Caregiver sibling abusive to bed-ridden grandfather

Nurses General Nursing

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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?

Specializes in MICU, SICU, CICU.

This is financial abuse.

Get the name of an Elder law attorney from the HH SW.

The attorney may advise you to file an emergency petition for guardianship. Would you do that to protect your grandparents?

If your Mother is diverting their funds it will be revealed in the financial audit when they go into LTC. She could be prosecuted under the elder abuse laws of your state. If she is stealing from them she will never agree to LTC. She will try to hide any financial abuse by putting them in a cash only unlicensed board and care home.

You need to deal with this now. Good luck.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
If she is stealing from them she will never agree to LTC. She will try to hide any financial abuse by putting them in a cash only unlicensed board and care home.
In the area where I live, the dumpy nursing homes charge $4,000 monthly for semi-private rooms and the nicer facilities charge up to $10,000 per month.

There's no way the daughter will place the elderly couple in LTC, especially if it will greatly reduce or eliminate the amount of money she stands to inherit upon their deaths. Placing them in LTC would entail a spend-down of their assets to qualify for Medicaid, which means she stands to lose her sizable inheritance.

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Specializes in Hospice.

What sizable inheritance are we talking about? SS and pension payments may possibly continue for a spouse but are not inherited by the beneficiary's children. I see no mention of any other estate.

I say again that there is evidence of some very difficult and angry family dynamics here. I think it's irresponsible to go on about abuse and theft based on one side of a complex story, told by an OP with his/her own axe to grind in the situation.

OP, I'm sorry that your grandfathers illness is being so traumatic for you all. I still think calling in an objective party like APS is your best bet for sorting it all out and getting all of you the support you need. Take care ...

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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.

Its time for a Come to Jesus Talk with mom.

Make it clear that you are unable to meet grandpa's needs because you work full time, and your brother is unable because he needs to get a job and move on with his life.

As long as you and your brother agree to continue (however grudgingly), you are enabling this situation to continue. Make it clear, in no uncertain terms, that you and your brother will no longer be providing care. Give a date, and stick with it.

Good luck.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

If you're brother doesn't want to get a job then he needs to do a better job of helping his family. You need to have a come to Jesus meeting with your mom & brother.

My mom works for Adult Protective Services & I have heard stories just like this. Some times they end well other times, if your mom & brother don't shape up your grandparents will have to be removed from the home & put in a nursing home because that is neglect. Like many people have said, you are a mandated reporter, you should have reported this a long time ago & by not now you are a guilty party.

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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

I want to add that I spoke with my mother & she said that you could get your license in jeopardy if you don't report this. You know what is going on & you have not reported it, & in the time you have taken care of your grandfather he has developed a pressure ulcer. I would report it ASAP!

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Specializes in MICU, SICU, CICU.

The military pension with a dependent, the city government pension and social security possibly for both grandparents equals a significant monthly income.

In ICU we have terminal patients who are full codes and whose POA is adamant about having everything done to keep the person alive. It is a huge red flag when the POA overrides the advanced directives. If the pt survives, the POA always refuses rehab and fires the home health nurse.

The POA does this to keep to keep the house and keep those checks coming in.

I hope the OP can advocate for his grandparents and keep it from getting to that point.

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If one of my clients called me with this story, using the same language as the OP, I would direct them to immediately call your state equivalent of Adult Protective Services. The OP is I assume a mandatory reporter. Knowledge of this situation and failing to report it likely means that unpleasant things can be done to your license, regardless of the fact that it is family.

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.

I want to add that I spoke with my mother & she said that you could get your license in jeopardy if you don't report this. You know what is going on & you have not reported it, & in the time you have taken care of your grandfather he has developed a pressure ulcer. I would report it ASAP!

My first thought was call APS as well. Talk to the HHA and the physician. Report it. You are a mandated reporter.

I'm a fan OF parents spending all their money on themselves and leaving NO inheritance. And this is one reason why.

Make that phone call.

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What a shame, that retirement income would cover a significant amount of caregiving services to supplement what the family is able to provide if their other expenses were kept modest. Even in California you can get dependable caregivers for $15/hr who would dote on your grandparents.

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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.

What part of you thinks this is ok? You truly need to call Elder Protective Services. Today. Seems like Mom is living off the money, and you OP and your brother are living in a free home.

People get arrested for this stuff, nurse or not.

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