WWYD? Elderly parents out of state

[Anonymous]

For those of us who live in a different state than our elderly parents, how are you arranging things with your family to help?

My Mom has been in and out of the hospital many times over the past 2 years. My sibling lives nearby with her family. I live in the DC area, a 6-7 hour drive away from them (since the 1990s) with my family.

We have a very difficult Mom, with a long diagnosed personality disorder, which has intensified further as she has aged. 20 years ago, my sibling lived here and chose to move her family from the DC area back to near our Mom to have help with their kids when they were young.

My relationship with our Mom has never been good. She hates me for moving away in the 1990s for better job opportunities in my field. Over the years, she has endlessly demanded that I move my family back to where she lives, that I "ruined" the family and that mine/my husband's jobs don't matter. When I was pregnant with my first child I was told there was "no point" in me having any children bc they would not be near her. She chooses to know nothing about me, my life, or my kids, but she has lots of demands for me.

I've been in and out of therapy for years to help me develop healthy boundaries for myself with regard to my Mom. She doesn't believe in boundaries and no matter what we do, how often we visit or help it's never acknowledged or I'm told it's not enough. I've been told by plenty of people over the years to just go no contact, but I've tried to do my best to continue a relationship and put some boundaries in place with how I will allow myself to be treated.

Over the past couple of years I've been cut out more and more by my Mom and sibling because I'm "not there". I'm only told anything if I reach out to specifically ask, if it's a real emergency, or if some detail comes out when I'm being berated that I don't help out and I should "be there." My sibling has everything on her plate with regard to my Mom. She has a full-time job, kids etc. I offer to help as much as I can and I've carved out a few things that I manage - including being the contact managing the scheduling and evolving needs for the 24-hour coverage by home health aides my Mom has required over the past couple of years.

Lately my Mom has called urgently telling me that she is dying soon. Her doctor wants to discuss palliative care. This took be by surprise. It's really scary and I told her I would look into it and get back to her right away. I started working on it and reached out to my sibling and was told to stand down that Mom didn't understand and was overreacting. The next day Mom reaches out to berate me that I don't care and my sibling is doing everything. A different version of this has played out several times now as additional health issues has arisen over the past year - panicked call from Mom, sibling downplays it tells me to stand down, Mom unleashes on me that I'm not doing enough to help.

It happened again yesterday. I reached out to my sibling to ask what I can do to help. She responded by saying "I don't know what to say to that. I have a lot on my plate that you can't do" then went on to list out several things she's taking care of (it's absolutely a lot - she pays Mom's bills, brings things back and forth to the hospital or rehab when Mom has been in the hospital, takes time off work to take Mom to doctor's appointments, etc.) I responded with a few ideas of things that could help make things a bit easier on her (for example, she doesn't need to go pick up Mom's prescriptions. The home health aides drive and that's part of their job to run errands like that. I offered to make arrangements for transportation for some of Mom's doctor's appointments and the aide can go with her, instead of her taking time off work each time). I was told my suggestions "don't do much" and several reasons why they wouldn't work - which I guess I couldn't possibly understand bc I'm "not there".

Anyway, it's a really difficult situation. If something urgent happens I've always traveled there. However, my family and I can't afford for me to go up there and post up in a hotel to be there waiting in case something happens or is needed.

Anyone out there navigating similar situations? I don't know what to do. I've been actively trying to help from afar when things are status quo and go jump in when needed. A week ago my sibling had a trip planned. Right beforehand my Mom went into the hospital, so I went up there so she could still go on her trip. I provided daily updates on her condition as I spoke with Drs and Nurses, etc.

But, getting verbally attacked and insulted weekly now because I don't live there is taking a toll. I know my Mom is going through a lot and is rightly terrified about what's to come for her. I'm trying to be empathetic and I'm offering to help. It's getting harder and harder to try to listen and give support knowing that it will be turned around into an attack on me before the conversation is over.

[Anonymous]

I mean, you have to stop caring about your mom’s ridiculous attacks or cut back on how much you talk to her. You aren’t going to change her.

You could offer to go relieve your sister for a week if you are really willing to do this. Your sister also could cut back on what she is doing, but she doesn’t seem willing. I agree with your that an aide can pick up meds, you could do bill paying, etc. My speculation is that your sister is codependent with your mom — and that actually isn’t your problem.

But there is also no need to think something like palliative care is super scary. Your mom is old, she is going to die. It does no one any good for you to get panicked about it. And I’m not sure what you felt the need to research. This is between your mom and her doctor. It sounds like you are emotionally reactive and you need to work more on detaching.

[Anonymous]

What do you feel so guilty about? As the PP says, the end is coming and there's nothing to panic about. Stand down. If they need you, they'll reach out. If they manage on their own, let them be. Don't call and inquire all the time. And yes, if you can go there for a week and do it all (if it's feasible at all depending on living arrangements, if you're "allowed" to take over) then do it. Otherwise let the game play until the end. I'm saying this as someone who has a mom on another continent, I left on purpose as soon as I could (to grad school on a stipend) and have seen similar playing out over the last years (including having to research something "urgently" only to be told it doesn't matter). Your mom and sister are co-dependent and enmeshed, after all, she helped with her kids, so let her be in charge. You really need to detach for your own sanity.

[Anonymous]

Anonymous wrote:What do you feel so guilty about? As the PP says, the end is coming and there's nothing to panic about. Stand down. If they need you, they'll reach out. If they manage on their own, let them be. Don't call and inquire all the time. And yes, if you can go there for a week and do it all (if it's feasible at all depending on living arrangements, if you're "allowed" to take over) then do it. Otherwise let the game play until the end. I'm saying this as someone who has a mom on another continent, I left on purpose as soon as I could (to grad school on a stipend) and have seen similar playing out over the last years (including having to research something "urgently" only to be told it doesn't matter). Your mom and sister are co-dependent and enmeshed, after all, she helped with her kids, so let her be in charge. You really need to detach for your own sanity.

Wanted to add that detaching is of course a process and it took me 20 years (from when I had to face the reality about my mom, even though I instinctually "escaped"), which accelerated in the last 2 years as the situation became more and more ridiculous and irrational (yes, getting blamed all the time for everything, even though I left 30 years ago). Be kind to yourself.

[Anonymous]

Your sister is reaping what she sowed by moving near your mentally ill mother to get free childcare.
My mother wanted me to leave DH and my career to live with her after my stepfather died. I didn't. I hired a geriatric care manager.
You cannot change or control what your mother and sister do or say. What you can address is how you react.
Hire a geriatric care manager if that can offload stuff you or your sister have to do.
Honestly I am amazed you seem to still love your mother and are unwilling to accept she either is or will be dying sooner rather than later.
I am very sorry for you. But you need to put yourself first.

[Anonymous]

Anonymous wrote:Your sister is reaping what she sowed by moving near your mentally ill mother to get free childcare.
My mother wanted me to leave DH and my career to live with her after my stepfather died. I didn't. I hired a geriatric care manager.
You cannot change or control what your mother and sister do or say. What you can address is how you react.
Hire a geriatric care manager if that can offload stuff you or your sister have to do.
Honestly I am amazed you seem to still love your mother and are unwilling to accept she either is or will be dying sooner rather than later.
I am very sorry for you. But you need to put yourself first.

It didn’t sound like they have the budget for that, although it would be great if they could.

OP, as the sibling/nibling/grandchild who remained at home, and the daughter of same, I have been through this out of state relative thing often. Even without the complications of your mother’s personality disorder, it’s a difficult dynamic. The far away family often don’t really understand what’s helpful and what’s not. The local family have to communicate very clearly about this, and it kind of sounds like maybe your sister isn’t communicating effectively with you. She probably does have some resentment that she’s largely alone with your mom and maybe that feeds the problem.

I think if I were you I would consider what amount of time and money I could offer, and ask your sister directly what would be most helpful for her. I know it would not have worked at all for me to have out of state family scheduling, organizing transportation etc, because things change on a dime and then I am stuck with scheduling that might not work for me.

As for your mom, you don’t have to listen to a long critique. You can just say that you understand she’s angry and maybe you can talk another time when she isn’t so upset. Or maybe you switch to email or letters if that’s possible. It’s a fraught situation and there probably isn’t any solution that will feel exactly right.

[Anonymous]

I agree that your sister is codependent, and probably also feels some additional obligation to your mom since your mom helped her with her kids.

I can empathize with your sister bc she's the one who's there, and it probably is sort of hard to figure out what to delegate to an out of town sibling. But at the same time, it's her choice to be a martyr. It sounds like your mom is old, how important can all these appointments be? Certainly she can attend some of them with her aide, if you arrange transport and are the POC to call if something goes awry. Furthermore, are there appointments that she really doesn't need to go to anymore? Can you come offer some respite care during the year just to give your sister a break during those dedicated times? If your sister is accruing any of her own costs due to the care of your mom, can you help with that?

Regarding the emotional piece of this, just try and tune your mom out. It sounds like she's never been rational or kind, and she won't change now. In fact, it will probably get worse.

Best of luck to you- I have a mom like this and a somewhat similar situation, and it's hard.

[Anonymous]

I want to look at OP's situation a bit differently. While many of the PPs are focusing on OP and OP placing possible boundary issues with her mother and sister, I am going to argue that the bigger issue is a bit more black and white. OP's mom is quickly declining as elderly people ultimately do. OP's sister is currently the primary caretaker and doing the far vast amount of support. And OP is being blamed by both that she is "not there" and then dismissed.

All feelings and family baggage aside and we all have plenty of history to sort through when it comes with our families, the fact is that OP is.not.there. She just is not. OP is not physically able to physically support her mother in a significant and needed way. Regardless of why OP is not there, regardless of physical miles between them, regardless of past hurts and wrongs, regardless of whether OP's mom deserves the help or not, regardless of whether OP's sister had mom's support prior with childcare, regardless, regardless, regardless -- the fact remains that OP is not there. When her mother and sister claim this they are 100% correct. If you take all the emotion and all the complex history out of it the fact is that OP is not in a physical position to do much for her mother. And it is what it is. That is how distance works whether it is an elderly parent, a sibling, an old friend or a new friend. If you are not in close physical proximity you are not there and thus you are not able to provide what they may need. And with most elderly at the end stage of their lives what they need - really need - are hardly the phone calls and checking in but instead the day-to-day physical support. Sure, a quick weekend visit to mom is "great" but it is absolutely surface and not what an elderly person of quickly declining health really needs. That is the truth and reality and anyone who says otherwise is fooling themselves.

So accept that OP. Accept that you can only do what you can but also accept that your mother and sister are completely justified in how they feel as well. What are your other options? It doesn't sound like you are going to be moving closer to your mother and sister. It doesn't sound like your mother is going to move closer to you. OP can bang her head against the proverbial wall all she wants but the facts remain: she is not there. And if OP has guilt from that and/or feels defensive about that (and she does seem to have all of those feelings) than she needs to lean into figuring out what she can do to help herself with understanding those feelings better.

Physical distance makes a difference in all relationships. Always has and always will. And that is okay OP.

[Anonymous]

I think you need to ignore your mother. I don't know why you engage with her, honestly, and why you try to take the lead when your sibling clearly wants everything to flow through her.

But you could have a heart-to-heart with your sibling, and tell her that:

1. She cannot both ask for help and criticize you at the same time. It's one or the other. Most adults in the world leave their neighborhood to make their own lives elsewhere. Most do not move back to help their elderly parents, particularly not when their parents were abusive. She chose that because she got free childcare out of it. She cannot demand that you make the same choices.

2. If she wants help, she's going to have to accept the long-distance kind you can give her.

3. Make sure to list all the things she's doing for your mother and verbalize what an enormous burden it is and how much you admire that she can take this on while working full time and parenting. That your need to defend yourself against her resentment and stress do not take away from the great effort she is making for your mother.

It seems like everyone is very high strung in this family. The apple doesn't fall far from the tree, OP. Your sister is very quick to judge you. You are very sensitive to criticism. You, who have the least burden here, are probably more emotionally functional and can be the bigger person. Just nail down something you could do that would make your sibling's life easier, even if she doesn't like to admit it. Then let them deal with their own emotions.

[Anonymous]

Be prepared to accept that your sister will always resent you for not being there. Even if it's not rational. The other PP is correct about distance. The only thing your sister gets out her immense labor is (the childcare, of course, but she's already forgotten that) the perverse satisfaction of being able to say, for the rest of her life, that she was the primary caregiver for her mother and that her sibling stayed far away and "refused to help". That's how she's spinning it. You've read such posts on DCUM, from overworked children who care for their parents and whose siblings are far away...

[Anonymous]

Anonymous wrote:For those of us who live in a different state than our elderly parents, how are you arranging things with your family to help?

My Mom has been in and out of the hospital many times over the past 2 years. My sibling lives nearby with her family. I live in the DC area, a 6-7 hour drive away from them (since the 1990s) with my family.

We have a very difficult Mom, with a long diagnosed personality disorder, which has intensified further as she has aged. 20 years ago, my sibling lived here and chose to move her family from the DC area back to near our Mom to have help with their kids when they were young.

My relationship with our Mom has never been good. She hates me for moving away in the 1990s for better job opportunities in my field. Over the years, she has endlessly demanded that I move my family back to where she lives, that I "ruined" the family and that mine/my husband's jobs don't matter. When I was pregnant with my first child I was told there was "no point" in me having any children bc they would not be near her. She chooses to know nothing about me, my life, or my kids, but she has lots of demands for me.

I've been in and out of therapy for years to help me develop healthy boundaries for myself with regard to my Mom. She doesn't believe in boundaries and no matter what we do, how often we visit or help it's never acknowledged or I'm told it's not enough. I've been told by plenty of people over the years to just go no contact, but I've tried to do my best to continue a relationship and put some boundaries in place with how I will allow myself to be treated.

Over the past couple of years I've been cut out more and more by my Mom and sibling because I'm "not there". I'm only told anything if I reach out to specifically ask, if it's a real emergency, or if some detail comes out when I'm being berated that I don't help out and I should "be there." My sibling has everything on her plate with regard to my Mom. She has a full-time job, kids etc. I offer to help as much as I can and I've carved out a few things that I manage - including being the contact managing the scheduling and evolving needs for the 24-hour coverage by home health aides my Mom has required over the past couple of years.

Lately my Mom has called urgently telling me that she is dying soon. Her doctor wants to discuss palliative care. This took be by surprise. It's really scary and I told her I would look into it and get back to her right away. I started working on it and reached out to my sibling and was told to stand down that Mom didn't understand and was overreacting. The next day Mom reaches out to berate me that I don't care and my sibling is doing everything. A different version of this has played out several times now as additional health issues has arisen over the past year - panicked call from Mom, sibling downplays it tells me to stand down, Mom unleashes on me that I'm not doing enough to help.

It happened again yesterday. I reached out to my sibling to ask what I can do to help. She responded by saying "I don't know what to say to that. I have a lot on my plate that you can't do" then went on to list out several things she's taking care of (it's absolutely a lot - she pays Mom's bills, brings things back and forth to the hospital or rehab when Mom has been in the hospital, takes time off work to take Mom to doctor's appointments, etc.) I responded with a few ideas of things that could help make things a bit easier on her (for example, she doesn't need to go pick up Mom's prescriptions. The home health aides drive and that's part of their job to run errands like that. I offered to make arrangements for transportation for some of Mom's doctor's appointments and the aide can go with her, instead of her taking time off work each time). I was told my suggestions "don't do much" and several reasons why they wouldn't work - which I guess I couldn't possibly understand bc I'm "not there".

Anyway, it's a really difficult situation. If something urgent happens I've always traveled there. However, my family and I can't afford for me to go up there and post up in a hotel to be there waiting in case something happens or is needed.

Anyone out there navigating similar situations? I don't know what to do. I've been actively trying to help from afar when things are status quo and go jump in when needed. A week ago my sibling had a trip planned. Right beforehand my Mom went into the hospital, so I went up there so she could still go on her trip. I provided daily updates on her condition as I spoke with Drs and Nurses, etc.

But, getting verbally attacked and insulted weekly now because I don't live there is taking a toll. I know my Mom is going through a lot and is rightly terrified about what's to come for her. I'm trying to be empathetic and I'm offering to help. It's getting harder and harder to try to listen and give support knowing that it will be turned around into an attack on me before the conversation is over.

I think OP has good intentions but is not really understanding the situation her sister is in. You know how when someone in your social circle experiences a death or receives a terrible health diagnosis the advice given by professionals is to not ask, "what can I do to help you" but to just do something for the person. Well, the same applies to OP's situation.

OP, again I do think you have good intentions, but can you not see how your "reaching out again" to your sibling to ask what you can do is not really a help? In fact, I would guess that the question at this point upsets your sister who is clearly in the middle of it all right now. Instead, OP, have you thought of things you can do to help support your sister as she supports your mom? Show your sister that you appreciate all she is doing for your mom. Maybe send your sister gift cards for a nearby dinner place or set up a cleaning service for your sister or offer to have one of your nieces and nephews to come visit and stay with you over winter break, spring break, a long weekend. Do something other than just ask "what can I do to help" because that is not the way to help at all.

[Anonymous]

Anonymous wrote:
Be prepared to accept that your sister will always resent you for not being there. Even if it's not rational. The other PP is correct about distance. The only thing your sister gets out her immense labor is (the childcare, of course, but she's already forgotten that) the perverse satisfaction of being able to say, for the rest of her life, that she was the primary caregiver for her mother and that her sibling stayed far away and "refused to help". That's how she's spinning it. You've read such posts on DCUM, from overworked children who care for their parents and whose siblings are far away...

I am sorry but I am not understanding when you write that that is how the sister is "spinning it". OP's sister IS the primary caregiver and OP is far away. There is nothing to spin.

[Anonymous]

Anonymous wrote:

Anonymous wrote:For those of us who live in a different state than our elderly parents, how are you arranging things with your family to help?

My Mom has been in and out of the hospital many times over the past 2 years. My sibling lives nearby with her family. I live in the DC area, a 6-7 hour drive away from them (since the 1990s) with my family.

We have a very difficult Mom, with a long diagnosed personality disorder, which has intensified further as she has aged. 20 years ago, my sibling lived here and chose to move her family from the DC area back to near our Mom to have help with their kids when they were young.

My relationship with our Mom has never been good. She hates me for moving away in the 1990s for better job opportunities in my field. Over the years, she has endlessly demanded that I move my family back to where she lives, that I "ruined" the family and that mine/my husband's jobs don't matter. When I was pregnant with my first child I was told there was "no point" in me having any children bc they would not be near her. She chooses to know nothing about me, my life, or my kids, but she has lots of demands for me.

I've been in and out of therapy for years to help me develop healthy boundaries for myself with regard to my Mom. She doesn't believe in boundaries and no matter what we do, how often we visit or help it's never acknowledged or I'm told it's not enough. I've been told by plenty of people over the years to just go no contact, but I've tried to do my best to continue a relationship and put some boundaries in place with how I will allow myself to be treated.

Over the past couple of years I've been cut out more and more by my Mom and sibling because I'm "not there". I'm only told anything if I reach out to specifically ask, if it's a real emergency, or if some detail comes out when I'm being berated that I don't help out and I should "be there." My sibling has everything on her plate with regard to my Mom. She has a full-time job, kids etc. I offer to help as much as I can and I've carved out a few things that I manage - including being the contact managing the scheduling and evolving needs for the 24-hour coverage by home health aides my Mom has required over the past couple of years.

Lately my Mom has called urgently telling me that she is dying soon. Her doctor wants to discuss palliative care. This took be by surprise. It's really scary and I told her I would look into it and get back to her right away. I started working on it and reached out to my sibling and was told to stand down that Mom didn't understand and was overreacting. The next day Mom reaches out to berate me that I don't care and my sibling is doing everything. A different version of this has played out several times now as additional health issues has arisen over the past year - panicked call from Mom, sibling downplays it tells me to stand down, Mom unleashes on me that I'm not doing enough to help.

It happened again yesterday. I reached out to my sibling to ask what I can do to help. She responded by saying "I don't know what to say to that. I have a lot on my plate that you can't do" then went on to list out several things she's taking care of (it's absolutely a lot - she pays Mom's bills, brings things back and forth to the hospital or rehab when Mom has been in the hospital, takes time off work to take Mom to doctor's appointments, etc.) I responded with a few ideas of things that could help make things a bit easier on her (for example, she doesn't need to go pick up Mom's prescriptions. The home health aides drive and that's part of their job to run errands like that. I offered to make arrangements for transportation for some of Mom's doctor's appointments and the aide can go with her, instead of her taking time off work each time). I was told my suggestions "don't do much" and several reasons why they wouldn't work - which I guess I couldn't possibly understand bc I'm "not there".

Anyway, it's a really difficult situation. If something urgent happens I've always traveled there. However, my family and I can't afford for me to go up there and post up in a hotel to be there waiting in case something happens or is needed.

Anyone out there navigating similar situations? I don't know what to do. I've been actively trying to help from afar when things are status quo and go jump in when needed. A week ago my sibling had a trip planned. Right beforehand my Mom went into the hospital, so I went up there so she could still go on her trip. I provided daily updates on her condition as I spoke with Drs and Nurses, etc.

But, getting verbally attacked and insulted weekly now because I don't live there is taking a toll. I know my Mom is going through a lot and is rightly terrified about what's to come for her. I'm trying to be empathetic and I'm offering to help. It's getting harder and harder to try to listen and give support knowing that it will be turned around into an attack on me before the conversation is over.

I think OP has good intentions but is not really understanding the situation her sister is in. You know how when someone in your social circle experiences a death or receives a terrible health diagnosis the advice given by professionals is to not ask, "what can I do to help you" but to just do something for the person. Well, the same applies to OP's situation.

OP, again I do think you have good intentions, but can you not see how your "reaching out again" to your sibling to ask what you can do is not really a help? In fact, I would guess that the question at this point upsets your sister who is clearly in the middle of it all right now. Instead, OP, have you thought of things you can do to help support your sister as she supports your mom? Show your sister that you appreciate all she is doing for your mom. Maybe send your sister gift cards for a nearby dinner place or set up a cleaning service for your sister or offer to have one of your nieces and nephews to come visit and stay with you over winter break, spring break, a long weekend. Do something other than just ask "what can I do to help" because that is not the way to help at all.

+1 to all this.
As the nearby sibling, it's so irritating when my out of state siblings suggest "aide" for this or "visiting nurse for that" so easy! It's not. They are difficult to set up, manage and pay for! So stop suggesting things and then patting yourselves on the back.

A sister came out for a week and it was very helpful because I was finally "off-duty" - for a whole week I didn't have to visit, fetch, etc. I didn't do a damn thing (except my full time job and kids). So don't underestimate a visit or two where you take over completely!

Finally, on the palliative care. I would love it if my mom opened up that conversation with a sibling and I would completely support the sibling taking all that on and I would do what their research suggested, especially since mom is willing. This means comfort, and peeling back every intervention. If I had a sibling do that and walk mom through it I would sit there as she signed things. Right now I'M the only one thinking about palliative care/hospice. My mom is not in the state of mind to do it and it feels very lonely.

[Anonymous]

Anonymous wrote:

Anonymous wrote:
Be prepared to accept that your sister will always resent you for not being there. Even if it's not rational. The other PP is correct about distance. The only thing your sister gets out her immense labor is (the childcare, of course, but she's already forgotten that) the perverse satisfaction of being able to say, for the rest of her life, that she was the primary caregiver for her mother and that her sibling stayed far away and "refused to help". That's how she's spinning it. You've read such posts on DCUM, from overworked children who care for their parents and whose siblings are far away...

I am sorry but I am not understanding when you write that that is how the sister is "spinning it". OP's sister IS the primary caregiver and OP is far away. There is nothing to spin.

The spin is that OP is refusing to do more, which is a lie. She wants to do more and has suggested many options. What the parent and sister want is for OP to actually uproot her life and be there on the daily, which is not a reasonable ask. So the spin is the usual "poor me, I'm all alone taking care of my parent while my sibling lives her life", which does not tell the whole story.

[Anonymous]

If OP is actually managing the 24/7 home health aides, as she said in her post, isn't that a bigger help than many out of town siblings provide? If she's actually managing the schedules and changes, she's hardly doing nothing.

Just pointing that out.