Yuen: Caregiving can be complex, especially if it’s for a parent who has harmed you

A Minnesota woman — let’s call her Sara — recently was in knots about a decision. Her elderly father became ill and suddenly needed help with his care. Could she be his caregiver in his older age, even though their relationship was strained?

Sara reached out to me after reading my column last month about Lt. Gov. Peggy Flanagan’s childhood history with domestic abuse. (I’m not using Sara’s real name because her father is still alive, and she worries about jeopardizing relationships on that side of her family.) “It was helpful to see Peggy’s story,” she said.

Sara, too, identifies herself as a survivor and child witness of domestic violence. Her dad emotionally and sometimes physically abused her mom. Sara’s parents eventually divorced, and she had limited contact with her father until he needed her help.

But as Sara began to step into caregiving duties, old memories came pulsing back. She was reminded of being a little girl, uncertain of what would next send her dad into an outburst of anger.

“I was struggling with insomnia. It was impacting my health,” she said. “Then there was also complaining [by my father] regarding how I was handling things. I just thought to myself, ‘Why am I doing this?’”

About 37 million people, or roughly 14% of the population, are providing unpaid elder care in the United States. The majority are women, and about 4 million are part of the sandwich generation, caring not only for aging parents but also kids under 18, according to the U.S. Bureau of Labor Statistics. The number of family caregivers in this country is expected to swell as baby boomers, now ages 60 to 78, begin to turn 80 and need stronger day-to-day supports.

Societal pressure for people to care for their parents, even if those parents failed to care for their own children, is enormous. That’s according to Laura S. Brown of Seattle, a semiretired psychologist and author of the book “Your Turn for Care: Surviving the Aging and Death of the Adults Who Harmed you.” She saw the phenomenon regularly in her practice among boomers caring for their parents, and now hears from Gen X friends who are in the thick of it.

“The myth that families are good places is a persistent one,” Brown told me in an email. “In the utter absence of social safety net support for elder care in the U.S., the pressures, particularly on people born female and female-identified, are tremendous. If there are siblings who have already been played against one another by an abusive parent (not an unusual scenario), then this creates yet another such opportunity.”

Brown said it’s important to remember that the parent, not the adult child, broke the “contract for care,” the duty of care that adults owe to the children they raise.

Here’s what else experts say about this sort of caregiving conundrum:

It’s normal for childhood survivors to feel guilt, shame and retraumatization when their abusive or neglectful parent ages and needs support. “Do you be a ‘decent’ person and care for someone who hurt you, showing that you can rise above, and defer paying the emotional price until later?” Brown said. “Do you step aside and be perceived as heartless and uncaring?”

Jennifer LaCroix, a St. Paul-based licensed marriage and family therapist, has also worked with clients who’ve agonized over this decision. Someone who has already started the work of processing their childhood trauma might be in a better position to cope with this transition, she said.

You know what’s coming down the pike, so start therapy now if you haven’t already, Brown advises.

“Don’t wait until your abuser gets old or is terminally ill,” she said. “Develop self-love and self-compassion, and clear boundaries. Know what your values are, so that you can live congruent with them as you deal with this last chapter of the saga.”

Examine the pros and cons from your specific situation and needs. LaCroix says she would urge the adult child to consider what they hope to achieve with a difficult conversation. “If what you’re hoping for is some relief or acknowledgment from the parents, I would say in my experience, usually that doesn’t happen,” she said.

She said parents may respond defensively and reject their children’s truth. “It can be very difficult to see we’ve hurt someone we’ve cared about.”

Explore the source of your guilt, which implies that you are behaving badly.

“Is having a boundary that is there to protect yourself, or the life you have created in the wake of the abuse done by the elder, doing something wrong?” Brown said. “Often a survivor was given the implicit message that their existence was for the use of the parent, period. That they existed simply to fulfill a parent’s needs, be they sexual, emotional, you name it. When we stand back from that, it’s clear how wrong that message is.”

Remember that whatever you decide, it’s your choice to make. And you have the right to change your mind. Recognize the agency you have.

“You maybe didn’t get to choose as a child. You weren’t taken care of, you weren’t safe,” LaCroix said. “But now you are, and you have the power to make those decisions. Knowing that can be healing.”

As for Sara, the woman with the ailing father, she decided to step away after realizing how much her increased contact with him was affecting her health. Does she feel a sense of guilt? Sometimes, she said, but mostly it’s a vast sense of relief.

One emotion she experienced came to Sara as a surprise: her sense of empathy toward the parent who hurt her.

“He’s getting frail, and he has a complicated health issue. I could have compassion for him in that moment,” she said. “That was a healing part of this whole experience.”