When you’re the adult child of a heart patient

by Carolyn Thomas    @HeartSisters

My Dad died of cancer at age 62, my mother decades later from a stroke following years of increasing dementia. So I have some experience being the adult daughter of a parent diagnosed with a life-altering medical condition.  And I’ve also seen the faces of my own grown children right after they flew home to be with me right after my heart attack.  Honestly, I don’t know which felt worse.

The majority of heart patients in North America have adult children.  And when heart disease strikes, it can affect not only the patient, but the immediate family of that patient.  If one of your parents has a cardiac event, as psychologist Dr. Wayne Sotile warns, you might have the makings of what he calls “the best hidden victims of heart illness: the patient’s adult children”.  In his highly-recommended book call Heart Illness and Intimacy: How Caring Relationships Aid Recovery, Dr. Sotile offers wise counsel to both sides:

  • to the adult children of freshly-diagnosed heart patients (who must now cope with this in-your-face reminder of a  parent’s mortality)
  • to the patients themselves on how to help all of their family members (and themselves) adapt to their diagnosis

Dr. Sotile also advises that regardless of the ages of one’s children or of the parents, highly stressful times (either during serious illness or just day-to-day life) carry with them the risk of what social scientists call “triangulation patterns” of behaviour.

Triangulation happens when mounting anxiety and tension in a relationship cause us to focus on a third party instead of on the source of the tension itself. It’s common in all human relationships, and not just in families coping with illness:  the greater the tension, the more we want to draw other people into the mess.

How might this look in families coping with a heart illness?

An adult child might support the parent who is the most vocal about being mistreated or misunderstood by the other parent.

Or the adult child might side with the spouse of the heart patient parent by trying to soothe that parent’s anxieties and fears about the impact of this diagnosis on the marriage and their life together. In either case, warns Dr. Sotile, the adult child may develop closeness with one parent at the expense of closeness with the other.

Here are some problems with triangulation:

  • interferes with the person’s ability to resolve differences
  • puts family members into marked physical and psychological alarm due to conflicting loyalties between two parents
  • can draw grown children so far into parents’ problems that their own lives suffer
  • interferes with rehabilitation from illness
  • may include several generations of children, grandchildren and other family members

This is even more complicated in couples already having marital problems before one of them was diagnosed with a serious heart issue.  As Dr. Sotile writes:

“If a heart patient is having marital problems, tensions can increase the odds that one of more of your children will become involved in the drama.”

He also adds a truism that’s too often ignored:

“The drama will continue forever.”

We sometimes see examples of heart patient couples – particularly older patients – in which the heart patient appears to be less concerned about the diagnosis than the spouse does. The over-responsible spouse thus becomes the de facto cop in a relationship with an under-responsible patient/spouse: Take these pills! Quit smoking!  Eat this!  Don’t eat that!  Hurry up so we’re not late for your doctor’s appointment!  What do you mean you don’t want to go to cardiac rehab?!

Here’s Dr. Sotile’s suggested sample conversation, for example, in order to maintain a non-judgmental, non-reactive position if responding to a parent who complains about the “non-compliant” heart patient/parent:

“You know, Mom, it’s uncomfortable for me when you talk with me about Dad that way. I know you’re worried, and I do want you to feel better. But I love both of you, and I don’t know how to solve your problems.

“When I come to visit, I like it best when you and I talk about you and about what’s going on in my life. When I’m with Dad, I like to talk about him and about me. I don’t like to gossip about either of you to the other.

“So why don’t we talk about ______?”

Sometimes, says Dr. Sotile, the adult child can even feel like they’re becoming a counsellor to both parents if each of them (the heart patient and the spouse) turns to one or more of the grown offspring rather than to each other for support and encouragement. 

Even well-intentioned Big Kids may be tempted to offer “parental” advice on how to deal with the problems affecting their parents.

If you have a parent who is a heart patient living alone, you may feel a unique responsibility to respond in a very specific way to help out.  Some grown children like this may have become the primary emotional (and even physical) caretakers of such parents even before a cardiac diagnosis hits. These Big Kids can also become caught in a web of family stress during that in-between sandwich stage of life that involves attempting to fulfill their own career and family obligations while at the same time trying to remain loyal to one’s parent.

It’s also important to remember, adds Dr. Sotile, that for some grown children, stepping up to help out after a parent’s cardiac event does not necessarily come naturally:

“The unfortunate truth is that many adult children do not choose to be lovingly connected with aging parents; they feel compelled to do so out of some deep sense of guilt or concern.  These uncomfortable feelings often fuel poor choice-making for grown children.”

Dr. Sotile has this advice for you:

  • try to stay out of multi-generational emotional triangles
  • speak openly and lovingly to your parent about your need to balance your energies among all your family members
  • accept that you cannot be the perfect son or daughter even if your parents have difficulty believing it
  • be loving
  • be available
  • be clear that your primary energies must be directed to living your own life

But his most helpful wisdom, in my opinion, was this reality check:

“No family fulfills all the glowing descriptions of healthy functioning, and no family is all bad. A steady state of perfection is never attained or maintained in family teams. Remember that ‘normal’ health families are those that continue to grow and change together.”.

Q:  How has a parent’s heart disease diagnosis affected your own life? 

NOTE FROM CAROLYN:   I wrote much more about adjusting to your new diagnosis in my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).

See also:

Living with heart disease – and your whole family

When the ‘wrong’ family member gets heart disease

Is family stress hurting your heart?

When you have a family history of heart disease

The new country called Heart Disease

A wife’s heart disease teaches her husband a big lesson


4 thoughts on “When you’re the adult child of a heart patient

  1. Carolyn,

    I had my SCAD (Spontaneous Coronary Artery Dissection) almost 3 years ago. A number of months after, it was holiday time. Things are definitely heightened at the holidays anyway but our family had one of those “knock down, drag out” family arguments, something we’d NEVER had before. So many feelings were hurt, issues were probably not handled the way they should have been, and things haven’t been the same since.

    Things have gotten better among some of the involved but I’m not sure what it’s going to take for everything to be totally healed. It still saddens me but I’m trying to be impartial, taking care of myself as much as I can and not taking sides.

    Until reading your most recent posting, I’d never put it all together as I really think a lot of it was brewing had I not even had my event.

    Thanks for discussing…

    Liked by 1 person

    1. Thanks for telling us about what must have been a very distressing event, Deb. I sure hope you and your family continue to find ways to heal – and as Dr. Sotile says: “grow and change together”.


  2. Thank you for this article dear Carolyn. I was thinking about the same these days. Of course, no worse thing there for a mother to see her kids’ faces when they are suffering, especially when the reason is her health, not theirs.

    I feel so compassionate about your feelings, as I have similar experience with my parents who also died young and suddenly. No words in the world exist to describe what you feel as a child, an adult child, but still a little baby in mommy’s hands…

    Also, in the last few months I realized one more thing. The situation when a parent is struggling with a serious disease is painful not only for the children. It is a complete disaster for the husband, too. Men naturally tend to keep their emotions/feelings to themselves. And when they cannot do this their usual way — they “detonate” with awful reactions, strange behavior and become helpless more than a little child. More than you struggling with a disease, actually.

    When the problem with my heart was revealed, it was my hubby who needed compassion, help, talk, support. He cried, yelled, was lightheaded, nauseous, dizzy etc. And now, even when he restored his self control, I will think twice before showing him my test results.

    Liked by 1 person

    1. You are so right – a diagnosis of heart disease can affect everybody in the immediate family: children, spouse, parents – everybody! I recommend that you try to get a copy of Dr. Sotile’s book “Heart Illness and Intimacy” (I believe it’s out of print now but you can still find it online or in your local used book shop).


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