How can I convince my mom (92) that her disabled daughter (57) can no longer be her caregiver?

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My mother has owned and lived in her home for 70 years. My father died at a young age, leaving her with four young children. She worked hard to raise us and maintain the home. My youngest sister, (57yr), was born with an intellectual disability. She functions at a high level, worked 25 years, drives, but, has never lived outside the family home. Three years ago, my mother was hospitalized with a septic infection that left her severely deconditioned. After 8 mos of rehab, she was able to return home with CNA's 6hrs a day for personal care, light housekeeping, and meal prep. My sister is the care giver the rest of the day. This worked well for a while. However, my mother has many health issues, CHD, severe arthritis, macular degeneration. My sister is morbidly obese, arthritic, diabetic, and has an undiagnosed digestive problem. My mother has been unable to stand alone, consequently she needs help during the night to use a commode. So, my sister will sometimes be called every two hours during the night! The situation has them both stressed and depressed. However, my mother cannot see that my sister needs help as much as she does! Currently, my mother is in rehab again, after a gall bladder attack left her dehydrated and deconditioned. The facility she is in is the same as before, she knows and likes the people there. However, all she wants is to go back home. My sister wants to move to an assisted living facility herself. However, my mother told her that if she moved, and my mother had to stay at the nursing home she would die! I have been supportive of the community waiver, (I am POA), but, at this point, I truly feel that the situation is untenable. I don't know how to get my mother to see this, or, at least see the terrible position she has forced my poor sister into! Any insights/ or suggestions?
I am so grateful for this sight!

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It's remarkable how many of the topics on this forum begin with "How can I convince....?" Sure, agreement is nice and makes life go more smoothly and better to have than not. And yes, there's the whole question of respecting people's autonomous decision-making power. So it's easy to fall into what I call "arguing about reality."

When the situation is serious and it is what it is, agreement is largely besides the point. If there's a painful reality I don't want to deal with, and you try to convince me about it, you actually undercut your own progress, in two ways.

One, you demonstrate by your attempt to convince me, that there's something to discuss about this reality, it's actually arguable, up for grabs. So I get to think maybe it's not that cut-and-dried after all, and maybe I can actually win this argument.

Two, you offer me a great way to NOT deal with the situation, NOT go in the direction that's needed. Instead of you just getting on with it and doing what needs to be done, there you are hung up on getting me to agree. And I can just keep not agreeing.

Here's a silly analogy: Suppose the house is on fire. You know it, but I don't know it or maybe I just can't deal with the idea. Please don't stand there and list all the reasons you think the house is on fire! Grab my arm and get me the heck out of there. I may or may not ever "get it" or thank you, but at least we'll both still be alive.
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If your mother has not seen the severity of the situation by now and she is 92, then she will never see it. I am not meaning to be offensive by this, but it is just shelfish for parents who do this to healthy children nonetheless unhealthy ones. My mother was legally blind (could not drive), had a ruptured disc in her back, struggled with severe anemia and eventually developed renal failure. My grandmother was insistant mom be her caregiver -- and later I helped. She too was too good to go to a nursing home because all these horrible things would happen.
Now, my mom was not an only child and her 100% perfectly healthy brother lived 1 mile away for a majority of the time the situation went on. My dad worked 3rd shift and because my mom did not drive, dad would come in from a night of maual labor, clean up and sit for sometimes hours in a doctors office with my grandmother and mom. My uncle worked first shift but his wife was a stay at home mom with very little responsibilities and she drove.
When my mom went into severe renal faillure, my grandfather (who chose to be hold and disabled to escape responsibility but wasn't to old to walk to town everyday to shoot the bull with his buddies) told me it was now my responsibility at age 14 to take over.
This is not love. This is not love. This is not love. This is abuse. Everyone feels sorry for the elderly, feels sorry for children but rarely is a thought given to the caregiver who is disabled themselves. I honestly wish there was a law where doctors reported this kind of abuse on adult children in the role of caregiver.
Have your mom grow up before she dies. Give your blessed sister some happiness. Set her free.
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While it's possible your mom is being selfish here, it's also possible she's speaking from fear. If your mom admits your sister can't take care of her, your mom might also have to face the possibility that your sister can't take care of herself. Could that be a factor? Even though your sister has obviously done very well, especially since she can see the need for assisted living for herself, your mom still probably feels responsible for your sister's well-being. She's the child your mom never had to let go of.

That 'if I have to stay at the nursing home I'll die' comment is very common, especially for someone of that generation. Many nursing homes used to be very horrible places and were only a place that the forgotten and unloved went. That's another fear your mom may have.

It's possible that if you will discuss the change in living arrangements with her, let it 'sit' in her head for a while, then discuss it again, she might be more accepting. That had helped my mom several times with changes she didn't want to make but could slowly accept.

Good luck.
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You said that you have the POA. I do too for both my parents. I believe the hardest lesson I have gone through is that I am now in the adult role and they are in the child role. They are not able, as your Mom is not able, to be 'in charge' anymore. There comes a time when you must communicate as with a child. I would say, tell Mom what her choices ARE (that are acceptable to you, as the POA, and that will keep your sister and your Mom safe) and then let her be involved as to which one she wants to choose. Perhaps, as one said, there is a residence connected with the rehab she is in, and she can just transition right there? Perhaps a facility, as another said, where both she and your sister can be placed in different wings so they can still see each other daily? Perhaps another place? If she can go 'visit' and see how different nursing homes are these days, it may be easier to accept. My elder care attorney and case manager for my folks have repeatedly told me that ALL their clients fight the issue of having to give up control in one way or another. It is a hurdle to get over. Like caring for a 6 yr old who wants something they cannot have, the fastest way to get past it is to just tell them, this is how it has to be to keep you safe. Here are the options. No it's not pleasant and it's sad to have to deal with it, but....as my dad's caregiver used to be fond of saying to him and my mom....' it is what is it....and we have to make a choice now...' It is NOT easy....was not for me, and will not be for you. I had to 'stay away'....'walk away'....refuse to listen to complaints and whines....but it comes down to what is safe for everyone. Another thought...with my Dad, it always helps to say: "Your doctor says this is the best way for now" This age group thinks the doctors know best and if the doctor orders it or recommends it, they are more likely to accept it, than if it's just their 'kid' who says so!
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I was pretty confused by 'joycews' statements. First statement was that if the 92 year-old-mother hasn't grown up by now that she never would. Then her last statement was 'Have your mom grow up before she dies.'!!! Well, you can't make anyone grow up and it sounds like your mom worked her entire healthy life to support her family and to keep her family home all these years. That's very commendable and as a long time divorced and working mom that took care of my children, grandchildren and myself, I know how hard it is to give up control of your own life. I really like 'Tennie's' comments. She pointed out many factors and fears that happen in this stage of life for the elderly when they become incapacitated. Being a long time Registered Nurse and a Nursing Home Administrator, my strongest suggestion would be to get your sister placed as soon as possible in an Assisted Living. That will remove the option for mom to return home as her daughter as the care giver. Mom will soon find out that it's very expensive and almost impossible to have 24 hour care for her at home that is competent and reliable. Reliable being the key factor. There are agency's that are free, like 'A Place For Mom' that can give you endless information on the services available out in your community from Adult Family Living homes, to Skilled Nursing homes, legal contacts, in home agency's, etc. You may also be able to find a place that has the level of care that your mom needs as well as an Assisted living on the same property or owned by the same company that your mom and sister would be able to visit each other regularly but in no manner would your sister be responsible for your moms care. These are popping up in almost every city and work great for couples and families that are in this situation. The hardest decision in all this is that now is the time to tell mom that she can't return home. The easiest transition is always from one facility like a hospital or rehab to the other facility or long term care. It's tough, but you have to do what's right for your mom and your sister and don't forget yourself. You have to be strong, but loving, and you might end up being the bad guy in all this but end-of-life care is hard for everyone to accept. Hang in there and get some help in making all the transitions that need to take place.
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I have no problem with what kathy said. Her mom is the way she is and will not change. Most elderly people will not EVER change. I too am very sick of all the caregivers complaining about their situations and I have only been on this site for 5 days. I don't mean that I am not empathetic or I don't feel their pain, I just deal w/my mom differently. I AM ALSO A DISABLED caregiver w/many back problems and worse, I have Panic Stress Disorder Syndrome. My mom is constantly stressing me out and or trying to put me down. I do not complain. This is mine and my moms house, however I refer to it as mine because I AM IN CHARGE and I am the BOSS! You teach people how to treat you. If you let somebody walk all over you elder or not, that is showing them that you allow that kind of treatment. I will ignore my mom or go for a walk or even when it gets really bad, I will threaten her w/assisted living. Just because our parents are old and losing it in so many ways, I feel sorry for them,. but NOT to the point where I will allow my self to be hurt or abused. She is totally taking advantage of your sister. I agree with Gigi11 totally. Hugs to all but take some control back over your life. Parents will do or say anything to get what they want at anybody's expense. Yes it may come from fear, but why do we have to suffer. Be your own advocate! Good luck to all, (A different Joyce)
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I haven't read through all the comments, but I have just gone through a situation like this. My mom is 96, with CHD, macular degeneration, lymphadema, and dementia/Alsheimer's and I am the disabled daughter taking care of he (two major, permanent disabilities)--until last week. when I bit the bullet and had to place her in a dementia care facility because I can no longer take care of her and all her constant, 24 hour needs. There is no explaining this to her and she is of the generation that wants to stay in there home to the very end. That's a nice theory and I wanted to try and make that possible, but with my health deteriorating, I just can't. My sister and I made up a "therapeutic lie" to get her to the home where we had decided she would be comfortable and in good care. That worked, but she doesn't like me much now. Just before I left her there, after trying to explain why I can't care for her any more because my health is being badly affected (If I get sick, there will be no one to care for her at all), she said, "You have just dug my grave." So, you have no good choices in this kind of situation. You just have the decision to make that will be the best for all parties involved.
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It was hard for my mom to go into a nursing home. I stewed about it for a bit.
Then I said to her "Mom we're going to visit nursing homes today (3). I want you to pick out the one you like the best and think you will be happiest there." We did, she did and the rest is history.
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Thanks to all for your input! I can see that I do not need to convince my mother what she needs. I know that she will not be able to return home, that's enough. I have found assisted living for my sister, and a home for mom!
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TAKE THE DOGGONE BULL BY THE HORNS AND DEAL WITH IT!!! STEP IN. GROWING OLD IS NOT FOR WHIMPS. Lol, I have to laugh at myself lolololool I have the biggest heart I know, but what comes out of my mouth on this forum I sound like a heartless, mean, grumpy woman. My mom is from Boston she is Sicilian and is not easy at all. No details now but lets put it like this a OT lady just quit because of my mom. Gotta Love Her.
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