Sibling Disagreement on Care

Stephanie65 · February 11

My 85-year-old mother was diagnosed with dementia 7 years ago. My older father insisted on caring for her and hiding how bad things were from my sister and me. We started 4 years ago to try to get him to consider in-home care or assisted living. He finally agreed and they moved into a lovely community in October. However, the adjustment for them was difficult and they mostly stayed in their 450 square foot apartment (after moving from a 2200 square foot house). Mom was very confused and had a memory span of maybe 10 minutes. Dad started to get angry and paranoid. He fell and broke his hip 5 weeks ago, and after 6 horrendous days in the hospital and 4 blessed days in hospice, he passed. The doctors told us not to tell my mother because her brain could not process the information, but to use "compassionate lying," which we have done. Currently, she thinks he is in England fighting a war. Long story short, 4 weeks have passed, and she is declining rapidly. Her memory is almost gone (both short and long), she is extremely anxious and afraid of all kinds of imagined things, paces, rarely sleeps, has almost stopped eating, and has indicated that she wants to die. A new doctor who evaluated her for 1 hour rated her at 4.4 (BS!) and told us, along with the salesperson at the facility, that with an increase in her SSRI and the addition of Seroquel, she would bounce back. That did not happen, and when she was on Seroquel, she started having crazy delusions like she needed to get somewhere to set a horse's mane on fire. I have taken FMLA so that I can give my sister respite. The new doctor, who is a PhD specializing in Alzheimer's, recommended moving my mother to a smaller unit and to try Seroquel again for at least a week. I am a university professor and have researched everything on the internet about Alzheimer's treatment, the impact of the loss of a spouse and caregiver, etc...and I feel certain that Memory Care would be the most compassionate option and I am opposed to giving her Seroquel because my mother is already a fall risk and because of the hallucinations the first time. My sister, who has POA, disagrees with me and instead has hired companions for a few hours a day and approved Seroquel again. I hate seeing my mother suffer and am so frustrated that my sister flip-flops on what to do depending on who she spoke to last. I had to leave and come home yesterday so we wouldn't have a potentially terrible confrontation. I plan to ask hospice for a thorough evaluation next week. I feel terrible leaving my mother in that situation, but I knew that if I did not come home for some of my own respite, I would lose it. Any recommendations from others who have been in similar situations where siblings disagree on the best treatment plan? We have already toured the Memory Care unit and talked to family members who have loved ones there and it raised no red flags to me. I thought it was exactly what my mother needed, but my sister has a friend who had a bad experience there a year ago.

H1235 · February 11

Welcome. So sorry you need to be here. This board doesn’t get many visitors, so feel free to post on one of the others (carding for a parent or general topics) if you don’t get many responses. Even if Al says they can provide care to the end, that is not what they are set up for. Staff is probably not well trained for this. Mc is really what is best. Has medication other than an antipsychotic been tried. My mom takes Amitriptyline. There are many here who have loved ones on seroquel and I do know that it can take weeks to take full effect. Finding the right medication and dose can be a challenge and take time. Add in a difficult sibling and doctors that don’t really understand dementia and you have a real mess. As far as a difficult siblings, oh how I can relate. Thankfully I am the DPOA, so that makes my situation a bit easier. I have accepted that moms life has and will continue to be negatively impacted by my brother who lacks intelligence, refuses to learn and educate himself about dementia, is lazy, passes blame whenever possible and puts a priority on his inheritance. Trying to reason with him is impossible! It’s incredibly difficult to protect her even with the DPOA. I found this a while ago and it has helped me. Obviously we are arguing for our loved one with dementia which means there is purpose, but we still may need to step back and consider the futility of it. The end says that’s not our burden to carry, but unfortunately in our situation I think it is truly a huge burden to carry (because it effects our loved one). I hope you and your sister can find a solution.

Helen Mirren once said: Before you argue with someone, ask yourself, is that person even mentally mature enough to grasp the concept of a different perspective. Because if not, there's absolutely no point.
Not every argument is worth your energy. Sometimes, no matter how clearly you express yourself, the other person isn’t listening to understand—they’re listening to react.

They’re stuck in their own perspective, unwilling to consider another viewpoint, and engaging with them only drains you.
There’s a difference between a healthy discussion and a pointless debate.

A conversation with someone who is open-minded, who values growth and understanding, can be enlightening—even if you don’t agree. But trying to reason with someone who refuses to see beyond their own beliefs? That’s like talking to a wall. No matter how much logic or truth you present, they will twist, deflect, or dismiss your words, not because you’re wrong, but because they’re unwilling to see another side.

Maturity isn’t about who wins an argument—it’s about knowing when an argument isn’t worth having. It’s realizing that your peace is more valuable than proving a point to someone who has already decided they won’t change their mind. Not every battle needs to be fought. Not every person deserves your explanation.

Sometimes, the strongest thing you can do is walk away—not because you have nothing to say, but because you recognize that some people aren’t ready to listen. And that’s not your burden to carry.

In the Frame by Helen Mirren:
https://amzn.to/4hsXFsk

eaglemom · February 14

Just checking to see how you were doing Stephanie65? Your situation where family members do not agree on care is not uncommon. If removing yourself from the situation is what works best for you, then that was the correct decision.

As for Memory care facilities you will always find someone who knew someone that didn't like something about some facility. That's just a fact. You have to do your own due diligence and come up with your own idea of what your looking for and what is available. Don't take the advice of others to heart, they mean well, but its your loved one, not theirs. Do research and start walking in some doors, that's the best way to do it.

eagle

caregiving daughter · March 15

Your mom is so fortunate to have both you and your sister. Your devotion and drive to research is so filled with love.

Your sister is poa and is on the ground on a regular basis. Please understand that she is likely trying to do the best she can and it's important that there be an understanding of all that goes into being a poa.

Given she is the decision-maker, identify an objective way to bring important information to the table. As said earlier, identify the truly important items to discuss. I would think housing would be a big one and I would think that memory care and all that comes with it in terms of trained staff and additional eyes would be a match. So if this is a "big one" to discuss, let go of smaller items, and seek out a facilitator. Perhaps hiring an elder care consultant for a couple hours to mediate between you and your sister would be beneficial and allow you to be in a neutral position.

I didn't understand your sharing of clinical guidance such as how an md would also have a PhD specializing in Alzheimer's. Perhaps you are saying they had a rotation in geriatric care. For the medication you are discussing, I would think it's critical to have a md, specifically a psychiatrist, involved in prescribing.

Sibling Disagreement on Care

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