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Taking Care of Elderly Parents

Feeling guilty and forgiving yourself.

Huy Phan/Upsplash
Source: Huy Phan/Upsplash

As caregivers, we often feel guilty for not rescuing our parents from the pain and discomfort of old age. But we cannot rescue them; we can only offer our love and support and hope they accept it. Yet, many of us do offer that to our elderly parents and still feel guilty. What is this guilt about?

In my experience and in my discussions with other caregivers I have found a variety of complex experiences that we refer to as “guilt.” Some forms of guilt have to do with not meeting other people’s expectations, while other forms have to do with not meeting our own.

There is the guilt we feel when we don’t do things that we think we “should.” These “shoulds” are injunctions that we have not completely internalized as our own. When you say “I should visit my mother every day,” it really means you imagine someone else thinks you “should.” Perhaps you imagine your relatives think you should visit your mother every day. When you think: “I should make dinner for my family instead of visiting my mother after work,” you are not saying you think that’s right or that’s what you wish to do. Rather, you are expressing the feeling that other people, perhaps your husband, thinks that it is the right thing to do. Conflicting “shoulds” can be quite anxiety-provoking, making you feel torn in many directions.

Then there is separation guilt—the guilt that communicates: “I am a separate person, I have different values or different needs than you do. We are not one.” Separation guilt may emerge as a result of physically separating from your parent—moving to a different city. But separation can be symbolic as well as physical. Making different choices about how to live your life can give rise to separation guilt as well. Each move toward self-development can feel like a betrayal of your mother because you are living your own separate life.

And there is guilt as a result of having an envious mother. One of my patients, Patricia, feels guilty for having anything more than her mother. Her mother did not enjoy her daughter’s achievements; she was contemptuous of them because she was envious. Having sensed her mother’s envy beneath the contempt, Patricia feels guilty for going to graduate school when her mother left school after high school to care for her sick father. Patricia admitted she even felt guilty for not having arthritis and cancer as her mother did.

On the other hand, there is moral guilt—a response to a violation of our own moral code. If you’ve spent your life believing elderly people should be kept in the community and decide to put your father in a nursing home, the guilt you experience is “moral guilt.” Moral guilt is painful because it shakes your sense of self and involves a reconsideration of beliefs you took for granted.

There is also the guilt that one experiences as a result of ambivalent feelings toward your parent. If you are angry toward your mother when you have to decide whether to put her in a nursing home, there is always the question of whether you are doing what your mother needs or you are trying to hurt her.

And then there is the guilt of feeling you are the special one who can offer comfort and solace, but other exigencies of your life (like living far away) make you unavailable to do so. Sometimes it is true that you are the only one who can offer comfort and solace — you may be an only child and your parent is widowed. That is a painful conflict when you have other obligations that are even more compelling—young children or a sick husband.

However, in some cases feeling that you are the only one who can offer comfort is a wish to be special rather than reality. In that case, as painful as the guilt is, it is the price for feeling special. Feeling less guilty involves the realization that you are not the only person who can provide some comfort for your mother, allowing you to mobilize other people to do so.

My friend Susan suffers from “shoulds” and from separation guilt. Susan’s mother was born in Italy and feels that daughters are obligated to have their parents live with them when they get old. She feels angry that Susan will not let her live with her and Susan feels guilty. Susan feels she “should” invite her mother, and if she were a good daughter, she would.

But Susan was not born in Italy. She is an American-born writer with a Ph.D., and she does not believe that daughters are obligated to have their parents live with them; she just feels like she “should.” In addition, Susan suffers from separation guilt. When she says “no you can’t live with me” to her mother she is also saying: “I am a separate person Mom, I have different values than you do. I don’t want to live my life the way you did.”

What might help Susan allay her guilt and forgive herself? She has to think about whether she agrees with those “shoulds.” Who is it that thinks she “should” do this or that? What does she believe is right? If what she believes is right does not coincide with the “shoulds,” then she has to decide if she wants to mold her life around what those people think she “should” do.

Susan knows that if her mother moves into her house she will feel perpetually angry toward her because her mother will not be satisfied with the level of Susan’s attentiveness to her. Susan will also feel bad about herself for feeling angry toward her mother for intruding in her life and violating her privacy. Her mother wants something that Susan does not want to give. Susan has set a limit.

If Susan cannot give her mother all that she wants, what can she do for her? She can fulfill her own moral standard by finding a warm, safe environment for her mother where she will have social contacts and be taken care of. She can talk to her mother’s doctor about prescribing anti-depressants. But she cannot rescue her mother. However, she may drown trying.

This is an excerpt from my book: Doing the Right Thing: Taking Care of Your Elderly Parents Even if They Didn't Take Care of You, pgs. 84-88.

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