Caregiving for a parent who hit you

There is a quiet population of adults in their fifties who are now the primary caregivers for a parent who used to terrify them. The research literature calls this ambivalent attachment in late life. It is genuinely understudied, partly because the children do not self-identify. They tell their friends 'oh, Mom is just declining' and they don't say 'and she used to lock me in the basement.' Mary Ainsworth's original attachment classification — secure, anxious-ambivalent, avoidant — was meant to describe infants in a strange-situation lab. It generalizes badly into late life, but it generalizes. The adult child of a hitter, taking the parent to a neurology appointment, is re-experiencing a version of the original scan: is this person safe today, or not safe today. The scan does not turn off because the parent is now in a wheelchair. What helps, practically: a clean and inflexible list of what you will and will not do. 'I will pay the bills, I will manage the doctors, I will visit on Sundays. I will not be alone with her in the house, I will not do bathing, I will not handle disclosures of regret she wants to give me.' The list is not cruel. The list is what makes the caregiving sustainable for the years it will take. Hire the bathing. Hire the night shift. If you cannot afford to hire it, ask a sibling, ask a niece, ask the county. You are allowed to be the daughter of a hitter and still show up for the dying. You are not required to be the daughter who pretends she wasn't hit. Those are different jobs. The literature on caregivers of abusive parents has grown in the last decade, mostly through the work of Karl Pillemer and others on intergenerational care patterns. The consistent finding is that caregivers in this situation experience higher rates of depression, anxiety, and physiological stress markers than caregivers in non-abusive situations. The difference is not subtle. The caregivers who have histories of being abused by the person they are now caring for show measurable elevations in cortisol, in inflammatory markers, in sleep disturbance, that persist across the years of caregiving and often into the bereavement period afterward. The elevation is not a personal weakness. The elevation is the physiological consequence of performing intimate care for a person who, for the duration of the caregiver's developmental years, was the source of physical or psychological threat. The body registers the proximity. The body's threat-detection systems engage. The systems do not differentiate between the past version of the parent and the current version. The body is performing the same scan it performed at age seven, on the same person, who is now smaller and weaker but who is still recognizably the figure who produced the original threat. What this means, operationally, for the caregiver. The first is that the caregiver needs to acknowledge, privately, that the caregiving is harder than it would be if the parent had not been abusive. The acknowledgment is not a complaint. The acknowledgment is the factual recognition that the labor of caregiving is doubled when the labor includes the ongoing management of the body's threat-detection systems during every encounter with the parent. The acknowledgment is important because it allows the caregiver to budget their resources realistically. The caregiver who tries to do this kind of caregiving at the same rate as a caregiver in a non-abusive situation will burn out faster, harder, and with fewer resources left for their own life. The differential burn-out is not a moral failure. The differential burn-out is the predictable consequence of an unrecognized differential load. The second is the construction of the inflexible list. The list is not a list of grievances. The list is a list of boundaries between what the caregiver can sustainably do and what the caregiver cannot sustainably do. The list is operational. The list is for the caregiver's own use, not for the parent's information. The list specifies the specific tasks that are manageable and the specific tasks that are not. Most caregivers of abusive parents discover, in constructing the list, that some tasks are categorically off the table. Physical intimate care — bathing, dressing the body, intimate hygiene — is, for many caregivers in this situation, structurally impossible. The body cannot do it. The body registers the intimate physical contact with the abuser as a threat in a way that the conscious mind cannot override. The impossibility is not a failure. The impossibility is information. The information says that the intimate care has to be performed by someone else. Hiring intimate care, for caregivers who can afford it, is the most common solution. The hired professional has no history with the parent. The hired professional can perform the intimate tasks without the threat-detection system engaging. The transaction works in a way that the family performance of the same task does not. For caregivers who cannot afford to hire, the options are narrower but exist. Adult Protective Services in many U.S. counties has resources for low-income caregivers, including subsidized respite care and in-home support. Religious organizations, in many communities, have volunteer programs that pair the elderly with non-family helpers. Other family members, even estranged ones, can sometimes be approached for specific tasks without requiring the full restoration of the family relationship. The third is the explicit refusal to engage with the parent's deathbed disclosures. Many abusive parents, in late life, experience a psychological need to produce some version of apology or reflection. The need is real for the parent. The fulfillment of the need, however, frequently requires the adult child to be the audience for the parent's self-examination. The role is asking a lot. The role asks the adult child to absorb, in late life, the parent's belated processing of harm that the adult child has had to process alone for decades. The role is optional. The role is not a duty. The adult child can decline. 'I am not the right audience for this. You might want to speak with a chaplain or a counselor.' The sentence is allowed. The sentence does not foreclose caregiving. The sentence preserves the caregiver's capacity to perform the parts of caregiving they have decided to perform. Some parents, denied the deathbed audience with the adult child, find other audiences. This is fine. The parent's psychological need can be met by other people. The adult child does not have to be the only available audience. The fourth, and perhaps the hardest, is the long acceptance that the caregiving will not, in most cases, transform the relationship. The parent will not, in most cases, have the deathbed epiphany that the popular imagination describes. The parent will, more often, die as they lived: with the same personality structure, the same defenses, the same limitations. The caregiving was not, despite the cultural narrative, going to produce the reconciliation. The caregiving was going to produce the caregiving, which is its own work, which has its own meaning, which is not primarily about the relationship. Doing this kind of caregiving well is possible. It is not, however, the same job as caregiving for a parent who was kind. It is a more demanding job, performed under more difficult conditions, with fewer internal resources available. The double load deserves recognition. The recognition, in most cases, the caregiver has to give themselves, because the social world around them is uncomfortable with the complexity and would rather the caregiver perform a simpler version of the story. Refuse the simpler version. Give yourself the honest one. Do the caregiving that is possible. Decline the caregiving that is not. Both are allowed.