There’s an old saying that “one mother can raise many children, but many children cannot care for one mother.” An oversimplification, certainly, but all too often true. Learning to cooperate as siblings to care for your aging parent can be as big a challenge as managing your parent’s specific needs for medical and personal care.
As a geriatric care manager, I’ve seen families cope heroically with aging parents and families fracture under the stress. Here are the key issues that often arise and some coping strategies to help your family pull together, rather than apart, as you care for your loved one.
Conflict 1: Unresolved Sibling Rivalry
Just because you’re all adults doesn’t mean you’ve left behind your views and feelings about your childhood and family dynamics. Especially when faced with a crisis of caregiving—deciding who’s in charge, determining how to provide personal care, agreeing when and how to proceed aggressively with treatment or to let go—siblings often act out their old roles and rivalries.
When such conflicts arise, it’s often useful for an outside consultant, such as a care manager or family therapist, to point out when such views and “old history” are impeding your ability to work together. In families with a history of serious child abuse or neglect by the parent, it may be impossible and even inappropriate for you or your siblings to provide caregiving, and you need to bring in outside resources.
Conflict 2: Geographic Separation
In our highly mobile society, families are often spread out, far from home. There are two common scenarios: Either no adult children live nearby, so there’s no one readily available to visit and assess your parent’s situation, or only one sibling is “local,” which sets up a host of potential conflicts about who bears the burden of direct care and who’s on-call for emergencies.
In the first scenario, you and your siblings may need to find a way to talk together about the situation and options. You can meet in person, on a conference call or by e-mail correspondence. One or more of you may need to visit your parent to assess the situation first-hand. If none can do so, you may hire a local consultant who can make an assessment and provide information about available resources; you’ll need to discuss how to share these costs among yourselves if your parent does not have means to pay for a consultant.
In the second scenario, if you are the local sibling, you often bear the responsibility of direct care. This may be an active, personal choice or a burden, and can become a flash point if your distant sibling flies home for a visit and criticizes the care you’re providing or how you’re managing your parent’s medical needs. Sometimes this advice may be helpful and worth hearing, and other times it may be intrusive, but it’s often your sibling’s way to feel like she’s doing something to help. Resentment can build when the distant sibling takes off and you’re left to do all the work.
Geographically distant siblings can provide valued assistance by regularly scheduling visits to provide respite, handling some tasks that can be done at a distance (e.g., financial management, insurance paperwork, research into services), paying for services that can ease your tasks, and, perhaps most importantly, providing a supportive ear and appreciation for all the work you’re doing.
Conflict 3: Who Pays for What
Caregiving takes a financial, physical and emotional toll on your family. Needed services are expensive, and if you are the caregiver, you may lose time at work and income. If your parent has limited resources or is unwilling to spend for needed services, you and your siblings may need to determine how to purchase care.
If you are caring for your parents at the expense of your own employment, your siblings may want to consider compensating you for your time. This can create real challenges if you and your siblings are not on equal financial footing. Who’s going to pay for what and how? If one sibling provides most of the funding, does that give her most of the decision-making power?
An alternative that may be appropriate and useful from an estate planning perspective is for your parent to pay you for your hours of caregiving. If this is the way your family agrees to proceed, you should seek legal advice about how to draw up a contract, how you as the caregiver should handle the income, and how your other siblings are affected by this arrangement.
Money can also be an issue if your parents have a significant estate and everyone is concerned about how best to preserve assets—both to purchase care and to leave an inheritance. Again, it’s often best for your family to seek legal advice about these matters.
To Minimize Conflict, Plan Before a Crisis Hits
When you and your siblings talk about aging with your parents before there is a crisis, many of the above problems can be addressed and avoided. It’s important that your parents decide, while able, which of you should handle their legal, financial and medical affairs. It also helps if your parents share this information with all you and explain their choices if asked.
No Matter What, Keep Talking
It’s impossible to overstate the importance of open and constant communication. With today’s technology, there are so many ways to stay in touch. I have found e-mail to be tremendously helpful with both my own family crises and those of my clients. Everyone can be “on the same page” almost instantly and can hear each other’s responses and concerns.
Face to face meetings are usually very helpful, if you all can agree to communicate respectfully. Everyone should be free to express opinions and concerns and feel heard by the others. If family dynamics are challenging, it’s often helpful to include a professional care manager, family therapist or mediator to foster respectful and productive dialogue.
Even if You’re Not Close By, Share the Load
As mentioned earlier, even if you and your siblings live far apart from each other and your elderly parent, each of you can take on a task appropriate to your ability and location. If a sibling is unwilling to participate, however, there is a risk of permanent estrangement.
The shared crisis of caregiving can bring out the best in every family member and bring all of you closer together. It’s an opportunity for brothers and sisters to get to know each other as adults and form new relationships. The work is well worth the effort for both your elderly parent, who benefits from care and love, and you and your siblings, who benefit from the process.
President of Deborah Fins Associates, PC, since 1995, Deborah Liss Fins is a licensed independent clinical social worker and certified geriatric care manager. Drawing on more than 30 years of professional experience in geriatric care management, DFA offers comprehensive assessments and planning, guidance in selecting appropriate care, help identifying resources for financial support and professional consulting. Please contact us to set up a complimentary initial telephone consultation.