Years ago, a journalist (we’ll call her Nancy) requested an interview with me to discuss common caregiving issues for an article she was writing. We bonded during our chat, and Nancy shared some of her own experiences of trying to cope with her aging parents’ needs. In addition to notoriously difficult care decisions, like determining whether Dad should stop driving or if Mom needs more help at home, Nancy was also struggling with years and years of toxic family history.

Initially, she felt that her experience was unusual. After all, we mostly hear about family caregivers who are forced to choose between their careers and quality time with their spouses, children and friends when parents’ needs begin increasing. What Nancy didn’t know—and many caregivers don’t—is that countless adult children grapple with the impossible decision of whether to care for parents who were unsupportive, neglectful and/or downright abusive.

A Daughter’s Attempt to Reconcile a History of Abuse

As we talked, Nancy described the inner turmoil she was facing as her parents got older. She grew up with a physically and emotionally abusive mother, and her father had been gone much of the time, doing what most men of that generation did: working to support his family. Therefore, he wasn’t around to “interfere” with the raising of the children.

Nancy had spent years in therapy learning to cope with her childhood issues. Through hard work, she learned to forgive her father for his lack of involvement and the fact that he didn’t put a stop to the abuse her mother doled out. She’d learned that he likely didn’t know about a lot of what went on in his absence and that he was probably in denial about what he did suspect, because he really didn’t know what to do about it.

Although he failed to protect her, Nancy extended forgiveness, primarily because her father acknowledged where he fell short. They formed a bond and he became a terrific grandfather to her children. As he aged and showed signs of needing more care, Nancy felt she was capable of caring for him in some “hands-on” capacity.

Deep issues remained between Nancy and her mother, however. Most notably, her mom would not admit to having been abusive. Nancy was willing to work toward healing together in family counseling, but her mother vehemently denied any wrongdoing. Whether this denial was conscious or due to “selective memory” didn’t matter to Nancy. She wanted to see the cycle of abuse broken and move forward.

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Caring for Elderly Parents Who Were Abusive

Nancy came to accept her past and was determined to avoid repeating any of her parents’ poor behaviors and choices with her own family. But that was not the issue at hand. The question was, what should she do when her mother inevitably began needing help, too? How was she supposed to care for a parent who didn’t do right by her? Was it possible for Nancy to “get over” her feelings of hurt and resentment? If so, how?

Understandably, the future frightened her. At that time, she felt that she wouldn’t be able to give her mother hands-on care, and she wasn’t even sure she wanted to be involved with her care at all. Nancy did have a sibling who, for whatever reason, wasn’t abused. She was confident this sibling could handle some of what their aging mother would need, but she still agonized over the decision that awaited her.

As a columnist and caregiving veteran, I receive many letters from adults who were raised by abusive, addicted, neglectful and/or narcissistic parents. These sons and daughters find themselves in a quandary, because they know that society expects them to care for Mom and Dad by default. Some of them have strong religious beliefs about “honoring their parents,” no matter what kind of childhood they endured. However, many feel that they just cannot provide the emotional and physical care their aging parents need without incurring additional trauma.

These adult children want to know if they are terrible people for struggling so much with this decision. They want to know what their options are. They want to know why they carry guilt for not wanting to care for someone who was such a destructive force in their lives. Some, like Nancy, have gone through considerable counseling, while others haven’t sought professional help sorting through these feelings.

It’s especially difficult for these people when they read inspiring stories of family members coming together to care for an elder. They imagine that these families have nothing but deep love, devotion and fond memories motivating them to create this perfect circle of support. Of course, this popular narrative makes them feel left out, just as the abuse did when they were young. The perception (regardless of how accurate it is) that everyone else comes from an intact family is merely salt in the wound.

It’s important to remember that most families have never been totally “functional.” Each one has had its share of secrets, disagreements, struggles and bad behavior. Regardless, abusive environments like Nancy’s should never be considered normal or irrelevant to caregiving decisions.

Options for Handling a Toxic Elderly Parent's Care

If you find yourself struggling with caregiving decisions for a family member with whom you have a complicated relationship, let me assure you that you’re not alone. You’re not a bad child or an uncaring person for vacillating on this issue. Over the years, I’ve received a lot of questions from people with difficult parents and pasts. These are the suggestions I often give to those who seek advice on caring for a dysfunctional family member:

  1. Begin going to therapy.

    Discussing your past and working through your feelings with a trained counselor can be a helpful exercise. It can get some people over the hump of resentment, enabling them to take on a more active role in caregiving. Or conversely, reflecting on past experiences, the present situation and hopes for the future may help some individuals put their priorities into perspective and validate their decision to limit involvement in their parents’ care.
  2. Read The Four Things That Matter Most: A Book About Living.

    In this book, palliative care physician Dr. Ira Byock illustrates the power of four simple phrases to acknowledge the past, promote emotional well-being and handle interpersonal difficulties with dignity and grace.
  3. Hire help.

    Some people are not able to find peace by stepping up to provide care or by stepping back to allow a parent to handle things on their own. This is a tough position to be in, but outsourcing care decisions is a possibility. Hiring a geriatric care manager (also known as Aging Life Care Professionals) is an excellent option for ensuring a parent gets the care they require. These professionals are experts on aging who know how to assess an elder’s needs and ensure they’re met. Their services are expensive, but they can be an asset for both seniors and their not-so-hands-on caregivers. They can act as a middleman, creating a buffer between you and your parent while spearheading their care. Visit the Aging Life Care Association website to find a professional near you.
  4. Consider guardianship.

    The other option for adult children who want to ensure a parent’s well-being but take an entirely hands-off approach is to get a legal guardian appointed for them. However, this will only work if your parent can be legally proven incompetent and therefore requires someone else to overlook their health care, living situation and finances. Your local health and human services (HHS) department or adult protective services (APS) agency should be able to help you initiate these proceedings. Once guardianship proceedings are over, you can rest easy knowing that a state-appointed individual is tasked with managing their care. If you must find someone else to handle the nuts and bolts of caregiving, don’t beat yourself up. You have gone out of your way to ensure your parent is looked after, which is commendable. Life is not always neat. So, do what you need to do to rid yourself of destructive feelings like guilt and then let it go.
  5. Accept their flaws.

    Try to be aware that your parents were raised by imperfect people as well. They often did all they knew how to do. That doesn’t make abuse right. But, understanding that they are human beings with flawed pasts of their own may help you make progress in your healing and gain a deeper understanding of your parents as people. This may amount to nothing more than acceptance, or this realization could encourage you to be a stronger presence in their lives.

Do I Have to Take Care of My Parents?

Every person has the right to set their own boundaries. This may mean there is a limit to your involvement in their care, or it could mean that you go no contact with elderly parents. The choice is yours to make, and it’s important to understand that you always have options. They may not be easy to accept, reasonably priced, or simple to execute, but they’re out there. Furthermore, if you make a decision and something just isn’t right, you can always change your mind.

Your parents are human and have likely incurred some trauma of their own, but you must remember that you alone are not responsible for their happiness. They have made countless decisions throughout their lives that have influenced their health, finances and relationships. Offering assistance is a truly kind gesture, but it is not compulsory. At the very least, there are ways to ensure their well-being from afar, without being personally accountable.

Prioritize your own mental and physical health, ditch the guilt, ignore society’s judgements and expectations, and do some soul searching to find the answer that is right for you.