<p>By summertime, my 89 year old MIL will move to an assisted living facility 5 minutes from her S1/wife, 90 minutes from S3, and 4 hours from S2/wife. It appears to be the best solution given the choices in each of our communities. S2 (my husband) has handled her financial and legal affairs for at last 15 years and will continue to do so. She has handled everything else up until now. Each brother has completely different skill sets and communication is not always smooth. Does anyone have suggestions on how the three households can work together to balance out the responsibilities of caring for her? For instance, since he will be 5 minutes away, it seems like it would make sense for the nearest son to assume responsibility for her medical and day to day needs. What has worked/not worked for your family? Can you recommend a book or other resource on how to try to make the transition happen smoothly? I typically get together with my MIL every 7-10 days so I am not thrilled about being that far away.</p>
<p>My parents are near me & one other sister, the other two siblings are way too far away to do anything. My Dad has a slow growing, but ultimately terminal cancer, so for several years there has been a lot going on medically and emotionally.</p>
<p>The biggest help from my siblings is the sympathetic ear, so I can call and vent when I am frustrated with silly little things- not complaining about what I have to do and that sibs are not, but actually prefacing the call with “VENT” It has helped maintain sanity.</p>
<p>If your DH is doing the financial work, that ought to help the nearby sib feel like he is not the only one doing anything</p>
<p>I deal with this issue, and it’s a tough one. Your mother-in-law may have handled everything but her finances up to now, but this will be a major change for her and for you. The closest son will indeed take on day-to-day responsibilities, and those responsibilities will grow. A lot depends on her personality, emotional state, and physical abilities. I could write forever about this subject, but to be helpful (instead of venting!), here’s what I suggest that the two out-of-town sibs could do:
- Plan regular visits and stay a couple of days. If you spread this responsibility around the family (are there older grandchildren? family friends?), then it’s easier. If someone else comes for a visit once a month, the local family gets to take a break.
- Take on some shopping responsibilities you can do from a distance. Does she need personal items? Order them on Amazon Prime and have them shipped to her, so the local sibling isn’t always running to the drugstore for lotion.
- Send snail mail to your MIL regularly. Subscribe to some of her favorite magazines. Send flowers periodically.
- Put together photo albums and/or framed photos for her new room.
- Don’t expect the local sibling and his family to handle every hospitalization alone. Volunteer to make an extra trip to sit in the room with your MIL. One of my siblings (who does not work) almost always comes on the spur of the moment if my mom is in the hospital.
- Being five minutes away often makes the local family feel like they have to be there all the time. In fact, most facilities don’t recommend that. Your MIL needs time to make friends in the new place and join in activities. Your 7- to 10-day system sounds right to me. I’ve known some people who just drop by a couple of times a week for 10 minutes to say hi. (I’ve always been 45 minutes away from my mother, so I go once a week.)
- Stay in regular e-mail and phone contact with the local sibling. You say communication isn’t great, but it’s important.</p>
<p>Being the nearby sibling is demanding, but it’s also hard being the one who is “away.” My mom is declining slowly but steadily. I know that my siblings have to adjust every time they visit, while I see her often enough to be used to it. It sounds like you enjoy visiting your MIL and will miss her. Figure out what you need to do personally to make the transition better for you–write letters, call often, send magazines and books, etc.</p>
<p>The “workable” model just depends on the family dynamic. In our family, one sibling is not in the loop because he’s a total narcissist. (And after all, caregiving is women’s work :).) In the end it will be his loss. I don’t think it’s ever uncomplicated. There may well be books on the subject, but my own family kind of defies any formula for making these shared responsibilities work. Lately I’ve discovered a great New York Times blog. It’s a comfort and source of good information: [Caring</a> for Elderly Parents - The New Old Age Blog - NYTimes.com](<a href=“http://newoldage.blogs.nytimes.com/]Caring”>http://newoldage.blogs.nytimes.com/)</p>
<p>Hope this helps. I just got back from a “care conference” at my mom’s new nursing home. So far, so good–but still 45 minutes away!</p>
<p>Edit to add this: Yes, being a sympathetic ear is a big contribution!</p>
<p>I congratulate you all for negotiating such a successful transition. Many families can’t get past the first steps and stay on speaking terms. Since everyone is still on board, I would ask them for input on visiting schedules and try to make sure you can cover for the primary caregivers. Perhaps the family that is farthest away could give up more of their vacation time so that the nearest family can take a few days off. </p>
<p>Given the differences in distance, you do have to defer to the family that is closest and visits most frequently, just as they should defer to your husband in matters of finance. However, keeping an open dialogue does stave off hurt feelings, as I’m sure you’ve realized.</p>
<p>You know that this care situation is not going to last long, and that sometimes there are no good answers, just hard choices. It’s the right time for everyone to be on his/her best behavior.</p>
<p>Sibs and I have been doing variations of “who’s in charge” for more than a decade and I agree with geezermom’s excellent advice. We are cooperative and work well together but still we all have had to come to the point where, when someone assumes a particular responsibility: the financials, the medical decisions, etc. the other sibs have to respect those decisions unless they are willing to take the job themselves. That doesn’t mean the “one in charge” doesn’t freely share information or sometimes ask for input but it isn’t fair to be always second-guessing the one shouldering the burden.</p>
<p>When I send small monthly care packages to my parent, I try to remember to include something for the sib in charge of daily care and also the home health care worker.</p>
<p>Great ideas Geezermom, one thing I will often do when I feel a bit overwhelmed emotionally is call and ask the others to make a point in calling the folks over the next week, just to make sure some one else is in touch with them besides me.</p>
<p>It’s like the way you feel when you are a mom of toddlers trying to take a bath and after a few interruptions it does not matter any more, it’s ruined, you think you will never had a moment to yourself. Same thing, with the old folks you feel responsible for their psyche, their actions, their emotions…but you have to also allow them autonomy to make their own choices- it is a real balancing act</p>
<p>Like alh said, I often call or email updates regarding decisions, giving those far away the opportunity to be heard- they may have clear headed ideas I have not considered and they cannot blame me later if they were part of it :D</p>
<p>We have one sibling, who lives farthest away and has had a lot of “stuff” going on in his life, who does not visit much. We could blame it on the valid stuff, but we do feel a bit snarky because really he& his wife are simply too busy, they have always seen themselves as too busy; stuff or not, I don’t know how often they would have visited- I think it has been twice in 5 years. And yet there is no problem, they are just busy. As I was so well advised, that will be there problem later, but it did hurt my feelings for my parents when my Dad was diagnosed as terminal and the folks offered to fly that sibling up to visit when the rest of us were already together. They were too busy to come. GRrrrrrr</p>
<p>One more thought. Our parent had taken the time to make a detailed living will, spelling out what should be avoided medically if at all possible, and gave power of attorney to all the children. However – the closest sib had neglected to actually read those wishes (and the parent hadn’t told that child who tends not to like to have to think about such things) so we were way off track by the time the rest of the sibs arrived at the hospital. And because our parent had not been as open about these issues with all of us the situation was unnecessarily complicated and the end result was not what our parent would have wished. fwiw</p>
<p>It really is family-specific. I am married to D4 (of 4). My MIL used to live about 75 minutes from D3, 2 hours from D2, and 5 hours (in different directions) from D1 and D4. Up to a point, D3 took care of 90% of everything (she had more free time then, too), and my wife handled some of the finances. Almost the last decision my MIL made independently was that she was going to move to where we live. </p>
<p>Originally, she was going to move in with us. But after some analysis we all decided that it made more sense for her to rent her own apartment near us. That lasted about 14 months, followed by assisted living, nursing home, intermediate facility, and frequent 3-4 day hospitalizations.</p>
<p>There was never any real possibility of equal division of labor. D1 is fairly self-involved. (When her adult daughter heard that her mother had come to help with the move, she gasped and said, “My Mom actually helped?”) D2 is really, really self-involved, and tends not to show up when she says she will. At first, D3 and D4 switched what they had been doing, but there was a reason D4 had taken on that task in the first place, and D3 was incompetent enough at it to wind up costing her mother tens of thousands of dollars before D4 took the job back. So now D4 is responsible for everything, including setting up appropriate opportunities for her distant sisters and their children to visit their mother (and holding their hands because it’s a pretty upsetting experience if you aren’t used to it).</p>
<p>D4 actually has a lot of help. Her husband. Me. Because D4 actually works about 100 miles away, and travels a lot for work. And D4 has a lot of trouble dealing with her mother’s bathroom needs. So I do a lot of the “hands on” stuff – taking her on outings, visiting her, schmoozing the facility staff, yelling at the administrator when they inappropriately send her to the ER again.</p>
<p>We made the decision when this whole process started that “fair share” was going to be illusory, and would only result in my wife and her sisters fighting and having a hard time with each other. So we have all the responsibility and all the control, but that has made it possible to foster good inter-sibling relationships – the best things have been in 20 years – and inter-cousin relationships, too. In the end, for the next couple decades of our lives, that is going to be far more important than anything else. We have, however, asked my SILs to come visit a few times when we were going to be away for a week or more.</p>
<p>We are not there yet with our family, but I did read this book that I thought was helpful in preparing for the inevitable.
“My Mother Your Mother” Embracing Slow Medicine, the Compassionate Approach to Caring for Your Loved One. The author is Dennis McCullough MD</p>
<p>We are in the middle of this now. Fortunately, my sister and her husband have been willing to take care of our elderly parents (my mother and stepfather) for years. Now it is just our mother, and my sister and her H built an addition onto their home for Mom (with Mom’s money). It’s wonderful, but still tons of work for my sister. We have caregivers coming to the house, but our mother is wheelchair bound with some dementia, so the whole thing is tough. I am 14 hours away and not a huge help, but I participate in the decisions and do what I can to be supportive. I try to get up there every 5 or 6 weeks to visit with Mom and provide some moral support. Our brother is not in the picture except to cause trouble. He isn’t permitted in the house.
Eldercare is truly about as difficult as raising kids. I wasn’t prepared for this and I don’t even have to do very much compared to my sister!</p>
<p>We have been through this for about 8 years with DH’s parents. They both required care, but one of them has died. For about 7 years the parents lived near 2 out of 4 sibs. One lived 15 away, one was 45 min. away, another was 4 hours away, and the last was 12 hours away. BTW, all sibs have spouses. We divided the work. The closest did the day to day visits. The 2 furthest away alternated visits about every 6 weeks. This gave the closest sib a break and that sib did not visit when one of the “every 6 week visitors” were in town. The one who lived 45 minutes away visited once per week and this relieved the the closest sib on that day. The 45 minute sib also took care of doctor appts. (took parents to the doctor as needed), and took care of financial and legal issues. Parents got regular frequent visits. Fast forward about a year… </p>
<p>Now that one parent died and some sibs have moved recently, mom has been relocated to be closest (10 min. away) to the sib that was furthest away. The next closest sib is now 90 minutes away. The “45 minute sib” is now the furthest from mom. We have also redistributed responsibilities a bit differently to avoid conflict. A different sib is now responsible for financial issues. The 45 min. sib still has loose ends to tie up from the old home and is dealing with that. The visits are still pretty constant with sibs far away visiting every 6 weeks and relieving the sib closest to mom. The sib that is closest is doing things differently. Not everyone agrees about how ongoing care should work, but mom is not neglected, and the disagreements are usually trivial, IMO.</p>
<p>I was the caretaker for both parents, doing everything (medical decisions, shopping, cooking, supervising cleaning staff and caregivers, financial stuff, doctor appts., etc.). All I wanted from siblings was support. What Mom of WC says, as the out-of-town sibling, would be perfect. Even tho I asked for other relatives to give me some relief, it didn’t come. Its hard being in the sandwich generation. </p>
<p>Whatever each sibling offers, be supportive. Its ok to offer suggestions, but always remember to praise.</p>
<p>Another sandwich filling here. My mom passed away a few years ago, and thankfully, my brother who has no children was the one there for her during her final illness. We both lived a 3 hour flight away. I could not have left my family to fend without me just then. Prior to that, I think I had done more, but who knows. My in laws have some “issues” now, with sudden acute problems now and then. We live an hour away, and their D lives across the country. She never comes for any problem, and in general rarely visits her parents. They are now too fragile to visit her. There actually was a problem on her last visit, and we were a couple of thousand miles away then. She basically ran out of there at any sign of trouble, not even waiting until our return. Yes, as mentioned above, narcissist is a word that comes to mind.</p>
<p>If you live the furthest, I suggest trying to be as supportive as you possibly can without killing yourselves, of those who are closer and will bear the brunt of the schlepping to doctors etc. Be thankful that someone is close by. My mom refused to move back north when she got sicker, and it was not good for anyone.</p>
<p>These are really good suggestions. Thanks, everyone. The link to the blog was linked to a number of helpful-looking sites and blogs that I didn’t know existed. This is a whole new world.</p>
<p>you’re working on FAFSA and the Long-Term Care Medicaid application at the same time, as I’m doing this week. Glad to share experiences, speckledegg. Check back if you need support!</p>
<p>LOL! Life comes at us. Actually, we’re just at the college tour stage now which is happening at the same time I’m trying to engineer a complete redesign of my MIL’s affairs and life while enlisting help from my two BIL’s, without starting a family meltdown. This is complex but strangely fascinating! And it looks like the timetables of moving my MIL to assisted living, cleaning out and selling her house, and staying on top of the college apps process will converge next fall into the perfect storm. My helicopter rotors are going to shred up that pb&j sandwich into a million little pieces.</p>
<p>Here’s what NOT to do: Tell the person who is mostly in charge how they should be doing it or could be doing it better!</p>
<p>Here’s what would be good to do: Tell the person who is mostly in charge what a good job they are doing & offer them help whether it is emotional or financial. Perhaps, give them gift certificates so that they can grab a meal on the go or get them a maid service once in a while. </p>
<p>Unfortunately my sister will be telling me how to do everything & tell me the way I should be doing it. She will then expect me to quit my job to take care of my parents all the while bragging that she is making six figures per year. Do you think she will offer me a portion of her inheritance since I will be losing my income? NO! Then when we are old & I have less because I gave up my job for ten years she will brag about her new car, vacation, house etc.</p>
<p>Fortunately I don’t talk to my sister anymore.</p>
<p>PS - I love my parents & will do everything/anything for them to be able to stay in their home & I will be doing it for them not for my sister. I can’t even begin to imagine how difficult this is going to be because it is coming VERY VERY fast. Plus my MIL is 88 & my husband is the only one left here too. I am so glad that we had our kids much younger than our parents did.</p>
<p>SE, I arrived at my parents the summer before my son went to college and realized they needed to move into assisted living and they had to sell their place, pack it up, etc. I found them a place and had them moved in a month and the place packed up within a few weeks. My son arrived from his summer school, he helped finish off things, I left for my job overseas, he left for college within a few weeks. It was a whirlwind.</p>
<p>I am posting just so I can keep an eye on this thread and read it more carefully when I have time. I am dealing with an aging parent long distance, and my one sibling is nothing but trouble. I’d rather have no involvement from him than his intrusive, manipulative, undermining, subversive, unhelpful, dictatorial, sick, pathological garbage that just makes my job 10 times harder. I envy you who have supportive, helpful sibs. Even if they are only a sympathetic ear, count your blessings.</p>