Dear Bel,

I’m in my late fifties and have cared alone for my father (in his nineties) for the past five years. There is little left of the person that I once was — creative, intelligent, with a life and friends. When I moved into my father’s house I left behind my friends, home and freedom and lost my partner because he couldn’t cope with my being a carer. I don’t drive (medical reasons) and this house is rural, with no bus services. I feel very isolated, and although, twice a day, care workers come in to wash and dress him, these kind people know me only as the “dutiful daughter”, and our conversation is invariably about my father. The few friends that I’ve kept from before tell me how wonderfully I’m doing, but they don’t understand that I feel as if, in Yeats’s words, “Too long a sacrifice/ Can make a stone of the heart.”

I am childless and an only child, so there is no one else to take on this duty. I used to get on well with my father, but being in an inverted-parental role has eroded much of our old friendliness. I have had some counselling in the past, but advice such as “look after yourself and consider your own needs” didn’t help, since there was no suggestion as to how I could address the one real need I have — to be free of this undertaking and to rebuild my own life.

My father is becoming incontinent, which tips me over the edge. I have schooled myself to cope with emptying commodes, but more than that and something in me snaps. Although the care workers will clean him up, if he gets dirty when they are not due, the agency will not send anyone to help, nor will social services. As neither I nor my father want me to clean him up, the only alternative is to leave him in his own mess until the next carer is due. Recently I told him I cannot go on like this. He said: “But you have your whole life ahead of you!” Besides his deafness, my father has the selfishness of the very old, and is genuinely unaware of the reality of those around him. He told me that if I put him in a home, it would be “the end of him”, and pleaded with me not to do so. He is not communicative nor emotional, so this counted as an outburst.

I feel terrible at the thought of turning him out of his own home, and guilty and sad at the thought of giving up on him — but I don’t know what else to do. Recently I went to look around a nearby home, which was very pleasant — clean, warm and welcoming. I want to persuade my father at least to visit it, but I don’t know how to convince him that I’ve almost come to the end of my tether, and desperately need my own life back. As I don’t really feel justified in sending him to a home at all, I find it very hard to be as assertive as I must be to persuade him. It seems easier just to carry on as I have been doing, giving him the best care possible in his own home until he dies. But by then I shall be facing old age myself. Please help me to see that I have a right to my life, too. Hilary

Surely no one could read your letter without answering, from the depths of sympathy and sorrow, that of course you have a right to your own life, and you should not feel terrible — no, not at all. It is your situation that is terrible, and I’m sure that many readers will identify. You have been a truly wonderful, caring, selfless daughter, and when you go secretly to inspect residential homes, you are still being such a daughter. There is no betrayal in trying to find a way through, no need for you to feel guilty for seeking a solution that will be best for you and your father. But of course sadness is inextricably woven into the warp and weft of this situation.

The truth is, were your father to agree to live in the residential home that you chose he might find the quality of his life improved. It must be intolerable for him to have these “accidents”, his dignity afflicted equally by the prospect of his own daughter cleaning him up and by having to remain soiled. If the accidents increase, the situation cannot be allowed to continue, for his sake as much as yours, for after all this is an old man who has not lost his awareness of what is happening. Who can help you to talk to him? I’m wondering if he has a doctor he trusts whom you could get on side.

What if you were to have a breakdown? I would have thought that a GP is ideally placed to assess the prospects for your health as well as the best course of action for your father’s welfare.

One of the reasons I decided to return so soon to the issue of parents was because of all the letters I had disagreeing with my advice to Lorraine (“I’m sick of being nice to my nasty elderly parents”, February 21). Since I began this column I’ve never had so many eloquent missives telling me I was wrong. You may recall that I suggested that Lorraine should go on trying with her parents; many readers in her situation said she should rejoice at being spared any more abuse from the nasty pair and just “walk away”. This gave me much to think about, and I’m grateful to all those who wrote from the depths of their own experience. No doubt they would also be quick to point out that your situation is very different: you used to get on with your father, whereas Lorraine’s parents have always been unpleasant. But all things considered, the difficulties of coping with parents, the conflicting demands of duty versus self (and so on) are perhaps not discussed enough.

Michael Bacon summed up the dilemma when he wrote: “Improved medical care, which allows many to live for far longer than in the past, has created an iceberg of a problem, the tip of which has just begun to be noticed. What can be done for the elderly per se? Please can we have suggestions for improving the social system which will serve the elderly (both problem parents and otherwise) in the 21st century.”

And Pat Brayshaw’s take on Lorraine’s problem is entirely relevant to you. Writing about her “nasty” and “manipulative” mother who died last autumn, aged 92, she says: “I visited every day and twice on Sundays. She would NOT have carers, though she could easily have afforded it. The social worker said that she was within her ‘human rights’ to refuse. I said, What about mine? But it did no good. (At the time I was looking after her and working full-time to pay my mortgage.) When she died all I felt — and still feel — was relief. Even now I feel very tired indeed. I did my duty but I do not expect my sons to do the same for me and have told them so. I hope I will know when the time comes to sell up and go into a home — though I will miss my garden.”

But that little word hope carries within it so many complications. For in 20 years’ time Pat may not feel as she does now; she may cling to her home as Hilary’s father does. None of us can know whether we will expect/require one of our children to be a carer. This is a deeply complex issue and not one I can easily address. My advice to you is to talk seriously to your doctor, and do everything you can to persuade your father to go to see the home you have found — or (a better idea?) one nearer to wherever you had your network of friends. I know perfectly well how hard this will be. But given that his condition will certainly deteriorate, the only alternative would be a full-time nurse, which you cannot afford.

The first thing you must do is release yourself from any feeling that you are being “terrible”. It might be helpful to plug into the huge network of carers through sites such as www.carers.org, and www.carersonline.org.uk — because (apart from anything else) the forums and message boards may help to alleviate your isolation. To preserve both your own sanity, your father’s dignity and what was good in your old relationship you should give yourself permission to move on to the next step, painful though it will be.

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