Last week, a journalist (we'll call her Nancy) wanted to interview me about some caregiving issues. We chatted a bit about the article she was writing and she got some quotes. During the talk, we bonded.
As Nancy talked, she described the turmoil she is facing as her parents age. I was able to assure her that she is not alone in her feelings. She grew up with an abusive mother. The abuse was physical as well as emotional. Her father was gone much of the time, doing what most men of that generation did. He was making a living for his family and that was his role as he saw it. He wasn't around much and didn't "interfere" with the raising of the children.
Now her parents are getting frail. Nancy had been through a lot of therapy so she could learn to cope with her childhood issues. She's come to terms with the fact that her father did what he thought he was supposed to do. She rightly felt, as a child, that he should recognize and stop the abuse her mother was doling out. Through therapy, she has learned to forgive her father for his lack of involvement and the fact that he didn't stop the abuse.
She's learned that he likely didn't know about a lot of it. She's also learned that he probably was in denial about what he did suspect, because he really didn't know what to do. He was wrong, but she's managed to forgive him for what he didn't know, and for what he didn't do about what he did know. Part of this is that her father recognizes where he failed. As he ages – and he's the one who is showing the need for care at this point – she feels she is capable of caring for him, in some "hands-on" capacity.
Nancy's even formed a bond with him, and though a bit envious about the fact that he's become a terrific grandfather to her children (the dad she didn't have), she is also happy that the bond is there for all of their sakes.
The issue remains that her mother will not admit to having been abusive. Nancy is willing to work on the issue with her mother and a counselor, but her mother totally denies any abuse. Whether this denial is conscious or "selective memory" doesn't matter to Nancy. She was abused as a child and she wants her mother to admit it and work on it. She wants to see the cycle broken.
Breaking the cycle of abuse is what Nancy is doing on her own, as she is totally aware of her background and is determined not to make her children victims of such a childhood. So, that isn't the issue here. The issue is what does she do when her mother needs help? How does she care for a parent who didn't do the right thing for her? How does she "get over" her feelings, or around them or through them?
Counseling can only go so far and Nancy feels she's done as much as she can, unless her mother is willing to join in the process. But she is frightened about the future. She feels that she won't be able to give her mother hands-on care and she isn't even sure she wants to be involved with her mother's care at all. Nancy does have a sibling who, for whatever reason, wasn't abused, and therefore Nancy knows this sibling will handle some of what the aging mother will need.
As a columnist, I receive many letters from adults who were raised by abusive, addicted and/or neglectful parents. They are in a quandary, because they know society thinks they should care for their parents. Some of them have religious issues about "honoring their parents," no matter what. However, many feel that they just cannot give the emotional and physical care their aging parents need.
They want to know if they are terrible people. They want to know if there are options. Some, like Nancy, have had considerable counseling. Others haven't tried outside help.
It's especially hard for these people when they read stories of families gathering together to care for an elder. They imagine that these families have nothing but fond memories of their childhoods, and they see this perfect circle of care. This, of course, makes them feel left out, just like the abuse did when they were young. The perception that everyone else comes from an intact family is salt in the wound.
Of course, most families have never been totally "functional." Most families have had their share of "secrets" and bad behavior. But most families don't qualify for the pain these truly abusive environments like Nancy's left, either.
How to Arrange Elderly Care When You Don't Want To
I can't fix things for these people who ask. They know that. They just want to talk. But I do assure them that they aren't bad people for having these negative feelings. I do suggest they consider a few things:
- If they haven't tried it, get some counseling. Talking out your past with a trained counselor can be helpful. It can get some people over the hump of resentment, and they are more able to have some kind of active role in caring for their elders.
- I suggest Dr. Ira Byock's book "The Four Things That Matter Most: A Book About Living." Dr. Byock is a hospice physician. He has witnessed many deaths. And he has seen the healing that can happen when emotionally destroyed families find a way to forgive. I've reviewed the book on my blog at www.mindingoureldersblogs.com, for those interested in reading more about this book.
- I suggest that if they cannot give hands-on care, they may be able to find peace for themselves by hiring a geriatric care manager to handle the day-to-day needs of the elders. These people know how to get the elders' needs met. They know who to call. Geriatric care managers are expensive, but for some people (not only those who aren't close to their loved one) they can be very useful. Unfortunately, not every area of the country has geriatric care managers, and also they are not uniformly regulated. However, AgingCare's directory of Geriatric Care Managers is a good place to start. Please be careful with Geriatric Care Managers. I've noticed on-line "credentials" popping up – and I don't mean real on-line distance learning. I mean the kind you can buy for a few bucks. This is going to be an area open for abuse until there is some true oversight. That time will come, but it's not here yet. If you don't have someone in your area that can be recommended by a site or an agency you know, then I'd make sure the person you select is licensed as a social worker, nurse or some elder related credentials. Always ask for references.
- The other option for families where things are truly an emotional mess is to get a legal guardian appointed. Many areas have agencies that specialize in this. You should be able to find out where to look by calling your county adult services. If you find you need to hire an outsider to handle the nuts and bolts of caregiving, don't beat yourself up. You have done what needs to be done to make you feel like a decent human being. Life is not always neat. You know that already. So, do what you need to do and then let it go.
- There's some chance that, during the process of lining up help, you may find a way to heal enough to forgive your elders and be with them, at least to some degree. Try to be aware that your parents were raised by imperfect parents. They often did all they knew how to do. That doesn't make abuse right. It doesn't make any of it okay. But, understanding that they are human beings with flawed pasts – they were likely abused as children, themselves – may help you reach their bedside while you still have time to say goodbye.