So, this is both a question and an update about a family situation that I've posted about here over the last 4-5 months. Several of you have offered some very helpful insight, which I appreciate a lot, and you've asked me to share updates as things develop. This is the current juncture that we're at.
The short version: My parents, both in their 70s, are struggling with mental health challenges, and my sister and I (both in our 30s) have struggled to help them without emotionally burning ourselves out. For our dad, the mental health challenge is mild cognitive impairment which has progressed in the wake of a bad fall he had in March. (He broke his hip and needed surgery.) For our mom, it's chronic depression and anxiety that she has never really committed to treating long term with therapy and/or medication. This can make it very hard for her to accept help when it's offered, or to avail herself of things that can help. When our dad was recovering from his surgery at home, my sister and I implored her to hire in-home help or consider a short term respite care stay for our dad, so that she could get a much-needed caregiving reprieve. Both options were affordable for them, but because the decision was in our mom's hands and she was burnt out, neither came to fruition.
What's been excruciating about this for my sister and I is that we are often the first people our mom turns to when she's feeling really down or scared about the future; which is frequent these days, given how burnt out she is. This has made it very hard for us to sit down with her and make a plan for getting her and our dad more support. A lot of our attempts to talk about this with our mom have turned into circular, stress-driven venting sessions that leave her feeling temporarily better and the two of us feeling awful. It has become abundantly clear that we need to draw more boundaries with her, and we have done this. But given the ground reality that our dad's MCI is progressing and our parents do need help, we can't walk away from this.
My sister and I have often joked/grumbled that all of this would be easier if our parents gave us their blessing to start setting things up like home help, mental health support, etc. And earlier today, we had a conversation with our mom (who's had a pretty bad week, mentally speaking) that felt like the closest we've ever gotten to that place; where she accepts more direct help from us and even allows us to start facilitating important things and being participants in the decision-making about their health and situation. For the short term, we persuaded her to make an appointment with her PCP for next week to discuss how she's been feeling and modalities. And we agreed that next week, we would re-group to talk about getting hired help for our dad, mapping out the process, and delegating the legwork. I even put it out there that if she needs like this is too much for her to take the lead on, my sister and I are willing to take the lead on setting up meetings with potential caregivers and proceeding from there, when it comes to the hiring and such.
She seemed more open to this than we've ever seen her before, and I have to wonder/hope if it's deeper self-recognition that she needs help; not only with the day-to-day challenges of caring for our dad, but in making decisions that (understandably!) feel overwhelming to her right now. My sister and I are cautiously hopeful that we may finally be reaching a turning point; that we can avoid having to give up and just wait for the next crisis to happen.
All of which left me wondering: Have any of you reached a point at which your aging parent(s) not only started accepting more direct help, but also allowed you to become more of a participant in making decisions with them? If so, what did that look like? And how did you respond to it?
(Footnote: In case anyone asks, we have established POA, health care proxies, and will matters legally.)
Perhaps you could tell your mom that her mental health is interfering with her functioning (for example, taking care of your father) and that's why you're pushing treatment, and that you'll help your dad if she can't help him. Your father might be past the point of having competency to decide that he's going to rely on mom.
Fast forward to old age. I moved both parents out to my state so I could help them. They lived in Independent Senior Living and mom was still a nervous wreck, but dementia was setting in, so she was even worse than ever before. And still unwilling to address the elephant in the room. At 87. After 2 hospital stays, she became so depressed she wouldn't leave the apartment or eat much at all. Dad had no control, he was her enabler for 66 years. So I called her PCP and told him she was seriously depressed. He prescribed Wellbutrin for her immediately, thank God. I marched over to their apartment and laid down the law. I told mom she'd either take the blasted antidepressants or I'd no longer help them at all with anything. Enough was enough. She agreed, believe it or not. Ultimatums often work with stubborn elders who need US more than we need THEM.
After that, mom calmed down significantly. I was then able to set down more rules and boundaries about how I'd be in charge of the bigger decisions going forward. By then dad was feeling ill equipped to handle the finances and asked me to take over which I did. Turns out he had a brain tumor which was wreaking havoc in his mind.
So then I had to get both of them into AL and I did after dad fell and broke his hip. Little by little I was in charge, and it all started with the ultimatum I laid down about mom taking the antidepressants. I'm certain she'd wished she'd taken them decades earlier, too.
Ya gotta start somewhere.
Good luck getting your mom on antidepressants to clear her head up. Anxiety will keep a person paralyzed with fear and unable to do anything. Mom needs you to make that first decision FOR her and the rest will follow.
good luck.
If mom isn't willing to be 100% honest with her PCP, and you/sister aren't there to gently prod her to be so, she may come out of her appointment feeling either 1) justified that there's "nothing wrong with her" or 2) feeling that her doctor didn't do anything to help, so why "waste time" going to see anyone about her issues?
This is a generation that didn't put much thought into mental health wellness, and any talk of mental illness was done in whispered conversations. My mother would get "that look" on her face when I would talk about my daughter's struggles with anxiety and depression. It took some sharp words to her from me to let her know that there was absolutely nothing wrong with my daughter getting care for her mental health, just as she did when she became physically ill.
Now, if mom's PCP blows off your mom's complaints about her mental health struggles, FIND ANOTHER DOCTOR.
Good luck.
I agree with Slartibartfast that you don't allow her to monopolize your brain time with griping that goes nowhere. It is NOT cathartic for her, instead it keeps her mind stuck circling the drain and produces stress in you and your sister. Stop it as soon as it starts to happen.
Part of her resistance is probably the feeling of losing control. In whatever issues need a decision, try to give her 2 simple options for her to pick from (both options that you are ok with).
When my 2 single, very elderly Aunts were needing my PoA intervention but not accepting it, I finally asked the one (without dementia) "If you could remove something from your plate that is difficult or causing you a lot of stress, what would it be?" And she gave and answer but then insisted she wasn't ready to give it up. Then 3 months later she called me out of the blue and said she was ready to give it up. Once she did that, allowing me to make other decisions for them came easier.
You are giving your mentally ill Mom way too much ability to jerk you around (albeit subconsciously). She's already jerking herself around, and now she's got 2 more people as marionettes. Take control of this so she doesn't burn you out. She probably won't like it but too bad -- she'll get over it.
Keep plugging along but work on clear boundaries with her. I wish you further success!
Lots of declarative statements will be needed. "It sounds like it would help if I handled XYZ (a visiting aid, whatever) for you. I'm going to hire one and we will see how it's going in one month and decide if we want to make changes then."
Here's a quote from your post "And we agreed that next week, we would re-group to talk about getting hired help for our dad, mapping out the process, and delegating the legwork. I even put it out there that if she needs like this is too much for her to take the lead on, my sister and I are willing to take the lead on setting up meetings with potential caregivers and proceeding from there, when it comes to the hiring and such." I would like to suggest that this is too much wiggle room and too many things for your mom to deal with. Without realizing it you're asking her to; talk about it again, help map out a process she probably doesn't understand, help interview caregivers (which may feel like admitting her shortcomings to strangers) and hire one. Take ALL of these off her plate. You and sis hire someone and tell mom we will revisit after a full 30 days of the caregiver, and not until then.
You're doing great!
I think if we don't at least make a gesture of asking for her consent on this front, or warming her up to receive the help, having hired help suddenly foisted on them could add to her feeling overwhelmed. But if our next conversation doesn't move us along, then maybe we'll just go rogue and do it anyway.
Thanks for the encouragement!
Yes, my mom reached a point at which she accepted more direct help and allowed my siblings and I to participate in making decisions with her. Unfortunately, I don't remember exactly what that looked like and how we responded. I can say that our response was positive; I don't remember the details.