Most caregiving advice assumes the person you care for was good to you. This piece is for the caregivers whose parent was the source of the harm: what the research says about you, and what can help.
Who ends up doing the caring
Family caregiving is one of the most common jobs in America, and one of the least visible. The 2025 edition of Caregiving in the US, from AARP and the National Alliance for Caregiving, counted 63 million Americans, nearly one adult in four, providing ongoing care for someone. A 2026 AARP analysis valued the unpaid care families gave adults in 2024 at $1.01 trillion, more than all federal, state and local Medicaid spending that year.
A 2025 study in the Journal of Child and Family Studies asked which adults take on that work. Researchers led by Erin Maher at the University of Oklahoma analysed survey data from nearly 19,000 adults in four states. People with three or more adverse childhood experiences (ACEs, the abuse, neglect and household upheaval researchers track in childhood) were somewhat more likely than their peers to be caring for a parent nine or more hours a week.
The detail underneath that finding matters. The category the researchers call parental challenges, meaning a parent’s substance use, mental illness, incarceration or divorce, explained the link more than direct child abuse did. Children who grew up managing an unwell or unavailable parent are, statistically, somewhat more likely to be managing that parent again decades later.
Many readers will recognise their own family in that sentence.
The caregiver the conversation leaves out
Most writing about caregiving pictures an exhausted adult looking after someone who was good to them. That caregiver is real and deserves every form of help on offer.
There is another one. She is bathing a father who frightened her. He is managing the medications of a mother who told him for twenty years that he was the problem. A 2021 review in Clinical Gerontologist, titled “Caregiving for Parents Who Harmed You,” estimated that between 9.4% and 26% of adult children caring for a parent had experienced abuse or neglect from that same parent. An earlier study of 1,001 adult-child caregivers in Wisconsin found that those abused by a parent reported significantly more frequent depressive symptoms while caring for that parent.
The hardest part is the position the care puts you in. Caregiving asks you to do, on purpose and for months or years, the thing that healing from that childhood usually asked you to stop doing: put the other person’s needs ahead of your own reading of what happened. Relatives often add pressure, whether it is the aunt who wants the past dropped or the sibling who lives far away and has opinions. A person can find themselves back inside a family pattern they spent a decade climbing out of, this time with everyone praising them for it.
There is no correct answer
No one can tell you whether to do this, and anyone who hands you a rule is being careless with you.
People in this position land in different places. Some give care and find something in it they needed, and others are worn down by it. Some decline, and carry that decision. Many settle on a middle version: money without presence, phone calls without visits, a paid aide instead of their own hands. Each is a legitimate choice made by an adult with the right to make it. Anyone else making it for you, even out of love, is overstepping.
The review’s authors take the same view. They write that abusive parents have “broken the basic human contract” with the children in their care, and they treat the caregiver’s sense of choice as protective: without it, they note, the adult child risks being harmed again in the relationship.
Dr. Jamie Huysman, who founded the STAR Network foundation, co-wrote Take Your Oxygen First with Leeza Gibbons and Dr. Rosemary DeAngelis Laird, a book for caregivers built on the airline instruction to fit your own mask before helping anyone else. That rule is harder to follow when the person in the next seat is the reason you learned to hold your breath. It is also more necessary.
What helps
The 2021 review offers practical guidance that holds up whatever you decide.
- Choose your tasks. You can agree to some kinds of help and refuse others. The review gives the example of an adult child abused by a father who decides against any care involving intimate physical contact. Arranging or paying for that care still counts as caring.
- Bring in outside help early. The federally funded National Family Caregiver Support Program pays for counseling, support groups, caregiver training and respite care through state and community agencies. The Eldercare Locator (1-800-677-1116, call or text) connects you to local services, including your Area Agency on Aging.
- Get support of your own. The review recommends connecting these caregivers with counseling and with other survivors. A therapist who understands trauma can help you sort what you owe from what you are being told you owe.
- Expect grief to be complicated. The authors flag a higher risk of difficult grief for these caregivers, and note that some unfinished business between you and your parent may stay unfinished.
A place to say it out loud
Services can cover the hours. What is harder to find is a room where you can say the true sentence, I am taking care of the person who hurt me, and I don’t know what I feel, without someone correcting you or telling you how lucky your parent is to have you.
That room opens on November 1.
If you are caring for a parent who harmed you, or deciding whether to, you can bring that here exactly as it is.
