One problem with being a midlife woman, with aging parents and adolescent children, is that you have to care for them in a positive way, even though they may be rotten to you a good deal of the time.

It may not be personal. So it's hormones, maybe it's dementia; who cares what the reason is, when you're on the receiving end of so much vitriole?

Of all the surprises of middle age, this is the biggest--and most debilitating one. Crow's feet, you kind of expect. Plus, there are creams for that. Being treated abusively by the most important people in your life while you're trying to care for them? Now that, dear reader, is a dispiriting conundrum. And contrary to the current debate on health care reform, you just can't kill these people. That would be very wrong.

And let's be clear, there is a whole lot of caregiving going on these days.  This info is from the National Family Caregivers Association:

More than 50 million people, provide care for a chronically ill, disabled or aged family member or friend during any given year

Source: U.S. Department of Health and Human Services, Informal Caregiving: Compassion in Action. Washington, DC: 1998, and National Family Caregivers Association, Random Sample Survey of Family Caregivers, Summer 2000, Unpublished

The typical family caregiver is a 46-year-old woman caring for her widowed mother who does not live with her. She is married and employed. Approximately 60 percent of family caregivers are women.

Source: National Alliance for Caregiving and AARP, Caregiving in the U.S., 2004.

I’m sure these problems occurred in previous generations, but but two current trends do not help: young people are ever-more-entitled (and ruder), and old people with chronic illnesses are living longer.

Both these groups demand independence and autonomy. And they're often angry about the limits of youth or old age. (And it's your fault.) They can also get into messes that only you can clean up, thank you very much. If only they would ever actually say that.

Chances are pretty good that you are pretty ticked off as a result.

But you can’t let the terrorists win. And, make no mistake, these relationships require a strategy.

It turns out that there is a whole genre of literature on the topic of dealing with difficult people in caring relationships. They range from the academic:  Aging Mothers and Their Adult Daughters: A Study in Mixed Emotions, to the self-help, like this book I found last summer at CVS, which would be worth keeping on your desk just for the cover:  

Roberta Satow, a New York psychoanalyst, has written extensively on the topic of dealing with difficult aging parents. Here's an interview. Her book is also a good resource.

Coping With Your Difficult Older Parent also gets good reviews over at Amazon:

 As does: Elder Rage: Take My Father, Please.

In the teen category, the classic Get Out of My Life, But First Would You Drive Me and Cheryl to the Mall still holds up.

Also, on the web, there are some resources, including Martha Beck over at Oprah.com, who talked to lots of caregivers and offers this pithy advice:

Nourish a sick sense of humor.

A morbid sense of humor isn't listed in any official guides to eldercare, but to the caregivers I interviewed, it is like oxygen. Take, for example, Meg Federico's memoir Welcome to the Departure Lounge. Federico's wry portrayal of her mother's senescence is both sad and hilarious. Without belittling her mother or her stepfather, Walter, both of whom suffered dementia, Federico recounts conversations like this one:

"I can't seem to find my keys," Walter told Mom. "Say, do you have them?"

"Oh, don't worry about keys, dearest. We don't need them. We can jump out the window and fly home."

"What?" said Walter. "You can fly? I never knew."

"So can you, but you have to take your shoes off."

To Walter's credit, he was not convinced.

Just acknowledging that this is funny makes it tolerable. Cracking up can keep caregivers from, well, cracking up.

Here are some tips that have worked for me:

Find—or reconnect with- a passion that has nothing to do with difficult people. Buy a piano. Take up needlepoint. Get out to an Italian class. Anything new.

Find new, or reconnect with old, friends. Make a date for lunch and when you meet, provide only a brief update on your situation and then move on. Contrary to popular belief, it often doesn’t help to talk about a crappy situation.

I'm starting to think, too, that we all need to stick up for each other when we see ill treatment in public. I cringe when I have to witness a teenager lipping off to her mother or an old lady busting her middle-aged daughter's chops, at the mall or at a restaurant.

And it happens a lot.

I always wonder: What would happen if we all said something when see this kind of behavior. Is this gauche or solidarity? What do you think?

                                                       --BJ Roche