Dear Family Advisor

My sister thinks our mom is faking Alzheimer's and refuses to help!

Last updated: May 25, 2010

I live two blocks from my mom, and my sister lives two hours away. Mom and I have always done things together (church, book club, shopping). About six months ago I started noticing some changes. I found slips of paper where she had practiced her alphabet again and again -- only letters were missing. She started making excuses for why she can't drive and has gotten confused about how to do simple things, like change channels with a TV remote she's had for years.

The doctor diagnosed her with early-stage Alzheimer's, and she's now on medication. I work full time but have arranged for Meals on Wheels and pay a care service to come and do light chores and keep her company several times a week. I've tried to talk to my sister about ways to help Mom, especially as the disease progresses.

Mom has always been a bit of a drama queen, but I trust the doctor's diagnosis. I've asked my sister to help with expenses and spend more time with Mom. She says I'm wasting my money and have helped to create this because I don't have enough to do. (I'm single -- she's not.) That's insulting!

How do I convince my sister that Mom does have Alzheimer's -- and that she needs both of us to provide care, not just now but in the future?

As much as we'd like to, we can't convince others of much of anything -- at least not until they're ready to hear it. In time, I believe your sister will come to realize that your mother has Alzheimer's, but until then you may have to be the lone caregiver.

Your sister may want and need your mom to be okay for lots of reasons. One is so that her world can continue on the way it is. When our loved ones need more and more of our time and energy, we have some major rearranging to do. We jump to that "my life will never be the same" place.

For a time I ignored some of my mom's symptoms because she so wanted to live independently and loved her life of church and friends. I didn't want that to change for her -- or for me. In retrospect, I realize I delayed facing that Mom had a memory disorder. And yes, our lives did change, but those changes were barreling toward us whether we wanted to deal with them or not.

Another reason your sister may not want your mom to have Alzheimer's is that might mean that one day she could have Alzheimer's, too. Behind the bravado and irritation, she may be fearful.

Try to get some sisterly time together -- not to talk about your mother but to reconnect. We frequently assume we know why someone is reacting a certain way -- that she's too busy, too into her work or family, that she doesn't want anything to do with caregiving. In truth, there's often something deeper. Listen to how your sister feels about your mom and about the disease. She may have some old wounds she hasn't worked through with your mom, or she may be mortified that Alzheimer's is now "in the family." She may have even felt left out since you've spent more time with your mom.

You may never see eye to eye. Focus more on the help that's needed than on whether the Alzheimer's diagnosis is accurate. Stress that your mom lives alone and is an older adult who's no longer driving. Suggest that your sister do a specific thing for your mom. Maybe it's a monthly "chore" (since she lives farther away), like taking her for a pedicure, mentioning that you don't want to have to cut your mother's toenails and this would be a great help. Ask her to cover one expense, say, yard maintenance or something else that focuses on general care.

Sad but true, your mother's Alzheimer's symptoms will increase over time, and your sister will eventually "see" she's not pretending -- although your sister still may not acknowledge it right away. The more time they spend together, the more your sister will understand that her mother does indeed need care, support, and close supervision.

Do all you can to include your sister (even though you're aggravated by her denial). The goal is for all three of you to grow closer. But if she doesn't respond, stay true to what you know -- continue to be your mom's advocate as you shoulder the responsibility yourself.

Meanwhile, find a caregiver support group so you have a safe place to vent and brainstorm -- the people there can also offer suggestions and know about community resources. Sometimes our caregiving community understands more than our family about what we're going through. Surround yourself with friends, neighbors, and others in the same boat. You'll need every one of them.

You have to find (and hold onto) the resolve and strength to be your mom's caregiver, even if you have to go it alone.