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We are nine siblings living all over the country. Three sisters live in the same town as the parents. At the parent's house live:
Mom, 80, losing weight and showing signs of early Alzheimers or just dementia. As an example, she recently asked my eldest sister where the lights and windshield wipers were in the car she drives regularly. She also falls asleep in the middle of conversations.
Dad,87, and in good health but not at all capable to handle caring for Mom or our mentally disabled brother. He still expects Mom to cook and clean and do the laundry for the 3 of them.
A mentally challenged brother of 53, who is being sent by Dad to go visit his sister as often as possible (a clear sign that Dad is panicking about caring for his son).
Our eldest sister lives in the same town. She is a 52 year old married mother of four young adults, 3 of whom are still in studies, and a grandmother of four. She has always been present and caring as the oldest sister and seems to look after everyone (plus host visits all the time from out-of-town siblings and their children).
She does not seem capable of saying no to Mom and Dad's increasing needs as well as our brother's health care needs. She is writing to me about panic attacks and depression, as well as feeling guilty for not being capable of handling it all and resentment towards the other siblings, who cannot even call the parents to see how they are doing.

Being such a big family, no one feels responsible for Mom and Dad and that seems to include Mom and Dad themselves. They need to talk to the family about what they have planned for long term care and what their resources are. Instead they just rely on the one sister. I live out of the country and would like to make it clear that this cannot go on. Were I to write an email, it would probably be ignored or I would receive answers such as "everything is fine, our oldest sister is looking after things". As the siblings don't want to face the facts, perhaps it is best that the parents do. It's all new for all of us and we siblings range in age from 57 to 37, all with children, jobs and busy lives. I just want to be sure our parents live their last years comfortably, that our brother is in good hands and that the eldest sister doesn't continue down the path of sole care giver in such a big family!

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Thank you so much for this very helpful advice Sunnygirl and akdaughter!! I cannot say how much relief I feel just putting words to the situation and realizing it's neither novel nor hopeless. Thank you again.
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Great advice from Sunnygirl. The paperwork is priority one. This situation is more complicated than most because of the disabled brother. Plans need to be made for his care when your parents are no longer able to live in their home. Your oldest sister is overburdened with her own family and your parents and sibling. If she doesn't get some help, her health will suffer. Just having plans in place may reduce her stress. It may be time for a family meeting with all of the siblings.
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It's good you are getting on top of this now. Ask them pointblank who is their Durable POA, Healthcare POA, Healthcare Directive, etc. It's an urgent situation, based on the information in your post. If they don't have those documents already signed, then I would proceed as follows: ( IF they do have their documents, then I would contact their DPOA and discuss the matter with them so you can plan a phone conference with parents and discuss their situation and how they intend to address it.)

Due to your parents' condition, (assuming they are is still competent) she and your dad need to sign Durable Power of Attorney, Healthcare POA and Living Will immediately, so the DPOA can act on their behalf. Explain to them that it will have to go to court if they don't do this now, which is not ideal as it cost money and is hard on them and the family.

I would be very blunt. In their predicament, you can't pussy foot around. They need DPOA one and an alternate, in case DPOA one is not available. Those two people need to accept being appointed, realizing that it's a HUGE job and will likely last for years.

I wouldn't waste time worrying about the siblings who don't want to get involved. I would put the word out that help is needed once and if they ignore it, then let it go. It's common that one or two siblings with take the load and the others steer clear. I wouldn't waste much energy as it doesn't seem to help much of the time.

Since your parents have a rather complicated situation with mom having a progressive disease that will eventually render her unable to care for herself, dad is aging and adult son is disabled, I would immediately consult with an Elder Care attorney who is trained in matters of Medicaid and drafting Trusts. They can evaluate their financial status and recommend ways to legally protect assets. They will need to determine if the adult disabled son needs a Guardian and what assets he may have if they become disabled.

After getting all the legal and financial affairs in order, I would consult with someone who can assess the home situation to determine what in home support is needed right now. I would also encourage a trusted family member to say in the house with the parents and adult child for a few days to see exactly what is not being taken care of. Dad may be misreporting just how dire the situation is.

I wouldn't wait for a crisis before I approached them with my concerns. If you are terribly apprehensive, you can say that someone you know had a terrible situation where the parent got sick and didn't have the signed documents and terrible things happened due to no one having the authority to handle the affairs. And that it made you get your affairs in order and they need to do the same.
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