My husbands cousin is considered as a brother in our culture. He moved in wish us two years ago. He has COPD and his oxygen levels are't good. He is overweight and has poor circulation so has a hard time getting around. He can drive, but has run a few stop signs and so he shouldn't be driving, but cannot walk more than a few feet without sitting down for a minute. I know he doesn't feel well because he will wait for me to come into the family room and then ask for the TV remote or a glass of water. tissues and other trash collect around his sitting area and he doesn't ever clean any of itl I have to do that. He will not let my husband or I share the details of doctors visits so we don't know the extent of his health problems, but I know he has a very hard time breathing. He refused to use supplemental oxygen and he needs it because he is going downhill cognitively. We have to repeat ourselves so often that conversations are frustrating. He constantly interrupts even when we are having conversations with others. He only bathes every 3 or 4 days and doesn't wear deodorant. He also takes over every conversation and goes on and on with the most boring stories. He repeats himself. If I turn the TV to a movie that he doesn't like or hasn't chosen, he will talk through the entire movie. When we have friends over, we have to go to another room if we want to visit because he monopolizes every conversation. He went on a short trip with my husband last week and it was so nice. The family room didn't stink and my children sat and visited and watched movies. We really enjoyed each others company and I realized how much this man has controlled us. I miss spending time with my kids. Cousin is a kind person and I don't want to hurt his feelings, but my kids count too and I miss our family time. Any advice?
There is also an emergency request process, like if someone falls and is incapacitated in a way that is not going to be short term. If that happens, you will not be able to get a power of attorney done because Mr. Cousin would be incapacitated.
If you don't have a family law attorney, look on your state's Attorney General website for Guardianship and see what it says. In some states, it's only called guardianship. In others, there is a differentiation between the role looking after the person and the role looking after the money & assets.
Power of attorney is less restrictive and VASTLY less expensive to do. I did my mom's for a dollar. The form was free at the Secretary of State site, and the notary at city hall charged the dollar. Mr. Cousin will have to show up at the notarization and be able to sign his name.
If his cognitive function is as low as it sounds like and if he has depression going on, he might not be functionally able to comprehend big obvious hints or change the behaviors. It's worth a try! So is managing him one task at a time like a kid. The only wrong answer is just letting it go and not trying anything!
Normal blood oxygen levels should be 95-100 %.
If it goes below 90%, it is thought to be low and may result in hypoxemia you might know it as hypoxia the effect is similar to what you see when people go to high altitudes without oxygen (that's where the term came from).
Once the level falls below 80 % you may see problems with the function of the brain and heart and liver - as he is overweight these problems probably already exist...... the sats levels being so low will exacerbate them.
As for hygiene. Oh this is so difficult and such a tetchy subject for everyone. For you because you are clean and he isn't, for your kids who probably want to walk around with a peg on their noses and for, and for him because once he does know he may be embarrassed and only the good lord knows what reaction that will have.
But
House rules are house rules FOR EVERYONE so call a family meeting. You need hubby on side for this family meeting for sure. You have an agenda not written down or anything but an agenda. First off the kids rooms are they tidy etc - don't go in cousin bashing from the off it would be wrong and disrespectful. Provide them with trash bins for their rooms and let them know you have them too (and of course cousin) and that you expect them to be used all the time. They will empty them every day into the main trash.
Then tackle the hygiene. As you do the laundry tell everyone that you have noticed that the laundry basket has started to emit an unpleasant odour. that means you all are not paying enough attention to washing showering and changing clothes. Set a regime in place that will let cousin know you expect him to shower and change every day and that it is NON NEGOTIABLE. Provide everyone with deodorant and tell them to use it but also tell them that using deodorant is in addition to washing not instead of
Get your husband to interrupt you (I'm going to call you husband Fred so you will see what I mean) and when he does raise one hand as a stop signal and say....Please don't interrupt me Fred it's rude ....and carry on talking.
You will still need to have a quiet word with cousin re his health. Hubby might be best placed to do this. Tell him you are concerned about his health but moreover really worried that in the even he fell or became really ill no-one would accept your word regarding his care. Tell him while HE might not be worried about it YOU are and that he MUST put something in place (Like a POA) to allow you to manage his affairs in the event he became too ill to manage them himself. Explain this one to him. My friend's husband who was really fit fell and hit his head and was brain damaged literally in the time span of a blink. As a result they have had to appoint a guardian at a huge cost and have no say over his care at all. She has been left penniless as the account was in his name. Now if that happened to him and falls are more likely with low sats then who would he want to decide where he lived and how his care would be paid for...I am sure he wouldn't want the state to make those decisions for him.
Good luck I foresee trouble ahead but keep the faith and keep the crash helmet on!
1. One of you gets durable power of attorney and healthcare proxy. These documents will let the doctor talk to you openly about his conditions and treatment options. You guys can't know what to expect by staying in the dark.
2. A social worker does an assessment on him. This is the door to services & help.
3. Services are brought in to assist him with his ADLs (activities of daily living).
You can't be expected to do these intimate care tasks for him. He will soon need help transferring in & out of bed, chairs, the bath, the toilet.
4. You & your husband agree to the limit of care you are able to provide in your home. Are you prepared to have him die there? Or can you agree that if the social worker recommends this man go into care that you will support it?
Coming to somebody's house (family or not) and just plopping down, becoming a huge burden, and not expecting to protect and contribute to your caregivers is pretty darn presumptuous to me. Taking care of this family member can also include making sure they are living in the right place to be as well as they can be.
If an emergency happens, call 911 and let them handle him. You can refuse to let him return to your home, so the discharge social worker can find him a place to rehab and choices beyond that point.
I think it's fair to say that neither one of you probably expected it to deteriorate into this kind of situation, so it's totally appropriate to reassess and replan.
There is a huge difference between "help out" and "totally manage".
I would read up on veinous problems in lower legs and tell your husband to watch and check for clots and other signs of vascular insufficiency.
This cousin is literally a ticking time bomb of medical conditions that COULD BE CONTROLLED.
If this cousin doesn't want to use his oxygen, he's only going to continue to decline; he may already have suffered some loss of brain function because of chronically low levels of oxygen.
From what I read in your initial post though, this person just doesn't seem to want to take care of himself. Whether it's from low oxygen or something else, he could benefit from intervention. Your husband needs to step up and take charge and get him to either see a doctor or get him to the ER before anything worse happens.
Jessie and Sandwich's advice is right on - if he doesn't want to keep clean, he's a hazard and a menace to others, especially the children.
Daisy, the specific approach for your husband is to read the answers here, have a talk with his cousin, and make it clear that the cousin is either going to use oxygen or find another place to live because your family can't be exposed to him.
In the meantime, do you have health care proxies to make decisions for him, because it may come to that?
If the cultural issues come into play, perhaps you could get some leaders in your culture or religious group to intervene. Explain about the oxygen levels and that you suspect the cousin isn't thinking clearly because of that, but that he needs intervention, and the sooner the better.
Hygiene is not just for decorative purposes. If he is not brushing his teeth, that can lead to cardiac problems and worse. Bacteria on the body can get into the body and make you sick. If he is not cleaning his body, fungus can start to grow. Since he's already compromised, this can make him sicker faster.
If he's just sitting around, he might have pressure sores, which MUST be kept clean. If he has foot fungus, DO NOT touch his socks or shoes with your bare hands. Foot fungus looks like powdery dead skin on the feet and nails. The nails get really thick, yellow/green, and are very hard to cut.
My mom had this because her blood sugar was uncontrolled and diabetics have a really hard time fighting off fungus because their immune system is already compromised. When her blood sugar got under control and stable, it went almost entirely away. She has bad kidneys & liver too, and can't take the oral meds for fungal infections.
I would have a social worker come in and do an assessment, pronto. He may qualify for services that won't cost you any money. He may qualify for some benefits to offset what does cost money.
Ultimately, you have to decide if you can have a full-time patient in the house because he's going to continue declining and need more & more care.
I'd be concerned for your children; it's neither healthy or helpful for them to see someone abusing their mother as the cousin/brother has done. I would hate to think that children would grow up seeing their mother treatedly disrespectfully as well as see that someone doesn't work for a living but can expect his family to support and tolerate him.
What's your husband's position about this situation?
As for the cousin being a "brother", brothers share everything that is going on in their lives, and that includes medical issues.