Four children in the family and I am the only daughter. Mom is 91 and still pretty sharp mentally. Two younger brothers live in the same town and are the primary care givers. They take care of her lawn, get her house cleaned and drive her to her appointments. Both sisters in law help,too. I live 500 miles away but stay with her when I am in town, usually every 6 weeks for about a week. During that time I give her mani-pedis, do major household tasks like washing windows and cleaning out the basement, painting and other spring cleaning types of tasks, cook her meals and stock her up with future meal options. I try to get her to go out from time to time, but her arthritis has become so crippling she's reluctant to leave her house. In the past 6 months her health has declined. She's lost weight, her eyesight is nearly gone, she's developed an infection in a finger from a burn a couple months ago,( doctor said he hoped he won't have to amputate it) and she's had two blood transfusions in the past 6 weeks. She wears adult diapers and has to be reminded to change them when they're soaking wet, has trouble setting the microwave time accurately, (ie;10 minutes instead of 1)and just rinses her dishes instead of washing them. The oldest brother visits once a year and has declared she's fine, that I'm not with her enough to know she needs additional home care and that the two brothers who are the primary care givers should decide. These two brothers are doing a good job, but missed the fact that her house was mice-infested until mom announced she may have eaten mouse poop in her cereal. I know I am not on the front line daily, but feel since I actually stay in her home when I'm there, I might be seeing more than they are. Or maybe as a woman, I'm looking at it from a different standpoint. Mom does not want anyone to come into her home to help except family. She gets depressed when I mention having someone come in from time to time to check on her. I don't know if I should gather home care information and call a family meeting (including Mom), or let the brothers who are really involved daily, make that decision. I feel totally out of my league here and hope someone else has dealt with this situation before. Thanks.

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Thank you for your suggestions. I contacted the two brothers who are managing her care about pulling together the information and discussing options. The one who is most involved with her personal needs has decided he and his wife will spend more time with her care, ie; bathing, and food prep. He buys her adult diapers and says she's changing them at the rate of about two per day and believes that's often enough. I have no idea how often is enough. I thought about the urinary tract infection possibilty and will mention it to him and Mom. I will be with Mom in about 6 weeks, and hope the situation hasn't deteriorated. I have thanked both brothers for all they do...essentially they make it possible for me to live 500 miles away, as well as Mom living in her own home. As for the older brother, his personality is such that arguing seems to be his main for of communication. It's sad that at such a difficult time for all of us, his only contribution seems to be ill will. I am so glad to have found this site! Your suggestions are excellent. Even if my youngest brother and his wife are willing to take on the extra work load now, at some point it may become more than they can handle and ready access to resources will be necessary. I know all four of us want the same thing for Mom, a safe place to live where she can be most happy. It sounds so simple...
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Usually the local caregivers have the best sense of what is going on, and the sibling from afar is perceived as interfering. But in this case you are probably right that living in the house for a week at a time gives you a different perspective than mowing the lawn or going to doctor appointments would. You think that your brothers are doing a good job -- be sure they know that! Don't let them get defensive and think this is criticism of them.

Do explore what is available. If finances are an issue, look into what she might be eligible for. And while this is going on, Also document your specific concerns - the kinds of things you've shared with us. Then have the meeting with your brothers. The distant one can particpate by speaker phone.

My 92-year-old mother has severe arthritis and some mild confusion/memory loss. She lives alone. She, too, did not think she needed help, but this is what we arranged: Meals on Wheels. Homemaking services -- laundy, changing bed, mopping, etc. Weekly nurse visit to manage medications and take blood pressure. Kids do shopping, and drop in to play cards, etc. She is not incontinent but we recently found out she no longer bathes. That is our next topic to discuss.

All of you need to figure out what's best for Mom, and then figure out how to get her to accept it. Not easy!

Good luck.
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I think your idea about gathering home care information first and then scheduling a family meeting (maybe without mom the first time, just to talk things out with your brothers).

Sometimes those closest don't notice the decline and the need to be proactive. One thing that is not good, is that she does not change the depends until they are soaking wet. This could cause a urinary tract infection and these infections can be quite serious in the elderly. And your brothers and your mom I'm sure; don't feel comfortable addressing this problem with her.

After you discuss things with your brothers, talk to your mom and encourage her to hire some in-home care. My mother had caretakers in the home for a while and became quite friendly and attached to some of them. If you call an agency, they probably will just send someone over; but if you call Elder Services in your town, they might have suggestions as to people that they could refer to you on an individual basis and mom would have a chance to meet them and determine who she feels most comfortable with. I found that most people who work at these jobs to have an affinity for the elderly and enjoy working with them in the first place. Good luck. Take care.
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