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Three siblings living in the same town care for and see their mother with Alzheimer's regularly. A fourth sibling visits several times a year from out of town. The fourth sibling sees the decline more than the ones that see her regularly. How can the fourth convince the three that the mother should not be alone. The stove and counter top appliances are functional presenting a danger.

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Can you get your siblings to agree to a professional "Needs assessment"?
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But Marcia, the local siblings aren't just seeing the mom more often than the out-of-towners. They're taking care of her. So they know whether and how often she falls, whether there have been 911 calls, whether the Mom can walk to the car or needs a wheelchair, whether she makes strange purchases or falls for scams, whether she's screwing up her meds, what the doctor's saying at each visit, all of it. They know Mom's financial situation and her feelings about going into care or staying in her home. They know because every little issue has to be dealt with, by them.

I was one of the three local siblings. On the occasion of my mother's 80th birthday, several out-state-siblings came down for the party. One such sibling took my eldest sister aside and said "Mom has really declined. She shouldn't be living alone anymore." To which my sister replied "Oh, we totally agree. Are you taking her home with you?"

What I'm say is, it's easy to recognize that a parent may not be safe living alone. What's hard is to find a solution to the problem, especially when the parent has no funds, is unwilling to move, and nobody can or is willing to take on the 24/7 live-in caregiver role. Been there, done that, got the T-shirt.
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They don't want to admit Mom needs more help. It was very hard for me to see my Mom get frailer as time went on. A hospital stay was the deciding point that she couldn't be left alone anymore. I was lucky that my disabled nephew lived with her but he worked during the day. There is a device that turns off the stove completely. To be honest, it will take something to happen before they see.
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We arranged for a service to come to the house and do a Home Safety Assessment. It was an occupational therapist and a social worker. It was covered by insurance with a doctor's prescription. The social worker noted that the LO was vulnerable because she couldn't call for help if it were needed and let anyone who knocked on the door in- without asking who they were. Adaptations such as improved lighting and bath rails were suggested. I think there are adaptations that can be made to the stove and faucets that would keep them from being left on, too.

I have to say I disagree that someone who only sees someone once a year can't see decline more than those who visit regularly. There are loads of people on this board who are beating themselves up because they didn't see the dementia sooner. You get used to something that happens little by little. It's not that they aren't doing a good job as caretakers. It's that the change was so incremental that it is hard to really see.
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An out of town family member used to tell us that our LO wasn't safe living at home and we needed to do something. We didn't need to be told this, as we saw the changes. Telling us the obvious didn't address that we'd had countless discussions with LO, each resulting in him saying he wanted to stay home. He also didn't think he needed in home caregivers. It was his call. To the out of towner, we weren't doing what needed to be done. To us, we were helping the best we could with the limits set for us. I finally told him as we couldn't hog tie the man and take him over in the back of a pickup, I was open to suggestions. Testy, I admit. But my point is start your dialogue based on the assumption they do know this and do much more listening than talking.
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Bring them to the doctor's visit. Or if they can't be present, video or voice call them in on the next appointment. Ask the doctor this question directly. Let the doctor be the 'bad guy'.
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I would not advise starting with the idea that Mom should not be left alone. This is likely to convey to the three siblings who are doing all the care that they're not doing enough, which would likely not be appreciated coming from the sibling who is doing nothing.

I would doubt that you are seeing the situation more clearly than the siblings that are caring for the parent. They probably see exactly what you see and have made their own decisions about how much they willing to contribute to Mom's welfare and safety.

Unless you are either offering to move in with Mom, or proposing a care home alternative that Mom can afford, I'd suggest you just keep your own counsel and let your siblings keep theirs.
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Dear RedRoses,

Its really tough in a family. I'm sure there is resentment about the fourth sibling given they are not around as much. If at all possible, I would try and call a family meeting and hopefully have an independent third party there as well to help mediate.

With my own siblings I did the day to day care. But when things got tough there was arguments and silent treatments among the siblings. Hard to get everyone on the same page.

I hope the siblings can have an honest conversation with each other.
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Concerning the issue of keeping out of town siblings apprised of the parent's condition, I don't feel obligated to do that when they don't feel obligated to even call my mother, or me. The incident I described above happened almost 7 years ago, and little has changed except my mother has declined even further (and now has a housemate who helps her out in exchange for free rent) and my elder sister has been deceased for two years. The absent siblings (there are 4 of them) know perfectly well that my mother is elderly and frail, that she requires a lot of assistance and can't manage independently, that she is frequently hospitalized with one crisis or another. Still, no phone calls, no emails, nothing. We let them know when there's a potentially serious event but that's it. They don't concern themselves with her, so I don't concern myself with them. Of course, she could call them too, but she doesn't. She never did, really. She only calls people (like me) who do things for her.

Everybody has their own perspective based on personal experience. You might think the out of town siblings would be more invested in their elderly parent based on your experience, but in my experience, that hasn't been the case.
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I have three out-of-town brothers. A few years back, one didn't want our mother driving any longer, one thought she did okay driving, and one didn't care. Of course, none of those brothers was going to have to be the one to haul her around -- THAT privilege (ha!) fell to me, the Dummy Daughter Driver.

My mother even said she didn't want to drive anymore, but I did nothing until she refused to drive anymore. I had to become her taxi driver (I have set strict boundaries about this, and she wasn't happy).

My mother should be in assisted living. I think my brothers are concerned when they think about it, but since I'm local, they are happy to keep it all in my wheelhouse.

My mother needs someone to monitor her showers, and could use help dressing. Several times now, she's burned stuff in the microwave. She has now said she won't cook spaghetti anymore, as the pot is too heavy. I'm not sure how she gets her big cups of coffee and tea to the table safely.

She has money to hire help, and refuses. Not even housecleaning help.

While I'm sure my brothers (well, 2 of the 3; 1 doesn't care at all) would LOVE it if I would help her by monitoring her showers, fixing her meals, helping her get dressed, etc., they wouldn't DARE mention it to me.

My mother, at almost 92, has no vision in one eye, very poor balance, poor hearing, atrial fibrillation (on blood thinners), neuropathy in her feet and lots of anxieties. She lives alone, housebound except for Mass, chair yoga/grocery trip afterwards. This is her choice. I've done plenty for her. And she tells me I don't do much at all for her.
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