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Mentally unstable sister, I fear for her young children
January 8, 2014 9:18 PM   Subscribe

Background: My sister (38) has a story of emotional instability and I fear for my niece (8) and baby nephew (Down syndrome). My sister was molested by my father when she was in her late teens, which might have something to do with her current condition. She is extremely dependent on (and at the same time very hostile to) my mother. My mother (divorced, late 60s), in turn, is struggling all by herself to help her daughter and the little children, while having to deal with lack of money and her own (physical) health issues.

My sister probably suffers from bipolar disorder, but refuses to seek professional help. She is often overwhelmed by anger and depression. She is, among other things, often difficult to interact with, (verbally) aggressive, controlling, volatile and negligent of her personal appearance and health. During the last few months her situation has worsened, she is extremely irritable, eats very little and badly, has become emaciated and her teeth have deteriorated notably.
My sister lives one block away from my mother, at an old house my mother lends her. She does have a low paying but relatively stable job. However, this also means that my aging mother has to babysit every weekday from 7 AM to 2 PM, plus any other time my sister chooses to go out on her own. My sister has had a number of short-lived affairs with men who disappeared quickly after she became pregnant. She is having another affair at present. She has for years been easy prey for exploiters, people who borrowed money from her and vanished, men who used her-literally-to do their cleaning and cooking, among other things, for free, and then dumped her. And this is a woman who graduated from high school at the top of her class and got excellent grades during her first year at university, until she became the target of my father's psychological and moral collapse. After that, it all started to deteriorate quickly for her in the next few years. She dropped out from college, became increasingly isolated and angry, stopped almost all social interaction, and ended up having a string of dead-end jobs far below her capacity.
Today, on a typical day my sister is watching TV at my mother's house, gets a text message and rushes out of the house, telling my mother to take care of the kids while she is away, no explanations given. When hours later on her return she is asked about what happened, she throws a fit about my mother not helping her enough and nobody caring about her well-being. She does not look after the children's (or her own) hygiene and nutrition enough. She often neglects basic safety precautions, as avoiding taking the children out unnecessarily during extreme weather conditions in summer or winter (the baby got pneumonia recently, which might have something to do with my sister frequently taking him out for a walk during very cold days). My niece has had a couple of infections which I suspect could have been prevented with a little more attention and care. I've visited their house recently and it is really rundown.
Tomorrow I'm traveling back to the city where I live and work, a 5-hour drive from this family drama. I can only visit my family a few times a year, and spend a lot of time worrying about my mother, niece and nephew's welfare in the face of my sister's condition.
What options are there to help bring some stability and safety to that home? Our budget is tight, and not being in a developed country, the options for state mental health assistance are very limited. Competent private counseling is available, it would be an expensive yet possible option. But first my sister should be willing to seek help. Is there a way to influence her to do that, considering that our chances of having a civil and reasonable conversation are slim?
Thanks in advance for any sensible guidance
posted by Basque13 to Human Relations (16 answers total) 2 users marked this as a favorite
 
During the last few months her situation has worsened, she is extremely irritable, eats very little and badly, has become emaciated and her teeth have deteriorated notably.

That plus the sudden and unexplained absences would make me suspect a drug problem. Is that probable? And if so, are there more options for drug treatment in the area?
posted by jaguar at 9:54 PM on January 8 [24 favorites]


Tomorrow I'm traveling back to the city where I live and work, a 5-hour drive from this family drama.

Short of reporting some sort of child neglect or abuse (and, without knowing where this event is located, it's difficult to provide advice), given your distance from this situation, I doubt there is much you can do.
posted by HuronBob at 9:57 PM on January 8 [1 favorite]


If someone does not want help, or even think there is any cause for concern, then no, there is nothing you can do to influence her. In addition to your sister you seem very concerned about your mother. Your mother is an adult and if she does not appear to share your opinion that her current relationship with her daughter is unhealthy or is exploitative; it is up to your mother to draw those boundaries and make changes in the relationship (after nearly forty years there will be unlikely any major changes). Personally, I think paying for private counselling is a waste unless the person is motivated enough to make the appointment themselves and pay out of their own pocket. Especially if the person is addicted to drugs. That money would be better spent on getting the children into a nursery school or formal daycare, even if it is only once a week. That would provide support to the children and respite for your mother.
posted by saucysault at 10:00 PM on January 8 [2 favorites]


the sudden and unexplained absences would make me suspect a drug problem. Is that probable?
Not really. I am used to dealing with substance abusers at work. This is something different, more related to emotional/psychological issues, probably bipolar disorder.
posted by Basque13 at 10:22 PM on January 8 [1 favorite]


Your family is obviously very important to you. Is there a way you could take a sabbatical or move closer to home? You might have the stabilizing influence that is needed.
posted by Brent Parker at 10:38 PM on January 8 [1 favorite]


I don't see what you can do about this from long distance. The situation has been going on for some time, but I'm sure it's getting worse and it worries you a great deal, as it should. Your mother is caught in a difficult place - she's trying to keep peace with your sister no matter what so she can be available to the children - and that leaves her open to abuse from your sister. I've been there.

If you can't move back to where your family lives, could you help them to move closer to you? If not, the only options I can see are to either get the child protective services involved or to enlist a friend or neighbor's help to keep an eye on things and notify you if trouble seems to be escalating. In that case, you need to keep funds available so that you can fly home immediately and take control of the situation if things demand it.

When your sister gets a phone call and immediately takes off, where does she go? Does anyone have any idea? Do you know for certain that she just runs to her current man when he calls, just to be with him? It takes a long time - years - of dental neglect before the teeth become obviously terrible to someone else; however, that isn't true with meth. Her overall neglect of hygiene and nutrition will eventually cost her her teeth, of course, but drugs are classic for taking over a person's life to the extent you're describing. That, combined with the instantaneous response to a phone call, sure sounds like the call of drugs available to me.

I don't question your experience or knowledge at all, but in your situation I'd sure find someone to follow her when she takes off like that and see who she hangs out with.

I wish you the best. I've tried handling situations similar to this from a long distance and it was nearly impossible, but it did eat up my stomach lining. I hope you find an answer to this soon for the sake of the children and that of your mother, as well as that of your sister.
posted by aryma at 11:00 PM on January 8 [5 favorites]


A 40-year longitudinal study of children in Hawaii (The Kauai Longitudinal Study - summary [pdf]) found that a good number of children exposed to risk and disadvantage at home were able to build age-typical, constructive, fulfilling lives, given the involvement of caring non-parent adults (neighbours, teachers, other mentors). Are there individuals in the community who can offer that? Also, in that community at least, religious organizations were effective in providing various kinds of support and structure. Anything like that, in the absence of state-run programs?

Nurturing by a positive role model at critical times was particularly helpful to the at-risk children in Kauai. If you can't be physically there, but are available by phone, email, however they (or the eldest, for now) can reach you when they need you, it will be an important comfort. (You might also be able to call in reinforcements in an urgent situation, and be made aware of it more quickly -- maybe, get to know the names/numbers of key emergency contacts so you have them on hand.) Your niece may be more likely to initiate help-seeking if you're a regular presence in her reality -- even though you're far away, you can make regular phone calls, just to say hello.

You can also remind your sister any time you have a chance that you're willing to help pay for counselling. She may take you up on it if/when she's ready.
posted by cotton dress sock at 11:27 PM on January 8 [6 favorites]


If things are bad enough, would you be willing to go to court to get custody of the children as a way to force your sister to get the help she needs?
posted by These Birds of a Feather at 11:30 PM on January 8 [2 favorites]


So much depends on how far you want to go and your country's legal system. Are you worried for the safety of the children's lives, or are you worried that they're getting neglected? Cotton dress sock is right, neglected, you can intervene - send a package every week with a simple book or toy for them or just letters and a chocolate bar, call on a scheduled time in the morning and evening to chat or set up video conferencing. Help your mother to get involved in a support group for parents of Down children and another like a playgroup - even though she's the grandmother, she's going the parenting by time.

If you're truly worried about their physical or overall safety, start planning on moving back into the same town and provide a safe harbour for the children. Talk to a lawyer to find out about custody issues.
posted by viggorlijah at 2:22 AM on January 9 [1 favorite]


Sounds like it might be worth getting county social services involved. The kids are clearly in physical danger from neglect and it doesn't sound like existing family resources are adequate.
posted by valkyryn at 5:11 AM on January 9 [3 favorites]


She often neglects basic safety precautions, as avoiding taking the children out unnecessarily during extreme weather conditions in summer or winter (the baby got pneumonia recently, which might have something to do with my sister frequently taking him out for a walk during very cold days). My niece has had a couple of infections which I suspect could have been prevented with a little more attention and care. I've visited their house recently and it is really rundown.

While some of your concerns seem valid, nobody gets pneumonia from being cold, and nobody gets infections from living in a rundown house. Poor people aren't any more unclean than rich people. Kids who spend more time outside in the world have stronger immune systems than those who are quarantined in "clean" environments.

You don't say whether you have spoken with your mother about this. If you are far away, supporting your mother directly seems the most sensible approach. But beyond your sister's temper with your mother and recent weight loss, I don't see why you're informally diagnosing her with mental illness.

She does have a low paying but relatively stable job. However, this also means that my aging mother has to babysit every weekday from 7 AM to 2 PM, plus any other time my sister chooses to go out on her own.

This is incredibly ordinary. Many, many people work hard but don't earn enough to afford childcare, or prefer family to care for their children, or have no other options. It sounds like your sister is in that position. What else would you have her do? It sounds like your sister is making do as best she can. As a mother who raised two children on my own, I can say it's exhausting and can make even the most patient person short-tempered.

Like some of the advice you got in your other question about this situation, your mother is an adult and if she is capable of telling her daughter to cut out the yelling, you should encourage her to do so. If she isn't capable of that (mother-daughter relationships can be fraught), and she wants you to intervene, then talk to your sister about it.
posted by headnsouth at 6:45 AM on January 9 [2 favorites]


nearly a year later and you describe things in almost identical terms (which often veer into judgmental). you can't be the fixer between your sister and your mother. you can't make your sister seek help. the answer might be counseling (or books on mindfulness) for you so you can find a way to not get so wound up over it all. short of doing the hard stuff - moving close, taking over some of the childcare, sending money to your mom, etc - there's not much you can do here. you might also consider that anything you're already doing that triggers a sort of "man of the house" feeling might be especially difficult for your sister to respond to.
posted by nadawi at 7:39 AM on January 9 [2 favorites]


"difficult to interact with, (verbally) aggressive, controlling, volatile and negligent of her personal appearance and health. During the last few months her situation has worsened, she is extremely irritable, eats very little and badly, has become emaciated and her teeth have deteriorated notably."

sounds remarkably like a meth problem. that person who she runs to when she gets a text? maybe that's her dealer.

this is a rare situation where i would say you need to call child protective services. the children's health and physical safety sound like they are at risk.

as for you, remember you can't swoop in and fix things, and try not to let the stress of the situation overwhelm you. i am sorry you are going through this.
posted by zdravo at 8:17 AM on January 9 [7 favorites]


Not to sound trite, but what about the kids here? Can your sister get benefits for them to alleviate some of the burden on your mother? Are they being well taken care of or is this a situation where CPS should be advised of what is going on?
posted by tafetta, darling! at 8:52 AM on January 9


First, a total disclosure - I have a bipolar family member who acts very similar to the way you describe. My recommendations are influenced by this. Feel free to memail me for details if you want to weigh my recommendations by comparison to your situation.

What needs to be done IMMEDIATELY is to establish support systems for your mother and the children, so that if and when your sister has an episode that puts her out of their lives or makes her a danger (for even a short period of time) they have a net to catch them. Is the son in special care for Downs? Does your niece have a school therapist, activities outside the home, mentors? Does your mother attend church, which might have a social outreach program, or have any other activities outside the home? There are groups and parenting classes and therapy and all sorts of great stuff your sister can use - it's well worth it to research and present her with what you find. But she is an adult and at this point there is not much you can do for her if she doesn't want to or isn't able to take the first steps herself. Your first responsibility here is to your mother and these children. If it helps, you might think that you are helping your sick sister by taking care of the things she would want to be taken care of if her illness hadn't prevented it.

DO NOT HESITATE to get social services involved if you have even a twinge of worry that the safety of those children is at risk. They are not going to take the children as a first or even a fifth step, unless there is a true and immediate danger. Also, just the existence of a file will be helpful later if something extreme ever comes up (for example, is your sister still having brief relationships with untrustworthy men? Do those men ever come around her children? Just the possibility of anything happening there should be enough to worry you).

I do think it's worthwhile to take off work for even a week or two to travel to the town where they live and try and establish where your mother and niece can go for support (at 8, your niece is old enough to talk to you about this, at least in terms of "Child, what do you do when you feel afraid? Who would you talk to?"). This would also be a time to gather contact information for these supports, so that you could check in with them if something serious changed about the situation.

THANK YOU for caring and for looking out for these children and for your mother. Please remember to take care of yourself and have a support network for yourself as well. As tempting as it is to keep issues like this within the family, the more support and resources you have to work with, the better the outcome will be for everyone.
posted by theweasel at 10:16 AM on January 9 [1 favorite]


Being the single parent of a child with a chronic medical condition is incredibly stressful on its own, even without a personal background of mental problems and abuse. Is your sister able to access adequate support systems, early intervention services and health care for her child with special needs? Is there a local support group for parents of kids with Down syndrome she might be able to join? Have you offered to help pay for any of his medical care, or help research organizations that could help her get access to appropriate medical care? Have you offered to come give her a respite weekend, where she can go do something like get her hair done or read a book in a library without worrying that she is overtaxing your ageing mother?

Her current level of breakdown could be driven in part by fear that she can't manage her child's disability adequately on her own, and no one is around who can help her beyond offering basic child care.
posted by BlueJae at 11:39 AM on January 9 [5 favorites]


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