Cancer in jaw in DM. DF depressed - long

[Ritaskitchen]

Short version - DM having major op and DSis doesn’t think there should be any outside help after the operation.

Does anyone have experience of a similar situation?
DF is late 70s and DM early 70s. There is me, DSis1 and DSis2
Both parents usually very active and busy.
DF has had depression in the past. It’s back just as DM has been diagnosed with cancer in her gums. We are waiting to find out if it has spread. She is going to have a big operation including gum and teeth removal, time in intensive care and hospitalization for 2 weeks.
Im visiting now and going to the hospital planning meeting next week.
DF has started anti depressants and is pretty up and down. I’ve arrived today and he’s just sitting in a chair and very down. He is usually very active, social etc etc.
DM was in healthcare for her whole career so is very clued up. She is also v v private. Doesn’t want anyone to know.
I would like to arrange some kind of support for them when DM is out of hospital eg professional help a couple of times a week to assist with things like some shopping, a bit of cleaning, prepare a meal, put a wash on. What ever would take the pressure off a bit.
DF will take whatever I set up.
DSis2 who says things such as ‘what if they steal from you?’ Or “it’s best to get back to things like cleaning and normal duties as part of rehab’
DM and DSis2 are very close. DM is very private and I think doesn’t want to admit she may need help.
My perspective is better to have the help and not need it than not have it and need it. It will take time to set up.
DH and I are more than happy to pay for this help. If it isn’t needed then that’s ok.
DSis1 is, I think, in agreement that help could be useful. She is self employed, can help out but isn’t local and has a DDog and DM doesn’t like to have DDog in the house. She will also be there for operation time and afterwards. Of the three sisters I have the most freedom with my schedule but I am the furthest away.
I don’t live in the UK. I can come over at shortIsh notice but it takes the best part of a day - think 1 hour trip to major EU city, into Heathrow and 2.5 hours by car or public transport to Dm and DFs house.
Dsis2 lives very locally to DPs and works full time in healthcare but is heavily reliant on DPs, especially DM- coming round for most meals, analyzing her career in minute detail with DM, lots and lots of talking. They help her a lot with almost everything in life. She comes and goes as she pleases. DM and her have a good relationship. DF and DSis2 it can be a bit rocky.

So what to do. Do I just let things run their course? Do I let DSis2 decide what help my parents get ? Or do I hope that they just cope? DSis2 and I had a disagreement tonight because I suggest considering some help. I don’t want to cause my DM and DF extra stress.
DSis2 will not help that much. She is very against having help in the house as in her option after 36 hours in intensive, 4-5 teeth down and part of her gums and 2 weeks in hospital and potentially facing chemotherapy or radiotherapy it will be good for DM to keep the house in its usual pristine state, deal with her depressed husband and cook all the meals.
I am definitely coming over for the operation and will be helping out as much as I can but I have also realized I don’t think I can always stay at my DM and DF house. It’s just too difficult with DSis2 as she is very confrontational and will go on and on at you. Plus I will need a break sometimes. DSis2 would not invite me to stay at her house. That wouldn’t even cross her mind to offer.

I think just let things run their course. You've made this offer which is lovely, but I don't think you can insist upon it. Maybe investigate possible options so that it will take less time to set up if needed (as you'll know who to call). Make it clear to your parents and sisters that the offer is there if needed. Make sure the fridge and freezer are stocked with easy meals. Who says the house has to be pristine? If your mum isn't coping you can be more forceful.

Sorry to hear of your mum’s diagnosis.

has your mum got the contact details of the head and neck nurse specialist? They will be an excellent source of information regarding recovery which could help you plan for post op care. They would be my first point of contact.

When you go to the hospital planning meeting, ask the surgeon what the expectation should be for the post op period and what arrangements should be put in place for your mum. A neutral, expert opinion can help cut through family differences.

Let them rub the course. It’s up to your parents. You have offered. Having people in your house can be hard work (as someone who has had to have random support in the house at times - I hated it).

Can you stay at a nearby hotel?

I think get someone whooshing supplies or order a proper online shop if your sister can’t pick up any shopping. Of course your mum can’t do everything. So either your dad will have to step up ( your mum being ill may bring him out of himself, may make him worse).

if it’s clear they can’t cope before you leave then offer again then.

Maybe look at some of the meal delivery services - there are some good ones.

Another vote for contacting the clinical nurse specialist.

I think that you’re right and you need to get something in place.

If she needs chemo and radiotherapy after the operation it won’t just be a case of needing to rest for a few weeks, it will be several months of being very tired. And it will be very hard to find someone good at the last minute.

Id find someone and book the visits to start during your stay so that you’re there to support. And I’d book them for a time when your sister won’t be at the house. I think a lot of the worries about stealing etc will stop when you’re talking about eg Sophie who they know and have met, rather than an abstract person.

And during your stay, if your mum asks you to do something eg pick up her prescription, I’d do it willingly and then say something about how you’ll ask the carer to do it next week when you won’t be there.

If your sister makes a fuss Id make sure you have a list of jobs on the go so that you can reply with “Ok, please can you clean the kitchen tomorrow then”.

What’s the prognosis though? Head and neck cancers don’t have great survival rates (my dh died of thyroid cancer so I’ve spent a lot of time in hospitals) & she may be over optimistic about how poorly she will be post op especially if they offer chemo.

Its a good idea to get in contact now with Marie curie for night nurses if the prognosis isn’t great.

Agreed speak to the team maybe, often one of the clinical nurse specialists is the link/liason. If they are anticipating a three day ITU stay is a tracheostomy/flap part of the planned surgery?
What sort of diet will your mum need immediately post op? Soft/pureed/temporary feeding tube are all possibilities.

As always if your parents have capacity then it is their right to make, what may seem to others, bad decisions. But that only holds if see is in possession of all the information she needs to make those decisions.

Thank you all so much for your replies. I’ve been out with Mum visiting my university son and then helping Dad sort out his car insurance (which was long and protracted as I found out he doesn’t have online banking so the transaction couldn’t go through)
Im going to read them all carefully and make some notes.
I truly appreciate it.