Temper Tantrums Are An Ineffective Tool at 95

Posted by: Kathy Harmon on 7/13/2010

Dear Kathy,
Although my husband and I divorced years ago, I've remained close to his mother who is now in her mid-90s.  She was recently hospitalized with a hip fracture and then, because her doctor believed that she could no longer care for herself, she was sent to an assisted living transitional facility to receive physical therapy.  When I visited her there, I was shocked to see a side of her I had never seen before.  She was uncooperative and nasty to the staff.  She was told several times that she could not continue to be in the community unless she followed her doctor's directives, which, unfortunately, suited her just fine.  She continued her uncooperative and abusive behaviors and they kicked her out.  She's currently on her own, living at home.  Although she needs round-the-clock monitoring, her insurance won't cover this assistance and she doesn't qualify for Medicaid.  I can't support her financially, and because I'm not a family and have a poor relationship with my former husband I have no right to intervene..  What can I do?
Bonnie in Bloomfield
Dear Bonnie,
What you've told me about your mother-in-law doesn't appear to be dementia.  She's definitely angry, most likely at herself and her body for breaking down.  Perhaps she thought that if she convinced everybody that she was a patient who couldn't be helped, they'd give her what she wanted, which was simply to go home.  Whatever her motivation, she got exactly what she wanted.  Medicare, Medicaid and private insurers have specific guidelines for coverage, which, if not followed can result in claim denial. 
You need a mediator who will work with her, her concerned relatives and her medical team.  You may wish to consult a geriatric advocate or geriatric manager to fill this role.  There are numerous in-home care providers who can supply non-medical or medical assistance, some combination of the two, and offer therapies.
Many counties in your state offer senior assistance "hot-lines" that can analyze the problem and offer alternatives.  You might have a conversation with the discharge nurse at the hospital where your mother-in-law was originally treated or contact a geriatric manager to intervene.
Nonetheless, as I'm sure you realize, your situation is additionally complicated because your divorce compromised your ability to intervene on her behalf.  I really want to help you work through this issue.  Call me or write to me with your contact information and I'll help you find the best resources in your community.


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