Mom's fears, Dad's decline

Originally published in the Lincoln Tribune, July 1, 2008

Q: I read your column about the family where the father-in-law was declining and the mother-in-law was close to a breakdown [see June 17 Tribune]. I am in a similar situation with my parents. Dad is in bad shape, although in OK spirits, but Mom is in denial. She panics every time someone talks about him getting worse. What should I do?

A: First of all, thank you for trying to improve the family's situation. It can be hard to ask for help when you have tried to deal with their problems—his health, her fears—by yourself. You are doing the right thing. Our palliative care team may be able to help both of them, perhaps your mother even more than your dad.

It sounds like you need to deal with her before anything else. She is grappling with one of the biggest fears adults can have—losing her husband. The cornerstone of her world is crumbling. Try to be as gentle with her as you can, even though she may say irrational things or try to argue with you.

I might try a different way to begin the discussion. Look for a time when she is the least stressed. Tell her, "We have all been so wrapped up in Dad's situation, I don't think we're taking care of ourselves. I have been thinking about getting us some help." When she asks what kind, tell her you believe a consultation with a palliative care clinician might help both of you understand your dad's needs. The consultation will help you identify specific services that can help you enjoy time with your father, instead of having to be his nurses. Should hospice be an option for your dad's condition, the team of nurses, nurse assistants, counselors, and more can help take care of the many tasks that may be difficult for the two of you. Emphasize how the consultation with a palliative care physician or your nurse practitioner can help relieve the burden on both of you.

Is your mother concerned about healthcare costs? I would also mention that palliative care consultations are reimbursed by most all insurance plans, including Medicare. Financial relief can also be a powerful motivator.

I wish you all the best in your conversation with your mother. Remember to be gentle above all else.

If you have a question for me, please email me at asklinda@pchcv.org. Until next week, be kind to one another!