Caregiver sibling abusive to bed-ridden grandfather

toomuchbaloney · Aug 19, 2015

My older brother (36 yrs old) and I (25 yrs old) are the primary caregivers to our two elderly grandparents with dementia. My grandmother is still able to do ADLs with assistance; however my grandfather is completely dependent on us. He is on a pureed food/thickened liquid diet (due to being hospitalized for aspiration pneumonia a few months ago); has debilitating back pain due to a mild compression fracture in his spine (receives steroid shots for this) and cannot walk or get up on his own. My brother gets very impatient with the level of grampa's care; for example, I ask him to help me get grampa up to the bathroom in the morning -- he comes storming in -- yanks him off the bed and drags him to the bathroom cursing up a storm while grampa is yelping in pain. He just sits grampa in his chair all day long without changing his position; and at night also does not change his position or underwear. Grampa is completely soaked in the morning. As a result, he now has a stage 2 ulcer (size of a pea) on the inner part of his right buttock (we are addressing this issue now with the home care nurse and DR) . I have gotten on to him about re-positioning and changing his underwear but he is lazy and would rather play video games all day. This stresses me out as I work full time (peds private duty) and go to school and I take care of grampa on my days off. I tried talking to my Mom about it (she is POA) but she is oblivious to the level of care grampa needs and just writes it off. We do have OT, PT, ST, home health aide and nurse come in weekly but it is only for 30 mins at a time. Grampa is not getting the care or respect he deserves here because of my brother; any advice on how to handle?

Hm

If your brother is neglecting your grandfather as you describe you should expect that the mandated reporters who are visiting him in the home are going to report the case to the authorities. Even if you do not.

Your language suggests that you feel very strongly about this even though you are not supported by your mother. Why not just report the perceived neglect and let them do their thing. Or, why not ask the HH team to conduct a case conference to outline the care that is expected and customary for an individual in your grandfather's situation?

FolksBtrippin, BSN, RN · Aug 19, 2015

The fact is that overworked, under-appreciated caregivers who are treated like freeloaders and not paid for their services can get pretty grumpy and even mean and resentful. Changing the family dynamic and getting respite for them does wonders.

Oceanpacific · Aug 19, 2015

The fact is that overworked, under-appreciated caregivers who are treated like freeloaders and not paid for their services can get pretty grumpy and even mean and resentful. Changing the family dynamic and getting respite for them does wonders.

I think we may have to agree to disagree. The freeloading brother isn't providing any care and has nothing to get a respite from. He has been overworked playing video games. It is reported by the OP that the brother is verbally abusing them and physically harming the grandfather. If this is true, I would prefer that the brother get his respite time in jail. I agree that a change in family dynamics could do wonders here, it is the method that I suspect we disagree on.

This is the grandparents' time to get a respite from abuse and freeloader(s) so that their assets can be devoted to providing them with dignity and respectful care

OCNRN63, RN · Aug 20, 2015

For God's sake...you're an RN! You should know what to do, if not legally, then at least ethically.

I have no patience for people who abuse the sick and infirm, and even less for people who stand idly by while someone is being abused. Grow a spine and do the right thing, instead of posting about it.

TheCommuter, BSN, RN · Aug 20, 2015

This is the grandparents' time to get a respite from abuse and freeloader(s) so that their assets can be devoted to providing them with dignity and respectful care

I agree with you on principle, but I also dislike the manner in which reluctant caregivers are shunned by society for filling a role that they obviously dislike.

We do not know the family's history. Many parents and grandparents abused their children and/or grandchildren physically, emotionally or sexually. Even more people neglected to provide for the basic needs of their children and/or grandkids. Millions of children have been ignored or maltreated while their parents or grandparents partook in selfish activities such as alcoholism, hardcore drug addictions, or pathological gambling.

These abusers, neglectors, and addicts grow old and need care. Not all adult offspring can toss their resentments aside to fulfill the caregiving role with a sense of honor. I know I'd be livid if I were forced to be a full-time caregiver at the fairly young age of 36, especially to people who mistreated me. However, society shuns adult children and grandchildren for considering alternate arrangements, which results in these reluctant caregiver situations.

The point is that we do not know the whole story. The brother needs to extricate himself from the caregiver role. However, I do not judge him for his obvious dislike of providing care to a demented, incontinent elder who happens to be his grandpa. Not all people are suitable to be caregivers. In essence, the grandma and grandpa need to receive caregiving services from people who actually wish to provide appropriate care.

Oceanpacific · Aug 20, 2015

The Commuter, I appreciate your thoughts. In this case though it would seem that the grandson is foisting himself on the grandparents, has moved in and won't seek employment. He has every right NOT to be a caretaker for his grandparents and to have nothing to do with them. That's fine. What isn't fine is to wait until the grandparents become cognitively and physically disabled to wreak some vengeance on them and squander their assets. I agree that we do not know the whole story. If we believe the OP, these people are in peril.

Been there,done that, ASN, RN · Aug 20, 2015

The fact is that overworked, under-appreciated caregivers who are treated like freeloaders and not paid for their services can get pretty grumpy and even mean and resentful. Changing the family dynamic and getting respite for them does wonders.

This issue is NOT about the caregiver needs! This issue is about a fragile senior citizen that deserves quality care.

" under-appreciated caregivers who are treated like freeloaders and not paid for their services can get pretty grumpy and even mean and resentful." In this case, it's a criminal offense.

Please.. rethink your stance on this. Sonny boy is living in grandpa's house.. has NO idea how to care for him.. and prefers to play video games.

My son helped with the care of his grandfather at the end. He was kind, gentle and realized.. it was an honor to do so.

ambr46 · Aug 20, 2015

To the commuter...you hit the nail right on the head.

mander · Aug 20, 2015

I think you need to get grandpa into a long term care facility or get some more help at home. Just as no one deserves to be forced into being a caregiver, no one deserves to be ABUSED. And if you don't want to call it abuse it is at the very least NEGLECT on your brother's part. Maybe find a hotline or some welfare agency who can give advice if the home care agency can not. This cannot continue or it will only get worse. He already has a pressure ulcer and that's not going to heal if he's laying in the same position and in urine soaked clothing.

FolksBtrippin, BSN, RN · Aug 20, 2015

I don't believe grandpa is being abused or neglected. My reasons? There is nothing to suggest abuse or neglect in what the OP stated here, other than the words "abuse", "abusive" and I think those words were improperly used. The OP states that the brother curses at grandpa. This is probably disrespectful and it might even be mean, but it isn't abuse. The OP states that grandpa yelps in pain, but it is not clear that this pain is the fault of the brother who is helping grandpa around while it happens. It's likely that grandpa would be in pain no matter how friendly and nice his helper was in moving him around. OP states that his brother yanks and pulls, but these are just judgmental ways of describing how grandpa is moved. They might be a sign that the brother needs an education on how to lift and move a patient. They are not a sign of abuse. The brother states that grandpa has a sore the size of a pea. This is not an indication of neglect, and is a very common occurrence for bed ridden people. Grandpa has a team of many people taking care of him, all of whom are professionals and trained to recognize signs of abuse and neglect, but they have not reported such. Grandpa has a relatively healthy wife who still has her wits. She has not reported abuse or neglect. The OP himself has not felt the need to report abuse or neglect and has instead chosen to post on a forum. For all of these reasons, I don't think this is an abuse case.

Now, OP could report anyway, and have DHS investigate and (depending on the state) they would likely make the conclusion that no abuse occurred and they might also make some recommendations on how to improve the family dynamic, etc. But this would come with a hefty cost for the relationship between these two brothers. If it's necessary, then so be it. The OP knows the truth. He knows if he's calling it abuse the way you call it when someone tells you you're a stupid jerk and that hurt your feelings and made you mad, and was rude and cold. Or if he's calling it abuse because his grandpa is in real danger and needs to be protected. He knows. I hope he's mature enough and responsible enough to make the right decision. I hope he hasn't been convinced by people who don't know him or his grandpa that he will go to jail or lose his license if he doesn't make a report against his brother. Because that's not a reason to report abuse. The reason to report abuse is to protect a vulnerable person from true harm.

The OP is 25 years old and his brother is 36. When I first read it, I thought he was the older brother, which did affect the way I phrased my original response. Now that I know that he is the little brother, I think the task might be too much for him, to hold a sit down, prepare compensation, etc etc. I still think it would be best though.

brandy1017, ASN, RN · Aug 20, 2015

Your brother is obviously not willing or apparently capable of caring for your grandparents and they are being neglected and possibly abused! Your mother is the POA and she should be making sure their needs are met. Your mother must accept that he is not able to care for them and make other arrangements. If your mother is unwilling to care for them while you are at work then they would be better in a nursing home rather than continuing to be neglected as they are now. Since your brother is unable to adequately care for them, he should move out and other arrangements should be made whether another family member or paid caregiver that can and will actually provide necessary care. If this is not an option they need to be in a nursing home where they can receive the care they need. If they do end up in a nursing home please continue to visit them often, help them and watch over them to make sure they are getting the right care and so they don't feel alone!

jadelpn, LPN, EMT-B · Aug 20, 2015

OP, as a mandated reporter, I am a little taken aback that you are pot-stirring about this as opposed to anything else. Seriously, you knew that your brother was not doing personal care. However, instead of acting, you chose to continue to let this happen until Gramps developed an ulcer. You need assistance. Know that you and your brother are tenants in your Grandfather's home. Nothing more.

You both are living in grandpa's house and "living off his money". Your brother is not doing much, you are equally as guilty for standing by whilst no one is doing much. And yup, you work, you this you that---but bottom line is that there are resources, you are choosing not to use them. And quite frankly, your grandfather is now the recipient of some sort of strange family dynamic. He lived his life, raised his kids, and I am sure doesn't need the drama. Nor for his grandchildren to sit idly by and watch him decline.

All that being said, there are services in the home. That you need to contact regarding increasing the level of your grandfather's care. I would let them look at the entire case, and make changes based on need. You need to call and get Elder Services involved in this as well. That you all are just sort of living there and hanging by watching the struggle is incredibly sick stuff.

In the meanwhile STOP asking your brother to do a thing!! You know that he doesn't/won't so why in the world do you keep engaging him in this? You need to fix your schedule around your grandfather's need at present. Until such time as other arrangements are made for his care.

You need to stop, take a breath and really think about what you are doing, how you are involving yourself or un-involving yourself and get a grip. It would be different if you said Grandpa is refusing any and all care. If that were the case, a prudent nurse (or prudent granddaughter) would jump on the train of thought "we need help". Same line of thinking....

And be sure you lock up Grandpa's pain medication. With an adult in the house alone that hangs and plays video games all day as you describe, there are significant issues there....