We're one dead dog short of a sad country song

May 29, 2012 9:44 AM

How can I best support my siblings, who are managing my parents while I live almost 1,000 miles away?

Less than 3 months ago I moved with my family (husband and child) about a 1000 miles away from my parents and siblings. It was a career move for my husband and returning home is not an option. It is a long term job (think tenure). There are three of us children: older sister, little brother and me. We (the siblings) are late 20's-mid 30's, my parents are in their late 50's, so not elderly. My sister is married, has a two year old and works in the service industry (so difficult hours). My brother is single and also works in the service industry, so also weird hours.

My mom was diagnosed with stage 4 cervical cancer in April of 2010. She has been cancer free since her treatment ended, but it popped back up in May of this year. She began chemo last week. My sister spends one of her two days off a week taking my mom to Chemo and sitting with her. My dad works M-F, so can't really do this, nor would he want to. The facility is really a ladies zone. I did half of the chemo treatments with her last go round and very rarely saw men in the facility. So, now my sister has this task solely on her, and I'm not around to alleviate any of that stress or help out--going to appointments, taking her to chemo, etc. My brother has never been there and just doesn't really show an interest in going with her (which again, ladies zone).

Fast forward to this Sunday. My dad was taken to the hospital by ambulance for a possible heart attack. He's had 3 prior heart attacks, the most recent one was 10 years ago and he had 7 bypasses. He's not overweight, but does smoke, and just generally isn't as good at taking care of himself as he could/should be. We are still awaiting test results to find out exactly what happened. My sister and her husband both had to leave work immediately so her husband could pick up their daughter from my mom, and my sister went to the hospital with my mom.

Then, this morning, I contact my mom and sister about 10am. No one is back at the hospital, and no one knows what is going on. My dad is not answering his cell phone, so they're just like "well, he's not answering his phone!" They both sleep late, my mom due to chemo and anxiety (doesn't sleep well at night), and my sister because she works nights. While that was frustrating, I didn't say anything, because really, what can I say? I'm not there.

And, of course, there are some financial issues. My mom is on LTD, my dad does not bring home a lot, and there's the cost of living and medical expenses. So, my sister and I have both lent them money (well, I gave, she thinks they might pay her back someday). My brother is really not in a position to help them financially right now, and he's at that point where he carries some resentment toward my parents for not being the most responsible people on earth.

But, to get to the point of it, how do I help my sister with this? Are any of you caregivers for your parents with out of town siblings? Is there anything they do that makes your life easier? I can only tell her I'm sorry I'm not there so many times, and I think that just makes her more frustrated when I say it.

Sorry for the long background, I just wanted to try to lay out a full picture.

posted by fyrebelley to human relations (18 answers total)

My mom is currently her mom's caretaker; her sisters live out of town. I'm sorry your family is dealing with all this stress. It totally sucks.

Helpful things:
- How often can you visit? Every six weeks is a good interval to give your sister a break to look forward to with day-to-day tasks, while letting them get into a rhythm between visits.
- Send money. I think this is not a time when you'll regret generosity. Don't go into debt, of course, but recognize that this caretaking is impacting your sister's finances in subtle ways -- from missing work to having to order takeout because no one has time to cook. If contributing financially is possible, it might help for you to take more of that on and relieve her.
- Stop apologizing (your sister knows you have to be far away; she probably understands that you feel bad), but be an open ear for her to vent. Caretaking is hard, annoying work. Complaining is something she may want to do to let off steam. You can use your distance to suggest some fixes (can your mom take something to help her anxiety or to sleep?), but in my experience the best thing is just to be a helpful, sympathetic ear.

This is a difficult, life-changing time for you too, dealing with your parents' mortality in an immediate way. If you are open to therapy, it might be helpful to have a neutral space in which to sort through your feelings. I hope your parents get better.
posted by purpleclover at 10:01 AM on May 29, 2012 [5 favorites]

Just wanted to say, if something serious happened to your dad overnight your mom or sister would have gotten a call from the hospital. So, no news is not bad news. Your dad might not be answering his phone because he is sleeping or in the middle of a bunch of tests. (Or because cellphones aren't allowed in hospitals. At least they're not at mine)
posted by royalsong at 10:06 AM on May 29, 2012

I'm a little flabbergasted/annoyed that going to chemo is being seen as only the work of women. It seems ridiculously unfair to your sister that your brother isn't participating in this at the very least. And possibly your dad, depending on the outcome of his current health issues. I get that nobody wants to do it, but the fact that mostly ladies are present should be irrelevant.

So it seems to me that the best think you could do for your sister would be to convince Bro and Dad to help out more since they're there and you're not.
posted by BlahLaLa at 10:07 AM on May 29, 2012 [6 favorites]

First, I would stop apologizing. Instead, I would say something like "It's frustrating that I can't be there in person. Please let me know if there is anything I can do. Do not hesitate to call."

If you are in a position to spare a few bucks, send money, not just to your parents but also your sister. Put it in a thank you note. Let her decide how to spend it. State that she can spend it any way she wants but you were thinking it might help cover gas or vending machine snacks while she waits at the hospital. Even if it is just five dollars, it can make a difference to their budget and mood. Feeling supported can make it far easier to keep on keeping on just when you think you can't anymore.

If you cannot send money, at least buy a pretty thank you note that is blank inside and write a heartfelt sincere thank you to your sister. Tell her you understand what is involved because you did it previously and that makes you all the more appreciative of what she is doing for the family. Again, do not apologize, because it tends to imply you are abdicating responsibility. Instead, again state that you are wiling to be supportive if there is anything reasonably within your means to do given circumstantial constraints.

In some families, it works well to send emails with links to useful health info or, if they aren't online, print articles and mail them. Sometimes, good information is very valuable and it can help them feel like they are still in your thoughts.

Best of luck.
posted by Michele in California at 10:08 AM on May 29, 2012 [1 favorite]

Your sister is carrying too much of the burden right now.

Are there any other relatives in the area who can help out?

Does your mom have any close women friends who can pitch in?

Could someone other than your mother watch your sister's kid, or could a neighborhood teenager be hired to help your mom watch the kid? (I'm assuming that there isn't decent affordable round-the-clock daycare available, this being the US...)

Are your parents members of a church? Churches can be good at providing support in difficult times.

Does the hospital have a social worker? Hospice might also help, patients don't have to be considered terminal to get hospice help and they help in numerous ways.

Is there a handicapped people van that could take your mom to and from her treatments when no one else can?

I hope things get easier for all of you soon.
posted by mareli at 10:10 AM on May 29, 2012 [1 favorite]

The facility is really a ladies zone.

What the...????

When my mom was getting chemo for cervical cancer, I (son) took her every single day because my teenage retail job allowed me to do it. She died a few weeks later (several months earlier than the doctors predicted).

Get everyone on board. That is how you can help, by getting brother and dad on board. Don't let dad live in denial, and don't let brother follow his model.
posted by TinWhistle at 10:10 AM on May 29, 2012 [9 favorites]

Yes, rallying the troups would help- there's NO reason your sister should be doing all the driving. That's nuts. "Ladies' zone," forsooth!! He can bring a stuffed elk head and a Guns and Ammo magazine to read if it'll help him retain his masculinity. Sending money would help. Coming up with some outside help would help. I mean figuring out anything that would take pressure off like the paratransit services (there is one where my dad lives that is volunteer run and they take people to chemo, to the grocery store, to doctor's appointments), Meals on Wheels, etc. Also, just being an ear to rant to can help a lot.
posted by small_ruminant at 10:20 AM on May 29, 2012

Thank you for the suggestions. I don't want to thread-sit, but am hoping this doesn't become a derail about my dad and brother not going with my mom to treatment. While I completely agree, changing the family dynamic and culture is much easier said than done. Also, my dad cannot afford to miss work and lose his job, as they are both on his health insurance and have little money. FMLA sounds great, in theory. I've requested my brother step up repeatedly. I will speak with him again.
posted by fyrebelley at 10:21 AM on May 29, 2012

I want to second Mareli: Is there anyone besides your immediate family in a position to help at all? Do your parents have friends, friendly neighbors, other relatives, a church group?

Gender is no excuse to bow out of caregiving - and I don't just mean your brother, I mean anyone male in a position to help.

Assuming there are others besides immediate family to help, you will want to start a (free) account at Lotsa Helping Hands. How Lotsa Helping Hands works (quote from website): When people rally to help someone in their family or Community, Lotsa Helping Hands makes it easy for each person to know what to do and when. In other words, you won't get ten casseroles when what your parents really need is someone to do their laundry.

Neighbors, friends and other family members can cook food, offer to do laundry, care for pets, babysit your niece, or whatever your family needs to have done. Even if neighbors, for instance, can't take your mom to chemo, they can drop off a pot of healthy soup or water the houseplants.

Reaching out for help beyond the immediate family, and coordinating that help (which you can do long distance via Lotsa Helping Hands) will be a HUGE helpful thing you can do.

Best of luck to your parents and all of you!
posted by Rosie M. Banks at 10:25 AM on May 29, 2012 [2 favorites]

And, reading that response, I'm clearly helping them make excuses for not helping out. Okay, that point has been taken. Other suggestions?

Unfortunately, my parents are pretty much loners. My mom's whole family lives farther away than I do, and my dad is not very close with his brothers, who also live long distance. They don't go to church. I will try to think of other groups of people that may be able to help. Thanks!

I will definitely send my sister a thank you card and some money--good thoughts!
posted by fyrebelley at 10:29 AM on May 29, 2012 [1 favorite]

My mother was her mother's caregiver. I live a thousand miles away, and her siblings were unable to help much due to reasons of distance and/or temperament. This is what I did to help:

1. I sent her a gift card for her favorite coffee shop. She has plenty of money, but sometimes she needed "permission" to do something nice for herself. Because she had the card, she could tell herself that if she didn't stop and get a coffee, my gift would be wasted. Social jiu-jitsu for the win!

2. When she was staying at my grandmother's house, I arranged to have dinner delivered once and wine delivered another time. This was helped by the fact that my grandmother lives in a rural area and is on great, great terms with the owner of the local market, so he was absolutely willing to drive 3 bottles of wine up to her house and leave it on the doorstep. Even lacking such a relationship, though, you would be amazed what people are willing to do if you ask nicely and offer to pay them.

3. I did research to find contact information for respite care and caregiver support groups, including cost and when/where they were available. My mother was frequently mentally and socially exhausted by her caregiving, and putting in the effort to get herself some help was more than she could bear. This way, she just had to pick up the phone and call.

4. I told her that I would listen to her bitch at any hour of the day or night. Honestly this might have helped more than anything else. When she couldn't bear having the same argument with her brother, or her mother, or her sister, or her husband any more, she would call me and just tell me how horrible everything was, and I would listen every time. Even when it was always the same thing.

This process is very hard to deal with, and it is just plain exhausting. Sometimes just knowing you have someone else in your corner can help a lot. Good luck, and I'm sorry this is happening.
posted by KathrynT at 10:52 AM on May 29, 2012 [2 favorites]

As mentioned already, sending money is good but you might also want to think about paying for house cleaning, food delivery or grocery store/restaurant giftcards. This can be for your mom, sister or both. While your mom and sister are getting chemo, they could be getting their homes cleaned or at whatever time is convenient. You don't have to do it weekly but maybe once a month. See if your brother would be willing to chip in.

Not to belabor the brother helping out issue, but sometimes it helps to be specific. "Brother, can you take mom to chemo on June 4th" can be better than a general 'will you help out request.'

Talking to the hospital social worker for suggestions is also a good idea, particularly for hospice assistance, which as already stated provides more than end-of-life care.

Life burdens don't always fall on us equitably. Let your sister know you appreciate her doing the bulk of the work right now.
posted by shoesietart at 11:07 AM on May 29, 2012

Sending money is great - but also see what else you can do remotely.
Does a local grocery store offer home delivery? Order groceries to be delivered - to your mom and to your sister.
Does your dad wear professional clothes to work? Find a dry cleaner who will do pickup and delivery, then schedule and pay for it.
Does your sister and/or mom not cook because she's exhausted? Find out what time either of them is getting home one day, then order and pay for (pizza, chinese, whatever) to be delivered shortly after she gets home.

Offer to be your mom's and sister's virtual assistant. If they are online, keep their entire calendars using Google calendar. If they aren't, do a daily or weekly check-in to update them on appointments. Schedule things for them so they don't have to think about it. Chemo, follow-ups with doctors, dentists, getting the oil changed in the car, everything you can think of.

If chemo is boring, buy them subscriptions to magazines.
If mom has trouble sleeping at night, get her a Netflix subscription so she can watch movies at night until she gets tired.

As others have stated - the best thing you can do from afar is to find ways to make everyone's quality of life better, so the actual burden of caregiving is more manageable.
posted by trivia genius at 11:14 AM on May 29, 2012 [1 favorite]

I am the only family member living near my 89-year-old (remarkably healthy) mother, so our situations are clearly somewhat different but I can tell you the things my sister does that makes it a bit easier on me during the times when I'm heavily involved in caring for her. She thanks me, often, for what I do and offers encouragement. She and I both know there is no need for her to apologize: she and her husband moved about 750 miles away because of his job, not because they wanted to leave this area.

The biggest thing, though, is that she calls frequently. She calls me to provide moral support, ask about my life, let me ventilate when I need to, offer advice and guidance (because I asked her to do that), and pass along any positive comments she has heard from our mom about how I'm taking care of her. She also calls our mom, often, so I'm not the sole supplier of news and entertainment for our mom when she's not feeling well.

In addition to what folks upthread have suggested: I can imagine that your sister feels pretty torn between the needs of your mom and the needs of her daughter. Can you send interesting books or toys for your niece, or arrange outings they can do as a family?
posted by DrGail at 11:22 AM on May 29, 2012 [2 favorites]

Being the caregiver is emotionally, physically, and financially draining.

Suggestions above about sending money, meals, cleaning, and subscriptions are great. I was too tired to even think of doing those things many days. And having someone else deal with billpaying and keeping track of medical and insurance bills would have helped so very much.

Additionally, a gift certificate to a massage or salon may be a bit of pampering that will let your sister recharge a bit.

Best of all is the suggestion to be a non-judgemental listener.
posted by mightshould at 11:26 AM on May 29, 2012

Re the brother issue that you asked for additional feedback on: Even if you cannot figure out how to effectively encourage him to take mom to chemo, he can still help out. If machismo is an issue, suggest "manly" things like mowing the lawn (for both the parents and the sister), working on the cars in the family, etc. If he will take care of some things for sis, that will make it easier for sis to do things for mom.

Sometimes, the family dynamic is pretty intractable in certain respects. That doesn't mean the men won't help. Encouraging them to contribute in a fashion they find more palatable is often a far more effective approach. Then make sure you express appreciation for those things and don't just focus on what they won't do.

Best of luck. Ye Olde Family Circus can be a really tough nut to crack.
posted by Michele in California at 1:59 PM on May 29, 2012

Michele's idea to have your brother pitch in by doing "guy things" like mowing the lawn, car maintenance (even just taking mom's or sister's car to the station and filling it with gas) and such like is a really good one. While I believe that gender doesn't get one a free pass for opting out of care work, trying to change your brother might be more stress than it's worth right now. So have him pitch in with traditional male stuff instead.

Can the more geographically distant relatives help out by chipping in for a cleaning service, food delivery, or help along those lines? Or by sending your sister a Visa gift card to help her with gas costs and all the expenses she has piled up? Can one of your sister's friends, or relatives of her husband, or your brother or his wife, take care of your niece when she needs it?

I know you say your parents didn't attend church, so that is out. I'd still try to round up any friends or neighbors that might be able to help, if you possibly can (and they exist - some people truly only socialize with their own spouses and families). Even people who can't do major tasks like driving mom to chemo can still do little things like water plants or send over a casserole or just offer some good cheer.
posted by Rosie M. Banks at 2:38 PM on May 29, 2012 [2 favorites]

Since this is still open, I thought I'd add that apparently this title wasn't very funny, because my dog of over 12 years died less than a month later. And then my grandfather-in-law died 3 days later. We are all doing okay, though. Thank you for the suggestions. Things seem to be a bit more on-kilter now. Mom is done with chemo, and my dad was having a reaction to some large doses of Naproxen. Phew! What drama!
posted by fyrebelley at 9:48 PM on January 7