My mother in law has congestive heart failure. She is nearing end stages but still doing very well and is not ready for hospice. In the last several months her behaviour has started changing and she is starting to act in ways that my husband and I would never have expected from her. She does have quite a few health problems along with her chef but most can be controlled by medicine and diet; however, recently she seems to refuse to do things that she herself has mentioned how well it works. When she gets better she suddenly claims that what we are doing doesn't work. For example, she has a distal hernia and she knows that she cannot lie down within two hours of eating yet she still lies down, causes herself a lot of discomfort and then continually calls throughout the night complaining about her stomach hurting. She lives in her own house which is only 15 feet from our back door so we are constantly up and down all night when she has a bad night. Last time she came home from the hospital (for chef related issues) she could barely walk and get around. I spent all day, every day at her peacekeeping her with feeding, dressing, taking care of her dogs, etc. I don't mind doing those things for her but she wouldn't make an effort to try and get her strength back. She claimed that she was doing her physical therapy exercises when I know that she is not. When confronted about it she gets defensive, claims she is doing her exercises. Sometimes instead of lying about it she claims that she can't get up and do anything because she gets dizzy and will fall, even though she can walk to the bathroom without getting dizzy. I don't mind helping her with things that she truly needs help with but she is capable of doing her physical therapy exercises and just won't do them. A few days ago we were actually having some good days. She was walking g to the mailbox (which is a good distance). We had gone shopping that afternoon (although she was in her wheelchair) but getting out was a sign that things were looking up. She had lost about 12 pounds in water weight over a few days and claimed herself that she was feeling much better. Suddenly that night, her stomach was hurting her. I gave her what medicines we have for it and told her that she shouldn't lie down so soon after eating but she insisted that she had to in order to make her stomach feel better even though she knows that it makes it worse. I checked on her a few more times that evening and she wasn't feeling better but there was no more meds that she could take and I told her that she would just have to wait it out. We went to bed and after going to sleep, she woke my husband and I up claiming that she had fallen in the floor. We ran over there terrified that she was hurt. When we got there it was apparent that she had not really fallen but had put her self on the floor claiming she had fallen. She was begging us to "help" her. We tried to get her up and eventually we did and we set her in her walker in order to get her over to her chair. I was holding her from falling over while my husband was getting ready to move her and she was pulling g against me so hard that it was difficult to keep her from flying forward because of how much she was pulling against me, the whole time trying to pretend that she was passed out. She was then telling us that she had been begging for help for days and we refused, and insisted that we call an ambulance which we did. I checked her boyfriend and it was very low. I also found a bag of prescription pills that I had never seen, that she has had for a while. She says that she didn't take any but I think that she did in order to lower her blood pressure so she would be admitted to the hospital. I take her to all of her appointments, take care of all her medications. I handle all of her care. What scares me is that she is faking symptoms and I will not believe her when something really is wrong. I have confronted her about it and she just denies it. She is going to be home from the hospital in a few days and I have to somehow make her understand that she cannot fake and pretend and that she has to quit doing things on purpose knowing that it will cause her pain or discomfort. She has never been like this, only recently has started this behavior. How can I convince her that this cannot continue for her safety and my sanity?
With my mom, her chf caused Mild Cognitive Impairment, which affected her ability to manage her finances and to drive. She also became overwhelmed with anxiety about EVERYTHING. My brother referred to this as "something mom is doing to herself". Nope. Anxiety is a very real medical condition which can be caused by changes in the brain, such as the changes that happen with the kind of brain damage that chf can cause.
It may also be that MIL has had a small, unrecognized stroke that has changed her ability to think, reason and communicate. In thinking about MIL's trying to fling herself in the wrong direction, it reminds me a great deal of my mom's post stroke inability to do " motor planning" ie, how to cooperate with being moved and her poor ability to use gesture to communicate ( she points at her open mouth when she wants a neck rub).
Depending on how severe her chf is, you might want to forgo an extensive neuro workup. But I don't for a minute assume she's being purposefully difficult.
From what you describe, she isn't seriously affected. People with the full disorder will visit many doctors and have very thick medical files with each. It may just be attention seeking behavior that will end quickly if she thinks someone knows. Good luck!
If these are relatively new symptoms (if MIL hasn't been an attention-seeker all her life) then I suspect that some cognitive or neurological impairment could be the cause. Maybe in addition to CHF she has developed some disorder, or is in early stages of dementia. Clearly she is not "in her right mind," as we say.
My husband had CHF but did not reach the late stage before he died of dementia. Curious, I've just looked at articles about the condition. Did you know that late stage symptoms could include "confusion and trouble thinking"?
I don't think confronting the sick woman and trying to get her to behave rationally is going to change anything. This is beyond her control. Instead I'd concentrate on ways to minimize the disruption to your lives while comforting and reassuring her. Maybe a companion or aide for part of the day, or in the evening would help her be more calm and less agitated.
She has a fatal condition in the late stage. She is losing control of her thinking. She must be very frightened. Poor woman! I hope you can find ways to bring her some peace. That is what I would want if I were in her situation.
Much of her problem had to do with handling her own medication. She was taking Metformin a few years ago for her diabetes. In the nighttime when her sugar was too high, she would take more. It made her gassy and sick feeling. This went on for a while until one day I counted her pills. Goodness, she had been taking a lot of Metformin. So I looked up what too much could cause. You probably guessed -- gas and nausea. The MRI had also shown a lot of gas. My mother had been creating her own problem, though she was sure it must be cancer or something fatal.
I managed to get all her pills away from her after she overdosed on an Alzheimer's drug. That was terrible, but a blessing in disguise.
She still turns every spot into cancer and every discomfort into impending death. But she stopped asking to go to the doctor and hospital. Two things helped -- her favorite doctor retired and I started taking her to Urgent Care instead of making appointments or going to the ER. She still gets care, but it's not as personal and fulfilling anymore. I still worry when she cries Wolf, but I follow my best instincts about if something is really wrong. Physically she is as strong as an ox with a bad back. Her vitals tell me the things I can believe. Sometimes I do have to remind her that nothing is going to make her 40 again. I wish we could reverse the maladies of age, but no one has found the fountain of youth yet.
Please think twice about "nursing home is not an option." This is your stance, I noticed. Is your husband in full agreement? Hubby will lose his mother, no matter what. That's the circle of life. Also losing his wife -- to a rabbit hole of servitude and gaslighting and going nuts trying to be the bigger person -- is optional.
You love MIL and you surely mean well. But you are not a cardiologist. Or a PT/OT practicioner. Or a geriatric behavior specialist.
And why do you have to tell MIL that she needs to stop faking and stop self-sabotaging, yada yada? Perhaps that message would sink in if it came from her son. Peppered with "we" -- meaning you and him.
Something more than MIL's issues are at play here. Can you give us some insight into how you became the family angel?
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