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First time posting. Hi everyone! I currently work full time and live on the West Coast w/my bf, and my mother lives on the East Coast with my younger sister, who has a family of 4. My mother has multiple chronic conditions (CHF, DM2..), and recently had a major heart attack, thus her care has become more complex, with added new medications, home health nursing care, and more frequent doctor's visits. I am a nurse too, so I have taken up the medical aspect of her care. I have tried my best to coordinate my mother's care, with dr's appointments, with transportation, keep her home health nurses aware of her symptoms, try to keep track of her daily blood sugars and weights and medication regime, and try to make sure she can eat healthy meals, since at this time she doesn't drive.
However, the big problem right now, is that she has always had a strained relationship with my little sister, and this new development has only made it more strained, with the extra care she has been receiving and needing. She is independent with her ADL's, no memory problems, but still, a lot.
Thus I have had to become the mediator and communicator between them both and my sister brings her frustrations with my mother to me (since she has 3 children living in the house with my mother on top of it & her and her husband work full time), and wants immediate solutions, which unfortunately, I cannot give at this particular time.
Any resources that would be helpful for this problem? Or Suggestions? I have seen in research that family meetings may be a good route... Thanks!

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Mom needs more care than sis can provide. At the top of sis's priority list is her responsibility to her family. Sounds like time to move mom to the appropriate facility.
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What kind of solutions is little sis looking for?
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Your sister has too much on her plate.  Your "help" is no where need what  your sister is doing, and may be regarded as micromanaging.  Long distance medical care is an oxymoron.  NO, a family meeting is not helpful.  YOur mom needs to be moved to a facility.
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With your superb organisational and mediation skills combined with your nursing and lower family commitments, your mother would be be better off with you. Tim to move to the east cost and help your sister with some hands on help.
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Lymie61 Aug 2020
First I’m not supporting the idea but why would this daughter, who’s life is on the west coast, move across the country to take her mother in rather than simply move her mother to her?
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How long has your mother been living as part of your sister's household?
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So, sorry, just to clarify:

The East Coasters comprise mother, sister, sister's husband, three resident children (ages?) and one child away at college or something? Frequent visitor or flown the nest?

Just trying to get a better picture of what sister has on her hands, exactly.
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I understand that the desire is to keep mom at home, but your post suggests that your sister is having difficulty doing the caregiving for all the people in her home: children, husband, and mom. She probably is not getting respite and your sister is probably not getting her needs met. Talk with your sister about respite care: home health care aides to "sit" with mom while sister spends some time away to care for herself and/or rest. If that doesn't work, mom's care may have become to onerous on your sister. Maybe mom needs to move into a different caregiving situation - assisted living.
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FloridaDD Aug 2020
It is difficult to get respite care during Corona.   HHA may work as temporary solution.   This situation is untenable for sister and another place has to be found for mom
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If sis and mom have a strained relationship....why o why are they living together??? There is nothing you can do that will ease your sister's burden. Mom needs to be in assisted living.
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Your mother is young -- only 61 years old! Seems that according to your profile that she provided caregiving for your sister's children. Was she living with your sister at that time?

What is your mother's financial situation? She's too young for Medicare. Is she Medicaid-eligible? What is the plan for her going forward (is there one?), because it's obvious that the current situation isn't working,
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My only suggestion is to be your sister's listening ear. No matter how much you are doing from afar, it is never close to the day to day pressures and exhaustion that looking after a loved one brings. No one can know that who has not done it every day! I'm not trying to downplay your good work, just suggesting that you try to see it from your sister's perspective- she's got children, husband, home, and many other pressures on her besides her Mom. I did my Mom's care alone and it is the toughest thing I've ever done. And Mom and I had a great relationship, but my best friend was my lifesaver by just listening and caring. Let her unburden to you and just listen. She needs someone to support her so she can support your Mom. Hope it all works out well.
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FloridaDD Aug 2020
That is just a temporary solution.   They need to find another home for mom
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I am curious how you keep track daily of her BP, blood sugars, weight and her food?

Are you having your sister do all the hands on work so you have this information? Are you telling your sister what food she has to prepare for mom or have you hired a home chef to prepare these healthy meals?

I just can't imagine how your sister has managed to deal with you and mom. Your mom needs to grow up and get her own home. Your sister needs you to facilitate that, not give her more work so you can be in charge of her medical care. Which is false and I promise you that your sister would disagree that it is very helpful. Your mom is capable of arranging transportation and doctors appointments, she needs to do for herself. She is to young to be sucking the life out of your sister.

Find mom a suitable place to live and tell your sister that you are moving mom. That is the only family meeting that should be called.
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Lymie61 Aug 2020
my Brother and I interchangeably keep track of BS, weight, water and food intake as well as medication from afar. Mom isn’t able to do BP with the machine on her own but her BS tester automatically uploads readings to an app on her phone which then shares the info with the apps on our phones and her scale also reports to an app over her internet and we use several methods for checking in and communicating with her throughout the day, Echo Show, her phone and a security camera over her medicine table as well as a dispenser that can be filled 2weeks at a time. So far we haven’t had to have someone physically there on a daily basis so it can work. I even oversaw Moms day to day needs from AZ for a couple weeks while my brother was away at training and I was helping my dad and his wife after surgery. Works for us.
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Its really hard to Caregive from so far away. I am assuming since Mom lives with sister, she doesn't have any money of her own.

Is she a widow? If so she can collect Social Security at the age of 60. Otherwise, its 62. If no money and not on Medicaid, I would have Mom apply for it. She maybe able to get some "in home" help. Medicaid also offers transportation. Your local Office of Aging maybe able to help with resources.

Seems you understand what strain your sister is under just not how to solve the problem. One suggestion is maybe take vacation time to visit and allow sister and family to get away or take Mom away. There are some hotels and resorts opening up. Maybe consider an AL if Mom has the money.
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I think that your Sister may not wish to resume care of Mom in home. I cannot imagine doing this with little children, her immediate nuclear family that she is primarly responsible to, and which needs to be her first concern.
Please have a very frank discussion with your Sister, who has likely wished to broach this subject, but has hesitated because of the difficulty of doing so. Ask her if she feels she can continue with in home care. If you are able to be there to discuss this face to face that would be a great help, but that may not be possible. Long distance care must be difficult enough for you, but in person day to day is, as you will know, something else entirely.
I hope you will update us on how things go and I wish you all every bit of luck. As a nurse you know what CHF means, and now with the heart attack that will likely be worse. I hope for the best for you all.
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Would your Mom’s insurance cover a stay in a Cardiac Rehab unit? Just like any Rehab, it would let her recover from her injury (the major heart attack) and learn to live her new normal. Then she may be stable enough to live on her own, perhaps in assisted living. That would get her off your Sister’s plate and make her more independent, since she is young.
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With all due respect, a family meeting is only useful if your family is on the same page with regards to moving your mom to another place. I’m a caregiver to both parents in their nearly 90s and they still live independently. I will never move my parents in with me. I have siblings, some nearby and some further and we’ve had family meetings. IMHO family meetings are useless when only one person is doing the care.
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AlvaDeer Aug 2020
I agree with you. My personal thought was that perhaps the Sister is not comfortable bringing forth to her older sister, a nurse, that she simply cannot do this anymore. A meeting together (seems there is just the two of them) may allow her to give voice IF she feels she cannot do this any more.
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I never could understand how a person can be a "long distance caregiver". A person who needs constant reminders and appointments made for them means they cannot live on their own.
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Isthisrealyreal Aug 2020
She doesn't live alone. She lives with OPs little sister and her family.
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While your heart is in the right place, daily scrutiny of your mom's needs may make your sister feel like you're criticizing her care and questioning her love for your mom. Even if they do have a strained relationship, she's doing the heavy lifting and if that's not love, I don't know what is.

It's a familiar situation. After 17 years of taking care of my mother, my sister who lives 500 miles away, insisted she would do a better job managing mom's healthcare. She threw in the towel after a week. Your sister has far too much on her plate, with no end in sight, which is a very lonely place to be. My suggestion would be to step back a bit and ask your sister what she wants to do since she is most familiar with mom's situation. Unless you want mom move in with you, tell your sister you will support whatever decision she wants to make in the best interest of BOTH mom and sis. That did not happen in my situation. Although things were much more complex than I can get into here, after mom's death last year, my relationship with my sister has never been the same.
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my2cents Aug 2020
Excellent advice
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i agree with other poster who says she would not have her mother/parents living with her. ditto here. my 95 year old parents living in their own home with 24/7 care-still have a lot of issues, falls for both, dad in the hospital this week for pacemaker, mom is pretty clueless about how much care/time they need from me on top of home care. mom refusing to go to facility community and dad will do what ever mom wants. i believe care would be better and more consistent that what they get at home thru an agency mixed bag of help. in the past 5 days since dad went to ER i have spent approx 6-7 hours per day involved in visiting dad early without mom, picking up mom and take her to the hospital. i go home for a couple hours to try to get something done-food in the house, a shower etc. go back and take mom home. Dad will be discharged tomorrow hopefully but now have new care issues for dad with the pacemaker meds, follow up etc. lazy brother unemployed lives closer has not lifted a finger for parents ever-just wants their money. I now do their bill pay banking and misc. problem solving, trips to the dr. I have older brother who is sympathetic to the overload but lives out of state and has issues with his own family that have landed on his shoulders. sis is in nursing home with LBD lives in my area, i am the only one trying to do something for her and never ending problems with behavior and decline-having lots of issues i had two meetings i had to cancel regarding her care cuz dad was in the hospital having surgery. i have postponed my own business, dental, checkups due to the needs of my parents take priority. I can not take on any more i acutally would love to cut my work load in half at least but no one will do what needs to be done for my parents or my sister.
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Imho, you could possibly discuss with your sister the fact that, most times, it takes a bit for the solution to come to fruition, e.g. in these cases, things are not instant solutions. Prayers and good luck sent to you.
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Is it possible for you to move mom to your house? You sister has FT job and the kids, you have FT job - so I am assuming you are hiring her care. You say you have taken up the medical care issues, so does that mean you make all the arrangements and sister doesn't have to be involved?

If sis has always had strained relationship, her situation of having mom there round the clock plus her own family has to be tough. If you get along better with mom, ask her to come and stay with you for a while and give sister a break.

If a move is out of the question, and you are the problem solver, maybe it would be helpful to talk with sister about what kind of help she really needs. Maybe it's time for 24 hr care by inhome assistance. Maybe sister would prefer she went to a facility. Perhaps if sis wasn't dealing with mom all day, they could have a less strained relationship. A meeting is a good route to take.
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By all means, call a family Zoom meeting and let your sister and mother vent, if necessary, but do not expect any lasting change in their relationship. Your sister has way too much on her plate but your mother apparently is also holding her own. I recommend that you try to visit more or take your mother to your place for an extended visit if she can travel. You might also consider bringing your mother to live with you and your boyfriend.
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