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My brother lives with and cares for my mother who is 71, disabled, and has multiple health problems. He is overwhelmed and is afraid of his future due to the fact he is unemployed and can't leave Mom by herself. She refuses to have anyone come to the house to help out. I live about 6 hours away and drive there every couple of months to give him a break, but it isn't enough. (I have two young children and a full time job, so I'm limited to the amount of time I can visit). We both want her to be able to stay at home and have someone come to help with light household chores and be there so that he could at least find a part time job. It would be healthy for them both, but she won't discuss getting outside help. She spent most of last year in a local nursing home and it was a bad experience. She had adequate care, but the conditions were less than clean and very depressing. I would appreciate any suggestions on how to talk to her about this, and if anyone knows of a way for my brother to get financial help.

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So nice that you care about your sib...most sibs turn the other way and let the caregiving family member deal with everything.
First, what a parent wants and what they need are often two different things. Try to explain how serious the situation is with your brother. Limit her chocies: either getting some in-home help, or choosing a facility. (are ALFs out of the question? more of them are doing "tiered" care now.)
The bottom line is that your brother is burned out. Find a reputable company who will "match" the needs of your Mom's household. I did this and the manager even brought the caregiver to introduce her to Mom. Since then she has had 3 different caregivers who come in once or twice a week and she loves them. Gives me a little break too!
I'm sorry, but no one gets everything they want in life. Hiring a caregiver half days so that your brother can get back to work, is not unreasonable.
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What is ALF?
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Assisted Living Facility
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You are in a tough place! I would suggest calmly speaking with mom and explain that if anything happened to your brother she would need to bring in some outside help...now would be a good time to start "interviewing" the people and trying them out BEFORE she would need to use them. It might seem like a revolving door for a while but eventually she will meet someone she likes. Then start adding more hours. It will be slow going for a while but there is a light at the end of the tunnel. Good luck.
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First let me say that I too am very happy to see that you are trying to get help for BOTH of them. Although I am not a healthcare professional but I know the challenges of caregiving. I shared care for my mother for over five years.

BEFORE discussing these 'suggestions' with "Mom" you will have to do some research. It's not a question of whether "she" needs help but that "HE (brother)" needs help. Once you have done some research you will know what is available BEFORE you try anything. No point in talking to Mom about getting a granny-nanny if it is OUT of the budget.

1. Find out what services are available AND affordable in their area. If money is tight, talk to church groups and social services about how they can help. If your father was a veteran, Mom could very well be eligible for Aid and Attendance benefits from the Veteran's Adm. See if she is eligible by looking at this website: http://www.veteranaid.org/

2. Make her doctor aware of the challenge here. Perhaps she would take to 'someone else coming in and helping out, if its "What the doctor ordered!!" After all, as everyone else has stated (and I agree) if something happens to brother, how will she get along? Our elders seem to listen to DOCTORs quicker than 'family'.

3. If the budget isn't there, and Mom is not eligible for special government programs, you STILL need to find respise for your brother. If you and your brother are truly the only 'family' in the area, it will be a bit harder, but not impossible. Cousins, aunts and uncles. even FRIENDS should be encouraged to start CALLING your mother more often, then suggest they offer to bring by tea and cookies, or whatever she likes. She is becoming more reclusive which is understandable as we age.

4. Tell her your brother "WON" some contest and they will receive "whatever kind of help you were able to secure in step one" for "X" number of times. Explain to the service/people that will be coming in, that they should come in as "a friend of brothers" and NOT just to help her. If she is feeling badly about her condition it will take the focus OFF her and onto your brother. Just do it slowly.

I am sure many others will provide additional suggestions, and you should try them all! You can see where I am going with this. You have to SHIFT the focus off her, and make it a 'repair man that is visiting, or a 'female friend' coming to call, or a long lost high school friend to visit "brother".

God bless and get the help that he needs, or it will get MUCH worse.
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After attempt in explaining the situation to mom and if she still doesn't understand, I will give her 2 options : to return to nursing home or accept outside help. If she can't reason because of her mental state, I would just go ahead to get outside helper. It's needs (of brother's sanity and economic practicality) versus mom's wants to go without helper, choose needs over wants.

Without $, yr mom would also suffer together with yr brother. :( Take care.
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I have had this problem with my brother and sisters since my mom died in 2005. The only way that I can make sure they will help is to give them things they can't turn down. My sister is responsible for his medication trays and my brother is in charge of dad's finances. He needs to pay the rent every month but most of the time it is late and I never understand that if it were any other bill it would be paid on time. We are trying to change his lateness. I make phone calls to each of them for doctor appointments and if one doesn't take dad they have to contact each other to find out who's on deck. I take this serious and stick to my guns when it comes to taking care of dad. I have the full time care and he has lived with us for 3 years now.
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Littlesister, I think everyone is on the right track when they say that your brother's needs must be met. If he is willing to take on part-time work, he deserves and needs the right to do so. I believe your mother is being selfish in considering only what she wants but perhaps there is more to the story. How long has your brother lived with your mom? Just since she became ill or was he dependent upon your mother and living in her home in the past when she was well so she thinks he "owes" her now?? Just wondering.
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Thank you to everyone who answered my post. All of your comments have been helpful. I wrote my mother a letter (she hates talking on the phone)telling her it is time for my brother to get help, that it will be good for both of them, and that I'll do whatever I can to help find someone they are both comfortable with. (In a nutshell)
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Your brother is burned out for doing this 24/7 for the most part and understandably is worried about his own future since he is not working which is also reasonable. Since the nursing home where she lives was not adequate, does your city have one that is better. I assume with your mother at 71 that you and your brother are in your forties which is an important time to be working and saving toward retirement. BTW, who had medical and durable POA? Does your mother not grasp or care that your brother is burned out, that her expectations of him are unreasonable which are keeping him from being able to work and prepare for his own retirement? If she is not able to grasp this, then has she been evaluated for how competent she is to handle her own affairs in a business like manner? In a sense, your brother is under the bus and your mom wants to keep him there which is making him into a martyr who might end up dying before she does, if you two don't find another solution that works for everyone.
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I still am wondering how it is that the SON (your brother) is the one who is looking after your mother? Isn't this awkward at times?? I am not saying that sons shouldn't have a hand in looking after their mothers but how was a man in his forties able to even start looking after his mother fulltime. Was he not working at the time your mother left the inadequate nursing home? How did he end up in such a predicament? Has he always been manipulated by his mother? Or has he been dependent upon her? I totally agree with cmagnum that the brother should be out working and saving for his own retirement. I wonder how much good writing a letter to your mother is going to do. I hope it leads to a face-to-face discussion with her concerning your brother's future welfare.
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SIS:

The problem is that you and your brother are still allowing her to dictate the terms of her care. Beggars can't be choosers. She knows he's overwhelmed and is fretting over where he is and is going to be financially in the near future.

Let her know she has three choices: (1) go back to a NH; (2) accept outside help and be grateful for it; or (3) take care of herself. Your brother has done more than enough, and you're doing everything you can.

Good luck my Sister, and to your brother a heartfelt "THANK YOU."

-- Ed
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I am actually considering having her come to a nursing home close to me, but I don't know if she could safely make that trip (6 hours) if I drove her. I've also considered my brother's health and the possibility something could happen to him physically as well. This has been a long time coming and I've been trying to get my brother to accept help so he can look for work for at least a year. For whatever reason he has put this off and it's now at a critical point. I feel guilty for not living closer, but also frustrated that neither he nor my Mom have been taking steps to make their life better. Her health has been declining for about 8 years and she only seeks medical help when forced to.
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Well, if he is under her control and lived at home for forty some years, then he is not going to take the initiative to make his or their life better. Thus, I assume that he has not talked face to face with his mom about this? What kind of work did he do previously. Does he have any health issues in addition to being burned out.

Even if you did live nearby, there is not much you could really do with working full time as well with two children at home. What does your husband think of this chaotic drama?

Would it be possible to get your brother online here? Has he tried to have a serious face to face conversation with his mom.?

It might be a good idea to have someone like a home health nurse to come in and do an evaluation of your mother's health and living situation because it does not sound healthy with her level of need and your brother's burn out.

How in the world did you manage to get your mom in the nursing home in the first place? I think your brother needs more than a part time job. That will not help with preparing for retirement and will not provide him any benefits.
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He had been living on his own for 10 -15 years and moved back in with Mom for financial reasons as well as being worried that she lived by herself. I know he has tried to discuss this with her, but I don't know how honest he was about it. I agree a home health care nurse is the answer and am hoping we can get one to come as soon as possible. Mom went into the nursing home the winter of 2010 for about 9 months. The doctors basically told her if she wanted to live, she needed to go to the nursing home until she was better-she had 2 bypass surgeries in her leg, then had to have the left one removed this past June. Again, I agree he needs more than a part time job, but he and Mom have to take this one step at a time.
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Littlesister, I just noticed that you asked in your introductory message if anyone knows of a way for your brother to get financial help. Would this financial help be for him personally or for the care of his/your mother? Is your mother in need of financial assistance?
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Hi, lcs, my mother recieves SS, a pension from a retail job, and Medicare. I went through the process of trying to get her aid and assistance from the VA (my dad was a veteran). I had heard sometimes family members can get paid for caregiving; I looked into it at the local level, but was told they no loner had the funds to do that. I was wondering of other agencies that may be able to help my brother.
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Thanks, Littlesister, for letting us all learn that your mom receives some money each month. I imagine other caregivers will write in to suggest ways in which your brother may (or perhaps may not) receive help from some agency or other. I hope your mom can be given care by an outside source so that your brother can get at least halftime work outside his/your mother's home. Does your mother own the home?
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What happened to the attempt to get help through the VA?
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