International caregivers, input needed. Any pointers are appreciated as I am starting my decision making journey.

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I have been living in the US for 18 years now and a US citizen. My brother have been living in Portugal for over 30 years now. Reality is not pretty but I am going to say it: my mother is a toxic parent. Her anxieties, control and OCD have drove both me and my brother to move as far as possible right after college. As a 25 year old I would fall apart when I was due for a phone call. There has been times when I felt like the phone cord was strangled around my neck from 9000 miles away. Over the years I learned to control the flow of information I was willing to provide and fought for my own independence from afar. My husband has been a great support in the process. While my brother stayed away as much as he could, I tried and tried to rebuild our relationship with fairly good success. We travelled home every year for the past 13 years for 2 weeks. It has been a huge strain on our financials. I feel a lot of the control, bitterness and anxiety has landed on my dad's plate once I moved away. It has been breaking their relationship down, and ending them up in a situation that they can no longer or willing to handle. My mother is bitter and hates the place. At this point they are totally alone with minimal check-ins from my uncle and his wife. The problem is that my mother does not drive and my dad is getting weak. When there is an emergency my uncle has to be called and he is less and less willing to do it. They never had much social life they said they always 'lived for raising us'. Since we left their social life went to 0. For the past 18 years they have literally spend weeks and months without getting out of the house and the yard, especially during winter, other than picking up food, and literally lived (or survived) for us to visit. Over the summer my parents and I have discussed what should happen to them. Time is pressing and 2016 is THE year. We discussed several options. 1. They allow a social worker to help them with going shopping, medication etc. a few times a week. - My mother refuses to let anyone into the house. Partially I understand, as the system is a lot less reliable and open for fraud than here. On the other hand I am shaking my head at her attitude. 2. They move into an elderly home. - my dad might have a chance, for my mom we would have to supplement. Conditions in healthcare over my country are very bad. Even though they have free social healthcare it is falling apart. Doctors are scarce, nurses are way overburdened. Sometimes they oversee and entire floor alone. I had a chance to experience it this summer and God forbid either of them have to stay in for a more serious illness. Often money is taken but service is not provided. Plus there would be no supervision possible from us to make sure they are being cared for properly. 3. They would live where they at, and once my dad passed they would move to my brother. - Honestly I can't wrap my head around this one. Why would you take one but not both? My mother hates my sister in law, and the feeling is mutual. So this option is almost out of the question except for the fact that she would have free healthcare. 4. I move them across the pond to live with my and my husband. - His kids are grown and I never had one. It would be the 4 of us. Through family unification I would be able to get them a green card and of course I would be fully responsible for their expenses. We are looking into health insurance and I am prepared that it will not be cheap but to be honest looking at the numbers and the uncertainty, it scares me out of my socks. Their retirement is $800 a month together and once my dad passes it will be only about $300. Their savings will be minimal compared to the US. My mother argues that her family have been pretty healthy. My moms family lived into their 80s ( she is 72 now) and when they pass it was because of heart issues and in their sleep. My dad is at the age when my grandparents died and with this summer stroke he might go fast when time comes. But again there is no way to foretell the future and at this point I think she is saying anything to get in.
The problem is that while solution #4 is their best option, I am terrified of the historical emotional baggage and the possible life breaking financial burden.
Anyone in same or similar situation? How to navigate this? Any pointers are appreciated as I am starting my decision making journey.

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It sounds like a minefield to navigate for you! NY-DIL is basically very right, and I would also give the strongest possible consideration to letting them stay where they are and giving your brother the most support you realistically can financially for their care, which he should be expected to provide on a solo basis. You have to weigh how often to visit in person versus saving the money for their material needs - maybe see if you can set up Skype to visit more often that way.
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Dolna - your mother is a toxic parent and you want her to move in with you or your brother so she can ruin either your marriage or your brother's marriage? Your #3 option above assumes that your dad will pass before your mother and it would be your toxic parent who would move in with your brother and his wife and that would be a good idea how? Even if they had $1,000 a month that would be spent in one week in America. I'm sorry to be so blunt but I think you've bitten off way more than you can chew given the distance - both physical and emotional - between you and your parents. In my opinion, offer to help your brother come up solutions that work for him AND his wife. It's not a one time thing either. Your parents will continue to decline and more problems will require more solutions. You and your brother cannot fix everything all at once. Proper meals are important and perhaps the top priority. That they don't leave the house is their choice. That they don't have friends is their choice. That they didn't build a life after raising you and your brother is their choice. Finally, don't guilt your brother into taking your parents into his home. You will regret it when he and your sister-in-law blame you for ruining their marriage.
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CM couldn't agree more - don't move them to the states Dolna - you will seriously rue the day I suspect if you do.
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CM makes some excellent observations and points.

The language barrier would render them virtually helpless outside of your presence, especially if they eventually need to be in a facility. I once saw an older man at a rehab facility; he spoke no English. The staff couldn't understand his Russian and they couldn't understand his English. He was miserable, flailing about trying to communicate.

His family came in once, swaddled in what appeared to be expensive furs and parading through the facility as if they were runway models. They spent a few obligatory moments with the man, then left.

I can't imagine anything more cruel than abandoning someone who can't communicate in the predominant language to a facility in which he can't even convey his needs.

Your parents have allowed themselves to become virtual recluses, looking forward to your visits for apparent socialization. This was their choice; they made their decisions, and unfortunately must live with them. Even if they wanted to change, it would be difficult at this point.

Bringing them over is a bad, very bad idea.
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Dolna…

What makes you think taking care of your mother, who speaks no English and would be wholly and utterly dependent on you for everything, for possibly twenty or more years, would work now; when your whole life has been about trying to build fortifications to keep her out?

Ref. the money: my late great aunt (who I loved very much, by the way, but that's not the point) moved in her eighties to the States to be near her only daughter and lived in a goodish facility. She ripped through what must have been about $440,000 of capital - she sold a house in London and had a legacy from her sister-in-law - in next to no time; plus she had a very good pension but not enough to provide the one-to-one care she needed to stay in Assisted Living, so she ended up in a nursing home anyway. Look at the price of medications in the States: it is INSANE. Health insurance would be ruinously expensive, too. Bluntly, I'd say it's unaffordable because your mother - may she live forever, but - will live too long at an advanced age, not least because heart disease is a good deal more treatable now than it used to be.

Rereading your description of how your parents are living, I am genuinely sorry for their situation. No one would like to think of any elderly couple struggling. But here's the thing. Their circumstances are their own creation. Lived for raising you and your brother? I'm sure they did a good job, and were good parents, but that's twenty-five years max.: what about all the other years? They have had ample time to look ahead and plan for their old age; and while it isn't a question of blaming them for not doing it - many people don't, I haven't for one - the key point is that you had no power to arrange their lives before, and it is not your responsibility to solve their problems now.

I raised my eyebrows, too, at the notion that your mother would move in with your brother and his wife. Did anyone consult your SIL about this?

I know that austerity in lots of European countries is an issue, it's true; but still the services are there. In your place, I think what I'd do is get hold of the names and contact details of social workers local to your mother, call them up and ask their advice. And talk to your brother, share any information you get with him. Your parents' wellbeing is at least 50% his problem.

Above all, do not allow yourself to believe even for a moment that once she's in the States your mother will be a different, happy person. That is a fantasy. She will be totally isolated for real reasons, not just because of her preferences and temperament as she is at the moment, and I guarantee that you will be punished for taking her away from her home and everything she knows.

Focus on your parents' needs, not the elusive concept of your mother's happiness. Think in terms of practical adaptations to their home and services to support their independent living. For your own peace of mind, remember that you did not create this situation and you cannot - not don't want to, not can't be bothered, you CANNOT - magically solve it.

Finally, take with just a pinch of salt the picture your mother paints of your parents' going into suspended animation, living only for your and your brother's visits. You're not there, remember, to see the neighbours drop in, the postman stop for a chat, the priest checking in every so often maybe? Okay, nothing you'd write to the newspapers about perhaps, but I doubt if it's quite as bleak as she lets on. You have to *talk* to social services, after all, to tell them to go away!
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Do not move them to the US. The culture shock alone will send your mother into a spiral of negativity. Old people are like big trees- they do not transplant well. Nor should mom live with the daughter in law. This will trigger Queen Bee Syndrome. No hive has two queen bees, one has to leave.
Mom needs medication for her negativity, whether it is anxiety or depression, it has to be treated right where she is. No move will fix that.
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Please re-read your question with this in mind: The FUTURE is so much like the past and present, only more of it.
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Let me start at the beginning. In my world view ( and that of my parents) people should expect to care for themselves, once they are adults. Parents are expected to love their children, make sure they become educated and learn something that qualifies them to earn a living. Adult children are expected to respect their parents ( not necessarily love them) and certainly should not be expected to give up their livelihoods for them.

Do you think you and your brother "owe" your parents your lives?
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I forgot to add, neither of them speaks English, which if they are with me and my husband, is not a big concern but they would be reliant on us 100%. I also have concerns about culture shock as they are very traditional even for the old world.
I am the main bread winner and working full time and I don't plan on quitting. For one I worked way too hard to prove my worth and independence and also financially if we have them here we might not be able to do otherwise.
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