When siblings share the caregiving for an aging parent, will it be welfare or warfare?
“It shouldn’t have to be this hard,” said Kelly, a 55-year-old woman caring for her 89-year-old father with Parkinson’s disease. “After all, my sister and I both love my father. Why can’t we agree on things?” Kelly wanted to respect her father’s wishes to remain in his home, where he felt comfortable. But as his health declined, Kelly’s father was no longer safe living alone. So Kelly hired a paid caregiver to help with meals, errands, light housekeeping and generally to make sure her dad was OK.
But when Kelly shared the plan with her sister Fran, things didn’t go well. Instead of expressing appreciation, Fran was furious. She’d been pleading with their father to move to assisted living and felt adamant that Kelly’s plan would, in the long run, make things worse.
Caring for aging parents is a journey many of us will take in our lives. Some will plan ahead, while others will unexpectedly become caregivers and learn as they go. Many will encounter common challenges: parents who need but refuse help, a fragmented health care system, the staggering cost of care and the daunting task of somehow finding time to juggle it all. But of all the difficulties family caregivers face, one of the biggest sources of stress is trying to get on the same page with our siblings.
Kelly and Fran’s experience is not unusual. Sibling conflicts that simmer for years can suddenly erupt during an elder care crisis. While many siblings experience increased closeness caring for their parents, others grow apart. A survey commissioned by the Alzheimer’s Association revealed that 61 percent of siblings felt they didn’t get the support they needed from their brothers and sisters and it strained their relationship.
And when it comes to caregiving, there’s plenty to fight about. These are just a few of the issues that can lead to all-out battles:
Round 1: Perception of need
A common area of conflict between siblings is the different perceptions of a parent’s needs and how best to approach care. While Kelly believed her father could manage at home with help, Fran wanted Dad to move to assisted living. Guilt can also be a driver in decision making, especially for the sibling who isn’t around as much and feels the need to step in. Getting professional guidance can help to minimize conflicts and provide families with realistic solutions. For example, care managers (also known as Aging Life Care Professionals) are trained to conduct a thorough assessment of the elder’s situation and identify appropriate resources, involving both the senior and adult children in the process.
Round 2: Sharing the caregiving
Unfortunately, the burden of caregiving is seldom divided up equally among siblings. More often, an adult daughter is saddled with the lion’s share of responsibility, assuming the role of primary caregiver. According to a report by the National Alliance for Caregiving and AARP, the average family caregiver is a 49-year-old woman who spends twenty hours a week caring for a parent. When you add siblings who don’t pitch in or show appreciation, it’s a fertile ground for resentment. Studies show that caregivers who feel unappreciated tend to have less collaborative and more problematic relationships with their siblings. But stewing in your juices usually just makes things worse. Learn to ask for specific help and divide up tasks according to a sibling’s skill set and availability. If all else fails, lean on other family members or hire paid caregivers to pitch in.
Round 3: Money
When siblings fight over money, they can lose sight of what is in the best interest of their parents. In some cases, adult children dip into their own pockets to pay for care-related expenses, adding to the overall financial stress. In fact, a recent AARP report estimates that family caregivers spend roughly $7,000 annually to help fund expenses related to care for their parents and loved ones.
Fights around money can also involve inheritance, which can get ugly if siblings are not on the same page. If disagreements become entrenched, it may be worth reaching out for expert help.
Financial planners, elder law attorneys and professional mediators can provide objective advice and information about costs associated with long term care and how best to plan ahead. They can also help bring family members together — including the parents — to come up with a course of action that takes the siblings perspectives into account, while respecting the elder’s wishes.
The final round: End of life care
All the forces that pull us apart and hold us together can come roaring to the surface as families face difficult decisions regarding end of life care. Death is one of those topics people assiduously avoid, often to their own detriment. Planning ahead can avoid the risk of intractable conflicts that may linger for years — even generations — after the death of a parent. Does the parent have an advanced directive, such as a health care proxy or living will? Do the adult children understand what life-saving measures a parent wants or doesn’t want to be kept alive?
These can be incredibly stressful discussions. Fortunately, caregivers today have a range of resources available — for instance, websites like The Conversation Project help guide family caregivers through the decision-making process. Siblings can review key questions ahead of time and decide how best to approach the conversation with their parents. Understanding an elder’s wishes can go a long way in helping siblings come together, rather than fall apart, when making decisions about end of life care.
Despite all the challenges, the rewards of having siblings to share in this life journey can be numerous. I was fortunate that my brother, sister and I took a divide-and-conquer approach to caring for my father with dementia for 12 long years. We supported our mother, figured out finances, found the best care providers — including two nursing homes — and even managed to laugh and enjoy time together as best we could. The most enduring relationships in life are often with our brothers and sisters: Our shared memories, both the good and bad, have the power to transcend our differences. While there may be quarrels and conflicts, there are also healthy and healing ways to work through disagreements and help our parents age with dignity, compassion and love.
This article originally appeared on Forbes.com.