My 85 yr old Mom lives with my sister. My sister is overwhelmed and it is affecting my Mom’s health. Any advice?

Obviously your sister is stressed and not thinking clearly. I feel bad for both of them. A welfare visit should be done

I am sorry if this sounds rude...My question is...why can't sister track Moms meds? You use a pill box and fill it up accordingly. M,T,W,T,F, S,S. Then by morning, noon, dinner, bed. Its a matter of sitting down once a week and following the directions on the bottle. Then a matter of giving them to Mom at the appropriate time. You can get blister packs. I did this for my Mom once a week and my nephew (who was living with her) dispensed them.

I would also look at the meds Mom is on. If on Cholesterol I may see if the doctor would drop it. It effects the enzymes in the liver and can cause damage. If high she should be taken off. Probably on blood thinners. If for a long period of time, blood thinners can cause internal bleeding. I found when Mom was in the hospital, she would be put on meds she could go off of once her problem was cleared up. Like fast heart rate because of Thyroid. It was corrected with the Thyroid meds so didn't need the heart rate pill.

I would not say sister has Dementia. I would say she has too much on her plate and is stressed out. Stress can do all kinds of things to your body and mind. And Mom, its not what she wants, its what she needs. She needs to be getting her meds on time. She needs a daughter who is not stressed out. Why not start with some respite care in an AL. Maybe a month to give Sis a break.

See if your mom's pharmacy will dispense her meds in blister packs that contain everything she needs to take at a particular time in one pack. They come on big cards, the blisters are marked as to the day (and I think "morning/noon/night," too), and they're much easier to dispense than filling up those weekly pill holders. You just pop out the Monday Morning fistful of pills from its blister, and give them to Mom, then do the same for the Afternoon and Evening ones as well.

That's how my mother's meds were dispensed by the pharmacy when she was in her nursing homes. You might have to find a different pharmacy than your usual CVS or Walgreens, but you can certainly start by asking if they do it there.

Help your sister set an alarm that goes off when Mom needs her meds.

There are ways to help without going all-in on assisted living or bringing in help quite yet, but if Mom misses more medications and it leads her to getting sick, then your sister doesn't get a say anymore.

I used to call my mom at every medication time. This way I was just "reminding" her or "checking on" her. I'm sure afew time she told me she took them, then went to take the meds after.

My mom is also in end stage COPD and has moved in with me, not due to fear of AL per se.. but it is mainly COVID scaring the absolute shinola out of COPD patients right now.

In her case at least the important things are-- the discus 2x a day, the budesonide to assist discus meds 2x a day, albuterol as needed (up to 4x a day), then her usual dailies for other reasons.

Breakthroughs/exascerbations won't necessarily be stopped by medication, though they hopefully prevent them from being as common as they could be.

But if sis is overwhelmed, and mom has cell and the ability to self-administer of her meds are in reach, just call, or even just send texts if mom is savvy enough with smart-tech. When my mom was alone my 3x a day calls helped her take her meds and these weren't 3x "how are you fine how are you"s, just "Hey mom calling to remind you to take your meds (daytime meds + discus and budesonide at noon-ish),. then before bed "Hey mom calling to remind you (night-time meds and PM discus/neb). So, a noon call, an 8pm call. A mid-day call was the normal "how are you whats up what are you watching" calls as she was very limited in moving around toward the end of her time in IL housing / sec 202.

IF mom can not self administer, then sister needs to set alarms to remind herself to care for mom. Or you call sister to remind her to give meds to mom.

I know ppl talk to their moms more than 2x a day anyway, two quick med-check calls can be quick, and also will help mom feel more connected to you even if it is only 2 three minute phone calls.

I'm slow and didn't read your "about" section re: moms mental status. But depending on how advanced it is, she might just need a time reminder daily for meds like my mom did. I do know that COPD itself leads to some dreamy-ness / disorientation just from lack of oxygen or CO2 trapping (which is a thing I know nothing about and my mom can't explain the sensation to me)

Thanks everyone. I have taken Mom to very nice AL facilities but she rejected them all for one reason or another.
I have the POA but have tried to do things collaboratively to avoid major family drama. I know however that at the end of the day I have to make the decisions that are best for my Mom.
My plan now is to sit down with my sister and tell her we have to get some help for her and my Mom. I will let her know that I am prepared to move in the direction of AL if she will not cooperate with bringing in assistance.

Fear is in control.
Fear, denial & stubbornness.

Sister's denial she needs help. Fear of family help, stubborn refusal to accept help offered family, fear of strangers or non-family help.

Mom's fear of assisted living, fear of strangers, fear of change. Also possible denial about her life stage & health needs. Stubbornness too.

I suppose you can sit down & discuss these fears, one by one. May take many many chats.. maybe involve a professional third party eg Doctor, Social Worker, Faith Leader.

Point out to both Sister & Mom they DO have choices. To stay the same - or change.

Change involves some letting go. This takes some bravery but can be OK! There are positive things to gain too. Many times people say Oh I wish I'd done this sooner!

The fearful & stubborn people who continue to resist change, well, a crises arises & change is FORCED upon them. The consequences are no time to plan & less choices.

These folk become members of the *awaiting the fall* club.
They risk being thrown into the nearest nursing home bed after a crises instead of an AL of their choice.

If your mother is not being properly cared for by your sister, why do you want to 'allow her to remain with my sister"? When dementia and incontinence is at play, the elder needs a caregiver who's present and tuned in, who's able to spend time with her and to make SURE her meds are doled out on time, etc. Your sister is obviously in over her head and not the right person to be caring for your mother. If this were my mother, I'd want her in Memory Care AL where she'd be properly cared for 24/7. Being 'deathly afraid' of managed care doesn't mean she's not in NEED of it. Perhaps a nice tour of a Memory Care AL would change mom's mind.

Your sister forbidding anyone coming into her home to help out reeks of dementia HERSELF, to be honest. What's going on with her that she's acting like this? Who has POA for mom who can perhaps step in and fix this mess?

Good luck

If sister is unable to track meds, is it because of her mental status? I'm concerned that she may have dementia going. Refusing help and not wanting someone to come into her house are signs. She has so many other things going on, but what? Is that verifiable?

Also, why is mom afraid of assisted living? So many people enjoy it because they have a better quality of life, things to do and make friends. Living alone with your sister who can't even keep track of her meds seems like a really miserable life for your mom.

Why don't you take mom to see some assisted living facilities? When she sees the people enjoying themselves, the dining room where food magically appears on schedule, the in-house hair salon, the fountain in the courtyard, a nice room that gets cleaned by staff - what's to fear?

Who has POA? That is the person should be making the decisions, not your sister or your mother. Your sister is understandably overwhelmed. and it will only get harder. If no one has POA or it is joint (I had this with my brother and would never recommend it) than they need to decide what is best for everyone.

If you sister has POA and chooses to continue to care for your mother without outside help, there is little you can do other than go to court (which I wouldn't recommend).

If there are other siblings, I would recommend that you have a meeting to discuss options.

It is overwhelming taking care of someone with dementia and incontinence. I just moved my mom at 79 from my house to assisted living. She's still adjusting but it has been a very good thing for me to have my house and my life back.

I wonder what other important things your sister has going on? If she is not willing or able to dedicate the time needed to take care of mom properly, then she needs to be willing to accept that something has to change!

Does your mom have money to pay for an aide? You should not be paying for this. I can understand, sort of, your sister not wanting someone in her house regularly but these are not normal circumstances. If she can't keep up with mom's meds, then obviously something has to change. It will be better for both of them if she gets help.

Who has POA??

Can you and your siblings have a family meeting with her? Not to gang up on her because she will just be defensive but to kindly tell her that she's been doing so much for so long and you appreciate it but now it's time for some extra help. If she won't cooperate with help, then you'll have no choice but to pursue other options. It's becoming unsafe for your mom to live there.

Although mom may be very reluctant to go to assisted living, it may be the best choice for her safety.

Best of luck.

Who, if anyone, has POA for mom's healthcare and financial decisions? That’s who decides what’s in mom’s best interests for care. If she’s not getting needed meds on schedule then it doesn’t sound like her current living arrangement is meeting her needs. Are you fearful of your sister? Why does she want to hold her grasp on something that’s overwhelming her?

Your mom is awful young at 65 to be dealing with dementia, and incontinence(according to your profile). Is she in fact suffering from both those things along with the COPD?
If not, why would she be "deathly afraid" of living in an assisted living facility? I'd be more afraid of perhaps dying because of not getting my medications when I needed them.
In an assisted living facility she would be around other folks her age and get to socialize along with getting her needed medications on time.
Who is mom's POA? They need to be making the decisions for your mom and doing what is in her best interests, and it sounds to me that she needs a lot more help than what your sister is capable of providing right now. It's a shame that your sister doesn't see it that way.
Perhaps it's going to something really drastic(God forbid)to happen to your mom before sister will agree that things have to change. I just hope that your mom in the meantime won't suffer needlessly and be made worse because of your sisters stubbornness and lack of awareness.