I am at my wits end and it is apparently my own fault?

Thomas, welcome to the forum.

For just a moment, ask yourself what your parents would do if the three of you didn't exist. There are social services that your parents can access that will get them the help they need, yes?

Does either of your parents have a social worker or case manager?

YOU (and your sisters) are allowed to say "no, I can't possibly do that." It sounds as though both of your parents need a higher level of care than a child who stops in to do occasional shopping or tidying.

The 21 year old who lives there, does he do any caregiving, or can he take them to appointments?

Every county in the US has a local Area Agency on Aging. I encourage you to look them up and give them a ring tomorrow. Your parents need a "needs assessment" to find out what they need and someone to find out what they are eligible for (like a Medicaid paid homemaker, mental health services for mom, etc).

Please let us know how you make out with that all important first step!

This seems like it isn’t really working out for anyone. Don’t expect your siblings to take on this responsibility. They may not be able to or have no desire to because of the level of care needed.

Do you want to care for your parents or is it out of some form of obligation?

Can they hire caregivers? Have you contacted a social worker to help plan for their future? What about Council on Aging in your area?

Is the young man acting as a caregiver to them?

Hi Thomas, Welcome.
You don't actually mention your parents a whole lot here, and why it is that they are needing so much care from the family. Because it seems to me the real question here is whether or not it is time for your parents to move into ALF for care.
I don't feel that any children are responsible to do caretaking for their parents if they do not wish to.That is to say I don't see that as an obligation of the child. Nor for one child to judge whether another is giving enough, or too much. That is up to the individual.
To be honest, if I had an abusive parent while growing up, I would not be involved in their lives after I was able to escape their home. Not in any way whatsoever.
So that is to say that we are all different. The care Sister #1 chooses to give is up to her. The care Sister #2 chooses to give is up to her. The care you choose to give is up to you. The amount of care you choose to give will depend on many many things. How much you love your parents, how close you are in miles, how much time you have, what your personal limitations are, the needs of your own nuclear family (which, to be honest, ARE your obligation, and MUST come first.)
So it is a matter of your parents deciding whether they can maintain on their own now, or if they need to go into assisted or independent living.
Wishing you all a lot of luck. Remember that the only person you have the slightest control of, therefore the only one you have real input with, is yourself. It sounds to me as though you have a family and a very busy life; concentrate more on them, and less on the parents.

I will echo much of what others have said. Calling your local Area Agency on Aging is a good idea. They can maybe offer resources to help. Your state Dept of Aging can also help. There's no need to blame yourself for wanting to care for your parents, it's only natural that we want to do that. But there's also no way to require your other sisters to chip in on your parents caregiving. Nor should you be expected to give up your family life and do it all. Your vacation days should be for family bonding not for caring for your parents. So many caregivers begin caring for their LOs voluntarily and with good intentions. As times get tougher volunteering becomes an obligation. Obligation breeds resentment when it comes to caregiving. To repeat Alva, your only responsibility and obligation is your immediate family. So seek outside help for your parents and if they refuse such help you must be upfront with them and say that you cannot devote so much time to their care. Talk to them about assisted living and maybe even visit some facilities.

Thomas,
Yes, there is something wrong with your thinking.
"I have to pretend to be in the office so my dad and mom can go to their appointments."

Do not do this anymore. Stop it.

Jobs are scarce. And if you want to keep your job, be honest. Does your job cover 'family leave'?

Just do not miss work for your parents.

If you cannot be there, hire caregivers at your parent's expense to drive them to their appointments.

You've got this. It is doable. Do not count on siblings, thereby saving your time, money, and stress level.

Keep reading on the forum to find out what long-distance caregivers have done to provide care for their aging parents. Whether you are close-by, or across the nation, caregive from a distance, imo.

Sorry, I had no time to sugarcoat my answer to you. But I care.

P.S. Have the 21 y.o. drive them.

I agree this issue may not unique - but that doesn't mean it is not SUPER hard! Or that you miraculously know how to proceed.

There needs to be a book on this *Aging Parents - Caring without going Cuckoo* ??

But you found this forum with loads of people who have been through similar - welcome.

For YOURSELF, for a more professional view on family dynamics I would start with the Boundaries book (by Dr Henry Cloud). Have you read it? (It's very churchy but non-church types can still read it). I found it amazing to get a clearer look at my own situation - a huge shoving of responsibilities onto me (that were not mine to own). A mess of porous boundaries where no-one had confidence to say no in a healthy way & instead said yes due to F.O.G (fear obligation guilt). Ring any bells?

As stated by others, YOUR responsibilities are to yourself/spouse/child/job.

Your folks are responsible for their own lives.

Now regarding your PARENTS,

It sounds like they are/or have moving from *independent* to the next stage *inter-dependant*.

The responsibility to arrange their care needs is theirs. They can ASK family/friends/neighbours for rides, groceries, cleaning etc but realistically they will need a sustainable plan. Not a few favours here & there.

You have already identified your Mother feels *entitled*. That she expects family to provide this - for free. Some assume you will be on call 24/7 - at their beck & call. Mine did. This is common. Reality chat time with Mother.

You may wish to re-word in a nicer way 😉

"Hey Folks. You got old. And sick. Not your fault. Not mine either. And I can't fix it. You will need to arrange the care you need. Your choices are;
A. Get help in
B. Move. AL has the help provided
Simple eh?"

Now if they are truly incapable of arranging the help themselves, then enduring POA takes over & arranges it.

There are more choices.. but start with those.

There is definately NO option that says enslave adult children & they must forgot their own family, home & job to support me as I wish in my own home for as long as I want.

No, you don't have to be "the adult" for your parents and no there is nothing wrong with you. Also, if your sister was abused by them (and this happens often that one sibling takes the brunt of it in a family), then she should not be expected to take care of them either. The grandson living in their house is the one who needs to step up and start taking them to the appointments and assume the caregiver role, not you. Make the offer to get them a home/health aide who will take them to their appointments and help out with other errands. Then let that be the end of it.
From what you've said here, it sounds like you and your siblings came from a dysfunctional home and have probably been dealing with your parents BS for all of your lives. Make the offer to help if you want to by arranging some in-home care or by finding them a senior community to move to. Always remember that the only way to be any kind of a caregiver or help is that it has to be on YOUR terms, not theirs.

Don't jeopardize your future because your parents did not plan for or refuse to take action on theirs. Sometimes you just have to let things fall apart and resist the urge to play the roll of knight in shining armor.

Decide what you can reasonable do. If that means giving up one week's vacation for their needs then so be it. But once that week is used up you are done. Stop paying for services. They don't appreciate it and they can afford it themselves. Just because your mother thinks it is your responsibility does not make it so.

As the above poster said...stop doing things on their terms.

Thomas, having boundaries (i.e., YOU refusing to pay for care when the parents have the funds to do so) is not abandoning your parents.

It is standing uo to bullies. Something your dad should have done long ago.

Your parents are triangulating you (oh look at poor dad's situation, you wouldnt want dad to suffer).

If the AAA can't help, call APS and report yur dad as a vulnerable elder

Hello
you may be able to help by helping them obtain other services.
Depending on their financial situation and Medicare vs Medicaid . The va has services if dad was a vet. They are resources to assist them other than you .
each state has resources to assist the elderly , meals on wheels , transportation . You may want to contact senior services in the county . Your fathers treating Dr. should be able to contact you to a Sw . Local hospital Pallative care program.
also each state has adult protective service agency .
remember to take care of your self . Companies have EAP which may be a resource for you as well .
good luck .

I hope I don't sound terrible here, but I'll give this a shot. You mention your mom is a narcissist. That one word can be a game changer. Caregiving is hard under the best of circumstances. But you throw narcissism into the mix and the potential caregiver(s) really need to decide if they are prepared to make caregiving their life or if the best choice they can make for themselves and their loved ones is to find a better living situation for everyone.
My BIL and SIL moved in with FIL 3 years ago. At the time it was because they needed a roof over their heads. FIL was reasonably self sufficient at the time. Fast forward a few months and anything SIL did once, was now required. FIL is a raging narcissist and even though doctors, PT, OT, and numerous other medical professionals have assured all of us that he is physically capable of doing more, he flat out refuses and has said "why should I when she is here to do it for me?". Not even "help" but "do". He LOVES having someone around to do his bidding and to blame...for everything.
Caregiving is a challenge for even the most patient person working with the sweetest, easiest patient. Please please consider the potential of how much full time caregiving even split across 3 people could explode into more than any of you are prepared to give. Consider ALL of your options before you make a move.

You and your sisters deserve to live your lives. Sister is already spending Saturdays with a difficult mother. I personally could not do this. And you are running yourself into the ground trying to keep everyone happy. This is not working. They can hire help and that is the purpose of their savings. If mother is not happy with this then oh well. Is she really ever happy with anything anyway?

Thomas, I am so glad that you are stepping back from getting sucked into what sounds like a multi-generational dysfunctional family.

Yes, you do need to step away.

Your mother is a manipulative narcissist.

You are never going to change your sisters.

You have your own family and they are your first and most important responsibility, not your parents, who actually have money.

That your parents *choose* to not use their money to pay for help is not *your* problem - it's their problem.

The 21 year old is living with your parents for free because your parents *choose* to allow him to live there for free. You aren't going to change him either.

What are you going to tell your wife (and kids?) if you lose your job because you put your parents ahead of her (and them??)?

You seem to recognize that your upbringing was dysfunctional, and the family dynamic was unhealthy. You rebuilt your life and deserve to live it.

No one, absolutely no one should be put into the position of providing care for their abuser. What was happening to you and your other sister while the older one was being abused?

Second point. Neither you nor your remaining sister have to do anything at all for your parents You are not responsible for them.

Why can't your parents make their own way to their appointments? Why can't their grandson who lives with them drive them to appointments? It is not his responsibility either, but he is right there.

It sounds like there are layers of dysfunction in your family. You need to step back and look from afar at how the dynamics are playing out. Why do you feel obligated to take a day off work to take them to appointments? Have you looked at other options for transportation? Why do you feel your sisters have a similar obligation?

Simple answers are this, your family and you take precedence over parents, siblings, nephew. It is time to step away especially since your parents do have the funds to have in home care or a move to AL facility. Does anyone have poa, medical or financial for both parents? If it's you, time to pull out the paperwork and see when it goes into effect and what you are allowed to do decision wise. Your jealous, entitled, narcissistic sister will not be able to see the forest for the trees where YOUR money and support for parents is concerned. Her and mom feel you should be footing the bill for everything. From a personal standpoint I have been thru this, husband and I financially supported his mom after his dad passed away in 1991. We took care of house taxes, insurance, fun money, and 1500 to 3000 a year to help with incidentals. Mom needs a water heater, microwave, stove, fridge, washer, dryer, new porch, a roof, toilet, sink,etc. We either bought supplies and repaired ourselves, replaced, or paid for work to be done (roof) NO ONE could ever help out but they sure could buy new cars, go out to eat all the time and go on expensive vacations. In my MIL case she really didn't have much to speak of except for social security and 200 a month pension. We supported 2 households, 2 children, lived within our means, saved for our retirement, paid our house off early by budgeting and choosing how to spend our income wisely. One SIL so deep in debt I don't think she will ever get out, but she has some great pictures of 5k a week vacations 2x a year. Other SIL is a major narcissistic pita that has an entitlement mentality that would floor most people. She tells people she did everything for her mother, no one else ever did anything for the poor lady, um did I mention that MIL lived with DH and I last 2 years of her life and sil who did it all (in her fantasy world) lives 1300 miles away. Nephew needs to step up or get out. He's 21 not 16. He's as much of a user as his mom. Apple, tree.
Time for a come to Jesus talk with mom and family. Mom pays for assistance at home or facility, which would be more economical. Nephew pays going area rental rates with a signed rental agreement or he's evicted as a squatter. You said mom is also severely depressed, has she threatened to harm herself or dad? If so time for psychiatric evaluation and treatment. Mom and narc sis feed off of each other. Your younger sister sounds like she cares for her parents unconditionally but is also still trying to win mom's approval, which will never happen so sis tries harder, mom slaps her back down in a vicious cycle only mom understands. Mom feels that YOU owe her, I'm sure with jealous sister egging her on, validating mom's belief. Get out while you can, set strong boundaries and maybe help youngest sis see she too is fighting a losing battle.

Thomas,
It is so hard, an almost impossible task to back away.
There are caregivers speaking to you who have had successes.
Unless you choose the emergency 'no contact' method to save yourself
(not advocating that --in your father's condition/cancer), this will be a battle for you.

I would like to suggest that you can educate yourself more about boundaries and narcissism (being careful not to hate the person, just the behaviors) and you can gain helpful techniques once aware of how you get sucked in and stuck.

How can this all be your fault? I am not seeing it. Not your fault.

Try not giving the narcissist information or announcing what you are planning too far in advance. [Tell the doctor at his appointment that he won't have care, but needs it. The doctor is always the one to order the care needed.]
Announcing your plans to the narcissist gives them time to twist things, forcing you to give in and change your mind. Example: " I informed everyone that this trip up tomorrow to take dad to his next procedure is my last for the foreseeable future." With that as ammo, your mother could create a crisis.

Try small changes, until you can effect changes. For example, have Dad schedule appointments for a Friday afternoon when you may be able to take off work earlier without consequences. As opposed to when Mom and Dad make the appointments. If you are going to be taking Dad at all.

The call made to the Area Agency on Aging did not go well for you. Do not give up. Call back, explain or ask: "You want to talk to the people so in need of help they cannot help themselves?". Ask them if they recommend you call APS because they will be without resources if AAA cannot help. Most people start with having meals on wheels delivered, puts a visual on their problems by an outside source. I was told that, knowing what the agencies have available to help is better than going in blind needing help, because they do not offer you a menu of available resources. An outside housekeeper can observe and report, confirm areas of need if you can get one coming in.

Each time you 'consult' a dysfunctional family member about what can be done, it is going to be like receiving darts aimed at that balloon of hope you keep trying to inflate, over and over again. Focus on what you can and are willing to do, just between you and your Dad if you are doing it for Dad.
Try saying "No" to your Mom, more and more. She has no need to be in charge of his appointment. Leave her at home, as she needs a break.

Take anything that I have said, and if possible, apply it to your situation. I know the details are not perfect or foolproof. I am understanding that you may not be able to just go 'no contact'. My sympathies.

Last note:
It is unrealistic and not sustainable to drive 2 hours, stay in a hotel, to take your father to his appointments. Been there, done that. But family will allow it! Absurd.
That leaves a huge budget for hiring a driver (ask AAA), whether you are paying or Mom is paying. Mom should be paying. But this could be part of your back-away plan, to hire a driver privately. imo.

Thomas, ask the doctor's office at tomorrow's aapointment to help your parents find resources to get dad to treatment. Tell them that your livelihood in being endangered (because it is).

Repeat this information to the doctor her/himself, that your parents HAVE resources but refuse to use them and that YOU will be stepping away.

Thomas, Losing your job puts you and your family in jeopardy, in your post this "family dynamic " of everyone putting parents care on your shoulders is not working for your wife either. Your health is also beginning to suffer because of all the stress involved. You can not help those who do not want to help themselves. I do not know if you have children of your own, if you do, help them by breaking this unhealthy cycle. Inform doc on this last visit that they have no in home care and no one to help out. That you can no longer make the 4 hr round trip for appointments that this situation is now putting your livelihood and wellbeing in jeopardy. Express concerns about mom's mental wellbeing, maybe it's more than her normal narcissistic behavior and she is actually on the road of dementia? She may be able to keep up the charade of normalcy the short amount of time you are present. You have tried to hire home healthcare in the past at your own expense to no avail. Time to let it go, chips will fall where they may. Aps may be the way to go, she refuses to get care they need be it in home or AL. At least they would be on the radar and maybe a needs assessment done.

No you should expect help. The 21 can step up and is an adult now and help. He shouldn't be off the hook either. Not a child. Maybe he can be paid a little something for his time to drive them. Im sure he will feign incompetence too. He has great teachers. So can the mom.
You need to not be available as much. I would just say I cant do it. Imp meetings I cant take time off. You can't loose your job in covid times. That is paramount. Better yet say you cant do it.. when they demand an explanation they dont have a right to one. No is a complete answer. Too bad if they whine and they will.

You keep stepping up so they keep backing off, acting incompetent, need to do something else etc.
And you cant do the hotel any more, it puts you at massive corona virus risk from mult strangers in and around the hotel and the room. They dont clean all surfaces. You could get it and give it to dad. You need your health too. You have to keep your job in these times. Corona virus is going up and up so you can't risk your parents. Your staying home. Your staying put. End of story.
If a doc appt passes without them picking up the slack so be it. They will see you are serious. They won't as long as they can keep pretending to flounder in incompetence.

You need to back off. Miss phone calls. Miss frantic dad/mom need help! What are we to do? We cant do it. Being more demanding they help, wont get you anywhere. Not stepping up will. You still can help. but every 2-3rd time. You are being competent so they don't have to. Your not even poa so stop it. Dont be surprised when daughter and son demand the house they are living in later.

You need to back off and not run every time parents need something.
I have a friend who had cancer. I dont know if everyone can get this, but she had a van come pick her up for all her treatments. Maybe you can look into that. Cant dad be more proactive in his care with the care team? Call hospital ask doc or social worker. If you cant. Then someone else can do it. Tell doc you just can't keep this up. They need to call the residence. Not you. Your stretched too thin. Take your name off as contact info.! That will be hard but do it. Your going to have to be on pins/needles till they get off their butts and help.
Remember you can't call them for a few days after they call. They will be frantic to get you to keep stepping up, and handle whatever it is. You are now unavailable. Thats all they need to know. Never ever go into to lengthy explanations. They dont need to know, or have the right to demand. Or criticize. They criticize, you are unavailable even longer.
Or say mom has made it impossible to help so your letting her step up now. Do not be available! Dont be surprised when you back off, there will be mult emergencies, and melt downs. It will be on purpose. Dont be surprised if they say they have covid, if the house is about to burn down, if dad has no one, their throwing up, he's missed 5 appts etc.
Dont answer phone for at least 48hrs.
If it was an emergency then they are closer to handle it. You know they can handle it, they dont want to. Get a back bone and dont let them walk all over you. It is not your job to fix others and their personalities. Get your name off the primary contact. it goes to their house now. Good luck

Thomas,

Thank you for replying to my earlier comment. I wanted to reply to it here, instead of replying to my own comment.

When I mentioned layers of dysfunction I was speaking from experience. My parents were well respected public figures to a degree in my small community, as well Dad was a high school teacher. He very much was a know it all and very full of himself. Mum was an active volunteer and highly regarded too. There were often in the local paper. I was considered to be a problem child because I rebelled against the abuse at home. Oh it was mostly not physical, there were few visible bruises on my skin, by my soul was damaged by decades of emotional abuse.

I have been chastened by some here for my strong stance on maintaining boundaries and not providing hands on care. I have been accused of not loving my parents, but in fact, I have learned to love and value myself.

It took thousands of dollars and hours of therapy to get to where I am now. And you know what? I am confident that the choices I have made are the best for me. Who else is going to look out for me?

Mum has stopped whining to me about not having any money, because each time she did, I reminded her she has a house worth over $300K, if she sold it at age 86, she has more than enough money to keep her going.

The #1 most important thing you wrote is "all this is having a negative impact on my marriage". That is a HUGE STOP SIGN!
This sounds too similar to the situation I was in with my wife and her need to caregive for her parents. Her brothers and sister and her Mother took full advantage of the situation and it eventually cost us our marriage.

Your issues here cannot get answered in one of these boxes.
Based on your description you are in a highly disfuntional, family. Unfortunatly your not alone. In order for your marriage and successful life you are building to survive do not be suprised if you end up breaking away from these people.

I mean this sincerely. You should stop after you read this. Sit down with your wife, the two of you find someone NOW to help you manuever thru this mine field (family) your in. I urge you to find a therapist or a clergy if you are active in a church. All the dynamics you have here can't be figured out in one of these response boxes. Check your health insurance at work it will most likely pay for some or all of the therapy.

I suggest some books:
The seven habits of highly effective families by Steven Covey
Seven Principles for making a Marriage Work Dr John Gottman
Boundaries by Dr Henry Cloud& Dr Henry Townsend
Tough times dont last tough, tough people do. Rev Robert Shuller
Don't You know who I am. Ramani Durvasula Phd

Depending on how much damage this has done to your Marriage (you may not even know how much harm has been done) there is a marriage strengthing program called Retrouvaille www.helpourmarriage.org. It is operated by the Catholic Church The actual program is conducted entirely by couples.

I urge to not ignore this. Take action now. Things WILL NOT get better. Your family will not suddenly start being respectful of you and your Marriage.

Best of Success

Sounds like you need to reexamine your priorities:

Most important human relationship - your marriage. Don't jeopardize what you have with your spouse with overwhelming responsibilities to others. Your spouse will feel neglected and the stress will bleed into this relationship.

Second most important relationship - family. Put parents and siblings on the same level of priority. Only your children will be higher in importance than parents and sibs - but always lower than spouse.

Since your parents' needs are more than any of you can handle alone, it is time for a family conference. Decide with your siblings if your parents are safe to be alone. If not, they need companions to be there all the time. Also decide if your parents' health is being adequately maintained. With a cancer diagnosis and a mental health challenge, it may be time for changes. Hire help to do the driving to and from appointments (sometimes cities and counties have special public transportation to handle this). Get more people involved in caring for your parents: family, friends, members of faith community and/or paid help. Lastly, consider that your parents' health challenges may require full time residential care: round the clock home health aides (least expensive), assisted living, or full care residential facility (most expensive). Whichever route you, your parents' resources should pay for their own care. If there is insufficient resources, talk to social work where dad is getting treatment for their help.

Thomas....welcome to the forum! You have received some excellent advice from the very caring people here. I agree 100% with the advice you have been given. Please get the book Boundaries and if your dad is receiving chemo or treatment you can get in touch with the American Cancer Society to see what services your dad would qualify for. I know they provide rides to dr appts/chemo/radiation therapies. Please contact them and ask the questions you need answers to. Also, google FOG (fear, obligation and guilt). I think that will help you understand some things as well.
There are so many good folks on the forum that have walked in your shoes, so please reach out and stay connected to the caring people that can give you suggestions and encouragement!!! Liz

Backing away may be the only real solution. Without POA and/or Dx of cognitive decline, the agencies are not likely going to talk with you. APS can try a welfare check, but if mom has all her marbles, she can refuse to let them in. Your hands are tied too - you can't make them do or pay for anything they aren't willing to do or pay for. So long as neither has cognitive decline, backing off isn't a crime! Even with dementia it isn't, but some medical professionals, social workers or APS *might* think so - it's an iffy situation to be in, but for the most part we are not our parents' keepers. If we try to help and get rebuffed, such as hiring help and mom gets rid of them, then you've tried and she has refused. Done.

Expecting siblings to help or chip in more isn't likely to change anything either. Certainly sister who has been abused shouldn't be expected to do anything. Any wonder why she ended up in an abusive relationship? Look no further than her upbringing! The other sister, showing signs similar to mom, let them work it out between them! Even the 21 yo isn't likely to step up - why should he? He's living there scot-free now, he's not likely to change now. You can ask or even demand he take on some role in their care, but I wouldn't hold my breath! You really can't force anyone else to do anything.

Your mother rules the roost, and won't pay for help. Well, when she's no longer getting her expected "free" help, she'll have to do something. She will likely ramp up demands, so you'll have to stay strong. Don't bother making any excuses, real or not, they just provide fodder for her next attack. Simple no. If she repeats, she gets a second no. If she goes for the trifecta or "hat trick", hang up. She sounds very domineering and strong willed, so be prepared for call back - don't answer. Let it go to voicemail. Given enough times, she will likely figure it out.

While it's clear dad would need medical appointments, possible on a regular basis due to the cancer, what exactly are mom's needs? You mention you "take the both to most of their more important appointments." What are her issues, above and beyond mental health? Do either of them drive? Depending on your relationship with your dad (is it better or the same as with mom?), I might be willing to help him out, but rather than jeopardizing your job or marriage, I'd figure the cost of gas, wear and tear on oneself and the car and the cost of the hotel and might find that paying for transport (only his! let mom fend for herself!) would be less expensive and certainly less time consuming. Your own mental health will benefit from this too!

Agreed it is something THEY should pay for themselves, but IF and ONLY IF my relationship with dad was okay would I consider paying if mom refuses to pay. His treatments are likely very important, so if all else fails he could at least get there and back. It might help take a little "guilt" off you if you could provide that - but again, it is highly dependent on how you feel about him and whether it is important enough to ensure he gets treatments. Mom may reject them as well, when they show up to drive dad.

Definitely stick with that back off plan. IF she ever "comes to her senses" and realizes she needs to be nicer to get you back, weigh each request carefully. NO is a complete sentence. Use it if you must! You still have the final say. Send a list of numbers for drivers/taxis/community vans.

ThomasJB,
I apologize in advance for not having read the previous responses!

First off, there is nothing wrong with you!!!
It's understandable how you could feel overwhelmed with the situation.

Is it possible for the 21 year old to help with Doctors appointments?
If not, why not try Uber etc...?
There are agencies that will help with transportation for a nominal fee.

The sibling dynamics are extremely difficult!
I can tell you that as the only daughter with 3 brothers, they all thought that I was the chosen one.
In a way, they were right!
What my brothers didn't understand was that I was chosen to be the emotional support dog.
Years of criticism and guilt.
Each of your siblings may have had an entirely different experience growing up!
So please be guick to listen and slow to respond!
My point is that you have practical solutions!
Before you let this situation tear your family apart, search for those solutions.

Wishing you all the best!!

Normal decent parents love and make sacrifice to help their children. On the other hand, narcissistic parents eat their young for pleasure. How sick is that!

Thomas,
I decided that you may just need a very little support.

I fully support your plan as stated:
" I informed everyone that this trip up tomorrow to take dad to his next procedure is my last for the foreseeable future." 

You've got this!

I'd. Suggest your freeloading nephew to take mom and dad to their appointments. There is senior service folks you could hire that could possibly help with transportation. Don't let yourself become a victim to others laziness. Good luck!