End-of-life care with an adult OCD child with special needs

July 22, 2019 2:12 PM

My mom is a widower in her 70s, and while she is sharp of mind and has a desire to be independent, she has limited mobility due to multiple hip and knee operations. My middle-aged sibling, diagnosed with OCD at an early age and who has been on SSI for many years due to that issue, is hounding her unreasonably for money and support. Help.

My mom lost my dad a couple of years ago and is on a pension. Thankfully, that limited pension is adequate to support her modest lifestyle. I've helped her transition to a a way of managing bills and savings online in a way that she's been comfortable with, and she goes once a year to her tax adviser, so financially she's doing fine and feels she can manage her affairs. She has been having some trouble keeping her house, but she has a small house, and she has been able to get help. I live close enough so that if there is a catastrophe, I could assist within hours, and she is OK with that.

Unfortunately, her relations with my brother, living in the same city she does, has been a different matter. He has been increasingly demanding for support, both monetarily and in terms of services such as driving and helping with his personal affairs, in a way that are certainly unreasonable and not related to a legitimate health issue - even for a middle-aged adult child with OCD. When the concern is raised that even with disabilities my brother might be able to support himself on any given simple matter, he becomes extremely angry and verbally violent. The violent language and threats can last for days. My mom has confessed to me that she is supporting him "under the table" beyond SSI, but only because she is concerned about him becoming violent towards her. At some point, and I am increasingly concerned that point has passed, I feel my mom needs protection from him.

I am married, employed, and live several hours away from them. Choosing to reside in the small town they both live in would result in my life becoming upended in ways perhaps worse than I believe my mom's life already has been upended, and this has resulted in a disturbing amount of soul-searching. Despite encouragement and the offer of assistance with a move, my mom does not want to move from the home she has had for many decades.

All of us live in states where it is legal after age 18 to not support one's adult children.

Please help, I genuinely don't know what to do.

posted by anonymous to Human Relations (16 answers total)

It might be worth having a discussion with a lawyer versed in elder law on this, especially if you (and she) are in agreement that he's being somewhat threatening in his demands.
posted by jquinby at 2:40 PM on July 22, 2019 [11 favorites]

What he is doing is elder abuse and it has to stop, especially if she is afraid he will become violent. The town or the county she lives in should have some senior services that might help her both protective services and housekeeping. Find the number for the local county social services or elder services (it could be called office of the Aging, Senior Support Services, or something like that) call them and ask for help. Of call the local domestic violence services.

Some practical suggestions: make sure she has caller id, has good locks on her door, and maybe one of the medical alert necklaces so she can get help quickly. In a small town there may be other options. Have you considering helping her find a live-in helper who could do some of the housework and generally keep an eye out for her?

You should not feel bad for not wanting to give up your life to help her.
posted by mareli at 2:44 PM on July 22, 2019 [13 favorites]

You can give up your life to help her if you want. You're not required to, but you're not required not to, either.

How technical is she? Depending on how legal it is in your state, a small high memory and long life battery body camera can be used to gather evidence to make a case to authorities that she needs legal protections from her son.
posted by Mistress at 2:56 PM on July 22, 2019 [2 favorites]

Could the brother move to your town? Sucky for sure, but you can share the burden. You don't have to, but you can. And, you know, mom could move without wanting to. It's the sort of thing people sometimes have to do in dangerous and seemingly unsolvable situations.
posted by Mistress at 2:58 PM on July 22, 2019

How is he contacting your mum? If it is via phone can you “take over” that phone number and give her a new number that she is not to give out? That would allow you to run interference (maybe including calling the police I f he starts threatening you?). This all depends on her co-operation though. She is still an adult who can make her own choices, including the choice to stay in an unhealthy, abusive dynamic with your brother. So providing help to her such as a PSW or social worker might be an idea. If she spends her money in her own self-care she will have less to spend on him however, which can be dangerous if she doesn’t advocate for herself.
posted by saucysault at 4:49 PM on July 22, 2019

Is your Mom willing to take action to stop his abuse? I have had to estrange myself from my child who has a mental illness and whose behavior can be unacceptable. It is very difficult emotionally, to put it blandly. There is an Area Agency on Aging near her, they will know what resources are available for her to get the abuse stopped. Protection Order possibly. Tell her from me that it is not good for him to get away with this crap and teaching him that is the best parenting she can do.

Smaller efforts she can make are using caller ID and not taking calls when he is angry, hanging up when he is abusive. She can learn to use a mobile phone well, and keep one on her at all times for emergencies. I took a bad fall in my driveway and that scared me, so I really try to keep the phone near me. A web cam in the house would allow you to keep an eye on things, too. You an also find out what resources exist for your brother so you and she can refer him to someplace that will help with his 'emergencies'. And, seriously, make sure he has a gaming system, and he can get games, because it would distract him from harassing her.
posted by theora55 at 5:15 PM on July 22, 2019 [5 favorites]

As a middle ground between helping from afar and moving there, could you take FMLA or other type of family leave from your job and go there for awhile? Some types of leave are paid, some are not. I'm not sure what level of need must exist to legally qualify. But maybe that would let you keep your job while spending significant amounts of time each year there, assuming you meet the criteria.
posted by slidell at 7:09 PM on July 22, 2019

I know that your brother is asking for both monetary support and other support. I think this is about money. I also think all the support demands would go away if your mother was not able to give him monetary support. I know you said your mother is capable of handling her own financial affairs. However, I suggest that your mother turn over her financial accounts to you to manage and pay her bills. Then your brother would have to come to you. Take the pressure off of your mother. It is hard to say no to a child and even harder to a child that needs extra support.
posted by AugustWest at 7:24 PM on July 22, 2019 [18 favorites]

I would have a serious talk with your mom and her tax adviser and maybe an elder law attorney too about how to protect her financially. It seems well within the possibility that your brother could get his hand on sensitive financial information and clean out accounts, open up lines of credit, or otherwise compromise your mother's finances. The situation seems like a disaster in the making.

Maybe she would be open to you have some power of attorney over her finances or appointing someone else she trusts to manage her money and accounts.
posted by brookeb at 7:41 PM on July 22, 2019 [3 favorites]

I can certainly appreciate your mother's reluctance to lean on one of her children for financial or lifestyle support.
What if you took away that support, for reasons? What if your support was based on limitations or clauses that she did not agree with? What is your spouse's role in this?
This is a slippery slope that rests on many unrelated and incidental factors. It would be very difficult for your mother to regain her independence once she voluntarily gave it away.

You mention that your mom does not always put her own best interests first. As well meaning as you are, she may be reluctant to have two children at odds with her or each other.

I would advise having a disinterested third party handle her affairs. This may include financial, medical and end-of-life decisions. That way your mother can get back to enjoying her children without putting them in conflict with her or each other about her decisions.

It is good that she is open with you about her relationship with your brother. I assume he would be less likely to try intimidation in a lawyer's office, where a record of his behavior would be on file.
posted by TrishaU at 8:00 PM on July 22, 2019 [3 favorites]

Something I realized when I felt my sister was taking advantage of my mom: My mom was a willing participant.

You can only do so much. You and your mom are not going to change your brother. The two of you can only do what the two of you can do for yourselves. You should not move or upend your life. I would have a very open discussion about this with your mom. If she is afraid, she needs to be in a place that is not as physically close to your brother as she is now. This probably means moving. She needs to hear that this is what she must do to be safe. If she declines and chooses to continue supporting your brother then she is telling you she is choosing to not alter the status quo.
posted by CoffeeHikeNapWine at 7:55 AM on July 23, 2019 [4 favorites]

What does your mom want, here? It sounds to me like any solution is going to be one that she has to implement, so she should be very involved in coming up with the plan, and it needs to be one where she's willing to do her part to uphold it, whatever that is. If the plan requires her to say no to your brother when he asks for things, and she's not willing to do that ... then you need a different plan.
posted by spindrifter at 9:11 AM on July 23, 2019 [3 favorites]

But if she's scared though?

N-thing the idea to get an external expert involved. Maybe a financial advisor could be the gateway for all support requests from your brother and nix the under-the-table payments as a legal liability for them?
posted by slidell at 10:32 AM on July 23, 2019 [1 favorite]

You're not obligated to upend your life to intervene in this situation, especially since you've offered to help your mom move and she's declined. (If she were trapped in her town, I might feel a bit different.) It sucks that your brother makes her life difficult, but life is hard.

I like the idea of someone not-your-mother controlling your mom's finances, but don't know how easy that would be to create. You could control her finances, but that puts you in direct conflict with your brother, and might make your mom uncomfortable. If a third party was actually controlling her finances (instead of advising about them) I believe you've gotten into the realm of third-party "guardianship," and that can be a very sketchy/abusive situation.
posted by sockanalia at 12:59 PM on July 23, 2019 [2 favorites]

Assuming you're in the US, "under the table" monetary gifts could be a problem if she's eventually in a situation where she needs Medicaid assistance for long term care or something like that.
posted by Kriesa at 1:29 PM on July 23, 2019 [1 favorite]

On another note, unless your mom has a terminal illness it's probably not a good idea to call her needs "end-of-life care". She's in her seventies and could live for another 20+ years.
posted by mareli at 6:04 AM on July 30, 2019