Question
I don’t know what to do about this situation. My mother is 91 and living in her own house. She is compos mentis and mobile. My retired single, older sister, in her late 60s, is her main carer – and a single brother also lives at home. She has homecare coming in for an hour each day.
Having recently come out of hospital, my mother needs extra care. What annoys me is that my mother, who cannot always make it to the toilet before having an accident, refuses to wear incontinence wear. We manage this during the day fairly okay but at night it means she gets up a few times to use the toilet.
This means my sister or whoever is minding her is up a few times as well. My sister is now exhausted. I feel my mother should wear incontinence wear at night so that my sister is not disturbed and I feel she is being very selfish in refusing to do this.
But I also feel my sister should be firm with my mother and explain to her that, as she is looking after her during the day, she needs to sleep at night.
‘Although my current job has a structured career path and is secure, I find it meaningless’
‘I am divorced at 60, envious of my ex-husband’s new life and struggling with loneliness’
‘I’m dating a previously married man but I feel sad that I will always come second to his children’
‘A stranger entered our family and turned them all against us’
My sister says it’s to do with dignity. When my mother was in hospital she was put into incontinence wear because they don’t have staff to take her to the toilet three times at night.
My sister panders to her every need, and she is now exhausted and has her own health problems. She will not ask for help either.
As I live in Dublin, I have limited input into the whole situation, but I feel it is very unhealthy mentally.
Answer
It is wonderful that your mother has all her faculties at the age of 91 and she needs to be included in any decisions related to her life and care. However, it sounds as though her children are all fraught with the exhaustion of minding her and are now getting upset with each other as a result.
Your local public health nurse might be of assistance here as they will be familiar with dealing with care of the elderly, and your mother might find it easier to take direction from a professional. If this is not available to you, your mother’s GP may be able to help as again your mother may have a long and trusting relationship with them.
Your relationship with your sister is one that should be given great care as you will need each other in the tough times ahead as your mother’s health deteriorates. Is it possible for you to offer some respite care and you care for your mother for a few days while your sister stays in your home?
After this, your sister may have some clarity and energy to discuss a care plan going forward as the alternative option is that any decisions will be made during a crisis. Your brother is also a participant and his role in managing your mother’s nightly incontinence is not mentioned. Perhaps if your mother knew that he would be involved in her nightly care, she might be open to alternatives? In any case, he is a central part to the whole family role in caring for your mum.
The difficulty for any family is that assumptions may exist that can underlie any communication and this is the first thing that needs to be tackled
In order to get a team approach, where no one feels unduly burdened in the caring role, there are some steps that might be taken. The HSE and Age Action Ireland have very good information and advice available for care of the elderly and there is a lot of expertise that can be leant into.
The difficulty for any family is that assumptions may exist that can underlie any communication and this is the first thing that needs to be tackled. For example, you may think that your brother is unwilling to do night-time support, or that your mother is unable/unwilling to change, and these ideas might then block conversations or prevent some options being discussed.
To create the best circumstances in which a useful discussion can take place you might first look to your own attitudes of helplessness and frustration, as this plays a part in the responses you get from your sister and your mum.
Choose an attitude of openness and compassion (for everyone, yourself included) and try not to solve everything in one go. Your mum is just out of hospital, so this is a good time to approach future issues as everyone is now aware that crisis and interventions are on the cards.
Could you ask everyone how they are and ask questions to open the discussion up to include their concerns for the future and what they think you all need to discuss as a family? Asking questions leads people to their own realisations. The others may have ideas of how to proceed that are similar to yours or they could suggest some things that you have not yet thought of.
The reason you are upset, and your sister is suffering, is ultimately because of your love for each other, and this is a great starting point as you all look at how best to take care of your mum and each other going forward. This is a wonderful legacy that your mum has created.
Acceptance and letting go plays a role throughout life and all of you have your own work to do on this. You need to let go of your solutions, seek out expertise and open the conversation up to include all of you, so that together you can meet the needs that are arising.
This will be an ongoing, changing situation so try not to hang on to fixed solutions but create flexibility and openness to what lies ahead.
- To send your question to Trish Murphy, fill in the form below, click here or email tellmeaboutit@irishtimes.com