The Crisis of the Ailing Toxic Mother: Caretake or Run?
When a mother is and has been unloving, the choices are always hard.
Posted October 24, 2016 Reviewed by Ekua Hagan
"My mother is in her 60s now and has several health problems. I was her caregiver for many years, but have not had much contact with her for six years or so. It is a constant dilemma. Do I take care of the woman who gave me life, but did everything to break me down? Or do I live my life without her?" — Caroline, 38

The core conflict in the daughter whose mother didn’t love her remains between her continuing need for the love and support she missed and her need to protect, heal, and reclaim her authentic self. As unloved daughters emerge from childhood into adulthood, they slowly come to terms with their experiences and the degree to which they have been wounded, and continue to be, by a parent who is dismissive, hostile, disparaging, emotionally unavailable or abusive, or downright cruel. That recognition absolutely coexists with a tremendous feeling of loss and, yes, the ongoing need for maternal love. The inner conflict is amplified and complicated by cultural assumptions about maternal love, the importance of family, and filial duty.
The conflict, most usually, is a closely held secret, shared with few. Most daughters believe that, somehow, they are to blame for the failure of this most central relationship, and the recognition that they are not may take decades to discover.
"I have always felt on guard with my mother. She can turn on a dime and strike like a venomous snake. Between times she has a coy smile through gritted teeth. Growing up, I never felt I could do anything right, not because of direct criticism, but due to being 'corrected' on how things should be done. Everything I accomplished, grades, activities and sports were somehow less than and never celebrated. I was a B+ student. My older brother was the head of the dysfunctional family as my dad was emotionally absent. He was encouraged to go to college; I was never even talked to about the possibility." — Rose, 54
Resolving the conflict between maternal need and the self
"My mom is 72 and we just began speaking this year after a 6-year separation. Although I knew it was probably a mistake, I reconciled with her anyway. Guess I'm not too bright. She's still toxic and I still want a mom." — Patti, 43
This conflict has a topography of its own, full of peaks and valleys, as the daughter struggles to make sense of it, works to set boundaries, manages her feelings, and tries to find ways of making it less difficult and painful. There’s no easy solution and the results more cobbled together than not.
Some opt for distance, moving a state hundreds or thousands of miles away; some put an ocean between themselves and their families of origin. They go low-contact by default, which is more like being in exile than not. Others stay in contact for reasons both simple and complicated: They range from not being willing to give up on the possibility of reconciliation, fear of disrupting important family ties, or the decision to make sure their child or children have grandparents. Some daughters, after years of struggle, decide that they can no longer brook the toxicity of the connection, and go no contact. In doing so, they often lose most, if not all, of their other family connections as well.
And yet not one of these answers actually resolves the inner conflict or salves the need for maternal love, support, and attunement. The journey is rarely smooth: Some daughters will find that low contact is still too much contact because their mothers continue to ignore boundaries, while others will find the finality of no contact unbearably painful and attempt reconciliation.
But nothing is more poignant than the crisis posed by the toxic mother who is in need.
The crisis of caretaking for the toxic mother
"I feel significant conflict. I never felt entirely comfortable going no contact, but I saw that it was necessary and it worked for me. I still worry about her because of her age. My mother is almost 78 now. She has a serious health problem and was hospitalized in the ICU recently. I broke my no-contact rule and I have contacted her a few times. She says she wants things to be the way they used to be before I moved away. She is ruminating about death now. I am caring about her from a distance because I don't want to return back to my old family role as the scapegoat. My family connections have been strained and some of them have been completely destroyed or severed because of the conflicts with my mother. My three brothers, in particular, are extremely protective of her. They don't understand the dynamics or my experiences with mother. They think I should 'be the better person,' apologize, and forgive." —Ariel, 57
"My family is pressuring me to visit the nursing home. I don’t want to. Every time I see my mother, it’s the same old: She berates me, tells me I’m a failure, that I look like hell. Why does filial duty include being beat up mercilessly? She’s old and infirm but has lost none of her venom." — Merry, 62
According to a 2015 study by the Pew Research Center, one-quarter of Americans with a living parent over 65 provide assistance to a parent; that number jumps to one-third for adults with a parent over 75—and one-third say they provide financial assistance. While 88 percent of those helping elderly parents report the experience as “rewarding,” not surprisingly, 53 percent also say that it’s stressful. It should surprise no one that daughters do the lion’s share of hands-on caretaking.
"Just this year I decided that since most of my life I have mourned the lack of loving parents, why wait until they die to no longer have contact? In my opinion, I mourned their 'death' many years ago. They are both 84, live three miles away from me, and I have not seen them in 14 months or spoken to them in 10 months. I have felt conflict in the form of guilt. I am a loving, kind person and do not treat people like she does so to make this decision is against my grain but I have had to do it for my positive survival." — Jessica
But what about the mother who has belittled you all of your life or dismissed and ignored you, or still tries to control you but who, nonetheless, gave you life? It’s hard to overstate the cultural pressures pertaining to filial duty—backed up by one of the 10 Commandments, no less—and additionally, the daughter’s own sense of herself as a caring and empathic person. And then there’s the cultural opprobrium: While I was never asked to take care of my late mother—we had been estranged for 13 years when she became ill—I have seen people reassess me when they learn that I did not see her before she died. I go from being seen as one kind of woman to another in an instant because, in our culture, it’s always the daughter who’s on trial.
For many daughters who have settled on how to deal with their unloving mothers, their parents’ sudden neediness or illness throws them into a state of emotional confusion. They worry about what precisely their duty to their mother is, and what other people will think of them. They may feel enormous guilt and angst, or pressure from siblings and other family members to “do the right thing.” They may also be afraid of how they will feel in the future if they do nothing.
"I ended up taking my mother in when she was dying after years of no contact. It looked like a noble or a caring gesture but it really wasn’t. Everyone told me that I would feel guilty if she died and I did nothing, and that swayed me. It was a nightmare for my husband, my kids, and me from start to finish. Even worse, I felt relief when she died. I wish I had left well enough alone." — Betty, 63
Sometimes, a crisis in her mother’s life spurs a daughter to recalibrate and regroup, as it did for Hannah, who was 59 when her mother had a stroke and was admitted to an ICU. Before that moment, she describes her relationship as distant geographically with conversations every few months, usually at her mother’s initiation. Hannah described these phone calls in an email: “She always—and I mean, always—opened the phone call with something like, ‘Oh, thank God you answered. No one else is answering their phone.’" With this crisis, Hannah’s sense of obligation kicked in:
"From the moment I received the text message from my brother about Mom's transport to an ICU, I felt obligated to be present at her side and to work with my siblings regarding her medical needs and plans for the future. We were in daily contact via phone and/or text, and one or more of us saw her every single day for the first two years after her stroke. My visits probably averaged three per week—a tremendous increase in contact."
But, of course, the crisis didn’t change the tenor of the relationship and that, predictably, took its toll on Hannah, as it does on other daughters who find themselves in similar situations:
"I was terribly conflicted but held that conflict inside. It was as if I had to make a choice of loyalty: either to my mother (be the good daughter, and stay in good—non-criticized—standing with my siblings) or to my own feelings. Inevitably, I self-medicated with food—salty, crunchy and/or sweet, required after each and every visit. It wasn't until I resumed working with a therapist who was familiar with my family's dynamics that I was able to give myself permission to change my pattern of allegiance and to go entire weeks without a visit. I maintained contact with my siblings, however, and there was no lapse in my contributions to troubleshooting my mother's medical and estate issues."
Hannah was lucky that while her siblings noticed she was visiting much less often, things proceeded smoothly: One sister understood and supported her, one brother said nothing, and her other brother limited his comments to the occasional dig.
But not everyone is so lucky. Some daughters report that the months and days that preceded their mothers’ death caused irreparable damage to sibling and other relationships. Some were shamed and berated for doing too little; others were effectively ostracized and scapegoated if they decided not to re-establish contact once their mothers became ill.
It’s a situation that has no easy answers or pat solutions.
The complexity of motivation: Hanging in and staying away
“I take care of my mother because it’s the right thing to do,” one woman in her late forties told me. “It’s crazy-making, painful, but I am a mother myself. It’s the right thing to do. I believe in doing the right thing in life and I’m not going to make an exception for my mother although, God knows, It would be warranted.” Not surprisingly, self-definition contributes to both the decision to hang in and the decision to stay away.
Women talk of their faith and religious beliefs, their sense of themselves as honest and true, and, tellingly, of wanting to show the world that they are better than their mothers were, and capable of better behavior—even if “the world” doesn’t know their mothers failed them. That was the reasoning Beth adduced:
"I took great care of my mother because she took terrible care of me. I’m not saying she didn’t feed or clothe me, because she did. But she put me down, never heard or saw me as who I was, and was bitterly disappointed that I wasn’t who she wanted me to me. I treated her well when she was sick, and that was what I needed to do to prove to myself, for once for all, that how she treated me had nothing to do with who I was."
Some daughters begin with those intentions and then discover that they just can’t. That was the case for Rose, 44, whose siblings had long since cut bait on their 75-year-old mother and who found herself unable to go forward:
"I divorced my mother (no contact) about a year ago. I did everything for her, until the day I said Enough, and ended it cold turkey. I know she is ill, she is lonely, and I wish she was a mother I could be there for, but she quite simply is not. I tried my whole life to make her happy, and it was never enough, I was never enough. I feel like the weight of the world has been lifted off my shoulders! I am happier than I have been in my entire life. Of course, I have occasional pangs of Catholic guilt—that was a staple of my childhood—but my sister and husband help me work through it. It's still a dirty little secret, and only those very close to me know that I have gone no contact. I've been shamed by other women who are now caring for their own loving parents and don't understand the pain I endured my entire life from an alcoholic, narcissistic, just plain hateful mother."
For many unloved daughters, the feeling of shame and isolation absolutely co-exists with the recognition that she has done what she needed for herself and, quite literally, her own preservation.
Processing the cost (and benefit) of caretaking
Elena always knew that the caretaking duties would fall to her since she was the only one of three who stayed in their home state. But she’d also made up her mind that, despite her mother’s life-long treatment of her, she would follow her own heart: “I stayed and took care of her, first and foremost because it is who I am. I am a compassionate person and even though it cost me a lot physically and emotionally, I could not nor would I have ever walked away. I also had an inkling that there wouldn’t be anyone else there for her and, on that point, I was right.”
Even though Elena’s expectations were low, the experience was often frustrating and exhausting—years of advocacy through falls, hospitalizations, and rehabilitation. Additionally, there was little change in their relationship: “While I never wavered in my hope that she would love and appreciate me, her criticism of me continued. Yet there were those few moments, every so often, when I’d see some appreciation come through. I fell back into her service. She was good at the dance.”
Reflecting on her experience, some years after her mother’s passing, Elena tells me: “I am grateful that I stayed and did what was in my heart. It caused me enormous harm both physically and emotionally and I am still working through the hurt. Through the healing process, I have found myself shifting my perception, finding strength in what I experienced being raised by someone I still feel was a mean mother.”
The view from the other side
Most unloved daughters envy those lucky girls who have mothers who not only love and support them but those mother-daughter pairs who enjoy each other’s company; seeing them in the street, at the movies, or at a restaurant together is often a painful reminder of what they missed. I hear this all the time—and I remember the feeling myself—and it’s an exquisite irony that sometimes, when my own daughter and I are out together, I wonder whether there’s a daughter who’s watching us thinking, “Gee, I wish that could be me.” Not surprisingly, the experience of taking care of or helping a beloved parent is very different from what this article considers. Not long ago, I spoke to a former classmate who’d spent close to two years taking care of her mother before she died. This is what she said:
“It was a privilege, really, to give back to her in small measure after what she gave me. I’m not saying that it wasn’t stressful at time or hard to see her in pain or that it wasn’t tiring trying to live my life at the same time. But it was a privilege, giving back for everything she did for me, for my kids. When I read to her, I saw a book in her hands when I was little. When I cooked for her, I remembered her meals. She was a wonderful mother and person.”
In case you are wondering, I was sad for her loss but, yes, I was envious. Really.

If you are at this watershed moment—no matter the status of your relationship to your mother or what you decide—please seek help and support. As you know, I’m neither a therapist nor a psychologist but this is a defining moment: Don’t do it alone. You need to mourn the mother you had and the one you deserved.
A huge merci beaucoup to my readers here and on Facebook who opened their hearts and told their stories, unvarnished.
Copyright 2016 Peg Streep