How to navigate parents staying in their own home? They both made it clear that they want to stay in their home.

LMR, yes, I've been there (with Mom) and witness to several aunts and uncles.

If mom has dementia, she should not be driving the bus.

Can you talk to Dad separately and get agreement that something needs to change? Because chances are good that HE will burn out, fall ill or die before mom without help in the home or a change in living arrangements.

What would happen if you and dad found a wonderful AL and planned a move, not telling her about it beforehand?

What happens when help comes in FOR DAD?

Sadly, if she is stubbornly resistant to change, you do have to wait for "the event" which will take away their choices.

Explained that way to dad ("you have have your choice of places now, or the decision will be made for you, by strangers in a hospital"), would he be empowered to take action?

I would leave mom out of the conversation entirely. You can't reason with dementia.

In my experience, you can sometimes "put your foot down" IF your parent trusts that you have their best interests at heart. Thank God, my mom trusted us enough that when we told her it was time to move, she didn't put up (much) of a fuss. Not so with Aunts and Uncles. Non-demented parent died first in both cases. Very sad.

My “boss” was herself the family caregiver, simultaneously serving as the president of a local bank, volunteering several hours a week, retiring, then focusing on dressing and looking like a model…..

We saw minor bumps and bangs on her cherished car, and I convinced myself that it wasn’t serious, but quite soon after we began receiving calls asking for “little”helps (ran out of coffee, 17 cans of string beans, can’t find her dentist’s office in the small town where she’d lived and worked her whole life, then the falls and bumps to herself, and ultimately, the fear of being by herself in the big old family home). But “You both have your own families and responsibilities and I don’t want you being involved in anything more because of me…..” And of course, we already were.

So we tried what was referred to as “a week in assisted living”, and learned, almost immediately upon her entry there, that her confusion was at least in the moderate range of dementia. So her independent days were numbered, even before we picked up on any signs…..

I was a major mover for the assisted living trial, and I felt like a guilty assassin as the one who stole her freedom, her independence, her life. In a matter of months, I realized that I’d been her hero.

Until the pandemic, her life there was a place of comfort and peace. She then suffered two separate COVID infections, and absent from the only family she had surviving, AND the expected ravages of her age as well, she’s now in hospice care.

I’ve made peace with my sad role in this, and you will have to do the same.

SAFETY for both of your parents has to be considered first, then comfort and consistency (impossible during COVID). Hard hard choices, and as Barb has so concisely stated, unless you assume responsibility for the choices, some else ultimately will.

What parents need is very different from what they want. Go with what they need.

It becomes what they need not what they want. If staying in their home means family now has to be responsible to mow the lawn, do upkeep on the house, clean, cook, etc..then they are no longer independent. If family was not there, they could not live on their own. So staying in their home is not doable.

Just registering my "ditto" to not having your mom drive the decisions and working on your dad to help him see that the romanticized dream of "aging in place" will be mostly you and aids orbiting around the 2 of them, and the loneliness and boredom and stress that comes with being cloistered in your own home.

Take your dad to visit some nice places (without your mom). His generation remembers some very nasty NHs so he needs to see the reality of places that have activities, events, transportation and distractions (for your mom) so he can picture himself regaining some of his former independence from her.

I think the argument that circumstances will eventually dictate where they go and when is a rational one, and it may help to have him read some of the posts on this forum by adult children who are struggling to provide realistic care for their resistant parents. The caregiving arrangement must work for both parties: the receivers AND the givers, otherwise it is not working. It cannot be onerous to you, ever, or you will burnout (or even become ill from the stress) and then where will that leave your parents? He needs help seeing that you're not giving him the bum's rush into a warehouse for old people but giving him power in choices of his own making and timing.

Don't be discouraged if he brushes off your first or even second attempt to broach this subject. He needs to bring his thinking around and it will be slow after a lifetime of entertaining a faulty vision of how he thought it would go.

Also, to stay in their home they will need scads of money -- when even 1 person needs 24/7 care (and some of it may be medical) it will exceed the cost of AL, MC or LTC. Plus, hiring aids privately makes them an employer in the eyes of the IRS (in many states so check theirs) AND will require a lot of your time managing schedules, even if you work through an agency.

I think you should also be honest about just how much time you wish to devote to keeping them in their home, as it can be substantial -- especially 2 people.

Lots to ponder. I think having him read some of the posts on this forum will be potent, as he can't deny the testimony of another, if he is a reasonable man (and he's getting worn out by your mom). I bet he never envisioned "losing" his wife to dementia for many years, either. I wish you much success in moving him towards a workable solution for everyone!

There is no right or wrong, or easy, way to proceed. We went through a decade long stressful elder care situation with both of my in-laws, who were very resistant to help in any form unless it came well disguised from a family member. Several crises occurred resulting first in them moving to "independent" living that actually had built in help up to 90 minutes a day. Then after more crises, we added 24/7 caregiver agency which was 15-16K a month on top of their IL rent/fees (this was 8 years ago -we are currently looking at 24-30K a month). After 6 weeks they refused the 24/7 help and literally 2 hours after the final caregiver shift, they both fell and pulled a bookcase over on top of themselves. When I received a call at 2 a.m. on a holiday that they were both in an ambulance on the way to the hospital, I thought it was a family member pranking me (in retrospect, LOL)! After that, back to 24/7 fees until they could be in a double occupancy room at a nursing home on the other side of town. MIL died after 2 1/2 years in NH and FIL lived a total of 5 years in NH. None of the family would have predicted they would live into their late 80's, mid 90's! FIL passed about 2 months before he'd have to go on medicaid. Could your parents afford skilled care in home if it came to that, and for how long? Who will provide breaks for the home helper, and consider that your parents will not always be capable of monitoring the trustworthiness of the helper(s). What happens if the home help has an emergency and there is suddenly no coverage?

At the beginning of all this drama, their family physician advised to move them into a living situation that could provide all levels of care all the way to the end of life. And by end of life, the situation should provide all the medications and medical care needed for the worst situations. Many care facilities who advertise "end of life care" are not accredited to administer certain types of drugs, especially psychoactive drugs. We wish we had followed the physician's advice from the beginning because each change in their care level, and especially the 2 moves across town, was extremely stressful.
I wish I could say we are wiser as we are currently trying to care for my own 91 year old dad who has progressing dementia (he lives alone in a house, with some help, 30 minutes away). But, we are fumbling our way along, living from crisis to crisis once again. I am constantly stressed. So if I could go back and advise myself 6 years ago when we moved my dad to be near by, I'd say "Find a nice living situation that can provide step wise increases in care all the way to the end...". And then, if I'd only listen to myself!

If you have your parents' legal authority to make the decisions then for their sake you should take control and put your foot down.
Let me tell you there has never been an elderly person who didn't make it clear that they're staying in their home as they age. So you're not alone. No elder goes willingly into a care facility and most won't even discuss with their family the possibility that they might have to go into one. That's when you just do what has to be done.
If your father still has his wits about him then deal with him, not your mother with dementia. Let him know that he cannot allow her to make decisions anymore because she's incompetent with dementia, and that if he doesn't take some kind of control in the home you and your sister will have her put into facility care. Your father needs to know what things like APS are. He has to understand that if there's refusal to accept outside homecare help the situation at home will get bad. Then social workers and nurses come and they both get put into a care facility whether they agree to it or not.
I've seen this happen many times in all the years I worked elderly homecare. Seniors who were coping well enough in their homes and had both homecare aides and family help who got "placed" by court order on the recommendation of some over-zealous social worker or visiting nurse who wants that company bonus, and gets it when they can place someone. I've seen how a home safety assessment gets done. If there's a step somewhere without a railing or a narrow doorway, the house is deemed unsafe for the elder and they get placed. Then their house and assets get liquidated. Then Medicaid gets the bill. Yes, it's a racket. The nursing home, memory care, AL, and even homecare is such a rich and powerful industry that they pretty much make their own laws. This is why seniors before they're elderly really need to understand that being "stubborn" about not accepting help, and families who obey incompetent seniors to prevent fights will result in exactly what I'm talking about.
Please show this post to your father. The person writing it has been in senior homecare for almost 25 years and have seen just this happen to many elderly individuals and couples alike. He can't let mom with dementia decide anything anymore.

Take control with love and kindness, but firmly.

My dad was the healthy one, and he was Mom's caregiver. He was so tired and burned out and sad that his world had become so small, but he was devoted to my mother and determined to fulfill his vows. I helped out weekly, and he and I would quietly plan road trips we'd take "later" without saying that meant after Mom was gone. I was going to widen his world again.

He fulfilled his vow not only "in sickness and in health," but also "until death do us part," but sadly, it was his death that parted them. He was perfectly fine, then he was diagnosed with cancer and gone in the span of six weeks. I was left with having to move my mother to a nursing home three days after my dad's funeral. She lived another 2 1/2 years.

Please help your dad by taking control or at least backing him up and guiding him. Mom is out of the decisionmaking loop now.

Dealing with it right now. Only child and relative who happens to live close (was planning on moving).

My parents have some money and planning in place....except what the plan was when they were unable to care for their home 1300 sqft..plus equal basement and 3 acres of lawn mowing and 100 ft of flower beds. Oh and no longer being able to drive from their rural town 50 miles round trip to doctors etc. Small details. They were aware that I was divorcing TWO years prior to the event and I would need to work to support myself.

I guess their plan was me although they never even bothered to mention it. Dad passed four years ago and mom, the sicker of the two, cannot drive and (of course) can't mow the lawn. We are managing but only because I have to set aside my plans completely to make it work.

If they've made it clear that they are staying...then they need to have a clear plan that they can articulate to do this. "We have money" is not adequate because you cannot hire everything done unless you have ALOT of money. You and your sister then need to draw up your boundaries and explain the limits of your abilities. If they are unable at that point to "maintain", you cannot rescue and they will have to do something else.

For instance, my hard boundary is moving someone who cannot adequate shower, dress, get out of bed, change diapers etc. I physically cannot do these things, period. I can clean, assist with meals, shop, drive, mow and even change the oil in the tractor....but I will not do that type of physical care. My mother and I are having the conversation right now....she is home recovering from a broken hip at 85, If she cannot get independent to a certain level...she will be doing something else. I cannot fill in every single gap.

Its presumptuous for parents to assume children are able to just step in to that level....and without asking or discussing.

Staying in your home means being independent enough to do what needs to be done from personal hygiene to yard work. My father's need for control stalled many a plan that would've helped both of my parents. Your parents don't see themselves as needing that much help, although they maybe miserable. In my case neither of my parents thought a bathtub stacked high with feces smeared clothing was a problem. The stack was 4 feet high. You and your sister need to have some serious conversations with your parents and with each other about what needs to be done and what you'll be willing to do even on a temporary basis. Contact that private home helper and get some references from this website. Perhaps contact an eldercare attorney.

The recipients of help cannot dictate what they want. The care givers should decide what is best for them.

Let them stay in their home AS LONG AS there is help coming in. Tell them gently but firmly they must have OUTSIDE help to do this - which you will oversee & help with. Ongoing decline has to be monitored: perhaps they can stay there until one of them goes. Do some forward thinking about that; at the same time cross that bridge when you come to it! You must not give up your life, to give
some aid & care to those you love!

Same for us. I visited 3 times a week. Spent the night some. Asked the next-door neighbor to look in.
My Dad said he didn't need any help. I hired someone to come in and drink coffee with him and maybe do some light cleaning. At least that's what I told my dad. I told him she was a friend of mine. As far as the home care people...that's another thing, but they deal with all kinds of situations and can handle it. You tell them what you told us.
At some point, when one or both begin to fall, drive recklessly, or something that can harm them, you can cross that bridge of more care. We managed to keep our Dad in his home until he died, but I already had a sweet lady from church helping (I paid her), the doctors were aware etc... until we had to call hospice in. Once you have to call hospice, you and / or siblings will have to step in and take some time off to be there. Hopefully, that's a long way off.

There is a list called ADL ( activities of daily living). Its a good indicator of what your parents should be able to do while living at home.

So glad you have a caregiver starting. We started my mom and aunt at first with a part time morning sitter and a part tine evening one.

In the meantime do as much online as you can, order home delivery meds, groceries, supplies. Pay their bills online. Fill their pill boxes several weeks out.

Call Elder Care in your area to schedule an assessment & see if they quality for help.

They need a life alert of some kind and if you can install a monitoring camera.

Can your parents move closer to you? My parents moved here because I was often going on a plane to help out, since they were in another state. They intially moved because my dad's health (COPD), was getting worse, but about 9 years after he died, my mom developed Alzheimer's, and she moved in with us, (not easy, but more doable than trying to be a long distance caregiver). When I thought about getting some help here, I thought I'd tell my mom that the woman was a nursing student, and she was doing research on women who played golf (the way she did), women who were accountants, (since she was), etc. My mom too would have been resistant to "help." I even wrote a book about our travails called, "My Mother Has Alzheimer's and My Dog Has Tapeworms: A Caregiver's Tale." If your parents are resistant to moving, you could tout all the nice things about your area. Best of luck.

I have exactly ONE friend who elected to move herself to an ALF. ONE. She was living alone in a big house and having some walking issues, made it around OK with a cane and still drove and is perky and fun at the age of 85!!

Once she realized she was struggling to handle the 'dailies'--she and her daughter checked several places and luckily for her, she could afford a really nice all-inclusive place. She has pushed herself to make friends, attend activities and take advantage of the free bus rides to various activities outside the ALF.

WHAT an amazing example she's been!! She has not harangued her kids with demands nor made grand pronouncements about how she can live alone and nobody better try to stop her! She gracefully accepted aging and while I KNOW she would love to have stayed in her home to the end, she made the choice that is safer, better and more thoughtful for her LO's.

Her kids were helpful to her---but she was adamant that she be independent and so the move was made on her decision alone.

Because she HAS made this choice on her own, she is happy with it, people go to see her constantly and she is as happy as she has always been.

To me, this shows such a level of thoughtfulness towards her family and her neighbors--b/c we did worry about her!

People who swear that they will NEVER leave their homes often wind up in places they really don't want to be, due to falls, lack of good decision making, you name it. If they had chosen a better path years prior, they likely would have had a better QOL. I'm thinking of my MIL who is now 100% housebound. She will not leave her house for ANYTHING and hasn't since Thanskgiving. It's heartbreaking, but she is insistent. So we sit and wait for that middle of the night call that she's fallen...again.

I did something similar to getting care for my mom. My mom loved quilting, the person I hired broke the ice by expressing an interest in quilting. This was worked out very well. Mom thinks this lady is neighbor. The social workers has noticed an improvement in things. The next issue is dealing with mom's financial mgt.

>we never talked about what it really means to ‘stay in your own home’ . It sounds dandy and doable until you’re in the depths of declining physical, emotional and brain health and them desperately trying to hold on to control and independence.

This is so true. I had these discussion with mom, we are assuming our parents will have the memory of the discussion, and the ability to think clearly.

When I get older and have that discussion with my love ones, I will need to work out a metric (doctor's rpt, skill test, etc.) for determining my move to AL. I will also video of this discussion. This should help my loves in dealing with me.

My mother wasn't doing well on her own after her live in friend passed away. She was getting confused and her memory was failing. She didn't remember to take her meds, could no longer figure out her finances and would occasionally forget to pay a bill. She also doesn't like to cook so she was not eating well. Even when I brought food over the leftovers would end up in the trash. She was very lonely and completely dependent on myself fir company. She's in her nineties and has outlived all of her friends. In spite of all of she also didn't want any outside help! My sibling and I went and toured retirement homes and then we took her to the one we thought would be best. At first she was willing to move and then suddenly changed her mind. We told the director of the home to let us know if another room became available. It did, two months later. We moved mom in within a week before she had time to change her mind. Even though we had to force her to move she is happy there and says she doesn't miss her former home. Sometimes when they won't accept help that they really need you have to step in and do what's best for them. It's not an easy thing to do but if you wait for them to make the decision it might never happen, until an unfortunate accident happens. Do what's best for them and fon't feel guilty!

If you take control you are in for a world of hurt. There is unlikely to be agreement and cooperation. You cannot take control for someone who is not demented; your father apparently is not. And when you have control everything can be a fight. If you enable things by doing things yourself for them they will not learn to/will not do things for themselves. I am assuming you have had the sit down talks with them; if not it is time to if there is any way you and your Sister can do that together with them. Tell them you don't live near enough to assist and are not moving. Ask them what their plans are. Or ask your Dad as it really is too late for your Mom. Ask your Dad how long he imagines he can do 24/7 caregiving. Check with them on their finances, what care they would afford if in assisted living. Would they want house sold so they could be there?
You recognize this is coming and burying your heads in the sand isn't going to help; it will come to crisis. At the least sit with your Sister and make a plan for her for when the crisis hits, when you meet with the call from hospital as I did with my brother, or when you visit and find chaos.
This is so difficult. You are on the cusp of what decisions you have coming. You say that they 'Want to stay in their home'. We ALL want that. That isn't the question. The question is, CAN THEY.
I think you need to be clear in your own heads what you and your sis can/are willing to do in disruption of your own life. Go over the "what if" screnarios together first. I wish you luck. You see the train coming. And you are right to be concerned.

I have been there. Your instincts are spot on. Hire the help. Your Dad is probably secretly glad, your Mom fears her loss of control. Tell your parents it is "temporary" or a "trial". Explain it to the caretaker so she knows how to navigate her role. Once they get used to this help, they will embrace it.

Staying in their own home is not exclusively their own decision. Sometimes their assessments are unrealistic. When that time comes you will have to take charge and make the decisions. I have had clients with adequate funds pay for round the clock in home care -but it is not the usual case. The usual advice is when they start to think as a spoiled child- You have to become the parent.

The decision is yours. You will be the determinate factor in their continuing care plan. If their living in their home is YOUR plan, get it all down in writing. If they can not commit to any type of legal arrangement now, they are not going to cooperate with your decisions in the future.

I speak from personal experiences and what I have seen and gone through myself. It ALL DEPENDS ON THE CIRCUMSTANCES INVOLVED. First of all, YOU TAKE CHARGE WITH A POWER OF ATTORNEY, ETC. AND MAKE SURE ALL FACETS OF THEIR LIVES ARE IN PERFECT CURRENT ORDER. Second, you set in place and find a way to enforce boundaries which they have to adhere to. Your mother is and will NOT give up being in control and this may make it bad the rest of the way. While your father has some control fine, but that won't last and will get worse. If you have the RIGHT caretaker who can handle them and the problems in the house, fine. DO NOT EVEN THINK OF BRINGING THEM INTO YOUR HOMES - SURE DISASTER. No matter what comes, if her behavior and actions cause endless problems with no cooperation, then you must stand up and place her and be prepared to do the same with your father. It all depends if you can get good help and it works and they (she mainly) don't cause major destruction. I became disabled and could not walk but had zero family and not a soul who wanted to help other than an hour or two. I lost everything I ever had - my beloved animals, my home, finances, way or life - everything when I went into assisted living which I despise because of so much dementia but there was no other way. I am extremely high functioning at 88 and take care of myself l00% but I can't walk. If dementia sets in, a facility should relieve the burdens involved before remaining families are destroyed.

This just has happened to me. Parents both 90 ish stayed in the dangerous old home( think rickety steps to climb up and down in and out) until my mother fell fractured hip, had surgery and rehab..but needed more care than father could provide. I had to step in and insist they go to assisted living type place until mom is "completely better" it's permanently temporary....
The first two months have been very difficult a transition but now getting used to new place. Excellent place with 24/7 help, emergency call system, activities, wonderful meals etc...
My brother lives in town and I live 200 miles away.
We do not have any financial POA but they have allowed me to step in and it's been a surprise as they were adamant about staying in house until mom was severely injured. Dad now knows it is for her best interest to be there. But it took some serious talks about doing what was best for mom....
Even with dementia, he finally gets it. Seeing her physically struggle every day has cemented the need for them to stay in AL. Dad has begun to fall and lose balance so even more reason to keep them in a safe environment.
You will have to decide these things as it happens in your circumstances. But you sound living and concerned so your good heart and loving protectiveness will win out I'm sure.
God bless

I think that with many elders (myself included) the desire to stay in the home you enjoy partially translates into the hope that illness and disabilities will not happen, that life will continue in the accustomed way. Few really want to anticipate the cruel fact is that for many it does not work out that way.

Of course, it is too late now, but the ideal time to consider what other courses life may take is when everyone is healthy and happy. These discussions need to be rather painfully detailed, specifying exactly what changes in health or cognition would require what specific changes in housing and potential aids, along with considerations of how care will be paid for and what level of care may or may not be provided by family members.

Like most people, my sisters and I sort of did that, but not really. We didn't get into the details, so as Mom deteriorated her definitions of "when it was time" kept changing. So did her notion of being "independent" and "taking care of herself and her home." Basically her last few years were a terrible example of why this painful discussion really needs to take place years before there is any disability. While it is true that the elderly can learn and adapt and manage much better than one may think, there is a time when it is simply not enough. It certainly seems as though your parents have reached that point.

However, as far as "putting your foot down" goes, can you? Do you have a POA or other legal authority? If not, your only possible role is that of an advisor. It sounds as though your father is of sound mind and body. You cannot tell him what he must do and trying to do so will just provoke confrontations. In the case of my sisters and me, we had no authority. Each of us committed to only what we were willing and able to do. Then we went a bit past the original commitment a bit. We tried to work together as a team, even though we had very different perspectives on the situation. Our primary goal was to avoid making the kind of confrontational demands that Mom would have taken as an ultimatum. In the event of anything remotely resembling an ultimatum she would have thrown us out and told us off. Our good intentions would have backfired. There was no way we could have had her declared incompetent and we knew it, so we did the best we could as advisors, offering her simple solutions to her problems. There is absolutely no doubt that her life would have been better in a residential care facility in her final 2 or 3 years, even with the enforced solitude that COVID would have brought. During the shut-downs of 2020 she was probably more solitary trapped in her own home alone than she would have been if she had been in a care facility. At least in a care facility she might have had a nurse or an aide who might have been able to assist her with Facetime or Zoom sessions once in a while. At home she was unwilling even to try.

You may be able to speak with your father, offer him moral support, listen to his worries and stress and then offer some suggestions. Let him know that you do understand that he probably loves his wife as much as ever and wants to care for her as well as possible. Ease into the idea that the best care for her may be only available in the appropriate memory care or skilled nursing facility. All you can do is the best that you can do. Don't get too stressed out about your limitations, that will only make matters worse, make it harder to talk to him. Let him know that you love him and care about him, that you want to help, but don't know what to do. Give him the opportunity to ask for your help in making decisions concerning your Mom's health. I am sorry, but that is probably the best you can do. Discuss your plan with your sister and see if you can agree on an approach. Remember that the two of you will still be sisters in 10 years.

Dad had heart failure at home at 90, his wish was granted. Two years later I found mom, medium dementia at that point, totally out of it and very dehydrated in the floor of her home. Packed her up and took her to my house. When she recovered a bit she screamed for 1.5 hours at the top of her lungs that I was abusing her and someone please call the police and she wanted to live any where but my house. I put her in assisted living. Two months later she is making nice with me to try to get out. Nope not happening. Mom is a narcissist and thinks I should stop my life and care for her. Her parents lived their final years happily in my home because my mom wouldn't help. Mom made her bed.

"Stay in my home" they say.

"Yes. As long as possible" you reply. Every time. On repeat.

As.long.as.possible.

Once that has sunk in, start discussing what "as long as possible" actually looks like. (Discuss with Dad if Mom has sadly lost some reasoning skills). It's not possible to list every scenario, but the big ones are safety based;
1. Fear. Wandering, delusions.
2. Fire. Kitchen accidents, burnt pots.
3. Falls. Frequent, head strikes, can't get up.
4. Fraud. Getting ripped off.

All these need 24 round the clock care.

Other 2 big ones for caregivers are incontinence & shadowing.

They want to keep control of their journey. But Dad must actually drive now.
Support from the roadside.
Let Dad know he CAN decide to change course at any time. THAT is still keeping control.

As many many others in their heartbreaking tales below tell, staying in your house does not mean you are staying independent.

LMRLMR: 'Living in place' is a lot of elders' desire. However, in many cases, it is simply not feasible. It wasn't for my late mother who declared "I'm so glad that I stayed in my own home." My response "I am not, mother. You chose to reside in your own home seven states from mine. You are a legally blind woman. Now your blood pressure has bottomed out at 60 over 40." The blood pressure issue caused me to leave my home, my life and my family and move in with my mother. That was VERY difficult since I was already an elder myself. Do not think that we didn't have a plan for mother. We tried everything to amend her elder living, but she left us (especially me, the daughter) a real dilemma. My mother was also a widow of 44 years.

My family is rather avoidant of any serious conversations, and the way my deceased father set up the trust containing the house and their funds, to care for my mother, is seriously imbalanced. One sister is very angry at the one brother and the youngest sister. Brother's wife has developed brain disease, so not able to visit much at all. Youngest sister visits, but often is on computer, stays up late and sleeps in, etc. I am the eldest - not allied with anyone. As it happens, angry sister and I live next door to each other, and mom in the family homestead.
Nobody will make a plan, or talk about next level of care, etc. So it will be a mess...I don't have much hope that all 4 of us will stay connected to each other very. much after my mother goes....I'm learning to just let go what I can't control, and wait until 'something happens.'
My point is that. you do the best you can, with what you know at the time. You and yours sister have put a lot of thought into the situation...so just see how it goes. The nature of elder care is that the person you are caring for will decline and die, no matter how hard you work or how great the plan or how many resources are in place. Keep in touch with your sister and support each other, without judging(as much as you can.).