I Deserve to Be Appreciated as a Caregiver, Not Treated Like a Villain

A daughter struggles with her father’s negative feelings toward her caregiving support

Barry J. Jacobs,

AARP

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En español

Published July 14, 2025

Editors asked AARP Family Caregivers Discussion Group members and other caregivers to submit pressing questions they’d like family therapist and clinical psychologist Barry Jacobs to tackle in his caregiving column. Jacobs took on this hot-button topic:

Q: The advice for caregivers is always to meet [care receivers] in their own world. How can I do that successfully when he thinks I am the big villain? In his mind, I took away the keys, I control his life, and I am responsible for losing all his stuff. I tell him to take his medicine, so I’m bossy. If I don’t remind him of things, I don’t care about him. His frustration and anger are hard to deal with.

(Letter edited for length and clarity.)

Barry Jacobs: That sounds extremely hurtful. You devote yourself to your care recipient, and they respond with protests, not thanks. It's enough to make anyone feel embittered and question why they are working so hard on their care recipient’s behalf.

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I know. Even eight years after her death, I can still feel the old wounds from a similar struggle with my mother; I was her primary caregiver for seven years as she declined from vascular dementia. During that time, my mother’s favorite saying, loudly exclaimed, was “You are not my boss!” She said it whenever I made changes to keep her safe, such as taking charge of her pillbox (after she became confused and could no longer put the right pills in the right slots), hiring personal care aides (after she fell repeatedly while alone in her apartment) and preventing her from driving (after it was clear she was a hazard behind the wheel to herself and others). I saw myself as a good son; she saw me as her tormenter. I felt for her as she gradually lost her independence but hated how she bad-mouthed me to other family members for ruining her life.

Meeting care receivers in their own world is excellent advice for any caregiving situation, especially when caring for someone with dementia. But why do care receivers with dementia frequently respond negatively to caregivers’ efforts? As you likely know, there are medical and psychological reasons.

Medical reasons for care receivers’ anger

Two symptoms that people with dementia commonly experience — anosognosia and paranoia — directly interfere with their ability to perceive caregivers’ good intentions.

Anosognosia is a lack of awareness of cognitive or physical deficits. In other words, because of the deterioration in their thinking skills, your care receiver (ironically) can’t grasp the extent of the decline in their thinking skills. They are consequently baffled by the steps you have taken to protect them.

Paranoia is having the delusional or false belief that someone is trying to hurt you. For instance, your care receiver may fear your caregiving efforts are a power grab to take over their life and harm them.

When both of these symptoms affect thinking, then even the kindest, gentlest caregiver is likely to be seen as a conniver and a threat.

Psychological reasons for care receivers’ anger

We human beings tend to take out our frustrations on the people closest to us, unfortunately, perhaps because we subconsciously know that they won’t abandon us when others might. The fact that your care receiver makes you the primary target of their general distress is a sure sign that you are the most important person in the world to them.
It is easier for care receivers to battle caregivers than fight a pitiless disease or disability. It was always clear to me that my mother villainized me because she felt helpless dealing with her unrelenting cognitive and physical decline.
There is an old therapist axiom that anger is depression turned outwards. Rather than expressing their underlying sadness about their many losses, which may feel frightening or disempowering, care receivers often express anger instead. This tends to be especially true for men who are uncomfortable or have difficulty expressing sadness.

Lower your expectations, then play the heavy

In truth, you deserve a medal for all you are doing; you should at least be able to expect common courtesy and cooperation from your care receiver. But the unfortunate likelihood is, if your care receiver has persisted in treating you as a villain because they lack awareness or need to manage their emotions, they probably won’t change.

More from Barry Jacobs

My Mom Is Dying, and I Am Overwhelmed
Uses and abuses of caregiver silence
Pros and cons of receiving pay as a caregiver
Strength, challenges of immigrant caregivers
How to handle ‘gut check’ moments

That stings. But it also gives you a certain freedom. You should not fear alienating them by stopping them from engaging in risky behaviors; consider yourself already typecast as the heavy. In that role, you can politely and firmly enforce safety precautions, such as no driving, using the stove, or living alone. It may make them chafe and bolster their negative opinion of you, but you should have fewer guilty feelings about using your best judgment, rather than theirs, to provide the help you know they need.

Seek validation elsewhere

We all need a pat on the back sometimes, to know our efforts are appreciated. Since your care receiver won’t provide that validation, it is important to seek it from others. Many caregivers of people with dementia will understand exactly what you are enduring. Your family and friends should assure you that you are no villain. You are a stalwart and loving family member who is doing what needs to be done, even though your care receiver doesn’t understand. I found consolation in that thought while caregiving for my mom, and it has buoyed me in these years afterward.

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Barry J. Jacobs, a clinical psychologist, family therapist and health care consultant, is coauthor of the upcoming book The AARP Caregiver Answer Book, scheduled for release on July 9, 2025. For more information, visit aarp.org/bookstore. Follow him on Twitter and Facebook.