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Mom is now in the moderate stage of Alzheimer's in AL facility that will transition to memory care. I see Mom at least 15 hrs each week, youngest local sis sees her 2 hrs per week, out of state sis and bro see her every 3 Months. Parents will/trust was 17 yrs old and stated eldest sis (out of state sis) was Medical POA. (I am # 2 of 4 Sibs).


My Sibs have ganged up on me that they "know best" even though I spend the most time with Mom. I provide 4-32 times more care than they do. When Mom moved to this facility big sis POA told me I could not talk to the staff- everything had to go through her. Local (lil sis) sis promotes herself as 'health care worker' even though she is a physical therapist. Eldest POA sis defers to lil sis to be her local 'eyes and ears' because of her 'health care background'..


This is pure bull-pucky since lil sis only visits 3 times per month. I have Mom at my house 3-4 days per week.


Plus, lil sis seems to have an agenda that Mom should be 'medicated'..she frequently sends texts/emails: "I called Mom tonight and she got agitated, I called the nursing station to check on her, maybe she needs anti-anxiety meds regularly?" It seems like lil sis is trying to establish a pattern. When Mom calls me with a "what is going on tomorrow?" call I walk her thru looking at her calendar, etc and she always gets calmer as we step through.


I understand there could be a point where Mom needs some meds..but from my frequent visits it doesn't seem we're there quite yet.


This disconnect coupled by their lack of visits and acknowledgement that I am the most familar with 'Alz Mom' frustrates and alarms me.


I have started to get comments by some of the staff that they only see me regularly but when other Sibs come they push their way around, lose patience with Mom and don't seem to really connect with Mom.


This is killing me.


I've talked with my significant other and if this escalates I have no problem going to an Ombudsmen or Elder Protective Services..anything less and I feel I would be failing Mom.


Does anyone have similar experiences and/or suggestions?


TIA

You are going to drive yourself nuts trying to control sibs thoughts and ideas. You visit the most to check on Mom. Yes you have more familiarity with mom and the care she is receiving. I do not read anything that would warrant a call to APS. Why would you contact them?

I would cut back on the time I spend with mom. This is effecting you and it sounds like because sibs are not as closely involved you are holding it against them. Give yourself a break and just accept that your sibs are not going to be as involved as you are. Accept what is happening and do what you think is right by mom. You can only control your own actions and thoughts.
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Rulanme Dec 19, 2018
The first reason I wrote about escalating is because at least two of my siblings (both via phone and in person) get Mother so confused, bombarding her with information that she gets agitated and starts crying. Even before she was diagnosed at her previous ALF I had two staff people and one cousin approach me that they personally observed the sibs confusing Mother and then berating her. it was the staff members that told me about the Ombudsman to assess if APS should be contacted.
The second reason has to do with financial things. There are some shenanigans going on, out of state sibs feel Mom should be paying for their gas, airfare, motels, etc. Funny how they were so anxious to get that Alz diagnosis to invoke Medical POA but they still keep having Mom sign papers and get them notarized and I am not allowed to know what's going on.
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If they acknowledged your contribution, it would force them to look at theirs’ and make them feel bad for not helping more. It seems that only when you live with someone with Alzheimer’s do you understand just how far and deep it reaches and being the primary caregiver, you’ve already had to go through all the stages of grief many times over along with the frustration and love it brings. Your siblings would have a lot of catching up to do to get as far as you have with your devotion.
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Lillyblue Dec 21, 2018
What an amazing, perfectly logical answer. You have actually answered my question too. God Bless.
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It sounds like you have developed a good relationship with the staff. I seriously doubt they would start medicating your mom solely on her mPOA's request. Keep visiting. Make the staff aware that your sisters may request regular anxiety medication and of your opinion that it isn't necessary.

Your POA sister is wrong. You can always talk to the staff. You can't make any medical decisions for your mom but you can share your opinions with them. She can request that the staff not share information about your mom with you, though, so tread carefully.

I would save escalation of the issue for a more serious problem than you don't like the recommendation your sister might make to the staff. For better or worse, your mom- when she was in her right mind -chose elder sister as medical power of attorney. But she only gets to make decisions. She doesn't get to prescribe medications. The nursing home staff and doctors are the ones who will decide what medications your mom gets. Try not to worry.
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I'm pretty sure that POA sis was told and then passed on to you that that there needs to be ONE person who is contacted with any issues and ONE person who makes any decisions because that's the way it is - you could be there every day all day but you aren't the one with the legal authority to make decisions or to question staff procedures. That doesn't necessarily mean nobody will talk to you, but it could if you are perceived as making a nuisance of yourself and trying to thwart the POA's instructions.
As for your sibs relationship with your mom - what exactly do you suggest should happen? It sounds like they are living in the land of denial and are unable or unwilling to take the changes to your mother in stride, the only way to save your mother from that is to cut them off altogether, something you haven't the legal or moral authority to do.
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At the ALF where my in-laws stay, the family can periodically meet to hear the ALF assessment of them. The assessment includes inputs from a variety of staff members. We have taken advantage of these meetings to get everyone (staff, local family members and long distance POA) to understand my in-laws needs/capabilities without getting into siblings battles. Perhaps you can set up a similar meeting the next time the long distance sib is in town.
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You are dealing with a tough, yet , not uncommon situation with sibs conflict when caregiving for an elderly parent. I agree that there doesn't seem to be a strong APS case. But still make the call to hear what they have to say. I fear there may not be much you can do legally as far as the medical POA. What screams at me is that you are spending so much of your time at the ALF. I would like to suggest that you start to focus on your self-care. Of course spend time with your mom. But you need balance and space. Caregiving will end some day. Your sibs won't come around to see things your way. Save yourself and let go of what you cannot control. Focus on your wellness and your life. In the end it is all you have.
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If your mother is able to sign legal documents (you mentioned siblings having her sign notarized paperwork), then maybe you can get her to change her medical POA to you. If she is sane enough for one set of legal documents, she should be sane enough for all legal documents. Do this sooner than later. If she is agreeable, definitely consult with an attorney. It sounds like you would have plenty of willing witnesses at her facility.
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mlface Dec 22, 2018
I was thinking same thing if possible attorney will do it.
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Rulanme;

This is a dicey situation. I can relate to the siblings being clueless AND not really visiting or knowing how to deal with mom. I researched a lot about dementia before we had to move mom and attempts to "educate" the brothers was met with denial or, even better, being call a 'know-it-all'. One brother is not local and at this point I don't expect him to visit anymore (he's no longer welcome in my house and we sold her condo, so he would have to pay for a place to stay and eat the cost of getting here.)

I would suggest seeking consultation with an Elder Care attorney. Generally most will do a one hour consult for free - if you schedule something, have as much HARD documentation as you can get your hands on and have all your questions prepared to make the most of your free consult. Although staff may tell you about incidents, more than likely they will not submit anything for you to back you up. If there were assessments, and any of the incidents were documented, you might be able to have these subpoenaed. You can seek guardianship (medical/decisions) and stewardship (finances), but it will NOT be cheap AND the others could fight you, costing more money and headaches. From what I have read, the courts can also assign an attorney to represent your mother as well (since there is contention AND she is on the cusp of being considered 'competent') and this could result in more costs if they decide to order evaluation. If both are approved, this would override ANY POA (and likely lead to more sibling contention, but you can block them out of your life if you need to!)

Generally the costs for this process can be covered by the "client's" assets, but if you don't have control of that yet, you might have to pay up and if approved recoup from her assets. If denied, you could end up eating all legal costs. If mom does not have enough assets to cover the costs, you will have to pay out of pocket, approved or not. This is why a consult with Elder Care attorney is advised - they will not be able to give you a total cost, but should be able to give a best/worst case estimate. Given that they fight you now, I would plan on worst case. They CAN and likely will contest.

Most posts I have read about APS sounds like this is a relatively useless avenue. If they are not there to witness the berating and agitation, they are not likely to do anything. It would be your word against theirs. Also, unless there is clear evidence of abuse, either physical or financial, they are not likely to do anything. Not being able to "relate" to mom in her condition and berating her could be construed as emotional abuse, but it doesn't occur often enough, from what you describe as their interaction with mom and isn't likely going to be enough for APS to get involved. Using mom's money to pay for their 'visits' may not be enough to say this is abuse of her funds. Morally perhaps, legally, maybe not. Sometimes a POA document can allow for this. Ours does not indicate funds can be used this way, but attorney recently said it also does not say we cannot do this. We three at least agreed to cover some of non-local brother's previous visits to assist in cleaning out/fixing condo. I do not pay myself for what I do.

Others suggested cutting back visits with mom. I do not agree with that - your visits with your mom are not really what is upsetting you, it is the negativity and lack of acknowledging your care and insight from the others that upsets you most, and seeing mom upset by them as well. THAT you cannot change, you can only try to block it out and not let it upset you. I would continue to do what you do for your mom and try to just ignore them (it isn't easy, and it is hard to see the effect on mom, but don't let their crap distort things.) If mom is upset by them, do your best to redirect her focus and calm her as best you can. It is not likely she needs medication for this.
TO BE CONTINUED - see my replies (2) to this, ran out of characters again... :-(
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disgustedtoo Dec 21, 2018
Curious also that you state eldest sis was designated Medical POA. Is there a DPOA assigned? Medical allows the person to be included in medical information and decisions, but does NOT grant that person decisions for financials. If possible, get your hands on the original documents, just to be sure!

Also curious about the little sister text/email "I called Mom tonight and she got agitated, I called the nursing station to check on her, maybe she needs anti-anxiety meds regularly?". Your older sister CAN grant someone to be allowed information (which can block you if she doesn't agree to it.) Has she done this? If not, how does that sister call and "check on her"? Since you do spend a lot of time with her, I am sure the staff is aware of that and can provide some insights, but if not "allowed" by sister, they legally cannot include you in sharing any medical information or making any medical decisions.

So, best advice is to keep on supporting mom as you best can, try to let what the others say and do not upset you and SEEK LEGAL ADVICE from an Elder Care attorney (if possible use the one who drew up the original documents)!
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Part of it is that saying something out loud makes it real. As long as no one acknowledges or validates it, then it's not true that you do more. The other part is family dynamics, siblings forge alliances to balance out power. If you have something on them because you're more responsible than they, then they will forge an alliance to "act as though" it's not true.
You're right you do have to protect her if they are pushing her around. You're the one there, not any of us on this site. You have to use your best judgment, not mine or anyone else's.
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because if they refuse to acknowledge, they they won't feel guilty for not doing their share.
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