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My parents live at home, but they need to move. They live in a two story house with bedrooms/bathrooms upstairs, but because my Mom first broke her hip, then while recovering, broke her opposite femur, she is barely mobile. So she hasn't had a bath in some time and the living room (downstairs) is now the bedroom. Three of 4 siblings see that it is time to move to an assisted living environment, but one insists on keeping them at home, and by the way, is being paid by Dad to provide care. The "care-giving" sibling is not a professional and it's easy to see how little she is doing to care for them. Mom and Dad aren't eating right and aren't getting needed medical attention. Now Mom has a UTI, but no healthcare is being provided. Are there family "negotiators" or "arbitrators" that are primarily elder advocates who can help bring us all together to do the right thing for Mom and Dad? For their health, their day-to-day living conditions and potentially for the inappropriate control one sibling is exerting over their conditions...

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I would hire a Geriatric Case Manager. They could deal with your parents healthcare needs, coordinator their care and also negotiate any family problems.

You can go online to Aging Life Care Association and find a Certified Case Manager in your area.
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Alicew234 Jan 2020
aginglifecare.org . We found a very good person from this website.
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In reply to @NeedHelpWithMom, @tevincolorado and @DollyMe....

Thanks for all of the answers. I will look into the Durable Power of Attorney. I don't know who has that.

Fair comment about walking in the caregiver's shoes. The observable data is that the house is a mess, my parents are undernourished and not receiving the healthcare they need. And, of course, it would be ideal if the caregiver (sister) were seeking help, but quite another thing if she is turning away all offers to assist. The parents are grateful for the care they receive, but may be wondering why other siblings aren't around.

If there is no PoA, then what?
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NeedHelpWithMom Jan 2020
It takes time to sort everything out but you will get there. Please update us. Wishing you all the best in your journey of figuring out what is best.
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Can you have a direct conversation with your parents? Is your sister burning out? I can tell you that it is physically and emotionally exhausting to care for the elderly. Is it possible to speak with your sister?

I appreciate your concern for your parents. You also have to show concern for the caregiver. It’s a team effort. Respect has to go both ways.

I am not trying to be overly critical. I am only stating that problems arise when only parents are looked at. Look at it this way, you go to work and if you are not appreciated, respected or recognized, would you feel motivated? Most likely not.

If your supervisor showed concern, would you be more forthright in sharing details? Be more motivated? Most likely you would. See what I mean? Courtesy goes a long way.
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National Academy of Elder Law Attorneys
https://www.naela.org/findlawyer
<naela@naela.org>
NAELA Council of Advanced Practitioners
1577 Spring Hill Rd., Suite 310
Vienna, VA 22182 
703-942-5711
<naela@naela.org>
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Take parents to the doctor who can demand that another caregiver or AL placement. Seems you have a case of neglect on your hands.
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Don’t be so fast to criticize if you are not walking in the caregiver’s shoes. Having said that, I totally agree that aging parents should not be in a two story home. At least they have been moved downstairs but it still isn’t ideal.

Bathing is necessary. Is there a shower downstairs? Does your sister have any help in caring for your parents? Does she get much needed breaks? Are your parents cooperative with her requests?

Did they ask her to care for them? Does she want to do this? Of course, she should be compensated financially if she is willing to be a caregiver. Why should she not have a source of income? Caregiving is a tough job

Have you or any other siblings looked at suitable facilities? Have you spoken to your parents about it being time to live in a facility because it is too much for your sister to care for both of them by herself? Are any legal documents in place, such as POA or POLST, a will, etc?

Best wishes to you and your family.
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Having POAs set up would be ideal and you would need to consult with EC atty, but in the meantime, does your sister refuse to allow any of you into the home or to take mom/dad for medical care? If it turns out that sister is POA, you can override that by applying for guardianship (EC atty will be needed - parents' assets should be used to cover that expense, if they have assets.) Most EC attys allow for a free first consult - have all questions/concerns written up and take notes!

While working on finding/utilizing EC atty, the current situation needs to be addressed asap. With broken hip/femur, that UTI really needs to be treated. Although doctors would not be able to discuss the parents' current medical conditions, you could set up an appointment and/or time to discuss your concerns with the docs. They should be willing to listen and then address the situation. At some point mom was under doctor care for the broken bones - I would start with PC and/or whoever had been treating the hip/femur.

If sister refuses to let you in, or a Geriatric Care Manager, perhaps a call to APS? I have read many comments where APS doesn't bother to get involved, but if you work with doctors and APS, perhaps some intervention can be attained. If the place is a mess, mom isn't getting treatment, mom and dad are not getting proper nourishment and mom isn't getting any kind of bathing done, that should be enough for someone to step in - you can let them know that you and the other siblings are willing to take on the proper care needed, even if it means moving them to AL. You don't want the state taking over!

As for sister getting paid, is there a proper legal care-giver agreement in place? If not, then if mom and/or dad ever need Medicaid, there will be penalties for all the money she gets (they will refuse to cover costs until the costs meet/exceed every dime sister has received!) This is another reason to get EC atty involved.
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Who holds the Durable Power Of Attorney for them?
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Who has POA? If you don't do something quickly the state could be involved and say neglect.
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Inform their physicians, their town elder case worker and their town's social worker.
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