When Elder Care Hurts: Caring for Elders who have been Abusive or Neglectful

I was working as a consultant and referral resource for family caregivers when I received one of my most memorable calls.  On the other end of the line was a mid-level manager for a large corporation, and I could hear panic in his voice as he rushed to tell me his dilemma.

“I got a call from a hospital in Atlanta,” he said.  “They’re telling me my father is there with a broken hip, and they told me to come and get him.”

He paused and took a deep breath.

“That man was an abusive drunk,” he continued.  “He abandoned me and my whole family when I was only fourteen.”

His voice cracked and trembled as he struggled to keep his composure.


“Sad” by Jako Jellema

“I went to college, got a good job, and I’ve raised a nice family.  I was determined to do everything that he didn’t do, and I’ve been successful.  Now I feel like I’m fourteen again!”

He wept openly on the phone, gripped by all of his childhood feelings of hurt, loss, and shame.

My heart broke for the boy who had worked so hard to become a man, for the man who was desperately trying to reconcile the demands of the moment and the terror that had seized him from the past.

We talked for a bit, and I realized that he needed permission to say “no” to the hospital’s discharge plan.  He needed reassurance that there were services available to care for his father, and that it was OK for him to set this boundary.  He needed support to deal with the difficult choice he was making.

The hospital didn’t know the situation, and the default discharge plan was to send their patient to his only son, even though they were separated by decades and distance, and by hurtful deeds that had been plastered over with diplomas and certificates and mortgages, but never really healed.

That day, I learned in a visceral way that many people provide care to older relatives, not because they want to or because they can, but because they feel they have to, no matter what.

  • Some children of abusive or neglectful parents simply opt out of providing care when the time comes, and while no one came blame them, they are often criticized by other family members for “not helping.”
  • Others engage in caregiving in a last-ditch attempt to gain approval and gratitude from a parent who has never been able to give it.
  • Still others provide care because it fits with their personal values and sense of morality.  They may say, “I would never treat another human being the way my Mother treated me.”

We know the stresses of caring for an older loved one can negatively affect one’s physical and emotional health.  Now we’re seeing research on how caring for a family member who has been abusive or neglectful can add even more risk for family care partners.

If an adult survivor of childhood abuse chooses to engage with a parent who has been (and still may be) abusive, they are likely to confront the ways that their family of origin has affected them.

Recent brain science shows us that children who are abused or neglected are changed by the experience and may be predisposed to chronic illness, obesity, anxiety, depression, and addiction.  There are social consequences to early deprivation, too, including lower academic achievement and socio-economic status.

The good news is that some relatively simple approaches can reverse those damaging effects and improve quality of life, and help survivors cope with caregiving if that is what they want to do.

It’s critical for these caregivers to connect with emotional support for themselves, and to obtain adequate help with caregiving.

With proper support and the development of a care partner team, there are possibilities for family and individual healing that can cascade through generations previously wounded by abuse and neglect.

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Do you know of situations where someone provides care for an Elder who has been abusive or neglectful?  Please share your ideas about what helps them cope in the comments section below.

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Lisa Kendall is a clinical social worker and gerontologist with a private practice in Ithaca, NY.  She has a passion for supporting Elders and their care partners, and offers trauma-informed treatment to adult survivors of childhood abuse and neglect.

8 Responses to “When Elder Care Hurts: Caring for Elders who have been Abusive or Neglectful”

  • Linda Mack:

    Lisa, Years ago I saw a woman who had severe depression, and a background of an abusive home situation as a child. As her parents aged,none of her siblings would or could be helpful, all turning to her because she was a nurse. Her struggle to care for them, with memories of emotional and physical abuse, and almost physical revulsion upon touching them, was so painful. As a lapsed Catholic (lapsed because she thought herself not worthy to appear before God, given her anger at her parents), she suffered all the more. I actually set up a meeting with the priest at the Catholic church for her, which I attended with her. He was fantastic. He instantly grasped the situation and blessed here for her efforts while forgiving her for her feelings. Quite a meeting!

    • Lisa Kendall:

      Thank you for sharing the story, Linda. Not everyone has the psychological or spiritual support you and the priest were able to give!! A wonderful blessing.

  • Lisa, I took care of my mother in law for my wife. She moved in with us after she retired. She had lived with us before without any problems. She was divorced from my wife’s father who was abusive. The next boyfriend claimed to be abused by mil but I did not pay any attention to that at the time because he was not always a nice person to be around. Next lived with us and no major problems. We moved and a few years later she moved in with us. She started verbally abusing me during 2004 and from there it never ended. She has diagnosed with alzheimer’s in 2009. When I lost my job, my wife and I talked about me taking care of her as the disease progressed which I thought I would not be effected by her abuse. I cannot describe how wrong that turned out to be. She continued her verbal abuse until she finally kicked the bucket last June. I have been going to counseling since January because of the anger I feel towards her and her actions. I understand now that I should have set boundries and consequences to prevent the abuse which would have ended in her not living with us. With the money she got from retirement, she may have had enough money for cat food for her to live on. In my opinion, anyone abused by an elder person shouldwalk out and not return or if they are in their own home, throw them out. You do not have to put up with anybody abusing you no matter who they are.

    • Lisa Kendall:

      I’m sorry for the pain you endured, and am glad you’re getting support. Your story will help others; thank you for sharing it.

  • Cat:

    I’ve cared for both a step-parent who was previously quite abusive (I still have psych issues resulting from her abuse,) and a foster parent who had become abusive since she fostered me. It can be…very difficult and somewhat traumatic at times. One of the things which helped is realizing that people change, and that the people I was caring for now, weren’t the people I knew back then. (The step-parent was no longer abusive, and the foster parent having become abusive due to medication and her own traumas did not negate or somehow taint the wonderful, caring person she had been during my childhood.) I did not find the notion of rehashing the past to be helpful. We all, basically, started anew, as adults. In the case of the newly abusive foster parent, knowing that my time there, caring for her, was finite helped immeasurably, as did trying to find remnants and glimpses of the person she’d once been. Having supportive friends helped, as did occasionally getting out of the environment (both at the step-parent and foster-parent’s homes.) In the end, I had to see each of them, and deal with them, as they are now, rather than as the people they used to be. That can be intensely difficult, at times, both with someone that one expects to be abusive and cruel without warning or apparent reason, as well as someone who one expects to be kind and caring, and no longer demonstrates much of anything but anger, rage and cruelty.

    Life is. The wheel turns. People change. We move forward. That isn’t to say that we leave the past entirely behind, nor should we. Else, we’re unprepared for the future. But the future isn’t the past, and none of us are the people we once were: Kind parents, abusive parents, or helpless children. And it’s now, not then, which is the most important time in and of life.

  • Jane Hawkins:

    As she once was, I couldn’t have cared for my mother and maintained sanity. As she is now, she really isn’t the same person. Dementia tears down the human mind in sad and terrible ways, but one of her losses seems to be the paranoia that drove most of her cruelty. What’s left of her is a pleasant old lady who barely even reminds me of my mother. Very odd. But fortunate for both of us.

    • Lisa Kendall:

      Thank you, Jane, for sharing your story. I’ve seen this happen, where it seems the dementia has worn through a layer of the mind where an Elder’s response to their own wounded-ness lived. It can be a peaceful time for both the Elder and her care partner!

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