Am I handling this the right way?

[nc9205]

My half-sister,who is 84 years old, has started showing signs of dementia.   There is 18 years between us, we have different fathers, and we have never been close (something happened before I was born). I have never known her father but both of my parents are now deceased.  Recently she was hospitalized due to a fall and, due to the fact that she could not tell the doctors what happened (she was alone at the time) and I am unable to care for her, the doctors and I made the decision to place her in assisted living.    I have placed my life on hold, trying to take care of her business but now I have to address my health concerns.  The problem is that she doesn't want to be there.    She says the place is nice and the people are nice but she wants to be on her own.  She feels she can take care of herself.  Problem is, she can't.  She has called me several times already, asking me to come get her because she does not want to be there.  I have explained to her several times when she was living at home that I was trying to work with her but if she continued as she was (misplacing things, forgetting things, making up stories, disappearing) I was going to have to place her somewhere and she seemed to understand.  But now that she is there, she does not like it.  The problem is I am only one person.  I cannot handle her business, my business plus keep her entertained.  Oh and I forgot to mention that, due to the way she handled her affairs, her business is very complicated and it is no simple matter.

[DrMarcy]

It is very difficult being a caretaker. You have assumed multiple roles which is often very overwhelming. you have identified clearly that there are multiple issues to coordinate including managing your half-sister's health, over welfare, her business and your life. It is a difficult decision to place a loved one in a facility. There are many situations where qualified staff can care for your loved one in a different way than you are able to at home. It is always helpful to stay in touch with the staff, medical professionals while visiting your sister. You can also consider receiving outside business expertise to assist with your sister's business. There are many colleges and universities where students may be able to assist you. Give yourself credit for al that you do. Best of luck in your caring journey
Dr. Marcy

[nyadrn]

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@nc9205 wrote:

My half-sister,who is 84 years old, has started showing signs of dementia.   There is 18 years between us, we have different fathers, and we have never been close (something happened before I was born). I have never known her father but both of my parents are now deceased.  Recently she was hospitalized due to a fall and, due to the fact that she could not tell the doctors what happened (she was alone at the time) and I am unable to care for her, the doctors and I made the decision to place her in assisted living.    I have placed my life on hold, trying to take care of her business but now I have to address my health concerns.  The problem is that she doesn't want to be there.    She says the place is nice and the people are nice but she wants to be on her own.  She feels she can take care of herself.  Problem is, she can't.  She has called me several times already, asking me to come get her because she does not want to be there.  I have explained to her several times when she was living at home that I was trying to work with her but if she continued as she was (misplacing things, forgetting things, making up stories, disappearing) I was going to have to place her somewhere and she seemed to understand.  But now that she is there, she does not like it.  The problem is I am only one person.  I cannot handle her business, my business plus keep her entertained.  Oh and I forgot to mention that, due to the way she handled her affairs, her business is very complicated and it is no simple matter.

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This is just another in the thousands of examples of the total lack of personal responsibility that so many adults are guilty of.   There is absolutely no doubt whatsoever that you are going to get old and face these issues.  While you are cabable you need review your situation and make your own decisons about what to do.  I hope that everyone that reads these posts and makes suggestions to someone else has made their own plans.  I can say that I have.  There is no excuse not to!  If you do not, then when the time comes and someone else makes these decisions for you, you will have no one else to blame.

[AnnaPlummer]

Hello, I agree with what the other replies said, and additionally:

Does your sister have someone who is her Power of Attorney? And like others said, it is a good idea to reach out to people who know her, like friends, previous neighbors, coworkers, her church - to ask them to visit with her on a regular basis. If she has visits to look forward to, it greatly helps.  If she likes pets, having someone bring their family pet to visit is a good idea.

I am all for home care, but sometimes, depending on the situation, and when it comes to alzheimers and dementia, sometimes it's better to be in assisted living or nursing home. Every situation is so very different and complex.

As far as thinking about your sister living at her own home, a lot depends on that, here are some tips:

- She would need an accountant or financial advisor or someone to be responsible for her money.

- She would need to have enough money to be able to pay for her household and someone to manage that.

- Instead of paying for an actual Geriatric Care Manager who has all of the creditials and degrees, there  is a more economical way of having a Care Manager:

There are many caregivers out there that can provide this type of service - former nurses, nurses aids, etc. For instance, there are married couples that do "Couples Jobs", there's even websites for that, who provide 24 hour live-in care, who can be responsible for hiring / scheduling / supervision of additional home health aides, and who take care of the household budget and deal directly with the financial advisor, etc. Or even one live-in person can handle this type of job with additional caregivers. The great thing about it, is that it is more economical to have live in caregiver, because the caregiver(s) gets to know the patient well, knows what the house & yard need, can help to keep utility costs down, can make sure the bills get paid, patient gets their medications taken on time, to prevent falls, drive patient to doctor appointments, and can provide exercise and physical therapy, occupational therapy, etc, without having a specialized degree in Geriatric Care Management. And most importantly, the patient is their only patient, so they are much better taken care of, are stimulated more, and become "like family" with the caregivers.

It can be tough to find a perfect match - My husband and I did a 2 year live-in job for our neighbor, until she passed away - It just so happened by chance, that we were available to do this at the same time our neighbor needed this type of service. We did everything & more that a Geriatric Care Manager would provide, my nursing skills and my husband taking care of the budget, bills, yardwork, etc. For most of that time, we were running 3 different households: ours, plus she had 2 homes in different states, so we had a lot to do, like keeping track of all the bills, plus providing 24 hour care - we did not sleep much, worked 7 days a week for 2 years.

Of course you would want to hire someone with healthcare experience, who knows how demanding the job is, and someone who the patient trusts. Reminder: A background check on someone does not show how trustworthy they are - you have to really get to know the main caregiver(s), unless it is someone that the patient, like your sister, knew from the past. 

With a bit of research, you might be able to find someone that your sister already knows, or even relatives of someone she knows whose family she trusts to take this type of job - maybe someone who is looking for a change in their career, or who is retired, who has nursing or home health care experience.

-Also, there are people who run an assited living business out of their own home - Years ago, I helped, part time, with a married couple who built their home especially for this type of business. They had 3 patients who each had their own bedroom, got a full bath daily, and were extremely well taken care of. They felt like they were more "at home". You could search for these types of arrangements online.

Good luck to you, please know that there are many responsibilities that you can delegate to others to help, to keep yourself from getting overwhelmed - don't be afraid to ask. You can even find other elderly folks who are lonely, to come to visit your sister. Search for volunteers for things like this on the internet.  I understand how hard this is, it's very time consuming to run multiple households, and to take care of all the needs of an elderly person.

[JaneCares]

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@nc9205 wrote:

My half-sister,who is 84 years old, has started showing signs of dementia.   There is 18 years between us, we have different fathers, and we have never been close (something happened before I was born). I have never known her father but both of my parents are now deceased.  Recently she was hospitalized due to a fall and, due to the fact that she could not tell the doctors what happened (she was alone at the time) and I am unable to care for her, the doctors and I made the decision to place her in assisted living.    I have placed my life on hold, trying to take care of her business but now I have to address my health concerns.  The problem is that she doesn't want to be there.    She says the place is nice and the people are nice but she wants to be on her own.  She feels she can take care of herself.  Problem is, she can't.  She has called me several times already, asking me to come get her because she does not want to be there.  I have explained to her several times when she was living at home that I was trying to work with her but if she continued as she was (misplacing things, forgetting things, making up stories, disappearing) I was going to have to place her somewhere and she seemed to understand.  But now that she is there, she does not like it.  The problem is I am only one person.  I cannot handle her business, my business plus keep her entertained.  Oh and I forgot to mention that, due to the way she handled her affairs, her business is very complicated and it is no simple matter.

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Hi there, half sister. I must say she is lucky that you stepped up. If you hadn't , or you didn't exist, she'd eventually be found incompetent by medical experts and a judge, and a guardian assigned, who'd then probably hire a geriatric care manager to do things for her until the money ran out, and then she'd be stuck in some Medicaid funded facility which may or may not be up to standards.

That said, i agree with the other posters, you've done well and she is lucky. So now what? Since she has enough income/ savings to fund assisted living care, is there enough to hire an accountant? a geriatric care manager to actually analyze the care she's getting and keep you in the loop? If you can manage and can stand it, do visit her. You have a tenuous connection but one that is important, and you are honoring it. Maybe hire an accountant with her money? 

I guess here my point is that you could and perhaps should for your own sake delegate as many tasks as you can.

Is there no one else? Any other relatives? 

A colleague of mine once had a client who had absolutely NO ONE, and my colleague found a former employee of the client who ended up visiting every week and spending wonderful afternoons with this lonely old guy. Loved each other, even as the old boss sank into dementia.

Anybody?

Write more. How are you feeling about this? What is hardest?  So glad you brought this up. A lot of us out here take on family members and we were never close... a sense of resentment can grow very quickly.

best of luck to you,

Jane

[n229052w]

I think you are handling the situation the only responsible way that you can.

I remember when we first had to put our mother in an assisted living facility we went through the same thing.  She hated it and she made darn sure that I knew it and that I was never going to be forgiven for treating her this way.  I was devastated.  I talked to her doctor about it and he told me that this was very common in the early stages because they still remain somewhat cognizant of the world around them.  As the dementia progressed, she began to relax.

I'm going to tell you what the doctor told me:  You have a life and despite what you are being told by your sister, you are entitled to live that life.  It is a life that you cannot live while you are consistently worrying about her health and safety in her home.

Do what you can, visit as often as possible and live the best life that you can.  You did the right thing.

[SIMPLEGAL]

n229052w,
Your response was excellent! How is your mother doing?

[bw74618660]

Maybe you should contact the director of the Assisted Living facility and explain your concerns. I am sure this is a common problem. Sometimes they have a medical social worker who can help as well. Good luck, you have my sympathies and respect for your courage.