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I'm the oldest (65 yo) of 3 siblings and have been spending about 9 months of the year for the past 3 years living with our 89-year old mom and helping her with daily care. I'm her health care proxy and have power of attorney.



Mom has dementia and can't do much for herself, though she is pretty healthy and until recently could walk just fine. We also have a terrific home health aide who comes 10-15 hours a week to help with bathing, exercises and companionship.



The other 3 months of the year, my brother who lives closest, stays with mom at night. But, it's taking a toll on him as his family life is more demanding and complicated than is my own.



Recently, my mom was hospitalized with an intestinal infection and is now in a rehab facility for past 2-3 weeks (her first such visit) trying to regain muscle strength. My sister and my brother want to put Mom in a nursing home/memory care as soon as she's discharged and my sister especially is being very aggressive about it. I personally would like to see Mom come back to live in her own home, the one she was born in and where she is most comfortable.



I'd be willing to retire from my job and live with her and my wife would support that decision. It's challenging to take care of Mom, but I actually enjoy it most of the time. My sister has flat-out refused to help with home care and my brother has reached his limit, which I completely understand.





This conflict, especially with my sister, is really stressing me out. I don't want to see Mom uprooted from her home and community and have to go to facility 3 hours away, where she'll know no-one and have far few visitors.



Maybe I don't see her decline the same as my siblings, since I live with Mom a lot. Maybe I am in denial.



This is my first post and I guess Im looking for advice and suggestions and experience. Thanks for reading.

Since you have POA, it is your decision.
What reasons does your sister give ?

Your mother should not be alone at all . She needs 24/7 care and it will get more difficult AND could go on for YEARS since you say she is healthy . Perhaps your sister is more realistic about the situation and is trying to save you from upending your life for some obligation you feel .

You have a very understanding wife FOR NOW . This may grow OLD fast . Why do you feel you need to upend your marriage so your mother can die in her house ? As your mother’s dementia progresses sadly the many visitors will stop coming even to her home .

Your sister isn’t doing any caregiving . It doesn’t effect her , yet she is urging you not to take this on . Think about that .

Read other threads here where people are in over their heads , and marriages in ruin. You may then listen to your siblings.
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JDPele Mar 6, 2024
Thanks for your input..it helps sort thru the situation

"What reasons does your sister give ?" My sister thinks it's crazy to care for our mom this way. She thinks that hired hands in some facility can provide better care and love than mom's own children and mom's home aide.

Believe me, my sister is not trying to save me from upending my life. She could give two hoots.

But, I take your points and will try to step back and listen to sibs.
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As PoA, you don't need to have the approval of any of your siblings if you are willing to do the hands-on, in-home care. And, your siblings aren't under any obligation to help you at any point, not physically or financially or emotionally. So, don't expect that from any of them and don't hold it against them. It's their choice and you can't assume anyone into the caregiving role... especially your wife -- she's the one who may be most affected by your decision.

Right now, neither you nor your wife can imagine how limited and stressful your lives may become if you keep her at home. As long as you read the other posts on this forum under the topic of Burnout and can honestly say that you're willing to change your Mom's care arrangement if your wife becomes unhappy with the commitment, then go for it.

Can you afford to retire early? Are you supporting your Mom financially or does she have enough SS/other assets to cover her needs and outside help?

Does your wife have aging parents? If so, what happens if they start to go south as well?
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JDPele Mar 5, 2024
thank you...this helps me process the many intersecting issues
especially, your point to "not hold it against them"...Im working on that.
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You'd be willing to live with mom and your wife supports that. Meaning she moves in WITH you or you do this alone?
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JDPele Mar 5, 2024
We live 8 hours away from my mom. Our kids are grown and out of the home now.

I don't think my wife would move in permanently but her job, as does mine to a degree, provides the flexibility of working remotely. So, she'd be able;e to come and help.
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Yeeow! What a decision! If you are willing to do it as it has been said expect nothing from your siblings. I cared for my parents, sister and brother. I expected nothing from my siblings until my father was bedridden and my brother wanted him home. I had a long talk with him and we agreed that if daddy came home my brother (eldest) would be in charge of bathing him. I would do other things. Well, when it did happen daddy was only with us for five days but daddy could not get out of the bed and he even with his ALZ he could not think of using a diaper. So for five days when he stated he needed to use the bathroom I would summons my brother, I would leave the room and daddy would use the urinal and it was good. As caregivers we need to set the rules and accept the consequences. So all that to say -- understand what you are doing and know that siblings will get mad, spouses will become jealous from lack of attention and you will become exhausted from the work. Blessings
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JDPele Mar 5, 2024
Thank you.
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If you have this much say in mom's care--as much as your sibs may be angry with your choice, they also don't have much of a say. You're not allowing them to have any say--and you're not listening to them. You also cannot expect them to jump on board this bandwagon.

Bring mom home and don't expect ANY help from the sibs. They have spoken their opinions and you must respect them. Even if it's through clenched jaws--they've stated that mom should go into care and your taking on 100% of her care--well, that's YOUR choice.

We recently went through this with my MIL.

My SIL would not even entertain any thoughts of placing MIL in a facility. She alone cared for MIL as she went downhill, slowly and steadily.

My DH wanted nothing to do with the situation--but out of love for his SISTER, he took early retirement and got on board the train that went nowhere. OB slowly stepped up also. (His own wife is ill and should not be left alone)

It was a huge mess and I sat back, with no voice or valued opinion as I watched these 3 individuals try their mightiest to keep MIL happy & safe at home.

In the end--OB cracked under the pressure. DH was PoA but would not do anything that opposed his SIL's will. So we had this going on for a year.

Even if DH and OB had not stepped up, SIL would have killed herself in the service of her mother. It was, well, ridiculous, and honestly? just stupid.

OB simply began looking at ALF's. DH went along with the ride. SIL thought she could still make FT care at home a possibility. W/O the PT help of OB, the 3 legged stool of support cracked and broke.

MIL wound up in an ALF and to the utter shock of the kids, she was deemed a level 4 care--almost a 5. She was actually in the process of being OK'ed for a placement in either the MC division of this facility or a psychiatric ward in a hospital setting. She had been in that state for months, yet the kids were too close to the problem to see clearly.

She died 8 days after being moved to the ALF, and she was never alone, not for a single minute, until the night before she died--it was Valentine's Day and the kids all wanted to spend at least a small portion of that day with their spouses.

I know the desire to make mom happy--and quell your own sense of guilt is hard. We lived it for years. It DEFINITELY impacted my marriage for the worse, and also OB's. We're now working on trying to 'find' each other.

In the end, you'll do what you want to do. As much as I bet you nobody on this site is going to be super supportive of that---it is, ultimately, up to you.

You don't need our opinions on what to do. I found that my SIL didn't give a hoot about what I thought, and my worries about how her 'choice' for her mother impacted 6+ grown adults--all she could see what was she wanted for her mom.

Your mother is not going to get better and better. She's going to have more problems and issues and she will eventually take over your entire life.

Sadly, I know this because this is almost always exactly what happens.

Do what you want and be mindful that your sibs do not have to support you in this.

(Don't mean to sound so judgy--but we're only 3 weeks out from MIL's death and still in the early stages of grief. I do know of which I am speaking.)
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JDPele Mar 5, 2024
Thank you. What you say helps me process our own situation. I appreciate it, especially when you are in the midst of just living thru this.
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Welcome to the forum!

You asked for feedback, so I will share my thoughts on your situation.

I took care of my mom in my home for 14 years with Parkinson’s disease and dementia towards the end of her life. It became overwhelming and exhausting for me.

My mom lived to be 95 years old. I see where your mom is 89. She may live for quite a few more years.

As you say, it’s not so bad in the beginning stage of care, but when their care needs escalate, it becomes more challenging.

I didn’t receive much support from my siblings. They had their own lives to tend to.

Your siblings have their own lives. Please don’t depend on them to help. Don’t risk destroying your relationship with them over your mom’s care.

A parent’s responsibility to their children is to raise them to be independent, right? That’s how I raised my children. I do not expect them to care for me should I need care in the future.

I would never want my children to give up their entire lives for me. Why should you or your siblings give up your entire lives for your mom? Do you feel that she would want that for any of you?

Your mom is doing what my mom did. She is going along with your decisions. I must tell you that at the end of my mother’s life she told me that she was sorry that I spent so many years caring for her.

I realized that I had trained my mother to become dependent upon me. This wasn’t good for either of us, in spite of my good intentions.

Mom’s care became more than my siblings and I could handle. So, she was placed in an end of life hospice care home.

Mom was perfectly content living in her care home. She had an excellent staff who took very good care of her. We visited her often and she was glad to have us visiting as her children instead of having the heavy burden of being her caregivers.

Please think about the possibility of having your mom cared for around the clock by a professional staff in a facility.

You can become more efficient as an advocate for your mom, than you can by being an actual hands on caregiver. Plus, your wife shouldn’t have to change her life to accommodate your mom’s needs.

Wishing you peace during this difficult time.
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Anxietynacy Mar 5, 2024
Beautifully said
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I had a similar experience and although my siblings weren’t as adamantly opposed to mom
living with me as yours seem to be, they have been extremely unsupportive. I have no regrets, however. Mom will stay with me until I feel I cannot do it, and when that day comes I have her on the list at a good MC.
I feel strongly that many people who respond on this forum are really invested in people doing what they wish they had done. I definitely understand how isolating and enraging caregiving can be, but sometimes it is also the right choice. I think you are the only person who can decide if it’s worth it to you to upend your life and marriage and possibly end your relationship with your siblings. As long as you always keep in mind things will change and you keep your options open, I think you should do what you think is the best thing for you and yours.
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Southernwaver Mar 5, 2024
Yes. He needs to keep in mind that things will change, meaning get worse as she declines. She will never stay where she is now and she will never get better.

I also wonder what his wife would say if she came here to post.
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JD, the beginning of the end of my marriage came about when my ex started working a plane ride away from where the rest of us lived. I realized in short order how peaceful it was to have him gone, and so did my kids.

Not only are you giving up your own freedom to keep mother "aging in place" in her own home, you're giving up the daily contact of your marriage which may not turn out well. Why are you willing to sacrifice SO MUCH to keep mom out of a Memory Care Assisted Living facility where she'd have more social interaction and activities?

A home is 4 walls and a roof. The importance you're placing on this house your mother has lived in her whole life doesn't make sense to what you'll be giving up to facilitate that. A job, a home of your own, your wife's presence, your community, etc. As moms dementia advances, you'll begin questioning your own sanity for making such a decision as you're changing dirty briefs and washing urine soaked sheets daily.

As long as you're willing to surrender when the price gets too high for this in home care, then I wish you good luck and Godspeed. I had my mother in Memory Care Assisted Living and it was the best decision for both of us.
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JDPele Mar 5, 2024
thanks ..this helps
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Don’t discount that moving her now will be better than moving her later. There WILL come a point in time where her needs will outpace your ability to care.

You enjoy caring for her now. With help. From your siblings.

You honestly have no idea what it’s going to be like to care for her by yourself as she declines. Please take off your rose colored glasses.

Your thoughts about keeping her home are nice. It’s very lovely that you would like to consider that. It’s not realistic imo.

You also are in denial about how this will affect your marriage. When you married your wife, you left your family to cleave to her. Your wife and your marriage are more important than your mother staying at home.

Yes, you are in denial.
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Southernwaver Mar 5, 2024
Also, how long would you be willing to do this? What happens if you lose the care giver you love so much to retirement, or injury or illness?

Golda’s mother lived until 109. Would you and your wife be willing to full time caregive for 20 more years?

Would your wife move with you or would you and your wife only see each other when your wife decides to visit?

Do you have any grandchildren? When will you see them?
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You’ve already been living with your Mom 9 months a year for 3 years . Does your wife visit you ?? How long do you go without seeing each other ? And now she’s willing to live apart like this all year ?
Did your wife say she would help take care of your Mom?
Or are you assuming she would ?
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Southernwaver Mar 5, 2024
I read that as the siblings split their time for a total of 9 months, so op does about a 3 month stint? It’s unclear.
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Hello, I am new to this opportunity to converse with others, so please forgive me if this feedback is too late. I have been in your shoes. Family dynamics can create additional stress to an already stressful situation, often bringing unresolved conflict to a head. That said, while making significant sacrifices for our loved ones is a common philosophy, there are other options. I am speaking about quitting your job, potentially putting you in financial disadvantage and career advancement. There may be options for home health care that is covered to augment care if not covered completely. I would look into Medicare/Medicaid services, Hospice, Department of Elder Affairs, and Area on Agency in your location for more resources and options. Institutionlization is extremely expensive and the care is less than desirable for those preferring to age with dignitiy in their own home (when possible.) I suggest you research options to present to your siblings to have a reasonable case. Conflict is never easy but deep down you likely all want the best outcome, use that as your foundation.
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JDPele Mar 5, 2024
Very true what you say. Much appreciated. Yes, we have a meeting set up in a week or so with an excellent lawyer skilled in navigating our state's Medicaid program. Finances are a huge part of this and that is a part of the puzzle. Thank you
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This is YOUR decision to make as you are the one doing the care and you are the POA.
It has nothing to do with the wishes or opinions of the siblings.
HOWEVER
I do not believe that, unless they volunteer time on their own, that you should expect their physical support in this care. It will be up to each of them individually to decide day by day what support they can give.

I wish you luck in this decision and in this care.
I myself always knew that my limitations would preclude doing one on one care in home; I never would have for a single second agree to do it or to regularly contribute if another sibling chose to.

I would suggest you do a solid good shared living expenses contract for yourself with a good attorney. I would hope you make it clear to your Mom that you and your wife wish to TRY this, but that if it doesn't work of ONE of you on every six months assessment, then placement will be necessary.

I do know you likely intend a good neuro-psych evaulation, and that you understand that your mother cannot likely be alone anymore safely, or soon will not be able to be.

I sure do wish you good luck.
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JDPele Mar 5, 2024
Thanks AlvaD this is solid advice. I have POA and want to do the right thing. We do have an attorney meeting in next week and I'm hopeful to get some good financial advice. Once mom gets out of rehab, and stabilizes in a month or so, her local care organization and the state's Medicaid group will give her an assessment that you mention.

I'm just getting stressed by my sisters insistence that she be transported directly from rehab to a memory care facility, which is way too expensive.

thanks again
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You are POA so it is your decision.
However you spending 9 MONTHS each year with your mom must be taking a toll on your marriage.
Unless you are able to retire with full benefits I think you are crazy for "quitting" / "retiring" from a job before you should. What will you be losing by retiring? Full pension? Insurance?

If siblings think mom should be in a Memory Care facility or even Skilled Nursing if that is needed don't count on the help that they have given in the past.
This would all be on you, you would not get the 3 month break that you have in the past.

Caring for mom will get a lot more difficult.
She will continue to decline.
You will need more help, you will need breaks. You can not do this 24/7/365.
You should increase the hours that you have help.

But bottom line...this is your call as you are POA.
The only way that that will change is if your brother or sister decide that they would want to become mom's Guardian. If they try to do that they would have to show that you are not caring for mom, that you are not making decisions that are in her best interest.
BUT getting Guardianship is not easy, it is expensive and it is time consuming.
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JDPele Mar 5, 2024
Thanks Grandma.. I hear you and appreciate what you say here.
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"I'd be willing to retire from my job and live with her and my wife would support that decision. It's challenging to take care of Mom, but I actually enjoy it most of the time."

Oh dear.

Your wife comes first. That was established the day you got married. Would you want your kids to put their spouse aside to live with you? As benign as 'taking care of mother' sounds, you'll be leaving your wife. For however long Mom lives. Your job, marriage, your whole world, will be tossed aside for Mom. This will not end well for anyone. In some ways it sounds like you'd be happy to just stay with Mom forever. Why?

I'm sure, like many on this forum, you have good intentions. But yes, you are in denial. Mom needed assisted living a long time ago. She may feel she is living independently, but she isn't. She is living in her home only because her kids keep propping her up. That is an illusion.

As things worsen, the Mom you know will not be there anymore. You say you want to keep her in her house and not move her where she has no visitors. But before long, friends won't want to stop in and chat anymore. She will not recognize them or not be able to carry a conversation. She may not even recognize you. Consider that assisted living has lots of people and activities that could be helpful as she declines.

You say it's challenging to care for her but you like it. Why do you like it? I don't think you have bad intentions at all. Just misguided ones.

Does it make you feel like a great son to swoop in and take care of her? That you gave up your job and wife for her, for likely years on end, because it shows how you're so devoted to Mom? I've seen this with some caregivers. That the more you sacrifice your life, the more devotion you have. Problem is, this is not love. It's martyrdom.

I don't mean to say this is an ego trip for you, not at all. I mean that you've possibly confused this level of caring for Mom as a way to soothe your feelings about her eventual decline and death.

But there is no getting around it. She IS going to decline and die. And you're going to lose YEARS with your wife. This was supposed to be your time to enjoy the empty nest phase while you're both still able to travel or whatever you wanted to do. What if your health fails (and caregiving can kill people, it's a fact) or your wife's does? You say your wife is okay with it, but it's common for spouses to say "sure, it's fine" because what are they going to do? Clamp themselves around your leg and beg you not to go? If your wife is fine with you being gone for months or years, it leads to wondering if she is happier without you there at all.

If you're hell bent on living with Mom... will you be comfortable bathing and toileting her? How will you handle it when she becomes incontinent? How will you handle it if she starts sundowning, gets agitated, or keeps you up all night because she can't settle or tries to wander off? The stubbornness and denial with “keep mom home no matter what!” can ruin an elder’s life way more than even the worst nursing home could.

Please stop and consider the future for all involved.
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JDPele Mar 5, 2024
Thanks Loopy. I came here looking for input and your comments are really helpful for me to reflect on my own motivations and what's best for the extended family.
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This is how it often goes. Aging in place (home) works.. until it doesn't.

It can stop working well when;
1. the care needs increase
2. the caregivers decrease their input (decide to pull back, burn out, fall ill themselves)
3. both - needs increase & care team shrinks

A review of the 'Care Plan' is then needed.

The care team can split into Home vs Facility.

Each adult is free to choose their level of input for themselves. It can differ. Insisting each offer exactly the same is not reasonable. Some will have dependant children, an ill spouse, live far, have a job with travel, or even no apptitude or wish to be a caregiver.

The Care Plan must work for EVERYONE in the plan. Otherwise resentment will grow.

So what's reasonable?

Your siblings step out.
If you wish to try Home for longer, you will need to replace them with paid care staff. Is this possible?

It will need;
1. funds (Mom's)
2. a team of reliable staff
(Sometimes being in a rural or regional area prevents finding staff)
3. a person to manage the care staff (this may be you at your choice).

What about a compromise?

Say another TRIAL of Home Care & re-assess in 3 months, 6 months? As Plan A.

Start researching appropriate facilities as Plan B.

My final words are to examine your own motivation. Ask yourself if you are feeling GRIEF? It would be totoally normal if you were.
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JDPele Mar 5, 2024
thanks Beatty..so very helpful and logical
just trying to figure this out..my brother and I are able to be rational, not so much my sister...but your words that the care plan needs to work for everyone is key..we will try..thank you
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I think you need to very kindly cut your sister loose. Let her know that you understand she is done with caregiving and she is no longer obligated to pitch in. She can stay a daughter and visit as much or as little as she prefers, and no overnights unless she wants.

You don’t want an angry and resentful caregiver for mom, so it’s in everyone’s best interest that your sister no longer caregivers.
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Southernwaver Mar 5, 2024
Or cut her loose as an occasional visitor, whatever the case may be. That may temper some of her pushiness.

Have you asked her why she has her POV? Have you listened to her reply?
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You and your siblings need to discuss your mother's needs in a meeting (or several) with the care manager/social worker at her current rehab facility. Ask the care manager to outline the tasks that your mom needs help with, the types of care that is available and that she qualifies for, and the expected date of her release from the rehab center. Bring copies of paperwork that give you the decision-making powers for your mom's medical and financial affairs. Let the social worker/case manager know what the current arrangement has been and what you and your spouse are willing to change to meet your mom's needs. Ask each sibling what he or she is willing to do to help mom. Help may be hands-on caregiving or it may be help that frees up some of your time (doing laundry, grocery shopping, running errands, yardwork...) or paying for service(s) that would help mom (or you). In the end, the person with the legal documents for health care decision-making and financial decision-making get to decide on what arrangements are made. Seems like that person is you - even if your sibling(s) do not endorse your decision.
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JDPele Mar 6, 2024
Thanks Tara..this is good advice and I'm trying hard to keep all involved and not be reactionary. Getting more in-home care is something I'm pursuing as an alternative to care facility. We had such a meeting with rehab case manager this past Monday and hope to have another in 2-3 weeks as mom regains strength lost while bed bound.
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JD, when you meet with the attorney, ask about farm exclusions for medicaid. I have read something here that said working farms are not the same as just a house. It could very well be that the farm doesn't have to be sold or go through MERP.

Best of luck with this hard situation. I will recommend that if mom is placed that you and your siblings have a meeting of the minds about how to advocate for mom to ensure she is getting the best care possible. Facilities are like every other business and right now, that means understaffed and possibly uncaring staff. You guys will have to be a presence and be willing to move her if the facility is not taking care of her. Don't get me wrong, not all facilities are bad and sometimes they are the best choice, you just have to be aware of the care.
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Geaton777 Mar 6, 2024
Yes, farms can be different. My son's partner comes from a family farm in PA and he was telling me how the succession is set up through a life lease. It may require a minimum amount of acreage. The Farm Bureau online has info on it.
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First of all, feel confident that you will see mom through. Start there. She is no longer able to care for herself. You are in the position to make the best decisions you can for her which means making the best decisions for the family as well. And yes, I think your position has you perhaps a bit close to the situation and not as able to see the larger picture.

Things need to be what’s as good for everyone concerned as you can make them. Your decision has a ripple effect. I would focus more on you and your wife and your immediate family as they will be the most affected.

About the facility 3 hours away. Which sibling is that near? Is that still 8 hours for you or further? Are you still going to have to visit mom as a long distance caregiver, only now you would be in a hotel when you visit?
If the 3 hours is to put mom in some equal distance location it might end up feeling like she is in the middle of nowhere alone.

People sometimes have a notion that to take care of someone in a facility is easy. It is not. Your mother will need an advocate seeing that her needs are being met on a regular basis.

What were your plans for retirement outside of being mom’s caregiver? Were you planning to return to her community? Will your wife have to also retire early or can she work from wherever she is?

Do either you or your wife have illness to manage now? Are you both active, free of diabetes, heart disease etc. Often I think we as caregivers forget that we are going to age as well as our parents. Medical care is not equal across our country.

When my DH aunt had to go into a facility at 94, DH did not want to move her from her community. I didn’t either but we are going on three years now. We live two hours away. I visit her once a week and spend most of the visit doing maintenance. And it’s needed. I wish I could say I don’t worry about her but I do. I don’t feel guilt, more like dread and resignation and being on hold. She has few visits during the year. She has outlived her contemporaries and many of her nephews. She has no children and very few family members who visit at all. She’s lucky to get a few cards each year. And she was a well loved and respected and involved aunt. Her most faithful visitor is from her church. She’s been on hospice for several years but other than being bedfast is in pretty good shape. For reference she didn’t become bedfast until 93.

I would listen to my siblings to a degree but if you already know you are the one who will be caring for mom, wherever she spends her final days, then do what is best for you and your wife. The decisions you make can be generational and affect more than where mom will be cared for..

A word about Medicaid. Your attorney will explain that mom can exempt her home for while she is on Medicaid and that a lien will be filed on it. So you may be thinking you will have time to deal with the home. In some areas taxes can be delayed for elders and will be paid after the elder passes and the property is sold. Otherwise, someone will have to pay the taxes and all the upkeep on the home. Mom won’t have the funds. So if she goes on Medicaid, just know that delaying the sale of the home can become a big expense. Many recommend selling it right away, using the proceeds to pay for her care and file for Medicaid after she has spent down. Be sure to speak to your attorney about your options. It’s a big job to be POA. Wishing you luck with all these difficult decisions.
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JDPele Mar 6, 2024
Thanks so much 97...this is really helpful and so very positive. 10-15 years ago our mom transferred ownership of her property to her 3 children. We share the taxes, landscaping and maintenance costs--she has a life estate to stay in her home.

The facility that my sister is pushing is down the street from where she lives, but still 8 hours from where we live. My wife can work from anywhere, but she prefers to stay in Maryland, where our grown children all live, rather than Mass. We are in pretty good health in our own mid and early 60s, but I'm starting to worry a bit about my own health due to the stress with dealing with Sis.

Appreciate the support and I will take your advice to heart.
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JDPele, because I saw you mentioned somewhere in a response that you were seeking to apply for Medicaid for MC (memory care) for your Mom, please know that in MA this is not something that Medicaid covers in your state. Most states' Medicaid only covers LTC, which is assessed as needed by a physician (it usually means the person is bedbound or has a profound illness requiring a lot of daily medical attention).

Source: https://www.memorycare.com/memory-care-in-massachusetts/

This means one has to qualify for Medicaid in 2 ways: medically and financially. In most states the "look back" period on the financial application is 5 years, so as your Mom's PoA it will matter a great deal how you manage her affairs. Each state has Medicaid Planners that will know the ins and outs of how to qualify. Sometimes a state offers a special financial trust where one can "off load" money in order to qualify sooner (and then upon death that trust money goes to the state as part of the recovery).
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waytomisery Mar 6, 2024
Not sure if Mom lives in MA since JD and Mom live 8 hours apart . Unless JD mentioned it somewhere and I missed it .
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Welcome to our world (posts here). Really, welcome. Glad you are here. It is an incredible / incredibly helpful site.

My sense:

1) you are the primary care provider - and you have the support of your spouse.
2) you have legal authority.
3) If I were you, I would commit to do what "I" (meaning you) want for your mom. If it gets to be too much, and it likely will, you can always make another decision.
I wonder if you know how much work it really can be - and will be. 10-15 hours of a caregiver won't be enough. You will be on or need caregivers around the clock 24/7.
4) Be clear that you are separating (in your head) the sentimentality of wanting her to be / live out her life in her home) with the reality of what her needs are / will continue to be, i.e., emergency trips to the hospital, incontinence (or already?), insuring she doesn't fall out of bed, or get out of bed... it goes on and on.

5) And, you want her to be as comfortable as possible. Make the decision on what is BEST for HER, not you or not as you would want the situation to be. She already has dementia / that could get worse. If she already needs / would benefit from memory care (24/7), then I believe that is your answer. Put your own wants aside and do what will serve her more / best.

I would though talk to MD, hospital, social worker, and start researching memory care faclities and ask them - what they offer.

You will burn out. No question even if you enjoy most of the care you are providing now. The relationship with your wife will change - as she likely will too (stress, wanting more 'us' time and not able to have it or it will severely decrease with the more time/care your mom needs). I encourage you to not take your spousal relationship for granted - in that I mean, that both of you will continue to feel as you do - a united front / intention. You want to put your marriage FIRST. (Or at least I would). You and/or you mom have the luxury to afford the care of a memory care facility - some / many cannot. It is a balance although don't lose your marriage / that connection due to taking on more than you can handle or think you can handle.

Still, if you want to 'try it out' for a while longer, do - you can always change your mind and place her in a memory care unit/facility (or so I believe). I do not know / see why it is 'essential' to do this transition now (or why your siblings feel that way). Perhaps this is a good question to them ... and medical professionals.

Gena / Touch Matters
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JDPele Mar 7, 2024
Thank you so much for your kind and helpful reply Gena. The many excellent points you raise I will think long and hard about.

One factor that is troubling me is the "rush" to put our mother in a memory care unit. The fact is we are not financially able to place her in a memory care for a long time. Her current assets will pay for only 4-5 months in a MCU. Then what? Of our siblings I'm the most able to help financially. Sis says she will contribute, but it's not a wise move imo, and brother can't help financially. My sister seems to think that this high-end MCU that she's identified won't "kick mom out on the street" once her assets are spent

I have scheduled a meeting, in 2 weeks, with an outstanding attorney who specializes in estate planning and Medicaid applications. Hopefully, that will provide us all some perspective and guidance as we navigate this situation.

Again, thank you for the advice from the heart. Much appreciated.
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You have posted early on that your sister “thinks that hired hands in some facility can provide better care and love than mom's own children and mom's home aide”. That makes your own view very clear. You DON’T think it’s possible for that to be true.

Some things to think about:
1) ‘Mom’s own children’ don’t always provide great care. They aren’t available 24/7 because they have to sleep. As they get more and more tired of it, they sometimes skimp.
2) ‘Hired hands’ are attached to people with hearts and brains. They often care a great deal about the work they do – as is the case for many workers, certainly for me and probably even you. The people with the hands go home to a different life, which keeps them fresh and sane. That’s a good thing. Over-involvement and burn-out are NOT a good thing.
3) ‘Better care and love’, certainly love, is not related to living in the same house or wiping her bottom yourself. You can still love your mother without being next to her, breath for breath.

Try to let your preconceptions go while you work out the best things to do. Your question asks ‘how to deal with siblings’, because ‘my sister especially is being very aggressive about it’. Your take on what you think your sister ‘thinks’ is actually one of the most ‘aggressive’ statements I have read on the subject. Don’t let your preconceptions ruin relationships with other family members. Read Midkid's enormous thread if you would like to see just how bad this can get.
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JDPele Mar 7, 2024
Thank you . I regretted my comment about hired hands as soon as I sent it. It wasn't right and thank you for pointing it out.

Maybe my "preconceptions" are wrong, but I see my mom now in a "highly rated" rehab center and she lies in her bed, sometimes wet and uncared for unless me or my wife or our health-care aide (I guess a hired hand that we love) comes into advocate. People are just over worked in these facilities.

I will read Midkid.

Thank you
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Please note that whatever decision you make, there will be guilt. There will be people who are going to judge you. There are some who can do this and it does not affect their family dynamic, but usually that is when all are in agreement. In times past families didn't have these options. Everyone took care of their parents when the time came. Times are different and people are different. Just know that whenever any change is made you WILL see some decline. It is inevitable.
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Southernwaver Mar 8, 2024
Yes and in times past, that job was usual put upon the oldest daughter or the unmarried daughter and she didn’t have a choice.
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Providing home care for your mother will eventually take a dramatic toll on you, your marriage and relationships with your children and friends. I agree with others who have suggested that you explore your willingness to essentially give up your life to take care of your mother when there are other options. One of the reasons that AL works so well is that caregivers get a break every day. They go home to their families, have days off and take vacations, all of which is necessary for good mental and physical health. Perhaps you could see a therapist to talk this out. Self discovery is essential to you while you’re considering the next steps. I wish you good health, happiness and good luck.
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JDPele Mar 8, 2024
I agree. Got my doctor's appointment in a few weeks and therapist is a good idea, Im thinking about--my wife says the same thing as you. Thanks
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JD,

Initially I thought it would be possible for my mom to live with me so I could support her for a time. I had been noting changes in her memory and odd actions, and I brought her to visit my home.

Thoughts of any type of homecare were gone the second night. It was the single most frightening event of my life, being attacked by my beloved mother. She attacked me while I slept and was delusional and hallucinating. She is fairly high functioning for the memory care, but for the safety of us both, it's where she needs to be.

That happening was a real eye opener for me. And it stopped me from giving up my life. I'm POA and monitor what happens with mom (she's less than 10 minutes from my home), but I also realize and see, she already is not the mom that I grew up with and knew and loved.

Don't think and make decisions based on memories. Look at the reality of the present.

Good luck in your decisions.
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fieldhouse Mar 8, 2024
“Thank you” for writing.
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My Mother who is 86 has lived with me and my family for 22 years, the last 3 with dementia. Had a brain MRI done Nov., 2023 and diagnosed with severe micro vascular dementia. Mom has gotten pretty bad both physically and mentally with stair steps downhill especially the last 5 mos. I am the oldest of 3 (66) and my brothers help in no way except one with verbal support. Know if her heart problems don’t take her first she will need to go to a facility at some point as I suffer from terrible chronic hives from the stress this has all put on me. Plus I know my very giving husband has given more than his fair share over the 22 years. Life is not always fair but her friends (who have gone through this with their Mothers) have told me there will come a time and I will know it. Praying I recognize that time.
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waytomisery Mar 8, 2024
fieldhouse ,
Chronic hives is your sign that it is time now .
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The siblings may be jockeying to have ALL the fun of caring for her.
Make them that offer.
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Listen to what members are saying about taking on too much responsibility. Pay attention to what OT, PT and social workers are saying about mom's recovery prior to rehab discharge date. Do not expect siblings to assist you here. Two suggestions, maybe 3... Seek legal help to ensure the POA will be effective for you to take over. Some POAs were written years ago and may not have enough"teeth". The second suggestion is to see a medical advocate. They may charge $200 an hour but they will be well worth it. My MIL's family did this when her $$$ would run out withing 6 months. She was a MA resident. The advocate gave a list of Medicad facilities that were the best in his opinion. Family researched and chose top 3. The problem with places is that there is a wait list for Medicaid beds but paying residents get top priority. Within 2 months a bed was opened to get her in. Within 3 -4 months, family was filing for Medicaid. Guess what? Current paying residents go to the top of the Medicaid wait list bypassing all others as a current resident. You are at that phase now. After telling you this piece of information, if you take mom in to your home and the money runs out, and you get burned out, will you be willing to wait several months for a bed to open up? And this might not be a top rated facility.
Your mom has been in rehab for about the maximum insurance days so you are already behind on this. So along with taking care of mom if you so choose, you may have difficulty getting out of the house.
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JDPele Mar 8, 2024
Thanks...great advice. Where do I find information on medical advocates?
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Without saying it directly your siblings are telling you that it has gotten to be too much for them. That is their right. As POA you can do what you want but you can't force them to bend to your will. If you decide to do this realize you are on your own.

Why is it so important to keep your mother in her own home and basically torpedo you life to manage that? How long do you think your wife will remain on board with this? What happens when your mother's care needs get to be more than you can handle even with a bit of outside help? At that point will you have a life to go back to? Why can't you bring her to a MC close to you and just visit all day long? At least you will be able to sleep at night. And if you were injured or sick you would know she still had others caring for her.
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JDPele Mar 8, 2024
I understand now what my sibs are saying and I am accepting it. Being on this site for just 2-3 days has opened my eyes to how my relationship with sibs needs to improve. I started the conversation asking how to deal with difficult sibs. Maybe I'm the difficult one! I get it.

I appreciate your questions. But, frankly we can't afford a memory care unit. Something my sibs don't seem to understand. But, in a few days we will meet with a respected estate/ Medicaid attorney and maybe then more options will emerge.
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I am sorry that you and your siblings do not agree. I have the same issue and it has not been easy. However, as POA and all, I am the decision maker and I just eventually had to be very clear that this is not care by committee.

I think you should discuss with your sister at length and understand her position.

There are many things to consider. All the other posters have already talked about your potential for burnout and the toll it may take on your marriage, etc.

When it comes to your mom, there are also things to consider. As dementia worsens, she becomes more of a danger to herself and you need to be ready. For example, my mother began to get up at night and go through closets looking for something (I never did figure out what). One night, she pulled something down on top of herself and cut and bruised her face. All I could think was that she could have been knocked out and I was at the other end of the house where I could not hear her fall while I was sleeping, since she liked to sleep in, it would have been 5-6 or more hours before I found her. She would also try to go outside to talk to people she imagined out there. We had locks that she could not operate but if she ever did figure them out (and people with dementia do odd things) she could have gotten outside. A friend's mother got outside in her nightgown during Feb in Philadelphia...that could have gone very badly! My mother fell three times trying to go to the bathroom because she forgot to use her walker at night. All of these things become less of a concern when there is a 24-hour monitor at a facility.

A word or two about facilities. It depends when, where, and what kind of facility as to the care mom will get. A nursing home or rehab hospital is much much different than a memory care facility. My mom spent a few months in a NH and spent most of her time in bed even though they had activities because she thought she was in a hospital. even though they would try to get her to go to activities, she would rather stay in bed so they let her. They had plenty of bed-bound people that needed to be changed, etc so she did not get immediate attention when bedding needed to be changed etc. Also, she did not remember to tell them that she needed anything so she didn't get a lot of attention (squeaky wheel theory). Now, at Memory Care, they get her up each day and take her to breakfast, then to activities. She can take an afternoon nap but they will get her up and moving after that so she does not just lay in bed all day. Because she is not in bed all day, changing is less frequent because she can get to the bathroom easier.

My suggestion is that you tour facilities. If you don't need it right away, you probably will eventually and it is good to know what is out there. Talk with your sister more and understand why she feels so strongly. Is the facility she likes closer to her where she can visit mom? At the beginning, you can go visit your mom daily and make sure things are as you need them to be. Eventually, you can go less often.
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JDPele Mar 8, 2024
Thank you
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