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My mom is living at home with my brother,she is an amputee,she has a pacemaker and she is on oxygen. she no longer gets out of bed and i have had to leave work to help my brother change her bed and clean her up. He is 60 years old he is diabetic, not healthy either. I have suggested nursing home care several times and he said he is not ready? I was told he can refuse to take her home when she is in the hospital, if he does not want to can i since i am secondary on power of attorney.

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Cndy, I think your options have narrowed.

1. You can continue to respond to your brother's requests, knowing that you're being tasked to help only in a limited way that suits your brother's needs and that you'll be witnessing a situation which you find unacceptable but about which you can do nothing, in that neither your brother or mother will cooperate with your suggestions.

2. You can decide that IF you can't help in a positive way that addresses your mother's entire situation, not just a one-time here and there issue, you either

(a) have to accept that your role is limited to spontaneous family EMT and clean-up service, or

(b) you will not be a part of witnessing, and having actual and constructive knowledge (legal terminology) of a bad situation which is not being corrected.

3. Either way, you're apparently not going to be allowed to intervene and brother will continue to be in control, with your mother's concurrence.

4. If you follow #3, you're going to continue to be frustrated, but you also are aware of a situation which needs intervention. You have knowledge of it; legally, are you obligated to act?

5. If you call APS, both your mother and your brother may be angry at you.

BUT, your mother may get the help she needs.

So, what's the goal here - if it's mother's short and long term needs, then act on that basis and recognize that you're going to be considered the family pariah, but that in the short and long run your mother can benefit from the intervention.

If you don't and something terrible happens to your mother, you'll regret it for a long time, wishing you had acted. Which is more important - to act and be resented or not to act and possibly regret it?

BTW, I wouldn't attempt to talk to the doctor; just put him/her on notice in writing. If you want to, you can blind copy APS, or just contact them anonymously and let them know the doctor is aware of the situation but refuses to speak with you and that you're concerned for your mother's safety.

The next time your brother calls for lift help, you could also refuse and call EMS; they'll document a situation they see that's bad and may even call APS themselves.

I can imagine that you're really torn between doing what you feel is best and worrying that you'll alienate your family. But remember that your brother isn't qualified to care for your mother, obviously can't do so, and that this situation is going to come to some decision point, sooner or later.

Frankly, I would rather alienate the family that worry that intervention may prevent something very serious happening.
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I'm sorry to say it, but it looks like a case of having to be cruel to be kind. The next time your brother calls you at work because he can't cope, you don't leave work. So beforehand you need to have had the gloves-off conversation where you spell it out to him that that is what is going to happen. He's not ready? Well, when will he be? If he can't cope without you, he's ready.

It is very hard. Also necessary. Again, I'm sorry for it but you don't seem to have a choice.
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i just talked to her about getting help and she changes the subject. i am trying to step away but it is very hard
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If yourr Mom does not want your input than she probably also does not really want your help.What does your mom say about getting more help than your brother provides? Is your mom worried about your brothers health? What would happen if you didn't take time off to come to the rescue? Maybe they need a reality check.
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And yes, if you are having to take time off from work to help out your brother who is her ostensible caregiver but can't ask questions, then you are being used. Step away from this circus.
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Cindy; If your mother doesn't want you to ask the right questions, then she gets the kind of care she gets. My husband and I asked too many questions when his mom was ill; she threatened to call APS on him because of "Elder Abuse". We stepped back. She did what she wanted to, which was to quit rehab and starve herself to death. Very sad. But even though this was his mom, he had to step away because those were her wishes.
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i have sent several emails to her dr and the only response i get is he can not talk to me about her because of HIPPA. and she does have a visiting nurse twice a week and i do not understand why the nurse does not say something. i know my husband an siblings said the same thing about being used but i feel guilty, she removed me from her hippa because i ask the dr too many questions
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This sounds like a potentially unsafe situation....one unhealthy person caring for another one, also a partial amputee.

And you have a problem not having HIPAA authorization. What you can do though is write to the doctor (start a document trail) expressing your concern and asking him to consider scripting for home care. You don't have to have authorization just to write to him.

What you are doing though is putting him on notice of a potentially serious and/or dangerous situation. I believe he would have an obligation to act, and the easiest way is to get home care involved. Explain to your brother that you're concerned for both he and your mother and most certainly don't at this point discuss a nursing home. He needs to focus on the fact that you're taking this action for the welfare of both of them. And from your description, he could use some medical attention himself.

A nurse and a social worker as well as therapist(s) can evaluate the situation, likely coming to the conclusion that your mother needs more help than your brother can offer, and possibly recommending to the doctor that he also needs home care.

I don't know whether they would contact APS - it depends on the severity of the situation. But it's one method.

Either way, unless your brother refuses to admit home health care people, it's a start to a longer process.

And frankly, I would NOT be willing to take time off work to go to help a brother who isn't realistic and a mother who withdrew HIPAA access. What if you're fired for these absences? You're being used by your family.

Why did your mother remove you from HIPAA authorization?
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i have tried talking to her dr and because she took me off of her medical papers he will not discuss anything with me and i have been trying for a year,her retirement and pension will pay for NH care and what is not covered she would be eligible for medicaid. no i have not looked at homes yet
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You need to talk to her doctor to see if she is eligible for nh care. Does she have the funds to private pay? Does she get Medicaid? Have you toured any nearby homes?
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