Why do caregivers allow abuse?

You and your deacon said it well. People do not have to put up with abuse. The problem is that guilt enters in. People wonder if it's their fault the elder is acting up (it can be, but generally isn't). They know the elder is sick so they try to be patient. And the biggest reason of all - they are still (unsuccessfully) trying to "earn" their parent's love.
While it's good to be introspective and see if our responses are making our elders' issues worse, when there is actual abuse, or when there is a situation like the deacon's, the appropriate thing is generally to take steps to get into separate living arrangements, and to set boundaries. Many people could use counseling by someone like your deacon who can help them through these tough decisions.
Take care,
Carol

I really like Carol's response, because it does not place blame or guilt...it is just the way things are, very often.

I do not think it is "natural" to combine any two adult households - whether that be bringing an elder family member home or having adult children move (and sometimes their children) back to your home. There is just too much need for both independence and privacy...you lose both when you move into another's home...it is unavoidable. Then resentment sets in...elders feel that they are imposing, caregivers feel trapped.

It takes so many things falling into place for this arrangement to work. I think some caregivers are reluctant to find an alternative placement because they are driven by guilt or misplaced obligation.

What we "owe" are parents are the same things they gave us: a safe, comfortable home, good meals and nutrition, and medical care.

Accepting physical or mental abuse from anyone is unacceptable.

We do have to respect and protect our own lives and relationships while assurin our parents (or loved ones) are safe and well cared forl

Great guidance here. I think emotional abuse is another point for discussion. I had a professional try to lay a guilt trip on me last night (at 10:20 pm but it was no emergency). Her intent was to guilt me into moving Mom in with my husband and I. Fortunately, I didn't take the guilt trip and was able to end the conversation without loosing my temper.

My husband asked "what was that all about" when I finally got to bed. In the kindest voice he has he said, "Well, if you need to live with your mother, please go to her house. I'll be here for you, But we can't let her come here to destroy our lives."

I treasure his honesty and I'm not broken by his words. He spoke the truth with love. We'll figure this out somehow.

My mother's refusal to take medication for bipolar disorder for more than 35 years added to my challenges in her care. The Excelon patch was wonderful once she was bedridden. She never knew it was being applied during her morning care. Those five months were such a blessing.

With my Dad, his occasional "attitude" can be hurtful and he'll try to justify as "his opinion". When I ask if he would find our opinions voiced in a snide or ridiculing manner appropriate he starts to see my point.

If you're fortunate to have open communications, please do.

My challenge is primarily with two much younger siblings who think ridicule, back talk, and screaming - often with lies - are appropriate for them to get their way. I question whether at least one is bipolar, but I can only work with what I have.

Setting boundaries where siblings are abusive is a different kind of challenge.

How about just plain old duty and responsability?

If the abuse is too hot, get out of the kitchen ! (situation) No-one should have to put up with verbal abuse every day your caring for a parent. Sick or not, no parent unless they have alheimerzers should treat their sibling bad if they are helping them survive. Parents need to realize, a Nursing home would gladly take them in. A grown child takes care of them because they care enough to try and keep them in their enviroment. If they don't show respect to their grown children when they are being helped let them see how Nursing facilities do it and maybe they'll show a little compassion for their children. Don't let a parent ruin your life just because you came from their loins. No obligation for cruelty.Parent or not !!!!!

Guilt should not enter into the equation. That being said, providing for a parent's needs doesn't mean we must do it ourself. Some of us can find the patience and love to overlook the abuse and work around it, some can not and should not have to be forced into doing it through guilt. At the same time we can not ignore or neglect our moral obligation to honor our mothers and fathers. So we place them where their physical and medical needs can be met and then we try to meet emotional needs by loving them and not abandoning them. We become the parents of the parent and hopefully treat them with the love and respect they deserve, even if that is a one-way street. Especially if that parent is a vunerable, frail person with Alzheimers.

I think that Carol and the deacon have exactly the right idea.

I also agree that DT's answer often applies.

I suggest, though, that mental illness changes the picture -- especially illness that has its onset in old age, such as dementia. (The relationship between caregiver and people who have been narcisstic or bi-polar for decades has been developing for a long time.)

I'm not putting this forth as advice or what "should" be, but simply in answer to the question -- why do caregivers put up with abuse? Physical abuse is especially dangerous in combination with dementia. The demented person may not know his own strength and may have lost impulse control. Most caregiver learn they can't simply wince and take it, or are convinced of that by others who love both parties. But a sad fact is that many facilities are unable to deal with violent residents. What is the poor caregiver to do? Trying to get the violent behavior controlled for either continued at-home care or for placement may involve the use of drugs, including anti-psychotics that are normally not adviced for the elderly or those with dementia. I think the use of these kinds of drugs is a little more understandable in the context of violent behavior..

As for non-physical abuse, many dementia caregivers put up with it out of love and compassion, knowing that it is not the loved one who is acting this way -- it is the disease causing this. We put up with it in the belief that if the situation were reversed our loved one would do his best to care for us in spite of what the disease is doing. We do it hoping that our presence and patience eases the terrible burden of the disease in some small or large measures. We do it knowing that our loved one can't learn new behaviors and can't help the present lack of impulse control. And we do it as a way of exploring the outer limits of love, which are remarkable indeed.

I don't mean to be suggesting this as "right" -- just explaining what may seem masochistic or psychotic from the outside. Caregivers of dementia patients may be approaching this whole topic from a somewhat different perspective.

Agree jeanniegibbs - I have often said that I was a lot more fortunate in my situation than many of you (it took this site to reveal this to me) in that at least my mom did not have dimentia - there was one incident that was only just rage at aging and becoming helpless. The capacity of some people to deal with dimentia and true mental health issues does vary, some are willing to put up with a lot of other bad behavior that others - I am not sure how I would have handled it at all! I know I would not have given up too soon in favor of some sort of managed care facility unless it was the very last straw, that is the way I am. I would not want to see others give up too soon either.

DT - there is NEVER any duty or responsibility to be abused, nor any "right" to abuse another person. Too often people are guilted into thinking there is. Compassion should extend to the caregiver too!!

I agree with rovana. There is never any duty or responsibility to be abused or right to do the abusing. My mother thinks because she is the elder and lived through the second world war that she has that right. My duty is to myself and to stay healthy to take care of these people. My duty is not to be run over and have tire tracks on me. I will be there for her but not to be abused. Fortunately she does not live with me. My house is very small and we just don't have the room among other reasons.

That is neither what I said or meant - I said I did not have dimentia or real abuse to put up with, of course you do not have to put up with that if it is how you are being treated. All I said that I felt it my duty to care for her and try everything one can first and not just stick her in a home because it was inconvenient, and I feel it is duty and responsability to do as much as one can under the circumstances, that's all. Abuse is something nobody should have to suffer. I am sorry you are suffering it.

Lilliput, I agree with you all the way to your last sentence. To say, "Accepting physical or mental abuse from anyone is unacceptable." probably sounds more judgemental than you meant it to be. If a caregiver elects to "accept" mental "abuse" from a mentally ill loved one, knowing all the circumstances surrounding it, I don't think it is up to outsiders to declare that "unacceptable." We can have opinions that it isn't the wisest choice, or that it isn't what we'd do, or that it requires a lot of support and ego strength. But to declare what is and isn't acceptable in a relationship with a demented loved one is, in my opinion, going too far. It is just too broad a generalization, and it criticizes instead of encourages.

I think many caregivers put up with physical and or emotional abuse as adults because that is what they experienced as a child.

I agree with the story above that the man's mother needed to go to an ASL for treating her DIL with disrespect was driving a wedge in that marriage. Who knows getting rid of his wife might have been what his mother wanted?

Physical abuse does not have to be tolerated. While we can understand why a mentaly ill person, particularly one not taking their meds or someone with a personality disorder is verbally and emotionally abuse, we do not have to absorb their chaos or become enslaved by their emotional blackmail. Anyhow, a person who verbally abuses someone is trying to wear them down and often will eventually physically abuse them. Putting up with abuse from an adult parent or relative that most people would not put up with in a marriage or want a child to experience is way outside of the box for my boundaries.

ROVANA:

I can't speak for anyone else's parents, but I do know what it's like to be tormented by them.

In Latino/Hispanic society, mothers are goddesses to be worshiped no matter what. As a little boy growing up in the 60s, child abuse as we know it today was called discipline.The method didn't matter as long as you learned your lesson: a hot iron to the arm, kneeling naked on raw rice strewn on a concrete floor for something you supposedly did. Add to that lashes with an extension cord and, at the age of 5, having your face rubbed on your own feces; then sit on a big rock facing the street where everybody could see the sacrifices your beloved mother had to go through to teach you that crapping on the bed because you couldn't find the mosquito and roach-infested latrine in the darkness is something you just don't do.

Everyone, especially older people, told me I must have done something to deserve it and that it probably hurt her more than me. Others would say someday I'd have children of my own and understand why she did what she did.

So I took the abuse in silence, and conditioned myself to believe she did the best she could with what she had. That if children came with instructions at birth everybody would be a perfect parent. ... Bull. Her idea of good parenting was terrorizing children to ensure their subservience well into adulthood. An investment for her twilight years. ... To this day, we're expected to pay tribute to a woman who brought us into a life of poverty and then charges us for it.

To her I'm an ingrate. The child whose birth, she said, was a regrettable accident. I saw her a couple of months ago at my older sister's apartment. She bragged that if it hadn't been for her brand of "discipline" I'd never be the successful man I am today. I called her aside and, with a goodbye hug and a kiss, told her "If every time I see you all you're going to do is use me, hurt me, humiliate me, and abuse me some more ... then there's no place for you in my life."

My motto? ... Respect yourself.

Accepting physical or mental abuse is NOT OKAY under any circumstances. In fact, I can't imagine a time where a licensed therapist or counselor would recommend that anyone put up with it. Would we say it is alright for a man to strike his wife or verbally belittle her just because he has a mental illness and she has "chosen" to put up with it? No, we would say she is a "victim" of abuse.

I think you are mistaking "accepting abuse" for understanding the source of these actions or feeling empathy for someone who has a mental illness...this is not the same thing. It our obligation to find help for our loved ones who suffer from mentally debilitating illnesses - it is not okay for them to use abusive language or physically injure someone...period. If a loved one suffers from Dementia, and therein, does not understand his or her actions, caregivers still have a right to protect themselves and their families from injury to body, mind, and soul. (please read cmagnum's and Eddie's responses.)

Jeanne: it isn't your place to "critique" the responses or experieinces of others in this forum, which you seem to have taken on as your personal responsibility. Interesting that you chose the word "judgmental."

Really....in the future, please address your comments to the original question. It is inappropriate to turn every post into a debate. And btw, I couldn't care less if you agree with me or not.

Dementia, Alcoholism, un-medicated Bi-polar stuff.

Many mental health issues are progressive. We sign up when the person is still kinda well and then one day we realize they really are nutz. Then we must re-negotiate all the social contracts we made to get into this situation in order to leave in a "good way".

For example. My marriage dissolved. My mom's house is near a great high school, I am out of work.... Seemed great for the kids and I to move in and care for her. But I have to be forever vigilent for the time when it is beyond me and I need much more help. At that point all kinds of things will have to change. The toughest one will be selling the house to pay for her care and moving the kids to a different school. Because of my obligation to my kids I will probably tolerate more crazy than I would if I was kid-less.

So it is not just that we are door mats. It is that the situation is fluid. They are changing. We are changing. And our siblings are changing. Our employment changes. We just keep trying to stay in that sweet spot of balance.

Lilliput, you and I agree on more than we disagree about. I suspect the disagreement might boil down to semantics. Is "tolerate" the same as "accept"? But we don't have to agree on everything to respect each other's views. I am sorry that I came across as less than respectful. And you are right to point out the irony of me fretting about judgmental language.

I think my basic sticking point, and it comes up often here, is that dementia is fundamentally different than many other conditions that put people in need of care. We are a community of caregivers in very diverse situations. One size sometimes almost fits all, but almost never does 100%. I think how one deals with a narcisstic person or a person who has been abusive all her life is different than how one deals with a dementia victim. That's my opinion, in any case. I think it is an important message and I share it often. I should have been more direct about it in this case. I apologize.

Rovana ~ I agree with you that no one should be putting up with abuse. And I think It would be helpful if we stated in our post as to whether the person we are referring to has a mental illness, because in the cases of Alz and dimentia the whole scenerio changes.

DT~ I like the way you think!.
JeanneGibbs ~ Great post…I agree with you. My mother had Alz. and I could not even get her into a day care facility so that I could grocery shop in peace. It was very difficult.

I like to look at things in a positive light but at the same time there is the reality~ Which is--- there are many circumstances where a person might subject themselves to the abuse (with hopes of change) simply because they are taking care of a loved one and want to honor them in this way. People with mental illness are not responsible for their actions. And I say this with kindness.~ In these cases if the caregiver cannot cope they should not be a caregiver. Because here is where you might end up with the most abuse coming from the caregiver rather than the patient. In my philanthropic work I have visited seniors where it was very clear that they were not comfortable with their caregiver...(many times a family member) who appeared to shut them out and talk over them, doing things for them in a perfunctory manner as though the patient wasn’t even there etc. What kind of life is that? I suspect that these were cases of caregiver burn-out! I feel certain that these people (patients)can still pick up on our emotions (as caregivers) whether they be of love or frustration, etc. and they will often react in a very telling way. Very sad!

Physical, mental and emotional abuse can undermine our health and self-esteem. This has been known and documented in health journals, etc. for many years.
NO One… should have to be abused ever! Even by a contankerous elder who is hating life and taking it out on you. In these cases once it is clear that they are not being abused and there are no medical reasons for their behavior, and if nothing can be worked out, they might be better served by being placed in an assisted living or other facility for the elderly…especially if they cannot take care of themselves. Some people even prefer this but the family wont hear of it…I think it is best to allow our elders to keep their dignity and to make decisions about their lives for as long as possible. It makes for a more peaceful environment all around.

Thank you Rovana and all …I have enjoyed reading all your comments and wish you the best. I always learn a little something new ~ Bobbi Henderson

Linda GS ~ You said it! Things do change and we start out with one set of responsibilities and end up with something that oftens does not look much like our original agreement. You sound pretty cool headed to me... but My heart goes out to you because I understand the challenges that you are faced with. . You take care! Blessings~ Bobbi Henderson

SISTERS:

The words we use in this forum are powerful. Trust me, I've said a few things without checking with my brain first and caught some flak. Jeanne corrected me once; so did a couple other people. Caregivers roll with the punches, mutate adapt, relocate. And we certainly can't afford to alienate anyone in this Family. Just take what you want from what's said and move on. Please Family! ... Please.

Eddie, I'm laughing. I've thought of myself as adapting, but mutating? Yeah, probably. Thanks for the laugh.

I've always thought of myself as a mutant........

Family:

Rovana's question helped me realize that resentment towards one's parents, left unchecked, can fester to the point we seek some form of support or start lashing out at the world just to feel better.

Of course there are caregivers whose love and unwavering commitment for their parents helps them transcend the limits of their own humanity and keep on fighting; even when there's no hope. Some come across as martyrs in need of recognition; others are in search of talk therapy. Some build community and strive to develop a support network; others relish spotting the smallest weakness in someone else's arsenal, whether real or imaginary, and try to dismantle the individual.

It's not surprising, then, that conflicts of personality eventually arise. What still amazes me is how people living in a mental glass house can throw a little stone powerful enough to trigger verbal warfare.

This isn't about whose side we're on; who's right and who's wrong; who's found the magic bullet to the trials and tribulations of caregiving and who isn't quite there yet. It's about loving one another and stopping all this nonsense.

Asking intelligent Family members to think rationally isn't too much to ask, is it?

What has been hard for me-- in this line of talking and thinking-- is I see my relationship with my parent in much the same way I saw my marriage. It is a personal and intimate relationship. How much sharing about "us" do I believe in sharing outside of my house?

So when I hear too much kvetching, I often think it is like a marriage that is about to SINK--- and it is already too late for those of us on the outside to help them heal. And just like that marriage, I will get my hand slapped if I tell my friend the obvious.

You are right. Good relationships-- started from a young age -- are the most peaceful and beneficial to a relationship of care-taking in old age.

That said, it also is very complicated because this time around it involves siblings and money--- more than it did growing up. So, we may have created our own good relationship, but there still can be a lot of buffeting from the "peanut" gallery we were raised with.

My sadness and empathy comes when there are no good solutions. Money is tight, support is limited-- within the family and outside the family -- and the caring takes on a life of it's own, because it goes on for way too many years. People are tired and can lose perspective.

My mom did great with my dad until hospice told him his death was soon and he could no longer swallow; then a caregiver started feeding him emfamil with an eyedropper and kept him alive 3 more AGONIZING months. We kids could do nothing right. We were supposed to stay out of the decisions, show up all the time to hold everyone's hands, and then it went on too long for us to remain civil.

We easily could have reduced ourselves to barbaric acts-- especially if we had no help or counsel and had jobs that were considering termination or nutty kids at home.

We do not know the shoes others walk in.

On a lighter note, I once read that we SHOULD walk a mile in someone else's shoes. Either you'll be far enough away that you won't hear them complain when they realize you took their shoes. Or you will have felt their burden enough to be compassionate with them and willing to have an open mind and heart.

We all have our own "shoes" to wear and they don't always fit perfectly.

No caregiver should have to put up w/an aggressive elder's abuse. In our family, we just recently buried mom's sister. They lived together in mom's home, and when they were no longer capable of living alone, my sister (the designated one) moved in w/two grown daughters. My sister did a wonderful job hiring caregivers, always doing some task or another for them. Mom's sister had congestive heart failure, and was a narcissistic type. She made the most unreasonable demands of everyone. Boy if she didn't get her way, she'd go out of her way to lie, defame, you name it. Total abuse. She created an on-going environment of negativity in that household until her death a week ago. My mom has Alzheimer's, but as my sister says, "she's the easy one." She's not demanding. My aunt even abused my mom.
Now, because there was this long history about the relationship between mom and auntie, they were too close. No boundaries, which was why the rest of us inherited this history. This lady had no children of her own, so we, nieces & nephews had to do the do. Throughout a 3 year period that my sister has been living w/them, it' became very volatile over there. I do understand in part, when my sister would say, "we can't separate these two for fear what it could do to my mom." But at the end of my aunt's life, she'd sabotaged the caregiving my sister had worked hard to find and who were/and still doing more than a great job w/them. One of them one weekend, notified my sister she could no longer put up w/aunt's abuse, (she threatened to call the police on this one). This lady was constantly trying to make a case that she was one being abused. She did it to the point, that on one occassion, she did call the attention of this to a social worker.
So now on top of everything else, my poor sister and me had to worry basically because our aunt had created a big lie about one of the caregivers. Finally when this occurred, I had to get kind of tough w/my sister and tell her she needed to have that talk w/my aunt about going into a nursing home. I mean that any family member, friend etc., would offer themselves up to do this work is one thing. But I strongly feel that caregivers have to really use some good old common sense, and know when possibly they too are offering themselves up for this, by going along w/other family members who many times haven't been at the other end of offending party's behavior. This is wrong, and duty and responsibility, well o.k.,
but this doesn't mean, getting yelled at, causing possibly people to lose their jobs, nor being reported because an abusive elder is lying in the worst way possible.

Margaux, I really appreciate your response. Especially about a worker getting wrongly accused - it could ruin an innocent person! It has sometimes appeared to me that appeasing an abusive elder because "they are old, they will die soon, etc." is a bad idea - it can be made to seem that anyone who does not go along with this is a bad person who is guilty of being unreasonable, not loving, etc. It is as if the evil an abuser is doing is somehow discounted simply because they are old.

Emotional abuse is sometimes hard to recognize when you have a patient who has some dementia issues but also is manipulative. It has often been subtle and calculated in my experience.

Caregivers usually do not allow abuse but it is common that they are being abused. They have to deal with it if they are getting paid. If they are being cared for by a relative it is usually out of guilt or an obligation because that person raised them so they are returning the favor.