We don’t / didn’t get notices of any extended family graduations ever nor have we done any Christmas gifts for any extended family members in many many decades. Haven’t been to an extended family marriage in decades either.

We only celebrate our son and his family and our daughter and her family so that’s 8 people. Mostly no gifts but we do experiences by paying all their camp fees every Summer which is a lot.

I think it isn’t necessary to give gifts either money or actual presents to anyone else. Well wishes by card or phone is plenty.

We give very large donations to several important to us charities and our children know this.

I guess this qualifies as ” my hill to die on”. Trailrunner/ c

I'd be sure to get a consensus or at least affirmative acknowledgements (from all of the affected family members who are indifferent) before moving forward with your obviously concerned and caring plan.

An oldster who may be in decline or need changes of treatment can present a difficult and heavy burden to attend to. The difficulty pales in comparison to having to deal with outraged family members who suddenly become obstreperous adversaries.

A first step - does your mother in law have healthcare/end of life legal documents in place (like a medical power of attorney, HIPAA authorization, advance directive, etc.) ? If she does and you're not a named person granted the various authorities, or if nothing exists, you may encounter obstacles with your being involved with or even getting a second opinion. Getting these done may be a good thing to do before pursuing the actions you think are necessary.

Good luck. These situations are always hard.

Our mom was diagnosed with Mild Cognitive Impairment around 80. Her concierge MD felt it was very mild and stressed that not all MCI progresses to dementia. As we began to see increasing issues with memory and executive functioning, the family decided it was in our collective best interest to move our mom closer to one of us.

She moved closer to me and into a lovely independent living apartment where she did well for almost two years. But it became clear her cognition issues were progressing despite being on Aricept/Namenda. Her primary MD was now a gerontologist who continued to order routine medical screenings but did not refer her to a neurologist until we formally requested it. Not sure what we hoped to learn but the neurologist said something important to me at the first visit. He confirmed the dementia diagnosis with the clinical protocol but recommended our mom have a full neurological work-up - MRI, blood tests, etc. He said "Your mom deserves it." And she did. If this were some other type of disease, we would not hesitate to confirm the diagnosis regardless of the prognosis.

Testing revealed a diagnosis of Alzheimer's type disease with contributing vascular dementia. This diagnosis helped us understand what to expect and how to prepare our mom and ourselves for her future. We moved forward with a more palliative care mindset. Our mom had no other underlying health issues and moved through the nine stages of Alzheimer's Disease as predicted. It was heartbreaking but we understood what was happening.

So all of that oversharing is to say, listen to your collective instincts, advocate for her as if she had cancer, heart disease or any other condition. From what you have shared, you and your family have reason to be concerned. And my guess would be your MIL is also anxious about the changes she is experiencing.

Wishing you and your family the best as you navigate the care of your MIL. None of this is easy.

We're in the process of getting a medical alert device.

Consider an Apple Watch. It looks cooler than one of those gizmos that would hang around her neck. Plus it works wherever she is, not just within range of the base. An Apple Watch has a fall monitor that will call for help and, if set up to do so, will allow you to track her whereabouts. After DH fell in the bathroom and subsequently died, I bought an Apple Watch. It gave me a lot of peace of mind.