Is your MIL cognizant of how detrimental she is acting? Are there any other
issues at play like alcohol abuse, or either denial of situation or
beginning dementia in the MIL?

No easy answer, but I'd start by asking the MIL when she is acting mean if
that is how she would like to be treated if she was in the same situation.
I'd also give her a "time out" to go have a talk with herself until she
became part of the solution and not part of the problem. You will have to be
the adult as the MIL is not acting like a caring adult spouse.

I'd have to no more info before giving further opinions. Do you have a legal
and medical power of attorney for the dad - and the mom? Sounds like maybe
they would both do better living apart, but I don't know if this means
assisted living for the dad or the mom moving somewhere else where she is
not dragging down her husband. One thing about dementia is that people with
dementia may not know what day it is or who is president, but they certainly
remember who is mean to them and who treats them harshly, so your MIL needs
to be made acutely aware of this fact unless making her husband really
miserable is her goal.

You are a brave guy to try and help in this type situation.   all the best,
AW

<groupsguy wrote:

<snip>

Boy, can I relate to this! Something very similar happened to a close friend
of mine several years ago. I'm going to give you my honest opinion here,
based on my friend's experience, but be prepared: you may not like what I'm
about to say.

One of my best friends was in tears almost every day over the abusive way
her father treated her mother after the woman suffered a stroke that left
her somewhat disabled, mentally. Physically she wasn't too bad off...but the
stroke caused cognitive impairment, which left her somewhat forgetful,
easily distracted and unable to follow through on tasks that involved
multiple steps, like shopping and cooking. My friend's mother was always the
sweetest, nicest lady. Her father was one of those Type A personalities, to
the extreme. He had zero frustration/patience threshold and the most minor
difficulties would set him off in a screaming and swearing frenzy. He was
very upset that his wife was a different person in some ways, and that she
now needed him to take care of her when it had always been the other way
around until then. In reality, we all knew he was really scared and upset
that his wife was ill and that he had lost a part of her. But this
translated into really terrible and unacceptable behavior on his part.

My friend tried to take over the shopping and as much as the cooking as she
could, going over their 2 or 3 x a day sometimes. But her father began
yelling at her then for not buying the right things and not cooking things
the way he liked, etc. He would scream and swear at her. It was impossible.
So then he tried taking over some of the work and he managed, but he
complained incessantly and was constantly telling everyone how he has to do
housework now because his wife is "too dumb now" to do it. He told this to
the mailman!

He screamed at his wife constantly, ordering her around and hollering
instructions at her, often times when she was doing just fine. It seemed he
thought if he could control his wife somehow, he could make her "better" --  
force her to overcome her disability. I remember stopping over w/ my friend
once to pay a visit. We were there only a few mins. when the husband began
screaming abusively at his wife. The woman had been talking on the phone
just before we arrived and she didn't hang up the phone all the way, so it
started beeping loud the way it does to let you know you're not hung up. The
husband realized this and went nuts. Right in front of me and his young
grandchildren he shouted at the top of his lungs, "You stupid idiot!! You're
so G__D___d dumb! You left the phone off the hook!! How can you be so
stupid!! What if someone was trying to call??" According to my friend, this
kind of thing went on 20x a day over there.

After we left, I told my friend I think she must intervene. It was not fair
to her mother, who was not able to defend herself, that she had to endure
such hateful treatment and live in so hostile an atmosphere. My friend
agreed, but she didn't know what to do. I told her I'd try to help. I called
a friend of ours who's an atty. in our county's public guardian dept. These
are protective services for the elderly and disabled adults. She told me
that there should be an immediate intervention and that the public
guardian's office could help. She gave me a phone number my friend could
call and my friend followed up. The guardian's office was very sympathetic
to my friend's concerns and they sent out a county social worker to
investigate. The SW interviewed both the husband and wife, other family
members and a few other people to corroborate the behavior they saw. Even a
clerk in the local grocery store reported that everyone working in the store
had witnessed the man screaming abusively at his wife when they came in
together. It was not at all difficult establishing a case of mental cruelty
of the husband against his wife.

My friend's mother was interviewed alone and the SW asked her if it bothered
her the way her husband yelled at her and spoke to her. She said she hated
it and it made her cry. The SW asked her if she'd like to stay w/ her
husband or live somewhere else and the woman said, "I don't want to live w/
him if he can't be nice to me! I'd like to go somewhere else unless he can
be nice to me."

My friend felt terrible because she really couldn't take her mother
in...they didn't have the room and they had stairs in their home, which
would be dangerous to her mother. But the public guardian's office took care
of everything. A case manager was assigned and she found a lovely little
apartment for the woman in a nice assisted living center only about a mile
from my friend's home. The PG atty. obtained a legal separation for the
woman, which meant her husband's assets didn't need to be drained for her to
receive public funds to pay for all her upkeep, though the husband was
required to pay a nominal mantainence fee for his estranged wife's support
(which he resented horribly, but still had to pay), which I think he
deserved. He ought to pay for the situation his bad behavior caused.

The public guardian's office paid for everything...social work services,
legal services, court fees...everything. It didn't cost my friend or her
mother a penny. And her mother loved it in assisted living! She was happier
there than she had been in years. She made tons of friends, took part in all
the activities and everyone was nice to her. She was such a dear and sweet
women, everyone naturally loved her. No more getting yelled at, no more
being bullied and belittled. At last she was in an atmosphere that was calm,
peaceful, nurturing and supportive. My friend and her kids were able to see
their mom/grandma all the time w/o having to contend w/ a crazy,
foul-mouthed hothead going off every 5 mins. and having to walk on eggshells
around him.

Her father went hysterical, of course, but there was nothing he could do.
Because the county got involved, he had no power in the situation and had to
deal w/ them directly instead of dumping on my friend. In court, the judge
gave the old coot a harsh tongue lashing for being such a jerk to his wife
who was compromised by a stroke and ordered that the man had to complete a
course of anger management and individual counseling before the judge would
even allow visitation. He was very resentful of course, but he wanted his
wife back (and he hated paying the maintenance) so he tried taking the class
and attending counseling sessions. In both cases, he ended up cursing out
the facilitator and not going back.

My friend was given POA over her mom, so the judge left it up to her to
decide about visitation. My friend would let her dad visit or join a family
get-together her mom was at only if her mom said it was OK and her dad would
agree to control his behavior. One time he started up, raising his voice and
getting nasty and they just put him out and told him that's it for today!

My friend's father resented her terribly for a while and was quite mean to
her. She felt really guilty at first, but I kept reminding her that she was
doing the right thing for her mother and that her mother's well-being was
the most important thing because she was the one who was vulnerable. Her
father had serious problems after that and started drinking heavily. But at
least her mother had a peaceful, pleasant last 3 years of her life, which
she would not have had if she had remained w/ her crazy hothead husband who
lacked the emotional control to handle the stress of his wife's declining
health. The doctor submitted a letter saying it was imperative that his
patient have a calm environment and avoid stress as much as possible because
she was at risk for repeat stroke and controlling blood pressure is key to
prevention. If my friend had not taken action and the guardian's office had
not gotten involved, my friend's mother might have been dead or horribly
paralyzed from another stroke within a year.

Ordinarily, when 2 people are in a dysfunctional marriage w/ one spouse
abusing the other in any form, I think both parites have to be responsible
for themselves and getting themselves help or out, which ever. But in the
case of your father-in-law, as was the case w/ my friend's mother, he can't
be responsible because he has a condition that affects his mental abilities
and he needs an advocate. He needs someone to look out for his best interest
because his spouse is not only unable to do it, but is the source of the
problem.

In your case, you have an advantage over my friend because your in-laws are
now living w/ you and your wife. Therefore, you and your wife are are in a
position to tell her mother that unless she can get her behavior under
control and conform it to what you 2 deem acceptable, she will not be
allowed to remain in the home w/ you and that you are assuming
responsibility for dad. If she gets ugly w/ you, let her know that you mean
business and that you will get social workers and attorneys involved if she
refuses to comply. And then, if you have to, do it. Make the call to your
county's public guardian's services and report what is going on and state
the kind of help from them you need. Let them take over, if necessary...they
can take the heat from your mother-in-law and enforce orders on her to
vacate if she refuses to comply. It's very possible that when she knows
she's up against the wall, she'll find a way to adapt her behavior and start
acting better.

Just like my friend's mother, your father-in-law is at increased risk living
in a stressful, hostile environment. His wife's abusive treatment is hurting
his blood pressure and upsetting him emotionally. For a person w/ AD,
increased stress and emotional upset adds to the usual disorientation of the
disease and could seriously detract from better functioning he might have in
a calmer home environment.

One more thing: you mention you have young children. It's also much better
for them to be spared the stress and turmoil of continually witnessing their
grandmother "beating up" on their mentally disabled grandfather. It's not
only distressing to children to see this, but it also sends the worst
possible message to a child...that it's "OK" for one family member to treat
another in such a manner. Everyone in a family deserves to live in a
harmonious environment, even children--possibly, especially the children.
People who can't get w/ the program should take their bad attitudes, bad
tempers and selfishness somewhere else where they won't inflict misery on
others. You and your wife have a duty as parents and as adult children to
make your home as safe, calm, peaceful and stress-free for everyone who
lives there as is possible. Talk to your wife and try to get her together w/
you on this. You need to have a direct confrontation w/ her mother to let
her know you and she will no longer tolerate her bad behavior. Get social
services involved if you need to. It's hard to handle these things alone.
Thankfully, you shouldn't have to...you should be able to get support from
the community.

I'm sorry to make this so long. I know a lot of people don't like to read
posts longer than a brief paragraph or 2. But I felt I had to share my
personal story w/ you to get my message across. I hope you will think
seriously about what I've said and I wish you the best in tackling this
problem. It's very hard, I know...but all of you deserve peace in your home
and your father-in-law needs someone to protect him.

Good luck. You'll be in my thoughts.

~katelyn~

It sounds like you are trying to do all the right things. Your frustration
is evident.

What you are describing reminds me of two things -

First - My grandfather could be incredibly nasty. Part of it was his
perfectionist nature. And as they say, age doesn't change you, it just makes
you be you - only more so. But my grandfather also had Parkinson's; anger,
paranoia and generally nasty disposition are part of the illness (though he
could be incredibly charming when it suited him). There are several
illnesses which could cause a short temper; some are physical and some
mental (depression)

So one thing to think about is conspiring with your wife to use your MIL's
wanting to put herself first by making sure she gets a very thorough
physical examination and evaluation for depression. And have it be with
someone who does gerontology - not just an internist. It's important for her
health. But if something is up (Parkinson's, thyroid issues,
hypoglycemia...), it could also be important to the entire household. And
make sure you send a letter to the physician before her appointment saying
you aren't expecting them to contact you, but they should be aware of some
behavior issues and you are concerned they have a medical basis.

Secondly - there was a recent documentary on PBS about an Assisted
Living/Nursing Home which was trying to change its approach to patient care.
One of the story lines was of a couple who each had different issues. The
husband had Parkinson's and was slowly sliding into dementia and the wife
had cardio/pulmonary issues. Once they were on separate floors, she refused
to go see her husband, saying very much the same things as your MIL is
saying about needing to put herself first.

My own conjecture - She could not handle the fact she no longer had a
partner, an adult by her side, but rather someone else who needed her
complete care. And after raising children and taking care of a household
with a partner , she didn't have it in her to do it as an individual. Or
maybe she did all the caretaking without his help and now resents the need
to take care of him so completely.

In the documentary, the woman said she enjoyed talking with her friends,
playing cards, etc. She just wasn't going to give that up. Left unsaid was
that she planned to do all those things *with her husband* and just because
he can not do that doesn't mean the plan should change.

In the scenario Katelyn offered, there was clear verbal abuse with many
witnesses, including non-family members, and a medical need for
peacefulness. Unless your description has been *kind*, your situation with
your in-laws is a little less clear-cut. When I was practicing law, some 15
years ago, the courts required there to be something more than just
generalized orneriness: physical threat, clear verbal abuse, refusal to
provide appropriate medical care.

You can start by keeping a diary of your MIL's abusive actions, in case you
want to call adult protective services. It will provide some evidence of
your allegations. It may also start to show you patterns that may point to
her actions having a temporal pattern (x hours since she's eaten if it's
hypoglycemia), y minutes since she took her medication (side effect of one
of her drugs, or an interaction).

If your family has the means, you might also want to look into some of the
nicer assisted living communities in your area for your MIL. One group here
boasts of all the activities, including classes and everything is enclosed
so you can go to any building on the complex and never step outside in
winter (a real plus in Massachusetts). Why - well, since she really needs to
see to her own care, its a place where her needs for adult company and
activities can be met. After all, your wife is so busy with the kids and her
Dad that Mom can't possibly be getting her needs for stimulation and care
met - right? But only pursue this if you have the means for both parents to
be in care. As much as you may want to avoid it, our Loved Ones with
dementia eventually need so much care that the physical and emotional burden
becomes too great. Well rested caregivers who can do the care in 8-12 hour
shifts and then go home away from the Loved One to rest,  becomes the better
choice.

Adelle

I think your mother in law is telling you exactly what she
thinks/feels. She doesn't want to look after him. She doesn't have the
inclination, the patience, the desire. Period. She doesn't want "help".
She wants him off her hands - to be unburdened. I don't think you can
do anything to change that, including guilt or force her. You may be
disappointed in her attitude, but it is what it is. Anger and
frustration aren't going to turn her into a willing carer.

Its unfortunate you and your wife didn't "hear" her message before you
moved in with the two of them. Essentially the situation is that your
wife will be the caregiver, and her mother will do whatever, so the
sooner that gets accepted, the sooner you can look at the real longer
term options. I know you have only just moved, but given that your wife
is already finding this frustrating, a better solution is probably for
your inlaws to live separately. If your mother in law is still healthy,
she may want to live on her own, rather than share a house with you.
After all, if she is active, well and able to be independent, she might
be happier doing just that.

With the entire burden of care falling on your wife, consider that its
early days yet, and it gets worse, MUCH worse as AD progresses. The job
gets harder and harder, and its 24/7. She isn't going to be able to
handle this alone - and she is not going to get meaningful help from
her mother. First step is to look into adult daycare for him to get him
out of the house during the day, to give your wife some time to do
other things. Start shopping for a  good Alzheimer's unit and get your
father in law's name on the waiting list. My mother in law was in one,
and although we regret she had to go through Alzheimer's, we don't
regret having placed her. We could not have provided the 24/7 support
and care she needed as the illness progressed. She was very content and
well cared for in the unit, by staff who did a really excellent job,
and made her as comfortable and happy as was possible.  

Mary G.