When aging parents require more help, their children naturally come together and assume the mantle of caregivers. But that rosy picture of family unity is often more idealistic than realistic.
Denise M. Brown, author of “The Caregiving Guide” and founder of CaringOurWay.com, expected her siblings to help care for their elderly parents, but one sister preferred to remain uninvolved. Her decision to opt out added a number of wrinkles for Brown and her other siblings — not least of which was that this sister lived five minutes from their parents and was ideally located to render aid.
The solution: The siblings who wanted to be involved communicated often and adapted to an evolving situation.
“The key is to be flexible,” Brown explains. “It’s helpful to stay in the reality of the situation.”
Here, experts share 10 tips for how best to work with your siblings to provide supportive care for your elderly parents.
1. Understand Issues Could Arise
Relationships can be sticky, and family dynamics can dredge up old hurts and traumas.
“It all just gets thrust in your face right at the time when parents need care,” says Joy Loverde, Chicago-based author of “The Complete Eldercare Planner, 4th Edition” and founder of elderindustry.com.
Each sibling has their own relationship with their parents that can be shaped by gender, birth order and history. Often, daughters and oldest siblings take control of the situation.
“There tends to be someone who becomes the automatic project manager, and that person starts to stand guard and acts as the gatekeeper,” Loverde explains.
Getting everyone to accept their role in the situation, however, isn’t always easy.
“Siblings may not agree collectively on who should be the primary decision-maker, which could cause issues regarding who has the authority to make decisions for their parents,” says Nicole Brackett, director of quality and care delivery with Homewatch Caregivers, a personal care service company headquartered in Greenwood Village, Colorado.
Communication and even a third-party mediator (more on that below) can help ease some of the tension from conflicts. And try not let yourself get pulled back into long-standing — and sometimes counterproductive — childhood roles.
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2. Engage in Ongoing Communication
Developing a workable communication strategy, whether it’s a group text thread or a conference call, can keep everyone up-to-date on their parents’ care.
“During the last few years of my parents’ life, I would set up a conference call between me and my siblings that worked well. That way, everybody heard what was happening at the same time and there was no way to misinterpret,” Brown says.
To keep meetings productive, Roger Miller, a licensed clinical psychologist and neuropsychology team lead with Aviv Clinics in The Villages, Florida, suggests:
— Setting an agenda
— Focusing on the present
— Sharing all relevant information
— Avoiding unrelated issues
— Listening to and respecting everyone’s opinions
— Giving everyone time to speak
— Including the parent in the decision-making process
“Siblings really need to dig deeper and communicate what we want rather than have our sibling take a guess at it,” Loverde adds.
For example, if one sibling feels like they’re shouldering most of the burden, they should let the others know and ask for help. If another sibling wants to be more involved, they need to tell the lead sibling.
“Do not suffer in silence,” Loverde advises.
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3. Plan Ahead
The more information you have at the ready, the more assured you can be that you’re making the best choice for your parents’ care.
You should:
— Gather your parent’s health information, including advance directives
— Determine who the appointed decision-makers will be for your parent’s financial information and related affairs
“Have discussions frequently, and include everyone in the family,” adds Jenny Munro, a gerontologist and response team manager at Home Instead, an Honor Company headquartered in Omaha, Nebraska.
She recommends discussing:
— What are your parents’ wishes?
— Where will your parents live?
— What is your parents’ financial situation?
— Which sibling will take the lead in managing care?
— What role(s) will other siblings play?
— What happens if one parent is diagnosed with dementia, Parkinson’s disease or cancer?
“The more conversations families can have, the better prepared they will be. The last thing a family wants to do is have discussions like this in a crisis situation. Make the time. You will always be grateful you did,” Munro advises.
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4. Give Each Other Grace
Accepting that an elderly parent is nearing the end of their life is difficult for anyone, and some siblings may find it more challenging. Be compassionate and patient with them.
“Everybody accepts the reality of the situation on their own timeline,” Brown says. “My siblings who remained involved sometimes were a little slower to adjust to the reality.”
Her younger sister, in particular, struggled to come to terms with what was happening.
“I gave her space to adjust at her own timeline, her own process,” Brown recalls, adding that she continued planning for the future in the meantime.
Loverde says that thinking of your sibling group as a team can help.
“It’s about working together. When we communicate with each other, the idea is not to necessarily agree, but to align with each other. Be a team, and work cohesively as a team would,” she suggests.
5. Play to Your Strengths
Each sibling has their own life experiences and skill sets.
“It’s important to look at the strengths that each sibling brings and then use that, knowing that your strengths are going to be different from your siblings’ strengths,” Brown says.
For example, if one sibling has a caregiving background or is a nurse, they might be best suited to handle the medical proxy role. Another sibling who has more experience or knowledge of finances or legal elements might be best suited to serve as power of attorney.
One sibling might also have more time or flexibility to take your parents to appointments, while another might have more money to contribute. Some may make a better companion who can feed your parent’s psychosocial needs. Another might be a great liaison between the siblings and a senior care facility.
“One person might be happy just doing yard work but not providing meals or driving their mom to the doctor, so accept what they are capable and willing to do,” Brackett adds.
In short, each element can help. Playing to your strengths will enable everyone to feel more involved with getting the best care for your parents.
6. Preserve the Sibling Relationship
The dynamics of your interpersonal relationships can also be useful — or challenging — in caring for elderly parents.
For example, Brown says one of her siblings was less able to offer concrete assistance but was a wonderful companion who became a trusted sounding board.
“If I needed a complete break from caregiving and its stresses, she was the one I’d call,” Brown recalls.
That sibling’s proximity to the situation meant she was fully informed and able to offer empathy and support without trying to alter the plan.
Brown’s sibling was also a great comfort to her parents, sitting with them for hours so they wouldn’t be alone. There are many different ways of loving and supporting your family members, and for some, that means simply showing up.
7. Get Outside Support
Tapping your network of friends as well as any resources in the community, such as your local Area Agency on Aging, a geriatric care manager or a social worker at a senior center, can be critical.
“The whole world of senior care is very unclear and confusing to the average person,” points out Charmaine Conaghan, owner and executive director of Always Best Care of Glenview and the North Shore in Glenview, Illinois. “Most people know nothing about any of it until they need to know everything all at once, and it gets overwhelming and emotional.”
And don’t overlook other family members, Munro adds. Perhaps older grandchildren can help with certain tasks, such as offering companionship or helping maintain the home and yard.
“It takes a village, and everyone needs to be open and honest on what they can and can’t do,” she says.
8. Manage Emotions Carefully
Often, the more siblings in your family, the more challenging coordinating care can be.
“You’ll have differing personalities and reactions to what’s happening, different opinions on what should be done and different knowledge of what the options are,” Conaghan says.
The emotions of facing the death of a parent can also make every decision feel more fraught and difficult.
“When emotions are spiked and you’re dealing with your siblings, childhood triggers come out. We see that a lot with large families,” Conaghan adds.
Finances can be one of those flashpoints, with some siblings wanting only to secure their own interests.
“Money is the greatest reason why families break up over parent care,” Conaghan says. “It’s taboo to talk about money, but you’ve got to talk about money and who’s going to pay for long-term care.”
In other cases, differing opinions on the best course of action can lead to a meltdown in communication between siblings. In those situations, the best option may be to see the assistance of an outside arbitrator.
9. Get Professional Help
If you hit an impasse — like the situation described above — get outside help.
“Having a neutral third-party who can listen and advise without the history of emotions that siblings share can be very helpful when making big decisions about where a parent should live or what type of care is best,” Brackett explains. “There are professional mediators and care managers who understand the language of geriatric care and know the local resources.”
Options for professional help include:
— American Association for Marriage and Family Therapy
— American Counseling Association
— Employee assistance programs with an elder care benefit
— Staff at nearby assisted living communities
— An elder care attorney
10. Focus on Right Now
Lastly, it’s important to recognize that most of us are doing our best with the information we have at the time. Caring for an elderly parent is a fluid situation, and it can lead to lots of self-doubt and worry about whether you’re making the right decision. Try focusing on “right now.”
“Right now, you’ve made the best decision that you can. The next right now you can change it,” Brown explains.
It’s also worth noting that not all families experience challenges, so there’s reason to hope you’ll be able to avoid the worst of such situations. Even in very large families, sometimes the pieces fall into place and all the siblings pitch in with their strengths in a meaningful way.
“It is possible for everyone to treat each other with respect and understand that everyone has the best interests of Mom and Dad in mind,” Conaghan says.
Look for that more positive aspect, and work to trust and respect each other.
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How Siblings Can Coordinate Care for Elderly Parents originally appeared on usnews.com
Update 07/23/24: This story was previously published at an earlier date and has been updated with new information.
