A: Your sister definitely has a lot on her plate, and I appreciate your concerns. I agree that your sister could benefit from some help. Even though her health insurance only covers catastrophic events, there were federal laws passed that mandate providing mental health coverage so I hope she has researched these options.
On the other hand, sometimes there are more services available to those who are experiencing financial hardship at local Community Mental Health Centers. It may not be completely free, but most agencies at least have discounted services or can connect her to resources to help in other ways.
However, most support groups (such as AA, Al-Anon, grief, domestic violence, and caregiver groups) are free. This may be an option for her to pursue as well, especially a care giver support group. Look for them at churches, hospitals, nursing homes or senior centers. Her local Area Agency on Aging may also have resources for your mother such as Meals on Wheels or transportation to medical appointments, which could help take some of the burden off of your sister. Have you or your other sister considered moving your mother closer to one of you?
As for the other issues, it will be up to her to set boundaries with her adult children, but you can support her in doing this. It’s also not impossible to leave a marriage amidst debt and medical issues. I’ve seen people do it and it is difficult, but not impossible. I worked with a client once who pursued a legal separation instead of divorce so that his physically ill wife wouldn’t lose her medical insurance, but he was free to move out and move on with his life.
My final note is somewhat of a pet peeve for me. I get very frustrated when people say that they can’t afford counseling when chances are that they have cable, eat out occasionally, or spend money on a vice such as smoking. I don’t know your sister and I am in no way passing judgment, but the cost of a therapy copay might be well worth it for her to get some support during this difficult time. Even if she only attended one session a month and supplemented it with a support group or some self-help books, it is a worthy investment.
I hope some of my suggestions can help. Feel free to share my response with your sister.
All the best,
Dr. Holly Counts