Dear Carol: My never-married aunt was like a second mom to me. She’s always been abrupt and forceful but still able to show love and kindness. Unfortunately, since her health has deteriorated due to pain from osteoarthritis and fatigue caused by lung disease, she’s become critical and sometimes downright nasty.

She’s in assisted living and she can be unpleasant to them sometimes, too, but I think she tries harder with them. She acts as though my physically distanced visits are useless and these latest changes due to COVID-19 are my fault. I manage her care and try to do nice things for her, but instead of being appreciative, she’s mean. I do love her, but am I childish to want some thanks for interrupting my life several times a week to run her errands and visit? — LY.

Dear LY: You are normal to want some thanks or at least some pleasantness in return for what you are trying to do. However, providing this feedback may be beyond your aunt’s current capacity, so you’ll have to choose whether or not you are able to continue on with delivering this type of care. Before you decide, consider a few things.

People have trouble showing appreciation for many reasons, but usually, it’s because of their own mental or physical health. Your aunt is likely in significant pain.

Additionally, severe fatigue can contribute to people being more self-centered. Then, there is mental illness such as depression to consider, as well as general mental exhaustion due to coping with unrelenting pain. Losing control of personal choices is hard as well, and that’s likely what she sees when she considers the life she has left.

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You mentioned the changes due to COVID-19. Your aunt can’t have you as physically close as you once were, which could explain part of her frustration. She knows this isn’t your fault but she’s angry about it. Additionally, there have been changes in activities, meals and social interactions within the assisted living facility that affect her.

I’m not giving your aunt a fee pass for rudeness and the inability to show gratitude for your caring presence. Maybe she is capable of trying harder. However, I think you’ll find that if you stretch yourself to understand her reality, you can appreciate that she trusts you enough to be genuine with you and that trust is an honor.

As with so many aspects of life, we rarely can change how others act, but we can change how we respond to them. If/when your aunt is truly abusive, it’s time to hang up the phone or temporarily leave her presence. Take breaks from visiting when you need to focus on your own needs.

However, if your hurt feelings stem from the fact that she’s not expressing gratitude, then your ability to better understand her pain may be enough to enable you to take a different view. You can still feel good about what you do for her even if she doesn't show appreciation for your efforts.

ARCHIVE: Read more of Carol Bradley Bursack's Minding Our Elders columns

Carol Bradley Bursack is a veteran caregiver and an established columnist. She is also a blogger, and the author of “Minding Our Elders: Caregivers Share Their Personal Stories.” Bradley Bursack hosts a website supporting caregivers and elders at She can be reached through the contact form on her website.