08/12/2013 12:05 EDT | Updated 10/12/2013 05:12 EDT

Ask Elizabeth: Taking Care of a Difficult Parent or Relative

Natalie Strouth is a nurse with Saint Elizabeth and the information specialist behind Ask Elizabeth, a free caregiver support service. Saint Elizabeth, a home health care company, has been a trusted name in Canadian health care for more than a century and is a national, not-for-profit, charitable organization.

In her weekly column, Natalie answers your questions about caring for a family member or friend who needs extra support -- and caring for yourself as a caregiver.

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Vicky asks: I've been taking care of my mom who is 74, in poor health and lives on her own. We've never had a very close relationship, and she criticizes everything I do. It doesn't matter if it's house cleaning, taking her to appointments, or getting her groceries -- it's like I can never do anything to her satisfaction. I am so stressed and frustrated.

Vicky, I can feel your pain and understand it must be hard to talk about this. Caregiving relationships come in many forms and are often thrust upon us without a lot of thought, choice or planning. I have talked to hundreds of caregivers through the Ask Elizabeth caregiver support line. In one way or another, many people are struggling with similar complicated family dynamics.

Making important decisions about someone else's care, finances and living arrangements may be expected challenges. However, the day to day issues you mention can cause just as much stress in a difficult relationship. The good news is that there are strategies to address and manage your relationship and changing roles.

Find the coping strategies that work for you. Often a calm, matter-of-fact and kind response to a challenging or irrational conversation can help a person refocus. Showing your confidence can go a long way. For example, if you're trying to help your mom with bathing and she is upset about some shopping you did for her, try saying calmly, "Mom, let's deal with one thing at a time. We are washing your hair right now." It may be hard for your mom to change her habits or dynamic with you at this stage, so you may need to be the one to take a step back and not engage in frustration (as hard as it may be sometimes). These conversation starters can help handle some of the difficult conversations that don't often come naturally.

Bring in health and supportive care professionals. Contact your local home health care authority about getting some support to help your mom remain as independent as possible, and establish the necessary boundaries your relationship requires. For example, a social worker might help you and your mother start to communicate better. Personal support workers can provide personal care, fostering your mom's need for privacy and maintaining her dignity, or an occupational therapist can work with you to understand your mom's needs and make recommendations to minimize home safety risks.

There are also many other supportive care professionals in your community who can be an invaluable asset such as friendly volunteers, Meals on Wheels organizations, grocery delivery, housecleaning and home maintenance services for seniors.

Our website has helpful information on finding home health care and support.

Plan early to address family dynamics. Talking with your mom and other family members about decision-making now can help avoid further tensions down the road. As hard as it might be, try to include your mom in decisions and conversations that affect her. She needs to know that her thoughts, needs and wishes will be respected as her abilities change. We all have different ideas of how we want to live out our aging years. Many friends I talk to want to age in the comfort of their own homes surrounded by familiarity, while some others envision moving to a retirement community where they can make friends and not worry about keeping up their house.

For more, read the article Caregiving: Dealing with Family Conflict.

Find emotional support. You need to be prepared for the range of emotions you may experience, such as guilt, fear, and frustration. You are in a vulnerable place, and being your mom's caregiver is a different dynamic from being her daughter. As a caregiver, you need to have breaks and time to yourself, to maintain your own well-being. If your ability to cope waivers there are 24/7 crisis support lines that can give you a non-judgemental professional to talk to about your unique situation. Contact 211 for your local crisis support and intervention line. Our post about crisis support may be helpful to read and save. Support groups, online chat forums and even just coffee with a good friend are all great ways to help manage and maintain your emotional health.

Try to keep an open mind, and reasonable expectations. It's definitely possible that through this experience, you'll be able to forge a better relationship with your mom and find great meaning in this time together. We all need to feel in control of our lives. Remembering that your mom is having to let go of a lot of control and independence may help to put her reactions into perspective. It's equally important to accept that things may get tough, and have the emotional support you need.

Send your caregiving question to Answers may appear in an upcoming weekly column. Ask Elizabeth does not offer legal guidance, nor does it answer questions about personal health issues.