Mom needs to take care of herself more. Help me help her.

September 24, 2007 10:48 AM

Caretaker (mom) almost completely neglects her personal health and life goals to help chronically ill but stable (dad). Her health is now declining. How do I help her understand that she needs to take better care of herself?

My mom has been taking care of my dad for about 3 years now. They are both retired, in their 60s. He has been adjusting to life in a wheelchair, and is incredibly slow with elements of his daily routine (but is otherwise in decent health).

She constantly worries, stays up at night and is by his side whenever he has any problems. She has not left his side once since he has been in a wheelchair. This behavior makes it so that he depends on her even more, and does not learn to care for himself. He even has a personal care attendant 40 hours per week (to take stress away from mom).

Each time we have a family meeting, the end result is that he promises to be more independent and she promises to take better care of herself. However, nothing ever changes. He has done a number of wheelchair camps and rehab programs, but reverts back to depending on her, because she continues to enable him. When we tried to cut the attendant's hours, mom quickly tried to fill the void by helping him more. She became exhausted.

Before his condition, dad was incredibly needy. He didn’t cook, clean, help with gardening or much else around the house. By default, she has always done all of the heavy lifting. But now she is getting old and I want for her to have some quality time in her life… time for herself. She has always been so selfless it seems totally unfair. How do I help her realize that she needs to take time for herself? How do I help him realize that he should enable her to care for herself?

posted by anonymous to health (9 comments total)

Threaten to put your dad in a home. Alternately, find something for her to do that she'd feel like she was letting other people down (say teaching a class) if she flaked.
posted by notsnot at 11:08 AM on September 24, 2007

It sounds like your parents are playing the roles they always have, and the problem is simply that the finger of disease is now on the scale, aggravating the inequity they'd tacitly agreed to all along.

(imagine for a moment - what if your mom had become disabled? would your dad have risen to the occasion or not?)

This sounds like it might be an intractable condition. The only solution I can think of is for your mother to go away for a while. A few weeks or a month, perhaps with one of her kids if any of you can swing it, or with a friend, with the knowledge that your dad is in good hands. Far enough away that it might be a bit difficult to make it home except for an emergency. Cruise, anyone?

That might be the only way for her to clear her head and consider that she only goes around once, and that perhaps there might be an alternative reality to orbiting around her husband.

Best of luck to you and your family.
posted by pammo at 11:17 AM on September 24, 2007

Can you meet with the PCA and explain your concerns about dad's independence? Perhaps during those 40 hours a week, the focus can be on empowering him and getting him to do things for himself, rather than just having a different person to do things for him.

This might give mom a chance to see that he can do things himself, without having to personally feel she is "abandoning" him or whatever other worries keep her from letting go. And once he gets a taste of doing for himself, dad might be inspired to take some initiative even when he's with mom.
posted by hilatron at 11:20 AM on September 24, 2007

when was the last time your mother went to see her doctor? if she's worrying all the time, you should take her to be evaluated for anxiety and depression. In addition, a physician or psychiatrist might be able to convince her of the need to pay attention to her own physical and psychological needs as well as her husband's.
Perhaps you can reframe your argument for her to take a more measured approach towards taking care of your dad as not something just for her benefit, but for his as well. if she doesn't get sleep at night, how can take good care of him for the entire day? and over weeks and months it becomes nearly impossible, and therefore would all but ensure that one of both of them would have to be placed in a nursing home. most people really hate the idea of having to leave their home, especially if it means selling their house of many years and moving into a nursing home.

you say your dad's in a wheel chair, but if he's still functioning well mentally, you should appeal to him as well. it might not be easy for him to hear that he needs to stop making his wife do everything for him, but if you tell him that it's something he has to do for his wife, then i imagine that would be pretty hard to argue with. emphasize how if things continued as they are, a nursing home is an inevitability. not as a punishment, but simply because of how things are.
posted by buka at 11:50 AM on September 24, 2007

you have to let your mom make her own choices. they have a system that works for them. only when it stops working for them (she gets ill or hurt, or otherwise interferes with something they want to do) will they change.

that said, instead of getting your mom to revise her entire outlook on life, why not get her into a support group for caretakers? there is surely one in your area, probably at your local hospital.
posted by thinkingwoman at 12:03 PM on September 24, 2007

I'm not sure I understand the problem here, or that there even is a problem. If their current relationship is consistent with the one they've enjoyed all along, why does it need to change, other than the fact that you don't agree with the balance in their marriage?

Do what you can to give mom a break from time to time, but if she's the type that's a natural-born worrier (as many nuturers are), the current situation may actually be the lowest-stress solution.

My grandparents went through something similar; Grandpa had a stroke and was severely limited in both mobility and mental abilities. Grandma, who is much smaller than he was, just about killed herself taking care of him for the five years until he died. But since they loved each other, there really wasn't any way they would have rather have done it.

After he passed (about 25 years ago), she bounced back physically and will celebrate her 90th birthday next year. She now lives with my mom, who's also a compulsive worrier/nuturer. What goes around, comes around, I guess.
posted by Doohickie at 1:06 PM on September 24, 2007

Take your Mom's place for a little while yourself and let her have a break now and then.

When you do, don't be so self-sacrificing. Help where your Dad needs help and encourage him to be independent where he is able to. This isn't going to change by lecturing at them; you need to step in personally. If you aren't willing to do that, I can't see either of them changing.
posted by misha at 1:53 PM on September 24, 2007

Every time your mom mentions how tired/stressed/worried she is, gently mention that one thing that might help with this is to do x/y/z thing to take care of herself (get enough sleep, take some time for herself, accept that she can't do everything). My mom (though not a caretaker right now) is constantly bending over backwards to do things for the rest of the family, to the point that she is always exhausted. Over the years, I have tried pointing out that maybe taking on these burdens is not the best thing for her OR the people she's trying to help (e.g., "if you continue to do [brother]'s laundry, he'll continue to feel like he doesn't need to do it himself"). I do think that, by putting the message positively, not going on and on about it, and mentioning it on a regular basis, she has started to change her priorities. Now, although she still does more for family members than I think she should, she does take time to exercise sometimes, stay on top of her own health issues, and relax on her day off (even though she still feels overwhelmingly guilty about that last one).

Also, would it help if you pointed out that nudging your dad into doing things for himself (by not catering to his every need) would benefit not only her, but him as well? It's win-win. (For example, [brother] now does his own laundry, thereby both removing that self-imposed burden off of my mom, and learning how to be a responsible adult).
posted by splendid animal at 2:57 PM on September 24, 2007

The baby step, the first step, to helping her take care of herself is letting her take a break, like misha said. Sometimes it doesn't happen by telling someone to do it, but by letting her do it, even if that means temporarily taking over her duties in the manner that she would like them to be performed. It might suck for you or the caregiver but that might be what it takes for her to get out of the house that first time and have a day at the mall or spa or church or wherever she needs to go.

Once she's having a day off or some time off each week, it will with any luck become addictive and she will complain if for some reason it is canceled one week. This is a good thing. Also when she comes back from her breaks she will hopefully be learning that dad wheeled himself around the block by himself or whatever other accomplishment he is more than capable of achieving. This is what worked a little with my stubborn grandma anyway, to the point that if she didn't get her daily break from her self-imposed schedule of caretaking we would all hear about it, whether we lived next door or out of state.
posted by PY at 7:02 PM on September 24, 2007