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I don't now if I trust my brother to care for my mom with dementia, but should I let him anyway?

A fellow caregiver asked...

I have medical power of attorney and my brother has financial power of attorney. Our mom, who is living by herself in her own home, has dementia and she is also post operative hear hematoma. I want to either move her to an assisted living facility, or get her a home caregiver, but she refuses and my brother also disagrees with me.

Now he's saying that he wants to move in with her and take my care of her. It's a good idea, but I don't trust him because he his job is in L.A. and my mom is in San Fransisco. I'm afraid that he might leave her along and go to L.A. He also lives like a pig. His own condo in L.A. is very dirty and messy. I live far away; if he should neglect her, I wouldn't know. Should I let me take care of her anyway?

Expert Answer

Kay Paggi, GCM, LPC, CGC, MA, is in private practice as a geriatric care manager and is on the advisory board for the Emeritus Program at Richland College. She has worked with seniors for nearly 20 years as a licensed professional counselor, certified gerontological counselor, and certified geriatric care manager.

You do not have many options at this time. It may help you to understand that people with dementia do not make reasonable decisions based on logic and the information they have. This area of the brain is one that is lost early in the dementing process. So, your mother is deciding she wants to stay in her home because that is familiar and that's where she wants to be, not because that is the best option.

You and your brother and your mother together need to explore the best options for your family as a whole unit. Rule out mother living at home alone because dementia is a progressive disease; she is going to get worse, never better, and her condition is not stable. It will be downward. What she can do today is no indication of what she can do tomorrow. You must plan for the future. So she cannot sty at home, alone.

Next option is to hire in-home assistance. Depending on her financial assets, this may work well. It allows her to remain in her home. However, there are problems, as she may well decide to fire the caregivers. If not properly vetted, the caregivers can be suspected of neglect or ill treatment. And, as her disease progresses, she will need more hours of care, which will cost more.

Next option is to move her into your brother's home. This is not a great solution. Basically, she will be incarcerated, jailed, in a strange place. If your brother works, he will be out of the house, and she will be alone. She may decide to leave and never be found. Or she might try to prepare a meal and burn the house down. Or any number of other things.

The best option is assisted living in a facility that is familiar with dementia care, with a well trained staff to keep her involved in activities all day so she will sleep well at night. She will probably not agree to this because of her disease. Now is the time for you and your brother to ensure that she has the best possible care.