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It is also dragging me back into a toxic and abusive family dynamic.

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Back out, get your life together, start building for your future. Helping is one thing, becoming a prisoner with invisible bars is another, you hold the key to your future, use it.
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Your grandmother is in assisted living. What sort of support are you giving her, and who is it bringing you into contact/conflict with, and what care is your grandmother not currently getting that you feel you need to supplement?

I assume you don't make the decisions about your grandmother's care and welfare - who does?
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Would you care to give us more details? Those will get you better answers.

How did it come to be that you are your grandmother's caregiver? Did you agree to this? Are you being paid for your time and caregiving?

When you attempt to change the situation, what is the response by family? Who has Power of Attorney for your grandmother?
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Caregiving can destroy the best of us in so many ways. I feel your pain. Run as fast as you can! If you feel like you want to help them, find a plan for others to do the heavy lifting. It’s too much for one person.

Money goes fast! Save for your own future needs. To help someone temporarily over a hump is one thing, to drain all of your resources is quite different.

I am not a ‘know it all.” I made my own mistakes. Please do better than I did. Take the opportunity to prevent any future damage now.

Best wishes to you. Hugs!
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I don’t know the specifics of your situation but I sense a lot of similarities to my own experience. To be honest, I don’t think this is something one can “navigate.” You can’t navigate your personal destruction or maneuver your physical, mental and financial demise. You put an end to the process. Destroying yourself to help an unappreciative family is not okay. You will be in a much better place to deal with it from a position of physical health and emotional well being. It’s not selfish, it’s survival.

When you return to health and stability you can choose to assist but do it with rock-solid boundaries. YOU set up the framework for what you can and cannot do, not your family. They’ll keep trying to pull you back into their toxic tornado so be prepared to keep your emotional distance and don’t engage in their bs. A support system is huge so keep reaching out on this site. There’s a lot of wisdom and heart here.

Wishing you strength, peace and better days.
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Don't give your family anymore money. If they are old enough to pay their bills, they use their money to pay those bills, don't bail them out. Cut your family out of your life, the bank of you is closed.
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You need to take care of your mental well being and financial stability. The therapist is correct in the suggestion of going low contact with the family. Let them find someone else to abuse. I wish you well.
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