As Americans live longer, many baby boomers find themselves providing financial and emotional support to aging parents. Experts stress the importance of discussing living and end-of-life plans to navigate who will take care of mom and dad. Do parents eventually plan to move into assisted living or age in place? Is there enough money to pay for long-term care in an assisted living facility or nursing home? Siblings should also discuss expectations with each other.
[See: 10 Money Tips for Family Caregivers.]
Traditionally, caregiving has fallen to the eldest daughter, but with family members dispersed across different locations, not to mention women’s advancement in the workplace, once clear-cut answers have become hazy.
Pamela Atwood, director of dementia care services at Hebrew Health Care in West Hartford, Connecticut, says caregiving discussions can get heated “where one is local and the other is at a distance or different expectations if one works and one doesn’t or issues that can pop up with the original sibling stuff like who’s the favorite.”
And when parents need financial support from adult children, siblings with differing incomes and obligations can also clash over who should pay for different services.
“There is nothing to say that responsibilities have to be divided equally, but none of these considerations are necessarily a ‘get out of jail free’ card,” says Cynthia Saffir, owner and mediator with Elder Resolution Partners LLC in Los Angeles. “Just because a sibling doesn’t live in proximity to the parent or is physically unable to travel doesn’t mean that he or she can’t help out,” Saffir says. For instance, far-flung siblings can pitch in by calling regularly to check on a parent, paying bills online, hiring help or visiting regularly to relieve the local caregiver.
In theory, having lots of siblings should help lighten the load, but in practice, Saffir says even people with multiple brothers and sisters can feel like an only child if others don’t pitch in.
Here’s a look at strategies for divvying up caregiving duties among siblings.
Start talking early. The worst time to hash out caregiving arrangements is immediately after an emergency room visit. “You see family members in the corridor of the hospital trying to work out these issues,” Saffir says. Ideally, you’d discuss options when everyone is clear-minded and healthy, which means you can get your parents’ input, too.
If there’s a history of family tensions, consider using a mediator. Saffir says this “may save family relationships and even strengthen them in the long run.” As an elder care mediator, she often helps families work through these issues. “It is important for the family conversations to take place and issues to get resolved before it gets so bad that someone in the family takes the disputes to court,” she adds.
Once you have the conversation and come to an agreement who will do what, “write it down because not everybody’s going to remember everything,” Saffir adds.
If you’re counting on Medicaid coverage for your parents, consult an elder law attorney in the state where they will eventually live so an ill-timed asset transfer doesn’t disqualify them. “If they’re living in Florida and you’re planning to move them up to Connecticut, before you do any of those things you have to consult with an attorney who has expertise in Medicaid laws for the primary residence state,” Atwood says.
[See: 10 Things You Need to Know About Medicare.]
Match your parents’ needs and your siblings’ abilities. Make a list of what your parents need, such as rides to doctors’ appointments, help cooking and cleaning and assistance paying bills. Then, look at what family members are willing and able to provide. “Caregiving involves many jobs, and one should consider that those jobs are best done by those with the skills, experience and aptitudes,” says Rick Lauber, author of “The Successful Caregiver’s Guide.” Lauber suggests, “finding the best fit for people based on their strengths, their aptitudes and their willingness to do the job.”
Lauber served as co-caregiver to his parents along with his older and younger sisters. The siblings took turns flying in to care for their parents and eventually moved them closer. “I managed their banking for them, paid their monthly bills and I became an advocate for my father with his Alzheimer’s disease,” he explains.
The sibling who’s geographically closest to aging parents isn’t always the best candidate to help out. Sandra Beckwith lives in Rochester, New York, several hours away from her ailing mother in Utica, New York, and she has four siblings spread across the U.S. and one in Japan. One of her sisters lives 10 minutes away from the mother’s nursing home, but that sister’s main contribution has been meeting her mother at the emergency room after she has taken a fall.
Meanwhile, Beckwith handles things like getting her mother’s house ready to sell, applying for Medicaid for her mother and paying her bills, and another sister in Denver takes responsibility for getting doctor’s reports on her mother’s health. “You would think normally that most of the burden would fall on the person who is geographically closest, but it was clear from the get-go that I was the default choice for this [due to my and my siblings’ skill sets],” Beckwith says.
Seek outside help if needed. If you and your siblings can’t provide all the help your parents need, evaluate other options. Tap into volunteer networks, hospital day programs and senior center programs to bridge the gap between the resources they have and what they need. Long-distance caregivers or others who don’t have the time or ability to help might also look into hiring a care manager “who has an ongoing relationship with that family to step in if there’s a medical crisis,” Atwood says. For instance, a care manager could meet the family at the emergency room, since travel time may take several hours or more for relatives who live don’t live nearby. A geriatric care manager, who can assess the situation and serve as your proxy, is another option. Atwood has also seen long-distance relatives hire a driver to transport relatives to doctor visits.
[See: 14 Ways to Protect Seniors From Falls.]
Don’t rely on email. It’s tempting to relay updates on your parents’ health or living situation over email so you’re not repeating yourself to several relatives, but that isn’t necessarily the best mode of communication. Caregiving is inherently stressful, and because emails lack voice inflection and body language, it’s easy for tempers to flare over misinterpreted messages. “If you can have face-to-face conversations or skype conversations or even just a conference call, you can get a better sense of what’s going on,” Saffir says. “You have to expect that your siblings are going to have different opinions, but the important thing is finding solutions that everybody can live with.”
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Dividing the Caregiving Responsibilities Between Siblings originally appeared on usnews.com
