My brother lives out of state, and thinks mom is doing "fine", but she really needs Assisted Living.

Started by

Mom was diagnosed with Alzheimer's a little over 2 years ago. Over time she has been getting worse, with very significant changes this last 6 months. After many stressful discussions my brother finally agree to letting me have a home care giver in. We started with several hours a day, but have had to go to 5 days a week. I bring mom to my house most weekends, as without someone around she doesn't take her meds or eat right. She also is supposed to use a walker for a worsening spinal issue, and is very unsteady on her feet. Her doctor thinks she really should have more continuous supervision and has suggested Assisted Living. Mom refuses to even consider the idea, saying that the doctors and I are crazy, and that there's nothing wrong with her. She now is at the stage where she gets very confused, can't really focus on a meaningful conversation, gets frightened very easily and is very agitated most of the time. She gets angry and mean for no reason, and has started accusing others of all sorts of things. My brother, who thinks he's an expert in everything comes to visit for a couple days, and bases his "assessment" on a snap shot in time. As of a few months ago she was still able to "fake" her way through the visit. He agreed to visit an AL with me while he was here, and totally rejected the idea of moving her because he "just can't wrap his head around it". He then proceeded to tell her where we had gone, and of course she totally lost it. She tried to lay huge guilt on by saying that if we put her into a home, she'd run away so no one would find her, and probably kill herself. He told her that we just went to "look" and that it would be a very long time before any decisions would have to be made. He is being totally unreasonable, and tries to block every attempt at discussing it. It's not easy for me to make this decision, but in my head I KNOW it's the best place for her. My heart aches at the thought of her not cooperating and making the move even more difficult, but is know it's the time to do it. How do I get my brother to understand that he's not seeing the day to day behaviors, confusion, agitation, anger and depression, and that being with a care giver is not the best way to keep her active and engaged. She loves people (or always has), and makes friends very easily. She love's being social too. But she's already pulling away from her friends some and many of her activities because she is very aware of how she's changing, but is still openly in denial. If she were in an environment where activities, staying engaged, and socializing with people her own age, and with similar interests, she'd do so much better. ANY SUGGESTIONS??


Why is it up to brother? Does he have DPOA, controlling the purse strings?
Technically I have POA, with him as the next person if I can't perform the role, but the agreement was made long ago that we'd discuss and act together in any decisions regarding mom. We both have online access to her bank accounts, but only my name is on all her accounts. I don't want to create "bad blood" between him and I since he's the only brother I have. I know I legally can make the decision, but would much rather have his support.
So while you are being so considerate of your brother, you are stressing yourself out? This is one reason these joint responsibility situations can be a drawback and block timely decision making. If your brother wants equal voice in this decision he needs to wear some equal ears and do some listening. If he can't bring himself to take the advice of you and her doctor, he needs to do some real research and care enough to spend some serious time taking care of her so he can make an informed decision with you. Just being your brother isn't enough, he has to be a responsible party in this joint decision relationship and take the time to actually familiarize himself with the situation. While ultimatums are not productive relationship builders, you can either throw one out there and demand he spend several weeks taking care of mom in his home -or wait for the big crisis that proves you were correct. BTW he won't feel guilty after the big crisis, his excuse will be that he had no idea it was that bad.
What is Mother's attitude toward assisted living?
I believe she said in her original posting that her mom's response was to threaten to run away and possibly kill herself. So not the best of attitudes.
Ah, yes, she did. All the more reason it is important to have Brother in on the decisions.

Has Brother actually talked to the doctor, or does only have your word for it that she needs ALF?

OncehatedDIL is right. Brother really needed to be informed, not only about ALFs but about Mother's real current state. If she could stay with him for a couple of weeks, (with the same level of in-home care she has now) that would be ideal.

You could also email him daily with what goes on each day -- the caregiver said she was pleasant but very confused; she was awake all night; she refused to eat and later was eating raw bacon -- whatever happens each day, good and bad, so he gets a better feel for how life really is.
Dabs, it seems to me that your bigger issue is your Mom's reaction to a possible move. Can you increase the caregivers time with your Mom as an interim solution? Sadly, at some point, your Mom will pass the point where she will understand where she is. At that point the AL will be the only choice. A dementia unit will provide a safe (escape free) solution. Also, at that point, your brother will accept the inevitable. Those of us dealing with the daily issues, (and using this website) understand what is coming in the future and are ready to take the next step. Your out of state brother can't really see the future and has probably never looked at the ALZ site never mind this one.

My Mom went from being fine on her own to AL in less than 9 months! Your job is to protect her as best you can. Bring in more help and start to visit the ALs so you know which one you would choose when the time comes. AND, make it close to you. The need for visits only increases as time passes so choose a good one and make it convenient for yourself.
Dabs, I have 7 siblings. I've been helping father caregive mom (dementia) since I was age 23 (24 yrs ago). I have always been a letter writer. In all these years, before I got a computer, I wrote to all my siblings by letters via the mail, everything that happened. Father and mother, my life, work, etc.. When I got the computer, I emailed to those who had computers. With one brother, I text to him because he's not into emails but FaceBook, and I refuse to have FB. So, I always update fam in the states and here on island. All my siblings know the true situation here. When father was beginning to forget to turn off the stove, I told everyone. When he sometimes forgot sis' name, I told everyone. Let's just say, that as the years went by, my siblings saw how the parents were going downhill mentally. No one was surprised about anything. It does make a big difference when you update the siblings every time something "new" happens. I even remember emailing that father will only shower once a week. Then a few months later, I recalled telling them that he now wil only shower once every 2 weeks. The last time I emailed them (before his stroke), was to tell them that it was going on 3 weeks and he refuses to shower. If you keep updating on the small stuff - it adds up to the Big stuff.
....Maybe you can ask for a Holiday away from mom? Ask bro if he can "babysit" mom while you're gone? That would be an ideal time for bro to learn what's happening - hopefully!
Have your brother come stay with her for a few days.
Thanks everyone for your insight.
I feel as though my brother is an overall control freak. Even though I manage mom's care and her finances, he thinks he has to TELL me what to do. Obviously I'm an idiot. He's younger than me, and in a high power position in his career, so everyone is inferior to him.
As to updating him, I do either email him for call him about once every week or so. I absolutely agree that he should have her at his home for a few weeks. My husband suggested that right off the bat. Two problems here.....his wife is "too busy" doing her thing(she doesn't work) to look after mom, and she won't have a stranger in her home.....OH PLEEEEZZZZ. A total princess... The other factor is that for the past year now mom won't go there to visit unless I go with her. She's not comfortable in there home, and gets so nervous about being there that something always happens. My husband and I were actually up there with her when my niece got married last year, and mom was bringing her pills into the kitchen to take them and one of their dogs jumped on her leg (small dog) and startled her. She dropped her pills and yes, the dog gobbled them up. TOTAL CHAOS!! It was an accident, and at that time she was still very functional. They yelled at her saying that she may kill the dog, etc. and the entire day was spent with her worrying about the dog who had immediately been taken to vet. Mom cried and cried, and kept saying how sorry she was for being "bad". It broke my heart. The dog was treated, and fine the next day.
He actually is coming for a visit next month, and I insisted that he go with me when she sees her neurologist (an Alzheimer's specialist, and one of the best in the Southeast). I spoken to the doctor about his attitude, and he's the one that told me to schedule her appt. around his visit. Hopefully he will advocate for AL, and this will resolve the issue. I certainly hope so.
It will be very interesting to see if he pays attention to her behavior and her symptoms while he's here. The care giver is wonderful, and mom loves her, and she adores mom. She has cared for patients like mom in the past and understands the progression of the disease. She and I have discussed the situation, and she realizes that mom would benefit from AL, but she also wants to keep her job. She's afraid of my brother because when he call moms house and talks to her, he intimidates him with his "corporate" tone. If she tells him about something she's noticed changing in mom, he tells her that she's the care giver and should see to it that the days go smoothly.....What do you think about me giving her a week off while he's here, and let him and the princess deal with her care? That would mean taking mom wherever we go while he's here. If she's gotten to the place where she can't "fake it" as well as she's done in the past, he'll love watching her do and say things over and over, and witness first hand how frightened and agitated she can get when she realizes that she's loosing control...

Keep the conversation going (or start a new one)

Please enter your Comment

Ask a Question

Reach thousands of elder care experts and family caregivers
Get answers in 10 minutes or less
Receive personalized caregiving advice and support