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I work full time, so I’m only helpful outside of working hours. In-laws live in their own house 15 minutes away. My wife cooks, cleans, shops, launders, everything they need. Any suggestions to help with our mental health would be really appreciated.

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Nick, welcome!

Does your wife WANT to do all those tasks?

Has she ever told her parents that they are expecting too much from her and that it is affecting her mental and marriage?

Has either of you investigated what outside help is available?

They can refuse outside help, but you and your wife have the right to withdraw from their care. In other words, their right don't outweigh YOUR wants and needs.

Consider telling them that you are taking a 2 week vacation and that they'll have to make other arrangements. Are they competent enough to do that?
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Nickname Dec 2022
Thanks Barb - being high risk, we stayed away from them for 6 weeks during the pandemic. That was a difficult time but they managed to struggle through. However, with the deterioration in their health over the past 18 months, this is no longer a sustainable option.
My wife wants to help but I’m concerned she’s burning out.
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Nickname
It is a difficult time for your wife with so much responsibility. The really hard part is for your wife to establish appropriate boundaries to keep from burning out.
The more she does, the more enabled they are to refuse outside help and for them to expect your wife to do it all. It isn’t sustainable.
If your MIL is expected to get better and be up one day soon, then your wife can perhaps cope knowing that. If this is MILs new normal then it will only get worse.
Does your wife have the in-laws POA for medical and financial matters?
It is a fine balance but your wife should consider backing away until the parents agree to hire help. If they have original Medicare insurance, MIL would be eligible for home health. This primarily provides a nurse to check on MIL weekly and an aide to bathe her. This aide could show your wife easier ways to change the linens etc. It isn’t housekeeping but it does help and it could get the in-laws accustomed to having help come in.
It is time to have the difficult conversation. They must have help or they must move into care. It is no longer about what they want, it is about what they need.
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Nickname Dec 2022
We don’t have POA so decision making is somewhat difficult. I appreciate the ideas about Medicare - we’ll have to look into those options. We’re learning as we go and really I’m glad to have found this website to find comfort in the fact that we’re not alone.
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When their needs impose excessively upon your wife and your marriage, your in-laws no longer get to call the shots.

Sadly, your wife will likely have to continue as she has or withdraw until there's a crisis that leads to a major change. If they're cognizant, perhaps she needs to sit them down and make it clear how the level of care is affecting her.

Too many people just don't state the facts and have an adult conversation with their parents, so I'd advise starting there before the crisis happens.
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Nickname Dec 2022
Thanks MJ
What you said makes perfect sense. I believe that there is a difficult conversation that simply has to happen here.
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It's a tough issue that many of us have gone through - I hope you find some solid suggestions.

Can they afford to have someone come in to help? It took some time, but I was finally able to get my dad to agree to have a home care person come in twice a week for two hours to start [gradually growing to four hours 3-4 times a week] to "help with laundry, light cleaning, grocery shopping, errands, preparing lunch, and whatever else." It was a less threatening way to describe why they come (as opposed to helping him dress, shower, for example, which is core to what they can do). He said over and over again that he didn't need or want someone to come in. I told him that he would be doing ME a favor if he agreed to it, which worked. Maybe she can position it with them that way - "I'm having a really hard time keeping up with my house and yours, and it's affecting my physical and mental health. Can you please help me by allowing me to arrange for this?"

Best of luck to you. You're doing the right thing, recognizing that the situation is not sustainable and reaching out for ideas. It may take some time, but being strong and insistent is important in moving the situation in the right direction.
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Nickname Dec 2022
Thank you Lisa - I like the way you phrased that and it might be a good way for us to start this hard conversation. Unfortunately they are insistent that they don’t want anyone else in the house. My wife has always been so close to her parents which makes this all the more difficult.
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Nick, a slightly different take. W is clearly taking too much responsibility for her parents. It’s time for you to take more responsibility for your wife. It will be easier for you to tell them that it’s ‘too much’ than it will be for W. She is bound to feel dreadful, guilty, inadequate etc, but you can say that you feel guilty for letting her take on so much without help. You do your bit in the evenings, and even that is hard after a full day’s work.

Come the heavy handed husband, and say that you feel you have to put a stop to it. She is your responsibility, and you will not let her kill herself over this. They accept in-home help, or she will stop everything but social visits. It’s a different way for you to ‘help’, it takes a huge pressure off W, and it really is the best way to use some common sense at this point. If they fight back, a useful line is "If she breaks down or has a stroke, you will be in a Nursing Home within a week. I certainly can't care for you". Good luck!
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Nickname Dec 2022
Thanks Margaret
I appreciate your thoughts and think this might be a necessary step. I’m willing and ready to do anything to support my wife.
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Nick, as you say "wife wants to help, but is burning out".

I loved my mom. At 88, she was getting querelous, anxious about all sorts of stuff and still lived alone in the 3 story house where we grew up. Dad had died in his early 70s and she coped just fine--went back to college, participated in social groups. And then boom, she was calling us everyday with some crisis.

There days running, she called me at work and said she needed me to come RIGHT AWAY. Had to drive across 3 boroughs of NYC, up to Westchester County to get to her--and there was no "real" crisis.

I say down and said "Mom, I can't do this anymore". (That was the hardest sentence I've ever uttered).

It turns out that my mother had NO insight into what she was doing to me. My previously empathetic, considerate mom was no longer in there. To make a long story short, she had an undetected stroke which had wiped out her planning abilities and a LOT of her higher level cognitive functioning.

I guess you could look at it this way; sometimes in these situations, we expect our parents, previously considerate and playful to continue to act in OUR best interests. But they aren’t capable of doing that any longer. It's up to us to set up reasonable boundaries so that their needs and wants don't destroy our lives.

A good therapist can help your wife negotiate this if she is unused to saying "no" to her parents' requests.
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Not to mention, without having POA for her parents, your wife shouldn't be agreeable to doing much for them at ALL. They can hire a housekeeper, a caregiver, food delivery from the grocery store, etc. When they see what that feels like with no help from you two, then the turkey talks can begin. As long as your wife enables them, why should they be agreeable to doing the right thing? Only when push comes to shove will they see the light, most likely. And sign over POA to her, as a start.

In old age, it's not okay to destroy ones daughter and her marriage in order to perpetuate the myth of independence or stubborn refusal to hire paid help or move into AL. Start saying NO and sticking to it. Force the parents to see that they're killing their daughter here and only then might they change their tune. But they surely won't until your wife puts her foot down. What happens If God forbid she dies? Then the parents have no other choice BUT to hire paid help or go to AL.

Good luck setting down some firm boundaries with stubborn elders before your wife collapses.
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Chat time. Book it in.

Folks, the time has come to accept a little help.

"Unfortunately they are insistent that they don’t want anyone else in the house". 

Of course. Who ever does?
They trust your wife & you. That's all they want.

But that is not reasonable.

The step between *independent* & *semi-dependent* is a doozy. That's the struggle... The folks want to stay independent, but old age happens!

It seems to be a common falsehood that if my grown children help me out that doesn't count as needing help. It maintains an *illusion of independence*.

So, chat time. Choose your style. Soft, humourous, hard or somewhere inbetween. Eg

Softly approach: Wife/you can offer to find the right person to help, someone kind & honest. As a trial. Just a bit of light cleaning to help you out. Maybe someone to carry the heavy shopping in & put away, that sort of thing.

Law down the law: Accept in-home help now. Or not.
If not, choose your nursing home. Or not. Or wife & I will.
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Lymie61 Jan 2023
You hit the nail on the head “It seems to be a common falsehood that if my grown children help me out that doesn't count as needing help. It maintains an *illusion of independence*. “!!!!
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Nickname, you are not alone.

Here's some little thoughts I wrote a while back regarding insight on needing help 😊

*Sunrise to Sunset*
I take care of myself
I live on my own
Except when I can't
So be by the phone

I eat my meals
I sleep in my bed
Just do my shopping & keep me fed
Do my shopping & cleaning & gardening & bills
Take me out when I'm bored
Stay here when I'm ill

I just need a little help, now & then.
From sunrise to sunset then sunrise again
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Why is your 74 year old MIL bedridden, and how long has that been the case?
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They have no incentive to accept other help as long as your wife is providing all the help. Whole and healthy parents would never want this for their daughter, but fear and old age has changed them into demanding people I’d bet no one recognizes the same as they once were. She must back off, for the good of all, especially her own health. They will come to see other options
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Just see to it that she doesn't move in with her and that they don't move in with you, as that will be the end of it.
Your wife should seek help in deciding her next steps forward for life. If she is giving up her life for her parents then this may mean missing some of the most free decades of her life. It is a real choice. I would suggest a licensed social worker who is in private practice as a therapist.
This will be the second time today I have parroted Beatty's (a poster here) good advice that "There will be NO solutions as long as YOU are all the solutions". Why would your inlaws consider a move when they have got your wife to do all of this. It is sad they don't recognize what they are asking of her, but many do not.
I wish you the very best in helping to support boundaries and choices for your wife. Consider attending those few sessions of counseling with her.
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Start with withdrawing assistance the same way it started slowly: first with shopping, they get groceries delivered
next step to go is cooking, they get meals delivered
then laundry, a helper comes to do laundry since wife can’t (for whatever reason). Since the person is already doing laundry then can do some cleanup too. Then perhaps an assistant can help with the health needs.
They wont like it but it has to happen for (insert reason)
it would be best to get all paperwork in order ASAP!
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Beatty Jan 2023
Your stepped plan is a very good one. A slow unwinding.

I've been watching from afar as my SIL seems to be implementing your steps, but still in the *step in* stage (not the *step back* yet). Started with doing the shopping (when groceries could be delivered) bringing meals, doing some cleaning & maybe laundry.

It will be interesting to see when she gets to her top capacity.. If she is able to change into reverse, or a denial-fuelled tantrum demanding all other family to step in & do what she choose to do.. or maybe a final physical step of enmeshment happens - where they merge into one person.

Old age sometimes sneaks up We don't always hear it arrive. Once we know it's there, we can start adapting.
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If they are able to afford help, perhaps your wife can find a housekeeper and be there while the house is cleaned. She can order groceries to be delivered on cleaning day, she can hire a home chef or prepared meals that come frozen. There are many services to take the weight off her.

She can help without being the donkey that carries the entire workload.

As we age it is imperative that we learn to work smarter and not harder.

Her parents need to be told that what they want and what they get are not the same thing.

Statistics have shown that 40% of caregivers die before the one(s) they are caring for. If she becomes a statistic or you do, what happens to her parents then? Helping doesn't mean propping up an asinine situation.
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All excellent ideas here-please start to implement some of them. I would only add to see an elder care attorney ASAP if all the DPOA, wills, important documents etc are not up to date. It is well worth the cost. Best of luck dealing with this scenario-it is so common.
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fluffy1966 Jan 2023
Great advice: The amount of money $$ expended on an expert "Elder or Senior Expert" attorney is worth its weight in GOLD. POA for person and estate, an Updated Will, just all manner of things to put in place, and an Elder Care Lawyer with a good reputation can be your guiding star. Thank you for pointing this out, Plymouth!
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Good Morning,

You are wise to pick up on this and seek out information. You can't continue like this. There comes a time when you have to bring in outside help. A lot of help comes with the person's health insurance.

For example, if you have an assessment by the primary care doctor (PCP), the doc can write orders for homecare, VNA, CNA, cleaning, etc. A lot of these services are covered upon a hospital discharge but also if the PCP suggests it.

The home modifications--shower chair, nozzle, railings in the shower, all kinds of gadgets again usually are covered under Durable Medical Equipment.

Home blood draws can also be arranged.

The parent who is still able to get around could attend a one morning a week day respite program in the neighborhood. Some offer transportation, have an RN on duty. Continental breakfast, lunch, exercise are provided.

It could be that your MIL needs "skilled care"??? Could your FIL go to the same facility. There are different tiers now. They own a house and your daughter could check on them and oversee everything rather than provide the manual labor for both. To do this long term is hard. Your wife sounds like a wonderful person and you are worried about your wife. I think the both of you are a good match.

It's time for a family meeting and an appointment to an Elder Attorney and Social Worker. This things are quite common. You are not alone and half the country is in your situation.

There are answers. Don't get discouraged but don't go down with the ship either.

Happy New Year!
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Hard facts: Your in laws will always reject outside help - most elderly will. They feel that it's families role to pick up the slack and they certainly would never agree to todays rates for outside help. Start asking around to friends and family for caretaker references. Check with your church, or local senior center.
You have to either put your foot down, or slide a caretaker in through the "back door", introducing the hired help as a friend to help with light housekeeping, or cooking, or whatever you choose to say.
For example, after extensive vetting - I found someone who I felt was a good fit for my Mom. I brought her over for an introduction and a coffee break. I lied about the cost and who was paying, even though I had POA and was paying out of Mom's funds. Before long, they grew to love each other and it was the best thing that ever happened for my mother. Eventually, I told my Mom the cost was coming out of her funds, but I still lied about the amount. What she didn't know didn't hurt.
The key is getting someone who they will connect with and to start with only a couple of hours/days until they relax and accept the help. Yes, they will resist at first, but you have to be strong and not give in. Your wife and you will find that hiring help is the best way to prevent burn out because you must keep in mind that as your in laws age, their needs will keep increasing. Best of luck.
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Just wondering...What is the plan if something happens to your wife?
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I would suggest therapy. It sounds as though your wife is coping now, but it sounds hard and what you can know is that it will get harder and harder.
Do you talk together already, or are you worrying along while she also worries alone? What are her plans when they need 24/7 care? It is important that you are on the same page, because you BOTH may need therapy together if you don't agree on the path forward.
Licensed Social Workers in private practice are often the best therapists for this step as they deal with life transitions work, not with what Freudian slips or slides led to today. They also have access to knowing what is available to help. They were trained in REAL life and how to deal with it. Then got special training to do private therapy. I like the work I have seen from them overall.
You are wise to think ahead here. You can see what is happening. I would sit her down and say "Hon, I see what you are going through, and I am afraid and I suffer for you. I know things are not going to get better. They will get worse. And I want to know how I can help and support you, but I also need to know what you are thinking, what your own fears are, what you are planning for the future. Whatever happens happens to us BOTH, and I want us to be united together. We need to talk. Can we have a sit down once a week to talk honestly about what we feel, about how things are going, about our niggling fears? Can we make a few plans, even if just a night out at Chucky Cheese, that's just for US?" One husband told me that he brought home a bouquet with a note that said "I SEE you. I know what you are going through. I love you". And with that the floodgates opened. His wife came to him to pour out all her hopes, all her fears, all her grief. From there they set up talks that helped them enormously.
Start there if you haven't been there. But also suggest therapy either together or for her alone to work through choices, boundaries, and how much you are willing to sacrifice of your own lives on this altar. Just tell her that you want to BE the support, but if you cannot be, you want her to HAVE the support and will make it happen financially if she needs it.
Congratulations on being a good and caring hubby.
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If parents have some money, it's time to hire some help. Tell them your wife needs the help when they say they don't need any. That might help both of you to keep them in their home longer.
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Sometimes you have to be willing to take a step back and let them fail a bit until they have no choice but to accept outside help. Your wife needs to explain to them that she can help but can’t be there as much as she has been. When things get hard for them they may agree to let someone come in. If they don’t, things will just have to be hard.
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I agree that a conversation between you and your inlaws (without your wife) would help a lot. Ask them if this is what they want for their daughter. Tell them how hard it is on her. Tell them there's a difference between being a loving daughter who gets to visit and enjoy their company, and someone who has become an unpaid caregiver.

When I had this convo with my mom, I said, "Mom, I want to continue to enjoy your company, do things with you, spend time here, but I'm at the end of my rope. It's help, or it's a home." That did the trick.

If they were/are good parents, they'll get it. If there's dementia involved, they might not, and you'll need your wife to get POA as soon as possible.
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againx100 Jan 2023
I think the conversation is better between daughter and parents not SIL and MIL/FIL. I would never had asked my hubby to do that.
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God love you both, but it’s time for you to start parenting them.

bring in the help whether they want it or not. It’s OK. If you read a lot of posts here you’ll see that time comes for many of us.

My Mr. and Mrs. both at different times, went through the cycle of acceptance when they required more care. First it was OK, then it was a little irritating, then it was annoying, then they got angry, depressed and finally acceptance. And it rotated until they got to the final acceptance.

work out compromises along the way to appease them but definitely, definitely start getting some help - it’s OK.
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iameli Jan 2023
It may not be quite that simple unless OP’s wife controls her parents finances. The money to pay help has to come from somewhere.
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Take a 2 week vacation so they can see how much your wife is doing for them.
Your wife needs it!!!!
And yes, you might need to be the bad guy, but it isn't fair to your wife or to you. You have your own lives to live.
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Nickname,

I did homecare for a long time. Almost 25 years. Most elderly people refuse to allow outside help to come in. What has to happen more times than not is they have to have it forced on them.
I can't even tell you how many elderly people I've had to lay a hard truth on.
Nothing will get a person a one-way ticket to a nursing home faster than being stubborn.
You and your wife need to set some boundaries with her parents. They will not accept outside help or any kind of change as long as you and your wife maintain the status quo and continue to be their care slaves.
Sometimes seniors have to live rough for a while to get over the asinine stubborness about refusing help or change.
You and your wife may have to let things get hard for them in order for them to become reasonable. If your MIL is bedridden she should probably have visiting nursing coming in. They will arrange aide care too.
Have the talk. Either they accept outside help coming in or it will be a nursing home. No debate about it.
Homecare or nursing home because the two of you are done being care slaves.
Now, I know this may sound a little bit harsh, but in my experience I have found that families have to be like this with their needy elders most of the time to get them to accept help.
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JeanLouise Jan 2023
*care slaves. That is a PERFECT description. I needed to hear that too. Thank you.
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Nickname, you are a caring and supportive husband. First things first: POA for both person and estate for both of your MIL and FIL. Seek help from an ElderLaw Attorney, and let the attorney guide and inform you. Your role is to be the strong protector of your wife. Perhaps your wife is 'enmeshed' with her parents, and you will need to be the one to say to MIL/FIL: This cannot continue. (for all the reasons aptly stated by several above comments). I cannot as a husband see my wife risk her physical and mental health by allowing to continue that which is going on here.
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Please ask wifey to stop all assistance for a week or two, then video the place and them and then call Adult Protective Services to evaluate for placement which will require sedation and medical transport if they agree that the situation is dangerous and unhealthy.
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Smithbarbl Jan 2023
I don’t know, Connie. Could you honestly do that to your own family?
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DID THEY GET HER A POA AND HEATLH CARE PROXY YET.....SHE THEN SHOULD GET HELP AND PAY THEM WITH THEIR MONEY,...SHE SHOULD GET THEM TO GET THEIR AFFAIRS IN ORDER SUCH AS A WILL IN CASE IT GETS WORSE.POWER OR ATTORNEY GIVES HER THE RIGHR TO ACESS A CHECKING ACCOUNT.
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Your wife is a very dedicated and loving caregiver who wants best for her parents. Unfortunately, their level of care is beyond what your wife can provide. Get a social worker to to talk with MIL and FIL to advise why help is necessary. Help IS needed at home, or her father requires assisted living at home or a facility, and her mother must have nursing care or be placed into a facility.
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This is a tough but very common scenario.

You should withdraw any help you are providing.

Your wife needs to get them to take care of their important paperwork like financial and medical POA, wills, etc. NOW, if they are still competent.

Your wife needs to start backing off. It doesn't matter what they want. Your wife is burnt out. She comes first and you should come next, then her parents. They can't continue to be first and call the shots for your wife. No way. They won't like it but you and your wife don't like how it is now, so there you go.

My mom, with dementia, lived with us for 7 years. When she couldn't change her sheets or keep her room clean, I hired a cleaning lady. When I was burning out as her needs increased, I hired help. And increased it over and over again until putting her into assisted living. She didn't like it and complained, but when the ladies were here doting on her for hours on end, she did actually like it and we were lucky to have a crew of wonderful caregivers.

All outside help is paid for with their money, never yours.

I like someone else's idea also of having things delivered to them. Your wife doesn't need to go to the store. They can have groceries delivered. Other things? Amazon is where I buy 90% of the things my mom needs.

And you guys need some couple time! Time to get out for a nice dinner or a movie!
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