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

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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??

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It's not really a question of having more care giver time as much as it is the expense. Right now, the costs costs of her home(taxes, insurance, utilities, home owners dues, alarm system, groceries, etc. plus what I'm already paying the care giver is already slightly more than moving her to the AL we've selected. It's a lovely facility and has an incredible management team and staff. Even though mom has funds, the longer she stays in her home, the more we eat into her money. If we move her now, it'll last longer, and there's no way of knowing how long she'd be able to stay in the AL before she would have to move to the memory care wing, which is even more expensive.
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dabs4mom, he may be ready to put her in AL by the end of the week. What I'm secretly hoping is that the caregiver can extend her hours, so your mother can have the best of both worlds -- assisted living in her own home. I personally think it is the ideal if the home is safe and a good caregiver or team can be hired. I know sometimes it gets beyond that point, though, and the only option is a skilled facility.
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You all can't imagine how much help it is to hear you all say such similar things. It breaks my heart to see mom get so upset when she's told that she "doesn't need something" and therefore can't buy it. This is a lady who has always loved and appreciated nice things, and looking pretty. My dad worked very hard for many years, made good financial decisions, and made sure mom would be secure after he passed away. They were by no means wealthy in any way, but lived comfortably. I think I mentioned before that because of my dads generous pension, she doesn't have to depend on her investments very much at all. Like most elders, if she had to depend on that money only, it would run out before she passed. The two sources of income will be able to take care of her until she dies.
I do tell the care giver not to listen to my brother because he is just trying to throw his authority around.
I think JessieBelle has a point. That the dominant male family member assumes that the "girls" will handle things, but still wants to have the last say so. She is dead on about how mom acts in his presence. She fakes her way through his visits and his phone calls. He buys it because he wants to, and refuses to see the reality of her day to day behaviors. He'll be in for a big shock when he and his prissy wife are at her house for nearly a week, and the care giver goes on vacation.( I told her it would be fine). I can't wait to hear my sister in laws reaction to having to clean up a mess mom makes in the kitchen because she can hardly manage to scramble an egg, let alone prepare a meal. Better yet, I wish I could be a fly on the wall when Mom needs her bottom cleaned because she waited too long to get to the bathroom. Mom wouldn't think of allowing my brother help her, and miss prissy pants will freak out! I'm laughing out loud at that visual.
I know I sound angry and bitter, and I'm sorry to dump, but I AM angry, and more than a little frustrated.
Last night (Valentine's Day) mom wanted to take my husband and I out for dinner, and wanted her care giver and her husband to come too. It was so sad to see her struggle with deciding what to order, then accusing the server that he brought her the wrong food. I had to talk her down. She spilled her water, which upset her to the point of tears, because she was just so overwhelmed by the whole experience and the unfamiliar environment. She tries so hard to be "normal" but I think she realizes that she's getting worse and it scares her beyond belief.
Once my brother gets here next month, it'll all hit the fan.
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Dabs4mom, I agree with everyone. Since brother is like that, please make sure to keep all receipts spent for mom. I'd photocopy or scan it and store it safely. If it's for clothes, and the receipt is not so detailed, write down on the receipt. If the receipt's name doesn't match the store's name - write down the store's name. Just remember to leave papertrail of her money. And watch your back. From what I read here, sometimes siblings get so upset over the money, they sneakily change the POA or outright use the legal system to take it away from you by lying. Document Everything. Boy, what kind of shopping is that if you only buy what you Need and not spend for the sake of a trinket or a pretty blouse that catches your eyes?
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dabs4mom, I think it is time for you to exercise the POA you have. Brother cannot dictate to the caregiver over your authority. If you tell her it is OK to take Mom to buy some clothes or something frivolous then it is OK for her to do that. Brother can stew and fret and complain, but he can't order. Your mother picked you to have power of attorney. Honor her choice and act in that role.
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I don't know if it is about money. I have a dominant brother who is dPOA, but really has no interest at all in what is going on. My mother can showtime for him the few hours she sees him each year. If I call to say there is a problem, the only answer is hang in there, sis. He doesn't want to be bothered with any responsibility. He rarely calls and never visits. Lord knows why he was chosen as POA -- I think because my mother thought the word attorney sounded like a man's job. She is of the old school.

I get the feeling that sometimes the golden males of the family just pull back and let their "girls" handle everything. As long as the girls are handling things well enough, then why be concerned. We can be intimidated by the management style personalities, but we have to put that aside and do what is best. My brother actually goes to the level of arrogant. I know him, so don't pay it any mind anymore. If I thought my mother needed a higher level of care, I would see about getting it -- I'm healthcare POA. And my name is on the bank accounts, so I can pay the bills.

It is easy for elders to appear normal for a day or two at a time. My mother does it by staying quiet. She also will not go anywhere without me except maybe to take a walk. So it's actually me that is appearing normal for her. Since my brothers are no involved in her day to day (or even her month to month), I wouldn't pay any mind to their thoughts about what she needs. IOW, dabs4mom, do what you feel your mother needs with an eye to what she can afford long-term.
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It is so sad how money tears a family apart, I've been through it myself. Please keep me updated as to what happens. I am hoping you have contacted her doctor and the Dept of Aging since we started speaking yesterday. Like I stated, I worked at our mental health facility here in Milwaukee and it is a horrible place! Most facilities are not equipped to deal with the elderly, they usually have them on the units mixed in with the general population. We all know how dealing with the elderly can be, they get confused, they get agitated and so on but in the mental health facilities their answer to everything is to medicate. This is a dire situation, you need to get your mom out of there, you need to do what is best for her and do what you feel is right. If your brother does not like, oh well, let him leave his cushy life and live with mom for a month, he's have her in a nursing home so quick! If you would like to email me privately I will give you my email address if you like.
My heart goes out to you!
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Donnarae,
I hear you loud and clear.... I also think it's about the money!!! And yes he has plenty of his own. That doesn't change the fact that I think think he's more concerned about how much he'll be able to add to his own "retirement" account than he is about what's really best for mom. Since I handle all her banking (but he has online viewing access to her account too) he questions me about every dime she spends. He even gives me crap about not "allowing" her to buy things. HE has instructed the care giver that if they go our shopping she isn't to let mom buy anything except grocery items and things she really needs. Heaven forbid he sees a charge to a department store or Walmart. Always wants to know what she's buying and saying things like "she doesn't need a single thing", or "why does she need to buy clothes". He even checks to make sure that if I write checks for her to give as gifts, especially to his kids or mine that they're for the same equal amount on birthdays or Christmas. She is very close to my son, and he adores her, and she always wants to do a little more for him because my eldest son tragically passes away at 14 (when my other son was only 6), and she has always said that as far as she's concerned I'll always have 2 sons, and that if she wants to give Ryan a little more it's her business and that she would have been giving to to his brother if he were still alive. My son is the youngest of the grandkids, single, still working very hard to establish his business, etc. and both of my brothers kids are married, all have extremely well paying jobs, and have gotten just as greedy as my brother. I'm so tired of the whole thing, there are days when I could care less if our relationship tanks when this is all over.
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Can you do any videotapes for brother of what is really going on when he is not there? Maybe video of a clinical interview with a geriatric nurse or doctor?
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N1K2R3 - Going to have to disagree with you on that age thing. I live in the Palm Springs, CA area. It's very popular with the retirement folks. One of the local comedians calls it "God's Waiting Room". Whatever.....they are very active, social, and OLD! They have access to wonderful healthcare, great weather, great golfing, and they're out and about until well in their 80's and 90's. Without a caregiver.
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