Rant/Advice, Long! Any thoughts?
Hello everyone:
我是新来的。我读过各种各样的文章,帖子和comments. They have been helpful.
我的情况：
I am 61. No spouse/children. I have been a caregiver twice in my life. My mother for 13 years and middle brother for a year or two. Both are deceased.
My remaining relative is my older brother, 73. He was living in his house. His wife died 2 years ago and his son in 2020.
He was not taking care of himself. The house was in decline (no hot water, refrigerator and stove not working, not able to do maintenance, mold and electrical issues, pest issues and a dog (my nephew's) he did not want.
由于Covid，我没有访问太多。我们每周讲几次。我问他是否需要帮助。答案，不，我很好。他的衰落变得更加明显。
Ordering out all the time, needing bug spray, etc.
I did not realize how bad it was until he was sent to the hospital as he could not breathe.
He had an issue with a weak knee/leg and unable to put weight on it. He was struggling to care for self. Not allowing groceries to be delivered, etc..
Once sent to hospital, I was able to get into the house.
It is not fit for him to return to unless extensive work is done. Just to clean, sanitize and gut house is $3,400.00.
Needs a plumber, electrician, stove/refrigerator before he can return. House is locked up and I cleaned what I could. The dog was given to a no kill shelter for rehoming.
The house is too much for me. Only hoarding professionals can clean that house. He has no savings for this, just SS.
Currently he is in short term rehab for the past 20 days.
Rehab wants to discharge as it does not have Medicaid beds.
He needs more time in rehab than he has been given. He is just being able to bear weight on leg for a brief time, then it gives out on him. He cannot live at his home at this time.
Maybe in a few months but not now. The house is in his deceased wife's name. There is still a large mortgage. Only 5 years equity. He was paying his bills and is capable of understanding and making decisions.
His options as I see them:
1.回家不好（需要工作）
2. Live w/me TEMPORARILY while he gets in home rehab to strengthen the knee. Then search for senior living options (waiting lists for senior housing)
3. Go to a NH that takes Medicaid for more rehab until a senior living arrangement can be made. He is under the limit.
4. Pay co-pay at rehab for 21-100 days under Medicare (this may not be affordable)
Frankly, I do not want to be his caregiver in my home. He was not there for Mom, brother nor me. I have been working on my resentment. He calls when he wants something. I help some but set boundaries. He has lost his support system (sis in law did everything) so I do not want to turn my back on him. I must also take care of self. I have issues too.
Our personalities do not mesh. I wanted to do some work on my house now that I am retired. He comes here, it will not get done. This will be my 3rd go around in caregiving. This would be more difficult because he would be resistant and dismissive.
He could get in here and refuse to move to a place. He can be argumentative. So can I. We do better at a distance.
I have some emergency savings that I was going to use
在我家工作。我还拥有一段时间以来一直没有触摸的退休资金。我不想为此使用。即使房子得到了修复，如果他不在乎，他也将是正确的地方，并浪费了钱。我没有钱浪费。
I asked him what does he want to do? He says he wants to be independent. He will be speaking to SW on these issues tomorrow. I have not spoken to SW nor has he asked her to contact me as he makes his decisions.
Any thoughts?
15Answers
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My brother is now in a nursing home about 20 minutes(up the road) away.
He was denied the appeals for Medicare rehab beyond 20 days.
His NH accepts Medicaid. He privately paid for rehab for 13 days while awaiting his 2nd decision.
He has been in his facility for 2 months. In the last 3 months, he has been covid tested many times, vaccinated, gained weight, his diabetes and high blood pressure are under control. He has a cna who has taken him under her wing. He gets physical therapy(which he enjoys) although the sessions have been reduced due to the limitations of Medicaid. He "works out" in his room. Leg stretches, arm curls...passes the time, I think.
他仍不能走路但是到目前为止沃克。
He has a tv and cd/radio player with all his favorite cd's. Brother's not a reader. He never wanted a cell phone but now is getting used to it. His floor does not have phones in their rooms(weird).
He likes the food for the most part and since he's higher functioning, discusses what he like or dislikes with the dietitian. He is able to make his feelings known to staff and in care meetings.
His NH has reopened to in person visits this week, the dining room, hair salon and outdoor patio are open. In room visits...not
yet. I am vaccinated and he is too. Visits are limited to 30 minutes.
He is still by himself in his room...as things change with the pandemic that will probably change.
Only been 60 days, the staff thinks he has adjusted so far....let's
see at the 90 day, 6 months or a year from now. Take it a day at time.
Will he be able to live on his own...in an apartment, who knows?
Question is, does he want the responsibility?
同时，他的房子被一个侄女接管。她已经清理了它，愿意接管抵押贷款（兄弟已经支付了欠款），直到她能够承担抵押。她对自己目前所处的生活状况感到不满意。她抚养了2个孙子。她想把它留在家庭中。
He now longer wants to live there ...too many memories of loss.
We speak several times a week and I visit when I can. I get him what he needs and asks for... which he pays for. He says he is being cared for. I've said to him to try to stay as independent as possible and speak up. The SW at the NH knows that I am not his POA but I am the person of contact as well has the niece. I am notified of any changes and am present at care conferences.
At this point, I am his sister and advocate.
For me, I am working on my house(projects that need attention).
走出去，大约更长。安全。
昨天，是一个超过40年的接种疫苗的朋友，我在露台上露出午餐，直到下雨，然后里面。我们庆祝了我们的生日（我的四月，她的五月）...均为62。
We ate, laughed and ate some more. Felt good for both of us.
Memorial day, I'll see my brother with some lunch and cake.
一次...
That has to be one of the THE best updates I have read. No magic wand, everyone 21 again but real outcomes from real choices.
I love how you say you are his sister & advocate!!
I love that your brother has adapted so far, thinking positive & is making progress with his health & fitness goals.
It also shows that staying in your own home, alone, is not always the answer for everybody. Some thrive in a new setting. With more social connections. For those able to consider CHANGE, to either be brave enough to go looking for change, or brave enough to seize a new direction when offered (even if pushed there by crises) to me, it still shows flexibility & bravery.
I wish you well, ML. Your good clear sense will help you, your brother & many others too.
Do not step in to bring him home or support him financially. The SW will find solutions ONLY of you don't swoop in to BE the solution.
在您的鞋子上，我会打电话给SW告诉他/她，您不愿意成为他的支持系统，他的备份计划或担保人。他可能会告诉SW您将带他进去。确保她知道您不会。
I am very sorry for your brother's situation, but the state has the state's resources to call on in helping him back to his feet, whereas you have only you. Be reasonable.
It was the strong thoughts I needed to hear and receive.
Update:
My brother has appealed the Medicare denial for additional rehab days. It's pending. He has paid for a week. He says he does not want to return back to his house...too many memories of loss.
He has a list of NH that accept Medicaid and have good ratings.
在他去医院之前，我联系了衰老的地区机构
(my city's senior services) to ask for meals on wheels and help in the house. Once I saw the conditions he was living in, I called for Adult Protective services and explained his situation. Since he is in a rehab, the case was closed out.
年代ince he has been in rehab, he is getting supportive services:
physical therapy, meds on a schedule, 3 meals a day, toileting, people to talk to.
He had the wherewithal to call 911 to take him to the hospital
和get out of that house.
He said when he trying to decide whether or not to try for the
appeal, "This for my health and life. I am going for it."
As for me, I have begun the process of getting my downstairs
ready for the work that needs to be done.
Don’t invite him to enter your house “temporarily” (it is NEVER temporarily).
Either he IS capable of managing independently or he is not. In NEITHER SITUATION is he in any way your responsibility.
Let him make his own decisions and let his decisions be entirely his.
您将通过自己的想法确定自己的自我照顾与您背弃他的自我照顾并不相同，从而做出更艰难的决定。
请接受这些明智的人的建议。他们有经验使他们有能力信任他们的信誉。
请保持界限。您自己的未来取决于它。
最好的祝愿。
兄弟与社会工作者一起满足了他的未来需求。
If he is deemed capable, he can choose from the realistic choices available to him. Usually the least restrictive option is trialled first : home if agreeable to home help services.
If he later dismisses the home services, he will bounce back into crises mode. Meet the SW team again for another round.
If his capability is questionable, SW may request Psych input & neuro testing. Can lead to emergency guardianship (but that bar is pretty low it seems).
我可以感觉到你对他的最大利益。但是您无需为他解决这个问题。实际上，他已经说自己想独立 - 因此他将感谢能够以自己的方式做到这一点。
It's OK to just be his Sister. Agree that life sucks sometimes & visit him wherever he lands.
Do not support him in any way. If he can't afford the house then he needs to sell it. Let the SW figure it out. Thats what she is trained for. Just keep saying No, No, No. You have a right to your life. Your worked and cared for people. You have done your share. He won't change, just bring you down.
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