I've got an additional complication to the more common aging parent w/dementia situation: My 93 yo mother has mild-to-moderate dementia and lives with my 55yo sister who has bipolar disorder.
Up until about 3 years ago, the mother handled 100% of the sister's care as well as the home and finances. Now, the sister needs to do at least the "bare minimum" to care for mom and keep the household going, which consists basically of light housework, laundry, shopping, meals, etc. Beyond normal household logistics, Mom needs relatively little care at this point, other than supervision to make sure she doesn't fall, someone to make sure she remembers to eat. Other than a few vitamins, Mom is on very few medications (baby aspirin and gabapentin).
Complication is that the sister has completely rebelled and refused to even do the things that would be required for her own personal daily living if she lived on her own. Sister says it's "not fair" that she has to do things for Mom, although those things aren't really that much beyond what would be required to do for herself. Neither will leave the home (Mom for AL, sister for psych facility), and are demanding that I quit my job and move 1000mi. cross country to take care of both of them. I have hired in-home assistance for Mom; sister has chased 3 of the providers away because *she* didn't approve of having strangers in the home.
Further complication: sister has been forging checks from Mom's account, using Mom's credit cards at will for her own personal purchases/entertainment, etc. She routinely withholds mail, bills, etc. from Mom (to conceal the unauthorized spending on the credit cards), so household bills aren't getting paid--I'm trying to take over doing that from afar before things get too overdue and utilities get shut off, etc. The sister will also interfere with mom's ability to communicate with me at times....she eavesdrops on all our conversations and has canceled mom's cellphone contract.
I've tried contacting Mom's PCP and associated social work office, state Adult/Elder Protective Services, etc. So far, can't get response, callbacks, or meaningful action out of anyone. This is frustrating and difficult to deal with from so far away.
My sister is untreated bipolar and my uncle had schizophrenia.
I remember my schizophrenic uncle would listen in on all calls my Mom made to her mother (my grandma). Schizophrenic uncle lived with grandma until both died within a month of each other.
I would engage as little as possible with the bipolar sister. In our experience mentally ill people are unable to compromise or be reasonable. It is also legal in the US to have untreated mental illness.
I'd focus all of your efforts in getting your POA in force. Get all bills changed so that they are emailed to you and not mailed so you can pay everything electronically. I'd cancel all of the credit cards. Keep one credit card open with a very low credit limit (like $500 or $1000) that can be used for groceries.
You might have to make all of this happen with an unannounced visit.
If Mom has a health situation and is sent to a hospital I'd push hard to get her discharged to anyplace but her house.
While Mom and sister live together it will be very difficult on you due to sister's mental illness.
We had very similar dynamics for many years with my grandma and my uncle.
Explain to your Mom that if she doesn't assign a *competent* PoA then both she and her unhinged daughter will be destined for court-assigned 3rd party legal guardians and you'll have no say in anything anymore.
You don't tell your sister any of this. As soon as your Mom finalizes the PoA then take her for her Medicare free annual wellness exam and request the cognitive test. Create a medical portal for her and through it request that her primary doctor provide a written diagnosis worded so that your PoA can be in effect. This is what I did with my Mom and her primary. The purpose is so that your sister cannot then convince your Mom to reassign PoA to her and make a complete mess of things.
You will also need to go to your Mom's bank and have her assign you as joint on the account. Hopefully your sister isn't already on it.
Maybe you will need to decide that you bring your Mom to where you live to manage her care (like in a good facility). You sell the house and your sister goes somewhere else.
You set up your sister with social services: get her assigned a social worker (I'm assuming she's on disability?); Section 8 housing or a group home, SNAP benefits, etc. She will be enraged, and then she'll be out of both your and your Mom's life in a way that causes chaos. You can threaten to report her financial theft to APS. You have leverage. Use it.
The problem here, if and when there is a problem, needs to be in the hands of your mother, her child who lives with her, and any auspices of their state who can help.
You already know that what I have said is true and this is why you are reaching out to the PCP and social services. Sadly, unless APS is involved and there is a court order of care (possible for the mother but unlike for the sister) of the state, there will likely be very little help from any entity here. That is the sad truth.
I recommend that you read Never Simple, Liz Scheier's excellent memoir about her attempts to intervene for her mentally challenged mother for many decades, along with the help of the social services of the city and state of New York. ALL to no avail. Not everything can be fixed.
Were I you, at this point I would visit with a licensed Social Worker in private practice where the mother and her mentally ill daughter live. I would ascertain exactly what can legally be done in a situation like this. I think it's important you speak with this person on the phone to know if they have any information as to any options at all. It's tragic, but there may be little to nothing that you can do about any of this. I am so sorry. There is mental illness in my extended family and I fully know, understand, can feel your utter helplessness in this situation
The sister is a 55 year old adult. Yes, she has bi-polar, but even people with mental illness can take some level of responsibility for themselves and be pro-active in their own lives and management of their illness.
Like I said in my comment, I also think she has Spoiled Brat Syndrome (SBS) because she's always gotten away with her behavior. Their mother needs to put her foot down even at 93 and stop letting her daughter take advantage of her.
I understand that your sister has bi-polar disorder, but I think she may have something else as well. The condition people often get when they've never had any consequences for their actions or behaviors. It sounds to me like your sister has never had to be responsible for anything. Someone else has always taken care of her and put out her fires so to speak. I call this condition Spoiled Brat Syndrome (SBS). The cure for SBS is forced responsiblity for yourself. Your sister is an adult needs to face the music for some of her actions and behaviors. Maybe she can't live a fully independent life, but she can take some responsibility for herself. It will do her a world of good. Many people with bi-polar disorder and other types of mental illness live full, productive, and responsible lives. They do have to work at it, but then who doesnt?
Go visit your mother and get her to a lawyer and have POA done (making you the sole POA), a Will (if she doesn't aleady have one), and an Advanced Directive making her wishes known what she wants as far as medical care is concerned.
After this is done, you have her bills set up on auto-pay and have passwords put on her credit cards so your sister can't use them unlawfully anymore. Doesn't your sister have her own credit cards at her age? If she's as bad off mentally as you're saying, isn't she on disability?
Also, if I were you when you are visiting have the police come talk to your sister. They can let her know that listening in on phone conversations and intercepting a person's mail are criminal offences that she can (and will be) arrested for. So is theft and credit card fraud which she is commiting when she's stealing your mother's credit cards. Your mother needs to have her arrested the next time she does this. Then don't bail her out. A few days in the clink awaiting her court date will do her a world of good. She walks all over your mother because she has always been allowed to with no consequences. That needs to stop, and it can.
Go visit your mother. Maybe tour a few AL communities or senior housing options with her (without your sister knowing). It's always good to have a few irons in the fire because it means there's choices. Good luck.
I wish I didn't have the experience with this that I do.
"Taking over" paying the bills on your end will not alleviate the problem of your sister using your Mom's credit card(s). She is hiding mail from your Mom, abusing her financially and doing nothing as far as the bare minimum in keeping up household chores. This situation will only get worse. Is your sister taking her medication properly, getting therapy, etc.
Is your Mom enabling this sister? Your Mom is 93 and has "mild to moderate dementia". That will only get worse and she will eventually be completely unaware of what your sister is doing.
If you choose to stay involved, you will need to make some hard legal decisions. You need to have a frank discussion with your Mom (ALONE) and then take her to an elder law attorney. She may still be legally capable of signing documents regarding her home, her care, and her finances. The attorney will speak with her alone (without you) and he can determine if she can understand what she is signing. Do not tell or involve your bi-polar sister in these discussions. She does not have your Mom's interests in the fore front. Sorry ~ you cannot do this from 1,000 miles away. You will need to get more involved by taking several trips home to get this done.
Bi-polar sister is not going to change. You need to protect your mother's assets from her. This will become a major $hit show sooner than later if you don't take action now. Consult an experienced Elder Law attorney in your mother's town.
I would worry about Mom. Tell APS you want to place her but sister will need to find her own resources. If house is involved, it will need to be sold for Moms care.
Please, don't feel your responsible for your sister. APS should help her find a place to live and get her resourses she needs. If they don't take their meds, thats their problem. I know that when they feel better, they feel they no longer need them. They don't realize they feel better because of the meds. Both my cousins say the meds make them feel weird, but that was years ago. Its not your sisters fault she is BiPolar but it also does not mean you have to care for her the rest of her life or yours. She should be able to function on her own.
Sister is on her own. You are not required to take on a mentally ill person who refuses to do anything about her her medical and living situation.
Do not move back home. Even mentally ill people work when they get the proper care. They also do household chores and upkeep of property. I know several people with bipolar disorder.
Your answer is overly simplified to "Set up wellness checks with the police, and be done with it."
Obviously, she's concerned about her mother being financially abused by her mentally ill sister. Sister is not doing the bare minimum of housekeeping chores and it will only get worse. Sister living 1,000 miles away is not going to "be done with it.". Not a helpful answer.
So your sister is abusing mothers funds. You need to gain poa for your mother - the sister will have expenses but that needs to be tempered with maybe a little help/reward for her looking after mother and not taking the micky. your sister needs a stern conversation - the law will make the choice if she doesnt want to take care of mother - but you arent moving so dont bring that up again because its not happening. She either works with you or the law will ensure your mother is taken care of and the house will be gone.
That said - your sister needs help - do they have such things as social workers where you are able to monitor your sister? Maybe you can come to an agreement. A little payment to entitled to look compensate for looking after mother - any more and you will call the authorities in. She sounds like shes not really had any responsibilities before? Maybe speak to mothers doctor about her health and how worried you are and see if they offer suggestions. It cant be anything new to them.
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