By Connie Taylor, LCSW

An article recently published in The New York Times blog, “A Risk in Caring for Abusive Parents,” describes the correlation between depression and providing care for an aging abusive parent. Adult children who choose to provide care for abusive or once-abusive parents are at higher risk than other caregivers of experiencing depression or other negative effects on their health. This article sparked a lot of conversation in the elder law and elder care communities about how adult children respond when their abusive parents require assistance as they age.

Adult children who are faced with care decisions for abusive parents react in many different ways, ranging from withdrawing completely and refusing to have any contact to working even harder than most to provide care in the hope of finally getting their parent’s approval. A lot of the time I work with adult children who have reached a point of general ambivalence: they don’t actively wish their parent to come to harm, but they can’t stand to be the one providing care for their abuser. In some instances, when their roles are reversed and the adult child is in the position of making decisions on behalf of an abusive parent, the pattern of abuse is also reversed, and the embittered child becomes the abuser.

As an elder care coordinator, I often find myself in the middle. In cases where the elder is a former or current abuser, I do my best to provide support for the abused child or children while still ensuring that the elder receives the care he or she needs. I may be the one to attend care planning meetings or serve as an advocate for the elder so the child doesn’t have to; I serve as a nonjudgmental sounding board when the child is conflicted about care issues; and I always provide an objective voice throughout the problem-solving process. I also do my best to link the adult child with the supports he or she needs to handle the abusive parent’s aging process in whatever way he or she chooses: I can recommend hired caregivers, assist with placement in a care facility, help to enroll in caregiver courses, and help to find caregiver support groups. My presence in the middle can ensure that everyone gains access to the support systems they need while minimizing the emotional impact on the family of the abuser. It allows the adult child to remain as distant as he or she wishes while still knowing that his or her relative is getting the care they need.

Outsiders are often judgmental when faced with an adult child who does not immediately run to the aid of his or her aging parent. Although children are not obligated to take care of their parents in their old age, many people (elders and caregiving professionals in particular) more or less expect it. Experience has taught me that when a child does not run to the rescue of a parent in need, there is usually a good reason for it. Professionals in elder care, elder law, and other fields related to aging adults should do their best not to judge and should keep an eye open for signs of abuse or other underlying causes. In cases where abuse, either past or present, is suspected, it may be wise to engage a social worker, licensed counselor, or other qualified professional to help the child and the rest of the family cope with the situation at hand. It is not the time to try to repair a broken relationship, but it is important to ensure that everyone involved gets the care and support they need.