Caregiver sibling abusive to bed-ridden grandfather

[millmick30]

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?

[Nic0co]

You need to report it whether he is your brother or not. Your grandfather may need to be moved to a nursing home for safety.

[icuRNmaggie, BSN, RN]

It sounds like the OP's family is taking advantage of the fact that he is a nurse. He is only 25 years old, has a FT job and is responsible for two elderly people who require 24 hour care.

His Mother is the POA and apparently is not a caregiver. The OP described her as being oblivious to the level of care that grandpa needs. She may have chosen to keep her parents in this situation not for their sakes, but to maximize her inheritance, as NH care requires a spend down of assets.

This woman is exploiting her parents and her sons for financial gain and that is despicable.

I would suggest the OP meet with the HH SW, gather as much as documentation as he can about the finances and get his grandparents on the waiting lists for assisted living or NH placement. Together if possible.

[hppygr8ful, ASN, RN, EMT-I]

Your grandparents deserve for ALL of their money to be applied toward their care with people who do not have a conflict of interest. It seems like a decent nursing home might actually increase their quality of life. If all their money and assets go toward their care in a facility, then that is as it should be. Better for them to be treated with dignity than for any of you to get an inheritance.

.

Well said and here here. It a best case scenario all our loved ones would be well cared for at home by loving sons and daughters- but this is not always the case nor should it be. Some people are just not cut out to be caregivers. My father left my mom with a whole bunch of money when he passed. More than enough to provide for any care she needs as she ages. I am one of 5 children and my mother was extremely abusive (due to mental illness) to all of us. She just started showing signs of dementia and we all agree that none of us could care for her for any length of time due to issues of resentment anger and PTSD. Still we want her to have the best care possible. Her money is her money for her care. We are all independent, productive adults and perfectly capable of providing for ourselves.

hppy

[OCNRN63, RN]

Abuse doesn't have to leave a mark to be abuse. If the grandfather is being made to feel fearful of saying anything because of possible consequences, that's abuse.

If someone taking care of a patient in the hospital did this, that person would likely find him/herself out of a job, at the very least.

[Oceanpacific]

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....

This is abuse.

[icuRNmaggie, BSN, RN]

He might want to invest in a baby monitor that records and can be viewed on a smart phone.

[BrandonLPN, LPN]

Grandpa needs to go to a LTC facility.

No, nursing homes are not all unicorns and rainbows, but at least there he will be fed, kept clean, and treated for his pain.

If you and your brother are unwilling and/or unable to care for him, then it's time to just give up the ghost already.

I've seen far too many elderly NH residents who arrive at the facility in bad shape because their caregivers just could not accept the fact that they were in way over their heads.

[heron, ASN, RN]

It's obvious to me that there is much more going on here than what is described in the OP, so I'm not comfortable drawing conclusion about abuse and who's exploiting whom.

I second the advice to get the home care nurse involved and making a report to adult protective services. Too many hidden agendas going on for an Internet forum to sort out.

[Here.I.Stand, BSN, RN]

There is nothing to suggest abuse or neglect in what the OP stated here, other than the words "abuse", "abusive"

This--

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

--is neglect. Neglect is maltreatment of a vulnerable adult, and as nurses we are mandated to report it.

Oh, I forgot the most important thing. If your brother's behavior did not cause you to call the police and throw him out right away, it's not abuse

Ombudsmen for elder care disagree. Quick example witnessed by one of my CNA preceptors back in my CNA days-- Elderly LTC resident had an episode of diarrhea in the bed, bed totally soiled. New CNA precepting under the woman who told me this story, uncovered the resident and saw the stool. She threw the sheet back over the resident and yelled, "You SOB, you **** the bed!!!" Preceptor immediately told new CNA, "HE CAN'T HELP IT, now get out of here!!!" She then took care of the resident, and after that reported this CNA. Calling the police wasn't an immediate concern; I mean, she wasn't actively assaulting anyone. However, her behavior was abuse--and it still would have been, had E. been a jellyfish and allowed her to stay orienting with her.

[angieperry]

I don't know what mum hopes to achieve here. Your grandparents deserve better than this. Caring for the elderly needs training. Some people just have the passion to care for the elderly. The fact that he's your grandfather, doesn't make family caregivers. At this point grandfather has to go to a LTC facility. Where his meals, baths, and others things are taken care of by people that are trained. This is absolutely abuse. I don't know what your mom does, but it's her responsibility to take care for your grandparents. And the fact that your brother has no job does not make him a caregiver. Discuss this with your family, get a HHA or send him to a LTC facility. Grandpa doesn't deserve this no matter what.

[TheCommuter, BSN, RN]

At this point grandfather has to go to a LTC facility.

But if Grandpa is placed in a LTC facility, the associated costs will most likely reduce or eliminate the daughter's inheritance payout when the old couple eventually die.

Call me cynical and jaded, but I suspect that money might play a vastly important role in the family's decision to keep the grandparents at home when their care is far more complicated.

[millmick30]

Money is the driving factor here for my Mom. Grandpa gets a nice pension from the city and the Navy as well as Social Security. Medicare pays for the therapists, home health aide and nurse to come bi-weekly; Mom seems to think that the "free help" is enough to tend to grandpa's needs. I told her grandpa is at the point where he needs to go to a LTC facility, however she insists she wants to keep them at home together and says she is currently searching online for an independent home health aide. I told her that we need more than one caregiver to provide full-time care for grandparents so that my brother can get a job and I can move out, but I got no feedback.