What to do when one sibling is the primary caregiver and the rest of the sisters do help with care, however it appears to never be enough.

@mbosak1, your sister’s outbursts are very worrying, especially since it sounds like this behavior is new. Her outbursts could actually be early signs of dementia: inability to control emotions, inappropriate outbursts, over-the-top anger coming out of nowhere, inability to verbalize what is wrong, etc…

Some dementias are hereditary. You report that your father has dementia amongst other age-related health problems.

At the very least, keep a detailed log* of agitated sister’s symptoms and odd behavior, so you can document its trajectory to see if it worsens, or figure out what brings it on.

A medical check-up, at the very least, is in order. Doctor can prescribe a mood stabilizer to help in short term, so if her tensions have solely to do with the stress of caring for your father, the medication can help. If your sister’s problems are bigger than that, then you all need to figure out a different care structure for your dad, and relieve your sister 100% of caretaking duty, since she herself might be on way to needing someone to take care of her.

——————————
* I know of what I speak. An in-law got worse and worse with hateful awful ugly words and actions, and unhappy chaos-making hatefulness that gyrated wildly. The blood family defended her and lied for her and protected her out of misplaced loyalty for years while she ruined each friendship of each family member. Doctors insisted, after numerous tests, that she did NOT have Alzheimer’s, and they weren’t interested in finding a diagnosis, saying whatever she had couldn’t be stopped or helped. I was frustrated and puzzled and kept a private detailed log and finally matched her actions and symptoms to Pick’s Disease, a frontal temporal dementia. Her squad of doctors were amazed and after investigation agreed that Pick’s Disease was 99.9% surely the probable cause of her worsening destructive chaos. The family was therefore able to deal much better with the whole sad situation (ie what to do, what not to do etc). Good luck.

I'm thinking it's time for a family meeting. Could be staged as an informal chat & cuppa.

1stly, pat yourselves on the back for a job well done - all of you - for working together as a team. That really is something to be proud of! Thank the caregiver sister - for her years of generosity. Acknowledge this massive contribution.

2ndly, ask how each of you is. How IS Dad's care plan is working for each of you? *Asking & listening* can be a good aim - not assigning tasks or ensuring everyone helps at the same level. (You are all individuals - different families, jobs & circumstances, so it's reasonable each will have different capacities to help).

The outbursts from caregiver sister may be a massive sign she is burnt out as Againx100 said.

Caregiver sister may have very mixed feelings about the next stage ie some see asking for more help or from aides (outsiders) a 'failure' - it is NOT btw. It is adding MORE care.

It may take more than one get-together to move from *asking & listening* to *what can we do* & then to *the new plan*. The new plan will need to be embraced by all, especially caregiver sister, or it won't work.

You've sailed so far together. With more hands on deck I'm sure you will keep the ship sailing along just fine.

8 years is a long time to be caring for someone. Even though you do certain days she still has nights. People suffering from Dementia don't sleep. As the desease progresses so does the care. Maybe its time to place Dad.

Since ur close, how about sitting down and ask her what is wrong. Ask if caring for Dad is getting too much.

I looked at your profile, and dad has quite a list of ailments, doesn't he? That can't be easy for any of you.

Your sister is likely burnt out. But that might not be the driving factor in her outbursts, but merely a mitigating one.

This is not meant to be judgmental. How is it that dad is living with her? And what I mean by that is what were the driving factors that made her home the "best" one? Is it more "user friendly" for a senior? Is she at home full time? Is she not financially independent, and dad's living there is supplementing her income? Or is she living in dad's home? And if so, has she always lived there, or did she give up a job to move in?

Could her outbursts be in any way related to her finances?

See, I had to give up working when my mom got sick. My mother had moved into my home (I have a 2 family house) over 20 years ago when she first retired, and it wasn't until the last 18 months of her life that she needed major support. The last 6 months of her life, I had to stop working because she couldn't be alone. Even though I was retired with a decent pension, and it was a part time job, the loss of income, as minimal as it really was, caused me *a lot* of stress. We weren't in financial trouble, but the very thought that we might get to that point - because you never know - and I would be unable to even consider working while she was alive because she was so ill gave me many sleepless nights. It's one thing to choose not to work; to be *unable* to work because you are as housebound as the person to whom you are giving care is quite another thing emotionally.

She also might feel as though it's *her* job to take care of dad because she lives with him. I would twist myself up in knots with those emotions as well - swing from anger ("she's not just my mom, she's my sisters' mom, too") to guilt ("but while she's under my roof, she's my responsibility") and back again. Even though I had extremely great support, I would often feel bad taking advantage of it. It's a "me problem", I am aware of it, but if your sister is dealing with all of these emotions, while she is likely aware that they're not logical, they still pack a wallop.

So what can you do?

I don't really know. If you had asked me, 18 months ago, what I would have wanted, I wouldn't have even known what to answer. No wait. That's not true. What I wanted was my mom back, the one who was independent and strong, who could take care of herself with no issues and no worries. I would imagine she wanted that, as well. I knew that was never, ever going to happen. Your sister might be there emotionally as well.

Talk with her. Maybe get one of the other sisters (or maybe a husband or BIL, if they're willing) to stay with dad for a time so you all can have a real heart-to-heart with her. Be as unjudging as you possibly can. You're all on an emotional roller coaster - just some people ride those rides better than others. DO NOT make promises you cannot keep. DO NOT use useless platitudes ("oh, it'll get better, eventually"). DO understand that she might just need to vent. DO understand that, as much as it sucks to say, there might not be anything that ANY of you (including your sis) can do to make it better/easier/less stressful. Reassure her that you love her, you support her, and you will stand beside her until your dad no longer requires this sort of care from his children.

(((hugs))) to all of you. I think it's really awesome of you to recognize your sister's stress and genuinely want to make things better. You are an amazing sister.

I'm finding that caregiving is affecting my relationship with my sibling in a very bad way, so I sympathize with your sister! One big thing I can suggest that instead of just watching Dad for a day while she does other things is to be willing to take over a whole entire task all the time. That could be something like refilling his prescriptions, or arranging his medical appointments, or handling his laundry. Basically, take an entire job (because caregiving is like 5 million jobs in one) off her plate.

Sounds like she's burnt out. It's time for dad to live somewhere else. Even when she gets help, she knows the never ending care of your dad awaits her.