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My father has been the primary caregiver for my Mom with dementia for a couple of years now but in the past year things have gotten pretty bad. She relies on him for everything and he is not a natural caregiver. There are many nights when she doesn't sleep and he just gets frustrated with her.

Us kids think its time that he got more serious about her care. We have already been paying for a nurse to come one day a week, but we need him to start contributing. He has the attitude that he will spend the money when he needs to, but that he doesn't need to yet. We don't agree. We think she needs and deserves better care.

Its ultimately Dad's responsibility, but my sister thinks that if she sets it all up (respite care or full-time care) my Dad might just go along with it. I know that he's exhausted and at his wit's end, but I think he's unwilling to commit to anything that might be expensive until he really has no choice.

Has anyone been through this? Any advice?

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Wow, a lot going on in this question. I would try to get the father to allow a home health aide 5 hours a day for awhile. If his spending the money is an issue with him, the sisters could consider paying the aide. This would give your
mother consistent care and give you dad this time to sleep. Dad is likely exhausted and if he gets some sleep he may be able to think more clearly about the situation.

I would consider your mother's care not just you dad's responsibility, it will take
help and/or funds from the children as well. Frankly, if Dad dies this week, you will all be it anyway. You have a vested interest in working with Dad and coming up with a consensus on how to care for Mom. Plus Mom sees him as her primary caregiver any steps to cut him out of the picture will not be good for her either.
While the Great Depression has an effect on parents who came of age during this period, no one feels happy spending down their life savings. They know the person left behind may lose the independence that having money gives them in old age.
I paid for the home health aides for my dad and I assured him our income
(his and mine) covered the costs with his long term care policy paid for it.
Eventually we did have to dip into his savings but while he was aware of it, it served no purpose to tell him he was down this or that amount of money.
No senior wants to have strangers (home health aides ) in their home. Try to find an excellent aide who is good with the care and respectful to them as people (one who does not order them about). I was fortunate to find the perfect
aide and kept her to the day my dad passed. She brightened his days while I was working and I did the other 2 shifts a day myself for almost 4 yrs.

Good luck. This is the beginning of a difficult period.
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A Guardian in NOT responsible for paying for her care, just responsible to see her money is properly spent. If she needs a nursing home, you sign her in and write GUARDIAN after your name to avoid confusion.
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At this point I would talk to an attorney and seek guardianship. His neglect is an indication that he may need a guardian as well. Make sure you kids all agree on who the guardian will be, all siblings will be asked to sign in agreement of the appointee.
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My parents have the same attitude about spending money. Guess it just part of growing up during the Great Depression, they only use money in dire emergencies.

Thus, their 30 year old house has the original windows, and original appliances. So I wouldn't be surprised if one of them became unable to care for themselves, the checkbook would continue to gather cobwebs.

I also would be curious how others here had handled this.
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If we do seek guardianship though, would we be financially responsible for her care? Unfortunately, none of us can afford it.
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I would tell him your mother is as much your responsibility as his, so your going to help, whether that be hiring more help for her and/or stepping in yourselves and taking turns to take care of her as well. Tell him it's something that you need to do for yourselves because you need to do this, she is your mother after all. I don't know for sure but I'd guess he'd appreciate it, he just doesn't want to ask or admit he needs help, but once it's there he's not going to put up a huge fight over it. Maybe a little, but don't give in. Good luck.
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I'm sure you're right, the two of you, that it's time your father got some support with your mother's care for both of their sakes. It's good that you and your sister are collaborating, that's a great start.

I think you should help her get the plan prepared down to the last cent and a detailed care schedule, so that you both have a fully costed proposal to put to your father that also highlights how it would improve both life for him, and the quality of care for your mother. Then the two of you pick your moment (!?) to put it to him in a business-like way. If she's right, he'll agree (or at least negotiate, maybe); if you're right, and he's not ready, no harm done - you put the project on ice and await developments.

The big USP, by the way, is that if he gets his support in place now, he has a much better chance of avoiding the kind of crisis that will land one of them in hospital or an NH - and tear her away from him.

Technically, of course, you shouldn't be covering the cost of the help you've already arranged - that is your parents' expense and they should be meeting it. But it's very nice of you and I hope he appreciates it (I'm not putting any money on that, though!).

Good luck, don't let the grass grow, and while you're at it see if you can VERY TACTFULLY get anywhere with setting up DPOA for him so that you can continue to support him in future. He will need your help to stay independent, but he won't want you taking over - mind you don't tread on his corns.
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I thought this is YOUR mother too. It is a shared responsibility. Set up services and wait. You can only try to help and if your father refuses the help, shame on him, and his health will suffer but that will be HIS choice. He is still trying to deal with her illness, and probably in denial she is going to die. But, trying to blame him and force him into anything will only backfire on you adult children. See your mother and do what you can, and that is all anyone can ask of you (all). Merry Christmas!
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