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My mom is 84 and having trouble caring for my dad (85) at home. His dementia is growing worse, he often refuses to eat or bathe and he no longer cares to socialize with their friends. He's also incontinent and she has difficulty keeping him clean. He hurt his shoulder and it bothers him so he wanders all night and screams in pain most mornings till around noon. That means she gets little rest and the doctors say there's nothing they can do for his pain. (He has no stomach due to stomach cancer so he can only take Tylenol which doesn't help.) Mom thinks an assisted living facility with a private room near her house would be a great option. She could spend time with him every day there and participate in activities with him but still maintain her own health and independence at home. My sister is infuriated and wants mom to hire round the clock care at home instead. Mom doesn't want to have to live with a third party in her small ranch style home and feels she'd be giving up any freedom she may have in the few remaining years of her own life. I see both sides. Each wants my support. Both my sister and I live too far away to be a daily or weekly relief system for our parents so I feel my mom should have the final word, I guess, but if mom makes this choice, I think my sister will completely cut her off. My mom is a higher strung person who doesn't deal well with stress and I know she's doing her best but truthfully, it might be better for my dad to be away from her for periods during the day because she gets frustrated and has meltdowns. But I can't convince sis. She's aghast that mom would even consider putting dad in assisted living and thinks it's cruel and cold. Needless to say, dad also doesn't want to leave his home or his wife. I do feel bad that my mom doesn't want to try home health first but with no kids nearby, I understand that she'd have to always have another person in her home and she's just not the type to be comfortable with that scenario.

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Of course wife should have the decision making power here.  If I read this correctly, it is Mom who actually is in the trenches, so to speak, and sis who is at a distance.  Why would anyone think sis had the deciding vote?? Sounds like dad would benefit from better care than can be provided at home, in any event.   What is sis problem anyway? Doesn't seem like money is the issue - fulltime home care costs plenty. What the neighbors will think?  Who cares? Perfectly reasonable for mom to try to preserve some kind of normal life as long as she can.  If sis feels bad for dad - well, where is she?
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I couldn’t even finish reading this post. It is his wife’s decision not the daughter. How dare she interfere this way. When the time comes for me to put my husband in a nursing home it will be my decision and no one elses!!
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In-home services can help a person living with Alzheimer's and their caregiver

In-home care for a person living with Alzheimer's includes a wide range of services provided in the home rather than in a hospital or care facility. It can allow an individual living with Alzheimer's or another dementia to stay in their own home and can also be of great assistance to caregivers.
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sandy1955 Jul 2019
Home care is great but very few of them provide 24 hour care and it still puts alot of work and responsibility on the caregiver , many times at night when rest is very much needed. It sounds like Mom has a good plan, and she needs the break before it wears her out.
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Please, listen to your Mother. Her welfare should be considered under the circumstances. You and your sister do not know how difficult it is to take care of someone with dementia day in and day out and especially with incontinent and confusion! If you care about your mothers health and well being, go with her wishes. She's done everything for your Dad, but can not take care of the constant needs of your Dad any longer. It would be very important to realize that your mother has the best option for them both. Your sister seems not to realize what is best for all. It's not cold to want the best for your Dad and Mother. If your sister does cut off contact, it's because she's not dealt with the realization that your Dad has changed! I wish you blessing and the will to decide what is right for your parents.
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It doesn’t matter what your sister wants. Why stay neutral. It is too much on your elderly mother to take care of him.
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The OP has not responded in 9 days. I suggest reading her profile.

https://www.agingcare.com/members/imsusan2
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anonymous912123 Jul 2019
Interesting, might be a troll.
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I agree with the option of having the sister take over the care giving for a short while so that she understands the stress and responsibility involved. The bottom line is that it's your mother's decision and you should support her in her decision. Another option is for both of your parents to move into assisted living. In some communities, they would be able to continue to live together, but your dad's care for ADLs would be left to the care staff. Have your sister visit some of the assisted living communities with you so that she can see that the current assisted living communities aren't like nursing homes of years ago.
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Caregiving is so hard and it sounds like Mom needs help now. However since none of us can put ourselves in another person's situation and don't know the people involved, it seems alot of assumptions have been made about what has occured , with some mean comments directed at the writer instead of support. I hope she is ok.
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let sis know how difficult this must be for mom and all of you!
Or have her care for him!
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I agree with the posts below. Why remain neutral? To what end?

And, yes, let your sister take care of your dad for a year or two. Then approach the subject again.

Caring for an elder is NO joke. It is about 24/7 of the most tedious jobs imaginable punctuated with emergencies and decision-making over and over and over.

It is a job filled with love and caring. And also fatigue and frustration. One hopes that does not develop into resentment but it can.

Not to be underestimated!
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qattah Jun 2019
Great summary. Especially the "NO joke" part.
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If sis wants him to be cared at home then let her take him in to her home otherwise she should shut up & let mom make the decisions - it is very bad of sis to say what mom should do but there is no direct effort other than mouthiness on her part - the person who is being most negatively on a day to day basis is the one who should decide not someone who is trying to be a puppetmaster
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IMsusan2, hope you are seeing these responses as you have not replied since the original post. Best wishes on working this out for Mom's and Dad's best interests.
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My guess is, Sis is not angry at Mom, she is angry at THE SITUATION. However, THE SITUATION will not change. Be supportive of Mom. Ask what she needs. Get in your car and go spend weekends with her to help out. Sis's "anger" gives her a convenient excuse to stay away and not help! (Could be just a ploy. I saw this in my own family.). I would be interested in seeing your update to this problem.
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It's all contingent upon who will be doing the caregiving, and how much of a contribution they will be making. If you're willing to do the work then you get a vote, if not then you don't. simple as that
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Dad needs to go to the faciility. That is very clear.
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I agree with most of what has been said here. I'm appalled at your sister's position, but I think you need to be stronger than you have been. Your mother must be the one to make this decision. You need to support her. Do you feel scared of your sister in some way? I only ask that because I have a very bossy sister who does try to intimidate and boss others around. She doesn't care for Mom at all (although she claims she did in the past) but wants to tell me how to care for her. I have to have firm boundaries with her to let her know that this is NOT her decision. I also agree that your dad is probably well beyond AL, however. My mom is currently in AL and there is no one there who has the kind of problems that your dad has. :( He needs memory care or skilled nursing.
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If mom is telling you she cannot do it any longer and neither of you in a position to give relief on a regular basis, then the decision should be hers. Perhaps, you can tell this to your sister yourself - mom just can't do it alone and is not comfortable with someone in the home (not to mention hiring someone does not ensure things won't come up missing).
Tell sis, neither of you have a real dog in the fight. Either step up to the plate or let mom make the decision without having to feel guilty. She probably feels guilty enough as it is.
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Then your mom needs to tell her to move in and help take care of him.
Make sure your sisters knows what all is involved in taking care of him at home.
It is hard and I can tell you you’re mom will not be able to do it! I took care of my dad and I was 38 at the time and even then it was hard to change him, his sheets. Not being able to go anywhere.
Having to help him into the wheelchair to get into the car to go to the doctors appointments. Putting wheelchair into trunk. Then ask her is this realistic for our 84 year old mom to do?
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I a only child so when I made the decision to put my mother in assisted living it was mine to make and it wasn't easy. I actually cried because I wanted to take care of her myself. But I found out it is really hard.

My mother had a stroke and she was sent there after the hospital. She still had her apartment in a senior building. So soon as I felt she was better I signed her out. I would go to her apartment everyday cook ect this was very hard on me but didn't want to admit it to myself. Mind you I had my own family at home. One morning as I did everyday went to do my morning routine. She was not home I thought I would lose my mind she suffers from dementia. She was at the hospital. That day i decided she was going back to assisted living. I remember saying I will never put my mother in a nursing home. You never know until it happens. Just find a good one.
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I don't think you can remain neutral but that doesn't mean you can't see both sides and be understanding about your sisters feelings. It sounds like you get where she is coming from but you are further along in recognizing that Mom is the one living with Dad and both knows better than both you and your sister how much he really needs and how much she can or can't do. Mom obviously doesn't want to separate from her husband, she isn't looking to get rid of him she wants to move him practically next door where she can see him every day but she also has piece of mind that he is safe and well cared for. Mom has known Dad longer than you and your sister have and I imagine she knows that her husband would want her to have a life beyond his care as well and these are things your sister may need help seeing.

Suggesting your sister spend a week with Mom and Dad and then a week taking care of Dad while Mom goes to visit you or something isn't a bad idea if she is really that blind to the situation at home. It isn't easy to see and really understand how much things have progressed with dementia when you aren't there, even being in contact daily from a distance away is not going to give a clear picture, it's hard to recognize the changes in our parents, kind of like the changes in a young child when you don't see them for a while and no doubt your mom tends to paint a rosier picture on a daily basis it's a natural thing to do. Good for you for recognizing that mom's needs and wishes really can't, shouldn't be ignored she is going through a tough time too and needs the support. I'm sure it isn't easy for her to be making the decision that she can no longer care for her husband by herself and needs to move him to a facility, if you and your sister feel so strongly about this imagine your mom's guilt, after all she raised you and probably instilled the feelings you are having in you...before she started living reality. I would urge you to try and get your sister on board gently without fighting her if possible and then the two of you can help mom and dad make this transition as smoothly as possible. My thoughts are with you all, this is the right thing but not an easy one.
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Treat your mom as adult and respect her wishes!
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This is not an easy decision for your mom. It's probably tearing her apart inside and family do not know, what it is really doing to her emotionally . It's stress full and caregiving is an exhausting. There are issues with in-home health care that your mom will have causing stress.
SUPPORT your Mom....

It's not what you want, but what is NEEDED at this time ...
God Bless your mom...
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He may need more than Assisted Living due to his medical history and dementia. Look into Memory Care or even Skilled Nursing. If your family is coming apart over this, perhaps they will agree on 2 weeks of respite care.
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All I can say is this and I say it kindly. Unless your sister is willing to move in with her mom and dad on a permanent basis and share the job of caring for her father and mother it should be her moms decision not hers. I am 756 caring for my 79 year old husband and I am overwhelmed and exhausted. To think I might be 85 and doing this is unthinkable. I love my husband and will care for him as long as I can but when I can’t do it I will be the one to make the decision.
Unless you have been a 24/7 caregiver you cannot understand what it is like. Maybe your sister could come for a month and see what it is like. Assistant living and nursing homes get a bad rap. I am a nurse and have worked in them.
blessings to your Mom. Support her
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Ask your sister to give your Mom a break and she take care of your Dad for 1 week. This way your Mom gets a break away and your sister becomes a caregiver. I guarantee you her perspective will change because once you do the caregiving of bathing, feeding etc.. then she will see your mother's point of view. Assisted living is a good idea because it seems to be getting too much for your mother and the stress will eventually get to her as it is doing right now, Unfortunately, you need to take a side and understand from a caregiver, its not easy to take care of another person, especially at 84. Think about both parents and where they are in life. Your father needs care beyond what your mother is capable of and she needs to be heard and not chastised for reaching out for help. Assist her by researching facilities near her home; do the budget for his care; and assist her in making these decisions because eventually she may need this type of assistance in the future.
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Yes that is a tough one. Home healthcare is the best way to start or your sister should consider moving to help Mom. Other option is to find another house where your Mom can have her own space with the live-in HC worker being there 24/7.
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I can relate to both you and your sister's concerns.  These decisions are serious and can be physically & emotionally draining for everyone involved.

First, it would be better if you and your sister were on the same page.  You both have valid concerns.  Try to understand each other's point of view.

Secondly, I cannot stress enough -- get informed!  Long Term Care is very expensive.  Depending on how many hours are needed, Home Health care may be a more cost-effective option. 

I would suggest researching online to find out the average cost of Long Term Care in dad's State & if his State offers any assistance with LTC costs.  Every State has different qualifications.  Find out the cost of Home Health care for hours/days needed.  Keep a notebook of the information.

Find a good Estate Planning Attorney to advise you on how to plan, protect & implement your parents finances. Make a list of questions for the attorney.  Find out how to protect your parents home if your dad goes into LTC.  Ask about getting Durable Power of Attorney from your mother so you can handle finances if she were to become hospitalized or incapacitated. There are questions about Pensions, Social Security, taxes, insurance, burial benefit, etc. that you need to know ahead so that you can plan accordingly. 

Once you are well-informed you will feel more confident in making decisions with your mother & sister that are in the best interests of all concerned.   

It's definitely a difficult time of life. All the best to you and your family.
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LorraineDe Jun 2019
It’s the wife’s decision not the daughters. Both of them should have supported her decision especially since neither daughter lives close to their Mom.
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An assisted living facility isn't the right place for your Dad! He needs to be in a nursing home if he's got dementia, refusing to eat or bathe, and incontinent with shoulder pain. Will your Dad qualify for Medicaid? Visit some local nursing homes and talk to a social worker that is employed at the facility.
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… and thinks it's cruel and cold.
Your sister is absolutely right - my advice is that your mom should hire someone to stay with him at night time so she can rest. Assisted living facilities are just 'assisted living facilities' and even if he has his own private room it'd be worse as he starts getting confused or nervous later in the day or when the sun sets that they start pacing or walking …
And if he is all alone that wouldn't be good for him either.
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worriedinCali Jun 2019
Her sister is absolutely wrong and her mother needs more than a night time babysitter for her husband. But who cares about her moms needs right?
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Your mom is the one who made the vows to your dad to love him as best as she could. In sickness and in health DOES NOT mean destroying your own health for your spouse. Especially if she is an introvert, she may lose whatever real peace of mind she has left in that deteriorating situation by bringing in a caregiver. If she can afford assisted living, she should call before the bed disappears. I don't think neutrality is an option. Your mom is also deserving of care. If your sister cuts her off, your sister is not a loving nor understanding person. If your mom is making plans with an AL place, maybe they have a social worker who can reach out to sister? I'm not sure they do that, but sister needs her worldview enlarged.
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