I truly miss my mother, who died 18 months ago, at age 90. She was the quintessential Jewish mother and an expert at guilt. When I phoned her in South Africa, I didn’t just say hello; I also said I’m sorry. I had almost always done something wrong. Perhaps I did not call my sister on her birthday or failed to keep a promise. She often said, “Thank God your father isn’t alive to see this” or “with a son like you, no wonder my blood pressure is so high!” Fortunately, my mother’s guilt trips were never demeaning but always related to making sure family came first. She never failed to tell me how proud she was of me and my siblings. 

While my mother’s ability to induce guilt still makes me smile, many children of my patients complain bitterly about their relationship with their parent, particularly when the tables are turned. Memory loss or physical disabilities lead to dependency that suddenly makes them their parent’s parent. This is a particular problem for baby boomers, who have grown up as free spirits, experimenting, rebellious and independent. Many have had tense relationships with their parents. Conflicts with a dependent parent can lead to lifelong guilt about what could have and should have been. 

A good friend was reduced to tears when she told me how difficult it was for her to meet the needs of her 85-year-old mother. Throughout their lives, they had constantly “butted heads.” Now her mother is essentially home bound and relies on her daughter for everything. Nothing is ever good enough; she blames the daughter for everything, is constantly insulting and refuses to listen to reason. She resists being parented by her child, refuses to take advice and makes her daughter feel helpless. Her mother insists on driving the car despite being a menace on the road, forgets to, or alternatively, takes too many medications, often at the wrong time and refuses help around the house. Most painful is the praise her mother showers on her two sons, who never show up or offer to help. The daughter is particularly guilty that arguments are becoming louder and more rancorous. Conflicts with her mother are affecting her marriage and family life. Her mother feels that her daughter is “too bossy”, overbearing and interfering. She vents anger at her daughter and wishes she would mother her less. 

Clearly this is a dysfunctional relationship. Unfortunately, there are no easy solutions, but there is help out there. Persuading your parent to be seen by a geriatric team can be most helpful. Access to highly qualified social workers and therapists can help both parent and daughter, as can health care providers who are experts in managing older persons and in the dynamics of caregiving. Many caregivers need intensive therapy to overcome resentment and guilt caused by feelings of inadequacy, helplessness and being unable to do enough. A therapist can provide insight into the problem and make you realize that you are not to blame for the situation.

Caregivers must understand that they cannot be responsible for every aspect of their parents’ lives. Try to involve other family members if possible. Force your siblings to do something, and encourage grandchildren, nieces and nephews to help. Respite is absolutely critical. Get away for vacations on the weekends, and spend time exclusively with your own family. Ask a therapist or social worker to help identify services in the community that can assist with home care, shopping, cleaning, bathing and dressing. Seek support from your church or synagogue and ask parishioners to make home visits. If your parent is homebound, visits by health care professionals may be possible. They will monitor the medical condition, assist with medications and provide nursing needs. Your parent may also be eligible for meal deliveries at home and physical and occupational therapy that may make them less dependent.

For some, being a parent’s parent can be an overwhelming burden. But with the appropriate help, support, understanding and, most importantly, forgiveness, caring for a dependent parent can be spiritually uplifting and become some of the best of times.

Dr. David Lipschitz is the director of the Dr. David Health and Wellness Center in Little Rock. To find out more about Dr. David Lipschitz, visit www.drdavidhealth.com