisions.  This doesn't mean that we try to go roughshod over her though.  We still try to pick out her favorite outfits from before, for example.  But it has made her more pleasant to care for.  She will still stay no to things and some, like FIL, have been trained from years of living with her to capitulate the instant she does, but now if I gently say, "you need to wash your face", she will actually do it.  

 

FIL on the other hand, is a bit lost without her to tell him what to do.  And that, according to dh, is what is fueling a lot of anxieties for FIL.  

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My father was a gentle kind man for his whole life. Until he started losing control of his brain. Then he was mean, violent, intolerant, and generally not very nice.

 

Caring for people with dementia is not like caring for other end of life situations.

 

My father needed memory care long before my mother would agree to send him. It was horribly stressful and frankly dangerous for him and for her.

 

There is no one right solution. Please don't insist that there is.

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My father was a gentle kind man for his whole life. Until he started losing control of his brain. Then he was mean, violent, intolerant, and generally not very nice.

 

Caring for people with dementia is not like caring for other end of life situations.

 

My father needed memory care long before my mother would agree to send him. It was horribly stressful and frankly dangerous for him and for her.

 

There is no one right solution. Please don't insist that there is.

I certainly agree with the bolded. 

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FIL on the other hand, is a bit lost without her to tell him what to do.  And that, according to dh, is what is fueling a lot of anxieties for FIL.  

 

I had that with my sister and my mother.  my mother was actually in better shape than my sister when grandmamma died.  my sister couldn't emotionally cope.  that isn't healthy for an adult - and is pretty darn sad.  I really think the completely out of it the last year of gm's life was God giving my sister an opportunity to "let go" before she actually died.

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Hmm, very interesting parallel there, and I'm wondering why you drew it, not that it matters, I guess. 

 

because you come across as though your viewpoint is the ONLY right viewpoint, and can be pretty darn insensitive to other people going through a difficult time.  in both areas.

 

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because you come across as though your viewpoint is the ONLY right viewpoint, and can be pretty darn insensitive to other people going through a difficult time.  in both areas.

 

That is certainly one way to interpret it.  I'd would say that the parallel points to a different conclusion, but you are entitled to your negative and erroneous judgments of my views, as you have repeatedly expressed.  The truth is that I'm merely addressing a few points that were presented with personal experiences to the contrary, lest anyone think that there is one acceptable route when a relative gets dementia.  Feel free to ignore my posts. 

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because you come across as though your viewpoint is the ONLY right viewpoint, and can be pretty darn insensitive to other people going through a difficult time.  in both areas.

 

Actually, I don't care if TM has a different viewpoint on elder care than others.  That would be appropriate on a thread that is asking for different viewpoints on elder care.  What TM is missing is that this thread is one that was asking for support.  It is true that I did not spell it out by saying "please give me support" in the OP and perhaps that is what I needed to do for her.  So, TM, I'm spelling it out for you.  My family is under a lot of stress.  We are trying to do our best in this situation and would like some support from others in the Hive.  Some people know how to offer advice and support at the same time.  But giving me criticism is not advice and is not supportive and is not helpful to me.  If you would like to debate elder care, please start another thread.  

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Actually, I don't care if TM has a different viewpoint on elder care than others.  That would be appropriate on a thread that is asking for different viewpoints on elder care.  What TM is missing is that this thread is one that was asking for support.  It is true that I did not spell it out by saying "please give me support" in the OP and perhaps that is what I needed to do for her.  So, TM, I'm spelling it out for you.  My family is under a lot of stress.  We are trying to do our best in this situation and would like some support from others in the Hive.  Some people know how to offer advice and support at the same time.  But giving me criticism is not advice and is not supportive and is not helpful to me.  If you would like to debate elder care, please start another thread.  

Gotcha.  If you were writing a "just agree with me" post, I would not have responded at all.    But others said things that were just plain strange or wrong regarding elder care generally, so I responded to those things.  I didn't realize that was forbidden on this particular thread, as many threads take twists and turns. 

 

I never criticized your choices at all.  I don't even know you or your story, specifically, except what you have said in this post.  

 

I simply addressed random assertions by various people that were presented as fact. 

 

Out now.    Good luck to you.  I've done it myself and it is hard, I know. 

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:grouphug:

 

You have my support Jean.  I know you have a good heart and have your ILs best interest at heart and you have so much on your plate.

 

(even though you won't help me with my own *literal* garbage, I still support you!)  

 

Actually, I don't care if TM has a different viewpoint on elder care than others.  That would be appropriate on a thread that is asking for different viewpoints on elder care.  What TM is missing is that this thread is one that was asking for support.  It is true that I did not spell it out by saying "please give me support" in the OP and perhaps that is what I needed to do for her.  So, TM, I'm spelling it out for you.  My family is under a lot of stress.  We are trying to do our best in this situation and would like some support from others in the Hive.  Some people know how to offer advice and support at the same time.  But giving me criticism is not advice and is not supportive and is not helpful to me.  If you would like to debate elder care, please start another thread.  

 

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:grouphug:

 

You have my support Jean.  I know you have a good heart and have your ILs best interest at heart and you have so much on your plate.

 

(even though you won't help me with my own *literal* garbage, I still support you!)  

LOL - I thought of you when I finally got the inside of my car clean enough that we could breathe in there!  (For those who don't know, FIL didn't pay his garbage bill, garbage piled up and I bagged it in contractor bags and took it all in my car - where two week old moldy sludge leaked out.  Dawn was having her own garbage crisis at the time and we were trying to get each other to take care of it.)

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