in Ethicist

The Ethicist: 3 January 2018

What if My Mother’s Extramarital Cravings Are Linked to Dementia?

Question:

My mother is in her mid-50s, which is the time at which people can develop frontotemporal degeneration (FTD), a form of dementia she is at risk for. Symptoms of FTD include a lack of inhibition or social tact and unusual verbal, physical or sexual behavior. My father and I have at times worried that she may be exhibiting the beginnings of other symptoms. A few years ago, she consulted with a doctor, but no diagnosis was made. I think it is pertinent to note that there is currently no cure for FTD…. I recently found out that my mother has been seeking sexual relations through various online platforms, and I am fairly certain that her efforts have come to fruition. I think it is fair to say that these relations have come to be because of a “lack of inhibition”; in addition, I believe that these sexual relations have included things that, for her, would have previously been considered “unusual sexual behavior.” … If, however, this is a sign that she is developing FTD, I feel that it is pertinent for my family to know of the situation. If I bring this up with my family and it turns out not to be related to the development of FTD, it could cause irreparable harm to her relationship with my father and my brothers. If I choose to discuss this with only her and she is later diagnosed with FTD, I worry that the disease might have been diagnosed sooner if this behavior had come to light … My mother is the one who manages both of my parents’ finances. When my grandmother was diagnosed with FTD, my mother and aunt took control of her finances. My mother also noted that perhaps the FTD explained a few strange financial decisions that my grandmother had taken in the years before her diagnosis. If, in fact, my mother is developing FTD, it could pose a risk to my parents’ finances and thus both of their lives after my father’s retirement.

Correct answer:

Suppose there was no question at all of dementia, and you discovered that your mother was conducting multiple extramarital affairs – in perfect physical and mental health. Why wouldn’t you tell your father in that case? She could contract a venereal disease and transmit it to him – your own father! You would be right to tell him and wrong to conceal it from him.

All the more so given the likelihood that your mother is developing dementia, and that you know that this can lead not only to destructive sexual behavior but also to destructive financial behavior.

You must tell your father. Whether you do this immediately, or whether you do it after discussing the matter with your mother and her doctor, is your own decision, but you can not treat it as your decision to allow your mother’s possible mental illness to destroy your family members’ lives.

Question:

My sister is in her 80s and lives alone in a rented apartment in a Canadian city where she moved nearly 60 years ago. Her formerly strong network of friends and acquaintances is dissolving as they age, sicken and die or lose the energy and patience to deal with her.
In my opinion, she has a hoarding disorder and the beginnings of dementia, and she has had problems maintaining her apartment to the landlord’s satisfaction. She also has trouble dealing with documents, paying bills and scammers. She never became a Canadian citizen, and her Canadian and American identification have both expired so she can no longer travel.
I am in my 70s and live hundreds of miles away in the United States. I have a husband, an adult child and grandchildren, for whom I provide a lot of child care. My sister is behind my other family in my priorities, and frankly she drives my husband and me crazy. I am not willing to relocate to Canada or have her live with my husband and me.
She has refused to give me power of attorney so that I can deal with financial institutions when she has been scammed or has neglected to pay bills. For some time, she refused to admit that she has any “memory problems” or to consult her doctor. She does not want anyone messing around in her business.
I see her a few days each year, during which I try to touch base with the last of her friends, do some cleaning and decluttering, have some fun with her and yes, nag her to make some changes. If she continues to refuse help, may I be excused from feeling guilty?

Correct answer:

This is a lot of lead-up to a question about whether you ought to continue feeling guilty or not.

If “feeling guilty” is keeping you up at night and preventing you from living your own life, despite doing your reasonable best to help your sister, then yes, you may be excused from feeling guilty. But if “feeling guilty” is what is driving you to try to help your sister in the first place, and what you really want is permission to stop helping her, then you should not stop entirely – but you may adapt what help you offer to what you think she is likely to accept.