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Two siblings are faced with the realization that their 96 year old Dad and 93 year old Mom, both with Dementia, but otherwise healthy, are at the point 24/7 care is needed for their parents. In an effort to prevent either/both parent from entering the nursing home, one sibling has left their home across the country to permanently reside with the parents and become their primary care giver. Aside from a home health nurse who comes periodically as well as a nurse’s aide to assistant with bathing and other necessary requirements, the one sibling is in the home 24/7. The other sibling has suggested the family hire a sitter to help alleviate some of the burden on the live-in sibling. However, the care giver sibling does not want to pay an outsider when they are already there full time. If they want to pay someone, the estate can pay the care giver sibling instead. This is not well received with the family as they feel it is a moral obligation to care for their parents and should not be compensated as such. What is the norm in this situation? I understand compensation if the parent moves into the child’s home, but this child has moved into their parent’s home.

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If they have dementia, "otherwise healthy" isn't going to be the case for long. The parents will start having frequent falls, trouble with swallowing, double incontinence, refusal to bathe, wandering, and other symptoms of dementia. Those symptoms are not considered healthy, and live-in sibling (probably elderly also) won't be able to manage it for long.

No one has an obligation to caregive their parents. Also, there is no estate until these parents are dead. If compensation is made, it will come out of parents' savings or income, is that right?

Home caregiving is a difficult job, and if caregiver can be paid, they should be. If this "child" isn't paid, the "child" should leave and let the rest of the family manage and care for the parents. Who, by the way, need a lot more than a sitter. Full-time care of two dementia parents will require a24/7 caregiver, relief caregivers for the main caregiver, and a host of other people to manage, clean, shop, drive them, make appointments, and so on.

All of you have a lot to learn. Good luck, and please let us know how you're doing.
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Navigatingaging May 15, 2025
Absolutely. We are fortunate they are the age they are and have only experienced minor health issues, but the dementia is taking its toll. I’ve lived through this before with a family member, but I’m not a sibling so my opinion is irrelevant. In an effort to provide the family with different perspectives, this forum has been very helpful. Thank you for your insight!
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It is a moral and legal obligation for a parent to care for their child. It is not a legal obligation for a child to care for a parent. Perhaps it is a moral obligation for a child to ensure that a parent is cared for (arguable, not always agreed), but it is certainly not a moral obligation to do that care themselves and for free. ‘Children’ in their 70s have no obligation to provide personal care for parents in their 90s.

If the 'obligation' is the commandment, remember that 'honor thy father and thy mother' had nothing to do with providing hands-on care. More like 'don't run them down in public'.
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I absolutely believe in paying family for any care provided. It's ridiculous to expect anyone to make the sacrifices necessary to provide care without compensation, especially since in most cases the care is given by one child while the others do little or nothing (and often sniping from the sidelines). Family caregivers are a bargain compared to hiring outside care.
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This child is in for a big surprise, this is only the tip of the iceberg, everything with their care will get much worse. One person cannot care for two elderly dementia patients.

Normally the patient pays the caregiver.

There is no responsibility for a child to care for a parent.

I hope that that there is DPOA in place as well as all the other legal documents so that someone can make good decisions for both the parents as well as the caregivers.
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Navigatingaging May 15, 2025
Tough waters to navigate, for sure. Thank you for your advice!
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Well, your sibling should not only receive payment, but should have a caregiving contract in place, including provisions for time off and the pay they collect should be subject to federal and state withholding/taxes - this protects caregiving sibling (continuing to contribute to SS/Medicare for their own future) and parent(s) (in case one/both need Medicaid LTC in the future, the pay sibling got won't be looked upon as gifting under Medicaid rules). With 2 people suffering from dementia, the probability of placement in a facility skyrockets, and you all need to make sure you have your legal ducks in a row so there is no potential Medicaid penalty.

Furthermore, this should not wait until both parents are dead with the plan for the "estate" to financially compensate this sib after the fact, because with 2 parents with dementia there might very well be nothing left of the estate to pay back caregiving sibling!

If the rest of the family feels caring for these 2 people in their home by family members free of charge is a "moral obligation", let them put their money where their mouths are and join that caregiving sibling at parents' home to help in the free caregiving. I don't see THAT suggestion anywhere in your post.
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funkygrandma59 May 14, 2025
Amen!!! Preach it sister!!
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Money & care. Two big factors that can wreck havoc on family relationships.

Money FOR care. Even in the same family, same culture & faith, values can differ between family members.

What you descibe seems to happen a lot...

One child wants to be a Lone Ranger Caregiver. Maybe they have the time, the skills, a big heart? Maybe hands-on tasks are how they show love?

Sometimes this care role pops up when they are in want of housing or want an excuse to leave an unwanted job or spouse. This new care role fits them well.. but then.. what to live on?

Others family members can see the sense in sharing the care load. Either in home or in a facility. Can see the potential for caregiver burnout. (Which is real & dangerous btw)

How to get the whole family on the same page?

I was told to start with everyone getting together to discuss. Everyone getting to air their viewpoint. Explain their reasons. I tried it. I then heard & understood the opposing views better.

I found there was a lot of FEAR.

Fear of strangers, fear of strangers in the home. Much fear of abuse in facilities. Fear of judgement by society & the wider family too.

I see families trapped in this *only family* stuborness. Going without needes services like cleaning, personal care, even simple grocery deliveries unless family do it. (My MIL is heading that way). Then others that understand we all need a village.

It's a long road.. I am sure there will be many opinions, much advice & personal stories along soon. Hopefully some can help give ideas to help your situation.
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KNance72 May 14, 2025
That is a reality the Person with dementia May fear a stranger coming in . Happened with My Mom she thought everyone was stealing from her .
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It is very tough to care for 2 sick people at Once - I have done it with my Mother and brother . Take that Into account . A friend of mine was Paid well - he took care of his house Mate with dementia for over 3 years But afterwards he was suffering from Insomnia and PTSD . I told him " to go home and stay with your Mom and get some sleep . " This is a reality . Most caregivers are exhausted and Burnt out with only one person never mind two . In Reality The Caregiver should Have weekends Off to recoup and recharge . And yes Of Course Paid with a contract .
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Navigatingaging May 15, 2025
Thank you for your insight! I too worry about the burnout this family member will experience regardless if they are paid or not.
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ANY person be it family, friends, neighbors, ANYONE who has to (for lack of a better description) babysit two people with dementia day in and day out, deserves to be paid for that very hard, very mentally-taxing work.

Not only should your sibling who gave up their life to take one for the team by moving in with the demented parents and assuming responsibility for them be paid, they should be paid well. The family should also have as much outside respite help as they can afford to give this person a break and regular time off. If the caregiving sibling does not want other paid sitters coming in and wants what would be paid out on that to go to them too, then respect their choice and let it be done. Leave it open that if they want time off and want some outside help it will happen.

The siblings who don't think family should be paid should be shown a bill for what an average (not top quality) nursing home/memory care facility costs per month for two residents. When these siblings come to after fainting from the shock of seeing that bill, they will change their tune about paying the sibling who's keeping mom and dad out of a care facility.
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Navigatingaging May 15, 2025
Thank you for your insight and reply! It is helpful to hear unbiased opinions on a very common topic!
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In my opinion there should be, yes, shared living costs. That is that the parents, having moved in with the sibling and taken over their lives, will pay for part of mortgage, upkeep, costs and management of home and grounds, and for utilities, food, the cooking of said food, transportation to and from appointments, any changes made to home to accommodate them. Said contract MUST be legally done in an ATTORNEY OFFICE in order to get good pointers on taxation (for instance "shared living costs" are not taxed whereas "rental " is). And to make this legal so that parents are never denied governmental assistance and accused of having done "giftings" of their savings.

This is apparently the CHOICE of the sibling taking on care. It is not the business of other siblings whatsoever. This sibling should be POA for all decisions since they are doing all care. There should be language in contract for reassessment of arrangement and that parents will go into in-facility care when this arrangement is not working for any ONE person in the family involved in caregiving.

I myself would not be able to do this; my limitations preclude such a choice. But it is up to the sibling and the parents who are involved, not up to others.
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Navigatingaging May 15, 2025
Thank you so much for the insight!
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Why can't the other sibling give the Caregiver a break.
This sibling is going to burnout ans quickly. No one can care for 2 people 24/7. Especially if they are approaching 70 or in their 70s. Dementia worsens. This person should at least have a weekend to themselves. An aide to do at least one shift. Paying her does not solve the problem that she needs a break.
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“This is not well received with the family as they feel it is a moral obligation to care for their parents and should not be compensated as such.”

How very convenient for the siblings! Even if each sibling were doing an exactly equal share it would still be allowed for one sibling to decline to participate but WOW. To decide it’s someone else’s MORAL OBLIGATION to do something that you’re not even participating in takes big brass ones. Wow.
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Beatty May 15, 2025
I experienced this.
A family member was taking the moral high ground & said "Family must help family".

I started my challenges;
"You are family. What about YOU?" Mumble mumble, not me.. I'm a man.

Does family need to help or CHOOSE to help?
Does family help have NO limits?
No limit to time? Money?
Does family help even though it may cause HARM to themself? To other people? Their job, study, financial security, health?

Caregiving works when it WORKS for BOTH the care-giver & the care-receiver.

Being related by blood is not a right to obtain a care-servant.
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YESSSS.
Anyone who leaves there home , job , life, etc. should be paid WELL. This person should also get paid vacation .
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ANYONE that is a caregiver should be paid.
I feel for your sibling that has left her home and family to care for the parents. No one should make this decision.
I also think the sibling is short sighted in thinking that there should be no outside help. Does anyone working a job work 24/7/365? A schedule like that is impossible and WILL, not can or might, lead to burnout.

I think if the siblings that do not want to pay the sibling that has given up their home, their family, their life then each sibling should take a 3 or 4 months turn at caregiving. Each in turn gives up their lives, family, home and stay 24/7 as an UNPAID caregiver for mom and dad.

I don't think this is a "moral obligation" in caring for parents I think this is an effort to preserve any inheritance that might come.
And as to the inheritance I think if this is the way things are going to be the one sibling that has given up everything should get HALF of the inheritance and the other half is split between all siblings. I know that is not how things will go though.
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Navigatingaging May 15, 2025
Thank you for your insights!
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Who cares how it is received by the family? If it is a moral obligation why is a paid outsider even on the table? Where are the family members that have so much to say about moral obligation?

If someone gave up their life to prop up their demented parents so said parents didn't need to go to a facility, this does not mean that this person is getting free rent and should be obligated to give 24/7/365 free care in exchange.

To say they are both suffering from dementia, need 24/7 care, yet otherwise are healthy is such an oxymoron. Obviously spoken by someone that doesn't know dementia from a hole in the ground.

The caregiver should be paid the going rate for a live in caregiver and room and board on top of any payment.

So, who are you? The care slave or the moral obligation sibling/family?
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Navigatingaging May 15, 2025
Thank you! This is why I posted to this forum, to allow the family to hear different perspectives from someone who is non biased.
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Absolutely!! The child that moves into the parents home should be compensated. That child is giving up their personal life and don't throw moral obligation into the mix.

A Formal contract with attorney to ensure the proper avenues are crossed and dotted.

In addition to the compensation the contract should state the max hours, time off vacation days and duties that will be done.

The sibling should also NOT be 24/7 and additional caregiving sources should be used.

"Moral Obligation" is a tactic to guilt and strong arm someone into an absurd amount of work for one person. Shame on anyone that tries that tactic.
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Why are they trying to prevent her from going into a nursing home? An offspring taking care of an elderly parent needs to earn a living, too. What does it matter whose home whomever moved into? The work is still the same. And it IS WORK.

Just do very carefully research, take tours, and find a nice LTC for her. Problem/Conflict solved.
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Navigatingaging May 15, 2025
It has always been the goal to keep their parents in their own home for their remaining life. Both children are adamant about that. I don’t agree, but it is what it is.
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Let's start with the fact that it should not cost the caregiver to give care to their loved ones as a general principle.

Why receive the family's criticism and try to save money so they can inherit, when just the fact that you are the caregiver often costs you extra money? (gas, food out, a little outing, lost wages, no SS retirement built up.)

What I have seen work was the siblings contributed their fair share to the person caregiving or to the cost of a facility. A sliding scale if one could not afford it.
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Giving up one's means of support, home, community, friends, and chance to build a retirement nestegg for themself, to care for aging parents, is never a moral obligation for an adult child.
The family is not respectful of what the caregiver is sacrificing to care for the parents.
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