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Series - Care for the Caregiver (PLwD) (1/3) - Ambivalence
- Mar 9
- 6 min read
Updated: Mar 9
Caregiving for a person living with dementia stretches your time and energy and shifts your emotional foundation in unseen ways. This isn’t the kind of stress you can walk off. It’s not a bad day, or even a hard year. It’s a reconfiguration of love, grief, duty, and identity, all happening at once, and over time.
You feel tired and torn. There is the up and down of emotions and sometimes the back and forth between your calm, empathic self and the impatient silently (or not so silent) ragey self.
For care partners supporting a loved one with dementia, the word is ambivalence - a persistent, gut-deep contradiction.
Ambivalence: The Meeting Place of Devotion and Disorientation
Ambivalence in caregiving for a person living with dementia reflects the deeply layered emotional experience of offering support. It can include the genuine experience of frustration alongside an equally genuine sense of devotion, each living within the same stretch of time. At times there is purpose, relief, or even gratitude in being able to show up when your loved one needs you. Within that same experience, there can also be exhaustion and resentment, especially when the responsibility keeps landing with you, or when it becomes clear that others are unable to take part in the same way.
Days that once held room for rest, childcare, or career demands can become increasingly filled with managing someone else’s banking, medical appointments, daily needs, and anxious phone calls. One moment your loved one remembers every detail of a family trip to Jasper or a weekend at Sauble Beach, where things are in the closet, or what they did yesterday. Another moment, they are standing in front of the coffee maker searching for the steps, asking the same question again and again.
The pressure lives in concern about scam calls, falls, and the loneliness or confusion that shows in their face. It lives in noticing their world growing smaller, and in the existential weight of your own shifting place as a child or spouse.
It can mean recognizing that their memories are changing, or that the family lore, the narratives you have trusted, are shifting through confabulation, leaving you unsure and disoriented too. You may feel the impulse to question, then catch yourself, tensing as you try to hold back the urge to correct while your loved one’s eyes reach, search, or turn away.
It can mean watching your children, who once ran into their grandparents’ arms, now offer a brief hello before drifting toward their screens or into other rooms. And sitting with the quiet ache that they may never fully know what that relationship once held. It can mean watching your adult children, for whom you once made decisions, casually pour a cup of coffee while gently telling you that they do not think you can do it anymore, and feeling anger and relief, pride and shame, all at once.
This is ambivalence. It is real, and it is worthy of compassion and care.
It’s Emotional, and It’s Biological
A 2024 study by Losada, Baltar, and colleagues found that care partners who experience high emotional ambivalence may face greater vulnerability to physical health concerns, including elevated inflammatory markers associated with cardiovascular stress. These effects were present across different levels of dementia severity. Even when symptoms were relatively mild, the emotional complexity itself was associated with physiological impact.
Ambivalence is a feeling, and it is also a meaningful health consideration.
It lives in what you carry, and in how deeply that experience can settle in the body.
Five Ways to Stay Steady Inside the Chaos
This kind of caregiving invites something deeper than constant calm or endless patience. It calls for emotional steadiness, a way of staying tethered to yourself even in moments of overwhelm, reactivity, or painful disconnection from the person you love.
Here are five ways to help regulate emotional intensity while making room for the truth of your experience.
1. Name What’s Real Without Forcing It Into Order
You can love someone and feel suffocated. You can grieve their decline and find yourself sounding snappy or terse. These responses are human expressions of a relationship that is reorganizing itself around uncertainty, change, and bewilderment.
You might say to yourself: “I may never make this situation feel easy or tidy. I can still tell the truth about what it is asking of me.”
Naming ambivalence can create room for self-understanding and can soften the grip of shame.
2. Respond Instead of Reacting, One Breath at a Time
High expressed emotion (EE), describes things like criticism and overinvolvement and is associated with more severe behavioural symptoms in persons living with dementia and greater caregiver distress, including burden and depression (Liu et al., 2025). Low EE doesn’t mean emotional numbness. It means practicing moments of pause before your nervous system boils over.
You may want to experiment: “I’m going to sit down before I answer again.” Or, “What if I encourage instead of correct.”
It can be helpful to pause and reflect: “This behaviour is not intentional, this is the dementia.” Seeking additional therapeutic support if the relationship history is difficult can also be helpful.
Allow steadiness to come into your body. These are rough seas and you are a mariner getting your sea-legs.
3. Use Shame as a Signal, Not a Verdict
When something comes out too sharp, or too flat, the rush of heat, gut twist, or even anger that follows is often shame. Not simply guilt for what happened, shame for what it says about you.
You may think, I’m a terrible daughter. I’m failing him. I’m tired of her. What kind of person thinks that?
That moment is not your whole truth. It’s your body telling you that something inside you is hurting too.
You can get curious: “What just pushed me past my limit?” Or, “What did I need in that moment that I didn’t get?”
Shame might feel like the conclusion, but we can get curious and curiousity gives way to compassion. You might explore self-talk which brings perspective and offers some nourishment:
“I miss feeling like we were in this together”
“Losing my temper doesn’t erase everything I’ve done right. It means I’m past my limit”
“This isn’t the life I chose, but I’m learning and I’m here, and that counts for something”
4. Redraw the Line Between Care and Control
Over-involvement may stem from love, but also from guilt, fear, or the belief that if I do enough, maybe I can stop what's happening. Many caregivers take on more and more in an attempt to soothe their own distress or prove their devotion. But care that erases you isn’t sustainable. And it doesn’t protect your loved one in the way you hope it will.
You might ask yourself: “Would I still be worthy if I stopped trying to get this perfect?” “Will my loved one feel more cared for if my care changes?”
Remembering you’re a person and not a solution allows you to stay in contact with your humanity… and the humanity of the person you are caring for. Relationship is more important than a task list - Relationship means the connection between you and yourself, your values, and the person you are offering care.
You are more flexible and adaptive when you aren’t trying to be perfect.
5. Practice Self-Compassion Like It’s Survival, Because It Is
Self- compassion isn’t soft. It’s a necessary counterweight to the internal punishment so many caregivers live with. Tolmacz and Pardess (2022) found that care partners who responded to themselves with warmth had lower emotional exhaustion, fewer feelings of guilt, and more staying power in their role.
Compassionate self-talk might sound like:
“Of course I feel this way. This is hard. I’m doing what I can. That’s enough.”
“I didn’t imagine this, It’s so hard and I can be proud that I am helping and that I’m learning to give myself kindness.”
Compassion is medicine.
Final Thoughts
We often try to land in one emotion or another, hoping to understand it and know what to do with it. But dementia caregiving brings layered losses that stir up complex, contradictory feelings. They do not need to be sanitized or minimized to be survivable. They need to be named, held, and met with care, and noticed as a reflection of the depth of what you are carrying.
It may be helpful to seek out local Alzheimer’s or dementia caregiver support programs in your area or online, or see a therapist who understands the journey. Finding moments of peace to sense into yourself, your purpose and meaning is important.
About This Post and Supporting Research
This post is for general educational purposes only and does not constitute psychological advice or therapy and is not intended to replace personalized care from a licensed mental health professional in Canada.
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