Prosperity,
I know what you mean. My friend will go dancing in the middle of a flare up because he has to have some sort of normalcy in his life. He refuses to give up until or unless the pain just gets to be too much to bear.
We never really know about anyone do we? We all look in from the outside and have no real idea of what is really happening behind the mask. Most people would never know how much pain my friend was in or even that he had RA. He works very hard at not overwhelming people with his problem and doing for himself as much as possible but I can see where it could be very easy to let other people do things for you that you are able to do yourself when you've got problems.
This person is after all only human and probably got sucked into her own game without ever realizing what was happening. By now it has become a part of her and the behavior is unconscious. (at least one hopes that she isn't doing it purposefully)
About the guilt. Stop It! :-) Do what you can or what you are comfortable with and don't worry about more or feel badly that you aren't doing more. Be mindful of your own needs and energy first.
Walk in beauty,
Rebecca