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Dear Care and Feeding,

My spouse’s mom has been diagnosed with vascular dementia. Her life partner of more than 20 years decided, seemingly out of nowhere, that he could no longer care for her, and dropped her off at our house. Due to years of health and medication mismanagement, she was in very rough shape, to the point we needed to take her to the hospital. From there, she was released to a rehab facility with a grim prognosis.

Well, she has rebounded. It turns out she was diagnosed with dementia more than a year ago, but told no one. She is now penniless, and we learned that she treated her ex-partner horribly, which is why he wants nothing to do with her and refuses to allow her back into this home. (Treating him badly was a possible side effect of the untreated dementia, but frankly she’s also a difficult person.) We are waiting for approval for Medicaid. She is in one of the worst facilities in the area because no one else will take her. And things just keep getting worse.

The lion’s share of her care has fallen to my wife and me, and we both have stressful jobs. I am trying to be supportive, because my wife is taking on a lot, but a part of me is growing resentful. Her mother planned absolutely nothing for her later years and now expects my wife to be at her beck and call. If we aren’t with her, she’s calling; if she’s not calling, we’re shopping for her; if we aren’t doing that, this is the only thing my wife can talk about. My formerly wonderful spouse is a ball of stress and agitation, even (maybe especially) with me. Please help me stay sane! What can I do to get my wife to take back some of her own life? I have tried talking to her, but she refuses to take anything off her plate, claiming that she isn’t burned out, and it devolves into an argument every time.

—This Isn’t Sustainable

Dear Unsustainable,

I understand that you’re frustrated and worried, and that both you and your wife are under a lot of stress. Elder care can be really challenging—emotionally, practically, financially—even in the best of circumstances, which these are decidedly not. It can feel much worse when the sick person has made no choices or plans for themself ahead of time. When my mother was sick, I felt like I was in crisis mode all the time; trying to manage her care and finances was like a second job.

It may be necessary, at times, to gently encourage your wife to remember to take care of herself, ask for help when she needs it, and seek more support—it’s so easy to forget to take care of our own needs when we’re focused on someone else’s. I also think it’s okay to let her know when you’re sincerely concerned for her, so long as you also make it clear that you’re there to help ease her burdens in any way you can. But from your letter, I think sometimes you might be trying to “help” your spouse by focusing on what you think she should do—urging her to “take back her own life,” for example. If you’ve said anything like that to her, or told her that her mother’s situation seems to be all she can think or talk about, I can understand why you’ve been arguing. She needs to feel like you’re in her corner, supporting her. Statements like that can sound like judgments, suggesting that you know better than your wife what she ought to be doing and how she ought to be feeling; that her stress and suffering is of her own making, because she’s not listening to you or following your advice. That would make anyone in crisis feel upset and isolated, adding to their anxiety.

Perhaps you’re familiar with the “comfort in, dump out” or ring theory framework when it comes to stressful and traumatic situations? The person in crisis is at the center; the next ring consists of their primary support system—partner, family, close friends; the next ring might include other, less involved family or friends, colleagues; and so on. The idea is that the closer you are to the center—and the more impacted you are by the crisis—the more support you may need from those in the outer rings. The further removed one is from the crisis, the more emotional or practical support they may be able to offer to those closer in. Right now, your wife is essentially in emergency response mode, trying to deal with her mother. You are part of her support system—arguably, the most important person supporting her. That does not mean that you are not also deeply affected by the situation, or working hard to try to address it. It doesn’t mean that you aren’t entitled to feel worried, upset, angry, sad, resentful, etc. about it. And it doesn’t mean that you aren’t also in need of some relief or emotional support—it’s a whole lot, as you’re learning, trying to support a spouse who is supporting an ill parent, and I’d never suggest you have it easy. But when you look for some of that support you need, or want to complain or vent to someone over how much your life has changed of late, it’s worth considering who you can dump out to so you aren’t always bringing those feelings directly to your wife (e.g.: Is there a good friend you can go to when you need to unload? Might you need to talk to a professional?).

The caveat here is that you two are supposed to be a team, and you do need to be able to honestly communicate within and about your relationship. So I am not suggesting that you and your spouse never talk about how this is affecting you both, or the impact it may be having on your marriage. You can’t shut down your feelings or sweep all this under the rug. But, again, keep in mind what both you and your wife are dealing with right now. It’s a particularly tough season: She’s in limbo, of sorts, waiting on Medicaid approval and possibly a facility transfer.  Her day-to-day life is dominated by just trying to react or respond to the latest emergency. The situation with her mom may always be very difficult, but it probably won’t always look exactly like this. So have the necessary conversations and try to address what you really need to address within your relationship when you’re both feeling relatively calm, or at least not in active crisis response mode. Be honest with each other, in the most loving and supportive way possible. Do what you can to sustain yourselves and your relationship; try to meet the demands of this particular moment as a united front, knowing that it is hard but it is not forever.

I want to point out a phrase you used: “my formerly wonderful spouse.” Think about how hurt your wife would be if she heard you describe her that way. Certainly, we can all be affected or changed by grief or trauma. But your spouse is the same person you’ve long loved, no matter what burdens she carries at this moment. Don’t do her the disservice of seeing her as fundamentally different, or thinking of her as “formerly” anything. Don’t accuse her of neglecting you, or your marriage, or her other responsibilities and joys in life. This is not a time to go on the attack, or become another source of anxiety, comparing her to how she was before. This is when truly loving partners suit up. You can be a safe harbor, a soft spot to land, and any love and joy you two are still able to experience together will remind her that there’s more to her life than worry and stress over her mother. Your wife needs your support, patience, and understanding, just as you’ve probably needed hers at other times in your marriage.

—Nicole

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My best friend, “Kris,” and I are sophomores in high school. We’ve been best friends since grade school, and so I’m really in shock about what’s happening to my friend and how she’s dealing with it. Kris and I are in the same history class. There’s this really awkward boy in our class named “Herman.” Sometimes when the teacher goes out of the room, Herman covers his lap with his coat, puts his hands under the coat, and wiggles around a bit. No one ever says anything, but they make fun of him a lot out of class. Last week, Kris confessed to me that she’s pregnant. She says that when we were doing group work in class, she sat in Herman’s chair, and the chair was wet, but I don’t believe her. That’s not even possible, is it? I think she’s making this up because her parents are very religious and are going to flip out. Now I’m really confused. Should I just tell Kris I don’t believe her, and that what she’s saying is wrong, or should I go to the principal or counselor or someone? Kris says her parents don’t know yet.