It's often the little things that can make a person's blood boil.
Case in point: Ann Allnutt gave her 85-year-old mother a basket for her mail. Read your mail, she said, and when you're done, put it in the basket where I can easily check it.
"I find everything in that basket but the mail," Allnutt, 68, says. "So, because of that, we missed paying insurance premiums, or we missed something that we need to take care of. I have changed the addresses on bank statements and she'll call and change them back."
Then there are the doctors' appointments her mother reschedules without telling her. Allnutt knows the dementia is likely to blame, but there's a part of her that thinks there might be more to it — that her mother is being difficult in order to hold on to her independence.
And then there's her father, 90, a survivor of two strokes, who says he doesn't need anyone to help him, yet in fact needs everything done for him. Both refuse to hire a home health aide, and both insist on staying in their own home.
"Up to a point, they think they can still do for themselves, and then they expect me to come in and pick up the pieces when things don't go well," says Allnutt, who moved back to Archdale, N.C., 13 years ago to help care for her parents.
How does this make Allnutt feel? Stressed, frustrated, miserable and lonely, she says. The situation has left her feeling unappreciated by both of her parents and has strained her relationship with her mother in particular.
Disharmony with Mom and Dad
All of these emotions, combined with the conflict and arguments, lead to a relationship that University of Southern California professor Merril Silverstein would describe as "disharmonious." The situation is not at all uncommon, at least in the United States. The relationship between adult children and aging parents is much more likely to be disharmonious here than in Europe or Israel, according to a 2010 study Silverstein authored in the Journal of Marriage and Family.
Silverstein compared data from a U.S. longitudinal study of generations with a similar European one that included responses from caregivers in England, Germany, Israel, Norway and Spain. Each country's study assessed responses from an average of 450 caregivers.
In Silverstein's study, 20 percent of Americans rated their parental relationships as disharmonious — more than twice the rate found in England, Germany, Norway, Spain and Israel.
"There seems to be more conflict, and less closeness, when [adult children] were caregiving or when the parent was frail," says Silverstein. For instance, the study compared older people's ability to climb stairs with the quality of the parent-child relationship. Parents who had problems with mobility — a measure of frailty — were more likely to report a disharmonious relationship with their adult children.
Why? Sociologists such as Silverstein believe differences in how cultures handle caregiving issues directly impact relationships at home.
The ease or burden of caregiving
In the study, the most amicable relationships were seen in Norway and England — countries with strong social programs that ease the financial burden of caregiving. In-home help is heavily subsidized there, as are assisted living and nursing home care. But cultural factors also come into play, says Svein Olav Daatland, senior researcher with NOVA, the Norwegian social research institute, whose data were used in Silverstein's study. Simply put, older parents in Norway don't want their children to do the laborious, and sometimes humbling, hands-on work of caregiving.
"This is hardly because they are not family-oriented," says Daatland, a gerontology expert. "Rather, they say, 'I don't want to be a burden on the family.' The response often is, 'When I no longer can manage myself, I need to have professional services brought in. Then I can be together with my family without obliging them to do any hands-on care.' "
In other words, families want to be able to get together for Sunday dinner and enjoy each other's company — not talk about who will help Mother to get out of bed in the morning, or who will be there in the evening to lay out the pills for the next day. Allnutt understands this all too well. When asked what would improve her relationship with her parents, her response is a simple one:
"It seems that the only time we share together are times when I'm doing things for them," Allnutt says. "We never really get time to have a one-on-one parent-child visit. If we could just go out and have a meal. Just the other day I took Mother shopping. She just wasn't physically able to stay away too long, but that was a good time."