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I feel guilty dont know correct answer. Five sibs vary on how much and type of care elderly parents need - Mom with severe arthritis and 4 months post bypass surgery, Dad with demntia and COPD, incontinence. Of course can have differences of opinion but how do we "factualize" needs, take emotions, personal opinions out of equations as much as possble. I stand my ground and offer to do what I can do while keeping parents safe and cared for in my opinion. But then feel guillty when one sib pleads they need 7 days overnite. Or about leaving parents alone one night a week after Dad's had a bad night of waking up and needing have whole bathroom cleaned from his poop. Another sib offers what she can - about one overnite thru 11 am couple of times a month, especially when others are out for some reason, like own health or vacations. Recenlty two on vacation, one health. I made out realistic week plus few days schedule with Mom'a input. At last minute, while sister was doing a Fri. nite to Sat. 11 am stint, she decided parents couldn't do Sat. afternoon thru Sunday dinner time by themselves (as per me and Mom's schedule). But neither she nor my Mom told me about this until Tues. night. Then told me she was overwhelmed by that and didn't get own house hunting and job work done.No one asked her to do that. I don't criticize her for it but it was her decision and she is not able to be there often so doesn't have a real feel for needs. But if someone had let me know, I could've readjusted my own schedule. Now on my own decision, I feel guilty and added another night for myself. So 1. how to "factualize" needs and 2. how to keep myself from feeling guility after surveying situation and making a decsion on how much I can do.

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It's all very overwhelming and you have done amazing!!! You need a plan to keep your sanity.

Sit down with Sibling A, with whom you share medical POA, and talk about getting full durable power of attorney so that you can start to manage their finances for when the time comes that your parents can't handle it anymore.

I agree with getting a professional assessment. Geriatric nurse practitioners are an excellent resource who will evaluate every room in the home and make safety recommendations. You and Sibling A can review the recommendations and determine who is going to implement them. What needs a handyman? What doesn't?

You and Sibling A should also discuss whether or not there is money for assisted living or memory care. I think it's important that you understand the realities of your parents finances. What is the budget they have to work with? Can siblings contribute?

How much longer do you think it's realistic to schedule caregiving responsibilities with your siblings? Do siblings have kids and, if so, what's going to happen once school starts?

Prioritize. Prioritize. Prioritize. Do what's urgent first. Niceties can wait. Tackle one or two big things at a time while remembering that you may need to alter plans in the future.

One of the best books about what you are going through is "Can't We Talk About Something More Pleasant?" by Roz Chast. I would encourage you and all of your siblings to read it. I wish you lots of luck!
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Call your local Area Agency on Aging and ask for a needs assessment. Most of the time, adult children are too close to the situation to see it clearly. I would rely on a professional assessment .
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You probably won't like my answer, but to me, it sounds like your folks need to be in a professional care setting where they can get 24/7 help from three shifts of professionals. Right now it sounds like you and your siblings are trying to bail out a sinking ship with five teaspoons.

Trying to manage schedules and care with that many people and professional caregivers and nurses thrown into the mix is just too confusing for everyone, including your poor dad with dementia. He needs to be in a routine where the same people are there most of the time doing the same things in a very predictable way. I would start investigating places your folks can go that would provide a continuum of care for both mom and dad. Just by way of comparison, I was caregiving for my mom and dad together for 9 years when my dad passed away. Now 6 years later (14 years in total), my mom is still going strong and it's a daily bit of work for me (by myself). So do you see yourselves doing this as a cohesive group for 10-15 years? Start planning now for the time when everyone agrees that your folks need more help than you can provide as a group. You've done an admirable job to try, but in my opinion, it's beyond your capabilities.
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Thank you. We never leave Dad alone but do leave Mom with him 1 sometimes 2 nights per week (never in a row) and varied hours per some days. Have Medical POA with Sib A who has a job and lives 1 1/2 hour round trip. She is at parents 2 days every other weekend and more weekends when needed. Another B lives close but available to help occasionally due to job etc. C used to come approx. 2 days a week, including overnite and lives close by but now own health issues. Two non-work outside home D and E (me) are there the most. We added home care 3 weeks ago for 3 days per week ( 4 hours each) from wake up thru shower, dress, breakfast, meds, laundry, bit light housekeeping.Mom just told me " I think we need home care only two days per week." I think with home care so new she is still dealing with issue that many elderly have of strangers in house and her own of being in charge of the CG. She has stated too many people coming into the home with CGs, home nurse ( which is ending this week) etc. Also adult day care for dad 2 days a week for 4-6 hours. Good for him to be more active and engaged and respite for Mom. She doesn't see that yet, but given time and experience... Can't blame her feelings but it's get help in or assisted lving move. She really has improved in communicating and supervising with hoem care CG. Sib D and I did stay in the home during first few entire days of home care to make help Mom direct CGs and feel more secure with them there. At first she yelled at us not to talk to them though, "This is my house". Now at least she doesn't complain when we talk with CGs as we still go there one hour before home care leaves to keep tabs on how going and make Mom feel secure. She's seemed much better with them there already - recognizing and communicating priorities, instructing how wants things done, which light housekeeping to do that day. These things take time. As far as sib work and schedule etc.,D insists she knows best since she is in the home physically the most days. She also lives close. But she is also dealing with anxiety issues of her own so difficult for me to sort out that part of her concern for our parents from reality. B has similar issue. Finally convinced D that parents OK alone together for several hours at a time during day so she can be home and/or do her own life - appts., classes,family stuff. I have 2 hour round trip and trying to do two days in row per week plus finances and as much as possible online at my home. re-configuring again now with C out of picture. Sib A says two non-working (D and E) are there the most so we know best. Says B and D not there enough to know what's best. Had one hour meetingwith 4 of us that did a lot - asked Mom what she needed help with the most. "Laundry" But she will notexpress needs so sibs tend to make own decsisions and sometimes criticize others who don't agree.
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Is anyone your dad's Durable POA and Healthcare POA? If not, is he still competent to sign it appointing one person and an alternate. Having all of the siblings working against each other doesn't sound productive. As far as factualizing needs. I would think that writing it down make help. Keeping in mind that after the early stages of dementia, they need around the clock supervision. As they progress, their need for assistance increases.

Your profile says that your dad has dementia and that he has left your mom at a store before and had gotten lost driving. I would think it would not safe to leave him unattended. He could wander off and how would your mom stop him? And even though your mom is there, she's disabled with arthritis and is a recent heart surgery patient, right? If she is competent, she can make her own decisions, but, I wonder if she is able to provide around the clock care for your dad, whose condition will progress.

Do you feel guilty because you know that dad should never be left alone and you are not always available OR do you just feel guilty for some unknown reason you cannot specify? I've noticed that is a very common thing with caregivers. I might try to figure that out and address it. If what is being required from you is just unreasonable, then I would have to correct that. I would insist on a written schedule from the siblings as to their caretaking times or hire in-home care providers who are dependable and provide backup if they are sick or unavailable. You can also explore other options like Assisted Living if that is needed.

If you all are not sure what is actually needed in the parent's home, why not have all the siblings meet at the parent's house and make a list of the things they need help with, including being present to supervise dad. Based on their mental and physical health, it seems that might be quite feasible.

You might ALSO hire a professional person to do an assessment. I would make sure the adult children are there for that though, so the person taking the information gets a clear picture of the situation. If they rely only on what the parents say, they may not get the full picture. They need to be aware of dad's dementia and history.
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