When we use the phrase “loved ones” in reference to caregiving, it always seems to imply a positive and rosy relationship, when in fact, research has found 96% of all American families to be dysfunctional to some degree.

That is to say, the way a family interacts is distorted by the addictions and compulsions of one or more members, thereby ignoring the needs of each individual. Ironically (or what may be called a cruel twist of fate), some of us find ourselves in the position of having to tend to the needs of those who ignored ours—or were downright abusive. It’s easy to see how such circumstances can lead to a conflicted relationship that does not serve either party well—creating a negative emotional state that will spill over into all areas of your life.

If you are financially unable to hire outside help, this is a battle that can be only won by mindset—something you may have to refresh on a daily basis. 

What is love?

Let’s start by defining what “love” means. Nearly all of us tend to confuse it with meeting certain conditions in an ongoing positive or pleasant fashion. That only works with dogs, as long as they don’t pee on the carpet or chew on our favorite shoes (oh, so it doesn’t always work). The secret is that due to their innocent nature, we are able to forgive dogs much more quickly. Loving people is far more complicated and forgiving them can be elusive. According to the ancient Greek philosophers, love is broken into as many as eight categories, but for our purposes, only two are appropriate: 

Different Types of Love: Philia and Storge

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The first is “philia,” a concept developed by Aristotle, which is a dispassionate virtuous love expressed as loyalty to friends, family, and community. The second is “storge” (storgē), which means love and affection between parents and children. However, more appropriate to this conversation, storge is also known to express mere acceptance, or putting up with a situation. In the scenario we’re discussing, the dispassion of philia combined with the acceptance or “putting up with” (as in “loving” a tyrant) of storge are the relevant definitions. These concepts can help sustain a caregiver through a difficult or tumultuous relationship. Put simply, the key to surviving an emotionally charged caregiver relationship with your sanity intact is the dispassionate loyalty and acceptance of philia and storge—otherwise known in the healthcare industry as professional detachment. 

Do the Right Thing and the Rest Won’t Matter

Giving care under acrimonious conditions certainly puts your ethical and moral strength to the test. Perhaps the most difficult ethical position to take is doing the right thing without hope of reward or recognition. However, it’s also the only truly ethical stance to take. Having expectations of reward changes the dynamic from one of inner nobility to blackmail, or at very least, negative bookkeeping, which promises to keep your ledger in the red.

It’s okay to admit to yourself that the relationship was not a good one, thereby removing guilt or personal recriminations at the outset. Ultimately, giving care under such conditions is made easier if you take a moral stance, such as, “this is what a good son or daughter should do,” or “I believe in helping those who are in need.” Some may also find strength in following the religious teachings of helping others. 

The best revenge is to be unlike him, who performed the injury.

Taking the moral high ground can help keep you motivated to give care in the face of personal resentment or outright abuse from the receiver of your care. At the end of the day, how you carry yourself in this situation is not about who the other person is and what they were/are to you. It’s about who you are to yourself and what you choose to be in order to live your life according to your standards. 

It’s silly to try to escape other people’s faults. They are inescapable. Just try to escape your own.

Modern pop psychology has proposed that in order to be truly able to have a good relationship with our significant others, we must “resolve” our relationship with our parents. For example, you may find yourself repeatedly attracted to the same type of person who turns out to be just like one of your parents. Such parings lead to bickering when old feelings are triggered. Resolving a negative relationship is supposed to free us from self-inflicted wounds brought about by perceived actions that we attribute to our spouse in error. However, according to classic Freudian psychology, you have subconsciously chosen a version of your parents and therefore your perceptions are correct. (Years of expensive therapy ensues.)


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Refrain from imposing your feelings on reality.

The question is, how do we resolve a relationship? According to Freudian psychology, the process can take years, which you may not have. And what if the parent you need to “resolve” with is no longer living? The more important question is whether the person you are attracted to or with actually does reflect your parent’s behavior, or are you seeing them through the filter of your emotional history. That is to say, are they really your mother (despite coming from a different gene pool and demographic), or are you interpreting their actions as something your mother or father did that you hated. The answer is this: Resolution is an illusion. Nature does not solve equations. In human relationships, resolution comes in the form of acceptance.

Reject your sense of injury and the injury itself will disappear.

Despite years of experience to the contrary, most of us hold out hope that we can achieve some form of reconciliation or vindication with parents who have wronged us. Unfortunately, in the case of a parent with dementia, that vindication will never come. Even if it does, you’ll find it a hollow victory, since there will be no positive change in behavior that’s forthcoming, and the past cannot be rewritten. In fact, you may find in a rare moment of lucidity, that the person you’re caring for was cognizant of their bad behavior by wondering aloud why you’re being so good to them.

While initially gratifying, it will bring on an entirely new level of frustration, since they knew what they were doing but didn’t do anything about it back when it mattered—and can’t do anything about it now—frustration further compounded by the fact that it falls to you to take care of them when they failed to take care of you. 

This begs the question, “How do you provide family care in complicated relationships without experiencing more pain?” 

If I do not view the thing as an evil, I take no hurt.

The first step is disabuse yourself of the notion that caregiving can be used for vindication or as a vehicle for healing a bad relationship. When we discussed resolution, we touched on the concept of whether or not we are seeing people for who they truly are, or whether we’re judging their behavior based on our past experiences. If your relationship was an abusive one, it would be easy to misinterpret the behavior of a parent or spouse you’re giving care to as simply more of the same.

However, in the case of those afflicted with some form of dementia, they may not see you at all. Their agitated behavior may stem from their own frustrations and anger based on mental and physical limitations imposed by their malady. If you simply write off any vile outbursts as disease-related symptoms, which they often are, it can reduce the sting of such outbursts. In this case, not taking anything personally can be the highest form of consideration. 

Change your perception of the situation.

One mental exercise you can try is to look at the person as you would a baby. We take care of babies, which involves some pretty unpleasant chores, but don’t judge them or expect gratitude (okay, maybe later in life we do). Granted this is much more difficult with someone you have a history with, and the innocence of babies covers a multitude of sins. However, when you think about it, dementia strips an adult of their personal history, rendering them more like a baby—a big old wrinkly baby—but a baby nonetheless.  


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You have power over your mind, not outside events. Realize this, and you will find strength.

Despite the fact that doctors have chosen a profession of tending to the illnesses and needs of others, they are often seen as cold and uncompassionate. This is because in medical school they are taught to view the human body as a machine that is breaking down, which can either be repaired or not—and that some things are still beyond the control of medical science. This is known as professional detachment.

Today I escaped anxiety. Or no, I discarded it, because it was within me, in my own perceptions—not outside.

It’s a state of mind that does not come easily, especially to someone who has dedicated themselves to helping others. It must be practiced. A physician’s detachment enables them to function more effectively and also serve as a pillar of strength for those in the throes of emotion. Do you really want your doctor to break down and cry with you, or be able to clearly focus on proper diagnosis and treatment?  

The Act of Balancing Caring with the Art of Remaining Neutral

Health care and social service professionals must balance caring with the ability to remain neutral, particularly in the face of being verbally assaulted by those who are either under their care, or the patient’s loved ones who vent out of feeling helpless. This level of professional detachment is much easier when you’re not living with the person you’re administering care to. However, if you can bring yourself to emulate professional detachment, it can help you cope with difficult circumstances. Think of each day as an opportunity to practice detachment. 

To sum it up, you have to find a way not to care that you care. To elaborate, if you have to care for someone you’re not fond of, don’t punish yourself with “who did what to who,” or feeling like life has dealt you a cruel blow and you’re being put upon. Caring for someone, regardless of your personal history with them, does not diminish you in any way. 

“Once you have done a man a service, what more would you have? Is it not enough to have obeyed the laws of your own nature, without expecting to be paid for it? That is like the eye demanding a reward for seeing, or the feet for walking. It is for that very purpose that they exist; and they have their due in doing what they were created to do. Similarly; man is born for deeds of kindness; and when he has done a kindly action, or otherwise served the common welfare, he has done what he was made for, and has received his quittance.”

– Marcus Aurelius

Editor’s note: The quotes are from Meditations by Marcus Aurelius (121AD—180AD), who was not only an emperor of Rome, but a philosopher as well. Aurelius was the last of the five good emperors and his writings remain relevant to this day.