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Brother has been taking care of dad. he has reached the burn out stage. there is nothing i can do to help. dad is stil aware of surroundings and i hate to see him go to a nursing home. brother cant handle his incontinence and has to do something. he has poa and i am truely helpless here. need advice on feeling guilty

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If your brother needs relief, get it for him ASAP. But that doesn't mean that you have to step in if you aren't able. Caregiving isn't for everyone and I tend to think it's the hardest job in the world. There's nothing wrong with not wanting to get into all of that. It doesn't make you a bad daughter or a bad person. When I was my dad's caregiver my brother would tell me that it was a good thing I was doing it because there was no way he would be able to do it.

But if your brother is needing out and you aren't able to take over then your dad will need to be placed in a nursing home and placing a loved one in a nursing home always comes with a little guilt, in my opinion. I had to eventually place my dad in a nursing home so I understand the guilt. I think it's normal and doesn't indicate that you should take over caregiving duties.
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Sometimes the exact right way to help is to realize we ourselves can't do it. I think we would be amazed at the deplorable conditions some people grow old and die in because family believes SO strongly that they cannot put their loved one into a care facility . . . like that's a betrayal...a surrender...or they refuse to spend "their inheritance" on getting their loved one proper care.

If that's your brother's decision, he's making the hard choice. If you support him at every turn, your dad will have a much easier transition; your brother will get the relief he desperately needs; and everyone can rest easy that your dad is being kept safe, clean, well fed. That he's have some social stimulation, many touches and smiles.

Nursing homes and assisted living facilities are not the snake pits we sometimes believe they are.

Support your brother's decision -- whatever it is. Dad entrusted his care to him. Your job to help keep the faith.
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Save your brother, please. And believe me when I say some of these places are very nice. Go up to the Search Site box and type in your city and state. Start looking around and also go to the Money and Legal tab and click on Paying for Care.
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Um.

There are options besides A living at home through to Z Nursing Home - what help is your brother getting with your father? Is it just the incontinence that's the issue? Or is that more like the last straw on top of a number of other issues that have already stressed the poor guy out over a long time?

I'm not saying NH isn't the right option, just that you and/your brother might have plenty of others to consider. It's always worth exploring the possibilities. Or have you already passed that stage? The best help you can offer your brother is to help him think through how to manage your father's care, then support his decision and do your best to be positive about it.

About you, and feeling guilty. Guilt is your conscience's way of telling you to check whether you've done all you can. And you have. So tell your conscience that if it has anything more to say it can either come up with some constructive suggestions, or else get lost.
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Please save your brother and both of you seek out reputable nursing homes or assisted living. I agree with the above. It's a very difficult call, but to save everyone's sanity and wellbeing, it's probably the best choice given the circumstances.

Best to you and your family…
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littlebit2, you can be helpful by supporting your brother wishes that it is time to place Dad into some type of continuing care facility.

Your brother is burnt out because he's doing the work of 3 people.... at a facility the workers work one shift, go home, and the next day start fresh.... your brother had been doing all three shifts. Be proud that your brother was able to put in the time that he did.

And don't feel guilty that you haven't been able to help out doing hands-on care. Not everyone can be a Caregiver, just as not everyone can be a doctor, a pilot, a lawyer, a firefighter, etc. You can send good wishes to your Dad, send him a box of things he might like, call him on a regular basis if you can, etc.
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Have you looked at the cost-benefit of having an in-house help to take care of your Dad and give relief to your brother? Somehow you have to come up with a solution that is acceptable to you, your brother and comfortable to your Dad. -
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I would agree with joesfortune, investigate paying for help in the home as well as AL and NH facilities. I would have a urologist check your father out to see if the current incontinence has a solution or not. If your father is still alert mentally he would probably find living in a NH less than stimulating. However, your brother can not cover his care 24/7 without help. Good Luck.
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U.S. Department of Health and Human Services (HHS) created a new organization, the Administration for Community Living (ACL). so we can live at home

About ACL http://www.acl.gov/About_ACL/Index.aspx

All Americans—including people with disabilities and older adults—should be able to live at home with the supports they need, participating in communities that value their contributions. To help meet these needs, the U.S. Department of Health and Human Services (HHS) created a new organization, the Administration for Community Living (ACL).
ACL brings together the efforts and achievements of the Administration on Aging, the Administration on Intellectual and Developmental Disabilities, and the HHS Office on Disability to serve as the Federal agency responsible for increasing access to community supports, while focusing attention and resources on the unique needs of older Americans and people with disabilities across the lifespan.

Caregivers
A caregiver is anyone who provides help to another person in need. In this section, we provide links to a wealth of information on the Internet designed to assist family members and caregivers.
Alzheimers.gov
This site is the government’s resource for Alzheimer&rsqup;s and related dementias.
Alzheimer’s & Dementia Caregiver Center
This site provides information about day-to-day help and services in your community; getting support; or preparing for the future.
ARCH National Respite Network
The ARCH National Respite Network and Resource Center provides resources to help families locate respite and crisis care services.
Consumer Information
Respite Locator
Family Caregiver Alliance
The site contains a wide array of publications and services based on caregiver needs, including a Family Care Navigator.
National Alliance for Caregiving
The site contains publications and resources for caregivers, including the Family Care Resource Connection, where you can find reviews and ratings on over 1,000 books, videos, Web sites, and other materials on caregiving.
Caregiver Action Network
The site offers a virtual library of information and educational materials for family caregivers.
eXtension
This website was created by the United States Department of Agriculture (USDA), Cooperative Extension System. Here, caregivers and advocates can access a wide range of information and materials designed to help them learn about and provide supportive services to family and relative caregivers. Topics include disaster preparedness, military families, grandparents raising grandchildren, housing, and nutrition.
HHS Office of Women’s Health (OWH)
The OWH website provides an extensive list of links of interest to caregivers.
Older Adults
Alzheimers.gov – This site is the government's resource for Alzheimer's and related dementias.
Eldercare Locator – The ACL Eldercare Locator is a website and call center that links you to state and local agencies on aging and community-based organizations that serve older adults and their caregivers.
Check for Benefits – The BenefitsCheckUp Website helps consumers find benefits programs that help them pay for prescription drugs, health care, rent, utilities, and other needs. The BenefitsCheckUp Website includes information from more than 1,650 public and private benefits programs from all 50 states and DC.
Find Helpful Publications and Website Resources – A part of the Eldercare Locator Website, here you will find useful topic-specific resources for older adults, caregivers and aging professionals.
Long-Term Care Planning – Long-term care includes a variety of services and supports to meet health or personal care needs over an extended period of time. The National Clearinghouse for Long-Term Care Information Website provides information and resources to help individuals plan for future long-term care.
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I agree that your brother needs help. I also agree that not everyone is in a position to jump in and take over the caregiving. Let go of the guilt and try to help your brother find a good nursing home for your father.

This article may help with your guilt: https://www.agingcare.com/articles/not-everyone-cut-out-to-be-a-caregiver-162192.htm

Take care of yourself and let your brother take care of himself. Your dad can receive good care, too, from hired help - though for some regions of the country this is harder to find than others.

Carol
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ok, I am not hearing from your query that you aren't able to take over for a while in the caregiving arena, or that you aren't able to do caregiving part time. If that is the case then I agree that it is probably time for the next stage. But don't think you can't be a co-caregiver for your father just because your brother is POA. POA doesn't mean he has to be the sole caregiver. At any case, if it is time for the next stage NH or ALF, and your brother is going in that direction, be supportive. That's is what your brother and your father would need most at that point.
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Lilbit, loose the guilt. I know that's easier said than done but it is not helping you, your dad or brother. get to work thinking about a solution and when you all agree on something help impliment it. just because your brother has POA and the fianl say does not mean you can't do some of the leg work or in this case make the phone calls. Your brother is exhausted beyond exhaustion and simply does not have the strength to do the research himself. Can you explain why you are not able to help in any way. I am not doubting you but others here may have creative suggestions if you can explain.
Nursing homes do have lots of activities for their residents and he is probably not very stimulated at home at this point. Are their other family members to visit?

DaveIFM, the information you have provided is a very vauable asset to have on hand and i would suggest anyone who is not currently in a caregiving situation at present takes the time to explore all these options. It looks as though it is a college course in itself and negotiating anything that has .gov at the end of the link needs many hours of perseverence to understand and actually obtain the help the act is meant to provide but thank you for taking the time to provide this information
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Living at home when elderly, fine and dandy, but it isn't for everyone....

As for living at home, when I reach a certain age I wouldn't want to continue to live at home.... sorry, I wouldn't want my house to start looking like a nursing home with a hospital bed, porta-potty, etc in once was the dining room.... I wouldn't want relatives bickering on who's turn it would be to care for me, who's pulling their weight, who's not... those would be the only faces I would see day in and day out.... why can't anyone smile?.... I would want to be kept busy doing activities but how could my Caregiver do that if she is doing laundry, making dinner, getting groceries, running errands, etc.... I wouldn't want to worry about who is going to shovel the driveway during a heavy snow fall, and could my Caregiver make it to my house.... I wouldn't want to worry about is it time to get a new roof on my house.... etc.

I want to be someplace where I am around people of my own age group.... I want new BFF's.... where we all meet in the dining hall for lunch/dinner.... where there are activities for me to enjoy.... places to go, people to see.... where the Staff starts the day off fresh... etc.
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Carol Bradley Bursack, the article "Not Everyone Cut out to be a Caregiver" was a live saver for me... it has helped me feel not that guilty for not doing everything my parents would like for me to do. I am not Caregiver material at this stage of my own life, where I am also a senior citizen.
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It's true what people are saying, and I am glad that the guilt issue is to be gone. Usually these have loads of that. I remember shopping for nursing homes for my gramma, and you really have to shop around [how they smell, how people are acting, etc], but some are really nice. Plus one can get a caregiver in right away to give your brother a break. In my area, there are like adult daycares, so seniors can be cared for the day outside the home when the primary gets a much needed break. Those things would help your brother out now, and many are covered on medicaid.
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If I could send your bother a link to this forum... I would. Depending on how your bother would react to you doing so... you should IMHO. It will help him to understand that you do care, do understand his predicament, and do have concern for his own physical and mental health. Being a POA is tough, and making these tough decisions, like moving dad to a assisted care facility, is part of that. Most us will a wait little to long out of obligation and or guilt, when for both your dad, brother, and rest of the family it would have be best to have done so sooner.
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Before you use a nursing home, see if Dad is eligible via insurance for visiting nurses or home aides who can assist with his care and cleaning etc, or if he can afford private pay. Is he a veteran? The VA can sometimes offer many services. As for incontinence, Dad will have to wear adult diapers if he isn't already, and that's a little much for anyone to deal with if they aren't a nurse [believe me, I've been there!] Don't feel guilt, either of you, if you can't handle the chores and extreme stress of caregiving; as other have noted, it is not for everyone. See what help your brother can get and then if absolutely necessary, investigate nursing homes. As others have noted, some of them are run well by decent people and are not that bad.
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I agree with \Lizann, check out at home care before a nursing home, your father will be much happier. But only if his condition is good enough to stay at home, and only if it will help your brother. Do you live too far away to help? If not, having at home help, and your help would ease the burden on your brother and he might be willing to have him stay at home.
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If there is nothing you can do, then try to understand what your brother has to deal with and if he cannot manage your father, then as POA, he can choose to place him or get home care. Not everyone can help, and you need to release those guilty feelings or else you will make yourself ill. Let it go...
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Depending on your state, look in to A Place for Mom on the web. They will help you find just the right place for Dad--don't be fooled by the name--at no charge to you. You need to check out their referrals but go for it. Mom lived with me for two years and when I could no longer provide the best care I knew it was time. I found a residential care facility that is small enough to be intimate with residents but large enough to have the staff to help her. Most of their residents are incontinent but adult diapers take care of that. I am a nurse and have worked in a Nursing home in the beginning of my career. I love the residential care aspect so much more than the NH side. Mom needs lots of help with hygiene and walking and meals and they do it all. I am at peace with the transition for the social stimulation and saving my family from going under. I feel she is better here than at home even if I had sufficient funds to provide 24/7 in home care I could not offer the stimulation she gets in her new home. I visit regularly and we are both much better off.
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Check into inhome support services. Check all your county's resources. Be there for your brother. It is a difficult time i my mom and my honey care for pops plus we have nurse and a cna who come and help . Meals on wheels
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I think guilt is also a sign that you care so do what you are able too and then give yourself some love for caring enough to feel guilty.
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"A Place for Mom" only lists/recommends facilities that pay a fee to be listed and exclude others that may be better for your needs. One can find nursing homes on line and elsewhere in your area.
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Unfortunately, I have found that an "in-house" caregiver can be extremely costly. They generally are not covered by Medicare either. They can drain your parent's finances rather quickly...and if a true emergency occurs and there is no money available, what then? This is the question my family was plagued with. Putting mom in a NH is not what we wanted; it's not what anyone wants. But life sometimes doesn't give you many options. I care for my 94 year old dad who still lives in his home (moved in with him) and although he can ambulate & toilet himself his dementia prevents me from leaving him for too long and the burnout from being the housecleaner/cook/caregiver while also holding down a part time job is immense.
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