Dear Roe,I am close to my sister. I’m in my 50s now, and she’s 10 years younger, and growing up I was kind of like her second mother. She’s incredibly warm-hearted and caring. My dilemma is this: I am seriously concerned that her lack of selfishness is damaging her health and potentially shortening her life expectancy, and I feel like I’m a bystander letting it happen. She has a child with a chronic condition and her husband is going through treatment for a serious illness. She has numerous significant health problems herself. In the last few years she is constantly exhausted, always in pain with headaches and back pain, and her mood is low (which is understandable). Despite all of this, as well as managing all the kids’ activities, she volunteers to help anyone in need, elderly neighbours, relations, school events, play dates etc, even when she doesn’t like the person that much or they haven’t been particularly kind to her. She is a wonderful person, but it’s heartbreaking to see her in constant pain. This lack of ability to protect herself is damaging her health and her quality of life, and it seems there’s nothing I can say or do to make it better. I help practically wherever I can, though she never asks. Any advice?The care you have for your sister is heart-warming, and it’s obvious that you love her deeply and want the best for her.I presume you know the situation deeply, but I would warn you against automatically conflating things, and to not assume that you know what is best for your sister more than she does. It is very possible that you have a clear-eyed view of your sister’s habit of over-extending herself and the stress it causes. But I do want to leave room for the possibility that your sister’s habit of volunteering and helping others in her community is deeply important to her and actually provides some relief from her feelings of stress, pain and low mood.Volunteering, feeling needed and appreciated within your community, helping others – all of these activities may give your sister a real sense of purpose, a feeling of connection, and may actually be emotionally important opportunities for her to get out of the house, have some time away from caring responsibilities at home, and give her some distractions. I understand your instinct may be to try to make her sit still, to take it easy, to wrap her in cotton wool – but it’s important to not only respect your sister’s agency, but to understand how the ways she chooses to spend her time enrich her life, before simply telling her to give them up.[ ‘My sister won’t leave her bad relationship - and I’m pretty sure she’s having an affair’Opens in new window ]The truth likely sits somewhere in the middle: that your sister does receive a huge amount of meaning and fulfilment from helping others, but that she is also over-extending herself. If she has always been a giver and someone who helps others, that may be a part of her identity that is hard to disentangle from her sense of self-worth. If you believe that you are only liked, appreciated, valued and indeed worthy because you are constantly giving to others, never saying no, and never setting boundaries, it can be very difficult to remember that you can say no when asked to do something – and even more difficult to believe that you will still be loved if you do.But just as we can acknowledge that your sister may find it difficult to say no, it may be difficult for you, her “second mother”, to stop viewing her as a child who needs to simply follow your instructions. In order to respect her agency and give her room to step out of that people-pleasing role, you may need to step out of the “mother knows best” role and not become yet another person telling her what she has to do and making her feel like she’s failing if she doesn’t do exactly what you want. You cannot cure her of people-pleasing by demanding that she please you.‘You could try to take her for a weekend away, or book a spa treatment for you both. You could invite her to meet some new people who don’t expect anything from her’Speak to your sister with genuine curiosity: ask her about her health, how she’s doing emotionally, ask her about all her responsibilities, and ask about what her various activities mean to her. Listen carefully to her answers. Ask her what the most stressful thing on her plate is right now. Ask her whether she has spaces where the focus is simply on her, or where she feels the most relaxed. Ask her what would she do if she had a week free from any responsibilities. Listen carefully to what she is communicating with you about what in her life brings her joy, meaning, purpose and distraction, and what feels draining.From there, you can do two things. Firstly, you can simply affirm her stress and express your love and concern, and bear witness to her experiences, rather than trying to solve them. Remain very aware of the language you use. You may notice that in your instinct to protect her, you jump to tell her that she’s wrong a lot. Try to be conscious of where judgmental, negative or scolding phrases like “You should” and “You need to” creep into your language, and try to replace them with expressions of care, affirmation and belief in her worth. [ Family fallouts: ‘I can’t describe the heartache of not having a relationship with my sister’Opens in new window ]Instead of saying, “You need to stop helping people,” you might ask, “How are you managing to carry all of this?” Phrases such as “I’m worried about you”, “I can see how much you’re carrying”, “You deserve to feel taken care of, too”, and “You don’t have to earn your right to rest” can be very powerful, and may help her not only believe them, but come to see you as a true ally, not someone else she has to perform for. Secondly, listening carefully to her ideas of fulfilment, rest and care may help you get a clearer idea of what kind of support or relief you may be able to offer her: it may be helpful to do some admin work like finding the best doctor for her, or if she’s open to it, helping her find a therapist so she has some support. Framing this as her needing to support herself so she can continue to be there for others may be a way of easing her into these ideas.Or you might realise that she’d love to be invited over to you for tea or dinner more often so she has nothing to do, and gets to just chat. You could try to take her for a weekend away, or book a spa treatment for you both. You could invite her to meet some new people who don’t expect anything from her, so she can just turn up as an adult woman, rather than a mother or volunteer or carer. If there’s a hobby either of you would like to try, that could be a lovely way to spend time together and to sneak some regular time for rest and self-focus into her routine. (Again, you could frame this as her supporting you in trying something new or sticking to a routine, if that helps.)If she’s open to reading about people-pleasing, Stop People Pleasing by Hailey Magee, and Fawning by Ingrid Clayton are both interesting, with some practical tips on boundary-setting.But most importantly, just keep being there for her. The fact that your sister never asks for help or support does not mean she doesn’t need it. So continue offering support, in the only way you can: be her sister. Not her rescuer, not her drill sergeant, not her mother. Her sister, who sees and loves her as an equal, and completely worthy, no matter what she does. That may be what she needs the most.