All responses to the parent’s aging must be taken into account – those of the parent, the adult child and the siblings.  If the feelings of all parties are not taken into account, they will …interfere with the healthy process by which we prepare to say goodbye. —As Parents Age:  A Psychological and Practical Guide, Ilardo, VanderWyk and Burnham publishers

At the Doctor’s office, your elderly parent has just received a diagnosis that indicates he/she can no longer live alone.  You feel that an assisted living facility is the best care option, but your brother disagrees.  Although you’ve always gotten along fairly well, now every conversation you have with him seems to lead to confrontation and hurt feelings.

Providing care for an aging or ill parent can bring out the best and the worst in sibling relationships.  Ideally, the experience of care giving is a time for siblings to come together and provide mutual support to one another.  However, as a stressful transition, the pressure can also lead to strained connections and painful conflict.

Furthermore, this kind of stress will affect you physically.  It will “go” to your weakest physical point.  Do you have migraine headaches?  You’ll have more.  Do you have a bad lower back?  I can practically guarantee that, in the situation described above, your back will flare up. So will your gastric reflux problem, your arthritis and other physical problems that you fight.  You owe it to yourself to try to stop confusion and constant arguments with your siblings.

One major source of sibling friction is the legacy of family dynamics.  Invariably, the demands of care giving bring out old patterns and unresolved tensions.  Wounds from the past are reopened and childhood rivalries reemerge.  It is not unusual for adult children to find themselves replaying their historical roles in the family, recreating old dynamics of competition and resentment as they view for mom’s attention and affection.

Another conflict can arise when one sibling is in denial over a parent’s condition.  Adult children who seem unable to accept the reality of a parent’s illness and refuse involvement may be protecting themselves from facing a parent’s eventual death and their own loss.  More active siblings may react with bitterness and anger to the truth that their parents are not what they used to be in every way.

Most often though, says FCA, the Family Caregiver Alliance, discord surfaces from the unequal division of care giving duties.  Generally, one sibling takes on the primary role of caring for a loved one.  This may be because he or she lives closest to the parent, is perceived by other siblings as having less work or fewer family obligations, or is somehow considered the “favorite” child.  Regardless of the reasons, this situation can lead the overburdened care giver to feel frustrated and resentful.  It causes the other siblings to feel uninformed and left out.

Resolving these conflicts can be challenging.  However, ignoring the difficulties in a care giving situation can end up creating greater challenges. Ultimately, strained family relationships can, and often do, impede the  family’s capacity to provide the best and greatest quality of care to a parent.

How can families come together in care giving?  Here are some ideas from FCA.

Express your feelings honestly and directly.  Let your siblings know that their help is both wanted and needed.  Don’t criticize them for the “way” they help.  If you constantly criticize their efforts, they will help less and less.

Always keep all family members, whether they help out or not, informed regarding a parent’s condition.

Be realistic in your expectations.  Allow siblings to help in ways they are able and divide tasks according to individual abilities, current life pressures and personal freedoms.  Assistance with errands, finances, legal work or other indirect care may be the best option for some family members.

Always express sincere appreciation to your family for help they are able to provide.

Accept siblings for who they are and expect differences of opinion.

Try to respect other’s perceptions and find opportunities to compromise.

If communication is particularly contentious, arrange a family meeting that includes an outside facilitator, such as a social worker, counselor, religious leader, geriatric care manager or friend.  A trusted outside party can ensure that everyone’s voice is heard.

If siblings are unable to help with care, seek other assistance in order to provide a respite for yourself.  Call the Area Agency on Aging, Senior Center, or other community resource to locate help.

Try to forgive, if you can, family members who continue to refuse to get involved in a loved one’s care.  The only thing we have control over in a situation is our reaction.  Attempt to work through your negative emotions to take care of yourself and move forward.  To talk to an FCA Family Consultant, call 800-445-8106.  To reach the Mid-Atlantic chapter of geriatric care managers, contact them at 410-661-1988, or check out their website at www.midatlanticgcm.org.

Thank you for reading.  Stay well.  See you next week