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How can I get my sister’s older children (I am 70, they are 68 and 66), to help me with their mom’s aftercare and caregiver needs after heart valve surgery and likely kidney dialysis care afterward? I have my sister living with me because she needed help prior to this newest issue. I take care of all her needs now because she is my sister and handicapped, but after this heart valve surgery and likely kidney dialysis, how can I get help? I’ve already explained the situation to her children, never getting a response from them. Her son has her Power of Attorney and is charge of her Trust, Healthcare and finances. I don’t have any authority at all, even though I have taken her into my home to help her out financially, physically and personally. She is my sister and we love living together, but I am afraid that after this valve surgery and kidney dialysis I won’t be able to care for her the way I do now. Doesn’t her son have some sort of responsibility with her care?? Her daughter lives too far away, her son lives 5 miles from us. Thank you so much for your input, I’ll appreciate anything you have to offer.

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Yes, your sister can have the POA and trusts changed.

First, you should not be financially caring for your sister. As POA her son is suppose to be using her money for her care. Paying her bills and giving her money to live on. If she is of sound mind that POA has not actually kicked in. She still controls her money and should be covering her own expenses. Maybe paying u something towards room and board.

I agree that her doctors would not be doing a valve if they didn't feel she would recoup well from it. Its a simpler procedure now. But dialysis? That is hard on the body. But all you can do is see how things go. If her care gets too much for you and she has the money maybe a nice AL.

Forget about her kids. You know, why have a family if when you need them they can't be bothered. I hate the word "owed" but I do think if parents have been "good ones" and loved you, does it hurt to give a little back. But when they refuse, just have to look for another way. You will feel better excepting they are not going to help.

What you need to do is find out what will be done after your sister has her operation. Will rehab be suggested? If so, make sure she goes. If not, will she qualify for homecare? Do not allow them to talk you into anything you are not comfortable in doing. My thing was, I am not a nurse. In home can be ordered.

With her dialysis. See if where she is sent has transportation. At one time where I live the closest place was 30 min away. Then the patient is there for six hours at least? Don't think you want to stay with her all day, 3 days a week. Office of Aging may help with transportation.

If sister has the money, don't hesitate in hiring help. I would bet son wants to hold on to as much as he can for his inheritance. Like said, if she is still competent, she can take her son off of everything. It goes both ways, they owe her nothing, she owes them nothing.
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You write of needing what I assume is medical assistance, although financial could be involved as well.  I assume that the adult children's "POA" means financial, not medical.    Is this the situation?    If the refusal is to provide financial services for your sister, that's not the same as providing medical care, unless specifically included in the enabling document.  

Notwithstanding, it seems as though the adult siblings aren't interested, or are unwilling.  Have you discussed this with your sister and suggested that she consider rescinding the existing document and executing a new one, including a medical authorization for you to care for her?

It's hard for me to imagine this kind of refusal to help with someone's mother, but, unfortunately, it's not unusual.
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Your Sister, who must be at least nearing 90 if she has a 70 year old son, is apparently of sound mind. Otherwise her doctor would never do such heart valve OR on her, nor dialysis in someone who is near end of life no matter what is done. I am frankly surprised she is electing these surgeries and treatments at this age as they are quite a crucible to go through, but then as a retired RN I perhaps know too much. However, if she is of sound mind and has chosen to go this route, then that is her choice, and she is welcome to make it. She can also, as others observed, choose to make YOU her POA, rather than her son.
Given she has made her choice, we come to your own choice. That has been to take your sister and her care into your own home. I am guessing you are close to her in age? This seems a difficult choice, but it is yours.
Now we come to your Sister's children, themselves of an age. They have a right to make THEIR own choices.
I think you have excellent answers below. I wish you and your sister the very best of luck and hope her procedures go well for her.
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MJ1929 Jun 2021
Sister is 17 years older than the poster. She's a peer with her niece and nephew.
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I would file a complaint with the police that her son is depriving her of HER money.

Trustees and POAs are positions of responsibility and they have legal obligations. That he isn't paying for her living and caregiving means that he is violating his fiduciary obligations and can be prosecuted.

Your sisters money should be paying for her care, it should be paying you for room and board and some money for caregiving, it should be used to hire additional help to ensure that her needs are being met. I would go after her son with everything the law provides. He is obviously financially exploiting his own mom.

I wouldn't try to get him to step up and do any boots on the ground caregiving but, I would make sure that HER money is being used for her care and not his retirement. You can't make people care and he obviously is not going to help her, so time to get HER estate paying for her care.
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Isthisrealyreal Jun 2021
I just read your profile. You can not expect her children to give up their lives to prop her up. It is unfair for anyone to think that everyone else should make sacrifices so they don't have to.

Her money should be used for her care if she is not able to take care of herself.

It is not her sons responsibility to do hands on care. If you are pushing him for that, I can see why he won't talk to you.

If you want him to engage with her care, you need to address hiring additional help, not enlisting him. He has made it clear that he will not do this, so let it go.
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Your sister (according to your proffile is 87). Her children have "turned against you".

What kind of valve surgery is she having? I hope it is the newer minimally invasive type, little recovery is needed. My MIL had this at 90; outpatient procedure and one son stayed overnight one night.

Why dialysis? Is she in kidney failure?

Do her children believe she would get better care in a facility?

If your sister is competent, she can revoke her son's POA and assign it to your son.

If she has dementia and can no longer reassign poa, then these interventions don't sound like a good idea.
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How old is your sister? She must be at least in Her nineties.

Her kids are in their late sixties so they are not kids they are elderly themselves and more than likely are just not able to take on a caregiver role when they are this old. And maybe they disagree with mom getting a heart valve replacement and dialysis.
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Is your sister of sound mind? One possibility is for her to remove your nephew from his POA ffor trust, healthcare, and finances. Is the trust substantial? Is he trying to preserve his (and his sister's) inheritance? There is no way you should be helping your S out financially, when there is a trust.

You are 70 years old. If you are afraid you won't be able to take care of her after the heart valve surgery and dialysis, have you found out exactly what could be involved?

What is the long-term plan here? The plan for you is to consider an exit strategy from your caregiving. You will not be able to convince her son to help out. He likes things the way they are -- apparently you are preserving his inheritance while doing everything for free. What a nice aunt you are! (Stop it.)
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sp19690 Jun 2021
They are almost 70 at that age if they even got an inheritance it would go towards their own senior care. So it would only be a win for the assisted living facility or caregiving facility
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If you've asked them, and they've said they do not want to help, that's that. You won't convince them, and caregiving for their mother is not their responsibility. Nor is it yours. You don't mention dementia or Alh, so I'm assuming her PoA the son has hasn't gone into effect yet.

It sounds like she needs a Nursing Home.
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Countrymouse Jun 2021
It actually is the son's responsibility. If he didn't want any, he shouldn't have accepted power of attorney for health care - it doesn't apply only when the person has dementia, it applies when she's incapacitated for any reason including illness and surgery.
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You have already explained the situation to her children, never getting a response from them.

Let's forget the daughter, she doesn't have any responsibility and she's too far away to help.

The son, your nephew, then. No response - meaning..? You haven't been able to contact him at all, you have contacted him but he just grunts, he says he'll help but doesn't do anything, or what?

Next question: does his mother keep in touch with him? - I'm wondering if she's undermining your request by reassuring him that everything is fine and you're taking marvellously good care of her, for example.

Last question (promise!) - is your sister mentally well, of sound mind, able to understand what's going on?
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sp19690 Jun 2021
There kids are senior citizens themselves. We have no idea what health issues of their own they have. Don't you think dialysis for an almost 90 year old is insane?
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