Helping someone you care about when they don’t want help is complex. When do you honor their wishes, and when do you superimpose your own beliefs out of a conviction that your instincts are correct? Several years ago, my husband and I faced this question with my mother-in-law. It was among the hardest and most important things we’ve ever done.
It’s hard to say when dependence becomes an addiction, when an aversion to going outside becomes a phobia, when a person moves from set in her ways to obstinate and rigid. Looking back, none of us recalled a particular date. We remembered instead a period of time over which a person we loved and enjoyed became increasingly inflexible, bitter and withdrawn. When, we wondered, did we let go of the woman we had known, and allow this stranger to take her place? When did we begin accepting this diminished version of my mother-in-law, as the real thing?
For several years after her husband died, my mother-in-law — we called her Bubbie — did quite well. She frequently ate at restaurants, went to movies, shopped at malls and enjoyed her family. She had a full and happy life.
We’re not sure when, and we don’t know why, but over a period of years things started to change. Everything became “too much” for Bubbie. She stopped going out, preferring to stay home. She stopped having meals with us; we ate either too early or too late. She became increasingly critical and withdrawn, opting to spend time by herself. Most of the time, she watched television and slept.
“You’re depressed,” we suggested. My mother-in-law insisted this wasn’t the case and rejected our recommendation of an antidepressant. “It will interfere with my other medications,” she said. We arranged an appointment with a social worker who did home visits; she cancelled it. “I’m not depressed,” she maintained. “I’m anxious.” She asked her doctor for Valium, a drug she had used on occasion when she was younger, and he agreed to prescribe it.
Soon everything made Bubbie anxious, and Valium became her method of choice to “get through the day.” We argued that her use was excessive. “My doctor prescribes it,” she said. Her physician was well regarded in the community, had a large geriatric practice and was Medical Director of a local nursing home. We contacted the doctor and shared our concerns about Bubbie and her Valium. “She’s set in her ways and will not change,” he told us. “Besides, the pills are only 2 milligrams.” “But she takes them all day long,” we countered. He seemed disinterested. We looked for another doctor and made an appointment. Bubbie refused to go.
It was a construction project that finally brought the situation to a head. Since Bubbie spent so much time in her bedroom, we offered to build a small sitting room adjacent to it and create a little suite. She wanted no part of it. “My life is awful and having an apartment won’t make it better. Besides, the dust and noise from the construction will make me ill.”
Against her wishes, we persevered and construction began. Within two days, Bubbie’s blood pressure was dangerously elevated and she was hospitalized. She called us with a request, “Bring me 30 Valium, a pad of paper and the phone number of Dr. Kavorkian.” We called her doctor. “She is going to commit suicide,” we stated. “We want her off Valium.” “She’ll never accept going off Valium,” he insisted. He was right. She didn’t accept it. We did it anyway.
That evening, my husband “fired” her doctor and “hired” another one. The new physician agreed that Valium was a depressant and that Bubbie was abusing it. The next day, she was taken off Valium and put on Zoloft.
Bubbie was furious. She was a mentally competent adult, and we were treating her like a child. We were forcing her to accept an apartment she didn’t want, and taking away Valium — the one thing that had consistently given her solace and reduced her anxiety. Why couldn’t we leave her alone?
Tough love is a concept normally applied to the actions of parents toward children, not children toward parents. But perhaps this norm needs to change. As children, we are taught to honor our parents, but is acquiescing to an aging parent’s wishes always honoring them? How do you balance love and respect with risk and responsibility?
My husband and I felt that we WERE honoring Bubbie when we took steps to end her Valium addiction. It wasn’t an easy decision. In order to do what we believed to be right, my husband caused his mother pain and incurred her wrath. It took tremendous love and courage.
The days immediately after her discharge were scary. Bubbie seemed subdued, but disoriented. What had we done? we worried. She had been miserable, true, but she certainly had not been confused or disoriented. But soon the confusion lifted, and what emerged was a Bubbie we hardly knew.
Over the next ten years, Bubbie spent what she described as “the best years of her life.” She read three to four books weekly, became an expert at card games on the computer and received dozens of emails weekly from friends and family. She knitted sweaters for living and yet-to-be-conceived great-grandchildren (“I may not be alive when they are born and why shouldn’t they have sweaters too?”) She was interested in everyone, and she was, above all, a terrific listener. Her wisdom and warmth made her a beacon for all around her.
Ironically, Bubbie seemed to remember little about her Valium-addicted days. “I wasn’t very happy then, was I?” We’re glad that her memory of that time was hazy. Her new self was so much more… well, the real Bubbie.
Bubbie lived for ten more years after her withdrawal from Valium. She took a small dosage of Zoloft daily, and although she had occasional periods of anxiety, she never asked her new doctor for Valium. She told us often that she had a wonderful life and that she felt fortunate to be alive.
My husband and I often think back to that horrendous week when, against her will, Bubbie was taken off Valium. We wonder what would have happened if we hadn’t been willing to do “tough love” for Bubbie.