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It sounds like both you and your sister are going through a lot. No doubt hands on dealing with an aging parent takes a lot out of a person and I think your sister is feeling very overwhelmed and frustrated. It must be hard for her in the midst of it all to see clearly. Your Mom has LTC insurance and potential VA benefits AND she’s 93. I think it’s time for assisted living. If she can’t afford the facility that her independent living apt is attached to then find somewhere that she can afford. Obviously your sister can’t physically and mentally do what’s she’s been doing anymore. You are unable to help any more than you are. End of story. Stop trying to convince your sister that you are already helping. Just make the changes that need to happen.
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I’m a little confused why you would talk to an aide. Long distance care doesn’t work. If your mom is in a facility, that would relieve a lot of burden for your sister and yourself, although probably not possible now with covid.
Your post reminds me of my out of town sister. She used to have many theoretical answers but has come to realize over time not to assume.
I’m caring for elderly parents both nearly 90. They live independently but need a lot of assistance. I am gifted funds and am appreciative of that but it is hard hard emotionally to be in this position.
Support your sister with gift cards to restaurants and other places to make her life a bit easier.
i have a number of siblings that live nearby but always busy with their own lives. One tries while another is really missing in action, other than phone calls. I’ve learned to let it go but not been easy, especially when an email full of criticism arrives in my inbox.
For all the siblings not involved in daily care of your parents, support that one sibling who is. There are ways. Just get creative.
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Accounting is much easier than taking care of a 93 year old loved one. Switch roles with your sister. Your 'vent' will be a different story.
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Moms 93! When are you going to use LTC policy? Say mom is forgetful and it’s a Saftey issue you are worried about. Forget ADLs say she left the gas on the stove and you are afraid she is going to hurt herself or others nearby. Get the 24/7 care in their for her and this will give your sister her life back. I know how she feels I was that sister. The daily phone calls on what she wants and needs the constant running over to fix this get that it’s haunting and I felt like I did it alone. Only thing is I have a brother who lives out of state. During COVID aids wouldn’t come to the house and I own a Pharmacy and had to stay open and all my workers didn’t want to come in so I had to work open to close 7 days a week and after much arguing with my brother to come in to help me. He was afraid of COVID thing and giving it to our mom. I said you have the ability to work from home so come here and stay at moms house and work from here and give me a hand with mom. He finally left his family and came here for 2 weeks to help. Let me tell you he finally realizes what I have gone through for the past two years. Now when we talk the conversations are much better and I am not bitter towards him anymore. While he was here I was able to set up the LTC 24/7 aids to watch over my mom. She is still not happy strangers are watching her she would rather be by herself or have me or my brother but that can’t be. I hear martyr theories on this forum and it bothers me. Your sister feels like she’s doing it all alone. She is nasty with you cause she is miserable. Some of the worse things I said to my brother was during the time of Covid. He said can’t you pay aids to watch mommy while you work. When I said no one wants to work and the agency said don’t you have family that could step up and help you that’s when he finally came in to help me. She may just want you to be next to her for a while and make some decisions so she doesn’t FEEL like she is doing this alone. Mom qualified for LTC and I have aids there 24/7. The daily care is off my shoulders but it’s not gone. Get everything of value out of your mind house because it gets stolen. Just this week I had exterminator come cause now she had roaches. The weekly shopping I still do and doctor appts and such I still take care of. I set up her medication pill holders every week. Every headache body aches rash itch phone call still comes to me. It’s still a lot but not overwhelming misery like it was before. If you want things better with your sister she has to feel like you are there for her and she doesn’t feel that. She’s miserable now and I’m sure just not taking it out on you. I lashed out on everyone. Doing moms finances are the easy part trust me I do that too. If you want to save relationship with sister you need to step up and do something or their will be resentment because she feels all alone doing something she doesn’t want to do.. I cried many nights feeling all alone. This forum helped me feel less alone and get rid of guilt more than my brother did. I wish you well.
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First of all, I am so sorry for your loss, the loss of your sister, a person who used to be a friend and partner to you in this. And I am so happy to hear to are getting counseling that you feel has been beneficial to you. I wish for your sister, that she would do the same, to be able to vent to an objective person that would help her find clarity about why she’s so angry & frustrated, and help her understand her expectations and what part of the situation she does have control over. My guess is she is also grieving the loss of your mother as she used to be, and it shows up through her anger and frustration.

Secondly, (and I hope your counselor has pointed this out to you) you ARE helping out. Dealing with your mom’s financial affairs and trying to find transportation for her while long distance is huge! And therefore, it’s something that your sister does not have to deal with. Most cities and towns have a senior services organization that might be able to help with community resources. Would you be willing to find some of those resources that might help your sister out? Could a home health care provider type person take your mom to doctors appointments? When my mom was living out of state, and was able to get herself to the doctor, but not able to tell me what was discussed (due to her dementia), the doctor and I decided to do a conference call between her and myself while my mom was in her office. That helped a lot, as I could ask questions, take notes, be aware of next steps that needed to be taken. Not ideal, but it worked well for us.

I wish you and your sister the best in trying to work together to share the often overwhelming responsibilities you are taking on. It really is not forever, though it often seems that way. Bless you both on all you both do for your mom!
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I went thru very similar conflicts with my siblings about my mom and we live in same state. Please be warned..i do not want to offend you but I am going to give an unbiased opinion from someone who has lived a similar reality. Hopefully it will help u see things from both sides and mend the relationship with her. From what you describe, You have it much easier than sis. Your sister is bearing the brunt of the responsibility. Period. Please acknowledge that with yourself and more importantly to her. It will help. I have full responsibility for caring for mom for past 3 years. There have been alot of tears,stress,pressure, sadness along the way for me. I've lost myself and life as I knew it. Your sis is probably feeling the same. It's the toughest thing to deal with. I no longer use home health aides due to covid and my mom lives with me. I didn't want the exposure. Sometimes it's to the point where I don't know how I will make it thru each day... she has dimentia..Its caused tons of arguments and hurt feelings with my siblings, then they both passed away suddenly last year. I miss them and wish I had the time back to do it differently for sale of the relationship with them. Since I live your sisters reality...I have to keep it real with you from her perspective. If you are in another state and truly want to share responsibility for mom, volunteer to have her stay with you part of the time. For example..she visits you during summer for a few months a year. It will give your sis a much needed break..and you can experience some of what she deals with because until you experience it, you have no idea what it takes. Making calls and handling finances from a distance pales in comparison to being the one there in person. The stress and pressure of caring for aging parents can take over a person's life. Also, is it fair to override her desire for what happens to mom if you aren't the one dealing with it in person? If you don't want her in assisted living then perhaps offer to have her move near u. Also I think covid is not a good excuse not to see your mom, sorry. The home aides are not part of her household so she is facing potential exposure everyday..so is your sis by default. You just have to be extra careful. I can also understand why she was offended when you asked the aides about your mom status behind her back instead of her. You are playing backseat quarterback and she's the one on the field taking all the hits....if you do right by your sis and offer more support, you will have her back.
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So sad. I would be devastated too if I lost my sister over this. I’m so sorry. My mom has dementia and one of my sisters lives out of state. To say I don’t have any resentment towards her would be a lie. However, if she did all the things that you do from afar I would not feel this way at all. Handling our loved ones finances, insurance, senior living facility matters, home care, etc. is extensive. What you do is HUGE. If I could be relieved of most of those things I’d be thrilled and be so thankful to my sister. Then I could just focus on taking care of my mom. And the fact that you leave your life for 4 months each year is amazing. It’s not your fault that COVID exists. So bottom line you shouldn’t feel guilty nor should your sister treat you this way. It takes a village to care for a parent and if you can do all those things from afar, you are certainly doing your part. Now having said all this, I know first hand what it’s like to be burdened every day with the responsibility of an elderly parent. It’s a lot and it can cause a lot of frustration, anger and even depression. I’m sure your therapist told you this and that your sister is just taking everything out on you. Some people handle the responsibility better than others. And if this has been going on for many years, she probably is burned out. Keep doing what you’re doing for your mom and it’s most likely that someday after your sister is relieved of this responsibility, she’ll realize her I’ll-behavior towards you and apologize. Best of luck!
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I don't know if your sister is a drama queen but it does take a heavy toll having to be mostly responsible for the needs of an elderly parent. Sounds like you've helped all you can. I've been there and sometimes I was very frustrated that my adult siblings would not or could not pitch in and help. Plus my mother had various family members taking advantage of her dementia so I had to battle with them too. From what you've described, it sounds like your mother may be ready for assisted living. You mentioned VA assistance. You might go ahead and apply for Aide and Attendance. This could be an additional funding source to help finance her care. I did this for my mother and it was fairly easy to get her approved. Also, I've recently read that some life insurance policies can be converted into long term care funds. If she has more than one life insurance policy, it may be worth researching. The point is, she might possibly have additional resources to pay for her care. I would also look into licensed residential elderly care homes. My mother is in one of these homes and we're very happy with her care. It's a very nice group home environment for the elderly. These homes are typically less expensive then the large corporation owned facilities and they are staffed by nurses and HHA 24/7. They may also have visiting physicians and podiatrist. Visiting home health care services are also ordered if needed. Good luck to you.
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Needing a stand-by person for safety when getting in and out of the shower, is one ADL Activity of Daily Living, that will meet the criteria of the VA's Aid & Attendance program. She only needs 2 to be eligible. Surely at 93 your mom would meet one other of the ADLs. There are a number of good organizations that help people who are eligible for veterans benefits, to access those benefits. I would suggest talking to a Service Officer of your area's American Legion, VFW, etc. these organizations have service officers who help families apply for and get different VA benefits for their family member. Both veterans and their spouses are usually eligible for a number of benefits. The Aid & Attendance benefit provides over a thousand dollars a month toward assisted living to a veteran's widow and closer to 2k per month if she actually is a veteran herself (was she a WAC, a WAV, etc.). There are also organizations like A Place For Mom that will help you with these ins & outs. Talk directly with her building's management too. It's possible she wouldn't even have to move but if she did it sounds like she could still be on the same campus. The director there will be experienced with what different companies' policies require to meet the qualifications to activate a policy, and also with the VA. You need to be on a first name basis with two or three people in the office there to work on getting these benefits activated. In the meantime until they are approved see what kind of services they can offer in-house on an ala carte basis. I'm sure many many families have been in similar situations where their family member needs the policies activated but the policy company or govt is making it difficult, you won't be the first person to need help with this. The Aid & Attendance I think may even require active use of help with two ADLs for 6 months before they will approve. See if your mom's building will provide that help and show it officially in her care plan and billing that can be used as proof to the VA. They might offer free 2 ADL helps for 6 months or a year or allow it to be billed now but paid later because they know the VA wants to see it to approve it.
When you are arranging rides to doc, etc. it seems her building should provide it, but if for whatever reason they do not, tap into the VA and the non-VA service organizations, her town or county's local senior services dept, etc. Some run a van around town for seniors to get to appts etc. or have volunteers providing one on one rides etc.
Also keep in mind the Veterans Homes in your state. That would be skilled nursing level care and veterans, veterans widows, veterans disabled children, and Gold Star family members all eligible to reside there. My dad was in a veterans home for two years and many people there didn't seem to have too much wrong except some physical frailty, and probably just help staying on an even keel and not having to deal with shopping, cooking, chores, getting to docs, and fighting bill collectors and insurance on their own.
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i am an only child and my mother is in an AL facility now. I used to wish that I had a sister (brothers tend to absolve themselves from any responsibility) to share decisions etc with, but now I realize that I’m lucky. It might be more work, but there are no resentments or disagreements to deal with. I know what I have to do and I do it. So for those of you who bear all of the responsibility, pretend you’re an only child and proceed the best way you can. Tell your sister that she can relinquish her duties and you will take over from long distance. In the end I’m sure she will relent and continue to do what she’s doing.
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I was the caregiver for my mom, as I was the only child. It was hard, but my mom was a sweetheart, and I'd do it again. However at the same time, my mother in law lived with us too. She was a quad, and in her 70's. She made life very difficult with her care. She had a caregiver from 8:30 til 12:00, M-F. The last year of her life was extremely difficult, and I became bitter at my out of state sister in law. She wasn't in the proverbial trenches as I was. She would fly in when I couldn't handle anymore, stay a few days, and go back to her life. And then she'd get all the praise about how wonderful she was.. It's different when you're in the actual day to day care. I'm betting that the sister doesn't want to be lashing out, and then apologizing. I know I didn't want to feel bitter about the situation. I'm relieved it is finally all behind me, But what a tough few years it was.
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As the sibling taking care of my parents’ needs, this was good for me to read through. I have found myself having thoughts of drastically reducing interaction with my sister because of her apparent lack of interest in my parents’ well-being. I’m doing it all as a single person trying to keep from losing my job because the duties of PoA and making sure my parents are safe have taken over my life. My sister lives 4 hrs away, has been here once in the past year and can’t even be bothered to ask me about them or call them more than once a month. I’ve become very angry. However, after reading this I realize I need to let go of that...my sister has always been self-centered. But I don’t want family estrangement. It’s her conscience that she’ll have to live with. Mine is clear, knowing I’ve done all I can to make sure Mom and Dad are living in a safe and comfortable place and that I am there visiting as often as COVID restrictions allow. Yes, my opinion of my sister has been drastically altered because of this and our relationship will never be close because of that. But I’m now vowing to not let it turn me into a bitter person. Sorry for rambling on about myself...new to this forum and needed to vent. But I VERY much agree with everyone who has said that exploring every option regarding ALF should be done. Maybe that is something the out-of-state sister could help with. I know ALF are very expensive...I just moved my parents into Memory Care. But perhaps a private personal care home would be more affordable.
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I "am" your sister. I feel angry, and tired, and resentful for having to take care of my mother, who has Alzheimer's.

I am the one who has to deal with the crazy, creepy behavior 24/7. My sister helps when she can, but I still resent that I have to do most of the care. I am also trying to work from home.

I know that you are helping a lot, but helping is not the same as full-time caregiving.

The best thing that you can do is to go ahead and place your mother in Assisted Living so that your sister can have a life.
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Asking a sister to uproot her life and her family’s life to care for an elderly parent living in another state is absolutely ridiculous. That sister’s first responsibility is to her husband and children. There are many other solutions available other than such a dramatic move such as moving. Especially when that sister is willing to help in other ways and has been refused. Your sister is being a martyr and I would bet she is loving it! Also, I know for a fact that my mother just loved all the drama she was causing. My mother lived for all the drama she caused between me, my brother, and my sister-in-law. Fortunately I had medical professionals advising as to what I “owed” my mother. You would be surprised how little was necessary because what was needed and what was wanted were vastly different and unreasonable. My mother’s visiting nurse took me aside on one her visits and told me I needed to take care of myself first!
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Let your sister hate you! There will never be a happy relationship with your sister. If she refuses any kind of help from you she obviously needs the martyrdom that comes into play here. Do not enable this sickness in her just if necessary keep reminding her she has refused all the help you have offered. If she stops listening, hang up on her, change your phone number, do whatever is necessary to save yourself from this very unreasonable person. The chance of a healthy relationship with your sister is nil. I have been through this with my brother and I sleep like a baby because many hours of therapy later I have learned that I owe him nothing, not even my respect! Good luck. On your own arrange for someone to check on your mother rather than counting on your sister to tell you. Pay for a visiting nurse if you can and if your sister refuses to accommodate her, inform your sister that you will report her for abuse.
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I have experienced this conflict and, non matter how hard it is for you, it’s toughest on the one “stuck with it!”
It sounds to me like you’re doing what you can. You need to see that she’s getting care; you shouldn’t have to provide all of it!
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Have you talked to someone in VA about benefits? My mother's husband was a veteran with Alzheimers but she was very much independent living at the same ALF. Once he passed she got enough benefits to help continue living there but she also had his pension and SS. It would be beneficial to contact a local VA rep. You didn't say but I assume you are her POA.
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Sounds like your sister has had enough and needs a probably well deserved break.

Snd if you want your sister to get back to being your sister then you need to release her of the stress of taking the responsibility for your mom.

If you can't or don't want to move back there full time, you should see if your sister and mom would like to move where you are and find a place close by.

If neither you or your sister want to move, then just have your mom move in to an assisted apartment and live close by you and you be responsible for her, to give your sister a break before she has a nervous breakdown.
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If I were your sister I would be upset too. My moms care falls heavily on my sister but the rest of us try to help out when we can. We all live further away from Mom than she does and she retired early. The bulk of the work has fallen on her. I finally had a talk with her and told her to do what she can and is willing to do - and no more. Mom can hire help - she’d just rather we do it instead of strangers. I get that too. But the sibling the care has fallen onto has to take a stand and stand up for themselves or they will have no life.
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If your mother is 93, I would start the process of having her assessed by the ltc insurance. Their criteria may result in findings that could be different than your or your sister's observations. You might be surprised by what they come up with for a care plan. Also, it can take a while and during that time, there could be some decline in her capacity in which case you'd have already done some of the initial legwork. If your sister is really ready for placement, and the ltc says no, then you're not the bad guy. Your sister would have to accept that assessment. No matter what, it sucks to feel hated. It definitely colors the events and responsibilities you're already dealing with with more stress and less clarity and peace.
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Been there, done ALL the caregiving for 14 years while my sister lived in another state and did nothing. It’s HELL caring for the elderly parent. See it from your sister’s view. You have a life, she doesn’t. Go out there, get mom placed in an assisted living and give your sister her life back. You BOTH have the same parent, not just her. “Caring for finances“ takes a few hours but caring for a parent takes everything. If you have Insurance, she doesn’t need advanced care to get her admitted. Your sister is doing her best and needs help. Put mom in an assisted living as I had to do when it finally got to be too much. Be prepared to help pay for it if needed. Send your sister gift cards for restaurants, maybe a spa nearby. She’s doing all the work, you’re not.
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She would meet the daily living requirements - don't talk to an aide, talk to the social worker or the head nurse or Director at the assisted side. Needing help getting in the shower is a criteria so is walking independently ( she needs a walker and probably someone to watch her since she's feeble). Request that she be evaluated formally for assisted living - it's not someone's opinion if she qualifies! Use that long term care insurance and get her over to the assisted side - that's why your Mom got it!!!
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Sorry to hear this! Yes! Aging parents tend to destroy the best of the relationships.
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It's not fair for your sister. Obviously your mom can't do it by yourself if your sister is asking for placement and she is burned out. They don't get better over time. They need more help and it's not fair to have your sisters life on hold and you make the decision for her while you get to do it. If you think your mom should stay in her home place then hire a caregiver so your sister can get out and be free, or you come down and do it if you think she should continue to do it or respect your sister's life and put you mom in an assisted home so your sister can get her life back. She reached out to you and you made the decision yourself and put your opinion to keep your sister hostage while you have the luxury of living your life. This probably isn't about you being down there not helping. You are probably making suggestions to make her fo more and have unknowingly made judgement while you get to live your life. This probably isn't the first time she asked for help and you made a decision for her
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It's unfortunate the sister took offence to the OP asking the Aides for ADL feedback.
This was to check insurance/funding for Assisted Living coverage I believe. (I would be surprised if the insurer went only on the word of family - I would think it usual for them to request professional feedback).
Explain this, apologise & move past that.

Country Mouse is wise indeed - if living alone, could Mother manage? Could she arrange her own home health Aides, groceries & transport?

If no, then maybe you will find she DOES quality for Assisted Living? Or if borderline, it may be good to get ready. Choose a place & get on the waiting list.
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Your sister does not hate you for living out of state, she does not like or hates you because she discussed concerns with you and instead of listening to her you went to an aide. Thats a major slap in the face. Additional homecare does not stop the phone calls or neediness. You should check out trusts and resources for placement.
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I also am the “out of state sibling. My brother retired early and is moms executor. The other 3 of us were still working full time. This went on for 10 or so years. Then he blew up at us. Said he quit. He had sacrificed all his time. I am still out state (2000 miles) he moved out of town. My sister drives 3 hours back and forth, 2 days a month. My younger brother is still working and has children at home. The executor brother really wrote a nasty letter and still is estranged from us. I don’t think it will ever resolve. It would break my Dads heart to know this. No real suggestions just know you are not the only one.
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I'm the caregiver for Mom.

I have a sister who lives in town who helps when she wants (and tells me what I should do, even if she isn't willing to help) which has caused a few blow ups - the last one resulting my husband telling her that the next time she saw Mom would be at the funeral home because she was no longer welcome here. She asked me if I would bring mom over to her house to visit or if I could meet her in town so she could take her home to visit. I said yes, of course. Anyway, 3 weeks later she apologized for her blow up and said she was sorry and wished she could say it would never happen again but that we all know better. At least she's honest.

My brother lives 6 hours away, His wife and 20-year-old daughter were here from March-October every week for several days almost (missed a few weeks here and there) when Daddy was in hospice but when Daddy passed, they stopped coming. THAT was a little hard for me to accept. I felt abandoned even though I knew they had their own lives.

When mom entered hospice a month ago, brother called and said he would gladly move Mom in with them as they would be better able to provide care (maybe true, but it hurt my feelings, and they will take Mom over my dead body unless Mom wants to go, and she doesn't).

I try very hard to not be like your sister but I'm sure sometimes I sound like her. I have another sister who listens from afar (Alaska and I live in the southern US) and keeps me in touch with reality. Telling me I can't pour from an empty cup, I need to make time for myself, and, when necessary, gently helps me see how unreasonable I am being. Also have a counselor who tells me that what should be reasonably be expected is not always realistic when it comes to the expectation being filled.

Sounds like your sister has had too much and feels under appreciated and is taking it out on you. Your offers have gone unaccepted, so it sounds like she is taking it out on you and I'm sorry for that. There probably isn't much you can do for her except tell her you will help as much as you can (it doesn't sound like she hears that) and maybe when she complains to you say "I wish I could do something to help you feel better" instead of trying to suggest ways to make it better. She may need to just vent....kind of like we do here. You may even suggest this forum to her. I asked for my user name to be changed after I realized that a sibling might stumble across this site, see my name and read what I had written.

Good luck. I hope your sister will eventually realize how much you love and support her in every way you can.
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I was thinking along the same lines as Country Mouse.

BBK, if your mom needs not only the daily support of one of her children but additionally needs more and more outside help coming in, she's really not living independently anymore.
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I think you have been a little naive.

I understand why you thought it sensible to run the ADL questions past the aide. Get an objective professional opinion that would satisfy the insurer, right?

Ah me. You were forgetting that once your mother is in the ALF the homecare people will lose a client.

Take dressing. Does your mother need:
no support
minimal physical support
verbal prompting
physical prompting
full support?

And where, on any given day, do you draw those lines?

The project is: how do we present the argument for mother to be admitted to ALF with funding from her insurer and the VA?

It may not be possible yet. I would be the last person to suggest getting too "creative" with your replies. But there is so much that goes on in the way of choice of words and fancy footwork depending on whether the form filler-in's goal is to admit the person, or to prove that she doesn't need admission.

First question first, though: what are you mother's views on moving to an ALF?

Next question: if, God forbid, your sister were to break down and be taken hors de combat altogether, how sustainable would it be for your mother to continue living at home? - because, when you boil it down, that's how independent your mother is.
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