Hi, I have DPOA, and my sister has HCP for our mother, who has Stage 6-7 Alz. As my mother has declined, my sister and I have more frequently disagreed on aspects of her care. e.g., She wants Mom to go out to medical appointments, and I would rather use the MD who is there at the nursing home. She wants surgery done on the pre-cancerous skin lesions on Mom's face and upper body, and I want to leave her in peace. This becomes an issue because what my sister wants costs money, which I control. So far, I have given in to sis, but I'm becoming more reluctant to waste diminishing resources on what I see as electives. My sister is appalled by my stance, thinking that I don't care about Mom. That is patently untrue, because I do the local caregiving, and my sister visits twice per year. How do families resolve these issues?

I'm certain it is annoying to have someone come in and "supervise" who isn't there to do the actual work.

Could your sister handle office visits when she comes twice/year? You could book them during her visit (and she may quickly realize why you prefer the in-house doctor).

Usually the pre-cancerous lesions are dealt with, not by surgery, but by freezing them-- a simple in-office procedure. I would have your sister call the skin doctor to discuss--if left untreated-- what possible complicatiosns there could be in the remaining years of your mother's life.

My mother no longer gets mammograms since we wouldn't treat the breast cancer, but has had skin lesions froze.

I see you're in Mass. When financial resources diminish, your mother may be eligible for Commonwealth Care and Prescription Advantage-- even if she's not on Medicaid.

Hello..My sister has DPOA and I have HCP for my mom..in the past month she has taken such a deep decline and we agreed to put her in assisted Living though my sister would have rather kept her in her own home with a full time caretaker which in the long run would have been even more money a month...well in one short month there she has been reassessed 3 times and ultimately had a stroke which was slight and caused no damage they tell us..just the same..Mom is now in rehab for 2 weeks while we try to decide what to do next since we have had all kinds of issues with this community and basically dont trust them any longer...Through this all..my sister and I have had many words..we have different opinions on lots of things...and thats because everyone is different...and everyone is STRESSED to the max..I have two brothers One of which is way more then financially secure and lives in Florida..but has not once been up here to visit or take part in any of this..and another brother who only wants to contribute his time WHEN HE WANTS TO..so you see..everyone deals differently. If your sister only visits twice a year she cant know the stress your under as the main caregiver..she needs to walk in your shoes to be able to feel your pain....I think you are doing the right thing for your Mom...If the funds finally diminish...I would think Medicaid would then pick up the ball...and I once read..if you run out of money just when you die.then you timed it just right...I am not trying to make light of a stressful situation but from my own experience I can tell you...that worrying about the money or how long it going to last is fruitless and only adds more stress to your plate..All I can say in your behalf is to do what you feel is best for your mom..from your heart...its all you can do..and anyone of us that are dealing with family with this horrific illness know what your going through and are here to support you.
God Bless you..your doing a great job!!

Hi, thanks for the replies. Bightwings, your suggestion to have my sister accompany Mom to her appointments won't work on two counts. First, my sister promises repeatedly that she is coming, then backs out at the last second in the vast majority of cases. Second, she has my Mom going out to appointments twice to three times per month, which to me is a colossal waste of time, energy, financial resources, and is a genuine stressor for my Mom. Because I work full time, I usually can't go to these (unecessary) visits, so we pay for CNA's to accompany her.

I'm beginning to think that all this activity may be my sister's way of 'caring' for my Mom, from a distance. Now I just have to figure out a way to help her slow down the spending of Mom's money.

Dear mccamere,

It sounds like you have gotten some good advice from brightwings and Jillie. Also, you seem to have an understanding of your sister’s actions. Long distance caregiving can be very challenging for different reasons than local caregiving. As you work hard on the frontline, your sister is trying to contribute to your mother’s care as well. It may be hard for her to handle the emotional aspects of not physically being there for your Mom. And it can be frustrating for you when you are doing your best to care for your Mom, and your sister offers different opinions regarding your mother’s care, but she is not there to help on a daily basis. Whatever the reason behind your sister’s caregiving methods, one suggestion to help with these sorts of family issues is to set up a meeting with your mom’s care facility’s social worker. The social worker may be able to talk with your sister about your Mom’s care needs, and discuss common procedures for persons in the later stages of Alzheimer’s disease. It may also be helpful for you and your sister to consult with a professional about future care plans, including financial planning, for your Mom.

Often times long distance caregivers find that their reason behind providing certain care for their loved ones stems from a motivation to ease their own emotional pain caused by their inability to be there physically. In these situations the long distance caregivers often need support and/or validation of their feelings and actions. Your sister may benefit from a support group for family caregivers. She can locate her local Alzheimer’s Association Chapter and find a support group in her area.

If you have any other questions or concerns please feel free to call our helpline at 800.272.3900 and speak with a Care Consultant directly.

Best Regards,

Jaimie E.

Alzheimer’s Association
Care Consultant

My siblings and I didn't always agree on care for my mother (died 2+ years ago). She did not have Alz. but had cancer and the doctors occasionally would suggest treatments that were 'a long shot'; there was a slight chance they would prolong or improve the quality of her life.
I think the doctors felt they had to offer us every possible treatment so that we could make an informed decision.
I was the one who dealt directly with the medical personnel and the question I often posed to them was, 'if this were your mother, would you do this?'. Often, the answer was no. Having a medical person admit that helped us all to get to a point of agreement based on what was in the best interest of my mother.