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Like much of the sandwich generation, I never ever thought I would be taking care of my mother-in-law. For one thing, she hated me. Susan was 82 when my husband and I got married, and when he called to tell his parents we were engaged she said, “Well, we will never see you again.”
Susan was a brilliant person. Born in the Depression, she had been forbidden by her family to accept scholarships to Catholic secondary school and university because “if your sister didn’t do it, you can’t either.” She took a variety of men’s jobs during the Second World War, was able to earn a university degree in French (the only major offered at night school) and escaped home to move to California, working as an analytical chemist. After the war her husband, a veteran, earned an undergraduate degree, then a masters, finally a doctorate and a temporary, then permanent faculty position. Each step in his career meant a move which separated her from another job. At their final stop she earned a masters in public health and ran medical studies for Crohn’s disease. They lived near the university for 60 years, raised a family and when her husband died of a stroke, she lived there alone.
She is a smart woman and I have a lot of respect for her accomplishments. However, on me, she used her high IQ to practice a clever form of abuse. She would profess interest in something about me, draw me out, then while my guard was down, say the most hurtful things. I never learned to brace for the shot. I started exaggerating my redneck background, so the person she stabbed wasn’t really me. Before each visit I ordered a box of murder mysteries and romances to be delivered. Each day, after the first insult, I would stand up and retreat to a quiet room to read for the rest of the day.
Susan and I always did better over the phone. Every two weeks or so, I would call to deliver our family news. But at age 96, she started yelling at me over the phone, blaming me for things that had gone wrong. I quit calling and my husband, Michael, delivered the family news. Once, after he hung up, he bemusedly complimented me on my powers. Evidently, from 2,000 miles away, I had broken her TV.
Michael and I didn’t associate her accusations with dementia. As she got more erratic and started falling, he would fly home to arrange for help with housework and meals but Susan would yell at the help, fire them or lock them out of the house. When a fall put her in the hospital again, she could not be discharged unless a relative came to pick her up. This couldn’t continue. Susan needed more care – she had wounds that were not healing – and Michael, her only living relative, lived too far away. So, with my support Michael brought her back to move in with us.
It didn’t go well at first. Sometimes she refused to have her dressing changed, Michael would argue, but he wouldn’t do it against her will. She goaded him into late-night arguments and made the nursing aids cry. She refused to allow anyone to change urine-soaked bedding. We lost eight care-aids in 16 months as she started biting, hitting and scratching.
In tears I called my sister, who is an ER doctor. She told me what an idiot I was (sometimes ER docs aren’t tactful and are only impressed if you are actually dying). She told me that no employee in her department or at a retirement home would interact with a violent person. They would give her an antipsychotic and come back an hour later. So I told my husband there wasn’t a choice.
I made an appointment with Susan’s doctor, explained what was happening at home and she was prescribed an antipsychotic, quetiapine. I ground up the pills and put it in her coffee. The drug made a huge difference. After medication she started greeting our health-care workers with interest, and she was grateful and happy about simple things like ice cream, her favourite German cookies, or a visit from her nursing aid’s dog.
At long last, we could treat the wounds from her falls so that they healed. Since then, the doctor has added an antidepressant and Nabalone – a prescription CBD synthetic that is thought to be good for dementia-related anxiety.
Despite the positive changes in our lives, I felt terrible about the medication. The history of the mentally ill over the last hundred years has veered between grossly overmedicating them for their caretaker’s convenience, to turning them loose in the streets without care. Rather than medicating her illness, was I medicating her personality? I take psychiatric medication myself – I have treatment-resistant depression. Adjusting to new medication sometimes makes me temporarily sleepy, goofy or irritable, but when they work I am more myself, not less.
It’s tempting to go back in time and wonder what our relationship would have been like if I hadn’t been the person who had stolen her son. What if she’d had that psychiatric evaluation at age 80? When I get old, I don’t want to be afraid, anxious or paranoid. I’ve told my children that I want to be medicated so I can still enjoy things like having guests or drinking coffee. I am not exactly at peace with my decision to medicate my mother-in-law, but it will have to do.
Kristy Dyer lives in Penticton, B.C.