Dear Captain Awkward:

My dad’s health is declining- in the past three years he’s had a quadruple bypass, and is now on dialysis. My mom, who doesn’t have a big support network and who isn’t talkative about her feelings at the best of times, is running herself ragged keeping up with his doctors appointments, sorting out contradicting information regarding his medicines, researching what the doctors are telling him, and generally taking care of my dad and the house that they live in. I would like to give my mom as much support during this time as I can (I live 8 hours away, unfortunately, so giving physical support will be few and far between).

However, I find it really emotionally draining to talk to my mom these days because it’s a continuous conversation about what’s wrong with Dad, how the doctors are doing everything wrong, how Dad is in horrible health, and underlying all of it is the fact that I know my mom doesn’t really have anyone to help her mentally or physically throughout all of this. I’d like to be there for her as much as possible, but how can I do that when I find it takes me a day to get back to normal (as in, not bursting into tears every five minutes because I’m so worried about her and my dad) after I talk to her on the phone?

Alphakitty here.

First of all, let me say I’m so sorry you and your family are going through this. It happens to most of us sooner or later that someone in the circle of people we love develops severe health problems, and we watch someone else we love shoulder the crushing burden of being their primary caregiver. It hurts so much, and distance makes you feel helpless. If you’re like most of us, you honestly can’t up and move to take on some of the on-site caregiving, but you feel as guilty as if you had that option and were choosing not to use it.

And in your case, even if you manage to forgive yourself for not being able to be there more, you have a collision between what your mom is (implicitly) demanding of you even from afar and what you need to get through this yourself.

(Before I move on to the specifics of your situation, let me say that my mom is like your mom. She is horrible about asking for help; she’s much more comfortable with the role of help-er than help-ee. She doesn’t have much of a local support network, either. And together, we’ve been through my Dad’s sudden death about 14 years ago, and her best-friend-for-70-years’s death of cancer a couple of months ago. So yeah – I feel your vicarious pain.)

Anyway, the first thing I suggest is to figure out if there is any way you can lighten her load even from afar. If one of her burdens is researching drug compatibilities, can you take that on? Maybe ask her to e-mail you a list of his medications and let you know anytime one is added or changed, and you will talk to a pharmacist and/or do some research (like so many things, I think there are apps for this!) if there are issues. If she doesn’t have one and you/she can afford it, maybe get her a smartphone or small tablet with a calendar app that will make it easier for her to keep track of appointments? Maybe (again depending on the finances) see if you can pay for someone to come in and clean every couple of weeks, or do a once a month deep clean? Doing any of these things has both actual value and symbolic value (making her feel less alone).

Also, is there anything you can do to increase her local support network, like a friend or neighbor you could talk to about checking in on her periodically – in a deliberate way, rather than a casual catch-as-catch-can way? If your mom is now or ever has been active in a church*, and you think she’d be ok with it, can you talk to someone about them doing some outreach, giving her the support of their community? I’m not a church person myself, but one of the things churches are usually good at is being there for members of the congregation in times of trouble – and they generally don’t even care if you only became a member of the congregation because of that trouble. Even if she’s already going to services, if she’s doing the stiff upper lip thing, people might not know what she and your dad are going through. Call her local hospital or senior center and find out if there are support groups for caregivers. Or, if there’s a hope in hell she’d do it (mine wouldn’t), suggest that she get a therapist to talk to about what’s going on – both for her, and so she feels less desperate to unload by the time she gets to you.

Remember, too, the community where geography doesn’t matter: the Internet. Guide her to an online support group or blog for folks in her shoes (her own Captain Awkward!), or help her start her own. Her situation is so common, in the unlikely event it doesn’t exist there is surely demand for it.

When you do go visit, help her with household stuff without being asked. Leave some meals in the freezer. Do some of the tasks that used to be your Dad’s job but he can’t do anymore – if she’s like my mom, those tasks will particularly weigh on her.

And now (at last!) for you. First, you need to make sure she knows how distressed you are by what they’re going through. Sometimes, because you hold it together on the phone, the person who’s in the trenches imagines you going blithely along emotionally unscathed – like as soon as you hang up the phone they and their troubles wink out of your mind. My mom used to say “well, I should let you get back to [some relatively pleasant thing she imagined I’d be doing when I hung up].” And I’d be like, “Really? You figure I can just go la la la la la back to that after this phone call??” Without laying a guilt trip on her for making you sad, make sure she knows it bums you out to hear what they’re going through and it takes you a while to recover. Tell her, “I know you’re scared. I’m scared, too.”

Explain that for you to keep functioning in your day-to-day world (succeed as a student, keep/prosper in your job, be a decent spouse/parent, not suffer a mental health crisis…. whatever applies), you can’t have the full-scale everything-horrible-that’s-happening type phone calls all the time. That you absolutely do want to know how she and your dad are doing, but that you need her to tell you most of that stuff by e-mail, so you can read it at a time when you’re in a position to process it, and so that on your once a week (or whatever) phone call you can have room to talk about less emotionally charged (and exhausting) things.

Unfortunately, that’s all I’ve got. This is one of those times when what you need and what someone else needs directly conflict – and since the other person is your mother (with whom I gather you have a decent relationship) one of the things you need is to not feel like you’re letting her down. When that happens, all you can really do is (1) try to reduce the conflict (by addressing their needs or yours in ways that don’t conflict), (2) figure out what you can offer without doing violence to your own mental health, and (3) be as articulate as possible about what you can offer and what you need. The good thing is that because this is a mom with whom you have a decent relationship, you should assume that she does not want you to do violence to your mental health for her sake… so treat it like a partnership to get you both through this as whole and hale as possible.

And, of course, good luck with that.

* church/synagogue/mosque…