Dear Scooby
You are probably not going to like this, but there is no gentle way of saying it: You actually have very little say in the future treatment of your sister, it is for your brother in law to have to make the decision and he won't have arrived at that conclusion without torturing himself.
It is fantastic that you and your other sister are at least involved in taking some of the caring responsibilities - so many families abandon the thought of involvement at all. But if you can try to imagine the stresses of taking care of your sister during the week and multiply this by 24 hours each day (hours no mental health professional would be called on to nurse) you can begin to see the problem.
No, you don't want to see her in a nursing home any more than any of us want our loved ones because you may be looking at it in the negative - a sense of letting her down. But wouldn't the situation be better for everybody if a good nursing home could be found wherein she was looked after around the clock, more at peace, and where you could all spend some quality time with her instead of the angst you are all suffering. How would that be letting her down? That's making sure she has every available treatment for her illness - the same as you would do with any other illness. That's the positive.
My mother, whom I love so terribly deeply it grieves me to even type this (that's my emotional), had become so ill with AD to the point past the aggression, she was a danger to herself, barely knew anybody or anything anymore. Dad looked after her at home and I visited to help each day. I had always promised that I would look after her at home, whatever. She's my Mum, I owed her a huge debt of love and care. Well, I learned the hard way, never to say 'never'. The 24 hour nursing care needed could not be afforded at home. Eighteen months ago she was admitted to an EMI nursing home, close enough to visit (10 mins away) any time we want, every day. This was at a time when all the professionals wondered how we had managed at home for such a long time - we did our best with love as does everybody dealing with this mental illness. But in the final analysis we were all going under - to the point of breakdown. We're still reeling from it today. That's the emotional.
The practical? Mum sleeps, eats reasonably well, is clean and always well-dressed and all other peripherals are catered for - opticians, GP calls, etc. We get the good bits, the best parts of Mum, and we are able to know that she is safe. And yes, we can then walk away, but then we walk back again when we feel like it or feel that she might need something or just to say, hello! And Dad? Well, he grieves, feels the sense of loss, the empty space in the bed, a shared private joke, so many memories. Me? I feel like a child of a broken home - and I'm no spring chicken!
When finally being forced into a no win situation, Dad was shored up by all of his family - daughters, sons in law, collectively letting him know that we would support any decision he made and nobody would ever point a finger. I think that meant a lot to him. Apart from when I come over all emotional in the privacy of my own home and go into rant mode to get it out of my system I have held fast to this (I sometimes romance the idea that I could still bring her home and care for her 24/7 and my partner indulges this - it eventually passes once out of my system). It's important to Dad to know that he did his very very best - because he did! We all did! But never believe it was a throw-away decision.
Your sister is lucky to have such a loving family and your brother in law your support. Try to work together in the best interests of your sister and everybody - and all of this love will get you through the whole horrible process. Hold on to that.
Thinking of you all
Chesca
