Caring for ageing parents and your relationship: what shifts between you

“Going to your mum’s again?”

Sunday, late afternoon. The bag with the medication that needs sorting into the pill boxes for the week is already standing by the door. The question is asked quietly, almost without reproach. But both of you hear it in full: again. Another Sunday without us, another evening when we will only meet once one of us is already asleep. And the person standing by the door with the bag in hand feels two things at the same moment — guilt for leaving again, and anger at having to apologise for it at all.

When a parent falls ill, grows frail or can no longer manage alone, it is not only the family schedule that shifts. What shifts is the distribution of attention, responsibility and loyalty. And one of the relationships that feels this most strongly is often the one that gets talked about least amid all the conversations about doctors, prescriptions and lifts: the couple relationship of the person who is doing the caring.

In this post I will not write about how to talk to a parent about the help they need, or how to share the work among siblings — there are separate posts for that. What interests me here is what happens between the two of you when a third person who needs a great deal enters your everyday life.

When a third person enters the couple

In systemic and relational family therapy, the approach I am training in, we do not see a family as a collection of individuals but as a system in which a change in one part moves all the others. Murray Bowen observed that a relationship between two people under pressure often stabilises itself by drawing in a third. We call this a triangle, or triangulation.

When you care for a parent, the triangle does not form because someone has done something wrong. It forms because the need is real. Your mum really does need someone to prepare her medication. Your dad really should not be driving any more. But when one partner’s attention is turned towards the parent for good, the other partner begins to stand a little to one side — and the relationship between you starts to be organised through the third person. Conversations are about mum. Arguments are about mum. Even making up is sometimes about mum: “Let’s not be angry, you know how things are with her.”

This is not necessarily bad. Shared care can also bring a couple closer. The trouble begins when the parent becomes the only topic you still have, or when one of you starts to feel there is no longer any room for them in this story.

How many people carry this

Caring for an ageing parent is not an exception; it is one of the most common life transitions of midlife. A US study by AARP and the National Alliance for Caregiving estimated in 2020 that around 53 million people in the United States were providing unpaid care for someone close to them — more than one in five adults. I do not have such precise figures for Slovenia, but anyone who has talked with friends in their forties and fifties knows that the subject comes up in almost every circle.

As early as 1990, the sociologist Leonard Pearlin and his colleagues described how the stress of caregiving does not stop at the tasks themselves. First come the direct demands: personal care, lifts, getting up at night, phone calls. But from there the stress spreads elsewhere — into work, into finances, into relationships with siblings and into the partnership. They called this stress proliferation. Even if your partner takes no part in the care at all, the stress reaches them: through tiredness, through cancelled plans, through silence at dinner.

Research on adult children caring for their parents shows that caregiving can be linked with lower marital satisfaction, but that the effect is not the same for everyone. Couples differ enormously — and the difference often lies not in how much caring there is, but in how they talk about it.

Loyalty: who do I belong to?

Ivan Boszormenyi-Nagy, one of the founders of family therapy, wrote about invisible loyalties. Each of us carries towards our family of origin a sense of debt and belonging that we mostly do not put into words, yet which strongly guides our decisions. When a parent grows old and needs help, that ledger suddenly becomes very concrete. “Mum looked after me, now I will look after her.” Or: “She was never there when I needed her — and now I am the one who has to be.”

Your partner does not feel this loyalty in the same way. They may have a respectful, warm or very complicated relationship with your mother, but their debt lies elsewhere — with their own family and with the two of you. When you say “I have to”, they often hear “I am choosing”. When they say “it is too much”, you often hear “your mother does not matter”. And so a conversation about the lift rota quickly turns into a dispute about who belongs to whom.

I have written about how families of origin enter a partnership more generally in the post In-laws and boundaries: families of origin in a relationship. Caring for an ill parent is the same theme, only under greater pressure and with less choice.

Roles that come back

One of the things that surprises people most when caring for their parents is how quickly they slip back into old roles. A grown woman who runs a department at work is, in her mother’s kitchen, once again the daughter who has to get everything right. A man who is an equal partner at home feels, next to his brother, like the younger one again whom nobody asks for an opinion.

If as a child you had the role of the responsible one, the one who kept the peace or even looked after a parent, you will almost certainly be the one carrying the most now too. When a child takes on care for a parent before they are ready for it, we call it parentification. Adult care for an ageing parent is not parentification — it is a normal part of life. But in people who knew that role as children, the two tend to merge into a single feeling: that they are once again solely responsible for everything.

You can read more about how roles take shape in a family in the post Roles in the family: the hero, the scapegoat, the invisible child. Which was yours?. Caring for parents also often brings out the old geometry between brothers and sisters — who was closer to mum, who moved away, who always “had an excuse”. I write about this in the post When your brother or sister won’t help care for your parents.

For a partner, this is often the hardest thing to understand. At home they know you as their equal, but next to your parent they see someone who cannot stand up for themselves, who agrees to everything and who comes home empty. Sometimes this angers them more than the time you spend. Not because they are selfish, but because it hurts to watch you disappear.

The partner as a silent carer

We talk about the carer as if there were only one. In reality, the care is almost always carried by two — the one who goes to the parent, and the one who takes on everything else at home. A partner who picks up the children alone, cooks, cancels plans with friends and listens to the reports from the doctor’s is also part of the care. It is just that nobody asks them how they are.

This invisibility is one of the most common sources of resentment I notice. The person doing the caring at least has a story: everyone knows it is hard, relatives praise them, mum thanks them. The one at home has none of that. And when they once say they are tired, they may hear: “You’re tired? I was in A&E until one in the morning yesterday.”

If you also have children, the pressure doubles — I have written about what it is like to be caught between two generations in the post The sandwich generation: caught between your children and your parents. Here I would like to add just one thing: your partner’s tiredness is not a competition with yours. Both are real. And both need room.

How it sounds in the kitchen

This is how a conversation that most couples in this situation will recognise might sound (composite, not a real person):

“I won’t be able to come to lunch at your parents’ again tomorrow. Dad has a check-up.”
“I know. You couldn’t come last week either.”
“What am I supposed to do? Leave him on his own?”
“I didn’t say that.”
“Then what did you say?”
Silence. “That I miss you. That’s all.”
“…I don’t know what to do with that. When you say it, I feel like I’m doing one more thing wrong.”
“You’re not doing anything wrong. I’m just here too.”

This conversation very nearly went astray. The first sentence sounded like an attack, the second like a defence. Only when one of them said what they really felt underneath — “I miss you” — did something else open up. And even then the other could not hear it straight away as love; they heard it as yet another demand. This is typical: when a person is exhausted, every need expressed by someone close feels like a burden. That is why it is good not to have this conversation only when you are both at the end of your strength.

Closeness that will come “when things get better”

One of the most common thoughts I hear is: “Now is not the time for us. When things get better, we will make up for it.” I understand it. But caring for an ageing parent rarely ends quickly and rarely ends in improvement. It can last for years. If you postpone your time as a couple until “later”, you may find that “later” you are strangers sitting next to each other.

The Swiss psychologist Guy Bodenmann developed the concept of dyadic coping — how a couple copes with stress together. His research shows that what matters most for the quality of a relationship is not only how much stress a couple experiences, but above all how they respond to it together. Does one partner speak about the stress or hide it? Does the other notice and respond with support, by taking something on, or by withdrawing? Do they treat it as “my problem” or as “ours”?

In caring for parents, it often happens that the one who cares hides their distress — so as not to burden their partner, or for fear of hearing “I told you so”. And the partner, not knowing about the distress, cannot help and feels pushed aside. Both mean well. The result is distance all the same.

Boundaries: not between you and your parent, but around your relationship

When we talk about boundaries, people often think they should refuse their parent something. Sometimes that is true. But in caring for parents, another boundary is often more important: the one around the couple. A small space that belongs only to the two of you and that the caring must not swallow entirely.

Bowen called the ability to stay in contact with your family without losing yourself in it differentiation. In caring for parents, this means you can look after your mum and still remain a partner, not only a daughter or a son. That you can say “this evening is for us” without feeling you have betrayed your parent. And that you can tell your partner how things are for you with your parent without expecting them to feel the same as you.

Boundaries around the couple are also practical. An agreement not to talk about doctors in bed. An agreement that each of you has the right to one evening a week that is not about caring. An agreement that bigger decisions — your parent moving in with you, a change of job because of the caring — are made together, rather than one of you making them with brothers and sisters and the other finding out afterwards.

The last point seems obvious, but in practice it is often the other way round. Decisions about parents are made in the family of origin, among siblings, over the phone, often under time pressure. The partner who will live with those decisions is merely a guest. No wonder they then feel like someone who is only allowed to pay the bill.

Exercise: an evening for sharing out, not for blaming

You can do this exercise with your partner this week. Choose a time when neither of you has just come back from your parent and you are not both completely worn out. It takes about half an hour.

1. Each of you writes down what the caring asks of you right now. Not only tasks, but also what is not visible: worrying at night, phone calls at work, things you have cancelled. Your partner writes the same — they carry a share too.
2. Read them to each other without comment. The other only listens and at the end says one sentence: “I didn’t know that” or “I see that.” Nothing more.
3. Each of you names one thing you miss. Not as a reproach (“you’re never here”), but as a wish (“I miss us going for coffee on Saturday mornings”).
4. Agree on one small, concrete change. One evening a week, one walk, one agreement not to talk about doctors after ten at night. Better too little than too much.
5. Check in two weeks later on how it went. Without deciding who is to blame if it did not work. Just: what helped, what you would change.

The exercise is not meant to solve the care of your parent. It is meant to help you see each other again as two people carrying it together.

When the cause is not the caring

I want to be honest here, because it would be too simple to blame everything on the parent.

Sometimes caring only reveals what was already there. If you had already drifted apart, if you had never been able to talk about difficult things, or if one of you already felt they came second in the relationship, caring for a parent did not cause it. It only made it show sooner. In that case it makes sense to look wider than the current strain.

Sometimes your partner is right. If you are caring for your parent in a way that means you do not sleep, do not eat and no longer see anything else, your partner’s concern is not selfishness. It is a warning. Exhaustion shows not only in the body but also in relationships — I have written about this in the post Burnout and relationships: what happens to a couple when one partner gives out.

Sometimes the solution is not psychological but practical. No conversation as a couple can replace help that is genuinely needed. If your parent needs more than the family can manage, the first step is a conversation with their GP, who can advise on nursing care and the community nursing service, and with the local social work centre, where they can tell you what forms of home help and other services are available in your municipality. I will not list rights and conditions here, because they vary and change — what matters is that you know where to ask. Sometimes the most loving decision, both for your parent and for your relationship, is not to carry the care alone.

And sometimes the relationship with the parent is simply too painful. If your parent was violent or neglectful towards you, caring for them reopens wounds that no agreement about the rota will close. Then it is worth getting support for yourself, not only for the couple.

When it is good to seek help

Couples therapy is not only for couples considering separation. It is also for couples who love each other but whom life has set a task in which they are losing each other. It is worth considering if you notice that you talk only about the parent any more, that every conversation ends in an argument or in withdrawal, or that one of you feels there is no longer room for them in the relationship.

In my work as a therapist in training under supervision in marriage and family therapy, I see couples in person in Ljubljana, and I also work with English-speaking clients. It often helps us to look at your situation across several generations — how parents were cared for in your family and in your partner’s, who carried what, what was expected of you. A longer genogram session, A Look into the Past, is designed for exactly this. You will also find a short explanation of what caring for an ageing parent can look like from a systemic perspective in the knowledge base under caring for an ageing parent.

What to remember

• Caring for a parent does not only weigh on the one who cares — it moves the whole system, including the partnership.
• Your partner is often a silent carer: they carry part of the load, but rarely does anyone see it.
• Beneath arguments about the schedule there is often a question of loyalty — who do I belong to.
• What matters for the relationship is not how much stress there is, but whether you carry it together.
• When the care cannot be carried within the family, ask the GP and the social work centre what help is available.