My 89-year old dad has Parkinson’s and in the past year his symptoms have gotten much worse. Nowadays, in order to keep him out of a nursing home he has 24/7 aides in the house. He is cared for by my 82-year old mother, who is actually (and luckily) in great health. Only she seems to be headed for a breakdown, she is often in such a funk and depressed at their situation that my sister and I worry about her more than we do about my dad, who is well cared for. But we can’t get her to step back and do more to take care of herself, including getting some counseling, much less take a few days off for a short, relaxing trip. So it’s the combination of someone who feels that they need to be in complete and constant control of the situation, but who also is running herself into the ground and will be of no use to anyone if she ends up with physical or mental problems. We thought the hard part would be getting the care for my dad, but once that was all in place the real challenges began! Any advice for motivating a caregiver to get the care they need?
Can you get her to take even short breaks - an afternoon/evening out for dinner, movies, a show with friends or family? Even small doses of an escape can be very cathartic. Outings with grandkids can be a good excuse. Hard to say no to grandchildren. 
Can she do a simple exercise routine like a daily walk/swim to clear her head, get away, generate some endorphins?
Does she have close friends you can engage to encourage her to take some self care steps?
Perhaps she is already doing so but worth mentioning.
Many senior/community centers have groups for caregivers.
My mother passed away last month after 15 months living in an adult care home. She went from independent living to that seemingly overnight. Even though we were not doing direct care, one of us (her children) was there every evening and 2 or 3 of us there (individually) Saturday and Sunday and we were exhausted and spent at the end.
If she doesn’t want a group, do everything in your power to get her out and about. Enlist her doctor if necessary. If your father passes first, she won’t have anything to occupy her if she hasn’t taken care of herself now.
Also, ask in the parents caring for the parent thread perma-tagged above.
Good luck and remember to care for yourself, too.
I use to run groups for caregivers. Group members would encourage others to disappear for a few hours, even if just a walk to the beach or breakfast out. We’d suggest the women continue to get their hair done. If you can’t yet get the caregiver to loosen the reins, then ask her friends to visit, bring lunch. If she plays cards, suggest she have the group play at her place.
It’s a very difficult situation. I see caregivers wear themselves out, lose sleep, barely eat. We have to keep reminding them to be diligent in their own care.
In our case, one intractable problem may be that my mother is not comfortable delegating my father’s care to others. So even though she has these aides there, it’s hard to convince her to leave the house for more than a couple of hours at a time. She does play mah jongg once a week and takes an exercise class and sometimes meets a friend for lunch, but that’s about it. I think with really labor-intensive cases like my dad’s, with a dementia component, a caregiver needs more of a break than that. And also possibly counseling for coping strategies. Easier said than done though!
I wonder if you could try to persuade your mom by gently conveying to her that being depressed has a negative effect not only on herself but also on your dad. My former MIL is deep into Alzheimer’s now but up until recently, she could still sense her husband’s negativity and it made her feel worse, too.
I’m glad she’s getting out some. Good to be put at least once a day
Perhaps she trusts one helper more than the others? When Mrs X is there. Your mom can set up her own doctor appointments and personal care appointments
Thanks all for your common-sense advice. I have to just accept that all of these good ideas, which of course we have already expressed to my mom, are going in one ear and out the other, and we can’t control what she does or doesn’t do to help herself.
We had the same situation with my in laws. MIL would not do any self-care. Even for her granddaughter’s bridal shower - we arranged for her oldest son to stay with Dad so he would not be alone (he was in a hosp at that time, so he really could be left alone, but she would not agree to that) while she was at the bridal shower. She still left after only an hour. She just could not relax and just enjoy the time with family and friends celebrating a milestone in her granddaughter’s life.
When FIL passed, she was physically in poor shape and had to ‘recover’ from several years of (self) neglect. It was hard to watch.
Just wanted say I’m sorry, OP. I’ll be there soon with my 84yo mom and 88yo dad … they’ll be 85 and 89 next month.
As a pastor/chaplain/home care aid, I’d say that she has a lot going on. Her generation finds it very difficult to accept being dependent - they were raised to pull themselves together and do what needs to be done. I’ve had lots of clients whose children hired our home care agency and really ticked off mom and dad…it strikes at their core identity, dignity and pride when they have to watch someone else do “their” work. Generally we start slow and let them work along side of us until they establish trust and slowly relinquish control over house work and caring for spouses.
In addition, she probably has a lot of anticipatory grief concerning your father’s decline and eventual death. They’ve been married a long time, I’d guess. Did she ever take trips without him when they were younger and healthier? What seems relaxing to you might be incredibly MORE stressful for her. She knows their time together is coming to an end and probably values every minute that she can care for him. Again, it takes a lot of time to trust people, even great aides, to take over “her” role.
@KKmama you are so right, now that you have put it out there. I think you are spot on, that alongside the inability to delegate because she feels it is her job and nobody can do it as well, there is definitely that anticipatory grief. I hadn’t really thought about that before, but it puts a lot into perspective. There is nothing like a degenerative disease, where things change for the worse every day, to foreshadow what is to come and to sort of put it in your face! And again you are right about her being stressed out by things that I would hope would relax her. For instance I am on the other coast and would love to have her come out and visit even for a long weekend, but just the thought of that upsets her so I learned my lesson about suggesting such things, which she considers the opposite of helpful!
As @bookreader alludes to, while we hope that after my dad passes away my mom can avail herself of more enjoyable things, such as trips, who knows what kind of shape she will be in by then if she doesn’t take care of herself now?
In a world of what often seems like throwaway relationships, I do respect the love and loyalty shown by putting one’s all into the care and concern for a life partner.
@doschicos I completely agree! My sister and I were saying that our mom is setting an example for us that we cannot imagine being able to follow, with her selflessness and dedication and patience! Plus, my folks are more affectionate toward one another now than we ever remember them being before. If it weren’t that the circumstances are terrible and sad, it would be a very nice thing!
Here a few suggestions: (1) Could you arrange for your dad to spend a few days in a respite facility so your mom could get a break in their home? My ex-h has done this with his mom at least twice (she has advanced Alzheimer’s disease). She did fine in the facility and I think my ex and his dad were very happy for the break, in his dad’s case especially because he didn’t have to leave home. (2) Arrange for other in-home “treats”: flowers, your mom’s favorite foods, phone calls and visits from friends and relatives.
I wouid encourage you to get your mom to go to a support group and a therapist. My mom started going to both even before my dad needed 24/7 aide. Even though she knew that she couldn’t be the primary caregiver without it taking a toll on her, the therapist gave her “permission” to step back and let the aides take over and it allowed her to go to her card games or lunch with friends without feeling guilty.
She still goes to both even though my dad passed away almost two years ago. She goes to support group to help others who are still dealing with the issues of an ailing spouse and the therapist to mostly deal with my sister who is a drama queen.
My mom is doing incredibly well, but she is lucky that at 88 she has no medical issues at all.
I wonder if she is anxious about ‘strangers’ constantly going in and out of their home (?). Maybe she is displacing her anxiety about all that.
Parkinson’s is brutal for caregivers. I’m so sorry.
I like the idea of encouraging her to go to a support group to help her “let go” of some tasks she thinks she should do. An added advantage is that if she starts allowing caregivers to help her take care of her husband, she may be less opposed to having help around the house for herself after he is gone.