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My brother has cared for my 96 year old mom in her home for several years. He takes her to doctor apt, does the shopping, cooking, and cleaning. She uses a walker and has a lot of joint pain when walking, so she spends a lot of time in her recliner. Her mind is great and she is relatively easy going, and is in reasonable health for her age. She is capable of being on her own for several hours during the day.
My brother shows all the signs of burnout and perhaps compassion fatigue. He doesn't leave the house except for errands. I live halfway across the country and visit about 4 times a year for a week or so each. I always suggest that he use that time to take a trip somewhere, or just visit a friend for dinner, but he won't do it. I've suggested taking walks, visiting the library, taking a class, etc., but he won't act on anything. I believe he's depressed (this may be a pre-existing condition from before caregiving), he also drinks a fair amount of alcohol, and sleeps a lot. He snaps at my mom frequently. I don't think my brother realizes how he's behaving, even when I confront him about it. This behavior has slowly worsened over the past year. I have tried to get my mom to move in with me, or even visit for several weeks, but she won't leave either. She's not open to leaving for a senior center during the day because of her mobility issues. What can I do when neither caregiver nor patient will leave so that they can get a break?

I don't think there is anything you can do.
Your brother may be "hiding" within his caregiver description. He's living with your mom, likely on his own SS at this point, and hers, and in her home (?) where he can safely hide, drink, and sleep.
And your mother is still "caring for" her most needy child, which is what some parents see as nurturing love. This has long gone on and unlikely to change.

What your brother NEEDS to leave the home for is AA meetings.
He almost certainly won't do that. He knows it's there.
These two are well and thoroughly enmeshed.
If this is your mother's home, hopefully she has left it to her son. He will almost certainly live out the rest of his life in it with his bottles as his companions.
That's a real life choice. He has made it. Your mom has supported it.

You have offered EVERYTHING, md.
You have offered care, respite, suggestions.
That's great. All were declined. Now you need to "leave it" as we say to our pups.
Once more offer that you are ever there if Mom would like you to come visit, or if she would like to visit you. IF you visit do not stay to sleep in the home. This will be intrusive and will lead to bickering.

Push will of course come to shove at some point, and you will get "the call" in which one or the other of them is "down" and help is needed. Son may well die before his mother if liver gives out.
Until then you are free, your life is your own, as are your decisions (just as their decisions must be THEIR own.)
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Reply to AlvaDeer
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I think Taarna says it best.
If your mother and brother are both happy with this arrangement, there is nothing you can do, and frankly, no reason to try and change it.

IF your mother is or becomes mentally incompetent, AND your brother is seriously neglecting her, AND you have POA, then you can choose a care option for mom which you think is most suitable for her needs.

If he has been living with and caring for mom for several years, then this is his (and their) routine. He no longer has friends to meet for dinner, and a walk is not enough of a respite. A vacation away would be great for him, but he may not feel comfortable leaving mom in your care for a week, if he likes having control over everything.
My perspective may be a little different from others here. I see many have jumped to the conclusion that your brother is an alcoholic. He may or may not be.
Your story touched a nerve with me. I have been the sole caregiver for my 63 year old husband for 9 years. It is hard to find any real help. I recognize that I use alcohol as a coping mechanism for my stress. I don't think I am an out of control alcoholic, or a danger to my husband. I really enjoy wine, and I carve out a window of time in the afternoons/evenings to enjoy about 3 glasses, before I have to go to "work" again, as my husband will require assistance until midnight.
I start at 6 or 7 am. Daily. Yes, I am burned out. But I like having a routine. And I don't have time to keep up on friendships.
I would really appreciate a family member to step in for a week, and allow me a vacation. But, that means I have to spend money to go somewhere else.
Try giving your brother advance notice when you plan to stay for a week, and discuss with him what he might like to do with that week. He is probably so caught up in his daily routine, he doesn't know what else to do. It wouldn't hurt to make suggestions.
It might be hard for him to "let go". Controlling individuals have a hard time letting others take over. Discuss with him in advance what he does, and what you plan to do with mom when you are there. That could alleviate some of his stress.
And, maybe he is an alcoholic. If your mother is mentally competent, and chooses this dysfunctional relationship with her son, there is really nothing you can do about it. Just be a daughter and let her know you are there for her.
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Reply to CaringWifeAZ
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Your brother is not only depressed but he's also drowning his sorrows with alcohol.
That can be a deadly combination, and I would worry more about your mom living with an alcoholic as if something were to happen to her and he's passed out in his bedroom, mom would be in big trouble.
I am actually going to a funeral this morning for a friends son who was just 49 years old and he chose to drink himself to death instead of dealing with the issues in his life. So very sad.
So both your mom and your brother need more help than you can provide. I would suggest calling APS and report the conditions that your mom is living under and that you're concerned for her well being. They will come out and do an assessment and make their recommendations from there.
There are NO easy answers here as there never are when an alcoholic is in the involved.
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Reply to funkygrandma59
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Don't ever take her into your home. Don't ever go to live with her. That's a sure recipe for burning yourself out.

The biggest problem here is not that neither brother nor mom will take a break. The true issue is that mom is getting substandard care from brother. There is no way that he, with his pre-existing condition, depression, anger, and alcoholism is taking the best care of mom.

There is much better care for mom in a facility than your brother is providing at home. For him to do an abrupt about face and suddenly become sober is not likely. At some time, such as when your mom falls and has to go the the hospital, there may be a chance for you to put pressure on mom's hospital social worker to see that she gets into managed care. Brother will continue down the path of alcoholism.

Advice to you is that you wait until that life-changing event with mom happens, do your best for her at that time, and wash your hands of brother because he won't want to change. Alcoholics seldom do. I'm very sorry you're in this situation.
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Reply to Fawnby
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mdcbkf Jan 17, 2025
Thanks for your helpful ideas, especially about using the hospital social worker to get her into managed care.
(3)
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Don’t move your Mom in with you. You are actually doing everything that you already can.

I agree with the suggestion below. At 96, your Mom will eventually land in the hospital. At that point, I would try to get her placed into AL.

If, in the meantime, if your brother realizes that he is in over his head, then he will let you know. The most likely scenario, however, is that a medical emergency on your Mom’s part will precipitate the possibility of a needed change.
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Reply to Danielle123
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Leave them alone . There is a saying " You cant bring a Horse to water and Make them drink . " Anyone who Lives to be 96is a miracle . Your brother Must Love His Mom very Much . Be Thankful she is being care for .
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TouchMatters Jan 21, 2025
He's an alcoholic.
An alcoholic, actively drinking, cannot provide the needed care.
She is not being care for, as you indicate.
(1)
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The Olympics have come to town. You can tell because there are so many people jumping to conclusions. Everybody's taking gold in jumping. We already have "certified social workers" recommending alcohol programs for somebody they've never met and read one sentence about. I have been a burnt out caregiver. A third party with bright eyes showing up out of the blue and stirring the pot is only going to anger everyone and create permanent rifts. If you unwisely choose to bring in the government, the government's going to come in and stay. You can't call them in and then say nevermind. So that's when Mom ends up in a substandard "memory care" facility and God knows what happens to your brother.

If you squeal to the government the way you're squealing now, your brother may even end up facing charges. And boy, won't you be the good daughter for having done that?

Leave them alone! You don't know what their dynamic is at all. Coming in from 2,000 miles away for one week a year does not tell you ANYTHING. All you wrote was speculation. That's all. There was no fact, only guesses.
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Reply to Cattypatti
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If both your brother and your mother are mentally competent, you can not change the situation. You can continue to talk to your brother about your concerns and encourage him to widen his world to include others in helping your mom.
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Reply to Taarna
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It seems they're comfortable with the living arrangement. However, if you're seeing a difference in your brother, maybe you should be talking to mom? If he's caring for her and doing all the financial stuff, sooner or later it will take its toll. You just can't walk away and stop caring for a week when you've been at this for years. You don't have a life anymore, where are you supposed to go and do things? It sounds like if mom doesn't want to leave her home, she's okay with her son. But if she's of sound mind, then maybe for his sake she should move? I can honestly say that having a few drinks and getting some deep sleep didn't hurt but I wasn't living with my mom. I'd go to work, care for mom,have a few before bedtime and on the weekend, I wouldn't drink at all.
I'd say that the poor guy is struggling with burnout and just can't get out of the cycle of being a caregiver. It's time to talk to mom about this. If she loves him,she wouldn't want to see him hurting. I know things got a whole lot easier when mom was moved into a care facility. If she does move, make it nearby so it's easy for him to visit. I don't know how anyone can "brand" a person who has stepped up and done their best to care for their loved ones. Your concern is noted though as your brother could be in the percentage of those who don't survive being a caregiver.
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Reply to JuliaH
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Explain to brother the phenomenon of caregivers often dying before the loved one they care for. His loyalty to your mom may prevent him from taking 'respite' but it is essential if he wants to see her to 'the end.' Now, his depression, and self-medicating for the depression, may prevent him from self-care. That is a counterproductive way to continue in what has been a familiar and 'comfortable' routine, for BOTH of them. Maybe on one of your visits, take mom out and about, leaving brother the house to himself for a change if he won't leave it; maybe he wants to rest in his own space. Or maybe feeling the change will motivate him to try a new way for both of their sakes; variety keeps things fresh, even if it's something small. And when you're not there, have mom's local friends or even a paid caregiver give the brother a break. It's hard to break out of a rut once we're in one, and sometimes we don't even realize it's a 'rut', it's just 'life', routine but also boring, monotonous. Change it up in small ways, repeated on a regular basis to add some variety without big disruptions.
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