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We are guardians of my husband's 3 yr younger sister. (62). She is divorced, has two children who live close but won't step up and help. She still lives by herself, but is getting close to needing either daytime help or go to AL. She wants neither, but we see no alternative. How to approach? Her mom is still alive and is denial of daughters diagnosis. Is care taking of a sibling than care taking of a spouse!

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My sister passed September 13. She was diagnosed with mid to late stage Alzheimer's in 2009. She lived in our home. We had caregivers come in during the week and my husband and I cared for her in the evening and weekends. She was 55.
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I brought my sister from NYC to live with me in VT in June 2012. She is 71. Her dementia combined with alcoholism tmade it dangerous (?) for her to live on her own. The pollce were calling me, and the super of her building was calling me, and she couldn't maintain a working phone even tho I was paying for it. Now she has been off the sauce for more than a year (sadly, I can't have any alcohol in the house or she'll drink it!) has gained appropriate weight, has been to doctors, had her hair cut and teeth taken cared of, and is on generic aricept. She has NO insight that she has a "memory problem," although I coach her daily about what day and month it is, and I writechecks for her and make appts for her and drive her and cook for her. Frankly, it's hard for me to take care of myself and keep myself organized, and I am very frazzled to have to do all this for her as well. She is completely unwilling to have a respite caregiver or go to adult daycare because she thinks she is fine. SW at Memory Center told me to get over my reluctance to lie to her! So I pay someone to take her once a week and I tell her this person is newly retired and needs company when she goes places.

It is VERY VERY HARD to figure out how to get help. I struggle with this every day.

If money isn't a problem, you might try telling your sister in law that she shouldn't have to cook and clean any longer, and you are giving her the gift of a cleaning person. Then the "cleaning person" is actually a daytime caregiver. OR you can tell her the "cleaning person" needs money so you are paying her to work a few hours every day as a kindness. Or perhaps you could convince her to share her home with a grad student who could provide part-time care?
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Gentle story telling is a part of care giving for those with dementia. Their mind is not in the same place as ours so there will be a constant battle otherwise. I had my unemployed friend spend time w/Mom. I paid for that out of Mom's checking account. Told her Ann wanted to work with seniors but needed experience first. That worked for a while. When it was time for a live in, I went to visit Mom a bit before the caregiver was t arrive. I told her the doctor wanted her to have someone with her to make sure she took her medicines on time. I know I was fortunate, my Mom never gave me a hard time. On the other hand, I never asked either. BTW, you are guardian, but do you also have health care decision authority? Are you POA and on the checking account? If not, you may be able to slip under the wire on a good day and get that all done!
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I love the idea of "gentle storytelling"! What a lovely way to express what we need to do.
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we struggle every day taking care of our Mother. What works today, does not necessarily work tomorrow. The paranoia is the hardest to deal with and figure out. We are doing our best to keep our Mother home, but we are not even sure that is the best thing. We all struggle with trying o figure out if Mom would be better off, in a home, with other people, activities but with a loss of privacy. Or is it better that she sits home with a home attendant, barely moving from the couch watching TV.
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Thanks for the insights. We do have court appointed conservatorship also. Which means we make medical decisions for her (least restrictive living arrangements deemed by dr, sign for all medical procedures, etc). She has been declared incompetent by the courts so we are responsible for her money and have to turn in a written report to the court every year which includes copies of checking account statements, copies of checks written, copies of her investment funds and any other assets she has. I wouldn't want it any other way--it protects her as well as us. We are going to ask the doctor about least restrictive environment and go from there. She was ill recently and had to spend the night with us. She was upset because she missed her home. I believe she knows she is getting close to not being able to stay by herself and is scared. We will just have to show patience and understanding through this transition. ( something hard to come by at times)
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You asked specifically about sibling care. Depending on your husband's relationship with his sister, sibling care can trigger different problems. My younger brother (age 59) has dementia. He's currently in a skilled-nursing rehab facility to get stronger for eventual surgery, but he has lived---and will live--- with me. The sibling relationship can complicate a caregiver's life by reintroducing old sibling politics. Because I'm slightly older (i.e., his "big sister"), an otherwise acceptable question ("Would you like some lunch?") can trigger childish responses, e.g., "You can't make me eat!" I try to agree with him (You're right. No one can make you eat."), then I leave food nearby and hope that he'll feel hunger and reach for it. I try not to get sucked into petty quarrels, but sometimes I fail. Your mileage may vary. Good luck!
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Sister moox, I understand what you mean. My husband is the big brother. He can say or suggest something and she resents it. I, the sister in law, can say or ask the same thing and get a positive response. I am their buffer, which is okay most of the time. They always had a good relationship before, but the disease has made her defensive. Understandable, but not always tolerable.
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