Dear Prudence

Dear Prudence Uncensored: Mom’s Health

This week, Danny M. Lavery and Future Tense editor Torie Bosch discuss a Prudie letter: mom’s health.

Torie Bosch: There’s so much I wish we knew more about here! Do the letter writer and her siblings live nearby? It seems like the LW has seen her mom have trouble getting around, so I suppose so? Exactly how was Mom active prepandemic–did she go for short walks?

But I’m glad that you’re focusing less on convincing the mom to lose weight–which will be hurtful and is difficult–and more on creating a productive discussion

Danny Lavery: yeah, I really want the LW to have a conversation with their mother about her safety that does not go in with the assumption that weight loss is the thing that’s going to address all of these concerns

not just because, as you say, it’s likely painful and distracting, but because it’s not going to suddenly remove her need for a second knee surgery

I think the LW should start by asking questions, because, as you say, it’s not entirely clear if the LW has seen their mother have trouble getting around, or if that’s something their mother has directly reported to them – I think it would really help to ask her what she wishes she had help with

Torie Bosch: Yes, that’s a great jumping-off point

At the risk of being all technosolutionism-y: I wonder if it might also help to discuss a subscription to a medical alert system. They aren’t really cheap, but it may bring some peace of mind to everyone

Danny Lavery: I hadn’t thought of that, which is a little embarrassing, given how popular Life Alert commercials were while I was growing up

Torie Bosch: My mother lived alone before she died, and it was always terrifying to imagine that she could need help and not be able to access it

Danny Lavery: Absolutely

Torie Bosch: You know, we all (or at least I!) made fun of those commercials, but they really did the trick!

Danny Lavery: they were a little cheesily filmed, but the underlying idea is a very good one!

and there are lots of different possible interventions that could start to help your mother right away

like, even if your mother agreed that weight loss would be the best solution to all her problems (which I don’t think it is), she would still need help getting around today and tomorrow

so a walker or a cane and/or a grab bar in the bathroom are all going to help her much more than saying “start losing weight right now in your 70s with a lot of knee pain”

Torie Bosch: And this is also a good opportunity (“good”) to start conversations, if they haven’t already, about long-term plans. LW’s mom may be worried that if she acknowledges how hard a time she’s having, her children may try to move her into a care facility–never an easy move, but made even scarier in a pandemic

but again, all of these conversations need to come from a place of finding accessible solutions, not wishing that things were different

Danny Lavery: right, especially since she’s already had a bad conversation with the sister

and maybe it would help to start by saying “I want to talk about you with your current needs for staying safe and healthy and independent in your home, and I know your last conversation with [Sister] went badly, so I thought I’d start by asking about what’s most important to you, and what you wish [Sister] would have done differently to try to help you instead of dictate to you.”

hopefully that won’t come across as an attempt to throw your sister under the bus, but it makes sense to me that your mother is/was worried about being condescended to or treated like a child

and asking her what she needs in order to have a frank conversation about the future should go a long way towards getting her to open up and not feel like she’s being scrutinized for evidence that she needs to be told what to do

Torie Bosch: Oh I love that approach

Danny Lavery: if she has reassurance from you that you’re not looking for “evidence” to try to control her

but that you really want her to be able to move around relatively comfortable and safely in her own home

Torie Bosch: And also help her feel like she isn’t being ganged up on

Danny Lavery: and that you want to know more about her concerns about surgery, or whether she’s in pain, or what you can do to make her life easier

yes, exactly

I think she’ll be much more forthcoming when she doesn’t feel defensive

and I just believe that help is possible/available for her without ever going into weight loss, partly because I think she deserves it no matter what, but also because I don’t think it’s realistic to expect an elderly woman who’s always preferred quiet, low-key hobbies to suddenly overhaul her lifestyle

so I just don’t think it’s the right thing to focus on right now

I think the LW believes weight loss is the best way to address these concerns but I really do think you can set it to the side and still accomplish most of your goals

and you can update your sister and brother afterwards; your brother might always stay kind of standoffish on the subject but you might want to at least afford him the opportunity to participate

Torie Bosch: At the risk of going into judgments on food choices, I’d also wonder whether your mom is able to cook for herself without pain

yes, I think that approaching the first discussion as a one-on-one, and then getting the siblings on board, seems the most likely to actually create change

Danny Lavery: right

yes, rather than assuming on any front (cooking, activity level, TV watching, whatever) that your mother is behaving carelessly or indifferently towards her own health, ask her how she’s doing and what she needs – she may be doing the best available thing for herself, if pain or mobility is a factor

Torie Bosch: bingo

Danny Lavery: and the fact that your sister’s approach leaves “a bit to be desired” is pretty vague, so I could imagine it was anything from slightly indifferent to like….wildly intrusive and rude

so again, just start by asking questions and assuring your mom you are not out to get her

Torie Bosch: Last thing–I’m so glad that your mom sews and crochets! I’d just suggest keeping an eye on that, because if she stops engaging in those hobbies altogether, things are getting worse.

Danny Lavery: I think that’s a good point – it’s great that she has hobbies she enjoys, and it’s better to think of them as positive things rather than “too bad she’s not playing tennis or hiking”

Now available in your podcast player: the audiobook edition of Danny M. Lavery’s latest book, Something That May Shock and Discredit YouGet it from Slate