Coping with mom's cancer while living abroad
March 16, 2015 3:35 AM   Subscribe

My mom was diagnosed with stage iv cancer 10 months ago. She has responded fairly well to treatment and the doctors give her 3-5+ years. I live on the other side of the world with my partner and my job. I am in my early 30s. Where am I supposed to be? How do I make decisions? What does "Family is everything" mean? Is my partner family, too? How do I prioritize?

My mom is alone-ish. I have a full life. How to cope with the two? Context below.

1. She lives with her adult son, my brother. My parents divorced 15 years ago, my dad was emotionally abusive and an alcoholic. My brother has never moved out. He lives rent-free, and works full time as a lawyer. He is making quite a bit of money. He emotionally abuses my mom by 1. no speaking to her 2. ignoring her 3. expecting dinner to be made (this just recently stopped) 4. having her do his laundry etc. I tried to reconcile with my brother ten years ago but he ignored my letter. I currently do not speak to him, and he ignores me. My mom has said that sometimes he speaks to her, and he does drive her to medical appointments when needed, but they never share meals together, and this past Christmas dinner he hid in his room and refused to join us. My mother admits to enabling this behaviour, and she has said he treats her like her ex, (our father). My mother, indeed, has allowed my brother to emotionally abuse her so he would stay at home, as she was scared to loose him. She has said on many occasions: "if he moves out, he will never see me again" as reasons to put up with him. He's done so much harm to her, it breaks my heart. I have just recently begun to see that I cannot be expected to bear this pain on my shoulders.

Suffice to say, the energy in this house is difficult and at times toxic and I have not lived at home in years. I have spent the past 10 years of my life working in my city, or abroad. As I grew up in an alcoholic household, and now with my brother still at home, it's the last place I want to end up living in again, but I know I will eventually (temporarily) when/if end-of-life care is needed.

2. My mom has some very good, supportive friends. But family-wise, she has cut-contact with *everyone* she is related to (brother, nieces, nephews, in-laws, etc.). I am literally the ONLY family member who talks to her and has a loving relationship with her. This fills me with a lot of anxiety and pressure. My brother is expected to do nothing, but naturally, I feel I am expected to do a lot. Even though he lives at home, I feel like it is me who is expected to quit my job and move home to take care of my mom. I have to admit, this makes me angry, and resentful, even though I love my mom and want to take care of her full time when the time comes.

3. My mom has suffered from depression but refuses to seek help from any professional services. She sometimes uses me as a therapist, as a result I have had her breakdown to me on several occasions, once even telling me she wanted to die, she was so lonely. Again, I felt enormous guilt to be living my life away from "home". However, I am also extremely happy to be living my life abroad, as it is in a country both me and my mom have ties to, and it fits my career choice, and I met my partner here, and I enjoy his family, and everything just fell into place.

4. I am currently living in Europe (original home is North America), where I am working in my chosen field and live with the most loving and supportive partner I could ever ask for. He has made it clear I can make any decisions I need to make. I am planning on doing a masters, and then move back home to North America with my partner. This would be in about a years time. Does my mom have enough time? Nobody can answer that question. I have a very understanding boss, and I go home every 3 months for a few weeks. My mom and I can spend a lot of quality time together. But, I still worry.

5. What happens when she spends the week throwing up? Or has unbearable pain? So far, so good- she's a trooper and she really is doing OK. But for how long? I know nothing is permanent, and I know that if her health takes a downward turn, I am on the next plane. I also know that I will move in with her if the time comes near the end and be her caretaker.

6. But, we're not there yet. My partner means the world to me. Am I allowed to want this, to think this? My first instinct was to drop everything and move back home, but it's been 10 months, and three visits home, but I am still "living" abroad. My mom says she supports my decisions, but I can't really know what she thinks. I feel guilty and anxious, but if I were living at home, with my brother and my mom, how would I feel?

7. I've seen a counsellor numerous times and a social worker at the oncology clinic. Both encourage me to live my life. But strangely, this doesn't comfort me as much as I should. What does it even mean, "live my life?" At this point, it sometimes feels selfish, not appropriate. At other times, it helps me avoid the current situation. But maybe this isn't a healthy coping strategy. I sometimes need to remind myself that my partner is very important to me and my #1 support system. Does he count as family also?

Just as a quick aside: I am not religious, however I turn quite often to Buddhist texts for comfort.

If you've read until the end, thank you.

To recap: Has anyone reconciled with/ lived through these types of circumstances? If you were my friend, what would you suggest to me? I am looking for comfort, but also, I suppose, seeking guidance.
posted by stumblingthroughitall to Human Relations (18 answers total) 9 users marked this as a favorite
 
I suspect you're female and that's why you feel this way. That you've been socialised to feel responsible for care taking duties. You're no more responsible than your brother. Do what you can, when you can. And don't take on board this expectation. Society does it to women all the time and we absorb it without questioning it and beat ourselves up when we think we've "failed".

Fulfill your dreams, wherever they are. As a mum, that's what I want for my kids. And when I want them to hold my hand as I die, I'd like them there, if that's what they want. Other than that, I'd like lots of phone calls and photos and cheery visits.

Don't take on the mantle of Florence Nightingale here. It's not fair, and it's not necessary. Your brother can rise to the occasion, this might be the making of him and his relationship with your mum.

Big hugs. Look after yourself.
posted by taff at 3:43 AM on March 16, 2015 [9 favorites]


I suspect you've got a heart, and that's why you feel this way. If you were living on the same continent as your mother I could see "how may I involve myself directly?" as a reasonable question, but you've settled in another place and are doing well. To my mind, the cost of travel and repercussions of prioritizing your mother over your career limits your options.

Although I'm not directly comparable to your mother, I'm sporting some brain cancer and have learned a lot about the benefits of others giving a damn for me, and have also come to appreciate what giving a damn means. I give more of one myself. I think that keeping in contact with your mother is likely to mean a lot to her, and that the most important thing that you can do is continue to love her. Distance doesn't have anything to do with that.

Regarding your fifth point -- will she be able to get a PCA or something along those lines when she is unable to accomplish the quotidian? Will your brother step up? That sounds like it may be something to look into.
posted by mr. digits at 4:21 AM on March 16, 2015 [2 favorites]


There are many ways to love. One of them is by leading the sort of life your mother hopes for you: as an independent, capable adult.

I feel for you and your situation, having experienced a variation of it myself. My father and I became very close during his terminal illness and while I had moved from across country because of this, I was also able to make it mesh with my career and own independent personal life. I know for a fact though that he was okay with (and proud of) me as his child making a way in the world.

It seems to me that the key is to find ways to make sure that you each have ample opportunity to share and cherish the love between you and your mother. That doesn't necessarily mean you have to be right there, though, especially nowadays with Skype, etc...

As for your brother? Somebody has to be related to the jerks of the world. Sounds like he and my sister are peas in a pod. Try to have empathy if you can because it sounds like your brother is setting himself up for some serious regret. You can have what he may not be able to achieve--a wonderful series of memories of you and your mother sharing that special bond of familial love that will nourish you for the rest of your life.

Best wishes to you.
posted by CincyBlues at 4:38 AM on March 16, 2015


My mother was ill with cancer for 5 years when I was in my 20's and I wanted to move to Europe but I stayed with her out of the desire not to lose any time with her and be there for her. My family of origin is very toxic and dysfunctional as well. After she died, I moved... I've now been living in Europe for 8 years and am married to a loving man.

My husband is my family and my life is here. If things were somehow different and she was sick now, while I was here- I would stay.

If you aren't careful, your mom's cancer can become your entire narrative. That happened to me. Looking back I think its important to put on your own oxygen mask first, make sure your needs are met, by being in a job you like and fulfills you, by having a supportive partner.

Those pieces of the happiness pie are just as important as the mom piece. Because when you lose the mom piece, they are what you have left to stave off depression and emptiness. In my case, my mother was the only thing pinning together my nuclear family... and I've had to create a new life and support system apart from that... but its tough because for a while you have to grieve the death of your family too. I don't know if that strikes a cord.

But of course you have to follow your heart!
posted by catspajammies at 5:14 AM on March 16, 2015 [9 favorites]


I don't think you have any obligation to move back.

That said, it sounds like that is a painful choice for you, and you already plan to move closer in a year. Do you have specific reasons for waiting until then or would it make your life easier to do now? (To be clear, I had no idea if that's the right choice for you, just one that might be worth thinking about.)
posted by metasarah at 5:16 AM on March 16, 2015


It's tough, and every situation is different. I was in a similar situation during my father's illness. In my case, the choice was easy since living in Europe offered me more support in taking care of him (more paid vacation, better compassionate leave options) and I decided not to go home. But as a consequence, my partner and I did not have a vacation that wasn't to the US for the 5 years he was sick.

I also had a sister in the US, so we were able to alternate. She was able to go home more frequently, but for shorter visits. I often did longer visits, combining things with work.

Lots of sympathy.
posted by frumiousb at 5:52 AM on March 16, 2015


I took off a semester 5 yrs ago from my graduate school to care for my mom who also had cancer. Just recently I spent the last 2.5 months of my father's life looking after him during advanced stages of cancer.

I think you should continue on your current track until you're more needed. Quitting a master's you might complete in a year given a 3-5 year diagnosis sounds like pulling the trigger too early to me. What if you move home for 5 yrs and could've completed your master's? Also, it's exhausting and very challenging to be a caretaker, you don't want to burn out too early.

I think your plan to rush home if really needed is the right approach. I'm definitely in synch with your desire to care for your mother and don't regret a moment I spent caring for either parent in their last days. It's the greatest gift you can give someone.
posted by airing nerdy laundry at 6:05 AM on March 16, 2015 [3 favorites]


This is a sad, tough story. I don't have very much advice to offer, only sympathy and support. You sound loving, thoughtful and ethical, and I think those characteristics will do a lot to see you through.

If and when end-of-life care presents itself as necessary, I wonder if you might reframe the situation so that you are open to having your mother come and stay with you, in your loving, healthy, adult household, instead of seeing her illness as something that can drag you into your abusive and toxic childhood home. There may be many logistical issues to work through; she may be very reluctant to accept this offer or refuse entirely. But if you open your doors to her when she needs you, you will have lovingly fulfilled your obligations to her. She can't force you into being a child again.
posted by pretentious illiterate at 6:06 AM on March 16, 2015 [5 favorites]


If your mom takes a significant turn for the worse and cannot care for herself, I would see that as the time to go and be with her (although it may be something she can recover from, eventually it won't be). As long as she can care for herself, I don't see how it would help to have you there, except as emotional support/in your therapist role - and it's not your fault that she has cut off ties from every other person in her life and refuses to seek mental health help, thus you should not feel obligated to fill these roles for her in person because of these other choices she is making.

If she is vomiting all week or having unbearable pain, she needs to call her doctor and get help, and possibly go to an urgent visit or the emergency department. Remind her that if she is too sick to get to the doctor, that's what 911 is for. You don't have to be there with her to be ready to take her to the ER if needed, and you can't write prescriptions. Encourage her to discuss end of life care with you and her doctor so that you know her wishes. Encourage her to set up a healthcare proxy and power of attorney. This will make it much easier in the future for you and for her to ensure what she wants to happen, does happen.

I also fully agree with pretentious illiterate that if you feel like you should be physically caring for her somehow at this point or she's hinting at that, and you've offered to do so at your home, and she's refused - that's on her, not on you. In fact, it is selfish or maybe even cruel or her part to be guilt tripping you about things she wants when she has other ways of getting help that she refuses to utilize.
posted by treehorn+bunny at 6:36 AM on March 16, 2015


I would also strongly encourage her to talk to her doctor about when hospice care would be appropriate (either in home or residential).
posted by treehorn+bunny at 6:37 AM on March 16, 2015 [3 favorites]


This is a situation I was in, sort of. Grew up with an alcoholic parent who was emotionally abusive (this is probably affecting your outlook a lot, fwiw) and a mom who was diagnosed with Stage IV cancer when I was in another country. I was just traveling for work though which was a thing I do a lot. My mom was the "I'm not going to really manage my feelings but sort of push them through you kids" type and my sister lived nearby and took the brunt of this and also was stuck being sort of co-dependent with my mom.

Things are a bit better now, maybe seven years later. My mom is still alive (modern medicine is wonderful) and we've all gotten to a better place with the whole thing. The main thing that was different about my situation is that my mom was super duper clear that she wanted my sister and I to live our lives and not just hover around her waiting for things to get worse. Your mom did not say that but you may need to give yourself that pep talk.

Families with alcoholism often have a lot of weird sticky emotional issues. This was true for you before your mom got sick. People often enable the alcoholic and/or wind up with martyr syndrome themselves for putting up with all that stuff. Kids get neglected. The fact that you don't have a concept of what "Live your life" means may point to some difficulties getting disentangled from messy family stuff. There's an awful lot of bad boundary setting and something called "emotional incest" where parents not getting the relationship they need from their adult partner put their kids in roles that are inappropriate for them (not sexually, mostly just emotionally). Sounds like that's what is up with your mom/brother. Sorry about that.

I'm here to tell you that my decision to have decent boundaries even in the face of my mom's cancer was a good decision for me and the rest of my life. My mom, like yours, had made some iffy decisions as a grown-up that were affecting her life. There were some expectations that my sister and I would compensate for them. My sister did a little but I mostly did not. This is a hard path to walk because there's a lot of doubt and there will also be people being all "I can't believe you are doing that!" grief you may get to have from other people.

My kind suggestions are that you keep lines of communication open with your mom. You try to encourage her to seek therapy/support from the things that are outside of your ability to manage or handle (cancer support groups are wonderful things for a number of reasons) and that you maybe see if you can go to Al-Anon in your home country. Consider making shorter visits so that you're not quite so enmeshed with her household when you are there. Refuse to be her therapist. If there are other family members who you are in touch with who she has shut off, maybe encourage them to get back in touch with her and you should get back in touch with them so that your lines to your own family are not just through your mom (facebook can be good for this). Above all, think about your goals for your family. You have a plan to be back in North America soonish. That is a plan. And it's your plan and makes sense for your family. I'm sorry this is so hard. It will get better.
posted by jessamyn at 7:05 AM on March 16, 2015 [2 favorites]


I have a very understanding boss, and I go home every 3 months for a few weeks. My mom and I can spend a lot of quality time together.

This is really good. When you see her next, some things may become clearer. You sound a lot like the way I felt when my mom was diagnosed with late-stage cancer. My sisters and I saw her soon after that, and it became obvious she had her own preferences about how things were done. Wherever possible, I would say to let the person with the illness lead the way. Yes, they will probably make an effort not to demand too much of you, but you can get an idea of what would be most helpful.

Wishing your family the best.
posted by BibiRose at 8:13 AM on March 16, 2015 [1 favorite]


I sometimes need to remind myself that my partner is very important to me and my #1 support system. Does he count as family also?

I just wanted to address this - YES ABSOLUTELY. I'm having a bit of trouble computing why you would think he is not? Are you not married? Regardless, it sounds as if you are both committed to spending the foreseeable future together, so YES ABSOLUTELY, not only is he family but he is your primary life partner.
posted by nakedmolerats at 9:10 AM on March 16, 2015


I'm in a similar, if less extreme, situation to you - mom has stage III breast cancer for which she just had her first round of chemo (I was in town to go with her and stay a few days after). She lives in Northern California with her son, my older brother, who I wouldn't say is abusive but is very introverted, lives rent-free, leaves laundry around to get "magically" cleaned, and will drive her to appointments if asked but is by no means engaging company for my mom to have. I have one sister in Michigan and one in college about 4 hours away from my mom, while I'm in Seattle. AND I'm moving even further away with my partner to North Carolina for a new job with no foreseeable time off until July (and a promotion for my partner). This is after ten very not fun months of unemployment for me, so I'm very much feeling the draw career- and fulfillment-wise, which then makes me feel selfish, while at the same time if I were to move back to California, or even just stay on the West Coast, I know I'd feel trapped and resentful for pausing my career. I'm already irrationally mad at my mom's cancer for 1) existing at all, and 2) coming at an inconvenient time.

But in both our situations, it seems like the addition of cancer really ended up bringing other ongoing issues to light. My mom has difficulty self-actualizing and improving her situation without becoming overwhelmed (she's been "trying to get the house ready to sell" and "waiting for the market to improve" for years and years, which now has moved from the back burner to off the metaphorical stove entirely while she's coping with her illness). Same with my brother and enabling his situation. (Forgive me for being forward if this is totally not-your-mom type stuff).

It sounds like your job and partner are being accommodating with your (pretty frequent!) trips home, so if that schedule isn't exhausting you financially or emotionally, keep up with that. There's not much you can do for your mom's symptoms other than encourage her to call the oncologist, or do it yourself if you're in town when she has her treatments. Try to make the time when you are home with her fun, and just be helpful in general. Otherwise, send emails and call home when it's a good time for her, and keep the channels of communication open. Send care packages, since everyone loves getting physical mail. I sent my mom books, after some very helpful suggestions from fellow MeFites. When and if things get more urgent, you can move home temporarily (I am planning on doing this in an emergency, although with my mom's cancer, she's expected to be cured). Or like others have suggested, encourage her to come to you, since it sounds like it may be easier to uproot her than for you and your partner, and potentially your masters project, to move (I'm trying this strategy as well with my mom :) ).

I don't think there's one right way to help a parent with cancer. I wouldn't bet on your brother suddenly stepping up to be a great nurturer, but you also have no control over him, so try not to let him become more of an emotional burden than he needs to be for you. Good luck, big hugs, and do your best to be nice to yourself and not get too hung up on feeling like a selfish jerk for recognizing the importance of your own life, your partner (who, yes, is your family), and your career.
posted by Drosera at 1:29 PM on March 16, 2015


The real question here is, is your brother so much as lifting a finger if she's vomiting and passing out/generally too ill to do his laundry? Because if she is being utterly abandoned by her in-home caregiver while she's in dire shape, then yeah, you may need to take steps to move home ASAP. If it's not THAT bad yet, then I'd say to wait it out a year and finish what you're doing before you move home.

How possible is it for you to move her to where you are, legally speaking?
posted by jenfullmoon at 7:12 PM on March 16, 2015


Mentioned above but I think it is worth repeating- something you can do for your mom from anywhere is havethe serious conversations needed about her care. What does she want? (All the chemo, all the surgery, none?) What sort of quality of life issues are affecting her? How much treatment is she willing to undergo to possibly prolong her life? These aren't easy questions, and you may not need the answers right now, but starting the discussion now could make her last days/years/months more comfortable, regardless of your ability to be there in person.

Depending on her insurance situation you might have access to in-home hospice care even before(if ever) she chooses to stop treatment. Look into your options here; it might also give you some peace of mind if you know there is someone scheduled to stop by and see about her comfort.

Also yay for skype. I am living overseas and thus wasn't able to go see my grandma before she passed earlier this year, but I did get to skype with her and for that I am grateful. You may not be able to see her in person as often as you like, but part of what you both need is human connection, which these days can still be had at a distance.
posted by nat at 2:26 AM on March 17, 2015


One thing that can be done remotely is to have the difficult conversations with her about her affairs when the inevitable happens. For example - does she have a will? Where is it? Does she have life insurance? Where is that information? Are there any particular wishes or requests that she has regarding funeral arrangements, cremation vs. burial, etc. May be worth it also find a good Estate Lawyer in the area your mom lives in, in case it's needed.

I'm so sorry you're going through this. My dad recently fell ill, and I offered to drop everything and move closer to help out. Unfortunately, he died suddenly, and I'm finding that I have to wing it when taking care of his affairs after the fact, because he didn't plan anything.
posted by spinifex23 at 10:18 AM on March 17, 2015


Response by poster: Dear all,

Thank you for all these responses over the past two days. I am touched.

My mom is actually currently in the hospital as of 15 hours ago, she had to undergo emergency surgery but is now recovering and I am hoping all continues to go well. Everything happened so quickly there was no time to even think about flying home. Add to this that my mom was insisting nobody tell me what was going on as to not worry me (!!) I was lucky enough to be able to talk to her over the phone as they were preparing to take her to the OR- those few minutes meant a lot to me, and I hope, to her. Her friends have been with her and I know she is not alone.

To answer some of your questions: She knows I would be absolutely thrilled if she came to live in my city, but has also said it won't happen. I think she needs the familiarity of her own town. We have already begun talking about "end of life" affairs, power of attorney (which I already have), and other logistical things. We've updated her will, and I will be the one to...? I'm at an absence for words at the moment but I'll be the one who is responsible for it. Over the past 12 hours I've managed to contact her closest friends, let them know which hospital she'll be in for the next week, and established texting connection for quick contact just in case. While in theory this emergency should have a positive ending (still alive, less pain, better quality of life, I hope), it is forcing me to reevaluate what I need to do, as the absolute anxiety and stress while someone you love is in hospital and you are across the world without knowing what is going on is- I wouldn't wish it on anybody. Thank goodness for my boyfriend, but if he weren't here, neither would I be.

With regards to one poster, my partner is my life, but no we are not married, nor do we have children. Therefore, I sometimes wonder, would people understand my "need" to stay where I am if I said I had "husband and children to look after" rather than simply "I am happy living with my boyfriend".

My brother, unfortunately, did not step up to the plate this time around, and I am trying to have more empathy towards him because at the end of the day, he must be suffering in his own way, even if I cannot understand. The poster who referred to co-dependence relationships- this is the word I was alluding to and describes a lot of dynamics in my household. It's hard to be the only person in your family who is trying to make their own way by doing what she chooses, while also trying to be loving to those who love her. In my family it was either 1.cater to everyone else's needs or 2. be selfish and abandon your family. I didn't get to see a lot of balance, and I don't want to subscribe to either dynamic if I can help it.

I'm very thankful for all your words of kindness. Wishing peace and strength to all of you.
posted by stumblingthroughitall at 2:31 PM on March 17, 2015 [3 favorites]


« Older How do I deal with a weird friendship?   |   What's happening in Cincinnati? Newer »
This thread is closed to new comments.