We as a society tend to paint a Norman Rockwell image of caregiving: A loving spouse caring for an appreciative mate, or a doting daughter or son seeing to the needs of a grateful, obliging parent. But caregiving can be a challenge within the warmest of relationships. When you’re caring for an abusive person—someone who’s hostile, controlling, or emotionally manipulative, the situation can seem impossible. Nothing you do is quite good enough.
Sometimes, the constant complaining or bad behavior is a recent personality change that may be due to an underlying illness or medication. If you suspect that’s the case, consult the doctor to see if some medical relief or understanding is available.
Other times, however, your loved one (or your relationship) has always been difficult. In some of these cases, time heals many wounds. “The caregiving starts out of guilt and obligation, and over time, seeing a family member in a more vulnerable situation suddenly can reverse the roles,” says Judy Santamaria, a family caregiving expert. “In the end, you might get a better understanding of each other, when suddenly you see a person who was hurtful to you in the past now in a more vulnerable place, and that experience can be healing.”
More frequently than one might expect, things are more complicated, and some caregivers find themselves caring for someone with whom their relationship is strained at best or toxic and unhealthy at worst. If that is so, age and illness are unlikely to improve their family member’s behavior. “Becoming a caregiver doesn’t resolve a checkered history instantly,” says Santamaria. “You have to be realistic that caregiving will bring up past hurts, and may make them worse.” Caregivers in this situation need to find the right balance, she says. “Even people who are emotionally vested in caring for someone have burnout and health issues. Doing it out of a sense of responsibility and with resentment can make things worse for you and bring serious risks to your health.”
Here are some strategies for coping:
Even if you’ve never gotten along, a direct approach is worth a shot. An honest, calm conversation could give the two of you a new start. Using “I statements” (“I feel as if…”), rather than accusations (“You always…”) can help keep the tone civil.
Boundaries are important for any caregiver, but they’re crucial in tough relationships. Setting strict limits and sticking to them will make you less susceptible to guilt trips or manipulation. If you’re caring for someone who is an expert at pushing your emotional buttons—know your “hot spots,” ignore the jabs, and calmly change the subject. Emotional abuse is not okay.
Consider spending your time together in different ways. If, for instance, visiting leads to arguments or complaints, try something that limits opportunity for conversation, such as watching a movie, or that lets you interact with the focus on something else, such as making a meal together. There’s much less chance of someone’s perceived failures coming up (again) if you’re engrossed in a favorite TV show.
Santamaria encourages caregivers in stressful relationships to reach out and talk to someone: A third-party professional, such as a geriatric care manager, doctor, or clergyperson, can be invaluable at running interference and offering practical advice. “Sometimes just a couple of conversations with an outside person can make a difference,” so don’t hesitate to seek help.
You don’t have the power to make another person happy. Period. Instead, focus on the tasks at hand and on doing the right thing. If you feel obligated to be involved, work behind the scenes rather than attend to day-to-day needs. Perhaps you can assist with the finances or organize other family members and friends. Otherwise, enlisting a geriatric care manager, or hiring a home health aide to provide home care may be a wiser solution. To avoid feelings of guilt, Santamaria says it’s key to remember that you are doing the right thing for your family member by not being a constant presence if the relationship is so toxic. “It’s not healthy for you, and it’s not healthy for them either.”
Finally, be realistic about what you can do. If the relationship is particularly troubled, Santamaria says it is important to know that not every person needs to feel obligated to take on the role of caregiver. “It’s a big job and a hard job, and it can go on for a long time,” she says. “There may be a point at which you protect yourself and realize this is a toxic relationship, and it can’t work.” If the difficult senior is your parent, you do have an ethical obligation to make your best effort to be sure he or she receives needed care. You do not, however, have a duty to provide that care yourself.