How do we decide on a parent's next level of care when there is disagreement among siblings?

I have waited for siblings to get on board with my dad when he went down hill, that all went so so horrible , and now with mom I'm dpoa and mom had her attorney filed a lady bird deed in michigan, now probàte court won't be able to screw her around like thay did dad. Take control and fast. Good luck with siblings,

Imho, moving her in to such a large household of seven would not be a good dynamic. Prayers sent.

I’m seeing that the sibling issue is divided 2 ways in my family: Those who want mom to keep her money for her care and those who are hoping she’ll die sooner because they’ve been counting in an inheritance

The endless sibling problems. What a shame. If somehow you can get them to agree to have all participate in family counseling with a third neutral professional, that would be a way. We hired a representative from Lifespan as a tie breaker on decisions. Now srart documenting everyday. You may r may not need this, but f a feud ever evolves, you will have a record of things. The good thing? It sounds like you have options, many do not.

Maybe the sibling who wishes to take her in can stay with her for a couple of weeks to learn her schedule. If she can handle to increased needs and has a good plan for meeting needs throughout the week, month, year... then this make be Mom's best plan.

My Gram lived with my Mom for 7 years. My sister and I would "sit" Gram when needed. Our adult children have also taken turns "sitting" Gram. It really depends on your mom. Is she the "relaxed, go with the flow" type or easily agitated when there are "changes"?

You deffiently have a good head on your shoulders.

There would need to be a trial run before your mom is uprooted to go live with your sister.

You should first talk it over with your mom. She will probably say no.

It is gard to live with anyone and especially moving from her own quiet place to a house with kids.
My 96 yr old Dad wanted to stay at his own home and he had Caregivers 24 7 which is very expensive so instead of his children getting an inheritance, my Dad gets to live his life out in his own home like what would happen if I wasn't managing his affairs.
My decision to allow it and not put him in a home where his Medicare would pay but I know he would be totally sad, scared and unhappy and he probably wouldn't live long as the will to live has a lot to do with it.

You may also think about hiring a Live In, thst's much more affordable as long as there is an extra room for the live in Caregiver.

I will be doing they later when my Dad outluves his money because it is about 1/4 the price of using 24 7 Caregivers doing 8 - 12 hr shifts.

Ask mom and then try to put yourself in her shoes and do what she wants you would want done for you.

Donto worry about anyone else.

It's very hard living with an elderly and I know several elderly that have sold their homes, given their money for their child to get a larger place then move in with them which all lasted less than a year and then the grown child couldn't handle it and the Senior ended up in a Denior Care home. 😥

Going from living alone to living in a house full of kids and commotion is A LOT for anyone, let alone a 90 yr old who is used to living by herself.  If mom is still with it, she gets a say in what she wants.  Can you hire someone to come in and spend several hours with her every day to handle her meds and take on some of her cooking, cleaning and laundry?  That would take some of the pressure off of the sibling who lives the closest and has taken on most of the responsibility.

I agree that moving her into a facility during the pandemic is a last resort.

Get a third party involve. Someone all of you trust or even a stranger to the family - like arbitration. Lay out options and the rationale; have them give input; See if that breaks the log-jam. Or you could just decide to go with the third party recommendation

I actually have identified who I want to be the third party, in case that happens with my sons.

It never is a good thing to move a parent into the care of one's' family home. While you think that it is best, it takes quite a lot more than your feelings. It becomes a 24/7 commitment. Vacations as you know it, other activities for normalcy will become forever changed. There is a lot more stress with them living in your home than anyone can imagine especially when their health goes downward, this can be over a long period of time or can happen overnight, and who will get the blame if mom falls, gets sick and stops eating, the person who has them in their home. It is best to start seeking out a senior care facility that she can afford or can get assistance via Medicaid or VA. While there will be issues with what you feel that Mom wanted, it is really in the best interest of all involved, I have actually taken the time to write in my POA what I want to happen should I need care, I have listed the facilities that I would like to stay if it is at all affordable for me at the time I need it. I have been in the position you are in now with the care of a parent with siblings disagreeing, and found that the best course is a senior care facility.

One thing is for sure; Moving in with the siblings family is not an option. The family has 2 options- leave her where she is or find her a care facility she can afford.

How about a disinterested third party that could gather your mom's history from the family and make an assessment of care level needed? Hiring a social worker for an assessment visit can help. Calling and talking to your state Dept. of Aging, your local Area Agency on Aging and the Alzheimer's Assn can help with your decision. They will all offer assessment help. They may also help in discussing care facility options.

You may not be able to all agree on anything. Hopefully you have a good relationship with them and can speak reasonably about what it best for mom AND best for each of you.

Sister with 5 kids offering to move mom in is CRAZY! Her house is already a 3 ring circus and there is no way your mom should go there. She's used to being alone and this would be way too much for her to handle! It's kind of your sister, but encourage her to find a different way to help out.

Glad you have POA. Talk to mom and see what she thinks. But sometimes the elderly don't have great decision making skills. They often just want to stay where they are, even when that is a very unsafe option.

Start with adding a home health aide who can help your mom with errands, cooking, cleaning, etc. Someone to sit with her. Does someone already take care of her meds, etc.?

This is not an easy time of life for any of us involved with our parents aging, not so gracefully.

Good luck.

The person with the medical Power of Attorney makes the decision. This is why ONE person should have the POA, not multiple siblings.

Thank you for responding so quickly. This forum is wonderful and gives me a lot to think about. I am praying that we can all agree to do what's best for mom.

The 1 closest needs to be in charge imo. Can you be firm enough to establish this with your 2 siblings? Or do they need to have loads of info to back off this idea?
Please before this gets too far along, educate yourself on just what Medicare and Medicaid are & more importantly are not; what type of secondary insurance with her current Medicare; what type of care or oversight she requires (gets done via a “needs assessment”) & what costs of inhome care and facilities are.

Also for her IL, any concern by staff as to her not being IL enough to be there? Possibly on cusp of being asked to move to higher level of care? If so, doubt IL would let her leave apt for a “trial”. May be a way to rid an approaching problem.

Cali is spot on.... Medicare will not pay for room & board as a resident in a AL, MC or NH. She’ll need to apply for state run Medicaid. Have to keep that in mind as she has no $.

I’m assuming you are eldest & nearby, right? & that you think its beyond crazy to move 90 yr old mom w/dementia out of her well established daily routine living solo in an IL & move into a household with 2 adults & 5 kids under 20, right? So do you currently have DPOA & MPOA for your mom? Or is it one of the other two? Or - horrors - no dPOA?

Got to ask..... Could your mom be promoting this? Like manipulating for attention? Does mom show dog when siblings visit, like she gets super duper independent, super sharp and carps about being an ignored, neglected widow behind your back? (my mil was this)

Or is this all that one siblings storyline? Sib with the team of kids, honestly what’s your take on wanting to have mom move? Perhaps thinks mom can be extra unpaid help around the house?? 5 kids is a lot of activity. Or thinks will have access to moms $$$? 5 kids requires a big budget no matter where you live. Or is this a Smothers Brothers “mom loved you best” dramarama playing out?
What about this siblings spouse, are they promoting the move? & if so, why? Has your mom ever been super involved in this family in the past? Like the kids for eons spent summer vacation for weeks with mom, so they have an existing deep appreciation & love for her? Teens will hate having old lady with dementia around.... even if they love grannie.

Realize that since move entails becoming a resident in a new state, any program or health insurance that is tied into her current state residency will stop. If she’s on any type of meal or transportation program that’s state supported for residents in her IL, it will stop. She will have Medicare (it’s federal) but if she went onto a Medicare Advantage Plan those are tied into tight narrow service areas, so she’ll need to find a new Advantage plan. If she’s Original Medicare some of thier gap plans too have set service area. All her banking, direct SS deposits, etc likely all need to get changed as well. New DL or state ID card. All new health care providers for a 90 yr old. Will your sibling or thier spouse, have time, patience & attention to detail needed to get all this stuff done with her??? Cant be 1 of the kids doing this. Her banking & SSA stuff likely need done in person, is her dementia such that she can seem competent and cognitive on her own with a stranger for 15-45 minutes? Plus she’ll need new legal done for the new state too.

I’d be very concerned that she’s all ok now as she’s on auto-pilot. Her days are much the same; she knows her apt, neighbors, mail / meals / activities schedule without having to actively process information. Move her & it will be constantly challenging. 5 kids is easily 3x friends in & out plus all thier stuff, noise.

If your sibling insists & moves her, imo you have to tell them they canNOT have option of a “trial period” & returning her. She’s not a library book. It’s not a vacay, she moves or she stays. Just sayin’. Good luck.

I think that the Mom is the main decider here; she is not very demented if she is living independently with only visits. I think the POA is the second in line to help with decision. The offer of the living space for Mom is wonderful, but wow, with that many in the household I sure do agree that a trial for several weeks to a Month while hanging onto the Independent Living facility that seems for now to be working, is an excellent idea. It may not work for Mom and it may not work for the family;and then it may work for all concerned.
All of this is so individual for the people involved; I just note that sometimes the elder her or himself is left out of the equation when discussing.
Good luck. I hope you will update us.

The POA makes the decision. If Mom is still with it and hasn't assigned a POA, she should. Makes things so much easier when she can no longer make informed decisions.

Medicare is health insurance usually received when you turn 65. If disabled and receiving Social Security Disability, can be received before that. It will pay for a rehab stay of no more than 100 days, 20 days 100%, 21 to 100- 50%. As said it does not pay for AL or Long term care.

Medicaid may pay for Longterm care but there is criteria that needs to be met. Its for people with no assets and a low monthly income. It does not pay, normally, for ALs or MCs. They are private pay. (In my state it will pay for an AL if you have paid at least 2 yrs privately and that depends on if the facility allows Medicaid)

It’s hard enough for an only child to decide on care for a parent. It’s more complicated when several siblings are involved.

I actually know a family that the mom with ALZ does move in with each sibling. She rotates three times a year. She is doing well with this. She has clothes and other essentials at each home so there is no packing of belongings.

She was a pleasant person before getting ALZ and continues to be. Who knows what the future will bring. They say they will address that when it happens but no one is burning out because they are a very rare family that shares the responsibility equally.

I have only known one person in my family with ALZ, my godmother. She was never a pleasant person before or after ALZ.

Rotating homes would have never worked for her. She was going blind with macular degeneration. She was always very argumentative.

My godmother was often frustrated and frightened. She needed to be in a facility.

Neither of her sons would have been able to do it. One of my cousins lives far away, is a music professor in California and the other one that lives close by has never gotten along with her because my godmother hated his wife. His wife hated her too.

So all circumstances are different. Can you speak to a social worker to help you decide what would be best for all concerned?

Wishing you all the best.

How do you decide on next level of care? The Area Agency on Aging will do an assessment to help determine what is necessary and plan for future. Disagreements between sibs should not be a factor. Remember this is about mom and what is best and necessary for her.

With five children in sib's home, this would NEVER work for mom. Too much activity especially considering her needs for quiet. Would be too confusing for her and most likely cause agitation which will not do anyone any good.

Medicare will not pay for assisted living or a nursing home or memory care. You need to talk to pros in the field to get educated on what options mom will have when the time comes.

https://www.agingcare.com/articles/all-ways-to-pay-for-long-term-care-195529.htm

https://www.agingcare.com/articles/planning-ahead-for-mom-and-dad-elderly-care-134124.htm

Medicare won’t pay for assisted living at all. Just so you know. As far as the disagreement everyone needs to focus on what’s best for mom. If she has dementia then moving her around could be very detrimental. And those who will be most involved-the ones who live closest-should have the most say.

Your mom should live near (not with) the sibling(s) who have PoA for her. Your sibling with 5 kids is well-meaning but has no idea how much care your mom is going to require and even more down the road. Have her read some of the thousands of posts on this forum under Caregiver Burnout. Many a loving, well-intended adult child has nearly lost their minds with stress and had their marriages and health deteriorate because they could not possibly understand how intense it would get. Others will soon post their personal experiences and wisdom. I wish your family success and peace as you work through this decision.