How to navigate end-of-life communications between estranged family members?
December 7, 2012 1:23 PM   Subscribe

Elderly mom is ill. If it looks like she's not going to make it should I tell her estranged daughter (my semi-estranged sister) despite the risk of an ugly scene ensuing?

My mother is 85. I just found out from my oldest sister (let's call her Georgette) that mom is in the hospital with some as-yet unidentified digestive tract ailment. She might recover completely, but she is at an age where I need to start considering what to do when she gets into an end-of-life process.

Georgette is 65, I'm 48. Our other sister (let's go with Angela for her fake name) is 50.

tl;dr version: If/when mom is on her way out of this world, should I tell Angela (who has been estranged from mom for nearly two decades and from whom I am mostly estranged) so she can have the opportunity for closure despite the very real possibility that contact between her and mom could become an ugly, painful experience?

My family is mostly estranged. Parents divorced in the late '70s. Georgette was already living on her own before then. Angela and I stayed with our mom and saw our dad every couple weeks or so. No overt abuse or anything, but dad was a passive-aggressive robot who didn't know how to relate to kids, and mom was always stressed trying to care and provide for two kids. She's also a self-absorbed narcissist. She's alo a high-functioning alcoholic (bizarrely, none of my siblings or I demonstrate any alcoholic tendencies). A lot of people had much worse childhoods/adolescnces, but growing up was pretty stressful for all of us in the family. Dad passed away in 2003.

Angela and my mom never got along. In junior high and high school this escalated into out and out hostility. Later it got worse, and the relationship pretty much broke permanently when Angela slapped my mom in the face and stormed out after an argument.

Angela has been treated for schizophrenia. I don't know if she's currently being treated. After several instances of her hostile behavior toward me over the years I decided I didn't feel safe around her and didn't want her in my life. We were forced back together when dad died and we had to sort out his estate. Everything was fine until she just couldn't handle the harmonious situation we three siblings were involved in, so she manufactured some drama which re-alienated me.

Facebook has provided the perfect level of interaction - we can feel connected and make clever comments on eachother's posts but we don't need to engage on any level that involves any real vulnerability. It seems from my limited perspective that she is pretty stable at present.

Georgette and I have typically been peacemakers in the family and tried to maintain relations with everyone (I finally gave up on Angela after the incidents I alluded to above). Angela and my mom have not spoken or had any interaction for the last 18 years (or more).

All three of us have had periods of up to 5 years where we have not had any interaction with my mom. Mom is opinionated, judgmental and difficult. She will find a way to argue with you even if you are explicitly agreeing with her. She craves attention from us, but demonstrates no interest in us, our lives or activities. She is unwilling to accept any responsibility for the state of relations in the family and punishes anyone who dares stand up for themselves with guilt and the silent treatment, casting herself as a martyr.

A few years ago Angela asked me to let her know if mom came down with any ailment or disease that might be hereditary or run in families. Her request was absolutely one of self-interest - she wanted to be made aware of anything that might be an issue in her own health. My feeling on the matter was that if she wanted that kind of information she should undertake to develop at least a civil relationship with mom. I didn't commit to telling her anything and I didn't share my feelings with her because there is no upside to engaging with her on anything of importance.

Georgette and I don't know what's wrong with mom right now, and it may turn out that she'll recover and live many more years. It may turn out that she has entered the path out of this world. We just don't know yet. In any case, we are now faced with the question of how much to tell Angela and when.

On the one hand, it would be awful to deprive Angela of the possibility of any kind of final contact and possibly some measure of mutual forgiveness with mom. On the other hand, given Angela's need to create drama and tension even where none exists, and her and mom's mutual button-pushing abilities and stubbornness, it's equally possible that any contact between them would turn hostile and just make things worse for everyone.

We could let mom decide whether we tell Angela anything, but if mom had her way Georgette and I wouldn't even know she had been hospitalized (she hates seeming weak). And while I would respect her wishes regarding any contact with Angela, I feel on some level that Angela should know if mom is about to die, if for no other reason than it would be less of a blow to her than just getting a call saying "Mom died."

I don't feel especially responsible for worrying about the feelings of these people, but I'm in a position where I have some knowledge that others might benefit from knowing, so I do have to make a decision about whether to share it. I don't see any choice that won't be perceived by someone as meddling or assholish, but even deciding not to take action is a choice so I am forced to at least figure out which kind of asshole I'd prefer to be perceived as.

So my questions are, does the risk of enabling a hostile encounter between a dying parent and her estranged daughter outweigh the potential benefit of informing said daughter? Should I tell Angela what's going on so she has a chance to possibly... not reconcile, that's too strong, but at least have a civil interaction and maybe get some closure? Or do I just step back, realize that these two adults are responsible for their own relationship and just let Angela know when/if mom dies?

From a more abstract perspective, between two awful people, who is more deserving of protection: the one who's dying, since dying sucks and it should be made as easy as possible, or the one who's not dying because they'll have to live with whatever happens?
posted by under_petticoat_rule to Human Relations (32 answers total)
No. Angela is a grownup and she can do the math (as she's demonstrated with her hereditary disease inquiry.) If she wants to be there for your mom or get closure, all she needs to do is ask how your mom is doing. You don't owe her some special notification and the risk of a horrible final scene sounds real here.

She should be notified if your mom dies about the funeral arrangements.
posted by bearwife at 1:30 PM on December 7, 2012 [4 favorites]

Check with your mom, assuming she is of sound mind and is able to communicate. As long as she is, it's her call. You can offer to contact Angela on her behalf, but I wouldn't do it without prior clearance. If your mom dies without her and Angela reconnecting at all, Angela may blame you, but you'll at least have this to fall back on.
posted by adamrice at 1:31 PM on December 7, 2012 [3 favorites]

You never know how people ultimately will react when confronted with news like this. Everyone is an adult, everyone is responsible for their own feelings and expressions of those feelings.

If you keep this from Angela, then it's likely that you will become the the bad guy. You will have made Angela's decision for her to reconnect or not, and I'm not sure that's your right.

Having seen other family members in similar situations, the estranged person usually finds it within themselves to come back for whatever goodbye they think is necessary, and usually without opening up the problems of the past, which probably don't matter anymore.

Everyone is different, though. But making this choice on your sister's behalf? I'd be extremely wary of that, no matter how well-intentioned you are.
posted by Capt. Renault at 1:34 PM on December 7, 2012 [5 favorites]

Yes, the right thing is to let her know. This is an empathetic urge on your behalf that should not be suppressed.
posted by steinsaltz at 1:39 PM on December 7, 2012 [10 favorites]

I wouldn't put this burden on your ill mother. Especially your high-functioning-alcoholic-self-absorbed-narcissist mother. This situation is a perfect cocktail for either your sister or your mother or both of them to turn it into a dramarama.

I would suggest having some frank conversations with your mother about some GENERAL PRINCIPLES that she'd like you to address. Does she have a living will? A will? A proxy medical decision maker? Ask her if there are any other details she'd like you to attend to. Don't suggest contact with your sister outright.

Look, you've already identified the fact that your role in your family has been one of peacemaker with profoundly broken people. This is just another opportunity for your to act on those codependent/approval-seeking behaviors. You need to stop that. For yourself. I know that sounds way harsh, and I don't mean it to be. I am sure this has been draining and awful and really painful, and you just want to Do The Right Thing. But honestly, the right thing when dealing with abusive, narcissistic, awful people is to protect yourself and be the happiest and healthiest person you can be so that if they decide to take part in being happy and healthy, they're welcome to join you.
posted by jph at 1:39 PM on December 7, 2012 [2 favorites]

Yes, let her know what's going on. Don't put any pressure on her to come visit - let her make that decision herself.
posted by Dasein at 1:41 PM on December 7, 2012 [1 favorite]

I would let her know. Then, the ball's in her court as to how she wants to proceed from here on out.
posted by spinifex23 at 1:45 PM on December 7, 2012 [1 favorite]

No doubt, you will be blamed by somebody in this situation, no matter your decision. So do what feels right.

I'd lean in favor of sending your sister an update and telling her whatever was important and then if she wants to drama-fy it, step back and refuse to engage. "That's between you and Mom," "That's your decision," "I'm not going to get in the middle, it's between you and Mom." Whatever you need to say.

Or don't contact her and let her blow up when your mom does die, if you think you'll handle it better then.
posted by emjaybee at 1:45 PM on December 7, 2012 [4 favorites]

I'm with bearwife. Your mom is quite elderly and Angela must be well aware that she could die suddenly at any time - if she wanted to have closure she would have made a move to get in touch with her already.

Let's be clear - you are not depriving her of the possibility of forgiveness and a final contact with your mother. She has deprived herself of that.
posted by treehorn+bunny at 1:48 PM on December 7, 2012 [5 favorites]

I think you might be overestimating the ability of a dying person to have a blowout with anybody, difficult or not.

And yes, the difference between "mom is dying" and "mom is dead" is the blowback you're going to have to deal with after your mother is gone. I'd rather be in the "hey, I told you it was coming camp" than be the horrible horrible sister who didn't even have the decency to tell her before she died blah blah.
posted by Lyn Never at 1:51 PM on December 7, 2012 [2 favorites]

Wait, you and Angela are Facebook friends?
Make a list of friends you don't mind knowing, and include Angela (make a list to avoid broadcasting to your whole friends list) As some point in your mother's illness you may be comfortable saying to those few friends, "Gosh, what a crap week. Mom's in the hospital since 2 weeks ago. I'm tired."
Angela will then have the option to contact you, ask for details, etc, but not the obligation. She will know, but you haven't sat down and said "mom's dying, I thought you should know", which she could htink implies that you want her to do something (like get in touch with your mother).
posted by aimedwander at 1:56 PM on December 7, 2012 [11 favorites]

We could let mom decide whether we tell Angela anything, but if mom had her way Georgette and I wouldn't even know she had been hospitalized (she hates seeming weak). And while I would respect her wishes regarding any contact with Angela, I feel on some level that Angela should know if mom is about to die, if for no other reason than it would be less of a blow to her than just getting a call saying "Mom died."

This sounds a bit like you assume your mother would not want to see Angela. Plus, it couples that assumption with your perception that she doesn't want people to know she's in the hospital. While that perception may well be valid, it can be separated from the question of whether she would like to see Angela again. And the thing is, you just don't know.

If I were you, I would bring up the question of whether she would like to see Angela at some point. Not frame it as "for the last time, because you're going to die," but just to see how her thinking about that is currently. Don't get your own feelings about Angela mixed up in that discussion. If your mother shows interest, you can ask about extending an invitation to Angela, and then hope for the best.

Otherwise I might agree that Angela has got to know your mother won't be around forever-- if it's really clear that the estrangement is her choice. What does Georgette think about this? With a lot of families I know, there are different versions of who estranged whom, depending on who you talk to.

I'm sorry you're in this situation.
posted by BibiRose at 2:16 PM on December 7, 2012 [1 favorite]

"Angela, Mom was just hospitalized. I have no details as to how bad or not it is. Do you want to be kept up on the details? Georgette and I are in contact with Mom and her doctors. Let me know."
posted by JohnnyGunn at 2:19 PM on December 7, 2012 [3 favorites]

This should be your mother's decision.
posted by L'Estrange Fruit at 2:22 PM on December 7, 2012 [1 favorite]

Ask you Mother,

Downside? Its no longer your business

Upside? Its no longer your business
posted by Blasdelb at 2:26 PM on December 7, 2012 [1 favorite]

As long as your mother is able I would say leave it in her hands. If for some reason she's incapacitated then I would probably say something to Angela but it also could be past the point of her being able to get closure if your mom isn't communicating anymore.

Honestly if you're friends on facebook and she knows you keep in touch with your mom, she's perfectly able to reach out if she wanted to.
posted by brilliantine at 2:28 PM on December 7, 2012 [1 favorite]

Tell her.
posted by GeeEmm at 2:41 PM on December 7, 2012

I vote for sending her a simple message on facebook: "just wanted to let you know that mom is in the hospital with some sort of infection, we're not sure how serious it is"
That's it. Short, simple, to do the point.
posted by Neekee at 3:37 PM on December 7, 2012 [1 favorite]

Ask your mom. It should be her decision about whether or not she wants to deal with a shitstorm when she's feeling so crappy.
posted by small_ruminant at 5:02 PM on December 7, 2012

I think you need to tell your sister that your mom is in the hospital. If there's any time that they might reconcile, it would be now.

All three of us have had periods of up to 5 years where we have not had any interaction with my mom.

Imagine what it would have been like if your mom died when you were estranged from her and no one told you she was ailing. How would you have felt about that, and how would you have regarded your sisters after they didn't tell you?
posted by oneirodynia at 5:41 PM on December 7, 2012 [5 favorites]

My mom passed away unexpectedly less than 24 hours ago. I can tell you that each child, no matter how screwed up, deserves to know about the death/impending death, and they appreciate it immensely as well- whether they explicitly tell you or not. Losing a parent is so, so hard as it is...

You have to let go of your protective nature and over analysis here and let the chips fall where they may.
posted by xm at 5:46 PM on December 7, 2012 [6 favorites]

I'm not sure why you both recognize your mother's unloving and uncaring behavior and how difficult it is to get along with her as well as your sister's mental illness (schizophrenia is very real and severe and it's not a choice) and then go on to blame her for her estrangement from your mother. Your sister didn't have a choice in how she was raised or by whom. You might be more resilient than your sister, and she might be difficult to handle, but that doesn't make your sister a bad person. Nor is your resentment towards her for having escaped while you still maintain a civil relationship with your mother her fault.

So, that said, letting your sister know might or might not be dramatic, but again, you're placing the responsibility where it doesn't belong--on yourself. If your mother or sister behave badly, that is on them. If your sister regrets missing out, that is on her (and your mother, as she certainly had a hand in the estrangement).

I can't endorse one action or another, but I hope that my answer is helpful anyway in putting this situation in perspective.
posted by the young rope-rider at 8:16 PM on December 7, 2012 [2 favorites]

I don't believe I blamed my sister for the estrangement, and it's quite an assumption you're making that I resent her for having "escaped". You're right that children don't choose who raises them, but adults - even adults with mental illnesses - make choices about how they behave, and whether they continue or abandon processes that help them function appropriately. Both parties have behaved badly, and in my opinion estrangement is possibly the best solution for their interpersonal difficulties.

I know that AskMeFi is not supposed to be a conversation, but this - " I hope that my answer is helpful anyway in putting this situation in perspective." would have been better realized if you had skipped the assumptions you made earlier in your response.
posted by under_petticoat_rule at 8:41 PM on December 7, 2012 [2 favorites]

When my dad was dying, his son (my half-brother) insisted on coming to visit, despite my dad not wanting him to come. It was awful. It tired dad out and upset him a great deal. It upset everyone around him. I know that he would have preferred him not to come, and the fact that we didn't prevent it by whatever means available is one of my big regrets.

I would say that if your mother is alert enough that there could potentially be drama, it's her decision. It's not about you or about your sister, so if your mum doesn't want to see your sister then who are you to prioritise your sister's possible feelings over the quality and peace of your mum's last few days and hours?

Just another way to think about it, but one that I strongly believe is best.
posted by kadia_a at 2:15 AM on December 8, 2012 [2 favorites]

I'm not sure how much I believe that people make 'choices', as such, whether people have mental illnesses or not; I see decision as a kind of collision of opportunity, readiness, timing, inclination, environment, and chance. Things fell the way they did for your mom, for your sister. Maybe they'll fall differently, if you let them.

Is it really up to you to protect your family? Is that obligation fair for anyone involved (including you)?

I agree that it's your mom, really, who needs to make the call. (On second thought: the passive Facebook comment idea is a good one, in that it opens a window for your sister to make enquiries, and for your mom to respond as she wills, before it comes down to urgent, forced choice.)
posted by nelljie at 2:32 AM on December 8, 2012

('Choice' in the last sentence meaning binary options. There are more than two for the moment.)
posted by nelljie at 2:38 AM on December 8, 2012

I don't believe I blamed my sister for the estrangement

You did, explicitly:
...the relationship pretty much broke permanently when Angela slapped my mom in the face and stormed out after an argument.

...she manufactured some drama which re-alienated me.

It's your choice to have decided to keep her out of your life, and I do not mean that in a blaming sense; simply pointing out that your sister is not the only one making dramatic choices. (I also do not mean "dramatic" in a blaming sense. I cut off my own parents during a time of high drama... although there were never really any other sorts of times with them... and own the fact that cutting off my relationship with them was indeed dramatic. It saved my life, and said life has been wonderfully calm in comparison ever since.) It's just somewhat odd, really, that you've written a question that carefully puts the weight of the drama mostly on your mentally ill sister who has been in treatment, presumably of her own choice, but you insist on focusing on her negative choices and writing a lot about how drama will ensue, all while quietly saying in the midst of it all, "It seems from my limited perspective that she is pretty stable at present."

Your mother nearly didn't tell you and Georgette she was hospitalized; how did that make you feel? "She is unwilling to accept any responsibility for the state of relations in the family and punishes anyone who dares stand up for themselves with guilt and the silent treatment, casting herself as a martyr." Yet you're still in contact with her, and not Angela.

Just accept that you too have made choices that could be interpreted any number of ways and that not telling Angela would be a rather cruddy choice. Tell her matter-of-factly, and if you don't want to be a permanent go-between, tell her she needs to get in touch with your mother herself from that point on since you don't want to be caught in the middle. Some of the healthier members of my own family have done this at times (myself included) and it's always worked out fine. We're all aware of the dysfunction, and it helps clear the air when it's acknowledged as a simple fact rather than as a dramatic neverending drama of drama-full proportions into which all dramatic actors must inevitably be pulled.
posted by fraula at 3:09 AM on December 8, 2012 [5 favorites]

I jumped all the comments, so excuse me if I am repeating something that has already been said.
My mother and youngest sister have been estranged for a lifetime, after fighting from my sister was a young teen till she moved out.
These days, I am witnessing the sweetest reunion - our mother was hospitalized, and I called my sister to say even though I was certain this would come out well, it was the beginning of a long, painful end. And she came to the hospital to visit, and then they started talking. I don't get their relationship at all, they bicker all the time, but they both seem very happy to have each other again.

My point of view is, that even though I do not really like my mother, it is my responsibility to help her and care for her. It's a question of dignity for me. So my mother is very dependent on me, but also knows I won't and can't engage in her crazy life. My sister has a very different approach, and engages 100% in all our mother's life decisions, generally critically. It works very, very well. Sometimes, something is good, even when we have no idea how it works.
posted by mumimor at 3:23 AM on December 8, 2012

Yes, tell her.
Don't get dragged into any argument or drama or extended conversation over her past. Simply say, "I think you should know that mom is failing and may not last more than a few more days" (or however long her prognosis is) Leave it at that. Let your sister decide what she will do on her own.

Deliver the news and move on.
posted by Thorzdad at 6:07 AM on December 8, 2012

Angela and my mom have not spoken or had any interaction for the last 18 years (or more).

Sounds to me like closure has already been achieved.

I'd let sleeping dogs lie.
posted by flabdablet at 7:52 AM on December 8, 2012

When my mother was dying, my uncle asked her if there were people other than the family already present that she'd like to see. He especially mentioned his ex-wife (my aunt, once a close friend of my mother's - Mum introduced her to my uncle) and she said no. She didn't say so in so many words, but she didn't want people standing around her bed wringing their hands - she just wanted to go quietly and with as much dignity as was left to her.

After Mum's death, I got a passive-aggressive email from my aunt, basically blaming us for not letting her know in time to come and visit. (She was not so passive with my uncle - apparently she bailed him up and yelled at him when she saw him in the supermarket.) Although I hadn't been in touch with my aunt, I had spoken to her daughter and son via facebook, and both knew that Mum was dying. I am sad for my aunt and her regrets, but I personally have no regrets about not contacting her, since my mother did not want to see her, and making her last days as comfortable as possible was absolutely my priority.

OP, your situation is a bit more complicated than mine, not least because there is drama and disorder in both your mother and your sister, but also because there's no obvious place for your loyalty to lie - your mother and Angela are both close blood relatives, you have complicated relationships with both of them, you want to help your mother but if she were to die you would still potentially have to deal with your sister.

If you believe your mother is dying imminently (as in, won't be going home from the hospital) you could ask if there's anyone she'd like to see, and if there's not, leave it there. It seems like your mother doesn't like people seeing her when she's in a weakened state, and is likely to say no. If Angela did have a desire to see your mother before she went, it's not obvious to me that it would override your mother's desire for others not to see her weakness (or desire not to see people for any oher reason).

If you're not comfortable with that position, and unless your mother has specifically asked you not to, you could consider letting Angela know that your mother is in hospital - the facebook option others have mentioned above seems ideal, except that facebook now only sends your updates to a small fraction of your friends (unless you pay them) so it would be hard to be sure she'd seen a blanket broadcast. (Though I wonder what would happen if you set up a friend group with only Angela's name in it - not sure if that would work or not.) As others have identified above, you don't have to be the peacekeeper/gatekeeper, and you don't have to make something happen or block it from happening.
posted by Cheese Monster at 4:20 PM on December 8, 2012

The hospital never really determined what the problem was, but mom was released from the hospital and is back to her normal life at about 85% power and improving.

Georgette and I spoke and have decided not to be gatekeepers or protectors of feelings that we can only speculate about. She let Angela know mom was in the hospital while we still didn't know what was going on. I haven't heard anything about it from Angela in our social media interactions.

Georgette and I are going to visit mom in March. As long as mom's health is good, we'll have a discussion about mom's end-of-life wishes including how she feels about letting Angela know about any future issues.

Thank you to everyone who took the time to reply.
posted by under_petticoat_rule at 11:55 PM on January 7, 2013

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