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My mother, age 83, has dementia. Sometimes she’s incredibly lucid and we can have cohesive conversations. But five minutes later she may not recall them at all. I have three siblings all of whom live nearby and we are all are spending extra time with mom. However, we’re reaching the point where she requires some assistance and supervision in her home over and beyond what the four of us can offer. We agree on that. But how to proceed with her care is another matter.

My brother wants to go ahead and engage the necessary services and health care aids without taking the time to consult our mother. I disagree and feel strongly that she should be part of the decision making, even though her judgement might be impaired. Does it matter which way we get going or am I just creating more work for us? Maria G., Miami, FL.

First of all, be grateful that your siblings are nearby and want to participate in your mother’s care. That’s a wonderful place to start and your mother is most fortunate to have her children's full support.

It’s not a surprise that four of you might have different ways of wanting to accomplish the same goal, which is to keep your mother safe and content. That is why I often recommend dividing up the many responsibilities of caregiving tasks according to each sibling’s availability and experience so that each piece runs smoothly.

I do recommend including your mother in important decisions to the extent that it is possible. I would begin a conversation about hiring companion care by expressing your concern for her safety and your own fear that you and your siblings might not be available at the moment she most needs help. If you have caught her at a moment of lucidity, you’ll know that she understood or that she was informed. Should she resist the help at a later point, you can comfortably remind her that this is something you discussed with her.

In the meantime, getting your mother the help she needs is a priority and you should move ahead with a plan as soon as you can. To help her adjust to the presence of helpers in her home, I suggest that you or one of your siblings be present for the first few days.

If your mother hasn't already had a comprehensive evaluation, I'd recommend that she have one by a physician who is trained and experienced in memory disorders. From it you can learn where your mother is on the spectrum of the disease. Equally as important, it will help you and your siblings understand the challenges you can expect in the future as well as help to plan for her future needs, both financially and logistically.