How to handle a former family caregiver who berates herself?

These habitual expressions of feeling inadequate, and the responses they get, which are also habitual, form paths in the brain. The things we say to ourselves over and over and over like a loop-feed have great power. Often it begins because of a need to have someone respond "Oh, you are so wrong; you were wonderful". People often do this to avoid going into real grief. Therapists tell us that this keeps someone in an area where the thought is that "SOMEthing" could have been done to prevent what happened. Then we don't have to actually face the loss and wade through the grief.
I think you should change your response. You co this habitual thinking by actually negating what she says. So don't respond "Oh, Noooooo.............." followed by the reasons she is wrong. Tell her instead "It is distressing to hear you say these things about yourself. You aren't a God, or even a good fairy with a wand; you haven't that kind of power; at the same time you are not a felon who should feel grief over his evil-doing". You are a human being. You have done what you could, and done it with love. Try to switch your G words out from GUILT to GRIEF, because grief is what you must face now. If you need help do seek it to comb through your feelings."
I wish her good luck. It is distressing to hear this behavior, and sympathizing with it will increase it. Do let her know that the more often she repeats these things to herself the more she cements them into her consciousness. That it does NO HONOR whatsoever to those she loved so very much, and now has lost. Give her ways to work through her feelings. Journaling often helps, especially if it is used to celebrate the lives of those lost.
Wish you all well..

She needs professional help. Just telling her she is not bad is like banging your head against a wall. It is a perverse way of grieving thinking you have had the power to reverse what was truly beyond your control. It is grandiose to assume you had that power. She needs someone who knows how to help her by dealing with more than the present and exploring her past relationships with the deceased. Just ignore her self flagellation. Tell her she needs help and change the subject.

It’s very possible that Susan is really really lonely. Her world has been very full until recently, she has no children, and now her world is empty. There is no pathway forward, and that must add to making her feel incompetent.

My first reaction is ‘how old is she’? A husband for 35 years doesn’t really indicate if she’s 55 or 70. Perhaps she should be thinking about downsizing, and moving to a retirement village or senior living, somewhere she can make the new life she needs. Phone calls to you aren’t the answer.

Can you find of a way to help her think along these lines? She needs a new plan!

Whether depression, grieving, or low self esteem, it would be good for her to seek counseling, to have someone to help her see that the negative "self talk" is only reinforcing her negative perspective which is not based in reality. I do like Alva's suggestion of letting her know gently that it is distressing.

I agree that AlvaDeer nails it. As a former family caregiver, I offer my perspective. I cared for my Mom with LBD for the last 10 years of her life. When she died, it was easy to see that I had made choices throughout the process - especially at the very end. It was not so easy to let go of the idea/delusion that had I made different choices, the outcome would have been better. She lived exactly as long as she had intended to and was reasonably happy until the last 2 months when we used hospital and nursing home. “What if” became the destructive game. What if I hadn’t agreed to let the ambulance take her to the hospital? What if I had not approved/allowed the intense dosing of antibiotics, knowing she did not want to be kept alive, only to die in a hospital or nursing home setting? What if I had (or had not) … ? It was hard to transition into “good grief” and I had to have help to understand that my refusal to give myself a break was not something that honored her. Yes, I knew better — I’m trained in psychology and life coaching and even some PTSD treatments. No matter. My heart was broken and felt dead like a rock. I needed help and luckily it was available, though it was still hard for me to acknowledge my need and use the resources available to me. I think many of us as caregivers have a fierce streak of independence that sees us through the years of caregiving, but is not the ultimate answer in the aftermath.

Within a few months after Mom’s death, my sister and co-caregiver had gone into a deep depression which ended in her suicide. Again, I got mired in the “what if’s”, as she had depended on me for much more guidance and support than I was able to offer. Why? Because by that time, my husband had been diagnosed with MCD and I was again being a caregiver. Now I also have the daily “What if’s” of second-guessing myself in my care of him. These 3 tragedies in such close succession were a direct challenge to most of my beliefs about who I was and what was mine to do in life. I had always been successful at work; now I saw myself as a failure at home. SERIOUS need for recalibration with reality when it seemed the only reality was all the ways I had proved myself inadequate.

Feels like being robbed at a very deep and invasive level. Building a new identity, a new self-image, a new life … yes, all things she needs to do and is likely struggling with. For the people around her, it seems that insight should be followed quickly with change and resolution. For her, it probably feels like she is wading through muck up to her neck — forward progress of a half-inch feels like a major victory to her, but like slacking to others. So yes, try to just be with her and reflect back her feelings — someone has said that your advice is only good for one person — you. She doesn’t need advice as much as she needs your unconditional listening, love and support. It’s very tiring and frustrating and difficult to find and maintain the patience that takes. You are already well on your way. But if you can bring yourself to say more things like, “wow, that sounds like it would be very hard — is there more?” (period. full stop) and fewer things like, “here’s what you should do” or “why don’t you try”… Relieve yourself of the responsibility for solving her problems — that protects your energy as well as honoring her own way of coping. People sent me books - some of which I read parts of and found helpful, and some of which are still untapped. But they reminded me that they were thinking of me and loving me. Cards with affirmations of her worth and your love. Invitations to visit, or to dinner, or whatever - but INVITATIONS only, not EXPECTATIONS that lead her to add more guilt when she does not comply. Demonstrate your confidence that she will continue to be an important part of your universe, no matter how she copes. Acknowledgement helps more than advice. Acceptance helps more than “constructive criticism”.

She's been a widow for TWO months after being with someone for 35 years. Of course she's grieving, second-guessing herself, and going through an entire raft of emotions.

You know her better than anyone, so whether she's the type to bounce back from adversity or not is better for you to say than for us. You might consider giving her a book on grief such as Martha Hickman's "Healing After Loss," and she can start working through her emotions one short page at a time. If she doesn't seem to be getting her head above water after a while, you can suggest a grief counselor or group to help her.

It's important for her to understand that she didn't do anything wrong, and to stop blaming herself, but it will take time.

Can you invite her to visit you. Change of scenery may do her good. Talking face to face may be better.

Other than what was said previously, just love her and let her know she is important to you and you want to see her work through her grief to the other side to find joy again in her life. Keep suggesting that she need counseling - if nothing else grief counseling.

Apparently, what you're doing is not working, so how about changing the conversation? My go-to approach is to ask for advice, either about something relating to her experience or an old expertise, like preparing mashed potatoes? You'd then be able to give her a compliment (i.e. "your potatoes were always the best")

While you seem to mean well, please stop analyzing this lady. She is hurt, she is lonely, she doesn’t know who she is anymore. In her time, she will get better, not on some schedule you may believe is appropriate. Listen to her, do not judge her, you certainly haven’t walked in her shoes and have no idea about which you speak. If she doesn’t readily take you up on the suggestions of things she can do going forward, don’t be offended, hold those ideas until she is ready, you will know when that time comes because she will tell you.

Love on her, as is for now. Thanks.