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Please read this post if you would like more background.


https://www.agingcare.com/questions/caring-for-a-schizophrenic-wife-with-stage-4-cancer-484616.htm


Short story: Caring for abusive schizophrenic wife with stage 4 breast cancer who refused treatment and has maybe a month to live. Trying to get her into a facility.


Things have gone from bad to worse. After 4.5 months of caring for my wife alone and I do mean it is ONLY ME (and hospice for 2 hrs, 3x a week), I finally called the hospice team and asked for help getting her into a skilled nursing facility. They were very helpful at first. They gave me a list of places and I had a friend help me research, make calls, etc. I picked out 2 that were great- nice places at $15k per month.


I knew my wife would not go willingly and I told the facility this. They understood and said that is common with mental illness and it was ok... they would still take her. They suggested non emergency transport and having the nurses there when she goes to give her some heavy sedatives to make the transition easier. I had it set up for a Monday and then on Friday at the end of the day her hospice nurse called & told me I could NOT force her into a facility even though I have medical power of attorney. The nurse said she and the social worker would need to have a "care conference" with my wife to get her agreement before I could admit her! So I had to call the facility and put that on hold.


Nurse came at 2pm on Monday (instead of 12 like she said). Then she simply does the regular nursing care & says the care conference will be tomorrow. So they come Tues and try talking to my wife. I kid you not that it was 40 minutes of my SZ wife telling them (before they even mentioned a facility) that she knew they were there to "break up her marriage" and force me to divorce her?! We all assured her that was not the case. Every time we tried to bring up the fact that her sole caregiver (me) was getting burned out and needed help she would say things like- "he's never leaving me and he's agreed to sleep in bed with me again." Then she would go on and on about how I was "hers" and they were there to break us up. She even thought the social worker was an attorney.


I have not been sleeping with her for 20 years because she kicked me out years ago and now suddenly I must sleep with her even though she insists the lights stay on. So because of this, I won't sleep there every night. This "conference" became her platform to tell the team that we are lovers and that I still want her, basically talking about our (past) sex life and that they can't mess that up by moving her anywhere. FINALLY they get her to talk about respite care and how I need that and she flips out, "No way, no how, never is she leaving the house!" She screams. We all agree, "Ok ok, we understand," just to calm her down. Then the nurse gives her a "test" for mental illness/schizophrenia (like they haven't seen enough already??) even though we have a diagnosis from Sept 2023 (and previous yrs).


Here comes the punch line: "Your wife scored a 17 so she is capable of making her own decisions. You can't force her in a facility." Are you kidding me? Hospice BLOCKED me from putting her in a facility! At this point my wife cannot walk, is in excruciating pain (bone mets), wears diapers, and her pain management is more than I can handle. She rings a bell we have set up every 5 min for me to come running "just sit with her" vacuum, ask me a question or whatever mundane thing she wants just so she can keep me in her sight at all times. I also work from home. If I don't do what she wants, she moans and cries and tells me I am a no good loser who is sleeping around. Then she calls her sisters telling them she feels she is in danger, he's mean to me, he doesn't love me, etc.



Please, please anyone tell me how can I get her into a facility? Is it legal for hospice to halt my ability to do this?

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You call APS and tell them that you cannot care for her anymore and no one is helping you. Then call an ambulance and have your wife taken to the hospital. The paramedics will take her to the ER. You follow them. When you are there ask the charge nurse bring a social worker to see you because you are requesting a 'Social Admit' for your wife.

A social worker will be sent to speak to you and that is when you tell them that you cannot and will not take care of her anymore at home. Tell them about her mental illness and all other conditions too. Then let them know what the hospice agency you're using is pulling. That they say she is competent to make her own decisions. Tell them that if they release her back home that it is an unsafe discharge because you will not be there. They will place her in care.

Then you call your sisters-in-law and tell them what's going on. Try to explain to them that this was the only way to get your wife the care and pain management she needs.

I'm so sorry for your situation.
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MACinCT Jan 13, 2024
I was ready to write the same advice. She has a psychiatric problem and might actually need a psych facility. That should be interesting with both hospice and psych needs. Hospital might need to keep her for a while. The OP will need to stay strong with refusal to take home
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@BurntCaregiver I know you are trying to help and I truly appreciate it. You have given me some good advise. But this comment "You do know that people can be commited involuntarily against their will." rubs me raw. Do you personally have a close family member with SEVERE schizophrenia? If not, then you have no clue what it takes. I have TRIED for at least 15 yrs to get this done. There are so many obstacles and our healthcare system is not set up to allow this very often. The mentally ill person has all the rights, while the caregiver/family is not helped. She was institutionalized twice and both times they would not keep her more than 7 days. Meds help but she would NOT stay on them. Now she is on so much methadone, morphine, valium etc. that they say the psych meds cannot be given because all the combination could stop her breathing. Priority now is pain management. I have liquid meds.

I married her when she already kids. I traveled a great deal for many years and I don't know what happened when I was gone. When I was around, I stopped the verbal abuse as much as I could. As far as I know she never physically abused the kids. We had one daughter together and I was successful in removing that daughter from the home. She went to live with my mom and has never once talked to her mom again. That is who I will stay with during my respite.

Our son was not really abused by her. For some reason he is the favorite and based on her family of origin, the brother of the family was a prince so she treated her son the same way. Pretty sure she was sexually abused so for at least 2/3 of our marriage she accused me of screwing everyone- including our daughter, neighbors, even men and I am not gay. Her abuse with me was mostly mental.

Should I have left? You bet. Why didn't I? I can't really answer that other than I felt threatened by her comments of "turning me in" for sexual abuse (which of course wasn't true but women have the upper hand in these situations) and the other reason I didn't leave is she most definitely would have been on the streets. She has not had one "friend", not a one, since the late 90s. She shunned all of her family and mine until recently letting the sisters back in.

Yesterday I was a wreck so some of my comments such as "raging lunatic" may not describe her now on her death bed. You are correct, she has little energy. But what she does still have is the ability to manipulate and convince others of whatever needed. And though she may not yell as loud or be able to physically fight, I guarantee you she will "fight"

Your name is BurntCaregiver....I am beyond burnt. For you to tell me to gut it out another 2 weeks or months tells me you really don't understand being at the end of your rope. I cannot do this anymore and thank God, her sisters are coming. I don't even care that they will all throw me under the bus. The facts, past history, recordings, police reports and evidence of the care I have provided speak for themselves.

@everyone Thank you for all for helping me....this site has really given me a lot to think about and some real steps I can try when I am back.
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Beatty Jan 14, 2024
"all throw me under the bus"

They may be at the sidelines.. may SEE your Wife is driving & SEE you already under the bus. They may have decided to ADVOCATE by involving APS to get you out from under it.
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I hope this is OK. I want to reply from the abuse side - I grew up with it. I’m sure you know, it messes with your thinking in so many ways (**nothing** wrong with you…it’s a way to survive in my opinion), and you have visceral/physiological responses that get trained into your being to try to placate, anticipate, prevent… It is so hard. I have no idea how you manage a job at the same time - wow. You are so strong to keep going.

This may be absolutely useless to you, but I’m passing it on anyway. The best advice I ever heard came from my mom’s attorney. It sounded ridiculous and insulting at the same time…probably because of a recent “incident” with my dad: She was told, “ You will know when you’ve had enough.”

Before you get as insulted as I felt :( please consider: that brilliant attorney empowered her ( my mom), by letting her know she was choosing to stay. Cut right through all the reasons and inconveniences and kids and dad can’t cook/appointments/have to’s plus the latest crisis… to she was “deciding to stay”. **Which meant** she could choose to leave when she decides. Eventually a thing happened and she’d had enough. She left with some clothes and her work bag, found a room to rent in a woman’s house, kept her RN day work and picked up a night job, and then completed the legal and financial details - the house, kids, china, furniture - **after** she saved herself.

I would not make it in your shoes for two days - I’d be out to preserve myself…check my own self into a retreat and call 911, APS, family to report a vulnerable and mentally unstable senior/adult, alone. My explanation (not that a lengthy one is needed) is that I feel this person cannot care for herself, and I am **unable** to do it due to my own health emergency. What happens after is on them. (I’m already not there.) If they decide she can take care of herself, I might decide to call again after a few days. If the siblings come, fine, but i would absolutely not wait for permission to leave, and I would not answer calls from her except through my attorney, and I would not return. I’m so sorry, because that’s harsh and easy to say.

(The original post compelled me to make an account on this forum - I visit often to read in hopes of helping our parents.)
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katnikwoo Jan 14, 2024
@BLT2024
I do not take offense at all. I am so sorry for the abuse you and your mother experienced. It takes it's toll and over the years those who are abused develop learned coping behaviors that are hard to break. I know this...yet I still stayed. Mostly because I know she is sick (even before the cancer she could not function normally) and can't take care of herself.

I am an older gentleman (62) and I was brought up to do what is necessary and right, to protect those in my family and to grit it out when things get tough. Also, there is still the stigma that only women are abused by men...not the other way around. Unfortunately that simply is not true

I am getting a break when the sisters come Monday. Thank God. I am sure I will come back to a mess and who knows what accusations they will have against me because when my wife finds out I am gone (I am not telling her I am going) she is going to go ballistic and will most likely falsely accuse me of all kinds of nonsense. I am so over it...if others can't see the insanity over the years, look at the diagnosis and the police reports and realize she is nuts then I'd say they are all insane
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While expensive, you might try filing for emergency guardianship. Guardian consent trumps hers and hospice.

https://www.google.com/search?q=emergency+guardianship+in+minnesota&oq=emergency+guardianship+in+minni&gs_lcrp=EgZjaHJvbWUqCQgBECEYChigATIGCAAQRRg5MgkIARAhGAoYoAEyCQgCECEYChigATIHCAMQIRifBdIBCTEyMTYyajBqN6gCALACAA&client=ms-android-verizon&sourceid=chrome-mobile&ie=UTF-8

With that, I personally would turn her over to her sisters and file for legal separation while I was gone. But, that's me and only you can know how much you can take.

Either way, I suggest you consult with an attorney to see what actions can be taken against hospice.

Hey, FWIW, you might be able to use the pressure sores as leverage to get an ER admit by saying you're worried they are going septic. Just a thought...

May you finally get peace someday soon.
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Grandma1954 Jan 14, 2024
If a person is of legal age (or emancipated) and they are competent a Judge will probably grant Guardianship. Although in this case I do not see how a doctor would find her competent
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Kat,
Your responses to us show you to be so very responsible and responsive, but also show that you are endangered yourself at this point, and I am worried for you. You could have a heart attack behind all this in a second.
You have said how unfair the laws are but you seem to understand that this IS the law now, and not the fault of Hospice who is trying to help. They used to have facilities to take people in. They don't anymore and are now a part of the military industrial complex, bought up by hedgefunds, supplying the minimal for enormous payouts from medicare (minimal being 2-3 bedbaths, one RN visit weekly, a call from clergy, a call from social worker, a bottle of morphine).
Because you wife is competent you cannot place here.
As she is helpless and dying you cannot legally abandon her if you have accepted next of kin and POA over her and no one can replace you.

I will tell you what you CAN DO. You can have a physical or mental (or BOTH) breakdown and call APS and tell them you are going to a motel with chest pain and they better get over there right away because she's helpless.
You can go to an ER.
That is I am telling you to LIE.
To tell you the honest truth, this is the system. You are angry about the system. I don't blame you for a single second, because it is a killer. So you will have to manipulate it the best way you can. As far as I can see it's about the only chance you have for real help.
When I was an RN men came in all the time, and women as well, having collapsed with chest pain doing caregiving. Their cared for one came in and was hospitalized as well, and from there social workers took it over.
You say she will die in a month. I must tell you that there's no guarantee on THAT one if she is still eating and or drinking.
I am so sorry. I feel your frustration to my core. I am so sorry and hope you will continue to update us.
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katnikwoo Jan 14, 2024
Thank you so much AlvaDeer. As said before there are a lot of good ideas here. When back, perhaps I will try some of the suggestions I have been given here. I have a friend telling me my health is in jeopardy just as many here are and I know if I don't get a break, I probably won't be faking the chest pain. And yes, at this point she may live 2-3 months. Who knows. She still eats some but is sleeping a lot and in more and more pain. I've done the very best I can. The hardest part of this is the family members who don't think I've done enough, done it "right" or whatever. They are dysfunctional to say the least.

I will be out of here tomorrow for 2 weeks. Thank you God
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Kat,

When all of this is over, I hope that you will take all the time that you need to heal.

I can’t imagine how it would feel being married to someone who is mentally ill.

Mental illness is a very complex topic. We want the stigmatization to go away, yet we shouldn’t ever forget how difficult it is for the people who live with them.

It’s so easy for others to tell you what they would do but I don’t think anyone really knows how hard this is until they have experienced it for themselves.

I am sure that living in this situation day after day after day has taken a huge toll on you.

I suppose when your wife dies, you will feel tremendous relief. Any grief that you feel will most likely be mourning for what you wish you would have had in your marriage, instead of grieving for the loss of your wife.

Wishing you peace now and after this tragic situation ends.
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katnikwoo Jan 14, 2024
@NeedHelp- Thank you for trying to understand and giving me the benefit of a doubt. It has been extremely difficult to be married to her for 33 years. And unless someone has LIVED with a schizophrenic who won't take meds, they absolutely cannot understand the complexity, anguish, guilt, obligation, responsibility, anger, hopelessness and desperation mental illness causes for both the patient and their family.
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I remember your post. It broke my heart. I can’t imagine how difficult that this must be for you.

It’s absolutely despicable that hospice has blocked you from getting your wife placed in a facility.

How on earth does this hospice provider feel justified in making this decision? It’s insane!

I think after the shock wore off, I would be mad as hell about their decision to allow your wife to have a say in this matter when clearly she isn’t capable to know what is best for her or you.

Fortunately, we had an excellent hospice nurse for my mom. Mom had Parkinson’s disease and dementia.

Mom had a great relationship with her nurse and this nurse truly cared about my mother’s best interests and our family. Mom was in my home for over a decade. She was also with my brother and sister in law for over a year.

Anyway, mom’s hospice nurse was moving to a different hospice provider. She gave us the name of the organization so we could sign up with the new provider. Mom’s nurse worked to get mom placed in an end of life hospice care home.

Mom received excellent care and was kept comfortable. She died peacefully in the hospice care home.

The entire purpose of hospice is comfort care. Have you considered switching to another provider? You aren’t obligated to stay with the same provider.

Why don’t you ask the facility where you want to place your wife if they can help in finding a hospice provider that will understand your situation?

I hope that you can resolve this soon. I am so very sorry that you are going through this nightmare. Please let us know what happens. We care.
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katnikwoo Jan 13, 2024
Thank you so very much. Since my first post, I am a complete wreck. I am so happy to hear others have good experiences.

I will say her main nurse is very sweet and she is a GOOD nurse who cares well for my wife. But she is over her skiis on this. She has NO CLUE or understanding about mental illness. Also my wife has multiple personalities and is extremely manipulative. Even though she is bat $hit crazy she still can put on a show when needed. She also throws me under the bus constantly if she is not getting her way (ie: me sleeping in bed with her and doting on her every minute). How she passed the test (which again was just a 10 min story where she had to repeat facts) is beyond me.

Another factor has come into play is her sisters (4 of them) from Canada. Hospice was told by my wife in the beginning not give them any info. Wife now has "made up" with the sisters and one called while the nurse was there a few days ago. The nurse proceeded to speak at length with the sister. The nurse is now speaking more with the sister than me because this sister is very forceful and wants to control everything. The good news (I guess) is 2 of the sisters are coming down (just found this out today) so I will finally get a break. I am leaving for the full 2 weeks they are here. Maybe when they see the difficulty and the insanity they will realize what I have been through.
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Ask Hospice for a Respite Stay.
Medicare, Medicaid will pay for Respite Care.
They will place her in a facility that will meet her care level for about 5 days. this would be covered by Medicare, Medicaid and other insurance.
At the end of the Respite stay you can then say that you can not care for her at home in a safe manner and that she needs to remain for a "while".
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katnikwoo Jan 13, 2024
No offense, but you make it sound so easy. I've asked for that and the Care Conference resulted in a "no" for removing her from home for respite or for a facility.

Please read this whole string. They won't take her out of the home against her will.
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I am so sorry, katnikwoo. How horrible for you and your wife.

I won't repeat any of the great advice below, but your wife's stated refusal to go to a facility reminds me of an instance from my time in the military. One of my guys had a terminal brain tumor. His wife was a tiny foreign national.

She managed the best she could to take care of him. I did what I could from the military side and give her all the support I could. A new hospice program opened at the local VA, but he refused to go. His wife struggled, much like you.

We had to wait until he was no longer capable of refusing to move him to hospice. I just wanted to point this out that once your wife isn't capable of refusing, at least at that point she can be moved. This may not help you much but at least it's possible.

This information sounds heartless, but caregivers desperately need help too. Best wishes to you.
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Im so sorry you are in this awful situation. My mom is in hospice, which means they only give her palliative care and will not treat her illness. She was told that if she decided to peruse treatment she could go off of hospice, and she could still go back on if treatment wasn’t successful.

If your wife already has a formal diagnosis from last year for schizophrenia, could you take her off hospice and then arrange her admission to the facility directly with them? She could still go back on hospice once there.

I get what everyone is saying about consent, but it doesn’t sound like your wife is capable of consent. You may have to get this particular hospice provider out of the picture. They don’t sound like they’re providing much help anyway.

Another thought..my mom is also bedridden and rings for someone to do things for her constantly. I have hired help. You said you work. The way I convinced mom to allow hired help was by telling her I couldn’t care for her while working. My job cannot be done remotely, but still, how can you work when someone is calling you every 2 minutes?

Let us know how it goes.
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