Siblings and Caregiving

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Old wounds and rivalries can come into play, making compromise about care decisions challenging

The doctor has informed you that your mother can no longer live independently. You feel that assisted living would be the best solution but your sister strongly disagrees. It seemed that at one time you were able to communicate with her, but not any longer . . . .

Ideally, providing care for an elderly parent would be a time of family unity and mutual support among siblings. Although this might be the case for some adult siblings, for many others, eldercare brings about painful conflict, and is an issue that our Family Consultants at FCA deal with frequently.

Discord among siblings can have devastating effects on family relations as well as cause unneeded strain on caregivers. In a study of women caring for parents with de-mentia, siblings were cited as the most important source of interpersonal stress (J. Jill Suitor of Louisiana State University and Karl Pillemer of Cornell University, 1994).

Although each family is unique, there are common underlying causes that can lead to friction between adult children. Often, the first close interactions that siblings have had since childhood are brought about through eldercare.

Old wounds and past rivalries will undoubtedly come into play during this time, making compromise about care decisions especially challenging. It is not uncommon for adult children to regress to childhood roles, where suddenly siblings are competing for mom's affection or tallying up how many chores each has completed.

Elderly parents can unintentionally contribute to this regression by favoring one sibling over the other; many times focusing their attention on the child who is actually the least involved in their care. Often, the anger and frustration that they are feeling towards their own dependency will cause them to lash out at the child who is providing the day-to-day care and representative of their lost independence.

Most often, the spark that will trigger sibling feuding is the unequal distribution of responsibility. Even in large families with multiple siblings, there is almost always one adult child who will take on the majority of the care-giving duties. Whether this role is taken on because of geographic proximity, age, or emotional ties, it is certain that the primary caregiver will feel some resentment for doing so much and other siblings will feel shut out.

Many adult children will unknowingly place themselves in the role of primary caregiver by slowly taking on more and more tasks for an elderly parent. Soon, a pattern is set in which the primary caregiver is responsible for all aspects of a parent's care. Changing this pattern can be difficult and it is best to get siblings involved early on. A primary caregiver who is trying to encourage sibling participation should remember these tips:

  • Keep siblings informed about an elderly parent's condition and care plan.
  • Listen to siblings' opinions concerning care decisions and be willing to compromise.
  • Let siblings know that their help really is wanted and needed.
  • Ask siblings to take care of specific tasks. Even siblings that live across the country can help by making check-in phone calls or locating services.

Family meetings are an effective way for siblings to work out conflict and set up a care plan. It is best to involve a facilitator such as a social worker, counselor, or trusted outside party who will ensure that all participants have a chance to be heard. The advice of an FCA Family Consultant can very helpful in this situation. Although emotions are sure to run high, it is possible to conduct a productive meeting by following a few guidelines:

  • Set an agenda for the meeting and keep to it.
  • Focus on the "here and now." Try not to bring up past or unrelated issues.
  • Share your feelings with siblings instead of making accusations.
  • Listen and respect the opinions of all participants.

Case management may also be a viable resource for siblings who are unable to agree on care decisions. Leslie Camozzi, M.S.W., a case manager with the ElderPlan Program, part of the Institute on Aging, says, "It is useful for siblings to have an objective third party's observations and opinions. A case manager can set up a tangible, working care plan. Dividing and compartmentalizing care tasks can help reduce sibling conflict."

Because of the emotional stress that sibling conflict can cause, it is important to seek outside support. Caregivers should feel free to contact their FCA Family Consultant to discuss these issues and learn about additional resources. To set up an appointment, call (800) 445-8106.

 

Fall 2001

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