Reluctant Caregiver

The care that Debbie quite obviously needs, never mind the doctor's tests, is clearly beyond Sally's capabilities, never mind her desires. Caring for someone who is gradually falling apart – whether through extreme age, mental illness, drug abuse or anything else – requires professional help, not simply a loving or well-meaning relative or friend. Sally has been extraordinarily steadfast in support of her old friend but this situation is now beyond her. She should recognise her valuable contribution in helping her friend and also that the time has come for Social Services to step in. That is, after all, what they are there for. Guilt has no place in her response – she has already stepped up well over and above what could possibly have been expected of her. She needs to step back and take care of herself and her own life.

That is what I would tell her – gently, with affection, understanding and recognition.

Absolutely agree with absent

Agree. But I think she needs to talk about her feelings and just get them out. Let her talk, don’t offer any advice until she’s got it all off her chest. Listen.

She’s probably come to this decision already and just needs to have your ‘approval’ as it were. Or if she’s still struggling with her conflicting emotions, you should still let her talk herself out, then follow absent’s suggestion.

PS she also needs the stress free environment I’m sure you’ll offer her. It is respite care she needs herself as you so astutely recognised.

The fact she's making the break to visit and give herself respite suggests she will be able to pass on the care with a bit of encouragement

Hello willa 45. I'm sad for Debbie and Sally has been such a good friend but if she wants to step back she must make it clear to social services that she in taking no responsibility for Debbie and that she is not related, if in fact she has any contact with them at all. I would not have any contact with them let the GP do it.
I found out they wrote 'supportive family' on my parents forms which was just me. This left me coping alone for years, organising every aspect of their lives, but then it was my parents and I had to do the right thing. The caring takes over your life.
Best wishes to you all, let us know what happens.

I agree with Absent & Anya allow your friend to talk through her feelings and reassure her that she has already gone over and above what could be reasonably expected of a friend and neighbour. There comes a time when we have to take care of ourselves and let the professionals take over.
The authorities do need to be informed that your friend will no longer continue with her supporting role and other plans need to be put in place. I think your friend should be very firm about this and not agree to offer help of any kind. Once the situation has been resolved then she could offer some limited contact if she wanted to.

Sally needs to make very clear to social services that she no longer wants to be responsible for Debbie. As long as she continues to do things, it will be assumed that she is happy, or at least resigned to doing so. X

Tell her to walk away now. She is not responsible and she will just just become more and more resentful.
Her life will be taken over.

She needs to stop this now. As stated above, make it clear to Debbie's doctor that she is not willing and cannot cope with being her unofficial carer any more, advise him of the dire state which Debbie is in and ask him to contact Social Services urgently.
I would be quite "strong " with my best friend regarding this, she is going to make herself ill at a point when she should be reaping the rewards of her hard work.
Also, please ring RSPCA regarding the poor dog. It is not fair to leave it in that situation.

I agree with Nana3 - either absent herself from any dealings with SS, or make it crystal clear that, although she has been helping thus far as a friend, she is not related and is no longer able or willing to fulfil the role of carer; sounds harsh, but SS will take advantage if at all possible in my experience.

Warn her to be prepared for emotional blackmail from Social Services and NHS about how fond she is of her friend and how hard it will be for Debbie losing Sally, her only friend, etc etc.

Just tell her to say, no, no, no, no, no ad infinitum. SS and NHS will eventually get the message, get in gear and provide care for her.

But Sally MUST remain firm.

Agree with absent totally, and find MOnica's point interesting and so true. Earlier this year an elderly relative (widowed and no ties) stepped in to help look after her friend's 40 year old disabled son (still living at home) while she (friend) went into hospital. This was supposed to be for one night only because his social worker couldn't find him a suitable carer. Unfortunately, this was in the run up to Easter and the social worker extended her imposition saying it was impossible to get somebody for the period from Good Friday to Easter Monday, so my 77 year old relative remained living with her friend's son, and looking after him. Fast forward eight whole weeks and my cousin was still doing this, having abandoned her flat and all her friends. The social worker took complete advantage of her - so please, please prepare Sally for all the emotional blackmail that will come her way, and please tell her to be strong and think of her friend Deborah because there is no way now that Sally has the skills to take care of her and if she tries she will make herself ill and throw away her chanc es of any life of her own after retirement, which she has clearly been looking forward to. She has done enough but her friend has now deteriorated and it's time to acknowledge that.

As others have said she needs to be firm and consistent. I had the problem of the Council assuming that I was part of a neighbour's care (pretty well all of it until I put my foot down). It isn't just that it puts an unfair pressure on the reluctant carer, it rarely results in the right level of care being provided because no one in authority is forced to create a proper care plan.
It needs a number of agencies, from social services, the medical services, environmental health etc. In my neighbour's case I think the difference is that she now has a care co-ordinator so my neighbour knows what is happening, that she is going to get support and that there is a way forward. I really did not think it would happen. It wouldn't have without the neighbours making it very loud and clear that we could not cope.

While there are willing helpers the authorities will not step up as the carer is saving them money.
I believe your friend should distance herself as the woman is not her responsibility, a break away is the perfect time to sever the caring.

All sound advice in a desperate situation. There were massive government cuts to all social services begining in 2010. You cannot blame the social workers for the effects of the budget cuts. They are in an impossible situation themselves .
(I "escaped" to retirement in 2010.)

Now here's a novel idea!
How about increasing income tax rates for those on higher rate income tax? This could help to reduce the massive inequalities in the very rich (hide your money in tax havens) brigade and the ordinary and poorer people.

They could invest the new money going into the treasury to support NHS and social care.

I agree with Harrigran. My family experience with social services is that they will only step in when the carer providing the care suffers complete breakdown. After all it saves them so much money to have somebody else do the job. I think Sally should look on it that she is doing Debbie a favour if she steps back because she will at last get the full care that she needs. Sally can pursue her own interests - and one of those is to take care of herself, so that she can continue to provide more limited support to Debbie, such as visiting her in a home and maybe helping, again, to sort out her flat for her, if she is moved into a home.
Maybe you could tell Sally that she is not helping Debbie by taking the whole responsibility as she is not sufficiently qualified to care for Debbie, who is clearly in a bad way. So Sally has no need to feel guilty, but should see herself as part of the problem. Best of luck to all of you - it's a tough situation.

What a dreadful situation. I agree that SS will not step in while someone else is holding the fort - it saves them a job. If Sally doesn't help herself by standing back she will make herself ill too. All the advice give is very apt.

While she is with you someone else will have to "look after" Debbie so I would suggest that Sally then takes a holiday so that it becomes very clear that she is not taking responsibility for Debbie. While she is in the same building this is impossible until she has cut free from her by going away and other arrangements have had to be made.

Great advice here fom everyone and a good suggestion from Milly. Hope Willa45 can let us know the outcome? This is such a topical issue - and very relevant for our times.

I hope you can make your friend see that she has done all she can for your old school friend. The not washing or caring for herself means your friend (as kind and helpful as she's being) is not able to do enough and professional help is now needed. Suggest she must stand right back and let SS or docs take charge of this sad situation, which will surely only get worse.

I agree with all those who say that Sally should stand back and not let herself be thought of as Debbie's carer. However, am I wrong in my first impression of the OP that this is happening in the USA? Not that that makes any difference as far as Sally's responsibility goes, but social services (and indeed, the RSPCA!) may be different. Sorry if I'm wrong, willa45, but you do have an American turn of phrase.

Tell your friend, Sally, to move as far away as possible and enjoy her retirement and take Debbie's poor dog with her.

Sally should take a long holiday as she promised herself, to pursue her own interests which she has worked long and hard to enjoy ! She will but should not feel any guilt whatever ....it would seem she has been used by her friend Debbie and SS ...as has been said, SS and NHS Mental health, etc will absolve themselves of all and any responsibility they can .....budget cuts should not be part of their consideration ......it is unfair to expect Sally to spend the rest of her life caring for a possibily mentally ill friend. My late father in law, as far back as the early 2000's was asked to take in his sister in law as she needed care ! He was then over 80 and she was in her early 80's ...he said no ...he had no downstairs bedroom or bathroom, and mobility problems himself. The s i l had only her OAP and a rented flat .....SS tried very hard to pursuade hime but he resisted, so she went into a care home ....so it can be done. Sometimes it is hard to say no, but if Sally's health and well being will suffer then she has to walk away and not be blackmailed by SS or any family that Debbie may have. Good luck !