My bossy sister can't cope any more

I'm afraid there is nothing you can do to change her way of thinking. I know a number of people in their eighties who won't have any kind of paid help. Often they run their relatives into the ground too, especially their children, who are no Spring chickens themselves!
Usually they do make themselves ill and then the help is forced upon them by circumstances. It's not nice to watch it happening but I've not found a way to make them change yet!

Playing devil’s advocate on your sister’s behalf for a moment. When does being strong, independent, competent and self reliant decline into “bossy” or “controlling”?
Obviously I do not know your sister but I have a sneaking admiration for her spirit, her refusal to admit she is unable to cope and her optimism that somehow things will come right.
Maybe she is in denial or maybe that is what is keeping her going?
I have to admit I’m a wee bit like that! Refused to accept it was time to choose the hymns when paw seemed close to the edge earlier this summer, refused to accept unquestioningly the diagnosis of an illness with at best a prognosis of months (he’s still here) and deep down thinking that things might improve.
The anger could be fuelling her adrenaline and I would be very careful (as I am sure you are) of in any way undermining her fierce independence. At first I also resented being “invaded”by Carers, physios, district nurses and all and sundry. It is partly having the reins taken out of one’s hands. Her generation (ours!) was brought up to get on with it, weren’t we?
Of course rejecting the cleaner was nonsense (is she still free?) but perhaps she needs to be allowed to remain in the driving seat in what is a new and scary situation.
Just saying.
But good luck to you all

Yes MawBroon, you're right, generally that is what has kept her going for most of her life! But in the present circumstances it's not working, which makes her try even harder, getting desperate & running around like a headless chicken. It's this that is making her ill. There's no talking to her, her mind is so full of things to worry about and try to change. I'm trying to think of a strategy to get her to focus on a few things that are really important (like the cleaner!) to help her cope. Like you say, it has to be done tactfully.

Maybe come from the angle that having a cleaner would free up her time so that she could spend more time with her DH, as he's presently poorly its unlikely that he will care if the kitchen floor is gleaming or the bathroom sparkles.
What is his opinion on the situation? The carers are there for his safe welfare and recovery not just to take over her role.
Also you could point out that if she herself becomes unwell she would have to relinquish her responsibilities anyway.
It may be diplomatic to give the impression that you regard this as a temporary solution. Good luck.

I think Maw is spot on.

I have spent a lot of my life around bossy boots, and all you can do is back off.
You have done your research, so the information is there if needed.
Make sure you stay in touch - phone as often as seems reasonable, within what would be a normal pattern (obviously more often than usual). Let her know that you are happy to offer such advice and help as she wishes. Don't try to tell her that things won't get back to normal - she will find out! If by any chance there is a little space when she appears to want advice, keep it for the most necessary thing!

Does she appear to want any practical help from you or her daughter? If so, be very careful about what you offer. I would suggest saying you can do nothing; but if say, staying for a few days would enable a conversation about who will help when you are gone, it might be useful.

My experience with people like this is that the more you suggest stuff, the more they play the 'yes, but..' game, and then can't back down. Better to sympathise that cleaners never do a job to such high standards (cross your fingers and give a mental apology to cleaners!) and wait for the penny to drop.
When it does, just be there to comfort her.

I'd also suggest that your niece tries to have a conversation with her dad about what he wants.

Its a combination of pride and denial. Your sister has always been in control and the thought of anyone else 'taking over' is scaring her to the point she cannot look at it objectively and accept defeat in any area.

You can just offer......let her know you are around IF she needs you and then leave her to it!

She may (or may not) reach the conclusion that she cannot cope on her own and will reach out for help but unless she does, constant pressure from you and her DD will add to her determination to see it through alone.....

Very independent people do resist the attempts of others to help. They see it as failure somehow.

No matter how hard it is for you both, I think you need to step back and respect her wishes. Once she feels 'in control' she may back down and admit...she needs help.

It’s very hard to accept others in your house as Mawbroon says, they don’t do things your way etc etc. It’s also tough to accept that you need help to look after the man you married all those years ago!

Good post Nannarose - my experience exactly with my now deceased elder sister. She was independent to the end and non-receptive to any suggestion or offer of help. She died suddenly of a brain aneurism at the age of 82. She had been a bossy boots always; being the eldest of five of us I suppose could have lead to that.

There is no helping people with that mind set so it's best just to make soothing noises and be there if circumstances arise allowing that.

Also Bluegal's post - spot on too.

Not a lot you can do. My old Uncle who I cared for was the very same. He wouldn't take any advice/help, to the point where it was stressing the rest of the family. He ended up having a stroke! (Nightmare getting him to go to hospital!!) He survived and recovered and only then realised he needed help!

Thank you all for the helpful comments and sensible suggestions. The irony is that sister's DH is quite content to sit and snooze or read a paper, now his surgery is successfully over and he is not in any pain. He can't do much, but at almost 90 and after major surgery, that's not very surprising! His DD has talked with him and he doesn't mind being confined to home. He has always been a quiet man, and I get the definite impression he is happier just to be left in peace. He has a pleasant comfy sunny bedroom, his radio and his paper. He is courteous to the carers (it seems always to be a different one!) & doesn't seem to mind them. It's only my sister who is so upset and anxiety ridden, but I think you are all right. It's how she deals with life, and all we can do is be there as a support network if she eventually admits she could do with some assistance. Gransnet is a great source of comfort when you hit difficult situations!

Nothing you can do unfortunately I know it's worrying for you and for your niece her daughter but if she won't listen there is nothing you can do.

I am in the position of advising someone that they are going to need care when they get out of hospital and he's not happy. The last time he was in this situation he didn't like that there were different carers all the time. He woke up one morning with two carers in the bedroom asking why he wasn't up yet. He had been awake in the night and had popped back to bed for a while. That is demoralising and I would hate it too. I hope I never have to face that or at least not for a very long time.

I think you should leave your sister to do it her way as long as the house isn't unhygienic and try not to worry so much. Would she agree to having a cleaner/cleaners do a deep clean occasionally and all she had to do then was to keep it looking good until the next deep clean? That's what I do.

As long as she is still reasonably competent, mentally and physically, there's not much you can do, as others have said. I think you've been given some excellent advice here, and I'm glad you've decided to take it. Best of luck to you and yours!