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I very much appreciate all the good thoughts and helpful advice from last night, when I posted about my mother-in-law falling and appearing very weak. Even though you spoke with me through the computer screen, the moral support was invaluable. I'd find a way to link to last night's diary, but I don't yet know how and I'm too tired at the moment to research how to do it.

This morning I called her doctor's office bright and early. He wasn't in, but was taking call, so I left my number and heard back from him very soon after. I explained the situation, and he advised me to call her and see how she felt. If she was up and about and well, she could wait until his office was open again on the 2nd. If not, I should take her to an urgent treatment center or the emergency room.

When I called MIL, she let me know that she had a fever of 101.3 F. I let her know about her doctor's advice, and told her that when she was dressed and ready, I'd come pick her up.

Next, I called the urgent treatment center and described her symptoms, and they advised me to go directly to the ER.

After picking her up, off we went. A few hours after checking in, we heard the diagnosis -- left lung pneumonia, mild dehydration, and severe hyponatremia. The low sodium levels likely contributed to her muscle weakness, but the exam did confirm that she didn't injure herself when she fell.

So, she was admitted to the telemetry floor, and will likely be there at least a few days, if not longer. When her RN was getting her admission information, we discussed whether or not she wants me to be her medical power of attorney. She does, so we'll take care of that tomorrow or shortly after. When the nurse mentioned advanced directives, I mentioned that we'd discussed various measures verbally in the past, but that it would be good to have her speak with someone and get all the specifics of what she wants in writing and official.

I'm not glad that there's anything wrong with her, but am relieved that my instincts that she needed care were correct. She admitted that she'd thought I was overreacting, but was glad I'd insisted she be seen by a doctor.

As for when she's discharged, I don't know yet. I haven't spoken with anyone about her hoarding, and don't know if and when it's my place to mention it. Someone noted on my previous post that my approach to the mess is likely bringing out her defensiveness on this issue. I'm quite certain it is! At the moment, I don't know how to proceed. It's not a case of her holding onto only useful things -- it is easily 35 years of magazines, newspapers, and old bills. I'm taking a wait and see approach on it, and letting myself quit worrying about it for now.

I'm hoping that her designating me as MPOA will give me the opportunity to speak further with her primary care doctor, and I'm going to be more proactive about making plans with her about what can be done to help her stay in her home as long as possible.  I really feel the need to start getting organized on this, because in 2 weeks, I start my new full-time job, as well as my RN-to-BSN degree (fortunately, I can do that part-time, as long as it's done in 5 years. I don't expect to need more than 2). I'm going to be extremely busy this year, and the children still need quite a bit of attention even though they're much more independent as they grow older. I'll feel less anxious if I can start having some sort of plan in place before any new incident, rather than fly by the seat of my pants if/when it occurs.

For now, I've called her family 3 hours west of us, and I'll call her again tonight. I can find time to see her every day until she's discharged. I expect to begin making contact with some of the organizations people mentioned in last night's post once the new year is here.

So now I am home, and am going to relax tonight with an easy conscience, which I wouldn't have if I'd let her talk me out of getting her some help.

Again, THANK YOU so much for all the replies. This was a frightening experience, but I got through it, and she is getting the care she needs at the moment.

FINAL UPDATE: Well, earlier today, before the children and I got ready to go visit her at the hospital, I got a call from her in-hospital doctor. Basically, they caught the pneumonia in the early stages, and since her dehydration was corrected, she's well enough to recover at home. She was discharged by 2 pm, and we got her prescriptions filled -- a challenge, since her usual pharmacy was closed today, and the closest one to her house closed at 3 pm. But it's done.

The doctor did recommend a home health visit for physical therapy, which she declined. When I got to the hospital, I mentioned to her that since she doesn't want people to see her house (and honestly, there is no room anywhere for a therapist to help her inside her house), that perhaps she could go to a clinic once or twice a week for a few weeks. She didn't think much of that idea either.

She's to see her regular doctor within the week, and I hope to go with her. I'm going to contact the local council on aging to find out what I need to do to get the medical power of attorney, since the focus was on discharging her, and that was never addressed, nor did I get to speak with a case manager, which I'd like to have done.

And no, I didn't go to her house and throw out a bunch of things last night. But since people have asked, yes, the amount of old papers, etc in her house is a fire hazard. If a large pile fell to the floor, or on her, it is a safety hazard. She does keep some old food wrappers. In each room, there is a path, usually about 2-3 feet wide, and the rest of it is stacks of papers, books, and assorted other stuff, at least 3 or more feet high. Her attachment to this is strong enough that she refused a home health visit by a physical therapist. I remain unsure as to whether it will make the slightest bit of difference to mention this to her regular physician. And I don't have the slightest idea what's the best thing to do about it.

But whatever else happens, I'm calling the council tomorrow, because once I start working, I will not always have time to do some of the things I've been doing for her. Groceries once a week or two, yes, most of the time. Sunday church and lunch, yes. But if I'm busy, or the kids are sick, or I have a paper due, I want the option to have someone else take care of it for her. The local library has a book buddies group, and I'm going to speak with her about setting that up. I need to get a network set up for times when she needs help and I'm simply not available, whether or not it's because I'm working, studying, or just burned out on taking care of two children, her, and my own mother who also sometimes needs help. Because while I love my MIL, and she is kind and generous, she is also demanding, and I suspect part of her insistence that I help her with things is that so her hoarding stays a family secret. And while I feel for her, I'm not willing to give over my life entirely to keep that secret. This may be selfish of me, but after nursing school ate my life, I'm ready to enjoy myself a bit more this year. I'm about to start my dream job (operating room nurse), and I want to have more of an identity than just what is defined by my family. The past few years I've been a widow, then a student, and the one person that all my local relatives called upon whenever they needed anything. I'm ready to be a bit more than that.

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