How do we move forward?

If it were me, I would leave the situation as it is until it becomes necessary to find a home for whomever survives the other. Let them cling to each other for now - at some point it will end and then you and your brother can step up.

My mother (95 yo) and my brother were super enmeshed even though they didn't live together. He would tell me that he didn't know what he was going to do when our mother was no longer here.

However, he passed away in 2019 at 60 years old and she's still going strong. You never know what will happen.

Sadly it sounds like things are at the point of making least-favored choices since the preferred choice of remaining home with family only to care for them is no longer practical. Unless there's an assisted living arrangement they could go to together?

A frank family conversation is needed where you and brother lay out for them their options - go to a facility or (if finances allow or they're Medicaid-eligible) accept in-home care from an outside source. They're at the point where they could be considered a danger to themselves and could be removed from their beloved home.

No, you do not have to take your sisters care over. I have a physically disabled nephew. He has a Neurological problem but it does not keep him from being on his own. I went to the County Disabilities Dept. I was able to get him set up with the State. He gets a voucher for his rent. An aide one day a week for 5 hours. Appts are set up for when she is there. There is help out there just have to find it.

Do you think they would agree to moving together to a senior facility? I think some senior facilities accept people 55 years and older. The advantage of a facility would be an easier life for them (and you). When I investigated senior facilities for my mother I looked for a continuing care facility that had independent living/assisted living/memory care/skilled nursing all on one campus so she wouldn't have to move to an unfamiliar place when she needed a higher level of care. Her place required starting in independent living, where they provided one free meal a day (the others could be purchased), had a kitchen in the apartment and washing machine and dryer, housekeeping was twice a month and they would change sheets. A doctor and dentist came to the facility. Then residents moved to higher levels of care as needed, and could move together if appropriate. Before discussing it with my mother I checked out the facility and then took her to see the one I thought she'd like, with nice apartments and activities and friendly staff and residents. At my mother's place, some couples moved together to assisted living and others didn't, but it was possible for the one in independent living to visit every day and spend time with the one in assisted living. In assisted living the facility would take care of 3 meals a day, housekeeping, laundry, etc. and would provide activities and people their own age. There would also be professional staff 24/7 to care for them and a nurse 24/7 in the unit. You'd probably have to help them find a facility, sell the house, downsize and move if they decide to do this. Try to find a facility near the person who will be looking in on them to oversee their care. You don't mention if the things you have to do as a caregiver for them are too much of a burden on you, but I'm assuming they are, since you say your mother will not accept any other help. You can set your own boundaries and limits to what you can do for them, and you will have to have an honest discussion about what you are capable of doing for them. Try to keep your feelings helpful: you want them to have a good life together with appropriate care, while not placing too much of a burden on you and your brother, who have your own lives and responsibilties. The hard part will be pursuading them that this is the best solution. Good luck! And all the best to you and your brother, mother and sister! You are being a wonderful child & sister and I commend you for it.

Sorry for the situation you are dealing with. That's a lot on you and your brother. Agree with raven that they should be moved into another type of living situation. What kind of disabilities does your sister have?

Does your mom have her paperwork in order? Will, living will, POA, etc.? If not and she has not been deemed incompetent , it is very important for this to happen so that whoever is named POA (you or brother) can make these decisions on your mom's behalf.

Assisted living often has 2 bedroom units. I would move them into one of those and then they will get help with a lot of things and you and brother will have a lot of pressure taken off you.

If this is not feasible for some reason, another option is to get in home care. Though she says she will not accept help from anyone, I would say it's falling into the "too bad" category. I don't have enough info to know what their needs are - can they prepare their own meals safely? If not, get meals on wheels. Can they handle their meds? If not you need an aid that can help with that. Cleaning? Cleaning lady. General assistance with laundry and other household chores? Daily aid to assist.

You might have to lower the boom and tell them that you and brother will NOT be providing ANY care until they move or accept a lot of in home help. Tell them you will help arrange it but there is too much for your and brother to take care of. It's a LOT, plus, you might have your own lives to live and other responsibilities as well.

Best of luck.

It sounds like your sister with ADL needs a POA or someone who can make decisions for her. Is anything in place, legally?

Does sister have access to social worker or some mental health intervention?
Do you? Some professional intervention is needed here.

No, you are not being 'left' in any situation. You can decide NOW what you will and will not do. It may be difficult however you will need to be clear on what you will and will not take on. You might need to tell your sister that you WON'T be there for her when mom passes. Sounds cruel ... perhaps. Someone needs to face reality and make decisions based on what is needed; not under the fog of dysfunctional / co-dependency behaviors.
You need to set limits.
And then let go.
Don't be sucked in. If you allow it, it will happen.

Touch Maters

First, your need for legal advice is paramount. Please make an appt. for you and your brother and then decide how to approach Mom. Depending on her condition, your sister has a need for legal advice too: is she competent to make her own decisions or does she need a guardian?

Second, it would be helpful to request Adult Protective Services to come to Mom's house to evaluate the living conditions, individual needs and the relationship between Mom and your sister.

A Geriatric Psychiatrist can educate and medicate your Mom as she is living in denial and might need help sorting through the facts and the consequences of doing nothing.

The way to 'force' Mom & Sis into other help is by reducing your own help.

I get it. You & Brother are family. Family helps family. Family trusts family.

But when needs exceed what family can sensibly do - then the common sense solution is to get some other helpers. Some *non-family* help.

Like it they may not.
Won't change the facts: age, illness & disability happens.

I would have a proper sit down chat with your Brother first. Where's he at? Are you on the same page?
Eg If you stepped back a bit, would he also? Or expect you to continue forever.. or pick up your share?

It's ok if you do differ of course. But if you agree, even better!

Next, sit down chat with Mom & Sister.
- Make it CLEAR what you are reducing or stopping.
- Make the replacement choices as easy as possible for them. Eg leave brochures for two home cleaning agencies or grocery deliveries services, whatever the most pressing need is.

Then the really tough part!
When they call you for cleaning, you say no. "No. Call one of those cleaning agencies. Brochures are on the table."

This is a three step program a Social Worker once gave me;
1. Advice them.
Help them locate all the services they need if you want to.

2. Let them decide. They can choose to try them! Or choose to refuse.

3. The consequences are theirs. This is how they will LEARN.
No meal deliveries = eat toast.
No house cleaning = House stays dirty.

Their REFUSAL is THEIRS.
It does NOT mean YOU arrive with mop or meal in hand.

This is where You & Brother stay firm & repeat your line.

"I said I would no longer be doing that".

The rational will give in quickly. However, some are slower learners..
At any time keep presenting the steps. They can RE-choose at any time!

(This DID work for my LO - eventually. So many services accepted now & happy & grateful for them too).

It seems to me that you are worrying about 2 separate things:

1) You and your brother are doing too much to prop up the current situation, which is a mockery of independence. There is only one way to deal with this: stop propping it up.

2) You and your brother resent what is probably coming down the track – Mother will die, and co-dependent sister will fall apart. There are two ways to deal with this:
a) Get your plans ready for where sister goes after the death. and/or
b) Wait for the results of you stopping to prop up the current situation.

Talk about it with your brother. You need a joint decision. Persuasion and sweet reason are not going to work!

As long as your mother is mentally competent, you can not change her living situation - since she is well able to make her own decisions. If you suspect that your sister is not mentally competent and may be taken advantage of by mom in any way - consider reporting the situation to authorities as suspected abuse.