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My wife splits time with her sister caring for their mom, who is 76, has MS, GI problems, dementia, mobility problems, and a host of other chronic and acute issues. She requires 24/7 care.



The challenge is my mother-in-law (MIL) lives in Europe and we live in the US. My wife spends 50% of the year (multiple week stints in Europe, up to two months at a time, as well as twice here in the US) caring for her mom. My MIL doesn't speak English and doesn't have US health insurance. Due to that, and other circumstances, long term care in the US isn't practical. In addition, her health has deteriorated to the point that travel to the US is probably no longer an option in the future.



My wife's sister lives about 15 minutes from her mom's apartment, where my MIL still lives. My sister-in-law (SIL) has provided care both in her home and at her mom's house. My SIL has school aged children, while ours are grown, so that is another factor that has led to the 50/50 share arrangement.



Residential care facilities and in-home care options exist in this country but my wife is convinced they are unacceptable. She and her sister visited one facility and, from what they reported, I agree that one is not an option. My ask has been that she, or her sister, perform an exhaustive review of the options that are available as a potential alternative to the care they're providing.



Regarding my SIL, who lives close to my MIL, potentially assuming a larger share of the care, that's not in the cards. At one point she nearly opted out of doing anything due to burnout. It's only my wife's commitment of carrying 50% of the load that keeps her involved.



The biggest challenge with the situation is the uncertainty and indefinite time horizon. Though my MIL is quite ill, it's entirely plausible she'll live another 10+ years in the current state.



Am I reasonable to feel that residential care, while possibly not as good as the current model and which potentially lead to shorter overall life expectancy for my MIL, should be considered as an option due to the relationship "cost" we're paying by so much time apart?

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I think that you are not reasonable to decide for others what they should do, as in the case of what your MIL, SIL, but I think you have a right to decide what YOU will do given you have a 1/2 time wife. And I think, if you ask her to, she has hard decisions to make.

For me, age 80, able to live my life happily and comfortably alone it would be different NOW than it was for me two decades ago, when my partner and I were newly retired, ready for QUALITY TIME, building a small part time home together in the country, traveling and sharing the last two decades while we remained (hopefully) hale, hearty and able.
I would not have willingly given that up to a MIL who doesn't recognize she should now be in care so that her children can have their own lives.

So that is to say that for me I would be rethinking my life. I would be asking myself hard questions. Could I share a life with my man for six months and give him up the other six. As I love alone time, perhaps. But at a time when I wanted shared time, if able, as we had in our 60s? Nope. I would not be willing. And I might make an ultimatum I might later regret.

I think it is unfair of your wife to put her mother, who has had a life, ahead of some of the most quality years of any life you have together. But that's me. I would have a big sit down discussion, and I think that I would ask her to have a discussion with her suffering sister and her mom.

Again, you cannot make decisions for MIL and SIL. But your wife has obligations to you. As well as VERY HARD CHOICES. If what you are left with is enough for you, that's wonderful; on you go. If it isn't you have decisions to make after your wife makes her own.

I sure wish you both the best. This is very difficult and I am sorry for it. Tough tough reality.
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What will happen to MIL when both daughters pre-decease her from this insane "plan"?

She will sent to whatever facility has an open bed and left with no advocate.

Just some food for thought.
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Your own marriage/immediate family is priority over your MIL's needs.

Your SIL's own marriage/immediate family is priority over your MIL's needs.

The current arrrangement is unsustainable from a relational and probably a financial/time standpoint.

Therefore the "least bad" option is to do an exhaustive search of facilities where MIL lives and transition her, or privately hire a team of people for her round-the-clock care. Which means someone will need to oversee and manage this.
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IntlChallenge, to answer the question in the title of your post, yes, I think it is reasonable to think the current situation is bad and alternatives should be discussed. I agree with you.

The problem we see on this forum all the time is the impossibility of changing other people’s behavior (even that of a spouse) and preventing people from becoming a martyr to caregiving if they are inclined to do so.
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This is a horrible situation to be in. I have enormous empathy for you being in this position.

You and your wife will have to make your own choices about how you choose to live your lives.

I am sure that you are aware that you cannot control your wife’s decisions. She is going to do what she feels best for her.

If you feel that you are no longer comfortable with the arrangement that you are currently living with, then you can choose to leave the marriage.

What other choices do you have? It’s either stay and accept the situation as it stands or leave and not be a part of it any longer.

As for your MIL, she hasn’t volunteered to enter a facility. She hasn’t been told by her daughters that they are no longer going to be her caregivers. So, she is going to go on allowing them to continue to care for her.

Your wife and SIL will continue to live with this burden until they decide that they are no longer willing to take care of their mom. They may possibly give up their own independence in order to care for their mother.

Focus on what is important to you at this point. Your wife has decided to care for her mom.

I’m sorry that your wife and SIL haven’t found a suitable facility for your MIL to be cared for. This situation is truly sad for everyone involved.
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Is this post a joke? If it's not then I'm going to go ahead and say you really don't have anything to complain about.
MIL lives in Europe which means no one has to go bankrupt and lose everything paying for someone's care needs.
Second, her other daughter is 15 MINUTES AWAY! So mom can get government paid-for homecare. Her 15 minutes away daughter can check up on the situation a few times a week.
Or if her health has deteriorated so badly, she can go into a care facility. Once again. the daughter who doesn't have to cross an ocean to get there can check up regularly on mom to make sure she being cared for decently.
If she's so very burned out, then mom will have to have a conservator appointed over her who will see that her care needs are met. Your wife from another country cannot take on this role.
Unless your wife is willing to pay herself to put her mother up in a high-end nursing home or move back to he mother's country and take care of her personally, she's going to have to accept that her mother will be getting placed in a facility she doesn't find acceptable.
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IntlChallenge Mar 2023
Respectfully, you aren't correct about the quality of care and the options available. This is a former communist country and the healthcare system is wretched. I shouldn't be surprised but I admit I was by the tone of some of these responses.
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Before MIL got dementia, when she was diagnosed with MS, what was her longer term plans once she lost ability to live independently?

Was there an expectation family would do all?

If so, that expectation should be looked at & re-evaluated.

I'll use that awful word: burden. It causes resentment.

Discuss this kindly with your wife.
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It really does depend quite a lot on which particular European country you're talking about. Bits of the former Eastern bloc are altogether a different kettle of fish from other bits of it.

MIL is too frail to relocate, and anyway too old and ill to be successfully replanted. SIL has her hands full and can't take any more on. They've looked at one facility and run away doing Munch impressions.

You're all of you a bit stuck, really, aren't you.

You don't say how you're circumstanced yourself, so this is only an idea: could you go with your wife on the next visit and reconnoitre? If you still feel afterwards that there are acceptable options available at least your wife will know that you've been to see what you're arguing for; and you'll have had an opportunity to talk things over with SIL. What do her family think about all this, by the way? - presumably she's got a husband too.

PS - I should have looked first, sorry: on your profile, it says you're taking care of in-lawS. Is your wife's Dad also part of the picture?
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MIL is 76 and has multiple health issues that ensure a pretty miserable quality of life until she dies. Has anyone thought about her feelings about this? That she might prefer her life to be shorter rather than longer?

Nope, everyone is sacrificing to make sure she stays alive. You mention that a less-than-ideal facility could result in shortening her life. How can you know that? You can’t. It’s speculation only. Furthermore, it’s a speculation that bolsters what your wife wants to do, which is keep her mother alive forever by doing exactly what she’s doing. So she’s telling you this and you’re buying into it?

What if you point out that if she’s right about bad care in a bad facility, her mother might not have to go on suffering? Sometimes death is a blessing. It certainly was for my mom.

You should poke and prod at your wife’s reasoning and see how she reacts. That might be all you need to know to move yourself forward from this impossible situation.
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This entire situation is so difficult! Both your wife and her sister need to see that their lives are NOT worth less than their mother's.
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