My beloved aunt and uncle (aged 90 and 92) are more like adoptive parents to both my husband and to me. They both have multiple very serious medical conditions and are both rapidly declining in their physical health. My uncle is also severely clinically depressed (I was a licensed mental health professional for 20+ years so I recognize all the symptoms.) They are still at home and refuse to have any paid help to come into their home, even though they could easily afford it. They are very comfortable financially. I try to do all that I can to be supportive of them but I live over 80 miles away and work full-time outside the home. The problem is that their son (in his late 60's) is endangering his own health by trying to do everything for them that they need. He doesn't live with them, but gets to their house at 5:30 a.m. three times per week to drive his mother to dialysis then picks her up and brings her home a few hours later. He does their grocery shopping and much of their cooking and cleaning (what gets done). He tries to take care of all of their car maintenance and home maintenance which is extensive. In addition to the 3 x a week dialysis treatments, the aunt and uncle both have frequent doctor appointments and either the son or the son's wife takes them to ALL of the appointments. My aunt and uncle are both appropriate for hospice care, but they refuse to consider it. They are both stubbornly determined to stay in their own home as long as they live (which they seem to think will be forever) and to depend on their son for all their needs. I do not think it is good for them to be staying in their home with no other adult. They are both very frail and fragile. I am very concerned for their safety and well-being, as well as for the son's, but all three (as well as their daughter) seem to think it is realistic for this arrangement to go on indefinitely. Several years ago my uncle had a serious car accident due to his age-related impairments, but he just replaced his totally demolished car and still drives. The son does not have the fortitude to take his dad's car keys away. He is totally dominated and manipulated by his parents and seems to be determined to ruin his own health to be the dutiful son. I have tactfully expressed my concerns to all of them and have essentially been told by all of them,to "Back off..." So I just do what I can to be supportive both emotionally and in practical ways - I go once or twice a month to visit and cook some of their favorite foods and clean the kitchen, which is always very much needing to be cleaned. I'm just very afraid that the son will eventually develop some serious stress-related illness and/or that there will be some serious crisis that will be exacerbated by their living alone...I say the Serenity Prayer a lot. Any other suggestions?