“I often think to myself: this may be the last time I see my mother, so I'd better go back.”
Diane, an expatriate wife in her mid-forties, has been living in England for the last fifteen years with her husband and three children. Her 82-year-old widowed mother recently developed some heart complications. Last year Diane spent two months back in her home town of Spokane, Washington, to take care of her. During the previous eight months, as her mother's condition deteriorated, she has flown back and forth between Britain and Spokane several times.
“I am absolutely exhausted. I can't tell you how guilty I feel leaving her there alone when she needs me the most,” Diane wept.
Diane has her hands full. She feels responsible for her aging mother, as well as her own family and children. She tries to be strong and take care of everybody, but deep inside she wants to run away.
Most people feel indebted to their parents. When they are confronted with the reality that their parents will die soon they cannot accept it. Meanwhile people living far away from their parents may blame themselves or unconsciously blame their spouse for their moving away.
For Diane, the fact that she has been living abroad, thousands of miles away from her mother, rarely bothered her in the past. But now, having realised that her mother will not live forever, suddenly the guilt feelings well up within her. The idea of abandoning her and depriving her of seeing the grandchildren growing up all those years causes many regrets in Diane.
Diane has to come to terms with her relationship with her elderly mother. During the many years abroad, she never felt an endearing closeness between them. But like many other adult children, she feels compelled to offer her love during the fading moments of her mother's life, only to find out there is a big gap between them. The emptiness soon turns into overwhelming sadness. Many ask themselves: “Why didn't I get to know her more?” or “Why did she make herself such a difficult person to like?” Feelings of guilt or resentment torment many adult caretakers.
Running back home to rescue an ailing parent is a way many people attempt to compensate for guilt and for not having spent time with them in the past. However, in Diane's case, her frequent returns to Spokane have a negative impact on her family in the UK.
The whole family, especially the children, have to juggle to survive during her absence. Her frequent travel inevitably arouses tension between Diane and her husband. What's more, whenever the family decides to travel, the destination is always Diane's mother's home town. Family members feel Diane puts her mother above everybody. They resent her mother as an outside interference to the marriage and family life.
What's more, running back every time something is not right may not be helpful for the parent. It causes a role reversal situation: the child now becomes the protector to the parent. This can reinforce the sense of helplessness for many elderly people. In fact, most elderly are very capable and independent. Having another adult hovering over them can be as overbearing and debilitating as an overprotective parent is to a child.
At the same time, adult children have to understand their own limitations and inability to cope with the stress of taking care of elderly parents. An individual like Diane totally puts her life on hold because she anticipates the need to run home any time. This not only disrupts family life but also causes her to feel out of control of her own life. If the situation is prolonged, people like her may resent the parent for putting them through this. Sometimes such frustration may be inflicted in turn on the elders, in the form of aggressive behaviors or abuse.
Diane needs to have more realistic expectations of herself as a caretaker. Since she cannot always be physically present it is important that she personally arrange some help that can lessen any pain or danger to her mother. For example: a live-in nurse or nursing home. Keeping regular contact through phone conversations can offer comfort and assurance that the elder is being cared for.
Diane also needs to draw a line between her mother's needs and those of her own nuclear family. She has to carry on with her life, accept her own limitations and trust that she is doing her very best within the bounds caused by geographical distance. Finally, she needs to try not to force her mother's problem onto the whole family.
Dr. Cathy Tsang-Feign is a Hong Kong-based psychologist and author of the book Keep Your Life, Family and Career Intact While Living Abroad. She is the former columnist for the South China Morning Post and American in Britain on topics of psychology and adjustment for expatriates and their families.