The complexities of navigating care for aging parents is a central theme in the memoir because it centers on Chast’s experiences in ensuring that her parents received proper care during their final years, highlighting the conflicts and challenges that arise. Summarizing the conflict at the heart of the memoir is this sentence: “I wasn’t great as a caretaker, and they weren’t great at being taken care of” (23).

Chast reflects on her shortcomings as a caregiver as her parents’ health declined, her father’s because of dementia, and her mother’s as a result of physical ailments. She ironically notes, “any Florence Nightingale-type visions I ever had of myself—an unselfish, patient, sweet, caring child who happily tended to her parents in their old age—were destroyed within an hour or so” (75). Her father’s incessant questions about his bankbooks and general anxieties, even about food, frustrated her. In addition, like many people, her parents initially resisted becoming dependent, vehemently claiming that they didn’t need help. After her father’s death, Chast struggled even more with her mother, with whom she had a strained relationship. Elizabeth required constant care, entering a limbo state between life and death, symbolized by the chrysalis.