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I will say one thing, I have no clue what it feels like to be 67 and dialysis, I here it's extremely hard and unpleasant. I suspect I would just give up and want to die. So please don't take this out on your sister. It's her husband that needs to step up, take control, get a home cleaner. Make a better life for those children. In my book this is not your sisters fault.
You could try talking to her husband, or you could call CPS have the kids checked on by them.
Your sister needs help, not judgment.
Faced with a remaining "lifetime" on dialysis if there is no hope of any other option - she may have given up hope or decided her options are limited. I've watched it happen with several family members. Once they've made up their minds that they aren't going to get better, they do what I call "sitting down and never getting back up". What I mean by that is that while they are still living, they decide that they aren't going to expend any energy actually living. They do the bare minimum of existing. If there is pain or if they don't have any energy - they may not have the ability to actually do the work needed to feel better - it's a catch-22. We tell them if they moved more they would feel less pain, if they got out of the house or got some fresh air, they would have more energy. But they hurt too much or are too tired to do any of those things.
Your sister is allowed to make that decision - no matter how ill-advised or unfortunate it may be.
But I agree with Slartibartfast - if her partner is not going to do anything to ensure a safe environment for those children - someone needs to step in and make sure the teenagers have a safe home. If what you are describing is their home environment - I've seen APS make home visits and actually take into consideration the emergent health issues of the parents - allowing time and interventions to get the home back up to par without removing the children in order to keep the family intact.
Then I'd have a Come To Jesus Meeting with the kids and the husband, if there is one, about pitching in to KEEP the house and the kennels clean. If these animals are living in kennels 24/7, they may as well be adopted out themselves because that's abusive to leave them locked up in their own filth all day in cramped conditions. Let the kids know that, and that they need to clean the kennels NOW bc Merry Maids do not do such things.
That's what I'D do because I'm me and I care about such things and my family members. Then I'd March over to the rehab and read sissy the riot act too. If she's depressed, there is help for that. She has a responsibility to her children to be fully THERE for them. Otherwise, CPS can get involved and take them away if she can't or won't get her act together. If not for her, for her kids. She took ON the responsibility of caring for these children by adopting them, and now they're alone? They CAN be taken away from her, and she should be reminded of that. These 2 kids should not be abandoned AGAIN in their life.
Sometimes tough love is vital to wake a person up out of their pity party mode. This seems to be one of those times.
Best of luck to you.
You didn’t cause this and you can’t fix this.
"They have decided to put her in a rehab facility because she does not even try."
She will not last long in rehab.
When you speak to your sister about her lack of trying, what does she say to you?
Does your sister seem to you to be depressed?
Does your sister have a POA?
What does your sisters (grown I assume) children have to say about her current mental state?
Do they believe she is depressed.
The sad truth is, young as she is, Diabetes has already taken her kidneys. Her heart and other systems will follow; she may be faced with amputations. She may no longer wish to live. She may well be "over it". Have you discussed her feelings with her? Does she have an advance directive? Does she understand that she can refuse dialysis, which would result in her death?
Quite honestly, life can become too difficult to manage for some people with chronic illnesses. I have often seen this as a nurse. I do not think it is unreasonable to be ready to exit when life is too difficult.
With support and talking and perhaps therapy, a try at anti depressant, your sister may regain some home. But I suspect here a lot is not being talked about.
You have brought this to a forum of strangers, when it is best you bring this to your sister in that "I love you and I worry for you. You are changing and the state of your home shows me that you are feeling hopeless and may not care any longers. Can you talk to me about your feelings?"
WHEN SHE DOES TALK TO YOU do not negate what she says. Recognize she may feel helpless. Tell her you understand that, but that together you can seek help both for the conditions she is living in and for her mental well being. Tell her you want to help her, and to think of ways in which you are able to. Then leave her to think a bit.
And understand if the fact is that your sister no longer wishes to go on as she is.
I am so sorry. This is dreadful to stand witness to. As Dr. Laura says, not everything can be fixed, there are not answers for every single thing.
Again. I am so sorry.
To me it definitely sounds like she's suffering from depression. Is she being treated for that, and if not why not?
You cannot make someone do something that they don't want to do, and if your sister has given up on life, other than anti-depressants to try and help, there really isn't much else you can do.
Perhaps if you mention bringing hospice on board for her telling her that if she doesn't try to get better that in fact she will die, so perhaps it's time to bring them on board, and see what her reaction will be.
It may just be the wakeup call that she needs to understand that this situation is in fact very serious.