Self-neglect: a practitioner's view

Aging, Spring, 1996 by Wendy Lustbader

This pattern may worsen as the years pass, with the older parents feeling ever more fatigued and alarmed. Savings they had intended for their own security may have vanished. As the end of their lives approaches, they may worry how this son or daughter will manage after they are gone. Hoping their protective role will be taken over by one of their other children, they may encounter hostility rather than sympathy.

Siblings in these situations usually resent the brother or sister they view as exploitative. Over the years, their resentment may have deepened each time this person caused their parents distress. Their fruitless attempts to convince their parents to stop wasting money on this sibling may have embittered them toward their parents. Claiming they have been cheated of their future inheritance, they may be angry about what they see as "special treatment," which drained resources that should have been shared equally.

Grasping the magnitude of this accumulated bitterness may come as a blow to older parents. The realization may be especially distressing if it occurs just as they are facing care needs of their own. Their other children may make their assistance conditional: "Mom, we won't take care of you unless you take Billy off your bank account. We're sick of him living off you." The siblings may feel that it is no use helping a parent who will only go on neglecting herself under the guise of being loving and protective.

When older parents allow an addicted son or daughter to move in with them, their Social Security income often ends up paying for the addiction. Lacking funds by the middle of the month, they may omit necessary prescriptions or fail to follow their dietary restrictions. Tensions often mount as bills go unpaid. With inhibitions blurred by drugs or alcohol, the adult child may abuse the parents verbally and physically. Too ashamed to seek help, the parents may then put off their regular visits to the doctor to avoid revealing their bruises. Gradually, the medical problems they have ignored may render them dependent for help on the very person who has been harming them.

Such profoundly entwined situations are difficult to unravel. The parents may feel as afraid as ever to say "no" to their troubled son or daughter when their help is requested. They may insist that they are only being protective, rejecting family members or professionals who try to get them to see the situation another way. Justifying their son or daughter's conduct by blaming others is another common defense used by these weary parents. As they drain funds that would be better spent on their own care, they may insist that no one else understands their loved one as well as they do: "Things just haven't gone well for Billy, and now no one will give him a chance to prove himself." Self-deception of this magnitude is often impenetrable. Some will go to their deaths rather than take a look at their own participation in the destructive patterns. Others may vaguely see that their protection can be damaging but fear that their vulnerable son or daughter will end up living in the street -- a fear that may not be totally unfounded.