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HEART Insight:
doi: 10.1097/01.HEARTI.0000390847.09194.17
Features: Heart-To-Heart

Caregiving Burden Increases Exponentially For Adult Kids Of Divorce

Papazian, Ruth

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When Mike Brady and Carol Martin wed to form The Brady Bunch, Mike was widowed and Carol … well, the producers never quite made it clear how she became a single mother. Anyway, the point is, there were no ex-spouses in the picture to complicate things.

In real life, instead of having to take care of one pair of parents in a single residence, caregivers whose parents divorced and married other spouses are faced with financially, emotionally or logistically helping family members scattered in different houses and cities - all with competing needs and expectations.

According to government statistics, the parents of over a million U.S. children divorce each year, creating a loose web of family members. Thirty percent of children in the U.S. have spent some time living with a stepparent, and 60 percent of adults will have lived in a stepfamily household during their lifetimes, either as an adult or a child.

Patrice Abrams, a Miami based speech pathologist, took care of her father, Jules Tucker, after an angioplasty and quadruple bypass, and as his health further declined after he developed vascular dementia. Naturally, she had less time to spend with her mother, Florrie Tucker, who had divorced Jules two decades earlier.

Clearly annoyed and resentful, her mother would ask, “When are you coming up here to be with me. You know, you still have a mother.” Meanwhile, an exhausted Abrams remembers thinking, “Why the hell is this my responsibility, instead of hers?”

Complicating matters, there was no indefatigable live-in housekeeper like Alice to help with the commuting, the cooking or the endless hours sitting in doctor's waiting rooms robbing her of time Abrams could be with her own family, including a daughter who had Childhood Nephritic Syndrome, a chronic kidney condition that occurred after she came down with a streptococcal infection at the age of seven.

An adult child of divorce, like Abrams, is often under more pressure because the other parent isn't helping care for the sick parent, points out Bonnie Eaker-Weil, M.D., co-author of “Make-Up, Don't Break-Up: Finding and Keeping Love for Singles and Couples” (Adams Media, 2010).

On the flip-side, Eaker-Weil notes that a whole new set of problems can arise when stepparents make caregiving and medical decisions for an adult child's biological parent that the child does not agree with. “If the parent is sick, you have to be careful how you negotiate with the stepparent so as not to upset the sick parent,” she says, adding that the parent should never feel torn between his or her spouse and you. To avoid this, Eaker-Weil suggests that the child enlists the help of the stepparent's adult children or communicate his or her concerns and opinions, or to use a doctor as a neutral party to discuss medical options.

Shortly after Abrams' father died in 2003, her mother needed an aortic valve replacement, which left her feeling as though she were living in an endless loop of a bad Hallmark Channel tearjerker. A few weeks before she died, Florrie told a frazzled Abrams, “You know, I'm not sorry I divorced your father.”

Abrams and others in her position “are less interested in the particulars of their parents' divorce than whether or not their parents care about how their lives were affected,” notes Joshua Coleman, Ph.D., author of “When Parents Hurt: Compassionate Strategies When You and Your Grown Child Don't Get Along” (Harper Paperbacks, 2008).

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Coleman adds that elderly parents sometimes feel entitled to care. When divorce has weakened family bonds, he urges ailing parents to “treat the love, care, or time [children or stepchildren] provide as precious gifts … and frequently voice appreciation for whatever they do for you and do not guilt-trip them for what they don't do.”

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Elizabeth Marquardt, author of “Between Two Worlds: The Inner Lives of Children of Divorce” (Three Rivers Press, 2006), is an expert on blended families - she had four stepparents growing up after her parents, who divorced when she was three-years old, each divorced and remarried again. Marquardt, who is vice president for Family Studies at the Institute for American Values, conducted a survey of kids whose parents had divorced and found only one-third of them went to their parents for comfort while growing, up as compared to two-thirds of kids who lived in intact families.

“There is a myth of the ‘good divorce,’ that after a few years of chaos, everyone bounces back,” says Marquardt. But her research suggests that the ramifications of divorce on children reverberate well into adulthood. For instance, if you didn't think your parents were there for you while they were going through their divorce, it's hard to swallow when your parents expect care when they are old or infirm.

“Those parents, unless they're saints - and few are when they are needy - are wanting more attention and it becomes crazy-making for the adult kid of divorce who wants to be good and do right by their parents and extended family,” says Mark Banschick, M.D., a child psychiatrist and the author of “The Intelligent Divorce” (Intelligent Book Press, 2010). He adds, “The irony is that this generation trained their kids by their example to value and pursue personal happiness over the commitment to the family.”

Lawrence Ganong, Ph.D., Professor and Co-Chair, Department of Human Development and Family Studies and Professor, Sinclair School of Nursing at the University of Missouri, who has studied stepfamily trends for three decades, finds that most grown children will get involved in elderly care on moral grounds, and that the quality of the relationship between a caregiver and the elder - not the bloodline - will determine how likely he or she is to help out.

In a survey Ganong did in 1998, 92 percent of respondents agreed that adult children should take in an elderly parent or step-parent who needs some help. The survey also found that people gave biological parents a slight edge if the adult child was struggling financially (83 percent said a biological parent should move in with the adult child, 73 percent said the same of a stepparent). Only when the stepparent had ample means did a majority of respondents (88 percent) disagree that he or she should move in with an adult child.

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In another of Ganong's studies of perceived obligations toward a widowed biological parent or stepparent who needs help with activities of daily living, 96 percent agreed biological mothers should be helped vs. 89 percent, stepmothers; 94 percent agreed biological fathers should be helped vs. 83 percent, stepfathers. When it came to more hands-on physical caregiving, 90 percent agreed biological mothers should be helped vs. 71 percent, stepmothers; 89 percent agreed biological fathers should be helped vs. 69 percent stepfathers.

Based on his findings and other research on blended families, Ganong concludes that “emotionally close relationships were not only more likely to be seen as familial, they also were more likely to be seen as ones in which help would be exchanged if necessary.”

And if the relationships are not ideal, Banschick advises that a caregiver “look for a sense of duty that emanates from inside of you.” He adds, “You are there for your Mom or Dad or an aging step-parent, because it just feels right to you. Without a sense of internal motivation, the pressures of being sandwiched can wipe you out.”

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What happens when a parent - or stepparent - becomes so debilitated that you have to be with him or her 24/7, despite a lifetime of simmering resentments that have been marinating for years?

That's the untenable situation Nancy Traynelis found herself in. Soon after her mother died when she was a child, Traynelis' father married a woman she detested. When she was in college, her father suddenly died of a massive heart attack and Traynelis and her step-mother became estranged until her stepmother began developing dementia four years ago. Traynelis left her two sons, two grandsons and a teaching career in CA and moved to Yonkers, NY, to care for the ailing elder.

“It's very tough,” Traynelis says, sighing deeply. “I work at a jewelry store for less money and come home and care for someone who is ungrateful and yelling at me to leave. I cook for her and have to clean her. I just don't know how much longer I can do this.”

She thought of going back home but if she does, her stepmother becomes a ward of the state and her father's home, which she co-owns, will be sold to pay for her care. Traynelis decided to stick it out because the family house is her children's inheritance.

To be sure, there are blended family success stories. Stephanie Coontz is one of them. Author of “Marriage, a History: How Love Conquered Marriage” (Penguin, 2006) and Director of Research and Public Education, Council on Contemporary Families, Coontz is devoted to her stepfather, Bill Waddington, who was married to her mother for 25 years. Although her mother died 10 years ago, she continues to spend time with him, along with his biological children. “I have him to dinner once or twice a week, and my sister goes to his place to cook dinner two to three times a week.”

Coontz says that she and her sister don't think of anything they do for Bill as an obligation or inconvenience, because they enjoy his company and appreciate the care and support he has always offered them.

After a series of transient ischemic attacks (TIA or “mini-strokes”), Bill had an ischemic stroke while he was in Hawaii with Coontz and her sister. The sisters had to make the decision to go ahead with clot-busting treatment, and made it a point to keep Bill's biological children in the loop.

“We make no distinctions between biological and step,” says Coontz. “We are as likely to help Bill out when he needs it as his biological children and can often be there more since we live very close by.”

With apologies to Shakespeare, when it comes to caregiving in blended families, the quality of mercy is not strained if relationships between biological parents, stepparents and adult children are genteel.

© 2010 American Heart Association, Inc.