1 of a 3-Part Series, By Penny Waller Ulmer, MACP, Registered Psychologist
The Weight of Mixed Emotions in Caregiving
Caregiving for a person living with dementia doesn’t just stretch your time and energy. It shifts your emotional foundation in ways that others rarely see. 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 don’t just feel tired. You feel 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 that refuses to resolve.
Ambivalence: The Collision of Devotion and Disorientation
Ambivalence in caregiving for a PLwD reflects the inherent contradictory experience of feeling through the process of support. This may include the true, felt experience of frustration as well as the just as true sense of devotion occupying the same capsule of time. Sometimes there’s a felt sense of purpose, relief, or even gratitude in being able to show up when your loved one needs you. But woven into that same experience can be exhaustion and resentment — from always having to be the one, or from realizing that others can’t or won’t step in.
Days you had to yourself or that are sandwiched with child-care or career become more and more filled with managing someone else’s banking, medical appointments, needs, and anxious phone calls. One minute 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. The next, they’re staring at the coffee maker unable to recall the steps, asking the same question, again… and again.
The pressure is in worrying about scam calls. About falls. About the loneliness and confusion in their face. It’s noticing their shrinking world and it’s the existential weight of losing your place as a child or spouse.
It’s realizing their memories are changing, or that the family lore - narratives you’ve trusted, are shifting in confabulation, and now you’re unsure and just as disoriented. You may question and then catching yourself, tensing to hold back the drive to correct while your loved one’s eyes reach, search, or turn away.
It’s watching your children, who once ran into their grandparents’ arms, now offer a brief hello before slipping into their screens or disappearing into other rooms. And sitting with the quiet ache that they may never know what that relationship was supposed to be. It’s watching your adult children, who you used to make decisions for, casually pour a cup of coffee while gently telling you that they don’t think you can do it anymore - anger and relief, pride and shame.
This is ambivalence. And it is real, and it is worthy of compassion, not correction.
It’s Not Just Emotional, It’s Biological
A 2024 study by Losada,Baltar and colleagues found that care partners who experience high emotional ambivalence are at greater risk for physical health issues, including elevated inflammatory markers linked to cardiovascular stress. These effects weren’t limited to caregivers facing severe behavioural symptoms. Even when dementia symptoms were mild, the emotional conflict alone had physiological consequences.
Ambivalence is not just a feeling. It’s a risk factor.
It’s not just what you carry. It’s how deeply it gets carried in you.
Five Ways to Stay Steady Inside the Chaos
This kind of caregiving doesn’t require you to be calm all the time or endlessly patient. It asks for something different: emotional steadiness. A way to stay tethered to yourself even when you feel overwhelmed, reactive, or painfully disconnected from the person you love.
Here are five ways to help regulate that emotional intensity while holding space for the truth of your experience.
1. Name What’s Real Without Trying to Make It Neat
You can love someone and feel suffocated. You can grieve their decline find yourself snappy or terse. These aren’t failures of character. They’re consequences of a relationship that’s reorganizing itself around unravelling and bewilderment.
You might say to yourself: “I can’t make this situation easy or tidy. But I can tell the truth about what it’s costing me.”
Naming ambivalence doesn’t erase it, but it may keep it from metastasizing into shame.
2. Respond Instead of Reacting, One Breath at a Time
High expressed emotion (EE), particularly criticism and overinvolvement, 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 - the relationship with yourself and your values, and with 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.”
That’s not indulgence. It’s 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. These feelings may relate to the person you care for, your daily experience, or your shifting sense of self. They do not need to be sanitized or minimized to be survivable. They need to be named, held, and met with care.
Feeling this way isn’t a sign of failure. The need for peace is human, not a weakness.
These feelings don’t make you broken. They reflect the depth of what you’re 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.
Losada-Baltar, A., Mausbach, B. T., Márquez-González, M., Romero-Moreno, R., von Känel, R., Jiménez-Gonzalo, L., Fernandes-Pires, J. A., Barrera-Caballero, S., Martín-María, N., Huertas-Domingo, C., & Olazarán, J. (2024). Longitudinal associations in dementia family caregivers of ambivalent feelings and disruptive behaviors with C-reactive protein, interleukin-6, and D-dimer. Health Psychology, 43(11), 833–841. https://doi.org/10.1037/hea0001352
Liu, X., Mo, W., Kanaya, R., Shigenobu, K., Takiue, K., Koujiya, E., Takeya, Y., & Yamakawa, M. (2025). Expressed emotion mediates the association between caregiver relationship closeness and psychological symptoms in people with dementia. Psychogeriatrics, 25, e70000. https://doi.org/10.1111/psyg.70000
À propos de Stellocare
Cet article est présenté par Stellocare, le répertoire de confiance des professionnel·le·s en santé mentale vérifié·e·s au Canada. Trouvez des thérapeutes, travailleuses sociales et psychologues autorisé·e·s qui répondent à nos normes rigoureuses.
Cet article a été rédigé par Penelope Waller Ulmer, un·e thérapeute vérifié·e de notre réseau. Découvrez son expertise et son approche ci-dessous.
