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wait, why is the friend legally (and morally) being held responsible and not the family? why would she be held accountable for abandonment and not the friend's children? She helped for 10 yrs. enough. why not hand over the case to social workers and let them sort it out and deal with absentee family? I can't imagine she would be held responsible to continue. If she is, not one person would ever step up and help another person if this would obligate them forever without legal help. Good lord she's done enough. Time for the family to step up. If they don't, then unfortunately, the friend may need to be placed in a home.
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Write a letter telling all the daughters you will no longer be taking care of their mother, and then stop doing what you are doing. It sounds to me like you have above and beyond the call of duty for your friend, and she is lucky to have you. However, each of us has to make a decision when caregiving impedes our life and health, and know when to stop.
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Liesl--
That answer helps us all to see what's going on. You are still wanting to care for your friend, which is amazing. HOWEVER, the situation with the off-board daughters will not change as long as you are willing to "take charge". Does anything in the past point to them being willing to help now?
Check into agencies available for providing care. (I assume you're in the US, but I don't know) I worked for an agency doing home elder care. I loved it, but I have to say, the burnout rate is high. And the pay is low, so you don't always get super quality workers. Just a heads up. I truly LOVED my client and took to heart my responsibilities. I don't know what your friend can afford....if you were able to sit down with the daughters and discuss this, maybe they would be willing to step it up or at least help out financially. Some questions you need to address:
Is your friend able to be alone at nights, safely?
Is she able to make decisions and follow through?
Is she safe in her home, alone or does she really need 24/7 care?

If the answer is no to any of those, she probably would need to be in a facility that can provide a safe environment. If the daughters were willing to help, they would have by now. I think they've found a great asset in you, and in 6 months' time or a year, you'll be right back here. You need to step out as caregiver and just be her friend and advocate. Just my opinion. You are incredible to have stayed this long with a friend---!!!
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MidKid58, pamstegma, SamIamW,
Thank you once again!! More issues to consider...

Keep thinking, what if I were the one receiving care, and what if my friend were the one providing me care? What would I want my caregiver to do with me?
She is at one of these stages where she cannot be on her own, but, also, IMO not bad enough to be placed in a nursing home. Assisted Living or Home Care may work, but, that means that her entire income, minus a small stipend, would go to her care. She does own her house, but, selling her house would not get her too far. The housing market is pitiful. In any event, she loses everything she has.

So, to give her some quality of life, it boils down to (1) my taking care of her, (2) her daughters taking care of her, or, placing her somewhere, or, (3) perhaps somehow we can come to a happy medium on her care where all three parties are involved. At this point, the option with probably the least stress for my friend and I would be the last one. Pulling that off is another story, though...
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Pam - Ouch. Good point. (And sorry about your ankle). Goes along with the 'no good deed goes unpunished' syndrome. As long as the services being provided are to their liking, the daughters are ok with the situation, but if something should happen to their mom while Liesl is providing care... they'll turn on her.

Freqflyer - it wasn't easy. I bought a rollater walker so I could carry food trays, laundry,etc on the seat portion. Unfortunately, by the time I could have my hip replacement surgery; there wasn't much bone left in the joint to work with. And the pain. oh god the pain. I chewed Percocet like pez.
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I almost took my MIL into my own home for hospice, but then I was told that BIL said " I think she's trying to plant mom". Mind you mom cannot move and cannot eat, which puts her on a very short road. BIL keeps insisting she is getting better. So I know when she dies, very soon, the BIL is going to accuse someone of killing her no matter whether she is in Hospice, a Nursing Home or a Hospital. So when family is in denial and ready to turn on you, walk away as quickly as possible.
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Liesl-
How OLD are the daughters? I have no grasp of their ages from the posting you've done. I am going to laugh if they are in their 50's or 60's (which I'm betting they are)...b/c that's my age group (58) and I wouldn't have the energy to "go after" somebody in any way, shape or form. These two will likely kick up a stink, but in the end, they are either going to have to face the music or get into trouble. How embarrassing to have someone call APS on you b/c you can't take time to get your parent into an ALF? You are being so kind to everyone, your friend, esp., but also by default to these women. I do hope things work out well for you. I think you will get some pushback from the "girls" but hopefully they will step up of their own accord and grow up a little. I'm thinking more and more how lucky my mother has it--she's a pill, but we all take care of her and none of us would ever leave her out to dry. Hang in there and good thoughts for you today!!
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TiredNBurnedOut, Mincemeat,
My apology for not mentioning your names. The response of all you kind folks has been beyond all my expectations.
All your comments and the different perspectives are greatly appreciated.

As mentioned before, I am taking all this in, copying all the comments in chronological order and giving each some serious thought.
There is so much to consider...
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SamIamW, GardenArtist,
Thanks for your thoughts and concerns.

Wow, SamIamW, you have hit on points that are the core of my concerns. Yes, the daughters have been irresponsible, and they have also taken advantage of the situation. Dump mother on someone else, and we will not have to bother with her. IMO, only time can tell the outcome on this one, however, I am not inclined to use APS, since that action may trigger these women to come after me, or even cause me harm. Maybe at a younger age I would have not cared, but, now, they pose a threat.
And, yes, my poor friend. Can you even fathom the amount of stress involved for her as a result of losing her caregiver? Holyshmoly!!

GardenArtist, funny you should mention this. Have a friend that keeps telling me I am being held hostage in a catch 22 situation for which there is no easy, or perhaps, even no possible solution.
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Garden Artist--
What an astute observation! I myself have just recently decided to take a break from seeing my mother. I think I might have a touch of SS myself, as I feel SO much guilt in "abandoning" her to my sibs' care. But upon thought--Mother isn't going to notice at all.

Liesl--again, best of luck. I don't know how things are handled where you live (UK?) So, I cannot comment on how it might all go down. Here in the US, the daughters would immediately be called into play by the authorities and they would probably have to step it up, and fast!
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Has there ever been a situation like this one where the friend and the person who needed the care went together to select a care home and the person who needed the care voluntarily checked themselves in???? Sounds like that could happen if these daughters do not step up? Liesl, you are a gem.
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Good grief, Samlam, how on earth did you manage to care for your Mom while you yourself were using a walker?

I agree with what you said about onlookers. I am sure my parent's neighbors are chatting among themselves wondering why I am not doing this or that for my parents.

Like I stopped shoveling my parents driveway once I developed a heart condition, as much as I enjoyed two feet of snow and the challenge, my doctor told me otherwise. Too bad I can wear an auto handicapped placecard around my neck so the neighbor's would understand :P

On the other hand, maybe we are more tolerant of a good friend who we are caring for than for an aging parent. We start out helping because we are friends, plus we have a lot on common and can relive some fun stuff we did.
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I agree Garden. And outside onlookers tend to feed into it. I was constantly being told 'you need to do this...that....etc.' Even when my health had deteriorated to the point that I was on a walker and needed hip replacement surgery, tending to my immobile 95-yr-old mother's needs - doctors, nursing homes etc., were still dictating to me that I must continue to put my mother's needs/health before mine. All the while chirping under their pasted grins "remember to take care of yourself". Every time I teetered down the hall, balancing meals, medicines, etc on the walker, their words would echo and I wanted to scream. But every day - I kept doing it. I probably should have put this comment under the 'whine' commentaries.

On the other hand - I laud people like Liesl. It's a piece of humanitarianism that we seldom see.
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This isn't a criticism, just a speculation. I think sometimes there are elements of the Stockholm Syndrome which occur in caregiving situations. Caregivers aren't technically hostages, but sometimes circumstances make them feel that way. It's hard to break those bonds.
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What a challenging situation! Liesl - you've done so much. I agree with Garden & the others. If you feel that the daughters are not fit guardians - get APS involved before sending your certified letter. If the daughters are this irresponsible, they may take over her affairs in a way that is not in the best interest of your friend. Perhaps APS can appoint a guardian. Normally guardianship must go through the court system and is time consuming and costly, but I'm thinking APS has a work-around for this.

Your doctor won't be able to help much unless your friend gives consent. A letter from the physician (my doctor scribbled it on a prescription pad memo and it was accepted by the attorney because it had his name, address and license # on it) indicating that your friend should not be making decisions regarding healthcare and finances may be of benefit.

At that point, she can't be talked into signing documents for the daughters that would give them more authority than they should be allowed. Once again, APS will be getting a mental evaluation and certification done and assigning obligations to the daughters as 'next of kin' under Familial Law which will be punishable in the court. This type of abandonment is shameful.

Your poor friend. How stressful to know that her own daughters are acting this way and scared for your future under such vulnerability. How sad. I would hate to put a family member under court guardianship. From the sounds of it; even though you won't be there everyday - you are the type of person that will be visiting her frequently. Hopefully that will help allay her fears. The very best to you.
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gladimhere, MidKid, cmeers, 0anonymous, MaggieMarshall,
Thanks for all the suggestions, and your personal experiences! It places many thoughts into their proper perspective. I am taking all this in, planning things out, and deciding what to do and when to do it. I must admit, there is a very high level of stress associated with all this that I have to suppress, and, gradually work myself into taking the plunge.

As far as the doctor and the lawyer, will play that by ear. The doctor knows what the current situation is, and I am sure she would help me with anything needed. Also, have some very good friends that I can count on. As far as family goes, I do not have any, so, that is not a concern.

The daughters will have to pick the facility, I have no POA, so, I plan to provide notice and proceed with the exodus. Hopefully they will let me know where she is.

at, or, maybe the daughters will make arrangements for home care. Hard telling.
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I'm actually surprised that you put up with this specific type of situation for as long as you have. Putting myself in your shoes, I never would've put up with what you've been putting up with for near as long, I would've been long gone long ago. I would've called APS soon after I discovered that things were getting a little out of hand. I currently know someone who was also trying to get me to live with him, but I just didn't fall for that trick. I was willing to sit with him for a while and even check on him when I could. I even ran errands. It eventually got to the point where I almost felt like I was almost living there even though I have my own life and my own place. Therefore, to some point I really know what you're feeling, because I was going through something similar from when I'm now recovering. When you're on section 8 and it takes a while for them to actually start helping you, you just don't want to screw up your section 8, especially when you have a very good bed to sleep in, and you just can't well sleep anywhere else. I also know what you're going through when others just won't pick up the slack, and they leave you to pick up that slack. I feel that you did above and beyond what was required of you. You should also know that not everyone is cut out to deal with what you're having to face. I think that all too often, this is exactly why family refuses to get involved knowing what's ahead, and it's often far more than what they're cut out to deal with, and not everyone is cut out for this kind of job. In other words, a hammer will never be a teacup, and a teacup will never be a hammer. Each one has a unique purpose, and you will never change one to be able to do something it was never designed to do. This is especially true for people. This is why there are so many families out there who know that they don't have what it takes to be caregivers, which is exactly why we face what you're describing.

http://agingcare.com/questions/tired-of-mom-saying-I-dont-feel-good-183863.htm?cpage=0&post=1&cm=500610&z=1#500610
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Why would you expect that things would "get done" as long as you're willing to keep caring for your friend? Call your area's Council on Aging or Senior Services or even Adult Protective Services. Let them know you are unwilling to continuecaretaking for your friend and her children have, thus far, been uninvolved. Ask for their assistance extricating yourself from this arrangement.

Don't feel guilty. You've done more than your share. Time for other arrangements.
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I am in a very similar situation, and there's been an awful lot going on. You may want to check out my other post, because I feel like I may very well be in the same boat as you

http://agingcare.com/questions/tired-of-mom-saying-I-dont-feel-good-183863.htm?cpage=0&post=1&cm=500610&z=1#500610
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I had been the full time caregiver for my parents for 5 years and with complaining sibs, a sarcastic parent and constant reminders that "you're living here rent free" and "this is your job"; I couldn't take it anymore. I left my well paying job 3 years ago to care for them and when I announced I would be leaving and moving cross country in 3 months- it was WWIII!
"you're not staying until the end?" and things fell apart: I continued packing and my father wound up in rehab and mother kept firing the 2 awesome caregivers I found who finally left because of her behavior and one day I just said " I can't take it anymore, I'm leaving" and they have to figure things out. If it hadn't been for caring friends who were supportive, I probably would have stayed "til the end" and woke up, much older and wondering what I was supposed to do next.
No other job is 24/7 and even if you take the odd couple of hours for errands or a movie- family resent you for wanting to leave while they go on vacations and live their lives. There is no easy answer because in the long run, nothing is ever fair when families are involved.
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Liesl-

If it makes you feel better to talk to the dr about what you plan to do go ahead, likely the dr will support your decision and even help you if your friends needs anti-anxiety meds or anything like that for such a huge change in her life. Mother had to be on something when she was in a rehab facility, she got so belligerent and uncooperative. It was nice that her dr was kept up to date and on board with all that was going on. You might need a dr's "referral" to help her move into a facility, that I don't know about. It really is up to the daughters, but obviously they are going to hear about it after the fact. Prepare yourself for some fireworks there--and you have nothing to feel guilty or bad about.
Having a lawyer in your back pocket it nice, I think. I have son who is one and I have had to drop "well, my attorney will get back with you on that" a few times and it works really well. (Blind threat, he's never had to call ANYONE...the mere mention of bringing an attorney in usually shakes people up enough they just choose to cooperate)
Are you the one who will pick the facility? I am assuming the daughters are not going to take you seriously. Again--keep us apprised and keep your chin up. Hopeful thoughts are with you!!
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Liesl, I cared for my mom and her hubby for four very difficult years. My sibs, I call them twisted sisters, were in denial for most of that time. Now that they have both moved to a facility there is still some denial on their part. I told them everything that was going on with mom in an effort to get them to understand. But, I now think that the twisteds thought I was trying to justify my presence and what they considered free room and board. It may make no difference how you tell the daughters, they may still not get it. All you can do is give them information, hope they process it correctly, and get yourself situated to reclaim your life.
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GardenArtist,

Thanks much. What you mention sounds reasonable. Actually, I do not feel the need to justify my departure at all. The kind of work I used to do required having all your guns loaded.:-) Guess old habits die hard.
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Lies, I wouldn't mention the situation to your friend unless she becomes too upset, and then tell her that you're working on some plans to ensure that she's cared for. I wouldn't even mention the daughters and their role, or lack thereof.

If you mean the doctor who cautioned you about your own health, no, I don't see why he needs to be involved. I think that would suggest that you're buttressing your position with medical advice, which you don't need to do. Ten years + is enough.

I'm not sure either what role the attorney could play, although I get the impression that you still feel the need to justify your departure. You don't. To do so puts you in a position of explaining and justifying, which might make you seem weak and somewhat ambiguous about leaving.

I've never been in a similar situation, so I obviously can't put myself in your shoes, but keep remembering that you have a life, you've sacrificed for 10 years, and it's time that the daughters step up to the plate and take responsibility, or make some arrangements so their mother is cared for.
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gladimhere, GardenArtist, MidKid58,

Thanks for all the advice!! My God, why did I not find you before?
Need to look at all the suggestions you gave me, and take appropriate actions.
Hate to admit that, even though I cannot handle this situation any longer, this is all very stressful. Don't give a hoot about the daughters, but, my friend is going to be devastated. She is scared enough about what is happening to her without adding any more to it. Guilt is not something that I suffer from, but, this will be one of the toughest decisions I have made in my life.

Do you folks think I need to get the Doctor involved (we both have the same MD), or the lawyer I normally use?
The Doctor has told me more than once that this situation creates too much stress for me.

Thanks again, everyone. Many, many, thanks.
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The fewer words the better. Too much it will be twisted and turned every which way. As midkid said, no explanation other than you are not able nor willing to do it any longer.
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Liesl4---You would still give these women 3 months to get something in place? You're giving them a LOT of rope. I'd go much more quickly. Say, in a month, as one poster said--Aug. 31st and take the steps necessary to get out yourself. I think at this point your concern about the daughter's anger is just "too bad for them"--wow, have you gone above and beyond friendship. And, do you really CARE if you have a relationship with these women? APS will protect your friend and if the daughters get in trouble ( they won't) then tough. You don't owe them a thing for all you have done. No explanation, no nothing. You will be doing yourself AND your friend a huge favor. You can still be a part of her life, but at your choice. Good luck!!!
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I agree with the others: give notice to the daughters by certified mail if necessary, but DOCUMENT the notice you give them. And document any other contact you have with the daughters.

I don't think you need to give so much notice that they don't take it seriously; you could say something to the effect that you are no longer able to provide any kind of care and they should make arrangements ASAP, but no later than, say August 31, 2015, or ever earlier if you think you can move by then. State also that you need to know what arrangements they have made by, say 2 weeks before the deadline or you'll reluctantly be forced to involve APS to ensure that your friend receives continued care.

I also wouldn't provide any explanation for terminating your involvement other than you cannot do it anymore. If you explain as you did here, that gives them a chance to attack you verbally, or turn the blame to you. So don't go into the reasons why you need to get out of this situation.

I.d., don't give them a chance to cop out and turn the responsibility back to you, or blame you for anything.

If you give them too much time, they might not take you seriously.
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Calling APS is not to report daughters, it is to report this woman needs care that you are not willing or able to any longer. It is a request for assistance since daughters are not willing to help figure it out. APS is for many, many issues related to adults unable to care for themselves, not just for physical abuse.
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gladimhere, freqflyer, staceyb,

Thank you, all, for your replies!! I sure appreciate having someone to talk to about this issue.

The thought of abandonment never entered my mind, and I appreciate your bringing it up, gladimhere. What I wish to do is exit, but, knowing she is being taken care of. Also, as far as Adult Protective Services goes, IMO, the daughters do not seem to be abusing her. If I contact APS, those women will be after me like two mad hornets.

Freqflyer, I do not get paid for being here, on the contrary, I pay for half of the utilities and other miscellaneous stuff. Since you brought it up, decided not to
do so any longer.

Staceyb, this is not a pity party, but, the "job" has truly become unmanageable, as you mention. I have cardiac issues, and in the last 6 years have flat-lined twice. The stress and frustration of taking care of her is basically overwhelming me. She is on my face 24/7, except when I go to bed at night. Even then, there are times when she comes up the steps and wakes me up a couple of times during the night to ask me what day it is, or, whether she fed the cat, or, some other stupid question.

Some background...my friend and I used to work at the same location, and we both lost our husbands. After we both retired she got very sick (not Alz) and begged me to stay with her because she was afraid to be alone. I hesitantly did so, but did not have intentions to stay at her house forever. I took the opportunity to remodel my house, did it all myself, and it took me 3 years. She would help me at my house, and I started noticing certain behaviors that were not right. After doing a lot of checking, and taking her to the Doctor, found out Alzheimer's was the issue.

Relayed the news to the oldest daughter, and after that, they did not want to be around their mother. I provide her daughter every month a status of the situation, but, nothing happens. This past year I asked her to get more involved with her mother, and this was done after talking to the Doctor and the Stage 5 diagnosis. Well, the oldest daughter has come around about 6 or 7 times in the last 10 months, takes her out to lunch or shopping for a couple of hours, and now realizes first hand what is happening. However, no matter how many times I bring up that I cannot continue to do this, and request she make arrangements for her care, still, nothing happens.

Thinking about giving the oldest daughter a deadline date by which I will no longer be here, and asking her to take action to obtain proper care for her mother. I need to give her until 15 October or so, for my own sake. I cannot take care of a move in two weeks, have to pace myself and do things gradually, otherwise will end up in the hospital.

Once again, thank you all for your help. If there are any more considerations you can think of, I certainly welcome them.
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