Hi RJQMAN,

Wow.  What a tough situation.  And what a shame your sister refuses to prosecute the neighbor who stole from her.  Sometimes I think the reason the elderly are so hesitant to seek legal attention on such matters is because they're embarassed they "fell" for it.    But that's beside the point, I suppose.

What is your sister's reluctance to move near or in with you?  I ask because if there are well-founded reasons, they should be considered.  But if she's simply putting her foot down because she can, then perhaps your reasoning with her could change a bit. 

What type of care does your sister need?  Have you talked with her doctors about deciding what would be best?  If she trusts her doctor, perhaps she would understand that a long-term care facility may be in her best interest.  Plus, once you get an idea from her doc what type of facility would be the most suitable, perhaps the two of you can go visit a few and let your sister see what she's really dealing with.  I've been to many assisted living facilities, for example, and the rooms are very much like apartments with safety features.  They were quite nice!

What's difficult here is that you're dealing with free will.  If you don't feel like your sister is mentally incapable of handling her own affairs, there isn't much you can do, legally, to force a change other than shifting your own level of support.  Do you feel like doing something like that would make her realize she should be making different decisions.  What happens if your health begins to suffer?  Or your wife's? (God forbid, of course) 

Hi

Thanks for responding.  In answer to your questions, as best I can;

1) She refuses to prosecute.  She will only rarely even be willing to discuss it with me.  She says the stress of thinking about it is too much for her to bear.  Her doctor, a visiting physician, has marginal skills in my opinion, but he advises that she has a weak heart and pushing it could have serious consequences.  Her attorney (a former student of mine and a good friend) is president of the Ohio Bar.  He advises that there is nothing I can do unless she agrees. If I want to pursue, I need to wait until she passes.

2) She has an incredible mindset against moving, no matter where.  I live in Florida.  She refuses to leave Ohio.  She is in her own place, and is totally unwilling to leave it.  More on this below...

3) She has a huge phobia against institutions, and is incredibly frightened of them.  Even when I take her for a drive, she cannot stand it if I drive down the same street where there is a retirement home or a hospital.  She becomes hysterical in the car until I stop and turn around.  Visiting retirement homes or care facilities is out of the question.  I can barely get her to even leave her place to take a short drive with me.  As an example of the severity, when mom was very ill a few years ago, I took her to the hospital to visit her.  We waited in the parking lot while she smoked most of a pack of cigarettes to calm herself down for well over an hour before she got up the courage to go into the building, and even then we only stayed for a couple of minutes before she bolted for the door and another cigarette.

4) When she was poisoned last year and taken to the hospital, once she realized where she was she became hysterical (I am told by a neighbor - I was not there) and screamed or carried on until they released her.  The doctor there refused any further treatment for her, and they would only release her based on her having round-the-clock care (I was told by the agency).

5) She has a difficult time keeping doctors.  Even her psychiatrist refuses to see her again.  On her last vist she sprayed his waiting room with Lysol to kill the germs.  She has gone through doctors like movie stars go through husbands. 

6) As to what care she really needs, she is incontinent and needs some physical help to get up and move around.  She cannot live alone, as she could not fix her own meals or tend to her personal hygiene alone, but she can be alone for brief periods of time OK (like an hour or two).  She has round-the-clock care now from a local agency.  I had negotiated a more competitive price from another agency, but when I went back to Florida for a week, she fired them and brought the first agency back because she did not like the aide they sent.

7) She has unusual sleep habits - awake for a few hours, and then asleep for a few hours, 24 hours a day.  She demands attention from the aides when she is awake, and is so demanding that many of them will not return after working with her for a week or two.  Of course, she does not see herself as demanding or abusive - she sees them as incompetent.  They am running out of aides, and we are both running out of money.  I considered trying to get someone to live with her, but she is so difficult that I do not think that is possible, and she refuses anyway.

8) When you say shifting my level of support, I am trying to gradually reduce the amount of time I spend there, but even with this the problem does not go away - in some respects it becomes more acute.  I am just not willing to let her suffer - I want to do what I can for her. 

9) I believe that the ideal situation would be to have her in a home where I was close by - perhaps here in Florida.  But she is totally unwilling to consider the move to Florida (where she says there are too many insects), she does not want to leave her condo where she has lived for many years,  and she is absolutely opposed to any type of institutional environment - so completely so that it is almost beyond any human comprehension.  I really think it would kill her, but I do not mean to be melodramatic.

So that is where I am with this.  Advice is appreciated.  Just some response is even appreciated, as I have no one to go to for help, and I need some help. 

Wow!  First of all *huge hugs* to you.  You are an amazing brother to have such loyalty to your sister.  I hope she appreciates your level of dedication.  I'm thinking about my own brothers right now and almost giggling at what I know they'd say to me if I refused to move near them in such circumstances because there are too many insects in their state.    I'm joking, of course.

First, let me say how sorry I am that you're in this situation.  It sounds like it's tough on several people.  Have you considered talking to a local Area Agency on Aging in the area where your sister lives?  What about a geriatric care manager, also in that area?  They may have some insight into alternative resources that would keep your sister in her home, keep you both from going broke and get her the care and attention she needs. 

I'm hopeful others here have some good advice for you as well.  Please keep us updated!

How would I go about finding a 'geriatric care' manager?  What is that?

Check out this link, which has got information about what one is and how to find one.  Hope it helps!

http://www.caring.com/questions/is-there-such-a-thing-as-a-geriatric-health-manager-my

Hi

Its a long shot, but its better than nothing.  I will be heading back to Ohio this week - Dayton Area.  If anyone knows of someone they could recommend, that might be helpful.  Thanks.

Wow, Your sister is one lucky lady!!  Does she recognize this?  ANd are you alone in caring for her?  Do you have power of atty?  may be time to get it?!!

   Seems like for what you are paying you could find someone to take care of her/??  This fee must include medical expenses as well?  I mean a person that would move in and be her full time care-taker, or maybe a couple so they could repite each other for that kind of money!!.  Obviouly trust is a huge issue after what happen, yet it seems with the right contract, and person  you hire  may be an option  a retired nurse? or CNA going to school,.maybe since she doesnt want anyone living with her, a care team could live close... personally chosen rather than the impersonal instiutuional feel of an agency... I know this sounds strange, but it seems like its time to think outside the box...Pray for something to fit that is out-side the box, yet compliment the situation

An agency is almost like an institution, ?!  Finding the right person-S- will take some dillegence, not to mention faith, and a planned miracle.  A person who understands the severity of the situation, with loads of compassion, some medical background, thick skin and a big heart!  Any chance there are family members who could take turns?   College students, medicare will take care of a daily nurse, so someone there to put up with her, maybe even grow to care like you do... She is ornery cuz she is scared..??  How does she do with your reassurance?.  Fear does crazy things to our minds as we lose our ability to do things that were once simple ... seems like just a minute ago, a year ago, oH that was 26 years ...? I notice my dad getting angry because he cant do the things he used to and he gets nasty lashes out...

Plan a miracle!.-and yes if you planned this little miracle close to you, it could be monitered so much easier, you could come have lunch with her, and she would be able to see you more often..Is there any carrot you could give her to make her want to move - or want to help you help her. . it seems like it is time for her to see this and if she wont, you may have to do it anyway... Just keep her posted as to what has to happen every step, and know it is in her best interest,  her monies best interest.... no institution but you gotta live closer..

Having support for yourself is essential....brainstorming with new people...( on this site and with those that I vent to)    has been good for me, if nothing else just hearing others going thru similare stories and caring...

kjw

I work for Senior Care services at Social Services in Maryland. We work with families in situations like this to help them identify resources and to access them. The person who responded to you to get a Geriatric casemanager gave you good advice. This is someone whose job it is to be an expert in all things related to Seniors, housing issues, transportion to doctors, competency issues, etc. In Maryland we have a process called an "Emergency Petition" This is a formal process to petition the court, (go before a judge) when you feel that someone is making poor decisions and placing themselves or others in danger. Just by your description I think that you would have a good chance of getting the petition signed. This would mean that she could be forced (even against her will) to seek medical care, seek psychiatric care, etc. You might also try to get Power of Attorney to make decisions for her, A casemanager can help you through these steps. The laws vary state to state, but in Maryland an adult has the right to make decisions, even bad ones, unless or until they have been declared incompetent IN WRITING by two physicians. You should contact the local Dept of Aging, Senior Center, and Elder law attorney, or Social Services to adults in her state. You are wise to start pulling back, even though you want to continue to be involved in her life and to be a support system. Your sister sounds like she is very strong willed, and is getting a lot of attention for bad behavior. Maybe she would be more cooperative if she had less help for awhile, and then she  might appreciate it. Or , if she really is mentally ill, you can get the help and treatment that she needs by accessing programs .Hope this helps. She is very lucky to have you. Most of the seniors that I have dont have a good support person.

I hope you have made some progress on this. It seems to me you could pursue being appointed as her guardian - that may be what the peitition that the other person mentioned, would have done. This would have allowed you to presecute the neighbor who stole her money, even without her consent. Obviously, you goal there is to get the money back. It also sounds like she would benefit from medications that might reduce her anxiety and increase her level cooperation, and the guardianship should allow you to pursue that. We al hate the idea of over-medicating our loved ones - but she is not making good decisions now, and someone needs to make them for her. Would you allow a child to make bad decisions? Think of her situation that way.

You say she has too much money for government assistance - at her current spending rate, and given the theft, that may not be true for too long. Unfortunately, government does more for people who need medical care - but just long term care.

I was also going to say to stop referring to a new home for her as a "nursing home." First of all, it does has terrible connotations for many of us. Also, it is probably ovekill for her - it does not sound like she needs a skilled nursing facility. You may not be able to get her to move anyway, you but you will have more luck if you call it an independent living facility, or simply a "new apartment."

Good luck

Dan

 I work with the condominium industry.  As a concern in solving her housing issue - at some point the Board may be forced by neighbors to seek legal assistance at having her moved.  The condo must ensure that its members have a safe, and peaceful enjoyment of their home.  And it also sounds like she could be a danger to the safety of the building.  Should a fire start in her unit, there is the possibility that you could be drawn into the aftereffecits by prior knowledge of the situation and not taking action.

As the wife of an Alzheimer's victim (and daughter who had both mom & mom-in-law to care 900 miles away), the cost and care issue I really appreciate.   My husband also had 2 aunts that we became responsible for decision-making,  I agree with the Maryland SS lady in STRONGLY encouraging you to seek legal authority over her affairs before the situation becomes more severe.

Go google for an elder law attorney in the Dayton area.  Also google for Senior Services in the area for leads.  The case manager that you hire can also assist in obtaining the evaluations you will need.

The stress of managing caregivers from a distance is life threatening to you.  For a year I had to hire round-the-clock care for my mom.  It nearly ruined my business, my own family, and this was with enough funds to accomplish it.  Moving your sister to within 45 min to 1 hr of you is important to your own health.  

As hard as it is to face or to say - it ain't going to get any better!  

Nana 

Thanks for your response.  I do have power of attorney.  However, her mental health is strong, and her will even stronger.  In my direct conversations with her, I do not refer to assisted living as a nursing home, but no matter what phrase I use she reverts to that one.

She smokes constantly, despite being on oxygen, and getting her to stop has been hopeless for me.  The addiction is both physical and emotional.  Moving her to a nursing home or any community living facility which does not allow smoking would be torturing her even worse than the COPD is doing.

I have a potential soiution with a local agency that would provide live-in care for about $180 a day.  That is a bit more than I like, but we could make it for 10 - 20 years at that rate if the government does not do anything to screw it up, and she could live the rest of her life as she wishes.  BUT the person has to be there 24 hours as a live-in or semi live-in.  My challenge is to get her to accept this.  I plan to have her banker, her attorney, and the care giver manager see her to convince her, as she will no longer listen to me.  Although I am 64, I am still a helpless little kid to her in many ways.  We will see.

Hi.  Thanks for your response.  I posted a response to another suggestion that explains where I am on this.  I am trying to help her find some joy in these last years of her life, but it is not an easy thing to achieve.  I appreciate your counsel.

Nana, thanks for your response.  I am working on it. 

Two things - the condo association is glad to have here there.  She is a good tenant.

And secondly, unfortunately, the man who took all of her money is on the board of the condo association. 

This may sound harsh, but sometimes you just have to give them tough love. I have found with my Mother (85) that she does not like change of ANY kind. I can not even move a chair in her apartment that is in her way with out it causing her anxiety. She has been like this all her life.

For many years we put up with her “strong willed” personality. We were afraid of the tantrums and sometimes it was just not worth it to rock her boat and we gave in to her wishes even though it would inconvenience everyone and was not in her best interest.

She never got better and never saw reason. I do not believe she can mentally. So I started taking a more parental roll and just insisting. She balked and I said if you don’t need my help then I can not do anything for you. I stopped going over and calling though I did monitor the situation through a neighbor. She never asked for my help again, but a month later I started to come back into her life but this time on my terms. When she would balk at a change, I would say fine, and leave. I did not argue, I just left, but I did not do what she wanted. She came to realize that if she wanted me in her life then it will have to be on my terms.

Sometimes for their own good changes must be made. They will huff and puff and it will seem like they are dying, but they will eventually get used to the change. I find it very similar to dealing with toddlers.

If your sister is of free mind and you can not get a court to rule in your favor, then there are a certain amount of life choices she is going to have to live with. It hurts when we see loved ones undermine their own lives when we are willing to help them live healthier ones. You should also not feel any guilt if you find she does not take to the new way you are dealing with her. You have done the best you can.

I also urge you to invest in yourself and your wife’s life.  I commend you for your love and devotion to your sister, but do not let her poison your life. These are choices your sister has made and she has to deal with the consequences. She does not get the right to ruin your life too.

((HUGS)) Caroline
 

She sounds like a "spoiled brat" to me.  Have you ever told her that she is obstinate and TOO demanding?  And, that no one wants to help out a snotty person who is never satisfied with anything that is being done to help her?  I'm sorry, but I think she needs to wake up and, and show her brother some respect and admiration for all his sacrifices!

Instead of asking your sister what you can do or what she will allow, would it be possible to lay out the problems that you have, and ask her to help you find a solution to them???  Does that make sense?  Then you can put parameters on her solutions instead of her being the one with all the "power".  I don't know, just a thought.  I applaud your loyalty, but don't spend all your money on her care especially when she will not cooperate, you and your wife will need it to take care of yourselves in your old age, which is not too far off.  Have you contacted the division of aging in her state for some solutions?

Another thing to consider would be to turn the neighbor who took advantage of her in to the division of aging in her state, especially if there are other elderly in the condos she is living in.

It is difficult to turn him in as I have no real proof.  I have no doubt that she gave him the money as that is her nature.  He was her only 'friend' as she had run off everyone else in her life.  So when he would come over she would give him money - sometimes large amounts.  Over a period of years it came to hundreds of thousands of dollars.  But she gave it to him of her own free will, and she absolutely refuses to speak to anyone about it.   I got her to speak to her attorney, and he wanted to pursue, but of course she refused.  He is not an 'ambulance chaser' - her attorney is a former student of mine and was president of the Ohio bar last year.  He was not out for fees - he was trying to help.  He says I need to wait until she passes, and I can pursue it then if I so choose.  I do not know of whom you speak when you say turn it over to the division of aging.  I think I would run into the same wall, and could be accused of defaming the character of this guy and find myself on trial with no proof other than missing funds and missing pages from her record books. 

This is the approach I am on now.  She is gradually coming to the realization.  She does not tell me so, but the girls that care for her tell me that she has been speaking to them about getting care in other ways that are less costly.

I have located a service that would provide a live-in for her for about 1/2 of what she now pays, and between the two of us we could probably afford this for 10-15 years assuming we get through these economic times ok.  But it is a gradual thing for me.  I am hoping that I can get something moving in about 2-3 weeks.  I know she has to think about it for weeks before she can make a decision, and her emotions will fight it.  I have to hope for her logic kicking in. 

She has suddenly become much more forgetful (really) and seems oddly mentally more alert at the same time.  She also is getting a lot weaker physically - she had trouble picking up her pre-cut food on a spoon the last couple of days.  I do not know if this is a sign of a quicker decline in health or if it is just one of those things.  If she were to decline and pass in the next few months, I would not have to put her through the change that will be so traumatic for her.  I wish I knew, but I guess it will all happen in its own time. 

Two weeks ago she seemed to be getting stronger, and so I was moving towards trying to get something in place.  Now once again I am not so sure.  It is not easy to know which path to take.

Possibly true, but not too likely.  And frankly I am not searching for thanks - I just want to make her last days as pleasant for her as I can, as she looked out for me when i was a kid.  It seems the least I can do for her.

In Missouri I don't think you need proof, just suspicion so the person can be investigated, I don't know how it works in OH.

You may have to remind her if she's forgetting more.  Just lay out the problems and maybe possible options, and maybe even give her a time frame or ask for one at least.