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My sister and I disagree on our moms care. Our mom has mid grade dementia. She has been in a NH for 4 months since developing covid. She needs assistance to walk, bath, dress and sometimes eat. She toilets with help rarely as she is incontinent. Previously she lived alone with help of my sister and I along with several aids. She now needs 24/7 care. My sister wants her to go home. Her house has 2 sets of stairs to get to the main floor. I am concerned about getting her in and out for doctors appointments, lab work, or in case of an progressing. Also dont know how she would be able to get bathed in the bathroom she has. (Normal tub and small) She has gotten much better since getting over covid but her dementia is slowly proggressing. If she would be brought home, she has enough money for a live-in person for about 9 months. Her house can't be sold if she's living in it and at that point she would need the money from her house to continue care. I am struggling with this on a daily basis. I do think she is better off staying where she is. She has access to medical/and emergent care if needed, more socialization, and limited pt to help keep her moving. We also are able to sell her house if needed for her continued care. Having said that, I still feel like the bad guy in not wanting her to go home. It is really putting stress on my sister and my relationship. BTW, we are both POA's, which probably wasn't the best decision. Thank you for any and all opinions on this issue.

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I would tell your sister that if she insists on taking your mother home you will not participate in her care, and will resign your POA at once. What she wants to do is unreasonable. I doubt, with her having sunk into a mental state so unreasonable herself that YOU will be able to reason WITH her, so simply make it clear that what she is doing amounts to a sacrifice of both your lives that you are unwilling to make.

Then, if she DOES this, you will need NOT to enable it.
This isn't an argument. This is a simple case of a very bad decision making on your sister's part. If she makes it she will have to live with it so long as she's able.

You and your sister didn't cause this sad situation for your Mom and the two of you together cannot fix it. Your Mom has had a life and the two of you have a right to have your own, rather than sacrificing your lives on some altar of perpetual enslavement to caregiving.

I am so sorry. This has to be so hard. Do it gently and tell her you are sorry but your limitations are such that you cannot undertake this care, and you have zero intention of attempting to do so. Don't argue with her. Simply state that one sentence over and over. I wish you the best and hope you'll update us.
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NeedHelpWithMom Apr 2023
I love this answer! This makes total sense to me.
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Why do you feel like “the bad guy” for attempting to make the best choice you have available for her current level of care?

If your sister prefers that she be brought “home”, is she prepared to assume full responsibility for your mother’s needs, in a house with “2 sets of stairs”?

What is your sister’s reason(s) for bringing her home?

Your mother’s situation WILL PROGRESS. dementia may seem to plateau, but it doesn’t go away or get better. Is your sister VERY CLEAR on that?

It is ALWAYS difficult to establish a SAFE, STABLE lifestyle for geriatric patients with cognitive loss, and if Mom is comfortable now, what reason is there really, to change the setting she’s in now?

Hoping that you and your sister can come to a reasonable arrangement moving forward, but as caregivers for a vulnerable dependent person, also hoping that you both can put Mom’s needs first.
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Your mother has dementia. Dementia is progressive and life limiting. Mom is not going to "get better" the way a younger person, fundamentally healthy, with a temporary downturn due to covid might.

What does mom's care team at the NH think about your sister's idea to bring mom home?

What is your sister's plan once the money runs out? Is SHE going to move in and care for mom around the clock?

It is sad when our parents need nursing home care. Feel sad, not guilty. You didn't cause this to happen.
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Yes , mom is not going to improve .
Mom is settled in care home now .
I think if you took her home , the transition could very well cause her decline to speed up again . That will just have you doing the inevitable U turn back to the facility a bit sooner .
The back and forth is not good for your mom .
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If you have 9 months worth of money for home care use it for the NH. 3 months or so before its gone, start applying for Medicaid so when the money is gone, you go right into Medicaid. Her home and car are exempt assets while she is living. Just be aware, once she is on Medicaid, her SS and pension are required to pay her share of her care.

My Mom was living in an AL when her money got down to 20k. April I applied for Medicaid, May 1st I placed her into LTC. The 20k paid for May and June and spent her down. I confirmed with her caseworker that she was spent down and he had all the info needed. Her Medicaid started July 1st. In my state u have 90days from date of application to spend down, get Medicaid info needed and place the person.

You sister needs to realize that bringing Mom home is not workable. And, if she does, don't expect you to help. Its just not realistic. Maybe a sit down with a SW at the home would be a good idea. She can explain to Sis Moms needs that cannot be met by taking her back to her home. If she is a two person assist, I doubt u will find an aide to care for her anyway. I agree Mom is not mid stage. There are 7 stages and I would say your Mom is in the final 2.
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You are not the bad guy here. You are the good guy. The reasonable and practical guy who is thinking clearly.
Keep your mother where she is. You say she needs 24/7 care. She's getting it where she is.
When someone doesn't use the toilet anymore and has to be fed by another person, that dementia is not mild to moderate dementia. That is advanced dementia and that will advance further quickly. She has been in the nursing home for four months. She's gotten used to it. Taking her home now may even cause serious setback in whatever independence and lucidity she has left. Also, she may not get it back.
Leave her where she is.
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To be blunt, your sister is a knucklehead and lives in a fantasy world.

Why does she want to bring her home? Is it guilt? It she incapable of seeing the level of care Mom needs? I haven't seen you address her reasons.

Ask her why she wants Mom to receive substandard care at home and see what she says about that.

Who gets to make this decision anyway?
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Peeps83 Apr 2023
She has no real reason for bringing her home. She just doesn't want her in the NH. She doesn't think beyond that or what is best for her. I think the main reason she wants her home is because our father passed at home. The difference is that he was able to ambulate, and could still take care of most of his ADLs at 92. He had some short term memory loss due to a stroke, but only needed slight assistance. His lung cancer came back, but he didn't get bad until Hospice had to be called in. He only lasted about two weeks after that. My sister doesn't understand that the two situations are not comparable.
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Leave mother where she is unless you get Acorn stairlift, lift machine, hospital bed & all other supplies…then you have to employ a schedule of Aides & be home to supervise & open door for them. All meds have to be administered by family as home health aides will not give meds or do wound care. Hugs 🤗
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You stated her dementia is slowly progressing, she needs 24/7 care, she has money for live in caregiver for 9 months.
And then what? You need 5+ year plan or money.
You need to tell your sister it is not realistic and safe for Mom.
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Ask yourself these questions..and ask your sister.
I am going to assume that you mean that mom is in Memory Care not a "nursing home" aka Skilled Nursing facility.
Is mom safer where she is?
Is mom getting the care that she needs?
Is mom getting involved with activities?
Is she "reasonably" happy. (I know this is a loaded question as everyone wants to "go home")
Can mom get the same care, the same safe environment she has now, the same socialization at home?
It is not that you "don't want her to go home" it is that you realize that mom is declining, she will need more help not the same or less as she continues to decline.
If you bring her home and her money runs out in 8 or 9 months that you figure that she has to cover her care..what happens then?
Dual POA is possible but when the 2 do not have a meeting of the mind it can get tricky.
Playing the devils advocate here...
If you both disagree and your sister decides that she is right and takes this to court (highly unlikely but let's pretend here for a bit)
I think the judge would rule in your favor as mom is safer where she is, she is getting 24/7 care.
(By the way did you figure 24/7/365 care when figuring that mom's assets would last 9 months? Overnight and if mom is taking meds the cost will increase)
If you are tallying votes...I vote that mom stays in Memory Care.
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