CHAPTER 134

2026-03-05

When parents grow old and need to move into a care facility, conflicts of core interests often get in the way, and a rift between brothers becomes hard to avoid.

In early October 2017, my mother suddenly developed inflammation in one of her fingers. It swelled like sausage. She was sent to the emergency department for treatment and had to go to the hospital every day for intravenous antibiotics. Because of her advanced age and frailty, her condition could deteriorate rapidly, with the risk of sepsis. Toward the end of the month, my fourth younger brother and I discussed the situation and concluded that Mother urgently needed full-time care. My fourth brother immediately informed the regional health authority and applied for her to be admitted to a nursing home as soon as possible. The application was approved.

Within a month—by the end of November—she moved into the nursing home. My fifth younger brother felt it was not good for Father to remain alone at home. I replied that we could only deal with one matter at a time, handling the most urgent issues first and responding to situations as they arose.

One week after Mother was admitted, the resident doctor asked to meet with us. He explained that the average length of stay in the nursing home (that is, the average survival time) was eighteen months. Since Mother had already suffered from dementia for four years, her illness had progressed beyond the halfway point, and her stay might be less than a year.

I was shocked to learn that Mother might have “little time left.” After returning home, I sent an email to inform all my brothers. To my surprise, no one replied except my PhD-holding brother, who wrote only two short sentences, one of which was: “We will all be like this one day.”

The organization had forty years of service experience, though the facility itself was only one year old. All rooms were private, and the service was first-rate. When Father visited, he praised it repeatedly, saying Mother seemed to be living in a hotel. After she had stayed there for more than a month, the family learned that the government fully subsidized the nursing home fees. Mother paid just over CAD 1,300 per month, leaving a few hundred dollars for daily miscellaneous expenses. The family only had to pay for adult diapers and protective underwear to prevent injuries from falls. (The actual cost of care was CAD 6,500 per month.)

At the beginning of 2018, all the brothers received an email from the fifth brother. He said Father had had a poor appetite for some time and might be suffering from anorexia. He suggested that I take Father to the emergency department and tell the doctor that Father had this condition, which might allow him to move into a nursing home sooner. His exact words were: “It may work.”

As a social worker, I understood the situation well. I replied by email to all my brothers (including the three living overseas), explaining in detail the actual procedures for psychiatric admission locally. At eighty-nine years old, Father did not have anorexia. Admission to institutional care was not the only option, and in any case, he was far from meeting the criteria for hospital treatment.

Apart from my fourth brother’s family, who were traveling abroad for several weeks, the other four brothers did not respond at all. Later, they proposed increasing the value of Father’s vacant house—repainting it, cutting trees, rebuilding the flower beds, and replacing the roof. I asked Father about this, and he replied, “Whether to sell the house depends on the market. There’s no need to do too much.” A true businessman to the core.

In early February, the regional home-care services manager (a professional nurse) came as scheduled to assess whether Father qualified to apply for admission to a care facility. She spent three hours observing him, conducting an on-site questionnaire assessment, and completing diagnostic forms. Her conclusion was that Father’s condition was very good. He did not meet the minimum requirement even for Assisted Living, let alone for a long-term nursing home with intensive care.

When Father learned that he could not move into the same facility as Mother and that they could not be reunited, and that he still had to live alone, he was very disappointed. That day I tried to comfort him, saying, “The nurse says you’re too alert and too sharp to be admitted.”

Because Father feared loneliness, he was willing to pay privately to live in a retirement residence. The next day I began looking for suitable places and kept everyone informed, but no one responded—until they heard about the monthly rent, which finally brought objections.

When core interests stand in the way, a rift between brothers is hard to avoid.