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I am trying to research a specific caregiving problem and cannot find information or help anywhere. My brother's mother-in-law is dying of cancer and needs around the clock care. She refuses any help from anyone other than my brother's wife, Amy, who has to feed her, change her, shower her, etc., while caring for three kids and working a full time job. Whenever Amy tries to leave her mom, who is now in an assisted living home, the mother goes on and on (while moaning and sighing) about how she is dying and how can Amy leave her alone like this when she is dying, how she needs this and that and doesn't want anyone but Amy to take care of her even though many other people are willing to help. Amy's mother has even gone so far, when she was still at home, as to call 911 as soon as Amy left her side and went to tend to her own needs. A doctor has suggested she is doing this for attention but Amy feels tremendously guilty about saying no to her mother's outrageous demands and I feel she is being manipulated into caring for her mother non-stop around the clock and is not having time for her kids and husband and not going to work or taking care of herself. How can we make her realize she is being manipulated and run ragged and that she needs to stop and take a break and set firm limits. I feel like she is being held as an emotional hostage. She says she is afraid to say no to her mother about anything because she could die at any moment and she would not be able to live with the guilt of saying no to her. I cannot find information or examples of this happening to anyone else. Where can I get help with this situation? My brother is worn out caring for his three kids himself, working fulltime and bearing his wife's grief and stress. Please help!

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SIL is being held as an emotional hostage.

Is her mother on hospice? We are all, after all, dying. MIL is dying more actively and presumably sooner rather than later. How soon is that expected to be? Is she on Hospice? If she is not eligible for hospice care, then I don't think the "might die any minute" is particularly valid. Any of her children or her husband or she herself "might die any minute." That is the uncertain nature of human life. It is not something we can allow to drive all of our decisions.

But, how to convince SIL of this? That is the issue, isn't it? And I am not sure logic is going to be very effective. Maybe instead of trying to get SIL to give up her hostage status, it would work better to convince her that her children need her, and that her husband needs her. I hate to suggest you press a different guilt button. But the fact is that the time she is neglecting her children now is time she will never get back. I hope your brother is a compassionate and patient man, but this situation can wear at their relationship.

If MIL is on hospice and may literally die any minute of her cancer, and is expected to have at most a few months to live, then maybe everyone being as supportive as they can of SIL and not trying to change her would work.

This is very difficult, isn't it? Please let us know what (if anything) you try, how it works, and how this situation unfolds. We learn from each other.
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You know, it's hard to get other people to change their behavior, especially when it is ingrained. Hospice is a great suggestion, because the hospice workers, nurses and social workers probably have more experience dealing with situations like this and can give good solid advice to your SIL. The question is, will she listen?

The other question is, is the mother really in imminent danger of dying, or is she just very ill? I wonder if your brother arranged a couple of days' vacation at a not too distant resort hotel or something of that during the next school break, if she would see the value to getting away for just a bit and leaving mom to outside caregivers?

You might point out to your SIL (or have your brother do this) that she's not going to be any good to anyone if she gets sick from the stress of doing this by herself. People who need 24/7 care need three shifts of caregivers. Ultimately, your SIL is being quite selfish.
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Thank you to both of you. This situation has been difficult because every doctor says something different. She got diagnosed last September with lung cancer. Some docs said she had weeks to live and others said three months and now they are saying 6 months to a year. The problem is that hospice won't come in until the patient accepts they are dying and one day the mother want chemo and wants to live and the next day she wants hospice and is prepared to die. She keeps going back and forth between hospice and chemo but she can't have both because one is a fight to live and the other is accepting to die. My brother is doing all he can to be supportive but I can hear the stress and exhaustion in his voice. From what my brother tells me is that the mother won't let anyone else except Amy care for her and demands so much from Amy around the clock that the other areas of her life are suffering. I just feel like Amy is being held emotionally hostage and manipulated by guilt and if I could find any materials out there supporting this theory and show them to her, that if it comes from someone other than me then maybe she would listen but when I google emotional blackmail it just brings up information on mental abuse and when I google caregiver guilt it just brings up stress relief tactics. I mainly want her to see that she should set boundaries with her mom and not let herself be controlled by the thought that her mom could die at any moment because this could go on for the next year and her kids and her own needs are being neglected. Is this unreasonable? There are plenty of people willing to care for her mom including all the staff at the assisted living home and Amy's whole family but the mother insists that she will only let Amy take care of her. Should I not try to convince her to set limits and just focus more on supporting her and my brother?
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Not much more to add to above. Being an emotional hostage is very real and difficult to overcome.

Suggest to SIL that she join or sit in on a support group for caregivers. The AL probably has one, or her church or the local senior center might suggest one. Also if she can visit this site, she might not feel so alone in this and will learn its okay and healthy to set boundaries and say no.

Would she be open to her husband saying something to mom?

It's very hard, but only she can set boundaries and limit visits and ignore constant phone calls. I had to do so, and my situation did improve. One thing I did was shut the phone off at 8pm in the evening. Friends, children, police have my husbands number to call if there is an emergency or they want to get ahold of me.

It allowed me to rest and have some worry free hours each day. Eventually mom stopped the evening calls. Now she rarely calls at all because she doesn't want to have to talk to my husband.

SIL can visit on set days and limit to an hr or so. I know it must be hard and not sure how close she is with mom, but mom has to adjust and understand that her daughter has other family members to care for to and HERSELF and that there are others that mom needs to rely on as well. It won't happen if SIL doesn't help her mom to rely on others.

i finally had the conversation with my mom...telling her I loved her, but couldn't be her everything and it wasn't fair to me or my family when she only wanted and only would accept my help.
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How old is mil? What stage lung cancer? Has it metastasized? How long ago was dx? How many opinions has she gotten? Has she always been this narcissistic ? Sorry to be intrusive, but there are a lot of different factors in play here.
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Most assisted living facilities and nursing homes have social workers. It would be a good idea for your sister to have an honest conversation with one of these counselors and then have a meeting including Mom. SIL's first responsibility is to take care of herself so she can care for her own family. Her Mother is being unreasonable and boundaries need to be set for everyone's wellbeing.

I have a feeling Mom has a long history of laying on the guilt and needing more attention than necessary. Very unhealthy situation for all involved. SIL should get a schedule of those willing to help and let Mom know others care about her and will be there to do what is needed. "Mom, I have to take care of myself and my family. I cannot do it all." Mom will adjust and SIL and her family will be happier. Good luck!
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Look up CO-DEPENDENT. That's what is happening here.
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I just want to add that when my dad was actively dying of chronic leukemia, my mom, by then in her 70s, kept up her 'one course at a time" March towards her BS degree. She told me that it was the only thing that kept her sane, that Daddy would complain endlessly about how awful it was that she was leaving (for 4 hours!). I learned a very important lesson from her in that example.
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And yes, Pam is right, it's called co-dependence. At some point, your brother needs to get her to a psychiatrist. A mental health counselor or social worker would be good for talk therapy, but she's almost certainly clinically depressed and in need of meds.
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Thank you so much to all of you. I will google co-dependent this weekend. I couldn't put my finger on the word for what to google. It is good to have validated what I suspect is going on. Now, to just get through to her. I feel like if the info can come from somewhere else than me then she would consider it more seriously because right now I am pretty much a meddling and worried sis/sis-in-law.

Bablou, her mom is around 67. It has metastasized and there have been many doctors these past few months. My brother says she has never acted like this before and it is uncharacterstic of her. He is not sure why she is acting like this. One doctor said she is looking for attention. My brother thinks she wants people to feel sorry for her. She just got moved to assisted living the other day. My brother said that when Amy was gone, her mother would just lay there and moan nonstop super loud for hours (she was living with my bro and Amy). My brother said he did not know how to react to her moaning. He said the whole thing is really weird. I will google more as soon as I can. Thank you all so much!
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67, oh how sad that is! If this is a drastic behavioral change, she really needs to be seen by a psychiatrist. There could be brain involvement, she could need antidepressant meds, and on and on. But severe behavioral changes should be reported to her doctors. "Looking for attention" is an easy out for a lot of docs. It's one thing if it's life long narcissism; it's another if it's a new symptom.
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While Amy may feel guilty if her mom passes and she's said no to her, it's also likely she will need to work thru guilt later even if she says yes all the time. In spite of her best efforts, she may feel guilty that she didn't do enough and she'll have to work thru it. But the guilt she doesn't want later is looking back and feeling like she wasn't there for her husband or kids at a time they needed her.
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My husband was always a patient patient. When he was sick he went to bed and stayed there quietly as I checked on him once in a while for beverage needs and other comforts. Me? I'm a lousy patient. I moan and groan and display my anger that these stupid germs dared to attack me. While my husband was dying he was his usual patient and quiet self. Lord only knows how I'll be when I know the end is in sight. I have a feeling that I won't go gentle into that good night. If so, I hope those around me will give me attention and try to sooth me, but not let me take unreasonable advantage of them.

I am glad to hear that this behavior wasn't life-long co-dependency. I am sorry for how early in her life Amy's mother is facing this. I don't blame Amy for wanting to do anything she can for her mother at this point.

But I also hope, for Amy's sake, that she can be persuaded to limit herself to what is reasonable, that she can accept some support from a counselor, and that she can give up the super-hero cape that makes her think she can make Mother's dying a stress-free experience for Mom. None of us have that kind of power over death.

Bless you for trying to help.

Perhaps another way you could help would be to take your nieces/nephews out for a day or a weekend, so she and your brother have one less thing to think about for several hours. Maybe you could bring a home-cooked (or restaurant) meal to their home. Or offer do to the laundry each week for a while. Gift them with a housecleaning service for a couple of months. Amy is understandably stressed right now. Trying to convince her to change her interactions with her mother could be very helpful. But there are also other practical ways to lightened her load. Keep in mind this is temporary.
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NeedsHelp74,

Your SIL needs to either come here and read or you need to print her out a copy of a thread on "The Power of Emotional Blackmail"

https://www.agingcare.com/discussions/power-of-emotional-blackmailers-176430.htm?cpage=0&cm=440543#440543

Mainly look at the early post to Overwhelmed that describes this dynamic, its effects, who does such emotional blackmailing, how they do this, what are the origins of this, and why it is so victorious like it has been doing in your SIL's life.

Then focus on the post that begins with the sentence, "How it is defeated."

I'd have your brother come here and read this or give him a copy of it.

Her mother is only 67? Wow! How long is your SIL going to be willing to put up with this mental abuse of emotional blackmail. Does she realize that the longer she puts up with this the more she puts her relationship with her husband and children at risk. She's enmeshed with her mother and her mother is riding this for all she can get out of it. Your SIL needs some serious therapy, but she must first see that she's being abused through emotional blackmail, be willing to stop doing her part of complying with this mental/emotoinal dance, and then go get professional help to reach the goal of freedom.

Sorry to say this, but right now your brother's wife is more emotionally attached to her mom than she is to her husband or to their kids. It's sad, but not an unusual story to be read here on this site from time to time.

I hope you can send her a lifeline that she will grab and hold onto. I hope her husband can gain some insights into what is going on with his wife and MIL.

Both SIL and your brother need the same information about this emotional blackmail stuff. Its powerful, blinding F.O.G. (fear, obligation, and guilt) that sends people into auto pilot. It's quite engulfing, but it can be overcome. This F.O.G. is the path to the dark side of manipulation and it is easy to get lost in.

I hope and pray this all works out.
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Something does not add up. Why, if she was never manipulative or selfish before, does she act as if she feels so much fear when her favorite caregiver steps out? Can she explain it? (Have you just asked flat out why she is doing that?) Extreme fear and loss of brain power to take others' perspective are things that can explain irrational and cruel behavior like that.

Would a third party, like a hospice social worker (who could be called in to make an assessment, expalin services that could be available, even if she is not "ready" for that) possibly be able to interpret what is going on and help?
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I don't think the question of "how long" will Amy put up with this is the most important question in this case. Amy's mother is definitely dying. Maybe not tomorrow, but within the year ... and very possibly much sooner. The behavior will be self-limiting.

And I personally don't find it so hard to understand that someone facing her own death would behave in ways uncharacteristic of her in the past. I think I might ratchet my selfishness ratio up a notch or two. (I hope not, but I wouldn't guarantee it.)

If this really is a drastic change in behavior, I don't think we have to worry about FOG and co-dependency and any other kind of dysfunctional relationships. I think it is more a matter of getting through an extremely stressful and challenging time with the least damage possible.
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Jeanne, I agree with you. In this instance I don't think a battle for self assertion is needed. What I see is a family in crisis and a MIL who is dying soon. I personally would be very reluctant to tinker with this situation. Instead I would offer all the support that I could to ease the burden on SIL and brother. The idea of cooking some meals or taking the kids somewhere enjoyable sounds like very good ideas to me. I would listen to vents and offer support. I would let the husband and wife deal with limits at the present time. Perhaps the marriage needs support so they can pull through this thing together, instead of being torn apart. That may be an important role the rest of the family can play.
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One of the hardest lessons in life is that WE HAVE NO CONTROL OVER OTHER PEOPLE'S THOUGHTS, FEELING, AND ACTIONS. If your SIL wanted help, she would be on this site asking and receiving help. She would be talking to a counselor.

But, instead, you are on the site. You are looking for help. You need help, too. Here is the hard part: you have to fold your hands,close your mouth, and let her do what she is going to do. It is her head, her heart, her conscience, her mindfulness (or lack of it). She will learn a lot from this and, just maybe, she will talk about it with you someday.
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I would add that your brother ought to insist that he and Amy go to the social worker TOGETHER. And while Amy and her husband are talking to the social worker, someone else should be babysitting the children at home. This married couple needs to work this out TOGETHER for the sake of their marriage and for their children. Amy and her husband need to talk about the problem and develop a plan for her mother TOGETHER. After Amy and her husband have determined what is best for their family, then the DECISION can be communicated to Amy's mom by Amy, her husband, a social worker, and someone with even more authority like the charge nurse. Bravo on you for being so thoughtful and caring toward your SIL. Good luck!
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I want to help you with this--as I was that member of the family that mom was very dependent on. I neglected my partner and my work suffered. But I really wanted to assist my mom. She was a good mom. Sometimes we have to be there for someone no matter what. It's written in the stars for that time. Well, three years went by. Mom's dementia got worse. I then knew I couldn't do it alone. I introduced a "friend" of mine ( a caregiver). We had lunch together a few times. Then that friend started to visit by herself. Mom latched on to her. So I guess what I am trying to say is it probably won't last forever, the change is gradual and everyone needs to have patience (and a little cleverness!) I still visit mom (she has moved to a facility) but I know there are a couple of people that love her as much as I do. Don't believe that your sister-in-law doesn't feel guilt about her own family. She is doing triage--helping the most needy first.
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I think amy and her moms behavior are both understandable under the circumstances. Mom is dying and just moved to a nursing home. Rather then trying to fix amy how about doing everything you can to help amy, brother and children. As suggested helping with daily household chores , food shopping, taking kids to activities, hiring a high school student for kids care, would take a great weight off Amy's shoulders at this time. Then and only then would i try and address her mental status. It may not be as easy for Amy to back away from her moms needs right now. Good possibility all will settle down with mom when she becomes adjusted to her new living arrangements.
When my kids were little and I was caring for grandmother on hospuce and mom with breast cancer, telling me what I should do was not helpful. Taking my kids to lunch with Santa for me, sending me over a dinner, doing some shopping for me, buying grammom new nightgowns, this is what meant the most to me and allowed me time to sort things out and make some priorities
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littletonway said it all. SIL needs to be told she is selfishly escaping her responsibilities to her own family for the sake of someone who CAN get help from others but is too selfish to let them. It is cut and dried, and...... it doesn't matter when MIL dies, SIL is still doing too much. Someone needs to step in and throw a hissy fit.
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Just wanted to add one more thing. When I was in a "caregiving crisis" people would do things to "help" me, things they chose. Would have been much more helpful to ASK me what I needed.
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OP, I think your brother sounds like a jerk. He is being put upon to take on some of the "mom duties" and he doesn't like it. Isn't that just too bad.

While your SIL needs some help and the poster who suggested contacting the social worker at the AL is a good idea.

But for your brother to say about someone who is dying "they're just feeling sorry for themselves"....well it that isn't a situation to feel sorry for yourself, I don't know what is. That comment speaks volumes about him. Poor guy he has to "woman's work" and he doesn't like it.

Part of married life is having to take on an extra load when needed, sounds like your brother resents having to make dinner and get the kids to bed, it is annoying to him.

And quite frankly, this isn't your business. It's between the married couple.

Suggest to your brother someone at the AL talk to your SIL and than back out of this.
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No one should throw a hissy fit when someone else's parent is dying. It's just unhelpful.
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Depends on how sick mom is. Older people are like children. They trust one person. Sometimes they are afraid. I had my mom in my home for 3 yrs. I experienced all the emotions, Now I wish I had been kinder and more loving. What I took as anger I now realize was pride and fear. I wished I had held her more and smooth her fears. We had always gotten along. Now she is gone. And my life goes on. I have plenty of time for those other things
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Hi Everyone, Thank you all so much. The thoughts I have read on here have been so helpful and insightful. I would help out and take care of the kids but I live a state away. I wish I was there to help. My brother is being very supportive of her. It's just that he and I are so close, I can tell it's taking a toll on him. This is very uncharacteristic of her mom. She has never acted like this before and she and Amy have always been very close. Cmagnum, thanks for the great website. I will send some of that info to my brother. I am not planning to approach Amy on any of this, just my brother with ways he can help Amy, her mom and his kids and himself. These are all great ideas and suggestions and very helpful. Thank you all so much for caring and taking the time to write.
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NeedsHelp74,

On second thought, I am not sure that the information from my thread would help. I've thought more about this and this does appear to be a unique situation and not something characteristics of her mom. I'm sorry that I jumped the gun with my advice.
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Cmangum, so you think because this is not normally how she acts that it is not emotional blackmail? Do you now think it is just more of the mom being afraid and clinging to Amy? Why won't she let other people take care of her? Amy's siblings are happy to help out and so are plenty of other people. It's just baffling. Some of the people are probably right that I should just stay out if it. I just feel so bad for Amy and my brother and the kids. I feel bad for the mom too, of course.
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This is a tough call because this is not normally how MIL acts,. So that makes me question my earlier advice. I think that I've been on this site for so many hours over several days and have been so focused on emotional blackmail that I may have reacted more than responded. I wish that I knew more about what went on in her childhood that might explain this, but we don't have the time or opportunity for that. For some reason, she can't detach and her mom is all focused on her and does not want her to detach although there are others around.

Your SIL can't keep up her current pace up for much longer and it sounds like know one really has an idea when mom might die.

Whatever it is, it is some kind of emotional dance. I not sure we need a label as much as SIL somehow needs to see the need for detachment which in the heat of this crisis is going to be very hard for her to hear.

Is there a social worker there at the assisted living place that can have a family care meeting with your brother and SIL present to explain some need to detach in light of the whole situation and how much she is burning herself out. Maybe she would hear this better from a professional like a social worker who for sure has seen this kind of thing before. Maybe your brother can talk with the social worker himself and get their input and see if a family meeting might be a good approach or what would be a good approach. Those suggestions I think you could give to your brother. Does your brother have some friends that he can reach out to for giving him some practical, hands on help with the children and other things that need doing? If there is not a social worker at the assisted living place, then maybe a friend could watch the children while he sees a family counselor for some professional help for this particular situation.

I do think balance needs to be restored and I think that your brother someone needs to bring a profession into this either directly at the assisted living or directly with him. Does all of this make sense?
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