Is it better to fly Mom (89) to a sibling for 2 months, respite care or use local AL?

The obvious solution is the local al, and that sounds like a good price for 2 months. You may even find that she likes the activities and being around more people. She may want to sign on for the long haul.

Thank you Anne :) - but if your brother makes a habit of not listening to what your mother needs, forget it: it's not worth it because, if you're lucky, it'll take you a further six months to undo the damage. Pop her in the ALF and let him come to her. But lavish praise on him for offering, of course… [eye roll!]

You are all very helpful, thank you! I like countrymouse's idea. You could write an elder travel guide mouse! I want to encourage their relationship but I do worry about compliance which has been a big problem with him in the past. I have anxiety about flying with her as freqflyer points out and maybe having an episode like chicago1954's not to mention her unpredictable digestive system. cwillie is right, she would definitely need an escort. I think I've talked myself into pamstegma and nhom36s opinion, between the flying and the compliance. The $$ is painful but, ouch?

Go for the local Assisted Living, for two reasons. Number One: Airplane cabin pressure fluctuations wreak havoc with the cognitively impaired. As above Chicago1954 saw the results with his elder. Add in the fact that she does not like flying and you could have a mid-air meltdown. A friend of mine got stranded in Detroit when her toddler got booted off for screaming on the second leg of a trip from Buffalo to Tulsa. Number two: Your brother has health issues. You know already how stressful her care is, it will not be any easier for him. So if he has a crisis, how will she be able to help? Can she call 911 or will she just go to pieces? You know the answer.

A lot also depends on when was the last time the elder had flown? If it has been more than 14 years ago, a lot has changed inside the airport with security and all.

First there is getting to the airport two hours before her flight, do you leave Mom at the front entrance while you park the car, which could take 20 minutes depending on the size of the airport or do you take her with you to park the car and put her on the transport bus to the main terminal or subway system [if she would even get on that thing]....

Then dealing with airport security looking in her purse, or her overnight case, and heaven forbid if they needed to pat her down if she triggers the metal detector.... my Dad proudly said to me that my Mom probably would yell at the Federal Officers for going through her purse or a pat down.... to which I responded that if Mom did that she wouldn't be flying that day, TSA has strict rules about that.

Then there is the issue of the long walk between the front building out to the terminal, then out to the gate... bus system, moving sidewalks, subway system... my Mom wouldn't want to ride in a wheelchair, heaven forbid someone she knows might see her :P

One thing to watch out when flying is dehydration, which can increase the risk of a blood clot. People flying tend not to drink a lot of liquid because of cabin pressure. Plus who wants to climb over the passenger next to you for a restroom run.

Then the fear factor... my Mom would probably ask to get off the plane while it is taking off. Thus, an elder flying is so very unpredictable.

Flying my husband's grandmother to another state was a disaster. She went from functioning in IL. to incoherent I'm AZ. The move was too much for her. She had to be flown back to IL and put in NH, there. She did get better, when in a familiar state.

I agree with countrymouse, but you are planning on having someone accompany her I hope? If the plan is to send her off on a flight by herself then that would be inappropriate, it would be too much for even a seasoned traveller when even day to day life has become confusing and overwhelming.

Does your mother have any major health care needs, Anne? You mention age-related decline and poor (declining?) cognitive skills but not any serious illnesses or dementia as such, is that correct?

If you can be reasonably confident that she will, in spite of not enjoying the travel, get there in one piece, be all right while she's there, and get back in one piece, then I'd accept your brother's offer warmly and with both hands. But I say that on the assumption that, all things being equal, you are sure she'll be fine physically.

If you do decide to go ahead, if I were you I'd be a bit cheeky and ask your brother to come and get her, and at the end of the visit you go and collect her. Then each time she's being accompanied by the person she's going to be with at the end of the journey, and she won't feel "abandoned" at either end.

Write copious notes about what her daily schedule is like - you could do a timetable, for example.

Write down prescription lists, over the counter remedies she's used to for minor ailments, usual eating habits and favourite foods etc., favourite t.v. programmes and pastimes, sleeping times and bedtime routines, bath time routines. You're not telling him what to do, by the way, you're just telling him what she's used to. It won't hurt her if he adapts it, so long as he's aware that he is changing something and will need to explain it to her.

Do a comprehensive packing list, and include it in her luggage so that your brother (and family?) knows what she's got with her. Ask beforehand if she'll need any special clothing for activities, family routines or even different weather conditions in his state.

So I tried all that, and it all went horribly wrong - but that's because my mother does have major health issues which my brother and SIL chose to ignore. But she did go to his house for a week, and I did get her back again, if not exactly in one piece, so in that sense the mission was accomplished. If your mother too needs serious attention to specific issues, and you're not confident that your brother is going to comply with instructions, then go for the ALF and don't apologise for it. He can always come and stay if he wants to spend time with her, after all.

But be positive about it. It'll be nice for her to spend proper time with her son, and he'll have that lovely fuzzy feeling from doing his bit so it'll be good for him too. Why should you feel guilty for asking him to do one-sixth of what you've done every year for six years?!

The local AL makes the most sense in my opinion. You didn't say if your mother will have to fly to your brothers. If so, the flight could be a real hardship for her and if your brother's health is perilous it doesn't sound like a good arrangement. You may find that your mother settles into the AL place to the degree that it would be a viable option for her long term. Either way - you need a break. Good luck.