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My sister is constantly at Dad's care facility. She feels the need to micro-manage every step of his care. Being there every day, she has made him completely dependent on her. Even though she has a big heart, she can be argumentative, mean and intimidating to staff and other family members when she doesn't get the response she wants to hear. As POA, I have been told that she is impeding staffs ability to do their jobs and they are finding it hard to get staff willing to work when they know she will be visiting, which is pretty much every night. She refuses to believe that she is doing anything wrong when approached about it. The rest of the family is happy with his facility and care he is receiving there.


Help! Where do I go from here??? Any advice would be appreciated. Thanks.


What helped me when Mom was in the AL was my daughter. I am a little OCD. Not overcontrolling because I did understand the jobs a responsibility of staff members and their limitations. I would ask my daughter if I should complain about this or that.

Do you know anyone who has worked in rehabs and NHs? If you do, ask if they will sit down and explain to your sister how these facilities work.

Here is an example. In Dads facility, lets say, each aid has 5 residents. Breakfast is at 8am. At 6am aides start getting residents up. If needed, they have to toilet them, if needed new Depends. They have to dress them for the day. Now this is for 5 residents. If the resident can do this for themselves, ok, if not divide 5 residents into 2 hrs. The aides then have to make sure they get down to breakfast. At Moms AL aides were expected to help serve and clean up. Being an AL Dad is not suppose to be needing constant care. Aides do not babysit. When they have time they will sit with the residents and talk. Keeping them busy with activities is the activity directors job.

I complained that the aides were not putting Moms bra on (she broke out with skin on skin). My daughter asked me where the bras were. I said the drawer with her socks. Daughter said that is why no bra. The aides first put on bra and top, pants then socks and shoes. By the time they see the bra, she's dressed and they have other patients. I always hung Moms tops and slacks that matched together. So I started putting the bras on the hanger with them.

You sister needs to understand that she and Dad have to adjust to what works for the facility. Being nice to the staff goes a long way. Not saying there won't be times to speak up, but pick her battles. And having Dad rely on her, he will never adjust.

I would tell the facility that they have your permission to ban her from the facility.
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Reply to JoAnn29
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SandwichGen18 Nov 11, 2018
Thanks JoAnn.  Definitely making a hard situation of just the fact that Dad is where he is, even harder with all the drama on her end.  She takes him out of the facility nearly every day to run errands with her or just for a drive.  Now he expects it, sits and watches for her car.  Wasn't so bad in the summer when daylight was longer, but now that winter is almost here, it is dark at 5pm and snow is on the way.   I have had a horrible weekend worrying about how she is going to take whatever the facility has to say or restrictions they plan on imposing.  But I have to keep convincing myself that I can't feel bad about it if they ban or restrict her access, this was not my doing. I can't control her behavior, and sadly I can't make Dad better.  All I can do is make sure he is well cared for, fed, bathed, gets his medications, and is safe.
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Tell her she is interfering in dad's care and causing problems for the staff. Also, let her know that this will not be tolerated and it is having a negative effect on dad and his care. If she doesn't knock it off you have no choice but to limit her visits or eliminate them completely. As dad's POA it is one of your responsibilities.
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Reply to gladimhere
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I would think about setting up a formal meeting between you, your sister, and the manager of the AL. Plus possibly a ‘neutral’ third party with experience but not part of the AL structure (perhaps suggested by them). I think your sister needs to hear the concerns direct from the facility, not as retold by you, and she needs to be outnumbered in the meeting. If the meeting doesn’t result in a change of approach by your sister, at that point you pull rank as POA. The meeting should help to provide you with a clear justification for a ban if necessary, and protect you to some extent from your sister’s personal antagonism. I know that it is your father’s business too, but I think that bringing him into the meeting would be very stressful for him and not a good idea in terms of family relationships. I would hope that the AL manager would respond positively to this (although of course preferring you to sort it all out by yourself!). If your sister refuses to participate in a meeting, then unfortunately her refusal is the justification for a ban. Best wishes in a difficult situation.

PS I wrote this before you posted last. I'll leave it to you to think about whether this fits in at all.
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Reply to MargaretMcKen
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SandwichGen18 Nov 10, 2018
Thanks MargaretMcKen.  I agree with all that you said for sure.  I just hope she gets the gravity of it all and changes her ways.  Because in the end, it will be my dad that suffers as the rest of the family doesn't have nearly the "available time" to spend with him that she does being she has no kids or significant other.
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Who did you have the conversation with, when you were warned that your sister is impeding the staff etc.?

And what, exactly, is your sister doing that is so terribly unacceptable?

Reassuring stressed and jittery family members, who because they're stressed can often come over as plain... let's say "difficult," is part of the process of settling a new resident in. Good team leaders or managers or even just ordinary experienced aides should know how to cope with this.

The constantly taking your father out of the facility, though, is a terrible idea. He needs to become familiar with a new environment, just at a time of life when that is bound to take him a while. Uprooting him every day will make it much harder for him. And maybe, while you're explaining to her that she really does need to cut that out and it is vitally important, you can lead her gently on to understand the value to him of developing good relationships with individuals on the staff.

Try not to let her develop even more of a "her and Dad against the world" feeling. Remind her the idea is to help him adjust to his new home, not to struggle against it.
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Reply to Countrymouse
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SandwichGen18 Nov 12, 2018
Countrymouse I have spoken with several staff members as well as the head of the facility.  My dad had only two agitated outbursts in the very beginning, both of which had triggers we could identify.  Other than that, he has been pretty content.  His behavior is not at issue, only hers.  Berating staff is one of the biggest things.  She has no boundaries and has even "befriended" another resident, has been assisting this other person with tasks when there and consoling/comforting this other person in their private room, and even challenged the staff's handling of this person she barely knows.  Again...NO boundaries... 

I almost feel she is intentionally doing this so that he gets booted and she can quit her job to become his full time caregiver.  Sadly, mom is also becoming more cognitively impaired as well, but still functioning enough on her own to be in IL.   Problem with her taking on role of primary caregiver instead of just loving daughter is that she treats the rest of the family so poorly it is not a good fit.
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Would you consider asking the staff to record her "wrathful" behavior.  Maybe they can team up when she is going off on a staff member, another could record it on their phone.  You could play it back to her.  She may be appalled at seeing herself.  She may not realize how abrasive her own behavior is.  It may be a hard pill to swallow, but maybe the medicine she needs.  Does this idea sound too harsh? I hesitated posting it.  It may cause more issues...????
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SandwichGen18 Nov 12, 2018
Wakankasha yes that is a great idea.  I have actually started doing that myself when she comes at me.  I get accused of getting her and my conversations wrong all the time...well not when it is recorded.  Thanks for the reply.
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They can ban her from the facility.

Have you gone to visit when she is there and pointed out to her that her behaviour is detrimental and if she does not clean up her act, as POA you will request that she is banned?
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Reply to Tothill
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SandwichGen18 Nov 10, 2018
She only does it when other family members are not around.  It is so frustrating because the staff walk on eggshells when she is there.  I feel bad for them.  I have been on the ranting end of her wrath many times over the years and cannot defend her as I know how she reacts to things she doesn't agree with.   I have spoken to her about it and she says she has done nothing wrong.  Cannot see her own behaviors when they are happening, totally out of control...Facility has recently asked her to stop the undesirable behaviors, let them be the caregivers and do their jobs (really that is what we are paying so much for...).  Will see if it improves and for how long.  Sad part is, if she doesn't get a grip on things and comply they will limit her access and that ends up only hurting or Dad in the end as he has become so dependent on her being there every day.
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This may be a control issue and if it is you may be for a wild ride.

You might want to have a talk with your sister (maybe with the rest of the family there too) and explain that she will not be becoming your parents' caregiver and her access may be restricted if she cannot be more cooperative and respectful to the staff.

You probably need to start acting like the POA too. You shouldn't be worrying about your sister endangering your father's safety by taking him out of the facility at inappropriate times. She should be asking for permission to take your father out of the facility and have him back at a time of your choosing. Maybe the facility could help you out here by requiring 24 hour notice before any trips? If at all possible, please get your other siblings to help and present this as family decisions.

If this is a control issue, be prepared for your sister to ask your parents to sign new POA documents or bring a guardianship petition to take control. Prepare your defense now as much as possible. Document the problems she is causing so you will be in a position to demonstrate to a judge why your sister isn't a good choice as a guardian. Make sure your have documentation of your parents' competency so your can challenge any new POAs. Get ready but do not confront your sister with these possibilities - no need add a spark to a smoldering situation.

I sincerely hope you never face any legal challenges, but it is best to consider the possibilities before you find yourself in the fire. My mother's POAs were over a decade old from a time she had no problems at all. But when my oldest brother found he had been excluded from the POAs in favor of younger siblings he filed a petition for guardianship. Although there were some monetary issues, I believe the primary reason was he just wanted to be or felt he had a right to be in control. My attorney (who has an undergraduate degree in psychology) believes my brother shows signs of being an injustice collector. A couple of injustice collector characteristics are the normal rules of society don't apply to them and they see themselves as the ultimate judge over everyone else's actions; it's awful for you to raise your voice to them but perfectly acceptable for them to raise their voice to you. Some of your descriptions of your sister's actions remind me very much of my brother.
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Reply to TNtechie
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My mom was in AL to avoid "low
income"nursing home that siblings
had picked because they resented
taking care of her and resented my
POA (neither could continue to steal her money w/me in charge).
Mom was afraid in her new room&
didn't like her 2hr/day homemaker.
The facility had one aide to wake up,wash,dress, get 30 residents to
dining hall..in 2hrs (4min.each)so I
hired someone to come in help mom from 7am-9am.She also did
laundry,cleaned room,went to dining room for food.Mom didnt like her,resented not being home so I was driving an hour each way
twice daily to help her up and get
her dinner and help aide put her to
bed.It was too much so after 2wks
I began spending the night.Mom had OT/PT from 9am-10am after I left.I didn't see a change so decided to stay to talk to therapist.
First overnight,I was awakened by
doors slamming.Mom was in last
room and I laid there listening to door after door SLAMMING twice. When night aide entered mom's room,I told her to CLOSE the door
coming in&out for"night check".
She did the "check" 2x/per night.
No wonder the residents were all
zombies who only left their rooms
for meals..they were sleeping the rest of the time because no rest at
night! She told me she was just doing her job.I told her that is she
slammed mom's door,there would be a problem w/me.She stopped
slamming doors,told me she would
have to report me.So be it,I said.
OT/PT person arrived at 9:40am
(not 9am)was startled to see me.
She apologized..traffic.I asked if she was staying until 10:40 since
she was late,she couldnt.So I said
I wasn't expecting 1hr billing for 15min.She said that day was free.
Two nights later,I stayed overnight
..no door slamming.OT/PT arrived
at 9:25am,surprised to see me.It
was traffic.I contacted her boss&
requested someone who could give mom the full hour per our
contract. The AL facility served
the same meal every morn..sweet
water,bread,powdered eggs,bacon
Mom was diabetic,hated eggs.I asked for fruit.One resident said
she'd been there 3yrs&would kill for a banana.I asked for facility
meeting after new,on time OT/PT
commented on how aides were inappropriately working with residents with obvious dementia..
like my mom.He said they needed
training&welcomed his advice on
doing things differently.I asked him
AL mgr &dietary dept to meet.
During meeting he offered to do staff in service to teach how to best work w/ dementia patients.
AL manager declined help.When I asked about the dietary guidelines
they were following for seniors,I
was told"corporate"set them. I
asked bout fresh fruits/vegetables in meal planning..fresh,not in her
"guidelines"..just canned.I asked if
frozen cost a lot more.She said no.
Then why not have some frozen
and occasionally fresh fruit.Week
later..bananas,the place went wild!
Zombies were getting rest at night
&a piece of fruit.However,despite the ads that showed "fun",events,
etc..there weren't any. Mom was used to her senior daycare.They kept her moving,engaged&fed her
based on her diabetes.So I had bus pick her up after OT/PT take her to daycare&back.I noticed that
her dinner was being given to her
cold so she wasn't eating if I wasn't there to warm it.I asked an
aide,who mom liked,if she could warm it,leave mom in dining room
watching TV ..that way it wasn't extra work for her to warm it and just leave until bedtime.She did,it
worked well until she told me mom wouldn't feed herself.So I
had fruit in her room came@ night w/home cooked or Subway. She
loved the sandwich,ate every bit.
I knew she had good lunch at day
care.She cooperated more with helper once she started back to day care.She got dressed easier so
she could get on bus to go.It was
comical.OT/PT was difficult do I
often stayed to help them.Then I'd watch her board the bus,perfectly
manipulating her walker,no help..
doing exactly what she refused to
do in the PT session.She loved the long bus ride,arrived in time for
lunch and activities,then long ride
back..no other resident left except
occasionally.Mom lived
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Reply to dil9397
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Greetings!
It is not correct for your sister to be argumentative and mean toward the staff however she has every right to stay on top of your dad's care. In 2013 I almost lost my mother who was in a nursing facility. My mother is my world and I am a beast in a good way when it comes to her care. You must be pleasant but very direct with the staff. If I had not been at her facility all times of day and night, I would not have caught the male staff attendant standing over her bed just watching her. She took the same pills everyday when I noticed one did not look correct. It turned out on that one day to be the wrong pill. One day I found my mother sitting in feces. After investigating I found out she had been in it for over an hour when I arrived. This facility was not a bottom facility. It was rated very good. I have also lost three family members (yes three) in nursing facilities to no fault of their own. I backed off so their immediate family members could handle things and three deaths were the end result. I often wish I had stayed on top of their care with the immediate family. So To YOUR SISTER, good job with staying on top of your dad's care. Be direct but leave out being mean and argumentative!
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Reply to OntoaByrd
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Hi SandwichGen,
I'd like to comment on others' suggestions. In most AL facilities, video'ing is prohibited. You might get staff fired if they agree to it.
I've got a brother and SIL who are compulsive liars. I've recorded most of what they say to me and what they do because history shows they're going to deny it or change it later. But, when I've played it back for them to prove they said/did something they claim not to have said/done, they get angry and change the subject. So, I keep the recordings now for when they lie to others either about our parents or about me, so I can play the recordings to whomever they've told the lies. I'm not convinced that showing videos to your sister will change her or be helpful.
Also, others have said you can limit visits, time, etc.. as POA. That's a slippery slope. I have POA too but have been warned against restricting visits because it can backfire and appear that you are trying to prevent your Dad from seeing those he loves and them from seeing him, which makes YOU appear to be the controlling one.
I put my Mom in a rehab facility for a few weeks to get her back on her feet, but thought it would also be great for my niece to see her. I had banned her from the house (when I found out she had gone to my parents church to accuse me of assaulting them), and two hospitals restricted her visits due to her constantly distracting (and even calling!) nurses and her inability to refrain from creating drama.
So, what did my niece do at those visits to Mom's rehab facility? She spent every day telling anyone on staff who would listen to her that I must be watched and am dangerous (she's trying to get rid of me so can resume her position of control over my parents in which she was able to get a free car, a free house, and constant gifts of cash, all of which my parents stopped when I arrived in town).
I was only given a few hints as to what was occurring. CNA's would come running into the room when I arrived, and made odd excuses to be there. Or they'd walk into Mom's room, and instead of asking, "are you Miss B's daughter?" they'd ask "are you the aunt?" The facility director was a friend and she finally told me that my niece had been trying to convince Mom that she was there forever and that I didn't want her to come home.
I asked the director what she recommended. She said they could not keep my niece from coming there, in part because there's no guard stationed at the door. People come in and out as they please. And I suppose she also meant that, for legal reasons, they couldn't restrict her visits. Or they didn't want the nurses to have to become police. So, restricting your sister might not be as easy as it sounds and might not have the desired effect.
And, btw, you said your sister doesn't have an SO or kids. That is utterly irrelevant. There are plenty of annoying and/or obsessive and/or controlling people who are married AND have kids. We all see them all the time.
Bottom line:
This is the facilities problem, not yours. I cannot imagine ANY facility kicking a patient out because s/he has an annoying relative. They're in the money business, and they deal with difficult patients/family all the time, so they'd never make money if they kicked out every patient who has difficult relatives. Unless she's putting staff or patients in danger, they're not likely to kick her out, and certainly not your dad.
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Reply to kimsgoneinsane
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Countrymouse Nov 15, 2018
That's one of the most sympathetic and enlightening and constructive answers I've ever seen. Thank you.
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