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Ethical dilemma


Registered User
Sep 9, 2015
Help, I am the sister, to a lady going through a diagnosis for early onset alzheimers, she has a difficult relationship with her husband and has two distant adult children. Despite considerable effort on my part to get her husband on side, he is not supporting her and still operating in a very selfish way, leading to her disassociating as a coping strategy in situations where she has no control, exacerbating her memory problems. The NHS are reluctant to offer her long term counselling because with the exception of me she lacks the self support and environmental support to embark on the therapeutic journey and - dare I say it - with the potential outcome of ending her relationship. Despite my wish to be boundaried about the situation,hoping her children will step into the breach, when asked who she wants to be her next of kin, despite her significant cognitive issues she says she wants me to do it.Having been through a similar situation with my mother and step father( where I seemed to have responsibility but no mandate) and having recently left an abusive relationship myself I am struggling with my own personal issues and the 'herding cats' nature of trying to manage her husband, I am really struggling.Having been in this situation twice , I am assuming others have been on the same path , so am seeking some advice/ solace/ empathy. If the NHS say no to long term therapy due to the possible consequences of it , should I do the same? And how do I deal with that, knowing my sister's desire for me to take care of her - how do I make the decision between a rock and a hard place for a person who cannot make her needs known ?


Registered User
Jan 20, 2014
Hi and welcome to TP. I can understand how you feel stuck with this problem and I sympathise although offer no solution.
However I am slightly confused by what you feel your sister needs. If she has dementia, then counselling/therapy may not be the route she needs to take and that would explain why it isn't being offered. However, she will need help from a variety of health specialists who deal with dementia. If her husband is not in board, then social services need to become involved at some point with her care. I found talking to an admiral nurse extremely useful, if there is one in your area, they offer help and support to family members such as yourself.


Registered User
Mar 1, 2013
West Hertfordshire
Are you sure that she, with dementia, can nominate a NOK? Can anyone? I thought that NOK would be her husband by definition.
After her husband would surely come her children?

NOK isn't someone you nominate, its one of those 'default settings' Isn't it?
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Registered User
Oct 18, 2010
North East England
Counselling may be of limited benefit to your sister, depending upon the range of retention of information she is displaying. Medication, in the form of Donepezil or perhaps an antidepressant may be of some help, providing it is Alzheimer's and not any of the other forms. There are other medications which may provide relief from some of the other symptoms.
As far as support from her family is concerned, sadly no one can make this work. The support may be provided ( and often is) unwillingly but from a sense of duty. I suggest that, for now you stay back from day to day caring, still keeping in contact, and watch how things progress. This way you could step in if needed, but the rest of the family may learn to cope by themselves rather than " Oh Auntie can do it, she's an expert at it" :rolleyes:

Despite your sister's affirmation that she wants you as NOK ( and I wonder if she means Power of Attorney by this), you don't have to take any legally responsive role. You can simply stay a caring and loving sister. ..... but try to make sure that someone is granted LPA.

Take care...Maureen.

By the way, I admire you for wanting to help. You have had an awful lot to contend with recently and perhaps you need to have some " me" time before becoming fully involved with your sister's care. .....and Welcome to TP. :)
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