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So, my brother who lives near my folks, but by my parents admission, is never there. Managed to access my parents email and then read their emails to their doctors about their health questions. My parents have round the clock care, have their wits about them and really are managing quite well. My brother insists we pay for a Geriatric Case Manager to evaluate the situation. I got on the band wagon as the voice to persuade them, but was met with, "what would they tell us that we don't already know?" And I spoke with their trusted care worker who shared the same opinion. My brother is not a collaborator and is run by anxiety. He seems to go into red alert easily. I really do not mean to minimize his being there, versus my not. But my Aunt was visiting and felt confident about their care. I don't like being told what to do and don't like his approach, but I really don't think he will change. Is it that I just need to set boundaries and respect that he's who he is, or is there anything I can do to decrease the tension?
Thanks!

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The fact is that you live away from your parents and don't see them regularly. How often do you see them? As one who lived near my Mom and saw my Mom decline and the one to care for her, I saw what was going on with her. When I tried to explain my mother's condition to my siblings and my suggestions for appropriate care, one of my siblings in the area told the others I was exaggerating and being dramatic. This was so hurtful. In time, my mother's condition validated my concerns so I felt justified.

I tell you that story because it is easy for a person to pop in irregularly and make an incomplete assessment. Your brother has more knowledge from seeing and reading emails. Please, what is the reluctance to get a professional to visit your parents? I think this is wise. Caring for the elderly is very hard and scary. Getting professional input is reassuring that our loved one is getting appropriate care.

So, that said, GO see your parents for yourself and allow a case manager to do an assessment, for your parent's sake. Offer support to your brother. He's probably overwhelmed...
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Your brother sees something that makes him uneasy and wants a professional evaluation. You see his position as an overreaction. Your aunt, parents and care giver feel things are fine and want to maintain the status quo. People are very invested in maintaining the status quo for many reasons, some out of fear of change, some out of fear of loss of job. The "trusted care worker" could fear for loss of her job if the Geriatric Case Manager recommends Assisted Living or Nursing Home care for your parents. Your aunt may want to protect your parents from the dreaded Assisted Living or NH. Those fears could cloud their perceptions of your parents' situation. Also, you are depending on the opinion of the "trusted care worker". What training/education does she have? Is she qualified to evaluate your parents function? She isn't as qualified as a Geriatric Case Manager.

I saw changes in my MIL that her children who lived at a distance and visited infrequently did not. They completely discounted what I had to say about the decline in her mental function - both said their phone calls with her were fine, she wasn't confused. She had a physical health crisis that caused them to visit more frequently and then they saw what I had told them about. She could put on a good performance (showtiming) during a phone call but was struggling with many things that weren't readily apparent until they came and spent significant time with her.

I see value in having the professional evaluation. At a minimum you will have baseline so as time passes and issues arrive, you can make comparison to current function as compared to the baseline. The Geriatric Care Manager could also provide information/resources that improve your parents current situation and make it possible to maintain that current living situation for a long time.

Stop discounting your brother's concerns - that will go a long way to improving your relationship with him. I agree with Perservance, go and spent time with your parents. I doubt if you are ready to do either of these things. I've read both your posts about this, I think you are shopping around for people's opinions that support your position so you can feel justified in maintaining the status quo.
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I do not feel I am discounting my brother's concerns as much as acknowledging my parents don't want to do this. I have consulted with a Social Worker who works with the elderly, and when they have their full faculties about them, she strongly recommends that they be involved in the conversation. My brother wants to over ride that approach and make them do it. I don't feel comfortable with that. And they have said, no, they don't want to have this service. So, I feel that it's not a discount of my brother as much as it is, that I'm not willing to over ride their wishes. I would say that I gave it a concerted effort, as my brother has tried and they don't want this assessment. Then my brother feels unsupported. But, I have said to my brother, if you feel strongly and want to proceed and over ride them, I think you should. That' is where we part ways.
It's difficult, because, I want to collaborate with them for as long as they can be a part of their own process, and they still can be. Does that change what your thoughts are in any way?
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When was the last time you spent time with your parents?
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It changes my thoughts on a couple of things. You have listened to your brother better than my husband's siblings listened to me. No on listened to me, it was so frustrating. I finally gave up telling them the things I saw that told me she was not functioning safely at home. We tried our best to keep her safe. She finally had a physical health problem that made it absolutely necessary place her in the nursing home. So now she is in a safe setting.

I understand that you want to respect your parents wishes and collaborate with them. What has your brother told you and them about the benefits of the Geriatric Case Manager assessment? You haven't been specific about his reasons for wanting the assessment (I can understand if you don't want to reveal that). Does the social worker you consulted know your parents?

I read that you phone daily, my experience is that phone calls are not a dependable way to know the entire situation. My mother-in-law could be very normal for a few minutes on the phone with her children, but was really struggling at other times. She wasn't sharing with her other children the amount of time we were involved in helping her stay in her own home. Your brother may be there more than you know. I still think you need to go for a visit, longer than a couple of days.
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I try to listen to them both. My parents have no dementia and they are really clear that unless they need serious medical care they would really like to be in their home and die there.
I went through this with my husband and his mother. They did bring in a GCM and she made very minor changes. The GCM basically shared with the family that unless she was willing to cooperate there was nothing to do but respect her wishes. She too had no dementia and wanted to die in her home. Her wishes were granted, when she had cancer and it was beyond help, her children surrounded her, in her home. So, you see, this has been a part of my experience.
I mean no disrespect to my brother and I know that we are different. He is more anxious than I. I feel more accepting of letting them live and die how they wish and while I know that may mean there comes a time where it has a burdening effect, I am prepared to be there, as is my other brother. I think my brother who is there, thinks he will be all on his own. And to some degree this is true, until we can get there. I'm not against him giving himself peace of mind, but it will be with a battle of anger and resentment from my parents. And you see, he's alienated his children from him, he's divorced and I'd hate to see him continue down the path of cut off from family, but I have no control over that, in the way that he has no control of my parents refusing this kind of assessment. Is that making more sense?
I hear how difficult your situation has been.
I was specific with my parents about our wishes from a GCM, they feel that they have enough contact with their Doctor's and with the care that they have that they wouldn't find out anything that they don't already know. I spoke with their main care giver and he echoed that. I don't know what he would have to gain by not being honest with us. He is having less hours, as he is wanting to wind down and my parents are finding other care givers. So, I don't think he would have anything to gain or lose and he is fully qualified.
I guess I just wish we could be all on the same page, and it's not going to be that way.
I will be going for a visit soon. We will be there, and I have been several times this year. My other brother has been there for an extended visit as well, and my Aunt was there for a little over a week. She's not one to enable.
So...
I can see why you have the name perseverance, thank you for listening to all of this.
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Even if your brother is more anxious, what a blessing he is trying to advocate for your aging parents. Just because his marriage faltered and he has problems with his children, doesn't equate to not recognizing a real need with your parents. Use this as an opportunity to serve your brother and your parents by providing an appropriate assessment for your parents so all of you children can collaborate caretaking going forward. The resentment may burst forth, but in the end, it is done in love so will eventually be extinguished. :-)
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