My sister (77) is in long term care and her children are not helping. What can we do to force the issue?

I don't know if you can force anyone to care for her. The only thing you can decide is what you are willing to do to help. It sounds like she is not a very pleasant person to deal with. What is her condition that she can't care for herself any longer?

You can't force anyone to be a caregiver...that goes for BOTH your brother and the sister's children. Definitely your brother should not be burdened with the care of two people. He has every right to step away from the sister...that doesn't mean you can force the children to be the caregivers.

If she is in a long term care center already, as you state in the title, then she already has round the clock care....what exactly still needs to be done? I'd assume that if shes already in a care home, he doesn't need to care for her...just for his mom (which is a huge job in itself).

Angel

Unfortunately, it seems that your sister's attitude has spoiled any chance of her own children taking care of her. Under the circumstances and the limited options you describe, the better solution might be at a facility with round the clock staff who are trained to deal with someone who doesn't cooperate. Sorry, but that seems to be the attitude your sister has.

It sounds like your sister's children have emotionally divorced themselves from a mother that wasn't easy to get along with. They are doing this for their own survival. There is no reason any of you need to be there every day. Visit once a week.

The concern here is for your brother. If he continues to have to put up with the caregiving burden for your sister, his life will be shortened significantly. Your mother has no say in it, really. (And where is she, and who is her caregiver?) If she's 99, will she even know if your brother steps back?

If your sister is in a facility, what are the day to day burdens that he bears?

Among your sister's faults, you mention her declining to take responsibility for getting well enough to be released. But if she's in long term care, how realistic is it that she could do that; and released to what sort of circumstances?

Is it possible that your brother is hoping for too much regarding his (presumably) twin's prospects?

Many caregivers would give their right arms to have a loved one tucked up in a care facility especially if they lived far enough away to not have to visit too frequently. I would say count your blessings, leave well enough alone and don't feel obligated to visit too often.

Thank you so much for all of your answers. I honestly didn't expect even one. My sister's conditions are lung issues, spine issues, extreme obesity, and bad knees. The doctors tell her her first priority must be to lose weight before they even consider fixing her knees. The day to day responsibilities of my brother, I shouldn't have said day-to-day. He drives to the facility to take her a goody basked prepared by my mom once a week, he tries to help her manage her finances, just little things really but that doesn't stop her from constantly calling him and asking him for this or that. Yes, she is in a long term/rehab facility and could leave if she just took the steps to help herself get better. Yes, her children have emotionally divorced themselves from her. What we ultimately want is for her children to move her to a facility near where one of them lives now or when my mother passes.

Um. Clearly you have a different understanding of the word "divorced" than is commonly in use if you can say in one breath that you agree that your children have divorced themselves emotionally from your sister, and in the next that what you ultimately want is for those same children to move their mother to facility near them.

Why would they?

Also. If your sister is extremely obese, and her doctors have said that her first priority must be to lose weight before they will relieve the pain in her knees, why in God's name is she still being fed a 'goody basket'? Or are they strictly a non-food goodies?

Where do you stand on the whole situation? What worries you most, and what realistic solutions would help?

Her children have divorced themselves, I mean. Sorry.

I understand how you feel, SDWebb50. It doesn't seem fair that your brother, who is 77, should be dragged into this when there is a younger generation who could be stepping up. But I agree that there's no way the adult children can be forced to step up, and I think it's a lost cause. It sounds like the children have not only divorced themselves from their mother, but they don't live close enough to each other to share the burden equally. (I gather this from you saying that you and your brother want them "to move her to a facility near where one of them lives now".) I can't imagine one child volunteering to be on the hook for the needs of the demanding, ungrateful, difficult parent when the other sibs are getting off the hook. Maybe each of the children is laying low hoping that another one will volunteer or get roped in, or maybe they've all agreed that none of them will do it. And honestly, they're wise to steer clear. Nothing can torpedo an otherwise good relationship among siblings faster than attempting to care for for a difficult, ungrateful parent.

I agree with CarlaCB, but it is still a very sad situation for the 77 yo brother! At this point, if she is there, and presumably going to stay there, and perhaps is on Medicaid? I would leave well enough alone, and have him visit only as he can, With low calorie snacks! There is no way you are going to get her children involved in her care, ans that is extremely sad!

SDWebb50, your family has extremely unrealistic expectations here. Your sister is facing the consequences of a lifetime of decisions and behavior. Perhaps she has been mentally ill and could not help her unloving behavior. I don't know. That would be very sad, wouldn't it? It might have been useful if someone had intervened years and years ago and gotten her some help. Maybe. Who knows?

But to try to intervene now by decreeing her children must take action on her behalf is absurd and totally unrealistic. What if it was one of her children writing here and saying "my mother is demanding, ungrateful, and takes no responsibility for getting herself well. My siblings and I have had to distance ourselves from her for our own emotional health. My aunt and uncle are trying to force us to take responsibility for her care. What should we do?" Do you think we would be urging that poster to take over their mother's care? No, indeed!

Sister is in a long-term care facility. Unless you have reason to think she is being neglected or abused, let them take care of her. It is nice of geographically-close Brother to visit her. It is foolish of him to let it become a burden. He should stop taking her repeated phone calls, unless he wants to talk to her. It is entirely up to him. That Sister tries to impose on him is not her children's issue.

What jeannegibbs said. Absolutely right!

Unfortunately I can't offer more than morale support - I know some people can be so difficult to get along with, they drive their children away. Nursing homes can also be abusive to those that may have had some contact with their mother. There were times I had to stay away for several months because of my mother's verbal and emotional abuse. The social worker from the nursing home would call me and say "You can't just dump her here and have nothing to do with her" (which isn't what happened at all - and they knew it).
There can be an expectation from the nursing home that any involved relative visit - and do so more frequently than is good for their patient or relative. It's enough to drive one mad. I can empathize with the children, and I can empathize with you as well, SDWebb50. I pray that you all will have the strength to get through this and still retain your sanity....(HUGS)

I should add that the nursing home my mother was in told me that when they get to be that old, they generally let them eat whatever they want.

SD, you say how difficult your sister is, her children grew up with it, you sis too, to a certain extent anyway. You say you are too far away to move sis near you. Her children do not want her either. I would not even suggest my children care for me, they have their lives to lead. Unfortunately, brother is stuck, but he doesn't have to be. He needs to establish boundaries of what he is willing to do and stick by them.

Who has sis's poa's? Is she competent? If so, she needs to find someone to help her. Think about a geriatric care manager.

Maybe move her closer to you, or half way in between some family members so more can participate. I do not know the answer to this but sis made her bed....

Anoni0000, how horrible the social worker put a guilt trip on you. Not all nursing homes are like that. My aunt was horribly verbally abusive towards me as she had zero understanding she had dementia and felt she should continue to be independent in her own home. So I was to blame for everything. I arranged for a psychologist there to see her weekly. Since she never understood he was a psychologist, she freely spoke to him and in the end, he was my ally as he gave me information about her day-to-day life there that she would never tell me. The point of this is, one day at a meeting with him he said "don't take this the wrong way, but you do not have to visit her." He knew she was abusive towards me. He said "she's not the same person. You need to see that." Anyway, it was helpful. I did conference calls for the three-month team meetings and managed her care from afar. But you don't hVe to visit in those circumstances.

I have a similar situation with a 90 year mother who lives alone in a large home 2-4 hours away from her emotionally divorced 4 daughters (years of emotional neglect and abuse). We each take a turn visiting every 2-3 months and take calling once a week. When she calls, we don't respond unless it is a medical emergency. If we can manage that by phone, we do. Her plan is to never go into a home "for old people" so we have made it clear that she needs to a have enough money to hire help. If her $$ runs out, she will go into a home. With narcissistic and borderline personalities, you need to set firm boundaries around what you as an individual can handle. I would have an honest conversation with her children, acknowledging the challenges with their mother now that you are all getting older and ask them to take responsibility, giving them permission to set firm boundaries. That is your only hope. Otherwise, give your brother permission to back off and tell your mother that food baskets are medically contraindicated. Hope this helps. Setting boundaries is hard to do but necessary for your own health and well-being. Good luck.

What "goodies" are in the "Goodie Basket" that your Mother prepares?
If the contents of the basket contain things like cookies, candy, soda, other sweets then your Mother in Enabling your sister in her obesity and potential failure to recover fully or even partially.
Your Brother should go through the basket and remove items that should not be given to sister. I doubt at this time telling your Mother that these things are not permitted would fall on deaf ears.
You can not force anyone to care for another.
If she has alienated her own children that is on her and her children.
At some point you might have to face the fact that your sister does not want to get better and her life will be shortened considerably by her life choices.
Loosing weight is difficult at any age and when you are older, less active and have other medical conditions to boot it can almost be impossible.
I am sure that your sister is fully aware of what she is doing and this is her choice.

If she does not have all her papers in order, POA for health and financial as well as a Will you might suggest that she get those done. Suggesting that might make her realize the finality of some of the decisions she is making.

There is no way to force your sister's children to become involved. Perhaps their mother drove them to stay away by her behavior toward them. Your brother needs to make his own decisions as to how involved he wants to be, and he may need to step back for his own health and well-being.

My difficult parent lives in my home and if I knew then what I know now, I would have made a different decision. Only one of my three siblings is slightly involved. The other two don't get involved at all with her care and see her only on holidays.

Do your entire family a favor and leave well enough alone. Your sister is in a care facility. Let the professionals care for her and visit her as you see fit.

Sounds like this situation has been in place since the children were growing up. Sounds like an uncomfortable but necessary family meeting. I don't even know your family, but I can guarantee the children will show up when the word "will" is mentioned. So sorry for you, your brother, and mother. Keep the faith!

I don't think anyone can be "forced" to take care of this woman.

Maybe You and your brother need to give yourselves permission to let go of her responsibilities. Maybe someone at the long term care facility can arrange for your sister to have a living will drawn up or power of attorney appointed to take care of her finances. You and your brother and mother making it clear you do not want that responsibility. The best thing you can do is encourage your brother and your mother and yourself as well to take care of yourselves, first. I would try and get your sister to write her adult children explaining your location and your brother's plate being full and ask them if they would be willing or able to move her closer or would they be able or willing to help with phone calls or handling her finances. If your sister is not able or willing to ask then maybe you or your brother can help her to write. Writing is usually best because you can check and edit it that it conveys what you think is best. Less chance of saying something you or she may regret later. Asking not expecting or judging, or in a complaining way but sincere we could use your help is there anything you are willing or able to do? Is any way they would be able or willing to help your brother, you and your mother to reduce or ease your concerns as a help to your brother, mother and you. They maybe more willing to assist you 3. Asking is not forcing, so why not ask. They may think your brother is enjoying what he does and think she is all taken care of. Encourage your brother to set boundaries and not enable her to be demanding, by giving in. If you want her to take responsibility for her life, her health, finances, living situation and her relationships start by letting yourselves off the hook by not enabling her. I hope this is helpful.

How can you force anyone to volunteer? You really cannot.

You can cause a lot more pain and strife...that's about it

PS if she has financial means maybe someone can be hired. I was hired by a family in the past as a companion/activity care giver to visit an elderly lady. I made regular visits, I was given a budget to purchase little extras, craft supplies, gifts, treats or personal care items. I spent time reading, doing activities and provided extra care foot baths, pedicure, manicure and hair curling. It was a great part time job for me and she and her family really appreciated it.