My mom with dementia won't enter care because she is still supporting my 54 y/o sister. What should I do?

I might be tempted to call Adult Protective Services at the least for advice. Explain what you’ve written here, that your
Impaired mother is at risk, living with her drug-addicted daughter who does not care for her properly. You might also use the therapeutic fib and tell Mom that sister will be coming along later.

Before you do anything, make sure you have Durable Power of Attorney so that sister does not continue to live in Mom’s house. You may also want to consult an attorney so that you can legally toss your sister out, sell the house and the car and use the funds for Mom’s care.

Here’s what we did. We left a calendar with what our expectations were. Brother and sister lived with Mom. If they didn’t initial we had to ask did you feed mom? Did you make sure Mom got a shower? Did Mom brush her teeth? Did mom get her pills? Etc. there was always excuses. The tipping point was walking in with Mom sleeping in her own feces and no sheets on the bed. Because of the “renters” rule of 60 days notice. We gave them 4 months notice. Luckily at the family meeting well before we had Mom on a memory care waitlist and they called with an opening.

Ignore the guilt from the “renter”. You are POA for a reason and were/are trusted.

Unfortunately this may be one of the situations where a LO has the right to make bad choices. If her dementia is mild and she is still legally competent, your POA won’t help you. Please think carefully before you do anything that she won’t agree with. If APS or some other body can force the issue, that’s fine, but don’t force things yourself if you are likely to be challenged successfully by mother or sister. You could end up with things being much worse.

I believe your sister needs just as much help & guidance as your mom! Is she collecting SSI? Does she work at least p/t? Does sis help take care of your mom? Is mom mobile & able to do ADL? Does mom have her marbles? I’d see an Atty & get financial concerns straightened out. If sis don’t participate in care of mom now, she surely won’t when mom gets worse. If sis is capable, she can get paid for taking care of mom. Hugs 🤗

Gdaughter has a point. You mother is probably happy to have someone else in the house even if she isn't getting everything she needs. You could formalize your sister's responsibilities with a care-giver agreement and you could install security cameras to find out how much your sister really is doing. It's easy to make assumptions from the outside. Care facilities just cannot provide what family can.

The issues in our society we face with mental illness, drug abuse, and declining health in later years are enormous and the lack of resources is abominable.  There is no easy answer.  Finding answers for your mother without finding answers for your sister will be no comfort at all to your mother.  Trust me when I say that she will go down quickly if your sister is not in a good place. 

There is no easy way to say this, but you have two problems to solve, which means that you need to spend time, creativity and ask for help via community resources. 

I would recommend that you keep Adult Protective Services out of the mix; the government is not great at solving problems and caring, but they are great with dictating the rules. Neither do they work and play well with others. With POA, you can already dictate the rules; you just don't want the guilt associated with it.  And until you come up with the best possible solution, you will feel guilty. 

That means starting with an elder care attorney for starters and taking a good look at the finances.  What can your mother afford?  Does your sister work?  Can she work?  Is caregiving her sole job?  Do you or other family members help? Is your sister mentally ill, drug-addicted, or both?  Does she see a counselor or psychiatrist?  It's possible that needs real help herself.  If you have performed any caregiving for an extended period of time, you know what it can do to someone. It can cause depression and act as a catalyst for alcohol or drug abuse. It can eradicate all the joy of life.  It's always more complicated than that, and your sister probably has a pattern of using others to avoid taking responsibility for her own needs, but her problems aren't going to go away by themselves.   

You need to dig in and get some real answers so that you know what your options are.  I'm so sorry; this is incredibly hard, and none of us are equipped to deal with it.  We have to advocate for anyone in our families who is vulnerable and not able to fend for themselves, even if it's against someone in our own family.

It’s interesting that you have power of attorney while your sister who lives there does not. I’d say that you are in charge and you need to do what you think is best. Yes. Do it.

That's a real concern to have your mother living with your sister, who is abusing medication. Her cycle of drug abuse won't stop unless she seeks help. Don't let your sister play the guilt card. It's all about mom's care. Time for the 54 year old "baby" sis to seek help.

In a word...imo...yes...because it is going against your mother's wishes...and right or wrong in re to your sister, it will cause your mother distress which will make matters worse and could contribute to a worsening of the dementia in addition to some potential worsening due to a change in her long-time environment. If you have POA than get hold of all the funds, give mom an "allowance" and sister will not have mom's funds as much. BUT you may not realize all that your sibling is doing even by being present and a built in alert system many hours of the day. You can arrange for in-home help to assist mom, meals on wheels. And can make it clear for things to continue that sister has to do SOME things to assist. Be careful what you wish for because having mom move in with you may be way more than you bargained for.

I second talking to an attorney, who will be able to advise you as to how to properly utilize the POA to make decisions in your mom's best interest. If mom has a dementia diagnosis, you should be able to activate the POA, but I'd check with the attorney before making any moves.

It does sound like your mom needs assisted living, to include medication management. If she is not able to perform her ADLs and is not taking her meds properly, the situation she is currently in is a danger to her health. Not to mention, it sounds like she is being financially exploited by your sister.

Your sister will continue to try to make you feel guilty because her meal ticket is about to get cut off. I wouldn't let her guilt tripping get to you. As long as you are doing what is best for your mom, you don't have anything to feel guilty for.

As mentioned by another poster, you can also discuss with the attorney the possibility of a rental agreement should allowing your sister to continue to live in the home be a possibility agreed upon by you and your sister, provided she pays rent and is responsible for utilities, her own bills, etc. The rental income, however, may affect your mom's Medicaid application should she need to apply, so I'd be sure and ask about how to properly account for that as well. Sister should not have access to your mom's bank accounts if you are the POA.