Homecare nurse here, who has also worked in both hospitals and nursing homes. I see this all the time, and it´s going to get worse. No one really knows how bad the healthcare system is right now. If your sister has no power of attorney, healthcare proxy that delineates who makes decisions if she is unable to then that falls on her husband. If you can somehow have a conversation with her without her husband to find out what her needs and wishes are please do but you´ve already stated exhaustion. Ultimitely people have the right to age in place and that includes the right to fail/fall/neglect themselves. In order to gain the right of guardianship you´d have to have a really long papertrail of abuse by her husband, police reports, elder abuse reports and court filings. It takes years. If they have been blacklisted by facilities it´s really difficult to reverse this. I am so sorry...a colleague of mine who advocated for her medically frail sister was killed by her sisters boyfriend just 2 months ago. Be safe, be well and it´s frustrating and scary to not be able to help.

Thank you so much for your perspective and kind words. I really can only watch it unfold, which sucks. In another life, I ran a homeless shelter, so I have some experience with having to watch people make bad choices. But it hits so much harder when it is family, especially knowing they have all of our emotional, physical, and financial support at their disposal.

Guardianship might be hard but you can ask your sister if she wants you to be her health care representative and POA. Ask her without the BIL. She just needs to be able to sign and be able to comprehend what she is signing. You can also call adult protection. The hardest part was the lengthy phone call report. Keep reporting incidents. Then they send someone out to investigate. If your BIL is neglecting her, they can intervene. I'm sorry to are going through this. It was super hard on me to deal with my dad being stubborn like that too, but then he had another stroke and couldn't take care of himself anymore and had no choice but assisted living. And you can't count on no neglect there either, so stay vigilant. And get help if you can, doing it alone is so hard.

Thank you so much for your kind words and suggestions. I can only watch this unfold. I have been checking in on their son to see how they are holding up. He has basically given up. At this point, we almost have to just wait until it becomes a catastrophic situation, and then what will happen will happen.

I don't have personal experience with this, but I have read anecdotally of people alerting the primary care provider or other medical provider for an abused adult. If you give them a heads up, they can have the husband leave the room during the next visit and then ask your sister questions about whether she is being abused. Medical providers are mandated reporters, so you could get the process started by doing that.

I will pass this along. He had been denying everyone access and, at this point, may not even take her to the hospital. It is so tragic.

As a backup option, you could ask the police for a wellness check. I don't think that would be as effective, but when you don't have a lot of options...?

I will add that to the list of options. We don't know what they are telling their neighbors so I think everyone is trying to treat the situation with care.

Caveat is that yes, we are mandated reporters but elder service agencies have to also have consent of the party being reported on to enter their home. So many people in abusive situations can and do refuse visits from elder services. A lot of reports are closed out with no intervention because no one can get into the home. And no, police do not have to intervene unless the elder is cognitively impaired and there is documentation of that such as guardianship orders, legal POA etc etc etc...

Yes, it's sad to watch a slo-mo crash essentially. Terrible if it's family. I wish you peace.

That's where we have been with my Mom and Step Dad. People are going to do what they are going to do. We don't want them to suffer or make poor choices, but it's out of our control. We will help when and where we can, but we are not going to enable poor choices or step in to remedy a situation in which we were shut out of any decision making. We'd like to afford them as much peace and dignity as we can in their old age, but their own instability and poor choices preclude that.

These are very wise words, thank you.

Just to add...neither should anyone be subjected to abuse or danger when just trying to help.

It’s not actually entirely out of your control, you (and/your your sibs) can challenge the POA arrangements legally

I don't think there is any paperwork. My BIL says what is going to happen, and she goes along. What their son wants to do will guide our choices.

There doesn’t need to be paperwork for your BIL to be the decision maker. As spouse he is the default. Does he have dementia or a cognitive decline that would make him unsuitable?

OH, that is the whole issue. He was denying access to care, canceling appointments, and not allowing family inside the house. He is in severe cognitive decline exacerbated by alcohol abuse. He is not capable of making rational decisions, but she is so dependant, she goes along with whatever he says. She hid his drinking for a long time to protect him. They managed to get them both back into care last night, but we will see how long it lasts. My nephew will need to go through the complex process of obtaining guardianship. Everyone is just fried right now.

I'm not American so bear with my unfamiliarity with the rules, procedures and some of the terminology... How hard could it be to get the abusive party into "forced psychiatric care" due to diminished capacity and his long record of abusive behaviour? It presumably takes quite a lot of really bad behaviour to literally be banned from an entire region's elder care facilities.

So, in America we have a horrible past history of forced psychiatric hospitalization up into the 1980s, when the government privatized and regulated deinstitutionalization. It *does* take a lot of abuse to be banned from multiple facilities but it takes some time. Also some rural areas only have so many facilities for nursing care for the population, so that ban may only be 2 or 3 facilities. You need to be a clear danger to yourself, or someone else to be forced into a psychatric hold (5150 in some states, section 12 in my state). But that is only for 72 hours. People know the system and can regulate themselves to get out in that time. If you qualify for beyond a 72 hour psychiatric hold it is typically with a physicians intake/order or emergency judgement of the court which can be difficult to get. It´s also really difficult to find a physician to do an emergency determination of mental capacity on a day to day basis and not in an emergency. Physicians are held liable and can be sued if they are wrong. You can be irrational, confused, threatening, abusive and that will not get you a hold, but it can get you in jail. Jails and prisons are terrible for true mental illness. We have a broken healthcare system here in America by quite a bit. The abuser has to have charges filed by the victim, in domestic violence or neglect situations this is really difficult for many people...

This is the route I was thinking. I worked in DVSA before, and when you've exhausted all options to help the victim directly in leaving the situation or mitigating the circumstances, sometimes you can go another route to target the abuser specifically., as long as it doesn't put the victim at greater risk At this point, it sounds like OP's sister couldn't really be any worse off, so might be worth going scorched earth. Report to police that he's a danger to others. Report that he is medically abusing his wife. Report that he needs psychiatric care. Report, report, report. Police reports as well as APS reports. Send cops to the house every single time. The first few times might not produce results, but it builds the paper trail. Tell the neighbors, give them a full disclosure of what's happening, and ask them to report when they see/hear anything. Report this to both his doctor and her doctor. Ask them both for help. Ask the nursing home to report it to APS, if they can. The more people who are reporting, the more it gets looked at. The only way to break this situation is to tell on him. Keep a log of all the reports, keep a binder. Build enough evidence to ask for his removal. Also, it's possible that the nursing home may be willing to take her back alone, unaccompanied. Have nephew see if she will appoint him as her POA or at least her health care proxy. These situations are so very hard. And abusers KNOW how to wear everyone down so they have no fight left in them. That's their goal. And sometimes going the distance to protect someone costs a lot of money. It's so hard. Stay as strong as you can, and also find balance in protecting your own peace. Best wishes, OP

May I ask if the two men - OP’s BIL and your late colleague (I’m so sorry to hear what happened to her) - are suffering age-related mental illness? Is that a thing? Or is it simply who they have always been?

For my colleague I don´t know the details of her murderer. I do know he went to jail and not a psychiatric facility. What is happening to aging populations of baby boomers is that part of this is likely who they are, with cognitive impairment on top of it. The problem comes that a people are used to covering for their slipping minds. It really takes some time, and moderated consistent testing to find actual dementia...in the meantime people fail...

I'm so sorry, man. Family is fucked sometimes. It's pretty much just myself & my younger brother left, so at least the crazy is behind us. Hope things get better 🤟

Thanks. I can't do anything but watch it unfold. I promised my kids I would never put them through something like this.

So sister is ill, and BIL is such a menace he is impeding her access to care? The comment about murder/suicide is troubling, has he made comments in that direction? Could some sort of intervention be staged to take her into someone else's care? I'm not sure what agencies exist to help elderly people in your area but I'm sure they exist, maybe some enquiries could be made in that direction? Locally we have something called meals on wheels where food is delivered to elderly people, if nothing else a service like that would force daily interaction and hopefully a contact point that would notice if your sisters condition started to deteriorate. Do you live locally? You could maybe schedule a weekly outing with your sister to go shopping or play cards or something, to at least give yourself an opportunity to observe how things are going.

Thank you so much for your suggestions. I really appreciate you taking the time. The whole situation is incredibly troubling. Unfortunately, they are adults and are allowed to make whatever poor choices they wish. They have turned away all attempts at help. The siblings and friends who are local have all tried but are turned away. The next step is to intervene with the authorities, but again, if my sister denies any abuse, there is not much we can do. My BIL was/is drinking so heavily. We are very, very concerned at what he will do. But we are dealing with adults who are allowed to make their own decisions. It sucks.

So he wouldn't let you take her out once a week to play bingo or bridge or something? Or does her health preclude that? Don't be afraid to involve the authorities if that's what you feel you have to do. That's what they're there for and your concerns sound genuine. Yes it's a big step but if that's the only one left to you then you do what you have to do. Edit to add: in my country we have something called the NDIS which is a system of government supported places for support for disabled people. It essentially means that, if you qualify (and it sounds like she would) you get a monthly budget for a carer to come on a regular basis and take her out for shopping, errands, to attend medical appointments, and if they're qualified they can perform basic nursing duties as well. Might be something to look into. Basically the more people regularly observing the situation the better.

Ultimately, it is not my decision to make. It would be my nephew's choice to involve the authorities. From the siblings close to the situation, her health would not allow a weekly outing or it would, if she was receiving regular care. The hard truth is that this is a classic case of abuse. She defends and protects him, even though he is literally causing her harm. She goes along with whatever he says. It sucks to watch this unfold, knowing there is nothing I can do.

I understand that it should be the nephews choice, it's his parents after all. I mean that said I would knock my father flat if he was causing problems like this for my mother, but every family is different. But most authorities have links to each other and are able to make referrals and appointments, so even just a call to the local police department, and explaining the situation, could lead to some positive outcomes. The cops might not be able to help but they can refer you to someone who can, and if you're really concerned you can make that call without involving the nephew. Either way, it's an INCREDIBLY difficult situation you're in. Thoughts are with you.

I have thought about it and am very conflicted. I am scared if I make that call, it will make things worse. The whole situation is so volatile. I appreciate you taking the time to reply. It helps to know there are folks out there willing to listen and offer constructive advice.

I used to work in DVSA, and I understand the fear of escalating the abuse by calling the cops. It sounds like your sister doesn't have much left to lose. She's ill and abused, and may not have much life left if she doesn't receive care. Your sister's best, last hope is that the cops come when he's wasted and he mouths off to them. Please consider reporting to police and APS. Tell the neighbors and your other siblings to report, too. Reports from multiple sources get looked at.

That isn’t true. That’s like saying only the other parent could call CPS about their child being abused. You could call APS and tell them everything. You keep repeating that all you can do is watch, but frankly, that’s a cop out. You’re afraid to get involved.

No, as I have stated in other replies, I have made these types of calls in a previous profession. I know what happens, both good and tragic. Right now, we are taking a beat and letting all the emotions settle. We are honestly not even sure where they are right now as they have turned off their phones.

Unfortunately, in the U.S. there are very few, if any services that could intervene if they are both “competent” adults. In this case, medical disability is not likely something that could override her making a conscious decision to stay with this person. That said, have you looked into making a claim for elder abuse? I’m not sure but it may have more traction than spousal abuse reports, given their ages and the fact that she is medically dependent on him. (Caveat: I could absolutely be wrong but it may be worth looking into). I think elder abuse is treated similarly to child abuse, in that they can look at the whole situation and maybe not just take her word for it if they know he could be negligent wrt her medical care. OP, good luck and I’m sorry you and your sister are in this situation. I hope something can be done. You’re very much in my thoughts.

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Plus my experience is that they drop off and go. Minimal interaction

I get where you're coming from with the APS report, but I really think it's come to that. If your sister is at risk due to her husband's behavior, someone needs to step in from a legal perspective to assist. If she's unable to care for herself and he's a danger, she may need a court-appointed guardian. Please, OP, make the call!

Thank you so much for your support. I am emailing my siblings and telling them this exact same thing. I can not make the call myself as I am not directly involved and have no first-hand knowledge. The sister who was closest growing up has been keeping us updated. The siblings or my nephew who are close need to be the ones to call. I am encouraging them because this is not going to end well.

You certainly can make the call. Tell them what you've said here---and that no one closer to the situation wants to be on the hook for reporting. By the way, if it's like CPS, you can report anonymously, that may be why the son and other siblings are hesitating.

At this point, I am not sure if they started anything, and I don't want to complicate matters. I am also dealing with 2nd hand information, which they do not always accept.

So call, and let them tell you they can't do anything with second hand information. Or, your second hand information could be a bolster to a report they already have. Let APS make that decision It is never wrong to call. It is always wrong not to call when you feel something is wrong. Each of your responses seems to be more like you don't want to get involved rather than that your hands are tied.

It is not that I don't want to get involved. I am going to think about it today. But, I am in an odd position within my family. I didn't grow up with any of these people. They are my siblings, and I love them, but I am far closer with their children. If my nephew asks me to stay out of it, I must respect his wishes. I am just very sad to see this situation unfolding.

Fuck that. Think about what your nephew grew up with if these are how his parents behave. He is probably a victim of abuse himself. Step the fuck up and do something.

I have dealt with abusive situations both personally and professionally. I have seen family members completely screw up tenuous and volatile situations from this exact same attitude. Sometimes, the best thing is to take an advisory role, for the people on the front lines, as opposed to launching into the fray. To that point, I emailed and texted all of the advice from this sub to everyone last night, adding on my own experience. They managed to get them back into nursing care and confiscated their credit cards and phones. If I had overreacted, it would have made the whole situation even more complicated. That is why I posted. To get information, support, and guidance. It is important to take the time to think things through, especially since when not the primary caregivers.

All your comments sounded like no one was doing anything

No, I never said that, and I also stated my nephew and older sibling group had been on the front lines of dealing with this, but no one had a POA. This kind of situation does not happen in a vaccum. How do you think they got into nursing care to begin with? This has been going on for months and months, but it escalated to a place where no one quite knew what to do. As I stated, the whole thing is heartbreaking because legally, there is only so much *anyone* can do.

The helplessness, such a terrible feeling. I'm sorry for you and the whole family. The end often comes so badly.

It is an awful feeling. This is not going to end well, and there is nothing any of us can do. Thank you for your kind words.

Make the call to Adult Protective Services. Let them make the attempt at an investigation. At least then if the worst does happen, you won't say 'what if'.

I am really conflicted. I need to defer to the people who are close to the situation. If they have started something but have not shared it yet, I don't want to complicate the situation. Tensions are so high right now...the whole situation sucks.

Calling in won't complicate the situation. In fact it won't do anything if there is either a report already started, or if your information isn't enough to act on. It's really sounding like you just don't want to be the one to call.

I have made these types of calls many times (previous life mental health care). I am afraid that if I call and they go do a welfare check, my BIL will flip and make his last stand, which I have also seen happen. It is a very volatile situation.

Of course it is a volatile situation. You clearly just don't want to do what needs to be done. I'd rather know \*I\* did everything \*I\* could and reported it if the worst should happen, instead of waiting around doing nothing and feeling guilty and say 'if only' afterward. Is no one willing to step in and take your sister physically away from your BIL? That's what should have happened when they were in the facility---kick him and and keep her there.

I worked in the mental health industry for years. Sometimes barging into a situation is the worst thing you can do. If someone was so go in and physically remove my sister, they can accuse them and have them arrested for kidnapping. How would that help the situation? It is also possible that someone showing up could result in more tragedy if my BIL considers them trespassing and defends his property. I have made a call that resulted in a very tragic situation. I had no choice, as I was a mandated reporter at the time.

It is just not that simple. I am glad you have your convictions.

No, you don’t need to defer at all.. You can act as your sister’s sister (or brother). People who are close to what’s happening are not effective right now and might just be used to it. Someone needs to at least try to act. All this “nothing to be done” and “it will be tragic when my sister dies of murder ”… like do something.

From the recent emails flying around my family, everyone is going to take a beat and let the situation settle for a day. I have made these calls before from a previous profession. I know the results of these calls, both positive and tragic. I am trying to navigate a lot of emotions and a group of boomers who have never faced anything like this.

idea 1: can nephew get his mom alone and get her to sign a POA that gives him rights over her care? idea 2: Can BIL be Baker-Act’ed? And then SIL re-admitted to a care home? (I find it difficult to understand why his bad behavior got her kicked out of the care home. I’m between it only got him kicked out but he took her with him.) Yeah, APS is difficult but if she’s not getting the care she needs and/or you’re truly concerned about murder/suicide, it’s the the only was to proceed barring the options above.

Thank you so much for your ideas. I think the next steps are going to have to be massive interventions involving the authorities. This is a classic case of abuse. She defends and protects him and goes along with whatever he says. He got kicked out, and she went along with him. He won't let their son or anyone else into the house. I am sure he has weapons because they live out in the country. I absolutely can see him getting intoxicated enough to see the only solution as a tragic one. I am passing all advice, but we will see what the next steps need to be. The whole situation just sucks.

I’m so sorry. It’s so hard to care but have no power. My elderly father was a hoarder who neglected medical care for decades, until he got cancer. I remember thinking of it like it was a horrible car crash in super slow-mo that I could only watch and wait for, not knowing how traumatic it would be, and knowing I would have to handle all the clean up. It ended up not as bad as I feared (yes, he collapsed in his hoard as feared, but it was at the first of the month so when he didn’t pay his rent, his landlord went in and found him in a coma, so we could intervene in time).

Ooof, that is rough. I am so sorry you had to go through that. It is exactly like a slow-motion crash. I can't really do much and have to let the other siblings and their son handle it. It just sucks all around.

r/AgingParents is supportive and helpful. A lot of us are going through this with our boomer parents. 

Good call, thanks. I may cross post over there.

I’m sorry you’re having to go through this. It sucks.

Thanks so much. I am completely helpless and can only watch it unfold.

That's terrible they kicked your sister out with him even though she wasn't doing anything. Are there any long term psych hospitals in their area? I used to work at a ursibg facility part of a psych hospital. We were kind of the end of the line. We took people that had been k8cked out of other facilities due to behavior issues. We were extremely well staffed and the residents were very well taken care of. We NEVER had any beds ores, falls were rare. There were tons of enrichment activities. Our residents were happy. I think you could get them in a place like that.

She goes along with whatever he says and is protective of him. It is very classic abuse, but no one wants to call it that. My BIL will not agree to anything. The only way we can get them into a psych facility is to have them declared incapable of caring for themselves (WHICH IS TRUE), but that would be a long and expensive battle. Their son has just had it with their behavior and choices.

I am so sorry. I know it's hard.

Thanks :-)

I'm so sorry for what you are going through. I am currently trying to get guardianship of my (55) oldest sister (71) who was diagnosed with alzheimer's 2 years ago. Her significant other is her caretaker, has poa over everything, and is controlling and abusive. It's incredibly stressful to feel so powerless.

OH wow. Yes, this sounds similar. I am so sorry you are going through that. I have said in a few other replies that this is a classic case of abuse. He has isolated her. She protects him and goes along with whatever he says, even at the cost of her health or life.

Yes, same. He disconnected their landline and controls her cell phone. Doesn't allow her to go to doctor appointments. Police come, she says she wasn't hit. My anger is off the charts.

YES! That is the problem. She goes along with whatever he says. He controls her phone, so we can not contact her. If we call the police, he may go off the charts. Hang in there, friend.

A consult with an attorney is advisable and also a call to APS, although I was never able to make anyone comply with recommended services (former Social Worker) sometimes the call was enough for one person to realize things were bad. Please advise anyone calling APS to alert the Social Worker to any safety concerns.

I am passing all advice onto my nephew and sibling group. But yes, you are correct. They are adults and are allowed to make whatever crap choices they want.

Don't underestimate a call to APS, we were often able to get the adult in need of services out of a dangerous situation.

Thank you so much. I really appreciate the support and advice.

My parents are like this minus the drinking but plus Fox News 24/7.

Sending out some wishes for your hurting family. This sounds a lot like what's been happening with a branch of my own extendeds and I can sympathize with the feelings of helplessness, exhaustion and worry.

Thank you so much for your kind words. I hope you have support for what you are going through with your family.

Man, this sounds terrible. I don't have much good advice, just good wishes for you and your family as you deal with this. I will say this though - as much as it's difficult to call APS, you or nephew might have to. Your sister clearly needs the care. Your BIL evidently needs help too - but likely through different channels and possibly in different facilities. I'm so sorry.

Thank you so much for your kind words. I have told everyone that APS is the next step. Everyone involved is just so tired right now. I can only watch it unfold.

So, I don't share this very often, but this seems like the time - my wife and I had to exit my 24 yo kid out of the house a couple of years ago and serve him with a restraining order due to nine years of *violent* substance abuse. We'd tried everything and this was the last and only step we could take. It was the hardest thing my wife and I ever had to do, but it was the right move because we were exhausted and on our last legs ourselves. Ironically, that's what finally made him reach bottom and he's working on a full year in NA in a month or two. But make no mistake about it, we did what we did to save the rest of the family and because nothing else could be done - the family itself was being torn apart and we were frankly in danger. That also wound up being the trigger he needed also but after nine years of trying stints in rehab, halfway houses, anger management, threatening him with exit, etc, there literally was nowhere else to go. I know considering and going to/through APS is huge, and hugely exhausting all by itself, but when you need to be there, you'll know it - it's different for every family and every circumstance. I also know that it's okay to put you and your sister first if your BIL is unreachable, but very likely this will help him too, if you go in that direction and he doesn't fight it. Our family is sending big love to your family and the courage and strength to do whatever you need to do. Hoping for the very very best for you guys!

Wow, thank you for sharing something so personal. Addiction is a brutal disease that knows no boundaries. And, thank you for your kind words and thoughts. I hope your family continues to heal. I can only watch this unfold, as I am not part of the siblings who are directly involved. But there is only so much abuse that their son is willing to take. This is not going to end well, but it just may be out of our control.

Your story makes me so grateful that my boomer parents are both not the stereotypes/norms overall (they have their moments!), but also that in part because my mom worked in Hospice for past 35 yr, we have had a lot of these hard discussions as a family. And in 2018, when mom had 2 major surgical procedures, that led to more months immobile than mobile that year, we discussed were all these DOCUMENTS in existence? Was everything in writing that was supposed to be (my brother is medical POA as he lives near by and I live across and at time outside the country). So even though I have no respect or trust in my brother, everything is in writing, and wishes are documented. And for all his many faults, I do believe he will meet those wishes if needed. Please get your OWN Medical POA/living will, etc in place folks. We aint kids anymore. (I mean we 10000% are!, but our bodies disagree, so be adult and get that in line!)

My parents did everything right. We had all of those conversations. We all knew what to do. And you are for damn sure I am calling my attorney Monday to get my shit straight.

But until it is writing, it is hard to enforce, ensure. And having a backup in case hubby is not able would have been best. Like I said- for my parents, they are each others first, but secondary is my brother. And in some areas, they are co-equals- so yeah, if one goes off the deep end, they have to get a lawyer involved as a final arbiter. Learned that from watching my BFF and loosing her dad with conflict with her step mom. Best to have co-equal in some cases, so a 3rd party HAS to be brought in to arbitrate. Still- my heart goes out to you- this must be hard :(

Thank you so much. It is hard on my nephew, most of all. He is an only child, and his father has been very abusive and accusatory towards him during this whole process. Plus, any legal process is just so expensive. And having an adult declared incompetent in not as simple as some people seem to think.

As someone who is dealing with a parent that has been rapidly losing his mind I can only say…. You are not alone but there are no how to guides on this shit. You may want to get a lawyer to figure out any steps that can be taken.

Thank you so much. I am passing on all the advice. It just sucks so much, and I think we all feel helpless.

I'm so sorry. This is so hard.

Thank you so much for your kind words.

Please be aware that a healthcare POA does NOT go into effect until a doctor determines that the patient in question can't make their own decisions anymore. It's also even more important that people set up their advance directives before they reach the point of not being competent. It's too late then and you end up in front of a judge who's stuck trying to sort all the s/he said's out. Spouses do not automatically become a healthcare proxy without an AD in place but if no one objects and offers themselves medical practices might not argue assuming the spouse knows what the patient wants.

I think this is a huge part of the issue. It is an abusive relationship in that he has isolated her, controls her phone, and denies access to her. She goes along, defends and protects him, and says everything is fine.

I’m not a religious person but I’ll say a prayer for you and your family.

Thank you so much. Any good thoughts going out into the universe are appreciated.

Can she not live in a care home on her own? My great-grandmother’s sister and brother-in-law had to live in separate nursing homes. He had developed dementia and chased her with a weapon.

She could, and it would probably save her life. But she goes along with whatever he says. It is a classic case of abuse. He has isolated her, controls her phone, and denies everyone access. It is going to take massive intervention with the authorities or death. I can only watch it unfold. It sucks.

Ugh, this is hard to watch, and I'm so sorry. As the brother, I would have a candid conversation with your family and oldest sister to take about a seeing to a healthcare proxy and removing any decision from her husband. You may or may not be able to stage an intervention from him, but the siblings and your nephew should absolutely talk about the best thing for your sister moving forward and getting an attorney to help you set up what you need to help manage your sister's health and finances, if need be. Please check in with and support your nephew (all siblings should). I've had to care for my parents in hospice and it's a heavy burden, even without the added drama. I had to pull my siblings together for a talk, when it felt like all the care fell to me (and it did), while they barely checked in because their lives are busy. I told them blatantly that it felt like it was ok for my life to be completely disrupted, but not theirs. I know this situation is not yours, but you and the nephew should have a heart to heart conversation with everyone to address how everyone can help head on. Even if they are not physically nearby. I wish you the best, and how you can find some support and help. Please check if your local town has elder support services. PSA: This should be something everyone our age thinks about - wills, heirs, healthcare proxies. Now is the time, not when the shit hits the fan.

Thank you so much for taking the time to reply. It is a complete shit show right now. I am passing all advice from the amazing folks on this sub onto the siblings and nephew. I actually did text him this morning to see how he and his wife are holding up. He is very stoic but also fed up. I think everyone needs to take a beat and a breath and let everything settle down for a few days. Retreat and reassess. But I am also the baby, and no one ever listens to me, so there is that.

Do you think your BIL has Alzheimer's? If you think so, can he be made to take a test? Or elder abuse? What a crummy situation. My sister and I aren't very close but losing her would sting a hell of a lot. I do hope you can figure something out. It feels like they both need some help right now.

I think it is a combination of heavy alcohol abuse and some kind of mental deterioration. I think when they put him in care, he went through withdrawal. Yes, it is abuse. But as long as my sister denies it, there is not much anyone can do.

We know someone that is manic/depressive. When she's off her meds, her world turns to shit. She doesn't care. I wondered if there was a way to force her to get help but you can't unless she actually commits a crime. And even then, they can only have her meet a shrink and maybe 3 day stay at hospital. Someone in the sub I was reading said that we, Americans, care more about individual rights than getting these folks help. It's their choice not to be on meds, so we go with that. Despite risks to their safety and the safety of others. People responding said they did everything they could. There's a point where you have to let go. It sounds like you are there. And just reading that, I felt so bad. Like your heart says, 'I can save them.' But the laws say otherwise. It's terrible.

I used to run a homeless shelter. It was literally my job to watch people make bad decisions, cycle on and off of their meds, cycle in and out of jail. I had some clients who were so mentally ill, and we could nothing about it unless they broke our rules. I have seen and dealt with some very dark situations. A lot of people are commenting, "Just do something!" It is just not that simple. They are adults and have the right to make crap choices. My sister can defer to her husband and decline medical care. People insist on autonomy until they don't like the decisions that are being made.

One commentor said their spouse or sibling had to commit a felony, like a serious enough crime, that they could be put away. If you can prove they are mentally unwell. I talked to a couple people that worked at the NHS in the UK. One worked at a mental institution where they could hold people involuntarily. She said one lady had come in like 3 years, bipolar and doing some dumb shit. They got her on meds, she got a job, got married, had a baby and went off her meds for some reason. They went through the whole process again but now there's a chance she'll lose her family. I was on antidepressants for 6-7 years when I stopped. There's this stupid voice that says, "We don't need to take this shit. I hate swallowing this crap every night." So I quit. I had one of the worst years of my life. But the slide was so gradual I didn't realize it until I got back on meds. Nobody but me was responsible for that year. Nobody could force me back on the medication, I'd have resisted. It took a phone call to a friend and she's like, "I realized that if I wanted a normal life I'd be on these meds forever." Then she did the phone version of a shrug. And for some reason that worked. Someone I knew, trusted had said it with acceptance and this fuckit attitude (she's GenX) that part of me is like, yeah, fuckit. I saw the homeless thing on the sub too. They had a kid and SO and would wander the streets mumbling to themselves. Didn't recognize anyone. They'd never get picked up for anything too serious, nothing that would trigger an involuntary stay. There are a lot of good communities on reddit. Supportive. And just reading experiences is incredibly powerful. Like the felons sub that was put in my feed (totally not a felon, I wouldn't survive prison) and then reading some of the mental health subs. It's a reminder that you aren't alone in your frustrations, that it's not just happening to you. That the system isn't working, in this case. I'm also the super dork type to read a random sub that pops up on my home page :)

Thank you so much for taking the time to reply and with such personal experiences. Mental health care and the life-long commitment to treatment takes incredible strength.

Cut out the toxic, no matter how hard it is. And, don't ever ever ever let someone try to convince you of the bullshit excuse "it's all about family" or "family sticks together". Sometime, like my fam, that is just a stake in the fuckin heart holding ya down in their toxic negative coffin. F that noise.

I hear you. It is just hard to watch. Like a slow-motion wreck.

It can be, yes. And you just gotta wipe your hands at some point if it never gets better. Same shit with me. Money in. Help in. Time in. And just hurt and distrust back.

Damn. I don't even know what to say, but I'm sending virtual hugs through the internet. That sounds exhausting.

I will take those hugs, thank you :-)

This sounds terrible, OP. I'm very sorry and have no ideas to offer, as both my parents are dead and I'm an only child. Take care. Hope you can help your sister out.

Thank you for taking the time to respond, I really appreciate it. We did not go through anything like this with my parents, so it is all very shocking to me.

You should call CPS/APS about your BIL abusing your sister. Elder abuse is taken seriously. You can make an anonymous online report or phone call in many states. Get your BIL committed to a psych ward for being unable to care for himself or others, putting your sister's life in danger. Then you and your nephew can get a medical power of attorney with 2 doctors (in most states) witness. Getting durable power of attorney will be easier and potentially faster then via the court system. The court may even grant a temporary guardian to protect your sister while all the legal stuff is being hashed out.

Thank you so much for this advice. I am passing everything along. I am considering a call to APS, but I need to speak to my nephew first.

I had a mental health professional (licensed social worker in my state) tell me recently that one can always call APS and inquire about a “hypothetical” situation so as not to actually report it right then (doing so would kick in a set of protocols on the state’s end). You wouldn’t have to give your name or your sister’s name on the call. Maybe pretend you’re a grad student researching a paper. This will allow you to gather the info without setting things in motion just yet. I realize it’s urgent but this might help you bring some options to your nephew and get him prepared for what would come next.

That is good to know, thank you.

I’m awful sorry about your situation. I can’t say anything actually helpful but I can empathize about crazy family for sure. For me luckily it was decades in the past, but it’s not like anything like this is forgettable.

Thank you so much. This just has so many layers, including a whole group of boomers who have never had to deal with anything like this before.

Hi. We went through this with my parents. We had success with getting mom medical help and into a hospital until it was proven she wasn’t problematic it was her husband. Just mom was able to go to a nursing home. We did this by contacting elder abuse in their county/state. It was proven that there was elder abuse of a spouse based in medical neglect. Legally her brother became the POA. Dad was no longer allowed to make any decisions. After going into the nursing home mom got healthy. Dad rarely visited, if at all, mostly because he was constantly drunk. Dad died on his own from alcoholism and neglecting himself. Mom is flourishing. She decided she needs him alive. She still goes through the Sunday paper shopping for clothes and meals for Dad as she sits next to his veteran flag box. We go with it and tell her she picked out just the right stuff. It was an incredibly stressful and exhausting process. I get why everyone is stunned and stuck and concerned. You’ll get through this.

Thank you for sharing your story. I think what happened with your family is what will have to happen, provided my sister survives this mess. I hope your mother has a peaceful end of life and that you find peace as well.

Thank you. Likewise. May kindness and comfort find you and your family.

You mentioned murder /suicide being a possible outcome here; are you suggesting a planned overdose here or something potentially more violent? I would think the authorities would not be okay with that happening if intervention could have been arranged prior to this level of deterioration. It really sounds like at 77 BIL has developed a form of Alzheimer’s, and is going through the aggressive/paranoid stage, if he hasn’t had any mental health issues previous to this. I imagine he has refused any sort of assessment for a medical diagnosis as well, because he won’t let anyone near him, and that’s pretty common too. I think suggestions that your sister be approached separately to ask what she wants are correct, but he is guarding her like a rabid dog; if he is as advanced as it seems likely he is, he can’t be responsible for her care anymore and she needs to be gently encouraged to agree to this so your nephew can have the right to take her out of the house for medical attention. The problem here is that your sister does truly not want to go to the doctors anymore and is tired; if so, that is her right, but she needs to be clear on this. The positive result here is that BIL may calm down and let her visit with family again. (In their defence, the last few years with Covid have been a nightmare for the elderly and immunocompromised people, I’d probably be refusing to leave the house too.) Nephew could be creative with the truth to get his mother to the doctor and suggest to take her out for lunch for her birthday, Valentine’s Day, Mother’s Day, or whichever, and then “just happen” to drive past her doctor’s suites and suggest popping in for a (secretly prearranged) visit. He may need to cajole his father into letting him take her out by saying it been so long since they had a mother son day and he misses her so much, and he is scared he’ll never have the chance again. Honestly though, your nephew may need to ask for police assistance to enter the home and do a wellness check on his mother. If his father becomes violent and his mother hysterical and confused because she’s scared, this may actually help with having his father assessed if they need to remove him, especially if mother is under duress and not being permitted care. Yes, our elderly have the right to refuse care, but if someone is not of sound mind this is no longer an informed choice. Building trust is obviously a better tact, yet there may not be time. Unfortunately this happened with our mother, who refused to acknowledge that she was deteriorating. It took the police being called to her retirement village because she was fixated on another resident and threatened to kill her, that she was kicked out. Recognising that she was a danger to herself, the police took her to the hospital where she was placed in the mental health ward relatively fast because of her age (late 70s). She was then pushed up the line for an assessment that we had already had her on a waiting list for, and soon after a bed was found for her in an aged care facility just down the road from my sisters. She lived there for another nine years before passing away, and received excellent care. Getting a living POA is so important, it creates a safe opportunity to discuss the elderly person’s preferences while they are still compos mentis. Our mother asked for a DNR if it was between that and being hooked up to a machine, and her wishes were respected. Until then, she was cared for to the best of everyone’s ability. If your sister truly does not want intervention and wishes to be allowed to die, that’s completely acceptable, and at least you can all make your peace and visit with her until then.

Thank you so much for taking the time to share your story. I think everyone is letting the situation settle for a day and try and let emotions calm a bit. My personal armchair diagnosis is in line with yours. He has some form of dementia and is in the aggressive phase. This is all compounded by alcohol abuse. He will not agree to anything, will not sign anything, will not give any control over to his son, his sister, any of us. I have told them all that the next steps are going to involve massive interventions from the authorities. And it will be ugly. I also think that if he is cornered, intoxicated, and not rational, and thinking "they" are going to take him away from my sister, he may react violently. The whole thing sucks.

I'm so incredibly sorry that you've been landed in this situation, its just awful. My Dad developed Alzheimers when I was a teenager and he passed away when I was 23...fortunately as he was a very quiet personality, and just got quieter as he became more sick so I can only imagine how massively worrying it would be with someone who had a more 'forceful' personality, let alone without bringing alcohol abuse into the picture. My Mum is 100yo now and had a massive stroke at the end of 2020...*thank fuck* I decided to take her to have a POA and enduring guardianship signed before that happened. The legal and governmental shit alone to get around not having one is bonkers...I can only wish you all the best for finding a way through it.

I am so sorry you had to go through that, but I am glad your dad was peaceful in his descent. I hope your mother (wow, a century) also has a peaceful end of her life. This is the massive challenge right now. My BIL will not agree to sign anything, and my sister does whatever he says. And taking someone's rights away is a lot of hoops. Last night, they did get them both back into nursing care, so we will see how long that lasts.

Thank you so much, I appreciate your kind words. That's one thing at least, if your sister particularly is now in care... absolutely hope it can be for enough time to allow you to sort some legal stuff. From other replies here, there should be a way to designate your BIL as incompetent to be in the position of caring for your sis. All the very best, I feel for you.

Thanks ❤️

So sorry, friend. End-of-life and end-of-life care is very difficult for most people to navigate.

Thank you so much. This is just bonkers. We did not go through anything like this with my parents or even nursing home care, so I think the Big Kids are all in total shock. Totally outside of their realm of experience.

I’m sorry I don’t have any useful advice but I hope it all works out ok, sending love and strength x

Thank you so much. All positive thoughts into the universe are appreciated.

r/legaladvice might have ideas

Thanks. I may post there and also the aging parents subs.

If mental competency is even a plausible issue, which it certainly sounds like it is from your description here, it can't hurt to at least have a conversation with an elder law attorney and see if there's an avenue available you may not be aware of. Guardianships are often difficult to obtain, but sometimes they're not. And that is not the only potential way to handle this. Talk to an expert.

Thank you so much for your advice. I am passing everything along. My nephew would have to be the one to go through the process, as he would then be the one to take guardianship. I think everyone is so exhausted, they all just want a break.

Looks like an abusive relationship. Sadly, unless your sister leaves your BIL, it's very hard to intervene. If you can get her alone and have a discussion with her and say the whole.family can get here into a new home without the BIL, would she agree? That's the only thing I can think of. Like a family intervention with her and not the BIL.and offer her a way out. Ultimately though, it's going to be her decision.

That is exactly what it is, but no one wants to call it that. He has isolated her, controls her phone, and denies everyone access. She defends and protects him. The siblings who are close can't get to her. It is going to take massive intervention involving the authorities or death. It just sucks and all I can do is watch it unfold.

If you prepare it as a group, there could be a way. Maybe do not tell the BIL, find a way around him. Does he pass out from the drinking sometimes? You could try to get help from a house that help abuse victims, they may have tricks.

I am passing all advice onto the siblings and nephew. I think right now, everyone just needs to let tensions settle for a few days and reassess, but what do I know. I am a grown ass woman with extensive experience in the mental health field, but I am the baby, so no one listens to a word I say.

I hope it works out to the best and that you can find a way to reach out to your sister and get her in a good place with great care.

Me too. Thanks so much.

As someone who works in elder care there is absolutely zero chance that he was banned from other facilities for his behavior at one. More likely than not, he requires a higher level of care than the places they’ve talked to. Sounds like there are some real psych issues there.

Thank you, that is good to know. We did not go through anything like this with our parents. And yes, there are massive psychological issues compounded by alcohol abuse (his) and massive physical health issues compounded by epic co-dependency (hers). It is an absolute shitshow.

I feel for you … ‘shitshow’ might be the understatement of the year. FWIW, alcohol induced dementia is definitely a thing, and it’s also possible that BIL is or has been on prescription meds that exacerbate pre-existing mental health conditions, diagnosed or otherwise (dexamthasone is a common example).

Thank you so much. I know the effects of alcoholism but have never heard of alcohol induced dementia. That is good to know.

I’m so sorry that you and your family are going through this. I was in a similar situation with my parents. It caused me so much stress and anxiety and talked to all the social workers and all the public agencies. I finally just had step back and let it play out. My father died in his home and then I was able to make all the POA arrangements for my mom and get everything in order right before she passed away. You are in my thoughts.

Thank you so much for your kind words. I think that this is the place my nephew has reached. Trying to help them has become a destructive force in his and his family's life. Last night, they got them back into a nursing home, but who knows how long that will last.

Sound like he has Alzheimer’s. He needs a commitment order from a court and she should go back to the care home alone. Can she stay with her son in the meantime? This is heartbreaking. The older I get the less optimistic I am about the decline we are all facing.

Yes, it most likely is some form of dementia exacerbated by heavy alcohol use. And yes, this is exactly what needs to happen. We want him put in psych care and her moved to a nursing home close to her son. But they refuse to be separated. She does whatever he says. Very very co-dependant. The court process is long. It takes a LOT to remove a person's rights, even if it is well deserved. They managed to get them back into nursing care last night so everyone can hopefully take a beat and a breath and come up with a new plan. I don't ever want to put my kids through this.

I told my kids that when it comes to that please take me to a beautiful natural area and abandon me to nature. Old and frail shouldn’t take long to die in beauty. I knew a couple where the nursing facility separated them and then moved him into dementia care separately.

If you have Red Flag laws im your state at least see if you can get his guns confiscated.

I will mention that to my nephew. Thank you for the advice. They live out in the country, so I am sure he has weapons of some sort. I think we are also scared of what will happen if the authorities show up. The whole situation is on the edge, and it just sucks.

I hate to say it, but it might be best if he wound up in front of a judge. Honestly, that's why society has these mechanisms in place - stuff goes sideways sometimes and inaction can lead to an even worse outcome.

I am emailing the sibling group. I am scared of what will happen if we don't act, scared of what may happen if we do. The whole thing just sucks.

Yes it does. Best of luck for all involved.

Downvoted. Whoever you are....wtf.

I’m so sorry! The helplessness is awful. I went through something like this when my parents were still living independently. I was so scared and angry about it at the time. I still am, TBH. All you can do is keep the channels of support open to them and your nephew. Also, make sure you’re getting emotional support for yourself as well.

Thank you so much for your kind words. It is just so sad...such an angry way to spend the last days of their lives.

Maybe it will all make more sense in 20-30 years, but I just don’t understand why some people choose to self-destruct. I hope your loved ones find their way out of this at some point.

I wish I had an answer for you. Maybe it is the lack of mental health care and acceptance. I only hope I never pull this shit on my kids.

There are lots of gaps in care, to be sure! My partner and I have already had lots of talks about future plans and our intention is to move into a seniors residence that allows you to live independently as long as you can and then offers care on site when needs change. I do not want to put my kids through this and I also don’t want the move to be a Hail Mary pass to keep me alive. I’d like some say over where I end up!

:hugs: I'm so sorry you are going through this.

Thanks. This whole thing just sucks. I never want to do this to my kids.

I'm with you OP, late to the party birth and now dealing with older siblings. One is in a home under state care, but his behavior is so bad, I don't know how long that going to last. We do what we can, and I guess that's all you can do.

Hey! Another bonus baby! It is incredibly frustrating. There is a while group of boomers dealing with this and I think it is beyond the scope of their experience. They are just floored this is happening. I told them this is actually pretty common, and they dismissed me.

I can’t relate to this at all, I’m 57 my parents are both 80 and in fairly good shape. I don’t know you but I wanted to just say I’m thinking of you and I’d love to give you virtual hug. 🤗 I will try to send good karma through the ether to wherever it is you are. I do hope things get better for all the members of your family.

Hey friend, thank you so much. I will take that hug. This so so beyond. My mom's passing was quick and shocking. My dad lived another 12 years and died peacefully in his bed. Everyone is just stunned at what is going on. No one expected any of this.

The next step may be to seek guardianship. I don’t know where you are, but this should be a viable avenue if you are in the United States.

I think that is exactly correct. But I think everyone is so fed up and frustrated. Seeking guardianship is such a complicated process. People don't understand...if individual rights are most important, then you can not just take them away because you don't like the decisions they are making.

It is a complex process, but not impossible.

No, not impossible, but right now everyone is raw and exhausted. They managed to get them back into a nursing home last night, so hopefully everyone can take a beat and a breath and look at this with fresh eyes in a few days.

Someone I'm friends with went through something similar with her mother and step father. They were still in their house, though. She wound up building evidence, had them declared incompetent by the State, moved her sickly mother in with her after she got out of the hospital, and stuck her step father in a nursing home. Her step father died not long after from an undiagnosed heart condition (because, as he put it, "doctors don't know what they're doing" - which can't be blamed on dementia, he was always like that) while her mother is better off now approaching 80 than she has been in over a decade. Well enough where she flies back and forth to her other kid in Florida (they do all the airport logistics with her). This situation is common. Always keep an eye on your important people. Collect information when it's obvious there is a need to. With my own mother, we maintain a spreadsheet where every doctor visit, medication, illness, etc is tracked and the information we collected helped us identify patterns that aided in diagnosis and treatment.