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My mother has Alzheimer’s and we are preparing to get her into assisted living. My brother's wife and my sister's husband feel it is disrespectful to not include them in all discussions and decisions as it regards my mother. I feel it is too tender-hearted a topic for so many people to be involved in. The relationships are difficult at best. Must they be included?

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Care, even in assisted living requires full family involvement. If the facility is close to you, constant visits will impact the time you have with your own family. If they are further away/out of state, the travel required for visit will also have an impact on the entire family's life. I involved my husband, my brother, and his wife when we placed my mother in a facility because I wanted my brother to be happy with my decision and his wife to support his need to travel more often. There are also potential financial issues to discuss. My mother has funds now but will run out, I wanted everyone to be aware of their obligations to keep her in care. Again, I think that is something that should be discussed with everyone.
I don't think you need to discuss health issues, but I think discussing what would be the best situation for everyone is something that should be agreed.
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Carolelove1: Sometimes you can't please everyone. If these individuals have valuable information to be shared in regard to your mother's Alzheimer's disease, then include them. Otherwise, they can be told of the care plan after the fact.
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I don't know that there is a general rule. I think whatever all the parties involved agree upon is the right answer. I will say, though, that unless you can absolutely say that the spouses will not be affected AT ALL by the situation, financially, care-giving, or otherwise, their feelings and opinions should be heard. For example, when we cared for my husband's mother in our home, I made most of her meals, gave her medication, took her to the bathroom and bathed her; you bet I had a say in things.
When my mother needed to go to a nursing facility for rehab, my two brothers and I worked together to choose a facility and do everything to get things ready for her to go back home. My husband and one sister-in-law weren't extensively involved but they were welcome to be if they wished. My other sister-in-law was invaluable to us in the advice she provided because she'd been through it before with her own mother. She helped us vet the facilities we were considering but due to Covid restrictions, just my brother and I did the site visit. My situation may be a little different than others, we all consider ourselves family and we all have a voice. I am so grateful to have their help especially when I think of my husband's situation as the only surviving child.
You should also consider that the spouses who aren't given any consideration in the decision-making are more likely to criticize the decisions made, particularly if their spouse (your sibling) is passive about decisions and pitching in to help. You are understandably upset right now, but many difficult decisions are ahead of you and it is time to be more practical and less emotional about your mother. Best wishes to you.
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I don't think it's any of their business, especially if you don't have good relationships with them. In my opinion, if someone doesn't really care about an elder and isn't doing much to help then they really have no say or no right to be in on making decisions or sensitive conversations about a loved one.
My brother-in-law treats my mom like sh*t and I don't feel any responsibility to include him in anything. My sister is always forwarding stuff to him about my mom but I don't think he has ever responded directly to any of it and he so obviously doesn't care about her.
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It’s none of their business!!! Only your sisters & brothers are included in the discussion.
They sound very nervy.
Hugs 🤗
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Everybody gets to have an opinion...they will give it to you, even if not asked.
Only some people get a vote in the decision making process - the adult siblings.
If there is no consensus, then ideally there is a designated decision maker for health care and also a designated decision maker for finances/property - these 2 need to make the actual decision.
My personal experience with a dysfunctional group of sibs is that having expectations of others but not directly asking for what you need, and being unwilling to acknowledge that you experience stress and frustration as primary caregivers creates a mess!
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Spouses of siblings may not be the ones to make the decisions about care and placement, but they are certainly involved if the siblings are helping financially with Assisted Living and/or Health Care. Their input and support might be helpful, but maybe there are family dynamics here that we do not know about.
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lkdrymom: "I think it entirely depends on how the decisions made will impact their lives."

THIS! If money or any kind of ongoing assistance, then these things affect the spouses.

For instance, my 88-1/2 year old MIL lives by herself in a 2-story house miles from town with mobility and other issues. Steep stairs no longer up to code, no bathtub/shower downstairs, etc. You get the picture.

Fortunately, we are one of two out of state couples out of her 5 children. The other 3 aren't that far away from her. She has stated that she will be carried out of the house, and will never leave of her own volition to live in a facility.

So when The Event finally happens that triggers a change in her living situation, we have no part in what that will be. Perhaps her oldest D and favorite child will take her in (as she did for 7 weeks when MIL fell and hurt her shoulder enough that she couldn't do tasks of daily living).

BUT if this SIL wants the rest of the sibs plus herself to contribute to at-home help for MIL or even some kind of facility, that would be a hard NO from me. MIL unexpectedly inherited a nice bundle of money, and spent most of it on exotic travel (Antarctic AND Arctic cruises plus other trips) among other things). She does like to cry poor about the high taxes on 2 houses. THEN SELL ONE!
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Spouses of siblings? Support and input. Hopefully free, unconditional support and logical insight. But the respect of decision making belongs to the direct children of the elder. And the spouses of siblings should be able to provide both while knowing their bounds
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In your situation where you are placing your mother, I don't think spouses have must of a say.

But I would not discount that you and your siblings may be dealing with a degree of FOG, Fear, Obligation, Guilt, and they may have a clearer picture of the situation. Just from your post, you say Mum has ALZ and you are placing her in AL. It may be that memory care or a nursing home is more appropriate for her.

If there is discussion about the parents moving into one of their children's homes, then the spouse has as much say as anyone and more than the children who will not be providing care.

In my case, Dad lives in a suite in my brother and SIL's house. My SIL has far more say than I do. She has the burden of him in her home, I do not .
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Just one person's opinion, but I feel that you and your siblings should make the decisions, but keep the spouses apprised of what is going on. If any of the spouses were particularly close to or provided care to your mom, they probably should be included also. When my in-laws were older, my sister-in-law, husband and brother-in-law did the deciding. If they asked my thoughts, I would tell them, but in the end, it was their parents and their decisions that mattered.

Please keep in mind that there will always be some people who will look for any reason to feel 'disrespected'. And there are others who will be contrary just to be difficult - you could say it's red and they will say it's blue just to disagree and keep stirring the pot.
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The way I see it is a combo of previous responses.

Marriage partners have one voice together; each may have helpful ideas, want to lend support, etc. It is right to include them if the blood spouse has a role that will impact their lives.

That being said, it really depends on their involvement and roles in the caregiving up til now. There's also personalities to consider and how everyone gets along or, as in some families, tolerates that certain one that makes things difficult or unpleasant.

My brothers and I had a group chat with just us, and it was up to each of us to inform our spouses and get feedback/make decisions, then bring it back to the table.

Everybody has their own style. As POA/POAHC, I would keep my brothers informed, listen to their ideas, ask for help when needed, but in the end, I made the best decisions for Mom. Because we operated as a sibling unit, their support was priceless. The few times when I felt an issue would cause too much discussion and disagreement, I would inform them after the fact.

One of my brothers is divorced, and it was a messy mean (from one side story) business. So, both my brothers don't include or want to communicate with my ex SIL. The thing that irked them the most is that Mom and exSIL continued their wonderful relationship. They were pinpals, and exSIL would call more than my brother. So, I kept her informed separately. I also quietly gave her some of Mom's things after Mom passed. She was close to Mom and they loved each other dearly. But I would never involve the ex in our group chat.

The other SIL, thankfully, didn't butt in. She's bossy and always "knows best" and "knows more" and has the attitude that everyone is dumb, etc. My brother would be the conduit for anything she had to say. I was lucky I didn't have have an unpleasant comversatiom with my brother about her. You may not be so lucky. All I can advise there is, take a deep breath, less is more. and smile while your talking, even on the phone, because it makes your voice sound nicer.

Bottom line, you know your family and which would add productive ideas and which probably would not.

Also, there may be an inlaw that just wants to be informed.
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In my opinion, spouses should be supporters more than contributors. As others have said, it depends on family dynamics, but in general I think the in-laws should not expect equal status in decisions regarding the parents. Of course, if a decision involves moving the parent(s) in with a child and their spouse or funds from a child and the spouse, the spouse should be completely on board and have a full say on that decision.

My husband was very supportive throughout my travails with my parents. I was POA and Trustee and he didn't always agree with some of my decisions, but he knew they were not his to make. I did, however, appreciate the contributions he could make from his distance. He was the one who finally spoke up and said I needed to get my mother out of her skilled nursing facility, because she was declining so quickly. I didn't really see it, but he did and he spoke up. I'm grateful that he did.

I have absolutely no intention of playing any role in my mother-in-law's care decisions when the time comes. My husband is one of seven siblings (five boys), and ALL the other sisters-in-law will have strong opinions about how things should be done, but they're also all much closer to my MIL than I am. (We've lived anywhere between 400 and 1,000 miles from them our entire marriage, while the rest of the family lives within an hour of each other.)

I'd say don't exclude the in-laws completely, but if they feel strongly about something, it might be worth listening to them. They might see something you don't. Otherwise, they need to stay in the background.
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Since your siblings are married, their spouses ARE family. To exclude them will surely lead to problems down the road. Better to have open discussions but allow the final decision to rest with only a few people.
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I can imagine both sides of the issue. However, I believe that you and your siblings should be able to have private discussions about your mother. Any decisions should be made only by the three of you, with your mother’s input and/or best interests at heart. You three know her best. This situation is hard enough without others’ feelings involved. It is not about them.

I suggest that you and your siblings discuss the issue among yourselves (either in person or by email). Then, the three of you could meet with your in-laws and present a united front. Thank them for their love and concern. Ask for their support, which may be the best way they can help.

If you are open to suggestions from your in-laws, tell them. Ask them to send their ideas by email. Make it clear that you will consider their ideas for your mother’s care, but cannot promise your commitment.

Just my two cents. I wish you all the best.
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If these people have been involved - then yes. Allow them input. It never hurts to hear a perspective maybe the immediate family has not thought of. If financial help from siblings is expected - then YES - everyone gets included.
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Since I receive no support from anyone in my family the input I receive from my spouse is invaluable. He is not bound by all the family of origin stuff that I am and
can deal with them like no one else. He can get them to do almost anything.
Shopping, banking, medical appointments, taxes etc. My parents are always on their best behavior when he is around. When they were looking into Assisted Living he took my Dad to all the tours because he knew I had reached my limit. All he asks is that we have a life together outside my parents. I suppose that sig others can be a problem but sometimes they have good insight into stuff that you don't see. They need a little input because their lives and possibly their money might be involved.
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iameli Mar 2022
He sure is a gem! Good for you.
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Have they been close to these elders???? Have they loved them, been accepted as a son or a daughter? Been loved as siblings?
If it is a yes to this, then I think they should be considered family and should be present, though in the final analysis I think the decision belongs to the blood family siblings, and this should be made clear.
If the relationships are AT ALL DIFFICULT then I think the siblings should come to the agreement that only the siblings will meet, and this in the interests of keeping too many chefs out of the stew, in the interests of hopefully coming to an agreement without someone inserting their opinion and trying to force it upon their own spouse.
You describe a difficult situation where at least some of the siblings do not get along with some of the spouses. For that reason I would kindly say that the decision is made to meet with the siblings only in the interests of coming to a conclusion without any input from anyone but the children raised by the Mom.

Best of luck.
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Why would it concern them to begin with? Are they caregivers to their MIL?
No, they do not have to be included in the decision making. Are you consulted and included in any decisions made for their parents?
Probably not.
There may be another reason why they're upset about not being included in such matters. That reason is money and possible inheritance form your mom. If a person goes into any kind of care facility it costs a fortune and whatever money or assets they have has to go towards their care bill. That might be what's eating your SIL and BIL.
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Hmm.

My 1st gut instinct was no. Involve the blood siblings only. I don't feel it's disrespectful not to include the in-laws.

But then I read that reply where a BIL wanted to lob caregiving onto others without asking them...

So I suppose it depends on many things.

I would expect my DH & his sibs to plan with their Mother such issues as moving house/downsizing/transition into AL. That does not really impact in-laws or my life.

But if a care roster was being drawn up, with my name on it - then YES I should be there. Or if a care plan is drawn up with my DH's name all over it, impacting his work, our family & finances then YES that affects me too.

A larger group gets harder to manage & work together to agree on the goal.

Maybe set the goal with family (AL? If so, which one?).

Once the path is chosen & plans set, then the group meetings could become less formal, more social & include the in-laws.
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Good Evening,

One person needs to be in charge. Don't refuse any help but who is the person that knows their parent(s) the best.

Also, who shows up? Oftentimes people voice an opinion because they want a done deal. Others may work out of self-interest, just wrap this up. You may get offers for help at the beginning but have they been around prior to this?

I think the siblings should communicate first--hold a meeting. If you have an in-law who is a doctor, nurse, elder lawyer or works at a facility that will be an advantage for your mother, that's different, they can participate at the 1st meeting.

It's not a one size fits all answer on this. I have been in the trenches as a caregiver (I hate that word) I'm just a daughter who loves her mother/grandmother/aunt, etc.

Some advice that my siblings offered was so way out that I couldn't believe what they were saying. They are good at their jobs but really didn't know my mother the way I did, not even how Mom takes her coffee or who her friends are. I'm into details. I'm calm and you have to make sure the one's who make a lot of noise in the family and don't deliver afterwards take precedent. Stay centered...

If you get the "in-laws" to serve as another person to work a shift so to speak in other words, show up at the Assisted Living and check up on things than by no means don't refuse their offer. Sometimes these things can go on for years. You will need coverage.

1. Hold a family meeting with your siblings first. It could even be on Skype.
2. Make some decisions
3. Include the in-laws, fill them in on what is happening and then ask if they have any comments.

Please Note: Look and see how your in-laws treated their parents. For example, my sister-in-law took a vacation and went to France when her mother was dying in the hospital. The in-law apartment that was supposed to be for that the in-law was taken over by brother and sister-in-law. You don't want to believe these things happen but they do. My mother was by my sister-in-law's father's bedside as he was dying as hospice cared for him, so she could teach. She never showed up. I'm not airing my dirty laundry out but look at people's track record.

I repeat, there needs to be a Chief, someone in charge. If they're always late or don't respond or don't commit to family events than don't look too much to them for guidance. I think you get the message. Every family is different.

Your remark "the relationships are difficult at best". You said that for a reason, what is that little voice telling you inside. If you have been doing the work all along even before this arrangement don't second guess yourself, trust your instinct. You mentioned this last but I think it was really the "first" thing you were thinking about and this really your concern. Don't let any of them take you down a rabbit hole. If they are disruptive, erratic in behavior or evasive/indifferent then they are not part of the team but their welcome to send an envelope, gift card, bathrobe for Mom anytime. In my case, brothers' like to buy Mom these massive flat screen tv's that she doesn't even need and it's not good for Lewy Body Dementia. I wanted to leave you with a laugh!

You sound like someone who loves their Mother and most capable. You are in my prayers! Amen...
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I think it entirely depends on how the decisions made will impact their lives.
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"The relationships are difficult at best."

So, there are already preexisting tensions with these spouses. Like BarbBrooklyn noted, some people are just looking for reasons to feel offended. In the OPs specific case, the spouses seem to be jerks. So in this specific case: no, don't include them if they can't see it's not about them. If they have productive input to give, then they should just offer it up and then let it be.

In general, I agree that spouses should have insight into what's going on as it is happening while diplomatically being informed of how the decision-making hierarchy is structured (like if one sibling is the PoA and the other siblings are there to provide support). This has short-term impact on the adult children. Their spouses' prior experience or wisdom can be sought. But in terms of being part of any decision-making: only if they will be impacted long-term by the decision (eg: an elderly parent will be moved into their home; their spouse will be taking up a certain time-consuming or stressful responsibility for care; etc.)

I have known my MIL since I was 18 and lived within 6 miles of her most of those years. She very definitely feels like immediate family to me. What happens to her matters to me, so it would have felt rather terrible to not at least be let in to hear discussions regarding her care, even if my input had no ultimate weight in decisions.
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Ideally, your mother has an estate plan to include HCPOA, POA, and estate executor when the time comes. Legally, the person(s) she selected for those roles are the decision-makers. It sounds as if you are in that role.

It's a difficult time for everyone but don't discard the feelings of other family members because it is emotionally hard for you. The spouses - who presumably love your mom - are insisting on being heard. They are also grieving. But it is not their place to make decisions for mom - it is yours.

You can respond firmly but with compassion in this fragile situation. Tell the entire family that you (and your siblings?) have a tough decision to make - but ultimately it is your decision. You know they love mom and want the best for her. You could ask if anyone has a specific concern and tell them you'll take it under consideration. Then do what you feel is best for mom.

Realize that your decision to include or exclude the spouses will set a course for future relationships. You'll do the right thing!
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If decisions impact them and their marriages, include them…

I am grateful I didn’t sit back and let decisions being made by my BIL, effect my marriage. His proposals would have had us doing the caregiving. All in the name of inheritance…
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Beatty Feb 2022
Yes, spot on!

It's never ok for others to make decisions FOR us like that.
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There are in-laws I wouldn't mind at a meeting and in-laws that I would not appreciate their input.

As said, the POA makes the final decision. I see both sides to the no and yes. My reasoning in saying yes would be, that being married to a sibling that wants to be involved in the decision making, if married to that sibling my life will be effected too. My SIL has the habit of saying Yes without input from my brother. That's how they got my nephew. My sister asked if they would raise him and my SIL said yes before discussing it with my brother. With all nephews disabilities, this should have been discussed between the two of them since they had 2 kids of their own. Living 8 hrs away, I could not help. She would also offer to help with money without asking DH.

Let them come. They may have good input. But final decisions are made by Moms children.
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I want my husband with me in any important meeting. It gives me a different set of ears.

If it is a very emotional subject for me, he can keep me straight on the issues in the event my emotions overshadowed my brain while information was being provided.

My husband is my family and if my birth family can't honor that, then we aren't really a family and I won't behave like we are, we are a package deal whether anyone likes it or not. Need my help or input, better be prepared for my other half to be present for me.

I will say that we don't get involved with the business at hand, it is for full support of one another.

Right now, you need your siblings and that should include their spouses, because that is now who their loyalties lie with. Don't try to create a separation, not right now.
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BurntCaregiver Mar 2022
Isthisrealyreal,

It's fine for the spouses to be present at meeting or discussions when the care is being planned for their in-laws.
That's great to have moral support because the decisions concerning the care of an aging parent can be hard.
So long as the BIL's and the SIL's want to be part of helping with the decisions for the right reasons. The right reasons are because they love their spouses and in-laws.
Not for the other reason which is usually the why they want to be so involved.
Keeping an eye on the money and any potential inheritance.
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I typically agree that spouses are more peripheral to decisions. However, IF the MIL lives with one of the couples or IF one of the spouses does caregiving duties, then I feel differently. They deserve a place at the table to some extent. I would hope, though, that the son or daughter does most of the talking and giving input when dealing with other sibs.
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It matters not how much dissension there is amidst a family. It is the POA who makes the decisions when an elder has dementia. Who is the POA? If there is not one, this could go to a guardianship fight that is in the 10s of 1,000s of dollars and in which a judge may ultimately choose NONE of the warring siblings, but rather appoint the state as guardian; in that case the state will decide EVERYTHING without ANY input from the warring siblings, and they will have no say in finances, in placement, in sale of assets or in any other thing.
Having discussions and input is lovely; warm up the teakettle. But ultimately there is a POA who makes the final decisions in the best interests of the elder.
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Here's the thing.

Some folks can be "insulted" about anything. Are theae folks both like that? If so, it makes for difficult family dynics no matter what the issue.

Do they think they have good information to share? Have they been down this road with their parents? Have some professional expertise?

Or are you calling on their help in doing the moving, explaining, money management?

One of my SIL's is a financial whiz and managed my mom's money. We involved her every step of the way
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