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My older sister has been living with and caring for our mom for the past 6 years. I live 5 hours away and don't visit nearly enough but work full time and have an elderly mother in law nearby who needs someone close (we don't live together). My own mother has advanced COPD, is 80 years old and weighs about 90 pounds. She has a history of psychiatric issues, which have only been exacerbated as she has grown older. She is mostly of sound mind, but her memory is going and she is incredibly manipulative and very very good at it. She always was manipulative but has reached "Jedi" status now. She won't consider even putting her name down for extended care and my sister is burnt out. I can't bear to see my mother destroy my sister. I have asked my mother to consider putting her name down in a facility closer to me so I can help with the care. Even then, there is at least a 6 month waiting list for a good place so it's not an immediate change. I am now "the evil mean child trying to kick an old lady out of her home and lock her away". I swear I'm not, I just want her to be in a good extended care home when the time comes, and it not be a crisis situation. I would also like to help. My mother has personal support workers come in for a half hour each day, she has terrorized most of them, afterwards she "can't remember it" and is all "sweetness and light" when asked about it. She won't allow a hired respite caregiver to come in to help. The long and short of it is, my sister is exhausted and my mom doesn't seem to care, even if you bring it up. Mom is mentally well enough that she isn't incompetent although her memory is a little rusty. What can we do? I would appreciate any suggestions. Mom doesn't have a lot of people around her, she's driven most people away.

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I suggest the next time she gets all worked up and an ambulance comes, have them take her to the ER for evaluation. Once there contact a social worker and refuse to take her home as your sister is unable to continue caring for her and the home is UNSAFE. They will have to find somewhere to place her.
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Threeoffive Jan 17, 2019
I thought of that too!  I am really kind of leaning towards that.  I'm not sure if you can be legally charged with abandoning your parent or not though.
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It’s nice to see you’re trying to help both your mom and your sister. But it seems to me like it’s your sister that really needs to cooperate in this. Is she willing to stand up to mom and say she can’t keep doing this? It’s fine for you to be the bad guy in making arrangements for different care for mom, but if sister won’t cooperate or is manipulated by mom it won’t work. Make sure sister is on board with a new plan, for her health I sure hope she is
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Threeoffive Jan 16, 2019
My sister is on board with the idea but Mom has her so browbeaten and unsure (think of an abuse victim) that my sister can't think straight and stand up for herself anymore. I tried standing up to mom this weekend, it was pretty bad. I've lost all compassion I ever had for my mother. I would never harm her but I wouldn't do much to help her anymore. I'm really only concerned about my sister at this point.
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It sounds as though you are going to need to go into rescue mode for you sister. A family meeting could be helpful, don't you think? Like where you all get together in one room and say " mom, we cant do this anymore". With support from the RN, of course.

Just so you know, in functional families, adult children say " no, I cant do that" to parents. All the time. Your sister needs support to be able to say that.
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Threeoffive Jan 17, 2019
We are standing by to rescue my sister if needed but for now, she is feeling that she can handle things day by day. Another sibling is coming to help for a bit and Mom has agreed to allow my sister to have a few hours of respite a week (for now). Unfortunately if we all had a family meeting, my mother would feel ganged up on and would lash out. It would not end well.  Suicide attempts and self harming are not foreign concepts to her.
I am so grateful to people here for listening and being here. I appreciate it so much!  It has taken such a load off my mind to know we're not alone in this!
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If possible have your sister plan a nice little get away.
Tell Mom she has no potions with sister going on vacation. But she can choose the option she wants.
Option 1. Go to Assisted Living for a 2 week vacation of her own.
Option 2. Someone will come in for 2 weeks and she can stay where she is.
If Mom does not make the choice then you can make it for her and I would opt for option 1.
She may discover she likes living in a facility where there are some people that will "cater" to her, where she can eat her meals in a "restaurant style" dining room or she can eat in her room.
Yeah she will not like it.
She will probably rant and rave.
She will probably say you are "trying to get rid of her" or you are "trying to kill her"
Let her rant and rave.
You probably did some of the same when she made you or your sister do things you did not want to do when you were kids.
And remind Mom this is not a "forever" move it is a vacation...1 or 2 weeks whatever your sister can manage.

And you make sure your sister takes that little vacation.
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What does your sister want to see happen?

Your sister will pre-decease your mom if she doesn't have regular respite. Can you arrange respite for your sister, say, two weeks off? If mom won't let the respite workers come in, make sure they have orders to call 911 because mom is not safe at home alone.

Please have your sister call mom's doctor and ask for a referral to a social worker to start a plan for mom's care.
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I note from an earlier post that all of you children left home as early as possible. How come your sister went back, and ended up becoming your mother's resident caregiver?
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Threeoffive Jan 17, 2019
She was the only one of us who is single and able to make that committment. We all are kind hearted and want to care for mom, being unkind or disrespectful is difficult.  The one sister is better able to separate her anger from her love for our mom.
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Neither you or your sister (or anyone else) has an obligation to do hands-on care for an abusive parent!  You say your mom is competent, so let her make her bed and lie in it! She needs help? Well, she can hire it.  There is no reason why just because your sister is single she should be stuck with an abuser.  This is a very unjust, unhealthy situation - I'd suggest you both withdraw - your mom can make and implement her own decisions.  After all, she would not listen to you anyway, would she?
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Please keep in mind, you and your sister HAVE THE POWER!  You are both entitled to refuse unreasonable demands, indeed to make up your own minds, for yourself, what treatment you will accept from your mom.  It can be a life-saving act to just say "NO"!  I remember the first time I did - seemed to me the world rocked and I was never the same. You and sis set your boundaries, stick to them and you will save your lives.  You are not little kids anymore.
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Mom "seems" to want my sister to get away for respite but she is so difficult and miserable when my sister has to go back, it's just impossible. Rant, rave, cry, nag, guilt, you name it. She will upset herself enough to mess up her own breathing and heart rate and then an ambulance has to be called. That's when she becomes the "poor old lady who's children are being mean to her". She won't let us hire someone in for the weekend. She won't go to assisted living. She did go to physical therapy rehab for a few weeks but refused to leave her room aside from the therapy sessions. My sister is involved in wanting help. I tried contacting mom's nurse practitioner to let her know things are heading into a crisis stage. She answered back that she couldn't discuss it over email, and not with me (I'm not the POA) and thought that perhaps a "family meeting to discuss mom's future care needs would be helpful". I don't think we're even on the same planet. The best we seem to be able to manage is for a sibling to come and stay in the house with both my mom and sister for a week or so a couple of times a year.
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Riverdale Jan 16, 2019
I think the demands of your mother are becoming punishing to the well being of your family. I understand the difficulty but it seems very extreme and controlling on her part. Your sister deserves to survive.
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Enough is enough. Save your sister. I like lkdrymom's idea (right below this post).
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