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Just a little background.....I feel like I would have to write a book to get everything in here that I want to say but if you are on this site........you all know the basics..... Maybe I really just want to vent........My sister, her husband (both are disabled and do not work outside the home) and myself (I still work) live with my parents while caregiving for both of them. My brother spends the night 3 days a week to care for dad during the night. My sister and BIL have him the other nights and during the day while I am at work. Our brother has made it pretty clear that he really doesn't want to be there helping to take care of them and thinks we are doing dad a disservice by having him at home instead of a facility. He made the comment that dad would have been better off if he would have died on the table while having the surgery that 4 doctors said they would not advice having. We are afraid that he will stop helping at some point and it feels as though it may be soon. He recently retired and told us he is NOT spending his retirement taking care of mom and dad. Dad is immobile a lot of times (due to the dementia and other physical problems, thus the surgery that is needed but not advised), we use a lift when his legs are not working well but try to have him walk as much as his legs will allow so he does not lose what little he has. Our brother cared for his MIL with dementia in his home but she was not immobile and did not have near the amount of issues that dad has. It feels as though he thinks he knows it all because he cared for his MIL but the issues are not anywhere close to being the same. Dad can not do most things for himself and my brother gets very frustrated and in a hurry with dad which only makes dad react in a bad way and in turn....my brother........we have been woke in the middle of the night a few times because they are having a screaming match that we have had to step in and stop because dad cussed at him or whatever happened this time and he is not going to let his dad treat him that way. Our mom was recently diagnosed with UIP for which there is no cure. She is on oxygen 24/7 and gets out of breath just talking or eating let alone anything that takes any amount of energy. She is feeling overwhelmed and guilty because she can't help take care of dad or with the house or much of anything. Our brother has been in her ear when we are not around and she is now talking about it may be time to put him in a facility. Mom and dad are both depressed and I'm sure they think often of end of life stuff now. I try to think of how I would feel....they have been married 67 years........I can only imagine how they feel knowing they are coming to the close of their lives. How have people that have had a difference in opinion on if a loved one should be put in a facility or left in their home come to an agreement? My other siblings and I believe at this point we are able to care for him as well as a facility if not better. They just don't have the number of people required to care for a person they same way that family can care for them. No fault of their own.......it seems to be the way of our society.

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Who has healthcare POA? That is who can make the decision. The family doesn't have to agree.

"My other siblings and I believe at this point we are able to care for him as well as a facility." Is that without your recently retired brother? Because you cannot make decisions for him, no matter who has POA. Count him out. That handwriting is on the wall.

Your mother, his wife, is now talking about it may be time to put him in a facility. Why can't you respect that? If she has healthcare POA, then it is her decision.

You think a facility does not have the number of people required to care for a person they same way that family can care for them. You know what? Neither do you, when Brother bows out.
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I don't understand why you think that 4 part time people can care for two disabled elders. It doesn't add up. I agree with your brother.

When he bows out, you'll have 3 part time people caring for 2 elders. Makes even less sense.
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The way I see it is that those who are willing and able can make the choice for themselves, but not for others and can't expect, require, or guilt those who are not willing and able.

My sister took more care of our mom very early on, I was working and traveling to help with a daughter's family out of state a lot at that time. I did as much as I could. After my daughter's family moved back in state, I was able to help more. As my mom progressed, my sister was less able to deal with the physical and behavioral effects and I took over more of the care. I now care for her 24/7. Through all of this out brother, who drives a big rig across country, had done no helping... And that is okay. He doesn't even come visit or call very often...I wish he did, but this is hope he deals with the loss of our mom as she used to be. We each have different capabilities. We need to be understanding of those.

I think if it is too much for your mom and one brother, for whatever reason, they should be able to opt out. If the rest of you can make it work, then you can keep him home. If not, find a nice care facility and you can still spend as much time as you have available with him.
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The other part of the equation is what is it costing each of you in terms of your own health and happiness to keep your parents in their home? Is that fair to you? Why should your parents' needs trump your own needs? I was 67 when my mom passed away and taking care of her for 15 years and my dad for 9 just about killed me. My mom's mom died when my mom was 52. Our elders are living much, much longer and creating all kinds of new family dynamics as a result.

We don't always get what we want...as the Rolling Stones sang. We sometimes get what we need. Your parents need dedicated helpers (and by dedicated, I mean people for whom that is their only job) and three shifts of helpers. You are admirable in trying to care for two elderly people who clearly need more care than you can comfortably give. Just don't let that care take your whole family down. I doubt your parents when they were young and healthy, would want that for their children.
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I know how frustrating it can feel when seemingly perfectly able siblings want to jump ship on caregiving. My mom has two sisters, one used to be primary caregiver for my grandma while my mom would send funds and visit as often as possible. The third sister will barely come visit. My aunt developed cancer and lost her battle after only 6 months, and after that, mybother aunt still did not step up. Nor did any of my 5 other cousins. My grandma could have stayed in her home, we hire and pay for some respite, and my cousins and aunt fill in the other times while we still fly back and forth frequently to provide more respite. But they all washed their hands. Heartbroken, we had to move my grandma across country to live in our house, where my mom and I figured us and my two sisters had more heart and would help, but then both my sisters completely washed their hands. They feel exactly how your brother does. They are too burdened even by just a couple hours a week. Now it’s all falling on my mom and myself, but I can’t keep putting in 80+ hours a week.
Sorry to rant on, but I just really understand the frustration of disagreement on the best placement and that feeling of family we expect to be good helpers simply bucking the whole thing. As someone said, eventually you will not have enough hands, especially if your brother no longer wants to help. And I also agree you cannot force/expect anyone to help. Have you considered hiring some in home care a few hours a week? We started doing that and it does help relieve stress and pressure. But eventually if you run out of help, a care home really might be better option. I know we’re at that point...
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Wow. Your family is impressive.

The 3 siblings and an in-law having got this far working as a team and sharing the care pretty much fairly, I mean. That is some achievement, and you are a model of considerate co-operation.

And it already isn't working.

Your mother feels bad that she can't do more to help.

Your father is sometimes combative, and that usually happens because the person is uncomfortable, and that usually happens because there are not enough physical hands moving him.

When did you last have a proper break?

It isn't disproportionate because there are two of them and they are always at home, but your sister and BIL are contributing more hours than anyone else.

This really isn't ideal for anyone, is it? And it most certainly isn't for want of effort, goodwill and filial dedication.

And it will get worse.

Your brother is right. Moving your father into a facility where his physical needs are met by *teams* of *trained* professionals will improve the situation for your father, for your mother, for your sister and her husband, for you; and your brother has already given you fair notice. He's out of there come what may.

To repeat, he is right.
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I agree with everyone who advises you to move your father into a facility. If you don't, it is likely that he may start falling, creating an emergency decision. That is what happened with my husband. After our hospice team convinced me to move him to a facility, he fell in the facility. They were able to offer options for what to do about it.
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It doesn't sound like it's working out. And if your mother is competent, she can decide where they are going to live. If they are unhappy and depressed, why not explore a better way? Relying on two disabled people (your sister and her husband) to care for another disabled person and a senior seems odd to me. If you're disabled, you would do well just taking care of yourself. I wouldn't expect them to be caretakers for a senior and another with dementia. I might read a lot, gather information and get more realistic on what is feasible.
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Wow, I so empathize with your situation. I am getting ready to move my 95 year old Father in to my home. My sister lives just behind him but otherwise up until December 2017 he has been living alone independently (since his wife of 64 years of marriage died in 2012. ) He had 2 hospitalizations for sepsis and since the second bout, his physician feels that he needs to not be living alone. He has much short term memory loss although we are not calling it dementia (yet).
Several years ago, my sister and her husband who are retired started encouraging him to think about moving to a retirement facility. They went and looked at a few places but my Father confided in me that he wanted to stay in his home of 58 years and just did not think he could live in a place like that.
I am a nurse, and in good health and physical condition and have the downstairs space in my home for my Father. Our third sibling has mixed feelings about my Father living with me, versus a "home". He is independent and needs minimal assistance, like your Dad, it takes him a long time to dress, etc, but he does just fine with only some help with some things.
I have been staying with him overnight for about 8 weeks now, and my BIL stays on the weekends. But we know that we need to find a better solution, and fortunately, I convinced my siblings to let my Father have some say in the matter.
Again my sister took him to look at some assisted living facilities and he has rather adamantly informed us that he prefers to live with me and my husband even though it means moving about 50 miles away from the place he has resided for over 60 years.
SO, I guess that I could have simply said, I agree, that all family do not have to be in agreement, I am determined that unless my Father's health gets to a place that I cannot manage to care for him in my home, he will remain in the loving care of family and not be in a facility. I would say, follow your heart and find another way to get help on those nights that your brother decides he cannot do anymore.
Does your Father have any long term care insurance or the like that might cover paying for some help just on those occasions?
We have used that some with my Father and found it to work very well.
Good luck.
My difficulty now is that my Father would prefer that we all just keep staying with him so he can stay in his house, it will be a difficult transition in some ways for him to leave his home, but we feel that this will hopefully be a good situation for him once he adjusts to the move.
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All I can say is wow that you actually have help from siblings. I am caregiver for my elderly mother full time and it is killing me. 8 years now. I have had to get part time help from a sitter so that I can actually get out of my house - If you all are against or unable to manage a move to home, have you considered at all having someone come in- even just for nights? Your brother is probably burnt out from previous care of having his mil in his home. Sounds like your Dad requires a lot of care and it sounds very physical. is your brother the only one who can lift him and get him around? I think my husband would actually lose it if we ever had to do this again. So., while it is his mother, it sounds like he is looking forward to retirement and living. You probably know in your heart of hearts if it is time for a move. Are things progressively getting worse? or manage-able? Sounds like you know its time for a change. Maybe look into a trial sitter or temporary schedule change to see if it makes things easier. Always have a plan B. Time to sit down and re group. Family meeting time. Best to you
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Who owns the house you are all living in? If your parents, would it have to be sold to pay for your dad to be moved to a facility? Then where would you all live? You can't force your brother to help out -- 3 nights a week that he's away from his wife & life, which is actually 4 days because he has to sleep during the day. What if he helped out a few hours a day 3x a week? Days HE chooses.

All over this forum you will read the advice from others to set boundaries and keep them. Sounds like your brother is letting you know that he will be setting some new ones. Frankly, I don't blame him. He's entitled to a life. We are experiencing this same scenario with my MIL. Hubby & I believe MIL would thrive in Assisted Living; however, SILs want MIL to stay with them & put a $50K-$75K addition on their home AND are insisting my husband & I "take shifts" being with MIL in their home because she is lonely. Ummm, NO.
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If your brother already did this for MIL, he is further into this chapter than you are. It sounds as if he is burning out or as he ages, realizes his limitations. Please don't judge him. He has been doing really great for several years now. How about a independent assessment? Elder services can send a nurse to assess your dad and give you a picture of his needs and elder services can tie you into whatever help he qualifies for, sometimes at a pro-rated cost. As I don't know your parent's income, you could also try a respite week. Place dad in a nursing home for respite services to see what your lives are like just caring for mom. It may be quite eye-opening. If you decide to place dad in a nursing home, remember, you can be as involved in his care as you want. Then, he gets their expertise (including nursing hours and bedside primary care doctor visits. Lastly, you must consider your mom's health and well-being. Ask yourself, will mom benefit if dad goes into facility. You have done a marvelous job to this point. Now it is time to look at the situation from as many different angles as possible to gain the best perspective.
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Your brother has brought this up & it is time to see about moving your dad - doing this now when you all can check everything out will be much better than doing it under a time crunch in a crisis - your dad will settle much better when he can pick what he wants to keep close when he moves

Your next question will be does your mom go with him too? - if she is capable she can choose - then you will need to look for a place for the 2 of them if she chooses that route or a place she might go later to join him but she will have to make up her mind somewhat swiftly -

Once this is decided then quickly start your interviewing process which can take some time on it's own & will be better done before the crisis [that we all here see looming on the horizon] comes - your brother may stay a bit longer knowing that there is an end in sight - have at least 2 people look at each place & make at least 1 a woman because we see a lot of things men miss

It is galling to know bro is right but he gets away from the situation & sees things with slightly fresher eyes - doing the paperwork alone takes time - this will happen 1 of 3 ways: 1 dad dies at home/hospital fairly suddenly; 2 dad has crisis & he is sent to whatever is available; 3 you start the process & do it in a gentle, kind non-rushed way - I'd pick #3 - good luck
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Although it's very difficult to place our loved ones in a nursing home I would personally advised to keep them in their home or your home as long as possible. We had to put our mother into a facility that was rated 5 and come to find out it was a 0. She was there for two and a half months and only had two baths, a virus of stomach flu went through and she had diarrhea for 2 weeks and they never cleaned her once. She had a UTI and they refused to give her medication and she was so weAK so we removed her and took her to the hospital ourselves and she was severely sick with a UTI along with sepsis infection due to it. After the hospital stay we put her in another home and it wasn't much better. So now she's back home with us for us to care for her but it's difficult because she has dementia and Alzheimer's. I feel your pain for we're living it too. God bless you and the situation
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Seems that your only option besides a facility is hired help to replace brother.
My in-laws had same situation when my husband decided he had spent his share of sleepless nights taking care of Dad and was done with it. MIL would not let hired help do anything; but your mom isn't able to do it herself, so that might work for you.
Once my FIL was placed in a good nursing home, he got way better care than they had been able to provide at home, even with Hospice coming in to help 3 times a week. His health improved, and MIL and other son even agree--now--that this is the best solution.
In reality, it took my husband walking away and MIL getting sick herself to get MIL and brother to agree to put Dad in a better place.
My advice is the same as other's. Find a good facility for him now before a crisis ends him (and/or maybe another of you caregivers) in a place you would not have chosen.
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And, don't rely on the nursing home's 5-star rating. Go there, talk to several residents and their family members. There are some lousy ones, but good ones are out there. Maybe not perfect, but better than untrained family care.
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I see a lot of good answers here. Your desire to provide care and the way you have all adjusted your life to do so is something very special.
The rest is my opinion based on caregiving experience...
No one has an obligation to care for another family member just because they are family. Some family members are not suited to be caregivers no matter how much they love the one needing care.
As you have seen forcing or guilting someone into care-giving when it is not something they choose to do is not a good thing. If your brother doesn't wish to help anymore maybe you should consider letting him go his own way with love and best wishes?
In my experience "forced caring" for someone out of obligation, guilt etc usually leads to less than desirable care being given. Your brother is entitled to his freedom from care-giving roll and you are entitled to choose the caregiving roll for yourself but only for yourself.
What should really matter most is that the person being cared for are given proper care in a peaceful environment. When you cease to be able to provide that care it's a good time to look into other options. If your brother is seeing a lack of quality care happening maybe step back, ask him for specific things he thinks could be better and really listen to his answers. Sometimes we get so close and are so emotionally invested that another outlook is helpful.
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When it becomes overwhelming and starts to affect your health and sanity it's time to move your parent to a care facility.I've been there and done it and would not wish it upon anyone.
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I can understand you wanting to keep Dad at home as long as you can. My sister and I shared care giving for mom 4 years. We alternated by the month. She started out fairly independent, ended up with a broken hip and dementia. It was difficult, we eventually were able to get help in 4 hours a day , most days. It was a sacrifice. Looking back on it, it was worth it. She finally broke a second hip and would never walk again and pretty much had to go into a NH. If I had known she would only last 3 months post broken hip I think we would have taken her home with 24 care rather than a NH. I completely understand you wanting to keep him home as long as you can. As long as you can a
get a break from it and have some back up I say do it. I suppose there are some good facilities but no one can take care of our love ones like us.
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Your brother should feel free to step away from the caregiving. Perhaps he can help in some other way. Life is too short. Let him go without making him feel guilty. For those of you who want to continue caring for your parents, seek ways to get extra help. Step back mentally, and take a good look at what is needed. Can you reasonably provide that? Make a plan and see if it works.
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Look forward to the time that your brother opts out, apart from social visits. Forget blame, it doesn’t change anything except happiness. Could you all cope? If not, what would you do? Plan it now and make it as easy as you can. Look forward further again to a fall or an illness for any one of you. It is bound to happen sooner or later. Could you cope? If not, what would you all do? Plan it now, which is easier than planning in crisis mode. When you have some options for the future, you can all look at them realistically and pick the best option to work towards. The best option may seem better for now than you all currently think, or you may choose to implement it only when you can’t cope. Whichever way the implementation goes, planning is the most sensible way to approach things now.
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I agree with brother simply because you won't be able to continue as such. You will break.
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Does your dad have a durable power of attorney for health care? Has it been activated by two doctors stating that he is incompetent? If no, he has the right to decide to go or not to go to a facility. If it's been activated, it seems like there are a lot of people involved in his care. For those who are able to recognize his needs, strengths, and limitations, have a meeting and talk about it. If majority says that it is time to consider professional caregivers in a facility; your family can become simply "loved ones" instead of caregivers. Be certain to visit facilities without notice. Poor choice facilities? You may see staff in groups chatting and not taking care of the patients. You might smell urine when you walk in the door. Just because it looks nice and it's quiet, doesn't mean that it is a good facility. I don't remember what you wrote about his diagnosis, but if he has alzheimer's, look for a memory care unit.
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I would like to thank everyone for their input. I am Rhonda's youngest sister and Durable POA of both our father and our mother, I am also disabled but I am still mobile. We have already looked into assisted living and dad has spent time in a memory care/nursing facility periodically. He use to go play cards with the residents. He has stated that he doesn't mind going for respite but doesn't want to live there. Right now the most difficult part of this is his immobility, his back goes stiff as does his legs, when this happens he has a tendency to slide down in his chair. There is so much more than this but you get the picture. Last time he was being taken care of by a facility he was there 2 weeks and came home worse.
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You need to be aware that not all seniors know what is best for their family & them - I say that purposely in that order because many have blinkers on about the effect on the family - a single person should not be sucking the health, financial & emotional resources of 2 to 6 people just to keep a promise given without knowing all what was involved - quite frankly the math doesn't work - don't waste your time on old promises that were made blindly but maximize what you can do reasonably WITHOUT JEAPORDIZING OTHER FAMILY MEMBERS OR THEM HAVING GUILT -

You can only do so much for your loved one before you need to prioritize the health of the rest of the family - many caregivers die before the care receiver due to burn out so be aware that this can happen - how much better that your parents get visits from you than going to your funeral because you of neglecting your own help

Sorry but be aware if you are in u.s. but there is $$$$ involved - I spend $2599.00 [1877.75 u.s.] per month for mom in a private room with private toilet including food, nursing, 'depends', toiletries, laundry etc - I feel sorry for you having to make some of the choices you need to do so you must be aware of all involved but it is not just dollars & cents but all the other parts of caregiving life that can suck the life out of your soul that cannot be retrieved - this means a making a choice in the balance of life - I hope I made this clear enough but I feel this can't be coveyed to all adequately
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Oh my, where to start? I read this post this morning, but have not had time to respond, and I have been thinking about the question all day. How have family members come to an agreement.........?
I believe it was the grace of God that kept my four siblings and I
working together to maintain my parents in their home for over 15 years. It started out with hiring a caregiver to come once a week to clean as that was not being done. My father and mother in early 70’s had mobility issues, and some dementia. Then you add alcoholism and mental illness to the situation. It quickly escalated to taking over their finances, helping them through bankruptcy, redirecting their mail, getting an unlisted number, hiring more caregivers, taking turns checking in on them, and dealing with innumerable hospital stays. We had to take over their medicine also. About 7 years ago, my sister moved in for financial reasons and to be closer to family. Every Saturday we took turns covering for her so she could go dancing, (in fact she met and married her husband who moved in with them!), and of course we still had the caregivers coming a few times a week, and we were handling the finances, house repair, etc. At this point my parents were, I suppose, at Assisted Living status because they still had some ADL’s. Over the last 4 years, we all had to step it up with more professionals. Every sibling except my sister who lived with them paid for extra hours with the professional caregivers as my parents needs progressed. We also worked in shifts to be there when the professionals weren’t so that there were always two siblings present.  We took turns spending the night over the years when my sister was sick,  and when she went on a cruise.  At this point, my 200 pound father had to be lifted in a hoyer sling into bed and into his wheelchair. My mother was heading that way also.
     We would have family meetings every couple of months to discuss what new problem had occurred and what everyone was willing to do. My older brother #2 was retired and was the only one strong enough to get my father in and out of the car, and my mother was quickly moving toward needing a two-person assist to move her anywhere. My brother often mentioned that all of us working together was like a house of cards - if one of us went down, it would bring the whole system down.
Well, the house of cards did not crash, but it tottered and swayed, as my brother became more and more stressed and butted heads with my father. He had gotten to the burned out stage, and had no patience with my parents or any of us. My sister said she had had enough and was moving out and had already exhibited several episodes of mental illness. All of us were exhibiting physical and mental strain.
COMPASSION FATIGUE, look it up. It is an eye opener. I believe that is what your brother has, and what we all had when almost two years ago at our next meeting we decided to move toward a nursing facility. Keep in mind, that we had all endured a lifetime of caregiving as we had dealt with our father’s alcoholism and our mother’s bipolar disorder. We all suffer from various levels of mental health issues due to this, and I truly believe we all have compassion fatigue.  I believe what saved our family, was that interspersed with the craziness while growing up, was a profound belief in God, a family talent for music, and a sense of humor.  And we knew our parents loved us.  Even amid all the disfunction, and violence, and police knowing the way to our house, we knew that they loved us.  
      It took us almost two years before we finally had them placed together in a nursing home. We and they are still getting used to this new situation. Though we realize that we still have to advocate for our parents in the nursing home, it has been a positive experience so far. I even believe they feel a bit more independence and control than what they had when we were all in charge and interacting with them in an exhausted state.
   Let your brother bow out, and if you feel you can continue to take care of your father, do so. You will know when it’s time to make other plans. Keep your brother in the loop. Keep talking to each other. Pray a lot.
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Despite the desire to keep it all in the family, I think Treeartist sums it up well. The concern I have is that while they had 5 working together along with outside help, you are 4, most likely soon to be 3, and 2 of those 3 have some kind of disability. What will you do if one of you becomes injured or ill? It is hard enough to care for one person, but you are caring for two.

Consider all options. There are good (and bad) in-home providers and AL/MC facilities. It may take time to find the right fit, but it will be worth it. If finances are lacking, research what services are available for those with limited funds (Medicaid, veteran's benefits, etc.) At least you can try having in-home help to keep them home as long as you can, but you should be checking out facilities as well, because as things progress, you may become overwhelmed by their needs or by circumstances you have no control over.
Also, please do not be harsh with your brother. It isn't easy care-giving and having to give up time, family and one's own desires in retirement, consider that he is also losing sleep by providing care 3 nights/week. While your brother may be stressed, it can also be the person being cared for who lashes out - it happens often to family members who are trying to help. If your brother is stressed and dad refuses to work with him, is verbally abusive, etc, it can escalate issues further.

Please do consider outside help, whether you bring them in or move dad (and possibly mom) out. Again, there are good places and not so good places. If you check them out properly, you can find a good place (do not just rely on ratings - those can be faulty, as another poster noted!) A scheduled visit can answer a lot of questions and give you some idea of how good a place is, but drop in at random hours after, to see how things work when they are not planning to show you around. Although it may seem like there are not enough care-givers, keep in mind some residents need very little help, so those who need more can get help.
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rhondadonda and Kswalker3321, please note that around 40% of family caregivers die while caring for a love one. Not good odds. What if one of you passes, then what? Was it worth a death to keep one's parents living in their own home?

Even if you hired professional caregivers, could your parents budget for that. Would your parents even allow a stranger in their house, many refuse. When my own Dad had around the clock caregivers it was costing him $20k per month, yes per month. I couldn't imagine the cost if my Mom was still alive.

I wasn't a hands-on caregiver, not in my DNA, but I was really good with logistical stuff like arranging doctor appointments, getting groceries, getting tradesmen out to my parents house for work that was needed, if they let them in the door. My folks thought I could do the repair work. Say what??? I was in my late 60's, that ship had sailed a few years ago. Even with doing logistical stuff, I had crashed and burned twice from the fatigue. And I aged quickly. I hate how I look now :P

As for your brother, he already went down that same journey with his mother-in-law. He is physically and mentally burnt-out. Thus, not fair to try to ask him to help. By the way, an elder having dementia is much more exhausting then having an elder who is immobile. One cannot reason with a person with dementia, it's like having a 3 year old in a 85 year old body. 
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