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Learning, Sharing, and Teaching => Ask a Mustachian => Topic started by: mtn on May 23, 2016, 03:59:35 PM

Title: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 23, 2016, 03:59:35 PM
My Mother-in-law has MS. She needs to keep working until February 2017 when she will be able to go on disability, and when that runs out she'll be able to retire with full benefits including her pension and insurance. Without getting into politics, thanks to ACA it is not feasible for her to stop working before February.

Now, the problem that I am having: She has a 30 mile round trip commute. When she started the job many years ago, she took public transport, but as her MS got worse she had to start driving. It is now getting to the point that she shouldn't be driving. Sometimes, if she is tired, she'll physically move her leg from the gas to the brake or vice-versa with her hands. She drives in stop and go traffic both ways. This obviously can't go on, which leads us to the question of what to do. As I see it, there are a few options, all of them with different costs to us and my in-laws. FIL and BIL cannot drive her in on a regular basis, my wife cannot either--I can since I work near where she does--close enough that it is only 15 minutes by bus or train to get from her office to mine.

So, the options that I see--keeping in mind that my wife and I are moving in September, and eventually we want to move to the town where her parents are from--that could be in September, or 5 years from now if we were to ignore the in-law situation. With any of the options except the last two, my commuting cost stays the same, my wife's goes down, my time goes way up, and her time way down.

Any thoughts or experiences to relate? Are we crazy for considering something like this? The one big pro to moving to the town in September is that we do eventually want to be there, so we'd be well placed to find the right house when it becomes available. The one big con is that I cannot do this for more than 6-12 months, and MIL wants to keep working until she physically cannot. Realistically I think that the MS will make sure that it isn't longer than 12 months, but I hope for her sake that it is.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: pbkmaine on May 23, 2016, 04:27:29 PM
Renting looks like your best option.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mozar on May 23, 2016, 04:31:16 PM
Why don't you think she can drive? Has she gotten into an accident? If she thinks she can drive there is not much you can do, unless you want to report her to the police if you think she is in danger. It sounds like she doesn't want to be helped, so I don't see why you would turn your life upside down to help someone who doesn't want help.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: Cassie on May 23, 2016, 04:43:47 PM
If she is physically moving her leg with her hand she will not be able to respond fast enough to avoid an accident. I think Uber is the best option. If her doctor is made aware of the sitution he most likely will notify DMV she shouldn't be driving.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: Sturton on May 23, 2016, 05:26:03 PM
Renting does look like your best option.  But your other problem is that your MIL is unwilling to acknowledge that she should not be driving.  Are you sure that once you go to all this trouble, she will let you take over?  That would be my concern.  Be very sure and talk this over with her straightforwardly before making any big changes.  I know you may be hoping to stealth-help her, but stubborn people can be stubborn no matter what.  It does sound as if she very much should not be on the road.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 23, 2016, 05:27:34 PM
Why don't you think she can drive? Has she gotten into an accident? If she thinks she can drive there is not much you can do, unless you want to report her to the police if you think she is in danger. It sounds like she doesn't want to be helped, so I don't see why you would turn your life upside down to help someone who doesn't want help.

She moves her leg with her hands at times. And my wife has ridden with her. It's bad.

If she is physically moving her leg with her hand she will not be able to respond fast enough to avoid an accident. I think Uber is the best option. If her doctor is made aware of the sitution he most likely will notify DMV she shouldn't be driving.

Unfortunately the dmv and Doctor can't do much. They can require a test, but she would be on her best behavior for the test. This I know from other relatives where we've tried to have the license taken.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 23, 2016, 05:28:54 PM
Renting does look like your best option.  But your other problem is that your MIL is unwilling to acknowledge that she should not be driving.  Are you sure that once you go to all this trouble, she will let you take over?  That would be my concern.  Be very sure and talk this over with her straightforwardly before making any big changes.  I know you may be hoping to stealth-help her, but stubborn people can be stubborn no matter what.  It does sound as if she very much should not be on the road.

We'd talk with her and make sure we're not wasting the effort. She probably would because she doesn't like driving everyday, and likes help getting her scooter into the back.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: Rezdent on May 23, 2016, 06:30:05 PM
Renting does look like your best option.  But your other problem is that your MIL is unwilling to acknowledge that she should not be driving.  Are you sure that once you go to all this trouble, she will let you take over?  That would be my concern.  Be very sure and talk this over with her straightforwardly before making any big changes.  I know you may be hoping to stealth-help her, but stubborn people can be stubborn no matter what.  It does sound as if she very much should not be on the road.

We'd talk with her and make sure we're not wasting the effort. She probably would because she doesn't like driving everyday, and likes help getting her scooter into the back.
When you have that talk, be sure to mention frequently that this is "until she is stronger".  No one wants to think about giving up freedom, especially if there's no going back.  But giving it up temporarily, until she is stronger...most reasonable people will accept and appreciate that.  Plus, who knows?  Maybe she does get better.

Not my idea - huge props to Grace, the nursing assistant from Hospice, who never denied my MIL any request, but often said "we need to wait until you are strong enough to sit up, then we can do that".
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: ShoulderThingThatGoesUp on May 24, 2016, 06:09:26 AM
It's amazing what somebody with a neurodegenerative disease can do to pass that test.


Edit:autocorrect fail
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: former player on May 24, 2016, 06:59:13 AM
If the problem for your MIL is currently limited to her leg movements, she could look into getting an adapted car that she can drive entirely using hand controls, or even one which she can drive from a wheelchair.  It may be possible to adapt the car she has, alternatively she could get a new car.  I don't know what the provision for this is in the USA, but I bet once you start looking there will be lots of options.  The benefit of this is that it would give your MIL a level of independence which would enable her to continue getting herself to work but would also give her independence away from work and after she retires.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: shelivesthedream on May 24, 2016, 07:12:26 AM
Renting the house next door sounds like a pretty good option. If it's vacant but they don't want to sell it for non-financial reasons you would probably be able to get a cheap, flexible deal. I know you'll be right next door to your in-laws, but having a separate residence with a separate front door is a big psychological thing, so unless they're really pushy about coming round all the time I think it would work for a while while you sort MIL's work situation out and look for somewhere permanent.

I agree that I'd phrase it to your MIL as "just helping you out until the work situation is sorted", or "we wanted to rent for a little while before finding somewhere permanent in this town, and we knew about this house, and while we're here why don't you let me drive you to work". Then you can spend some time talking up how great it will be when she doesn't have to work any more, and hopefully she will just ease into the idea herself.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 24, 2016, 07:18:36 AM
If the problem for your MIL is currently limited to her leg movements, she could look into getting an adapted car that she can drive entirely using hand controls, or even one which she can drive from a wheelchair.  It may be possible to adapt the car she has, alternatively she could get a new car.  I don't know what the provision for this is in the USA, but I bet once you start looking there will be lots of options.  The benefit of this is that it would give your MIL a level of independence which would enable her to continue getting herself to work but would also give her independence away from work and after she retires.

She's stubborn and doesn't want to be seen in a van. She also doesn't want a big suv that can fit the wheelchair. The hand controls are an idea we've brought up before, but my wife doesn't think she's coordinated enough to manage acceleration and braking along with steering.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: former player on May 24, 2016, 07:49:12 AM
If the problem for your MIL is currently limited to her leg movements, she could look into getting an adapted car that she can drive entirely using hand controls, or even one which she can drive from a wheelchair.  It may be possible to adapt the car she has, alternatively she could get a new car.  I don't know what the provision for this is in the USA, but I bet once you start looking there will be lots of options.  The benefit of this is that it would give your MIL a level of independence which would enable her to continue getting herself to work but would also give her independence away from work and after she retires.

She's stubborn and doesn't want to be seen in a van. She also doesn't want a big suv that can fit the wheelchair. The hand controls are an idea we've brought up before, but my wife doesn't think she's coordinated enough to manage acceleration and braking along with steering.
Your MIL's MS is not going to get better, and will probably progressively get worse.  She has a better chance of keeping her independence for longer if she starts taking advantage now of what is available to help her, both in her own home and to help her get out and about.

It sounds to me as though your wife's family has existing levels of dysfunctionality which are nothing to do with the MS but which certainly won't be helped by it.  I think the best thing you can do is remember not to help someone more than they help themselves and to put you and your wife's life vests on first.  Etc., etc.  From your original post I would certainly suggest you completely avoid option 1 (murder is not a good solution), 3 (don't tie yourselves to a property you don't want) 4 (as before, plus its a teardown next to a restaurant) and 6 (its just a rewrite of the murder option).
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 24, 2016, 08:05:48 AM
If the problem for your MIL is currently limited to her leg movements, she could look into getting an adapted car that she can drive entirely using hand controls, or even one which she can drive from a wheelchair.  It may be possible to adapt the car she has, alternatively she could get a new car.  I don't know what the provision for this is in the USA, but I bet once you start looking there will be lots of options.  The benefit of this is that it would give your MIL a level of independence which would enable her to continue getting herself to work but would also give her independence away from work and after she retires.

She's stubborn and doesn't want to be seen in a van. She also doesn't want a big suv that can fit the wheelchair. The hand controls are an idea we've brought up before, but my wife doesn't think she's coordinated enough to manage acceleration and braking along with steering.
Your MIL's MS is not going to get better, and will probably progressively get worse.  She has a better chance of keeping her independence for longer if she starts taking advantage now of what is available to help her, both in her own home and to help her get out and about.

It sounds to me as though your wife's family has existing levels of dysfunctionality which are nothing to do with the MS but which certainly won't be helped by it.  I think the best thing you can do is remember not to help someone more than they help themselves and to put you and your wife's life vests on first.  Etc., etc.  From your original post I would certainly suggest you completely avoid option 1 (murder is not a good solution), 3 (don't tie yourselves to a property you don't want) 4 (as before, plus its a teardown next to a restaurant) and 6 (its just a rewrite of the murder option).

Yeah, we know it is only getting worse. It is secondary progressive at this point, some days are better than others, but it doesn't ever get better. But when she spasms, we're not sure that we trust her with hand controls that much more than foot controls. It only takes one time and she could kill someone. Yes, my wife's family has dysfunctional aspects--but most of them stem from the MS. Her brother is a different story, but that is something that we can ignore for now--that is just siblings fighting. We get along great with him, he's just not someone you like to live with or someone you should rely on.

As for the house next door, if we can rent it, it might be the solution. If we can buy it, the only reason that it is a tear down is that the restaurant owner wants to make a parking lot of it because he has no parking lot. It is a nice enough home in good, albeit dated, condition.

Anyways, I talked with my wife about this last night. We explored our options, including talking to her parents about it (who have no idea we're considering this). The biggest hurdle would be presenting it in a way that we want to do this because we eventually want to live in the town and not to babysit her mom--which is not an outright lie. She was all for living with her parents just to save money, and help out her dad with the mortgage. I told her that if we do that, we'll need to plan on being a lot more active outside of the home--set up regular date night, golf night, run night, bar night, etc., and escape to either of our extended families vacation spots at least once a month without her family. We'll see what happens; we have until September or October to decide.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: SKL-HOU on May 24, 2016, 12:03:50 PM
I am sorry but this pisses me off. If she gets into an accident, she could hurt other people! It is one thing to take a risk with your own life but she has no right to put others in danger.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 24, 2016, 12:14:57 PM
I am sorry but this pisses me off. If she gets into an accident, she could hurt other people! It is one thing to take a risk with your own life but she has no right to put others in danger.

Preaching to the choir. We've seen this before with relatives that had neuro diseases such as Parkinson's. What we've conjectured ("we" including people with medical backgrounds, although not neurology or psychiatry) is that as people lose control of themselves--especially as they become incontinent as eventually happens with MS and Parkinson's--they try to grasp onto whatever control they can. That includes first and foremost their independence, and that to them is their car.

My wife is always on the verge of tears when we talk about it. I think that we decided last night that one way or the other we're going to move out there with or near them so I can drive her in.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: former player on May 24, 2016, 12:22:54 PM
I am sorry but this pisses me off. If she gets into an accident, she could hurt other people! It is one thing to take a risk with your own life but she has no right to put others in danger.

Preaching to the choir. We've seen this before with relatives that had neuro diseases such as Parkinson's. What we've conjectured ("we" including people with medical backgrounds, although not neurology or psychiatry) is that as people lose control of themselves--especially as they become incontinent as eventually happens with MS and Parkinson's--they try to grasp onto whatever control they can. That includes first and foremost their independence, and that to them is their car.

My wife is always on the verge of tears when we talk about it. I think that we decided last night that one way or the other we're going to move out there with or near them so I can drive her in.
If it's that bad, you can (and should) report your MIL to her State licensing bureau and have her driving licence suspended for medical reasons.  Now.  No excuses.

And don't eff up your own life for this selfish, delusional old woman.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: GizmoTX on May 24, 2016, 12:26:23 PM
Driving is a privilege, not a right, & should be subject to demonstrated physical & mental ability. My mother continued to drive after her cancer diagnosis, but her treatments were for quality of life, not a cure. I did drive her to doctor visits, at her request, & took that opportunity to ask her doctor about driving. He was shocked that we even asked the question, & made it clear that her medication had reached the point that her driving days were over. So doctors aren't necessarily being vigilant for this. By this time she was living with DH & me, & we could easily drive her places. Later I discovered that I needed to hide all car keys, because dementia suddenly kicked in & she forgot she wasn't supposed to drive -- fortunately I was able to stop her when I heard the car being started.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: Sibley on May 24, 2016, 12:33:42 PM
I'm dipping my toes into the ocean of dementia. Based on some discussions I've heard, if the family is aware that the person shouldn't be driving, and doesn't take the keys away, if something then happens, it opens up a whole new world of hurt. Criminal liability, civil liability, etc. NOT pretty.

If she's truly not safe to drive (and from what I've read, she's not), then you're got two options: take away the keys, permanently, or stay 100% out of it so you can't be sued.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 24, 2016, 12:56:57 PM
I am sorry but this pisses me off. If she gets into an accident, she could hurt other people! It is one thing to take a risk with your own life but she has no right to put others in danger.

Preaching to the choir. We've seen this before with relatives that had neuro diseases such as Parkinson's. What we've conjectured ("we" including people with medical backgrounds, although not neurology or psychiatry) is that as people lose control of themselves--especially as they become incontinent as eventually happens with MS and Parkinson's--they try to grasp onto whatever control they can. That includes first and foremost their independence, and that to them is their car.

My wife is always on the verge of tears when we talk about it. I think that we decided last night that one way or the other we're going to move out there with or near them so I can drive her in.
If it's that bad, you can (and should) report your MIL to her State licensing bureau and have her driving licence suspended for medical reasons.  Now.  No excuses.


You ever try to do that? She is of sound mind, so the most we and her doctor can do is get them to test her. I can guarantee that she will go in to the test on a day she is feeling good, and pass the test. Been there and done that.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: GizmoTX on May 24, 2016, 01:20:28 PM
This is where tough love is required. When you know that a person is impaired, you don't enable them or expect a test to do the job. "Sound mind" does not equal competent driver. You keep all family members out of the car if she's driving & don't help her into the driver's seat. Ultimately the car should be sold.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 24, 2016, 01:24:23 PM
This is where tough love is required. When you know that a person is impaired, you don't enable them or expect a test to do the job. "Sound mind" does not equal competent driver. You keep all family members out of the car if she's driving & don't help her into the driver's seat. Ultimately the car should be sold.

Agreed. Easier said than done. (At least she is the only one in the car anymore when she drives. Small consolation knowing that she's not the only one on the road).

And FWIW, it isn't my place or even my wife's place to take the keys. Which is why we're considering moving out there so I can drive her in.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: GizmoTX on May 24, 2016, 02:04:59 PM
It's so much easier to convince a person who is not isolated. My MIL at 90 clearly needed a safer environment than the house she had lived in her entire adult life -- now that was a tough one. Driving was a concern; she finally only made trips to the grocery store when she thought few people were on the road, & was constantly badgering my SIL to make 3 hour round trips almost daily to drive her & keep her company. SIL finally had enough & found a fantastic senior independent & assisted living community 10 minutes from her house. The move upset MIL at first but she once again found plenty of friends & a great support system -- she lived to 99 there.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: shelivesthedream on May 24, 2016, 02:06:39 PM
I know you've said you think she'd pass a fitness to drive test, but is there actually a downside to making her take one? You could talk to her GP in private and say you're worried about her driving and can they recommend she take a test. She might fail! And if she passes, you say she'll keep driving anyway at the moment. What's the reason not to try the test?
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: mtn on May 24, 2016, 02:28:49 PM
I know you've said you think she'd pass a fitness to drive test, but is there actually a downside to making her take one? You could talk to her GP in private and say you're worried about her driving and can they recommend she take a test. She might fail! And if she passes, you say she'll keep driving anyway at the moment. What's the reason not to try the test?

Good point. I'll tell my wife to tell her GP to call it in.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: jim555 on May 24, 2016, 04:31:21 PM
Has she looked into the FMLA to get up to 12 weeks off as needed due to her condition?  I don't understand why she must get to February 2017?? 
She should quit and go for Social Security Disability.  She can get Medicare in 2 years after she is declared disabled.

Ultimately she will need a full time care situation.  Never easy on all involved.  I feel for anyone who has to go through something like this.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: Cassie on May 24, 2016, 05:15:02 PM
When my Dad had a big stroke physically he was fine but mentally not. He loved to drive and the first thing he did when he got out of hospital was to crumble his license and throw it stating that he could never drive again. I really admired that.  In Cali a doctor calls the DMV and license gone.  Not in Nevada. I had a friend with severe MS continue to drive as well as one with dementia. Finally convinced the DH of the one with dementia to sell her car and hide the keys to his car. My other friend drove years after she should not have but finally quit.  So check the laws in your state.  Here an old man passed out and killed 2 small children. The problem is that he can done it 2x's/before but the first time someone was killed. Ugh! It should have never happened a 3rd time. 
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: KBecks on May 24, 2016, 05:17:16 PM
Just be careful not to make permanent, big decisions in your life to help out with a problem that is temporary for your MIL.

February is only 10 months away.  Don't buy a house or apartment you don't really want.  You could rent something cheap for one year and help out.

Getting through to those retirement benefits is a big deal.  Have you checked the UBER costs?  30 miles is a long way.  Is there anyone she works with that she could carpool with?  Are there rideshare services in your area?

Added: Could you hire someone kind and friendly with a similar commute to drive her for less than the cost of daily Uber?

Added again:  This should be a conversation between your wife and her mom.  Mom, we know that driving is a hard job and it can wear you out sometimes.  We'd like to help by finding a nice person who you can carpool with so you can focus on working for as long as you want, and your commute will be more pleasant.   

Sell it to her!

Best of luck with it.  Just keep the timing in perspective so you are not bending your lives too much over it.  You have to make decisions that work very well for you and not over-sacfrifice.  Definitely help, but don't go nuts with your actions.
Title: Re: What would you do? Deteriorating health of a parent and living situations
Post by: bogart on May 24, 2016, 09:17:42 PM
I started to respond to the various other commenters, but the quote strings were long and I think I'd have messed them up.  But I have tried to get an incompetent parent's driver's license taken away and can back the OP up and empathize -- at least where I live it was the opposite of easy (indeed, I never managed -- like you, best case scenario I might have gotten my dad to have to be tested, and he might have flunked the test.  And having flunked he might have stopped driving.  Instead, as things turned out, he broke his hip (not while driving!) and never drove again.  So there's that to be grateful for, and I am.). 

It's hard.  I'm sorry.  I have no particular words of wisdom, other than to concur with other commenters that a period of less than a year is a short one, and you should do what you can (including to keep our roads safe, but also to help your MIL), without making permanent changes to your own life that may not be good/workable ones.  Good luck to you, and I'm sorry about what your MIL is having to deal with.