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I could use some assistance in trying to prioritize resources and care for my family. Basically, my mom is in the mid-stage of Alzheimer’s. My father was her primary caregiver in their home, which he called "The House of Misery" due to my mom’s anxieties, hatefulness, and narcissism. My sweet Dad just unexpectedly passed away. We never had any sort of family talks about my parent's final wishes, their finances, basically nothing! I have been commuting from a different city to take care of all my dad's final arrangements (funeral, legal stuff, etc.). I threw together a team of in-home caregivers for my mom and they are there with her 24/7. The added complication came when my brother's home was destroyed by a tornado, and I had to go rescue him and take him into my mom’s home. "Brother" is somewhat mentally limited himself and isn't comprehending Mom's disorder. Twice now he has forced caregivers to leave Mom's home because he thinks THEY are the cause of Mom's tantrums and weeping. I can't afford to lose this caregiver agency because, I live in a different city. Being the only one with any sense in the family, I've been trying to make decisions for four souls. Dad, mom, brother, and their cat. Feeling like I'm failing at every turn. Where do I start getting back on track?

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Nine Cats,

You aren't failing. The simple truth is that no one but a magician or an Omnipotent God could manage this one. We are human. We have limitations.

A step at a time you ARE doing this. But I worry about mixing the needs of the brother now with the needs of the mother. Was the Father ALSO caring for HIM? Who else is there in that area who is family and willing to help?

Were you POA for your Dad or are you POA now for your Mom?

I would say you can only take this one day at a time, but the sad truth is that if you cannot BE there physically, take a leave from work, you cannot do this. It will simply not be possible. If you cannot do that then you will need to notify APS that your Mom is there, without a POA or guardian, and is unsafe and in need of placement. She may need to become a ward of the state if you cannot accept emergency guardianship for her. So this is the most dire situation. A situation in which you have NO power, NO access to financial power, and NO power to place someone, WHILE you live miles away.

Now, let us assume you take a leave and go to Mom's place where you say brother also lives. That would mean A) seeing an attorney to get emergency guardianship after the burial of dad takes place. This is paid for by your Mom's assets, but keep careful records of expenditures you make so when you are guardian you can reimburse yourself.
B) find placement for Mom. If you have to let her spend down, fine, but you will also be spending down as you use an attorney for guardianship and making home safe.
C) Sell or make safe Mom's home (which she can keep with medicaid clawing back the funds after her death.
I don't think you can handle your Bro as well. HE may need to be a ward of the state with placement if he cannot function on his own.

I honestly cannot imagine this. Looked at one way, if you did not exist, if it WERE only Mom, Dad and brother with his limitations, the STATE would be taking over, or brother and Mom would be living in a very unsafe manner and this IS often what happens.

You are only human and you have a life and this may not be able to be handled by you. If it can, it can only be done one day at a time. To be frank your situation is so overwhelming as to be unimaginable to me. I am so incredibly sorry. I wish you so much luck. Your every day now is going to be a learning about your own limitations and the limitations of our health system. I hope you will update us as you go as you will be a beacon for others who will be faced with this sort of thing in the future.

Again, I am so sorry. I so wish you the best.
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"Brother" is somewhat mentally limited himself and isn't comprehending Mom's disorder."

Was brother on his own or in a group home? First, you tell the aides you are the client who hired their agency and they are not to listen to brother. When you can, check out Moms finances and if she can afford it, place her in a Memory Care Facility or if no money LTC with Medicaid helping with the cost of care. Then you deal with brother.

My Mom allowed my nephew to live with her when he turned 18 not realizing what it took to get him help. She was 80 showing sighs of decline. Really, him living there was a big help. It started out getting him Medicaid for help. Signed up for Supplimental Income (SSI) and Social Security Disability. All this done at Social Services. Eventually, he received SSD, Medicare and Medicaid. When Mom died, the house needed to be sold so we then had to work on getting him a place of his own. Our County Disabilities helped me there by putting me in touch with the State. They excepted him into their program. He gets a voucher for rent, he pays 1/3 of the rent. He gets a Coordinator and an aide for 5 hrs 1 day a week. The aide cleans, takes him shopping, and to appts. He was working at ARC (workshop for challanged people) but COVID has stopped that for now. He lives on SS and his mothers pension for now.

I found I needed to take each problem one at a time.
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It's not clear how limited your brother is from your letter. Was he living on his own before, or in a group home? Is Mom's condition something he CAN understand, or is he in denial? Does he help your mother by being there?

The aides MAY be the cause for your mother's tantrums and weeping, even if they're wonderful. If your brother can't understand this, then he needs to be somewhere else, because he's standing in the way of her care.

You'll need to get POA over your mom immediately, including medical POA. This involves a lawyer and a doctor; the doctor has to declare her unable to make decisions in her own best interest, and the lawyer can give you, as the only fully functioning relative, be POA.

For now, forget trying to take care of everyone's state of mind and get those things done asap. After that, you'll have the legal power and ability to get them into better situations.
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