Nina had many good thoughts. If your mom moves in with you, adult day care a day or so a week would give her the company of peers and give you a break. This arrangement could work for awhile. But you need to consider the long term. If she lives with you, and you pool finances, you may want to consider having a legal document drawn up, especially since you have a sibling who could cause you problems down the road. Also, if she needed to go on Medicaid, they want records five years back (of her finances), so you should keep very good records.

We, as caregivers, want to do what seems right in our hearts, but that can come back and bite us in the real world. So, please go into this with your eyes open. I hope you can find something that works for you all. Things will change as her stages of Alzheimer's change.

Please keep in touch for support and let us know how you do.

Carol

Caregiving for a loved one with Alzheimer’s disease can often be a complex and heart wrenching process when factoring in all the elements, such as finances, direct care, family dynamics, etc. Despite the fact that you have met some roadblocks along the way, it sounds like you are doing a good job and giving her the best care that you can. This is highly admirable, and your mother is fortunate to have you for a daughter. However, you don’t want to run into the all-too-common caregiver problem: stress and burnout. Many caregivers are at risk for burning themselves out because they take on too much from the beginning. It is not unusual for family members to try to be heroes to their loved ones by taking on a range of responsibilities that include hands-on care and financial demands. At this pace you may incur undue damage to your health, the health of your family, your own financial situation, and other areas of your personal life. You are in a particularly fragile situation due to the family dynamics you mentioned.  With that in mind, it is necessary to consider your options – how you can preserve yourself for the long haul while ensuring your mother’s safety and optimizing her quality of life.
 
You mentioned that you have not returned to work in order to take care of your mother and that will present financial strain in the future. This is the optimal time to consider other options that could allow you to resume your own lifestyle while making sure that she is still receiving care. I strongly urge you to file a Medicaid application for your mother without delay. Medicaid is a public benefit insurance program that can help offset the high costs of care, such as most home care, adult day care, nursing home care, medical equipment, transportation, medications, etc. For more information, please contact 1-800-MEDICARE, or visit the Web sites www.medicare.gov and www.cms.hhs.gov.

You also inquired about next steps, particularly your mother’s living situation. If you want her to move in with you, you should first consider what it might take to keep her safe. Families need to wonder about how to design a safer home, arrange for adult day services, find time for doctor’s visits, find room for home care aides, etc. And it is also necessary to consider that this might be a temporary move – if your mother declines further in the future, she may need to be transferred to a long-term care facility. If she were to be moved now, she may find it easier to adjust over time to the same environment rather than moving from residence to residence. Although what you choose for Mom is an entirely personal decision, you want to really think things through, keeping in mind your family’s best interest while making sure that your mother has a safe, reliable living situation for now and for the future.
 
Although your relationship with your sister appears somewhat strained, you may be able to mend things, if only to serve your mother’s best interests. If you haven’t done so already, think about asking her to join you in a support group someday. Support groups are warm, supportive environments that allow people to let loose and be themselves. It is a perfect forum to release tension, discuss deep-rooted fears, and uncover latent emotions. It is possible that with the help of this type of group, you and your sister may be able to discover reasons behind your deteriorated relationship and work towards goals to heal yourselves and help your mother together. Best of luck to you in whatever direction you choose to take!
 
Although your relationship with your sister appears somewhat strained, you may be able to mend things, if only to serve your mother’s best interests. If you haven’t done so already, think about asking her to join you to discuss family issues with a social worker or geriatric care manger; sometimes, input from a third party helps move things along. Or, consider asking her to join you sometimes in a support group. Support groups are warm, supportive environments that allow people to let loose and be themselves. It is a perfect forum to release tension, discuss deep-rooted fears, and uncover latent emotions. It is possible that with the help of this type of group, you and your sister may be able to discover reasons behind your deteriorated relationship and work towards goals to heal yourselves and help your mother together. Best of luck to you in whatever direction you choose to take!