Dear Carol: I am a 75-year-old woman living at home with my 96-year-old mother. Mom has dementia and needs around-the-clock care. My younger brother, who lives 500 miles away and only visits twice a year, insists that Mom should be cared for by family for as long as possible. His contribution is doing the financial management online.

I worry that I could fall or have a heart attack and Mom wouldn't be able to call for help. I’m in reasonable health, but I do have some risk factors. My doctor is concerned about my being a full-time caregiver at my age, but my brother insists on “the two of us” continuing to care for Mom, with me doing the on-site physical part. I’ve been grateful to be able to help but I can’t keep this up much longer. My brother says that I’m selfish for wanting to “give up on Mom.” Am I? — RT.

Dear RT: It’s stunning to me how many siblings or other family members who are not direct, hands-on caregivers for aging parents insist that the parent must continue to have only family care at home. Some of them have this attitude because they genuinely love the parent and are simply clueless about what day in, day out caregiving takes out of the person most involved with the care. Sadly, some are simply looking at the financial aspects and realize how much money this would save. I’ll be kind and place your brother in the first group.

Whatever your brother’s reasoning, he needs his eyes opened about the risks of this arrangement, both for you and for your mom. Would it be possible to have your doctor write a letter to you telling you that you must make changes for your own health as well as your mom’s safety? Sharing such a document with your brother may open his eyes.

As you’ve noted, even if you are healthy, your age does put you at more risk for health events, so it makes sense to wonder what happens should you fall, have a heart attack, or experience any other health emergency. You could die because your mom can’t get help for you, and she could die alone because she’s unable to care for herself or even make a call. Dramatic, yes, but such things happen.

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If your brother won’t listen to you or your doctor, seek a family friend or religious leader who may have more influence. Alternately, you could hire a geriatric care manager to assess your situation and then explain to your brother the realistic choices that need to be made as soon as possible.

You could start with in-home care for your mom and then expand with plans for a care facility where you could help her get settled. Then, you'd still be able to care for your mother in a setting that’s safe for both of you. It’s just a different arrangement.

For now, I hope you have someone who checks in with you at least twice a day.

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at She can be reached through the contact form on her website.