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not even 2 months ago my sister was doing well. She was driving, she was cleaning up her house, she was eating. Now she refuses her PT. is bed bound and stuck in the hospital. They have decided to put her in a rehab facility because she does not even try. She calls and begs me for things and to come and visit with her. When I do, all she does is sleep and ring the nurses for snacks and to hold her hand.My sister is 67, with two teenage adopted children. Her house looks like a storm hit it, and her partner does not clean up. It smells like urine and unwashed VJay jay, and the pets are allowed to go to the bathroom in their kennels. The teenagers ignore the cleaning of them. I am tired and worn out. I keep asking can I come over and clean the house at least, but I am met with stern no's.

You say:
"They have decided to put her in a rehab facility because she does not even try."
She will not last long in rehab.
When you speak to your sister about her lack of trying, what does she say to you?
Does your sister seem to you to be depressed?
Does your sister have a POA?
What does your sisters (grown I assume) children have to say about her current mental state?
Do they believe she is depressed.

The sad truth is, young as she is, Diabetes has already taken her kidneys. Her heart and other systems will follow; she may be faced with amputations. She may no longer wish to live. She may well be "over it". Have you discussed her feelings with her? Does she have an advance directive? Does she understand that she can refuse dialysis, which would result in her death?

Quite honestly, life can become too difficult to manage for some people with chronic illnesses. I have often seen this as a nurse. I do not think it is unreasonable to be ready to exit when life is too difficult.
With support and talking and perhaps therapy, a try at anti depressant, your sister may regain some home. But I suspect here a lot is not being talked about.

You have brought this to a forum of strangers, when it is best you bring this to your sister in that "I love you and I worry for you. You are changing and the state of your home shows me that you are feeling hopeless and may not care any longers. Can you talk to me about your feelings?"
WHEN SHE DOES TALK TO YOU do not negate what she says. Recognize she may feel helpless. Tell her you understand that, but that together you can seek help both for the conditions she is living in and for her mental well being. Tell her you want to help her, and to think of ways in which you are able to. Then leave her to think a bit.
And understand if the fact is that your sister no longer wishes to go on as she is.

I am so sorry. This is dreadful to stand witness to. As Dr. Laura says, not everything can be fixed, there are not answers for every single thing.
Again. I am so sorry. 
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Reply to AlvaDeer
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lealonnie1 Nov 20, 2024
"My sister is 67, with two teenage adopted children."
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If this were me, knowing sissy is in rehab, I'd hire Merry Maids on my dime to get into her house and clean it completely. Too bad she says No. Just don't ask.

Then I'd have a Come To Jesus Meeting with the kids and the husband, if there is one, about pitching in to KEEP the house and the kennels clean. If these animals are living in kennels 24/7, they may as well be adopted out themselves because that's abusive to leave them locked up in their own filth all day in cramped conditions. Let the kids know that, and that they need to clean the kennels NOW bc Merry Maids do not do such things.

That's what I'D do because I'm me and I care about such things and my family members. Then I'd March over to the rehab and read sissy the riot act too. If she's depressed, there is help for that. She has a responsibility to her children to be fully THERE for them. Otherwise, CPS can get involved and take them away if she can't or won't get her act together. If not for her, for her kids. She took ON the responsibility of caring for these children by adopting them, and now they're alone? They CAN be taken away from her, and she should be reminded of that. These 2 kids should not be abandoned AGAIN in their life.

Sometimes tough love is vital to wake a person up out of their pity party mode. This seems to be one of those times.

Best of luck to you.
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I'm sorry you are going through this.

I will say one thing, I have no clue what it feels like to be 67 and dialysis, I here it's extremely hard and unpleasant. I suspect I would just give up and want to die. So please don't take this out on your sister. It's her husband that needs to step up, take control, get a home cleaner. Make a better life for those children. In my book this is not your sisters fault.

You could try talking to her husband, or you could call CPS have the kids checked on by them.

Your sister needs help, not judgment.
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JeanLouise Nov 26, 2024
The pets are being neglected as well. Confined to a kennel in their own filth is inhumane.
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Stay out of it.

You didn’t cause this and you can’t fix this.
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Reply to anonymous144448
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My mom is fond of saying "old" isn't an age, it's a state of mind. When you reach a certain point in life, especially if you have a chronic illness, or if you have battled mental health issues your entire life - if just "one more thing" happens to you - it can often be the straw that breaks the camel's back so to speak.

Faced with a remaining "lifetime" on dialysis if there is no hope of any other option - she may have given up hope or decided her options are limited. I've watched it happen with several family members. Once they've made up their minds that they aren't going to get better, they do what I call "sitting down and never getting back up". What I mean by that is that while they are still living, they decide that they aren't going to expend any energy actually living. They do the bare minimum of existing. If there is pain or if they don't have any energy - they may not have the ability to actually do the work needed to feel better - it's a catch-22. We tell them if they moved more they would feel less pain, if they got out of the house or got some fresh air, they would have more energy. But they hurt too much or are too tired to do any of those things.


Your sister is allowed to make that decision - no matter how ill-advised or unfortunate it may be.

But I agree with Slartibartfast - if her partner is not going to do anything to ensure a safe environment for those children - someone needs to step in and make sure the teenagers have a safe home. If what you are describing is their home environment - I've seen APS make home visits and actually take into consideration the emergent health issues of the parents - allowing time and interventions to get the home back up to par without removing the children in order to keep the family intact.
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Reply to BlueEyedGirl94
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Rehab will not keep her if she does not impove or does not attempt to imrove, She will be discharged and will have to go home or to a LTC facility if youcan find one.

Was there a specific episode that put her in the hospital? Why is she bed bound? She sounds depressed which can make not want to try to improve. Your description of the condition of the home, sounds like she was depressed already.
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Reply to RedVanAnnie
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Your sister can make her own decisions but those teenagers need help. If you're not prepared to offer them a clean place to stay for a while (which is fine) you could call their school and let them know what's happening at home or call child protective services to pay a visit. Child neglect is a kind of child abuse, as is the nasty environment you describe.
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Reply to Slartibartfast
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Oh Sharon, Don't go clean your sister's house. Why do you want to so badly?
You don't have to live there. Don't worry about it.

And, stop coming to visit her when she begs! And don't bring her things she wants.

Your sister needs to take an active part in getting better or she will not get better.

Let her go to rehab. Most hospitals will not keep a patient for rehab. Their job is to get a person medically stable and get them out of the hospital. Often, a rehab facility is the next step. That's where she needs to be. And if she continues to refuse to cooperate with recovery therapies, she will be discharged from there as well.

I can see how much you care about your sister. Unfortunately, there is not much you can do if she is unwilling to work on her own recovery. You can serve her best by having the tough conversation with her and let her know what she is facing if she gives up trying. You can give her encouragement if that will help her. But do not let her manipulate you into being part of her fantasy to be waited on in a hospital indefinitely. You can't fix this, and you can't fix her home for her. Just be her sister and let her know you love her.
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Reply to CaringWifeAZ
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Being a young 65 year old myself I find it so interesting that someone at just 67 years of age has no motivation to get better to try and enjoy whatever time she has left in this world.
To me it definitely sounds like she's suffering from depression. Is she being treated for that, and if not why not?
You cannot make someone do something that they don't want to do, and if your sister has given up on life, other than anti-depressants to try and help, there really isn't much else you can do.
Perhaps if you mention bringing hospice on board for her telling her that if she doesn't try to get better that in fact she will die, so perhaps it's time to bring them on board, and see what her reaction will be.
It may just be the wakeup call that she needs to understand that this situation is in fact very serious.
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Reply to funkygrandma59
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JOANGRABE Nov 26, 2024
She is on dialysis which means she has end stage kidney disease. Dialysis itself is debilitating and in the long run stopped by the patients themselves. Our family just went through this recently when my nephew with advanced heart and kidney disease went to his last dialysis just to say goodbye to the staff.
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What you should do is prepare yourself knowing that if your sister continues to refuse PT she will continue to decline and her life will be shortened by HER decisions.
You can encourage her to do the PT but you can't do it for her.
I would also make sure that she has all her "legal ducks in a row" does she have a Will and has a POA been appointed for both Finances and Health? She should do that ASAP.
Does she own the house that her children and partner are living in? If she owns it it may have to be sold to pay for her care. Medicare / Medicaid will not pay for rehab is she is not participating or if she is not progressing.
Has she planned her Funeral?
Does she have her Medical directives written, a POLST or other document stating what her wishes are. Does she want CPR? Does she want to intubated? Does she want artificial nutrition> If she wants any of these does she want them as a trial or a permanent method of keeping her alive?
maybe asking these questions might inspire her. If not you have to accept that she is making the choice to give up
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