We live in New York and my husband’s family lives in Arizona. His father just passed away after being housebound for the last two years of his life. He and my mother-in-law, who is 90, were inseparable, and so she had been housebound along with him. The day after my father-in-law’s funeral, my husband’s other family members took his mother to a nursing facility to “check it out.” My mother-in-law insists that she doesn’t want to leave her home, although she does have her own health issues, including the onset of dementia. My husband’s family won’t consider the idea of investigating options that might help my mother-in-law stay in her home. I’m worried about the effect on my mother-in-law to be forced to leave her home so soon after losing her husband. There is another daughter-in-law who had been helping my in-laws a lot, but I feel she has become controlling and insensitive to my mother-in-law’s wishes. Since we are so far away, it’s been difficult for us to have any real influence. What can we do?
You clearly are a compassionate and devoted daughter-in-law. You take umbrage at what you regard as the unjust and self-centered decision by your husband’s siblings to force their mother into a nursing home. Yet umbrage alone isn’t going to alter the current plan. Powerful emotional barriers stand in your way of actually helping your mother-in-law.
You could confront your husband’s siblings by telling them that they should be doing everything within their power to fulfill their mother’s wishes. The siblings, in response, would greatly resent you on multiple accounts: They would contend you are overstepping your bounds as an in-law and not a blood-relation. They would pillory you for questioning their love for their mother. They would accuse you of dictating to them from afar about the sacrifices they should be making to keep their mother in her home while you yourself are offering little in the way of self-sacrifice. Finally, they may defend their actions by saying that, for her own well-being, their mother needs the kind of professional supervision and care that can best be provided in an assisted living or skilled nursing facility.
You could ask your husband to call a family meeting (probably via conference call) to discuss the matter. As your mother-in-law’s child, he would have greater credibility to express an opinion and would wield greater influence to shape the final decision. But he, too, would draw his siblings’ resentment for “interfering” from 2,500 miles away.
You and your husband could devise a comprehensive plan for keeping your mother-in-law in her home and then present it to the siblings. This might require that you hire an Arizona-based geriatric care manager to identify necessary resources, such as reliable home health aides, and create a sustainable in-home plan. The siblings may react to this with less resentment and greater consideration than if you are perceived as simply objecting to what they are doing. But they might also bridle at any aspect of your plan that would require that they take a role as, say, local overseers of the aides or drivers to doctors’ appointments.
As the saying goes, you have to walk the walk, not just talk the talk. The actions and self-sacrifices you and your husband make will alter the siblings’ perspectives more than hours of impassioned or well-reasoned arguments. I’m afraid that the best way you can demonstrate this is by moving from New York to Arizona to either live with your mother-in-law or to settle nearby in order to help supervise the comprehensive plan you’ve devised. Not only would the siblings be impressed and likely defer to you at that point, but, upon seeing your example, they may also step up and help more themselves. Moving cross-country is a big sacrifice to make. But there aren’t any plausible plans that will work nearly as well at turning the tide and keeping your mother-in-law in her home.
My husband and I are in our mid-50s and have been married nearly 30 years. He was recently diagnosed with cancer that has metastasized. He has begun chemotherapy. Ever since we received this diagnosis, my husband has been lashing out at me. He yells at me and orders me around, he gets angry at how I do things, and he is generally making my life unbearable. This is a total change in our relationship, as he never acted like this before. When he treats me this way, I walk away so that I don’t get upset in front of him. When I do this, he makes me feel as if I’m abandoning him. I’m the only one he treats this way.
I can’t afford therapy and I don’t have access to the Internet. I’m afraid to leave him alone so I’m missing a lot of work, which is a problem. I love my husband very much but I’m feeling completely beaten down and depressed. I can’t seem to stop crying and have no one to talk to about this. What can I do?
Unfortunately, this is a too typical tragedy: The caregiver gives generously of her time and best energies; the care recipient, frustrated and depressed, scapegoats the person who’s nearest and dearest — the eager-to-please caregiver. It is utterly unfair and causes great hurt. I would suggest you take whatever steps are necessary to change this pattern of behavior.
As a first course of action, please share your concerns with your husband’s primary care physician and oncologist so that your husband can be evaluated for three possibly treatable conditions: depression; nausea and other side-effects of the chemotherapy; and metastases to his brain:
• Major depression is a common co-morbid condition with cancer and a frequent side-effect of chemotherapy. Many men express their depression not as sadness but as anger. (There’s an old therapist aphorism: “Anger is depression turned outwards.”) That anger frequently is focused not on the cancer but on the caregiver. Your husband may benefit from an antidepressant medication that would make him less hostile.
• Aside from depression, chemotherapy often causes nausea and other gastrointestinal symptoms. Those persistent physical discomforts may themselves be making your husband irritable. His physician may be able to provide him with symptomatic relief (e.g., an anti-nausea medication) that will make him more comfortable and less apt to lash out.
• Occasionally, cancer metastasizes to the brain, thereby compromising neurological functioning. That may include altering the patient’s personality, lowering frustration tolerance, and decreasing control over expression of emotions. Your husband’s oncologist may need to assess him for such brain “mets” and possibly prescribe an appropriate treatment.
In addition to seeking these medical evaluations, it is important for you to have a frank conversation with your husband at a time when he is relatively calm and, therefore, more likely to listen to you. Calmly tell him that you love him and know that he is afraid of the outcome of his illness. Add that you empathize with his need to have some control over what feels like an uncontrollable situation. But explain that his attempts to control you — and his angry outbursts at you in the process — are making you feel mistreated. Inform him that you find this intolerable and that you’ll leave the room whenever his tone of voice turns angry. State that you have no intention of abandoning him but that you need to set some limits on his behavior for your own self-preservation.
If you are firm in your resolve to consistently carry out what you’ve said, then your husband’s behavior should change. The two of you will then be in a better position to support one another through this crisis in a manner that brings you closer together rather than allowing the cancer to drive you apart.
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