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Managing toxic family relationships and dementia patients
A parent was recently was dx with Alz. I have two siblings. I will be the primary one helping my parents but I can count on one sibling (#1) to provide support when needed. The relationship with my other sibling (#2) is precarious, at best. They (my sibling #2) have a mental health disorder that was not managed for many, many years. During the time it was unmanaged, they had a very poor relationship with my parents, they would have verbal altercations, and they would blame my parents for all of the bad things in their live.
Sibling #2 does not live nearby. In recent years (probably 2-3), they have been slowly building a long-distance relationship with my parents. It is unknown if my sibling has begun to manage their mental illness, but they have held down a job for over a year.
My parents have not told Sibling#2 about the alz dx yet. My caregiving parent is concerned that my sibling, if not properly treated for their mental illness, could try to move back to our area and become triggered living in the area and around the stressful situation. Sibling #2 can be manipulative. They have, on occasion, been violent (at least two fights which may or may not have been provoked, road rage, punching holes in walls, screaming, cursing, broken furniture, over 20 years). They have experienced possible delusions that my parents are to blame for some of their problems.
My parents want to tell my sibling about the dx, as none of us feel it is right to withhold this info . However, since they don't live nearby and we don't have a good picture of their current mental status, we don't know how to ensure my parent's safety in general, as well as keep my Alz patient parent from being manipulated or threatened in any other way should my sibling be impaired in any way after learning about the DX.
There is another factor in all this:
When my sib is on the right MH meds, they are amazing! But the last time that happened was years ago and they stopped taking the meds because they did not like the side effects and then did not think they needed them.
I would appreciate some wise thoughts on this. my parent is declining and we want to do the right thing by them both.
Would it be possible or useful to put firm boundaries or limits on sibling #2's in-person interactions with your family?
If I understand correctly that sibling #2 was threatening or possibly a danger to your parents, I do not think it is out of bounds to require sibling #2 to be in treatment and compliant with treatment before being present with your parents, even for a visit.
Perhaps have a plan for action if they appear and are unable to maintain adequate control to allow everyone to feel safe.
I imagine it is important to reduce as much stress as possible for your parents, both the caregiving parent and the parent who has the dx.
I wish you the best and am looking forward to reading other responses. It is a complex issue.
Anyone that complicates elder care should be a secondary concern, dealt with only when all other ducks are in a row.
With a mentally unstable sibling, consideration of how to best deal with this sibling will extend beyond your parents deaths. A CELA could recommend how to deal with this (i.e. a trust) if it is expected there will be any assests left to inherit. Even if not, they can write ROCK SOLID legal documents that can protect your parents and make sure decision making for them is protected.
Make sure the mentally ill sibling was not named as a successor POA because Mom and Dad wanted to be 'fair'. Only you and sibling #1.
2. Determine what the living circumstances will be. Do you anticipate placement? If so, do your best to place first, inform sibling much later.
IMHO, counsel your parents that right now, we need to just make sure Dad is getting good care and everything is in place. We can tell _______later. , right now it just adds a complication for Dad Put it off until legals are set. And personally, if blow back is expected from sibling 2, I wouldn't feel the need to tell them anything until they asked. They forfeited their ability to be a productive family member long ago.
You don't need to add police visits and restraining orders, court appearances to an already difficult situation. Also consider the fact that by telling them you are setting into motion a PROBLEM. It is the DPOA job to act in the interests of their person. From what you describe, the best thing for your parents would be if sibling 2 stays away, there has already been a dangerous situation in the past to prove it. And there is NO WAY to really moniter if a person is on their meds.
Consider letting your sibling get to the point that they actually ASK what is going on. Why does everyone feel the need to enlighten them given the fact the best thing would be for them to stay away? Also, if push comes to shove, consider "He's having memory issues" versus a full disclosure.
I had a complicated relationship with my siblings at one point, and one mistake I did was giving them way too much information. I was the one dealing with things, my only responsibility was to my parent. I should have let them ask for information as things evolved, would have made my life a WHOLE LOT EASIER.
I always recommended people pull a credit check for their parents with all 3 credit reporting agencies, examine it for funky stuff, then put a FREEZE on them. Avoids additional credit, loans, etc. being taken out in their name, by family members or strangers intent on identity theft. Our elders give away their personal information easily as the disease progresses.
The short answer in my opinion: NO, don't tell sibling #2 anything. Is there anything good that will result from telling them? Probably not. Is there anything bad that will result from telling them? Quite possibly. Deal with the problem of sib#2 moving to your area if/when it happens and don't do anything to entice the move. Just formulate a plan of protection for your parents in the meantime.
I had a similar situation with my sister. Totally disfunctional, drug/alcohol addict living 1500 miles away. The only time she ever contacted mom was to beg for money. If she had known mom was compromised, she would surely have come and begged in person. That would have been a disaster for everyone.
I think it would be best to tell your sibling but in a low key way- unless you think your parents wouldn't want you to.
I have a difficult sibling, to whom I send updates about once/year.