Sister and I can't agree regarding Mum's care

I’m so sorry. I hope it goes smoothly

Does your sister also have a problem with alcohol? This is a difficult situation for both of you but that sounds like harassment.

Would your sister and mother agree for you to be the PoA, buy in some extra care visits and your sister can relinquish the responsibility? (I'm not recommended this but sister's response might be interesting). Otherwise task sister with looking for potential homes, doing the legwork etc.

Key points for me would be what does your mother want (she still has some capacity) then consider recommendations from both the social worker and the good carer, particularly the latter. I agree with PP that good carers will often spot when its time to make the transition. They may suggest an additional visit each day or something else to let her stay home for longer or they may say to grit your teeth because its time to move from a position of objectivity rather than emotional distress.

We put nan into sheltered accommodation she had dementia she didn't last the year she had to put her own mother into a care home and was scared of having the same thing happen to her so sheltered was a good halfway point for her

I've been in this position too.

When I said I couldn't help any more as I was working all hours (I was doing shift work at the time and a lot of colleagues were off) and barely finding time for my own kids my neighbour fairly quickly decided that it wasn't as unthinkable to put her mum into a residential setting as she'd previously believed. In fact she moved within a couple of months.

Sympathies, OP. I see the same battle taking place between DH and his sister. In their case it seems likely that the decision about ongoing care will be taken by the hospital MIL has been in relatively long-term (a specialist unit for psychiatric patients). DH sees no realistic alternative to finding a care home if she can't remain where she is, whereas his sister wants to give up her job, move in with her mother and provide 24/7 care. FIL is still living at home, but is neither physically or mentally equipped to provide adequate care. SIL doesn't live nearby, so staying with her parents will obviously have a dramatic impact on her personal life.
DH thinks this is a terrible idea, both for his sister and his mum, but also objects to the halo of martyrdom that has settled on his sister as the 'good' child. He has their mother's best interests at heart too, even if they see things differently.

I recently just organized this for my aunt. Things were very chaotic at her own home, my uncle was her carer but was struggling as she was resistant to washing, wouldn't eat, take meds etc. She's been way better & happier since she went in. I think she finds the routine reassuring. She's gained back some weight, she's always clean and properly dressed, and she's definitely calmer.

I know I'd prefer to organize that transition calmly, without an emergency prompting it. My aunts was prompted by a hospital admission, and we were scrambling to find her the right spot. I've found generally that people with dementia don't tend to have slow steady declines, it's more often a sharp drop, usually after hospital admission. I think I'd get on it and start looking for a good place for your Mum. Don't leave it till it's an emergency and you're forced into making a bad choice.

Please don't discount the difference in your mother's life & your relationship with her if she goes into a care home.
I kept my Mum at home for as long as possible, for the last 6 weeks I even had a live-in carer with me.
At this point she had lost capacity, no longer recognised her home, in fact because of the uniform of the carer, she thought she was in a home already.
It became extremely obvious that it was no longer working so I did my research of local care homes.
It was the 2nd best decision I have made so far the quality of her life.
The care has been brilliant, Mum blossomed & I was able to return to bring a daughter not a frazzled carer.
The last 5 years have been great - yes she's got worse but seeing her is something I look forward to not dread.
Now I'm making the 1st best decision regarding my mother's quality of life.
She's had a massive stroke & I am about to talk to the stroke consultant about withdrawing the drip & taking her back to the care home for palliative care.

If she’s safe at home and not a danger to herself then I would leave her be for now. Do bear in mind dementia can affect sleep which means she may be up at night confused.
some care homes also run day centres, so that’s a good way of getting them used to somewhere and getting them out for the day.
i have to say we reluctantly did the care home for my grandmother as she just wasn’t safe at home anymore. And it was an absolute blessing. We became her children and grand children again instead of carer. We still went most days. It was a lovely (council) home, she was happy, they had a pub (may or may not be a good thing after the drink comment!!) and entertainment. It was a lovely place and my grandma was so happy there. The staff even came to her funeral.

your sisters clearly struggling with it, it’s hard when your the one doing the work day in day out and then someone chimes in when you probably know the situation better. I don’t think either of you are wrong, good luck navigating it.

MiL and FiL were adamant that she would be cared for at home, she had mild dementia, they had help, and family support. MiL had a slight fall, more of a sliding to the floor really. We insisted she was taken to hospital for a checkup. Not long after she came home FiL's mental health deteriorated, we found a lovely home for her; her mental health has improved, because she sees people, they do activities, she eats regularly, his has improved because he can see her without having to care for her.

Have you had a discussion with your Mum about what she wants?

If your sister is struggling, she needs to be taken out of the equation re a caring role.

What about looking at a personal assistant, someone who is employed by your Mum, would be paid via a third party if you didn’t want the job of that as well as everything else? The PA could support your Mum with going out, doing tasks at home, even just keeping her company listening to some music/watching a film etc.

There is a system justchecking.co.uk/ that you could consider if you are concerned about your Mum and her sleep patterns etc.

Or you could speak to your Mum about some telecare equipment, this doesn’t just consist of a pendant alarm, you can have a variety of additional equipment attached, door sensors, temperature sensors, a bed mat that would trigger a lamp to come on when she gets out of bed in the night.

Re the DoLS, if your Mum does transfer to residential care, she will be assessed by the home manager and if she meets the criteria for a DoLS then the manager will refer to the local authority for this to be completed.

It is always a difficult decision but you do need to think of yourself too. Your husband and family? need you too. It am not sure if you are working too but 6 days a week is a big commitment and it is obviously going to get harder. As others have said it seems time to have a look at homes and find one you like. Do you ever get a break, go on holiday? What happens then, would she manage or would your sister step up. Perhaps you could find a home you like and she could have a few days respite and see how it goes. Once she is in a home it will be far less worry for you. You will know she is being cared for and you will not have the extra house to run. It will be just a more pleasant relaxed visit.
It is always difficult to just make the decision and unfortunately usually happens when there is a crisis but it would certainly help to be prepared and informed on what is available locally.

Surely your DM pre dementia would not have wanted you to put your life on hold indefinitely and be going round there everyday to tend to her just so she could stay at home, increasingly at risk. Would she?!

Have you told your sister that if she doesn’t want to provide care she doesn’t have to? It seems like you expect her to do her one day a week and actually she doesn’t have to even do that and it’s unfair for you to expect her to. Not everyone can cope / manage with caring for a parent and that’s okay. I think you’re at risk of damaging your relationship with your sister here as there’s an undertone of “I’m doing 6 days a week and she’s only doing one” - no one has to do anything. You do it because you choose to, but lots of people in your situation- with an alcoholic parent who has dementia- would just wash their hands of it all and put their parent into care, as your sister is suggesting.

I was in a very similar situation with my own Mum - alcoholism, mental health issues and terminal bowel cancer. I lived 5 mins drive away from her and as her only child everyone seemed to expect me to drop everything and be her carer but I just wasn’t prepared to do that. We had a difficult relationship and I have health issues and a disabled child to care for. I popped over most days and arranged carers 4 times a day but in the end she had to go into care. I just couldn’t and didn’t want to provide the level of care she needed.

If you are happy to keep providing care for your Mum then that’s absolutely your choice but don’t put any pressure or expectation on your sister to do the same.

I would try it for a couple of weeks of respite care and see how you both find it. Your mum would also have company all the time and things to do, which if she is housebound, she won't have now. We have had to place three of our four parents in care homes for various reasons and found finding a good one tricky, but all three were the right decision in the long run.

This is very tricky OP. The problem is that neither you nor your sister are right - or at least, it's not obvious who is right and where your mother will be most comfortable. However, on balance, I agree with the posters who suggest starting the process of getting her into a care home now. It can take a while and will probably be a harder transition if she continues to deteriorate.

I have to say, my MIL had dementia and home care for a few years, with us and my sil doing a fair bit too. Eventually she started wandering and obviously wasn’t safe on her own, so we looked into homes. We were lucky and found a fantastic one. She didn’t deteriorate, she thrived. Yes it took a couple of months for her to settle, and she’d say she wanted to go home a lot (but she’d say that in her own home too), but she was really well cared for, cleaner and put weight on. It was better for us. In the first few years she was in the home we took her out for trips to cafes etc. It was much more enjoyable for us all, her included, than the previous years that we’d been doing her care at home. Like quality time. When she got older and the dementia got worse they were very patient and kind with her. That home was just what we needed.

I do think if my sister was determined to put Mum in a home, she would do more to drive it but she has form for getting really involved for 2 weeks and then being too busy or not being able to cope. It has been a pattern in Mum's care throughout. I being pressured into a decision I am not sure about then I will end up sorting it all out too.

You* *could agree that it’s time to start looking for a home. Give your sister the task of researching suitable care homes. Tell her it’s a great idea for her to do some looking around and seeing what the options are. That you agree it is the next step but just at the moment you’re concentrating on sorting immediate issues with the home care team so if she can do the work needed to get the ball rolling with places to have a look at that would be great, perhaps with an aim to move mum next year.

OP you said upthread that in some ways it would be easier if you did it all yourself, so maybe that's a way to go.

It's an amazing commitment to go over 6 days a week, but to be honest I would also find one day a week hard to manage as well.

Also you said you had some health issues - what happens if you get a bad cold ( my DPs are very disappointed I could not visit this weekend as I have a hacking cough I don't want to give to them) or you want to go on holiday?

Your DMs care should be a balance between what is best for her and ultimately what is sustainable from her carers. Your Dsis doesn't want to do it anymore- that's her prerogative, but by all means see if you can get her to investigate nursing homes and take that one on as she's the one who wants it.

In my opinion, if you are doing the bulk of the caring anyway, and your mum wants to stay home and is safe at home, I think you are the one who should be deciding and not be railroaded by your sister

We had similar with my dad, he had a degenerative disease and didn't want to go into a nursing home, we had a big family disagreement about it, two siblings wanting to support my dad in his wish to stay at home and pass away at home.The others wanted him in a nursing home, in my view it was only for THEIR convenience, albeit it was in the guise of us not 'doing the right thing for dad'.

My sister and I ensured dad stayed at home, and he died peacefully where he wanted to be. I will never regret that decision.

Having been through this, moving to the care sooner will be better for all of you in the long run, my mum passed way last week after even happy years in a place she was cared for and had friends. It was not easy and at first she was in shock but I wish we had moved her sooner and she would have enjoyed it even more. Once you have started the cycle of falls and deteriorating health it is harder and harder to move them.
I understand both of you and your sisters POV as I and my sister flipped on the decision but ultimately it was better for everyone to have 24hr care and not getting the alarm calls when carers were not in the house.

look at increasing the care package and step back yourself.
I'm north west and a decent care home here is £1500 a week.
For how long will your mum be able to self fund?
Does she have a home to sell?
4 times a day care would take the strain off you and your sister.
If you are looking for a care home , personally recommend a dual home. They do exist. As in the have care and then nursing for when residential care is no longer feasible.

(Sorry) the carers said they can usually tell when a client needs to go into a home... often it starts with night waking, so if they are very disturbed at night, that sort of thing.

Would look at home availability locally. Up the number of care visits, employ a cleaner and gardener .

Your sister does not want to be involved in personal care and probably sees the deterioration in her ability to look after herself more only seeing her once a week.

My DGP with dementia went into a care home and it's added years to her life. She enjoys the company as she was lonely living alone and getting 3 good meals a day and someone making sure she takes her medication has done wonders for her.

Personally I think it's sad making people live alone at home in their own place. I guess it depends what the care home would be like, but I think we need to move away from the "a care home is the last resort" mentality and see it as adding to someone's quality of life.

If she's living at home at the moment, she probably doesn't need a dementia care home and would manage in one with a bit of nursing care.

Why don't you think about putting mum into a care home for respite for a month - you can then extend the stay to permanent if you both find mum is coping better.

MIL has dementia (vascular and alzheimers) she has carers in 4 times a day which is working at the moment. The carers said