Dear Family Advisor

Dad's killing himself to take care of Mom.

Last updated: Apr 27, 2010

My mom has vascular dementia, and Dad's trying to care for her to the point where he's risking his own health. Until she got sick, Dad was in great shape -- he biked 10 miles a day. In the last 18 months, he's lost weight, doesn't sleep or eat well, and "forgets" to take his heart medicine. Recently, he had a mild heart attack. If he doesn't start taking better care of himself, I'm afraid he could die before Mom.

They live about two hours from me and I go there every weekend, but I can't afford to quit my job, and I haven't found one in their area. I think they need round-the-clock care (she has sundown syndrome), but Dad's afraid they'll be separated. How do I convince him that their situation isn't safe -- that he's hurting himself and not able to give Mom the care she needs?

When it comes to taking care of a spouse, we don't even think of it as caregiving; it's just loving the person who stood with us and vowed "for better or worse." We'll risk our health and our finances to keep our partner with us even when it's not the healthiest or wisest choice. Your dad's devotion is commendable, but it's your job to show him that loving and caring for himself is part of loving his wife.

I firmly believe that every caregiver needs a caregiver, and your dad really needs you right now. Be his strength. Call him often. Give him a chance to vent; become his go-to person for advice and encouragement. The more he feels you're on his side, the more he'll listen.

Thank him for how faithful and good he's been to your mom. Praise him for all he does, and then add: "Dad, if you don't take good care of yourself, you won't be able to take care of Mom or be with me -- and I need you, too."

Tell him that the more he does to care for himself -- eating right, getting a decent night's sleep, taking his medication, and even visiting a friend for a long lunch -- the better he'll be able to help his wife. You might even point out that caregivers do have higher mortality rates, but with decent self-care and [stress management] (, he'll live longer and have more to give to her care. Make sure your dad feels he can get away to attend to his own medical appointments. Heart disease is the number-one killer in the United States, but it's also a disease that responds well to treatment after heart attack with medication, medical procedures, and a healthy lifestyle. It's possible that he may have mild cognitive impairment or other undiagnosed medical problems.

Call him or get him an alarm clock to remind him it's time for his medicine. Try not turn into a nag, but do be his steadfast companion and biggest ally. Every time you visit, take your father on an outing, relieve him so he can ride his bike, or rent a movie he'll enjoy.

Think about your own future: What will you do if your dad's health begins to fail and you have two parents to care for? What happens if one dies and the other is left behind? What if you do find a job near them -- will you move in with them or live nearby? What if you have to continue to commute? Could you telecommute from their home a few days a week?

By exploring such scenarios, you can begin to brainstorm solutions. Pace yourself -- you might be in for a long haul. Investigate all the available care possibilities, whether in the home or in an outside facility, so you're prepared. If you become educated and informed ahead of time, your own life will be less likely to fall apart and you won't have to scramble for less-than-ideal solutions in a crisis.

The best that can be done for your mom now is to make sure she's safe and loved. There may come a time when, sadly, they aren't able to live together. You may eventually have to "pull the ace card" and make some hard decisions your parents won't like.

But for now, spend quality time with them. It's so easy as adult children to swoop in after a long week and turn our parents into a chore: Do the shopping, do the vacuuming, do the bills "¦ do, do do. No wonder they don't want to hear our nagging. We neglect the most profound aspect of being a family.

The most important thing we can do is to be with those we love. Find ways to connect with them -- as friends, mentors, and a part of your legacy.