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I go back and forth between being fed up and "knowing" I'm not the crazy one and feeling guilty that maybe I should be doing more to help. I just don't know what to do anymore.


Some background information: my sister and I have been caregiving for my Dad for at least 8 years. He had a stroke many years ago (which started the caregiving) and now has cancer that has impeded his eating and swallowing, but he can still eat soft foods and soups. The doctors told him last year that he probably had less than a year to live. One of my boundaries from the beginning was I won't do any bathing/changing clothes etc. I don't want to see my Dad naked. Dad now had incontinence issues and has a catheter which has increased his needs in that area. So far I have held firm with my boundary - I do not doing any changing, cleaning privates etc.


Dad's health has now steadily declined. He is more confused, but does not have dementia. IMO though, he should NOT be living alone, but Dad won't move and my sister seems to be doing everything in her power to keep him home.


I have suggested hospice which I think would be a huge help to Dad (and us), but I get screamed at that Dad doesn't need hospice and WE should be taking care of him and I'm a horrible person for not doing certain things (changing clothes etc). Dad has fallen twice in the last couple of weeks and each time I keep thinking this will be our chance to get him help, but no - my sister goes and picks him up. She won't call 911 because she knows they will take him in and tell him he cannot live alone. She is an RN so she at least does assess him to make sure there are no injuries.


I just don't know what to do anymore. Do I just sit back wait for another serious crises and let my sister handle all the small ones that keep happening? If something serious happens that Dad has to get admitted to the hospital then the doctors there can be the bad guys and tell Dad he cannot live alone. If I contact hospice and open that can of worms I would be creating a HUGE family problem because they don't want any outsiders in the house and Dad doesn't want to move.


It feels like it's 2 against 1 and I'm just tired of feeling helpless, tired of being yelled at when I cannot do what my sister thinks needs done. We both work full time, but I also have children to take care of. I've tried to do as much as I can, but I'm burned out. I just don't know how to find the balance between MY life and happiness and helping Dad.


Sorry this was so long. I suppose this was kind of a rant and venting as well as asking for advice, support and encouragement. Thank you for reading.

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DO NOT do any more than what you are doing! Your sister is the one enabling this foolish notion of staying in his house alone.
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NeedBoundaries Feb 2020
Thank you for your reply! It helps to know from other caregivers that I'm not crazy. My family assures me I'm not, but then I let my sister's rants bounce around in my head and then I second guess myself. I KNOW that's what narcissists do - try and bully others to get their way, but it's so hard to separate myself from it. I know my sister loves my Dad and she means well, but she has absolutely no regard for anyone but herself and my Dad. I think she promised my Dad that she would never put him in a nursing home so I think that is part of her motivation. It's just become so absurd the lengths she has gone to.
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It sounds to me like you have good boundaries and your sister does not. If anyone is yelling at you remove yourself from the situation. Hang up the phone, walk out of the room etc.
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NeedBoundaries Feb 2020
Thank you! I do try to remove myself. The last 2 times she started yelling at me on the phone I just set the phone down and walked away. So she kept yelling at nobody and I suppose when she figured it out she finally hung up. I just feel bad for her that she is killing herself! I tried to tell Dad that he can't keep her doing everything like this and his attitude was that I'm a troublemaker and she's fine. It's like he EXPECTS her to just do everything to keep him home without any regard to her health or happiness. If she would step up and tell Dad she can't do it and he needs more help I would back her 100%. But she won't - she just keeps going and going, making modifications to Dad's house, leaving work to run when he falls etc. I can't help her if she won't help herself. I'm worried about her becoming one of the 40% of caregivers that die before the patient, but my stress and anxiety have been so high lately I should probably be worried about myself. I also think my Dad treats me different than he does my sister. I have kids so I think he's less demanding of me than my sister. I don't know how to react to that.
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To me, you have excellent boundaries and should continue to keep them in place.

Me, I would back out entirely and let your sister handle him, if necessary she can hire an outside service to assist her. He will continue to get worse, and the truth is...he is no longer to care for himself and he needs to be placed in a facility.

Your sister is not thinking clearly or doing what is best for him, he needs 24/7 care.

I wish you the best, stay firm!
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I found that the caregivers we are trying to help from many states away are sometimes like drowning people. They are anxious and angry and desperate. And they lash out with "solutions" that might keep them afloat.

I don't try to justify the number of times we visit or the "choice" to live far away. I'm not convincing them. I'm clear on what we can do to help and what we aren't willing to do. And I will accept that the decisions I make are not the decisions they are making for themselves. I understand it is unfair and it makes them mad.

So..maybe find a time when your sister doesn't feel frightened and overwhelmed, and talk to her about the situation. Actually, listen to what she says and don't talk. Don't defend yourself or argue. If she says "we have to keep dad home" don't argue for assisted living. If she says "If you would just do this or that" you can say "what would we do about this if I wasn't available." Ask are there any circumstances where she might feel your dad would get better care in another living situation.

If she feels heard and can hear herself saying things like "no, we are keeping him home forever" and you don't argue- you just receive it- you may find that she reflects on the conversation and possibly comes to another conclusion.

The next time you have a conversation, start by restating the things she told you in the first conversation with as little judgement as you can. See if any of her ideas have mellowed. At that point, you have to tell her "These are the things I am willing to do (research care homes, organize the house whatever) and these are the things I won't do anymore. " Don't defend your decision. Apologize for disappointing her. Let her yell and get it off her chest. She's scared.

This is hard. You might need to practice with a friend so you can hear hurtful things like "You don't love Dad" and "You're abandoning me." without defending yourself. Just keep saying "I know you are disappointed" and "I'm sorry, but these are the things I am willing to do."

This is hard, hard, hard. Be kind and firm. I do have family members who have cut me dead because of this but I comfort myself that it really isn't about me. It's about their need to control things that frankly, are not under our control. No matter how much care you give your parents, they might decline and they are definitely going to die.
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NeedBoundaries Feb 2020
Thank you for your reply and your suggestions! Palliative care would probably be good for Dad. I'm not sure if she'll agree, because she is distrustful of EVERYONE, but that might be an option. I think she's afraid that anyone that comes in will see how Dad lives and will mandate 24/7 care which she and I cannot do ourselves. But, I might be able to bring up palliative care this week after Dad's next appointment with a specialist. If I can get Dad on board with accepting more help he can tell my sister that is what he wants.

I do think you are right that she is scared and overwhelmed. I think she is denial that Dad is dying and she is doing everything she can to pretend he's not.
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I would ask to sit with Sister and all caregivers and again make clear where you stand. Something like this:
"I need to make my position clear. I will talk for no more than 3 minutes. Then I will listen to you and respond to you. I believe that Dad now needs hospice care, or in any case more care than we can provide for him. If I am outvoted on that, and the rest of the family refuses to seek this care, then THIS is what I am willing to do:
1. Cook the things that Dad can eat.
2. Clean the house and do the laundry.
3. Be here on (list days) for (list the number of) hours.
These are the things I will not do:
1. personal care involving Dad.
2. Whatever else you will not do.
(End with) Now, I understand that I have limitations and inadequacies; I am not a saint and I am not perfect. You are free to judge me as you please and speak with one another about me; I however, after today, do not intend to hear your judgements firsthand. If you insist on giving them, I will withdraw from any care and I will do visits only."
Add whatever you like but this gives you an idea. You are NOT a Saint. If you were we would fill you full of arrows and send you into eternity to answer ALL of our prayers. You have made the decision from your own soul; you have insight into yourself. Yes, they will think you aren't good enough. Fine. I am not good enough either. Most of us aren't good enough; we just can't admit it.
I wish you so much luck going forward. Will it hurt? Yes. Will it be easy? No. And the others are IMO WRONG WRONG WRONG not to get Dad the hospice care he needs and deserves. So they aren't getting my vote for Sainthood either.
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KatD81 Feb 2020
This is a very good plan, with the exception of the threat to withdraw from care work. This may escalate things, as people tend to get their backs up when they sense a threat.

If you do need to give an ultimatum, make sure it's one you will follow through on. Otherwise it just teaches others that they can talk you out of sticking to your word.
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Sounds like a terrible situation your sister has created! Yes keep your boundaries!!!! Like you say, your sister does what she wants about your dad, she may or may not realize she is running herself into the ground, and for what? A selfish father who is content to let his daughters be his slaves?!? Um....nooo!!! The only person we can change is ourselves, no one else. As long as you stated what you will and will not do, then stick to that. And Hospice was a blessing for me... i worked in oncology and lost my husband to pancreatic cancer, and its hard to try to handle everything yourself. You just cant....you are a loving daughter and have no reason to feel guilt for anything....that would imply that youve done something wrong, and you havent. Hang in there and come back to vent anytime!! Liz
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NeedBoundaries Feb 2020
Thank you so much for your reply! Sometimes I do think my Dad is selfish in expecting all of this of his daughters. And then I feel guilty for thinking that because he has been a good Dad and very generous with us throughout our lives.
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I imagine your dad is of the generation of men who expected women to run the house, raise the kids and take care of HIM when he has any needs, without any thought to whether the women in his life wanted to, or were capable of this.

I know this b/c my DH is the very last living dinosaur of that generation of men! (I know there's more, but I'm making a point)

Your dad is aware enough of the situation to accept outside help or even a move to an ALF or something--but he has sister running herself ragged trying to do it all for him. And to him, that's business as usual.

Your sister has no right to demand you do anything beyond your capabilities to do. You are actually offering to do a LOT.

Having boundaries--yes, I also refused to bathe my dad, I felt he would have been mortified at the thought. My 2 brothers handled that when it became too much for mom.

Sounds like your sister is on the brink of a complete come-apart. Your offers to help are good and kind and if she doesn't see that--that's her problem.

Sadly, your dad sounds like he really needs palliative care--and later, Hospice. Your sis is and RN? Then she certainly has seen dying people.

I have found, when I vent and rant to my older sis, she is simply quiet and listens. Doesn't judge, doesn't try to make it all ok, just listens. Silence is a great 'answer'.

Your boundaries are fine and sis is just trying to manipulate. Hang tough!
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NeedBoundaries Feb 2020
Thank you so very much for this! You are exactly right! That is EXACTLY how my Dad thinks! It annoys me to no end, but I know that I will never change his thinking. I suppose that's why I try so hard to keep my boundaries in place. But inevitably I let my sister bully me and go along with what she wants - to keep the peace in the family. I just wonder if my sister would be one of the people on a forum like this complaining that she is doing everything and that her sister (me) isn't helping enough. Which is why I am trying to find the balance. In my head I know that I'm doing what I can, that my sister (and Dad) are unreasonable in what they are doing. I just worry that I can't empathize enough to understand that Dad wants to stay at home at all costs. I DON'T understand it -I am at the point that I have emphatically told my children (and my husband) that I will never do this to them and they are to put me in a home if my health declines to the point that I cannot take care of myself.
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I am the main caregiver for both parents in their late 80s. My boundaries are set in stone. They know I will not do personal care like showers etc. I make meals, clean their house, keep track of meds and appts etc. It’s a lot of work but I’m ok with it as long as no personal care is involved.
I would write your thoughts down for your sister as to what you are willing to do to help. Keep your boundaries firm to preserve your mental health. Maybe ask your sister to read the book titled Boundaries by Townsend. This was very helpful to me as well. All the best.
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NeedBoundaries Feb 2020
I actually considered giving that book to her for Christmas. Ultimately I decided that she would be offended by that and didn't do it. I know she knows about my personal care boundaries because that was one of the times I was screamed at. Apparently Dad's catheter was leaking (which I did not know because he didn't (and won't) say anything to me about it and I wasn't feeling him down there to detect that he was wet.) He told my sister about it and she called me about changing him. I told her no -which she already knew that was the answer so I was screamed at on the phone that I'm a horrible human being and this is our FATHER and we should be caring for him and..... (I missed the rest of it because I set the phone down and walked away.) She showed up 45 minutes later to change him and basically told me to get out. So I happily did as I was done with the rest of my "jobs" anyway. I am not a nurse and I'm not comfortable doing that stuff anyway as Dad is at the point that he cannot even stand without assistance. I am afraid that I would drop him or otherwise hurt him.
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Hospice is an excellent suggestion. It seems you are the only one of the three of you who is thinking clearly. I think you need to let go of caring what your sister or any other person thinks of you and hold true to your knowing and your boundaries. Put your own family first. Your sister may have a meltdown soon and that will be of her own design, no?
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I can’t get my head wrapped around even considering not wanting to see your dad naked as a “boundary”.

All of us have “limits” that exceed our capabilities and comfort levels. You have yours, and you’re entitled to them.

Since your sister, as an RN, has a certain set of sensibilities and tolerances she needs to learn that your “tolerance set” just isn’t the same as hers is.

I think the elephant on the sofa here is that your father really isn’t in a safe place, receiving the care appropriate for his condition. For whatever reason, your sister seems to have taken his “wants” as her crusade.

You may find yourself in the situation where you will not be able to continue working in cooperation with your sister. You need to advocate for your welfare whether she feels as she does or not. She sounds pretty unwilling to let go of control.

Under this kind of stress, you will often encounter issues that simply can't be solved. Don’t hold yourself accountable for being asked to do “your” impossible. She may be making choices for her own contributions that should actually be her impossible too.
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NeedBoundaries Feb 2020
I asked her once "When is enough enough?" and I started to get the lecture again about needing to take care of Dad etc etc. This was the point that Dad was on antibiotics, but was too confused to remember to take them at the designated times. (I had set his dual alarm clock to go off at the times he needed to take the next pills.) Apparently he was confused by that, didn't know why the alarm was going off, what pills he was taking or why. My sister's solution was to call him every 6 hours to remind him to take the pill. Stuff like that she thinks is no big deal, but that is stuff that I find to be beyond what we should be doing while holding down full-time jobs. Maybe I AM the selfish one. It's just that I see Dad's needs increasing and increasing and when is enough enough? If it was a one-time event that we needed to help him through I could see disrupting our lives to help out. But I see this as a downward spiral, never-ending series of events.
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You’ve gotten wonderful advice already but I want to add that you are definitely NOT one of THOSE siblings. I would be blessed to have a sister like you, one with compassion and empathy. You’re doing the best you can and I applaud you for setting boundaries. It is something I have needed to do for a very long time but just now attempting it.

I also want to mention hospice. My father is in hospice at home. I still do whatever care is necessary. The nurse visits at least every 14 days, more if we need it. The social worker visits regularly, and they have offered a CNA and chaplain but we have declined at this time. They provide and deliver all his medication and durable medical equipment we need. I guess I’m hoping your sister will consider hospice if it means he can still stay at home. Then if your dad needs to be placed in a hospice house, they can encourage your sister to see the light...then you don’t have to be the bad guy. I hope things get better for you. I think you’re pretty great!
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NeedBoundaries Feb 2020
Thank you! This brought tears to my eyes! I think hospice is wonderful (in general). I'm just afraid they will not let him stay home. Dad can barely transfer from his bed to his wheelchair. (He's fallen twice in the last couple weeks that I know of) I'm also pretty sure he cannot actually get into bed by himself anymore. I've helped him the last couple times I was there even though it was early. He does sleep a lot, but I think he was opting to go to bed because I was there to help him.
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If Dad falls when I was there, I would call 911 anyway because I don't want anyone to accuse me of neglect. Your sister is a licensed medical professional (RN) and should be able to asses him medically, even if she's fudging. The court would see her not calling 911 in a better light than you not calling 911 when she's not there. That's your opportunity and responsibility. If she's not there, you should *not* take the liability upon yourself to deem dad fine. However, you *don't* call her, because 1) obviously it's your shift of duty, and 2) you know she would not take him in and hear that he needs 24/7 care.

Also, I would go ahead and hang up the phone when sis is yelling. You might have an important telemarketing opportunity that you miss with your line being tied up for so long! She's going to be mad anyway. Letting her know that you are hanging up is a very firm boundary. I would take the easy way out when I wanted to stop talking to my mthr on occasion, but I felt empowered when I began to actually let her know I was no longer listening. It's really taking control of the situation. You can temporarily block her number while she's mad.
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mally1 Feb 2020
When I hang up on someone (usually my BIL, who calls us when he's drunk), I always say "I have to go now", and then just DO it. You get to hang up and stop the abuse, but they can't really prove you "hung up" on them. (:
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I was glad when Dad went before Mom. He was from that generation that Mom took care of him and the 4 kids. She never worked. She waited on Dad hand and foot. Dad went on disability at 52 so she then had him to care for him. Yes, I think he would have expected me to care for him if Mom died. But I told my brothers I will not care for Dad. I will not care for a man other than my husband.

I am with you. You gave sister boundries stick to it. She is a trained Nurse. She is the one who is not willing to place Dad. You have other responsibilities.
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Your father does not care what he does to her as long as he gets what he wants. Dementia patients lose their ability to have any empathy for anyone else. He may have been a caring dad, but now, he is perfectly happy to let her sacrifice her life. And she is in some spiral where she maybe feels she must do what he wants to be a good daughter. And she is mad at you because you are not doing your duty. It is not your duty to provide his care. When we no longer can take care of ourselves, it is not our kids job. I am 67 and my husband is 69. My FIL is 94. We got him and MIL to move, emptied his house and handled the sale, moved them again from independent living to memory care where MIL died in October. I am a retired nurse. Perhaps family members thought they should live with us. It was never a consideration. If we wanted that, we would have done it but that is not how I am spending my retirement. And we don’t feel guilty. Nor do we expect our own kids to take care of us.
do only what you want to do and don’t feel guilty. If you value your relationship with your sis, try to help her. But you don’t have to martyr yourself on that alter.
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OMG OP your sister!

Seen it with my brother. "Dad is old and needs our help now and he did bring us up". Yes fine but, like your sister, hes decided hes the one who decides what.

My Dad is fine for his age both physcially and mentally. He NEEDS nothing to be honest. He WANTS a lot.
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I feel for all children in the family. It’s hard for a family to care for parents. I can’t imagine what the objection to hospice would be. Your dad needs more care than family members can give. Hospice was a great suggestion!

I would continue to stand your ground. No one should be forced to do something they are not capable of, emotionally or physically. I feel for your sibling but she isn’t being reasonable towards you.

Sooner or later she will burn out and have to ask for help. Your dad won’t like accepting help but he really should not be offered a choice.

I am not heartless. I feel badly for your dad because no one likes to lose their independence but you know what, that will happen to all of us unless we just drop dead from old age or have a fatal accident.

I don’t want to have to depend on others in my golden years but I hope if I am that I will be gracious. I have already told my daughters that I do not want them to be burdened with caring for me. Why not? Well, I cared for my dad, brother and mom and it nearly killed me.

Being the only girl it fell in my lap. I did burn out and my siblings criticized me horribly. Guess who has my mom now? My brother and sister in law because 15 years in my home was enough. I miss mom and I do love her but I don’t miss the agony. She wasn’t very considerate of my needs.

I said to my mom that since no one thought I did enough let someone else take over! Her doctors always complemented me on my care for her.

I did more than my share. I don’t think any child should have to do it. It’s too much for anyone without help. There is a reason why hospice and facilities are needed.

Sadly, I do not get along with my brothers so I went no contact. I have only spoken to mom on the phone a couple of times. Oh, she hired help for him. He’s a man! Sister in law works full time. Mom never hired help for me. Old people are stuck in their ways to be sure.

You don’t sound like a person who can be easily manipulated. Good for you! Still, I am sorry they are working on your last nerve. I wish you the very best and hope the situation is resolved soon.
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First, Dad is being selfish and unreasonable. Maybe he can be cut some slack because of fear, pain, etc., but the fact is he is NOT be fair. Your sister has no excuse - You have the right to set boundaries about what you can/will do.  If she wants more done, then SHE will have to figure it out.  Her decision about keeping Dad home does not give her the right to rope you in, criticize you or demand you make her decision workable. This is simply an unreasonable expectation. She controls her behavior, but you have the right to control yours.  She and Dad don't want carers in the house?  Well they need to change their thinking for sure. They may have set their demands in stone and are creating a great deal of unnecessary stress, but you really have no obligation to feed into a bad decision.  Have you simply told her so? To be blunt, Dad and Sis don't get to call the shots for you.
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NeedBoundaries Feb 2020
Thank you so much for this! I especially needed to read this today. My sister definitely knows that I believe Dad should not be living alone. And, to be fair, she does seem to be taking the increasing burden on herself. I'm just worried about Dad's safety since I think it's clear that he's declining, but she acts like he's doing fine and doesn't say anything about how much and how often she is going there. I'm just waiting for the other shoe to drop. Sometimes I think I have PTSD because when my phone rings and I see it's her I get immediately tense and anxious wondering what's happened now. And sometimes it isn't even anything important - just pick something up at the grocery store that Dad wants. I just hate my immediate reaction and the stress.
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Dad wants to stay home at all costs?  Well his medical situation is not your or your sister's fault is it?  You have no obligation to make his unreasonable "wants" happen. He (and your sister) have the obligation to make necessary adjustments to the reality of his needs.  I mean, I'd like to be chauffered in a limo to work...isn't going to happen, so I take the bus. That's just life.
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NeedHelpWithMom Feb 2020
Very well said!

Right. There are some situations where there shouldn’t be any choices offered.
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UPDATE: So Dad has declined enough that he and sister have agreed to hospice. Dad has not been sleeping much and now has considerable pain so sister has been basically living there the last 4-5 days. I'm sure she is burned out. At the initial hospice consultation I asked about home health care to supplement hospice because Dad lives alone. I was screamed at after the hospice nurse left for bringing that up because "they'll think he's not safe to live alone". Ummmmm…….. hello? HE'S NOT!! I'm just so tired of being yelled at! So the actual hospice assessment is tomorrow - I'm torn between just letting my sister handle it and let her figure out the rest of the caregiving (she also has visiting nurses coming to talk to them about possibly filling in a few hours) and speaking up to actually get Dad the care I think he needs which would then also help my sister. She's killing herself trying to keep Dad at home. I suppose it's a step in the right direction that she agreed to hospice and some home health care I just don't think it will be enough. I think he would truly benefit from inpatient hospice.
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anonymous1010889 Feb 2020
It is a big step for your sister to agree to hospice and home health. But I’m with you, I don’t think it’s going to be enough. Your dad really requires 24/7 and I’m sorry that your sister has been so resistant to acknowledge that. The good news is hospice will see through it pretty quickly. And if they don’t, you can reach out to one of them and share your concerns. Then they can lay out the options to your sister and spare you from catching her wrath.

I am so sorry for your dad’s decline. You obviously have been trying so hard to do what you can to help everyone, an impossible task. Help is on the way though, and that is very good news. You’re doing a great job. Thanks for the update and let us know how everything goes with the assessment tomorrow.
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UPDATE 2: Hospice did their assessment. Dad's getting pain medicine and stronger anti-anxiety medicine so hopefully he'll get some rest. We also signed up to have aides come to the house for overnights and working hours. This will be very expensive, but my sister seems very relieved and thankful. She was in a better mood and apologized for yesterday. She also still thinks I'm selfish, however, because I said I would not do this to my kids and I don't believe we "owe" Dad just because he took care of us growing up. (She tried to give me that nonsense which I wasn't having and told her so - which is why I am supposedly selfish and have no compassion or common sense.)
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anonymous1010889 Feb 2020
I’m happy to read that your dad will be receiving the care he needs. I know that must be a big relief for you as well. Please don’t let your sister try to guilt and shame you. Your first responsibility is to your children. You have fought to get qualified help for your dad. There is no obligation to provide that care yourself. I believe you’re doing this the right way.
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No point; she won't hear you....
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You don't have to trade insults, with your sister telling you you're selfish and you telling her she's obsessional. Say instead "I think this approach is wrong. It's wearing you to skin and bone and it's not getting Dad the support he needs."

[It would be fine if you pulled your weight!]

"No. It still wouldn't be enough, or the right kind of care, and I'm not joining the circus."

But I'm delighted to see I'm far too late to comment and even more delighted that the stress is already falling away from your sister. May the path ahead be smoother for all of you.
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NeedHelpWithMom Feb 2020
Great advice because if it comes off as an attack on her sister, the sister will become defensive.

It is a very frustrating situation for everyone.

Still her sister has no right to call her selfish.
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I sincerely hope things improve for all concerned. It’s terribly frustrating. I lived it. Being a caregiver is the toughest job that I ever had. Throw in raising a family on top of it and it’s really difficult to find a balance. I feel your pain and I truly hope there is a viable solution to your situation.

I hope healing can begin in your family. It’s a sad ordeal to deal with.
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