We are lucky to have another guest post by Barbara Friesner of AgeWise Living, a generational coach who works with families around issues of aging, care-giving and helping siblings maintain or improve their relationships while one or more of them is caring for an aging parent. Barbara has generously offered my readers a 10% discount on any of her products for care-givers. Call her at 877- AGEWISE (243-9473) to receive the discount.
Eldercare is hard enough without adding sibling issues to the mix but too often they’re very hard to avoid when you’re talking about Mom and Dad.
As a Generational Coach, about half the time I work with just one adult child. Sometimes, however, that one person has siblings that either are not helping or are actually sabotaging their efforts.
For example, the caregiver lives near Mom and is doing all the work. They’ve been doing the day-to-day care-giving, getting groceries, cleaning the house, doing chores, and running errands and it’s getting to be too much for them because Mom needs more care than they can provide. So s/he is working hard to get Mom to move into an assisted living community – and making some progress!! And then a sibling calls Mom from across the country and tells her “No – it’s ok, you don’t have to move!!”
Sometimes a sibling will do that because they honestly don’t know how bad it’s gotten with Mom. Other times they do that because they know Mom doesn’t want to move and they want to be the ‘favorite’ child – so they tell Mom what she wants to hear!
Sometimes it is a sincere difference of opinion on what was best for their aging loved one. For example, a 90-year old mother eats a lot of sweets and one daughter thinks she shouldn’t eat any sweets because they’re not good for her. The other daughter says that Mom doesn’t have a health issue – she just likes sweets and if she wants to eat sweets – let her!
Sometimes it’s real controversy – for example, one sibling wanting to do what’s best for their parent regardless of the cost while the other sibling wants to spend as little as possible so there will be more money for their inheritance.
Some children say it would be better to be an only child, but being an only child – or the only caregiver – can also be overwhelming, frightening, draining and very lonely.
As hard as it may be to believe, getting help from sibs can make it easier. Siblings allow shared decision making. Ideally they will share responsibility. Your parent may take information/suggestions from a sibling better than they will from you. In fact, even those who seem “practical” or even indifferent may see things less emotionally than the stressed-out caregiver or more emotional siblings. And a sister/brother has been there – they know all the players from the inside – so they bring a perspective not even your closest friends can bring.
But perhaps the most important reason to work with your siblings is the relationship you will after your parents are gone. Right now may think you wouldn’t care if you ever talk with them again but handling it in a positive way now allows you to leave the door open for future relationships – perhaps an even stronger one!
So what do you do?
Best way to get it to work is to get above the emotion – make it more formal and business like. And the easiest way to that is to call all the siblings together for a care planning meeting so that all the issues can be discussed in an orderly, unemotional way. (Ideally everyone will come together in 1 place. If that’s not possible, then people who cannot attend in person can participate by phone and there are a lot of free conference services that make that very easy.) At the meeting, your primary objective is to create a Care Plan so everyone knows what needs to be done and who will be doing it.
Who should be involved in the care planning meetings?
Ideally you want all the siblings and those involved in your parent’s care. Should you invite sibling’s spouses or children? Maybe – if they are directly involved but you want the meeting manageable – especially at the first meeting so choose wisely.
Should your parent(s) be there? Possibly at future meetings but I don’t recommend it for the first meeting.
At the start of the first meeting I strongly recommend setting some ground rules. For example, how everyone will treat each other (as in . . . no one will make alliances or vote anyone off the island!) and what to do I case of conflict.
Once you’ve established the ground rules, move on to creating a care plan for current and future issues.
What is a care plan?
Care plans help us get above the emotion so we can focus on the practical and make decisions good decisions so that rather than reacting – you can be pro-active. A good care plan is active and fluid and takes into consideration changing needs and opportunities as they arise. It also needs to be flexible because eldercare is often unpredictable (there is often a crisis so you can’t prepare for every contingency); it’s intermittent so you can’t always set a schedule; and caregivers often have limited time to resolve the crisis. And if there’s dementia, dementia is progressive so you don’t always know how it will manifest itself.
In addition, every care plan of every family is unique because they are created to support the needs of the individuality and personality of the family that creates it. Therefore, a care plan depends on where you, family/friends/other caregivers and your aging loved one are in the process and how much needs to be done. But what is true of all care plans is they:
1) List the needs – both the short- and the long-term
2) Determine how and by whom those needs will be met
Whoever has called the meeting (usually the person doing all the work!!!) should start by presenting the situation clearly and unemotionally. (For example: “Here’s the problem. I can no longer do it all.”) and then identifying and clarifying current needs and anticipated long-term needs. In other words – plan for the long-term and detail for the short-term.
Start with the most urgent problem. Just bear in mind – and be prepared for – a wide range of opinions on this. (If you’re the one doing all the work – it’s more urgent to you than to a sib that does little or nothing)
However, remember that,
regardless of what others say, don’t start arguing or getting
defensive. If one of your sibs says that Mom wants to live at home,
you might say something like:
“Yes, she does and I would love for her to be able to do that. However, that would require making sure she has constant care. Up to now I’ve been the one providing that care. Unfortunately it’s gotten to be too much for me so we need to take a look at what our options are now. Let’s start by looking at what it will take to keep her at home, what her needs will be down the road, and how much that will cost.
Once you all agree on what needs to be done, determine how and by whom those needs will be met.
Be prepared to “negotiate” alternatives (for example, financial support in lieu of time) and allow for flexibility. However, just because they can’t do – doesn’t mean you have to. If they can’t do it, ask them to suggest someone who can (not you).
However, responsibilities are not set in stone. In other words, the responsibilities set up in a care plan reflect only the situation as it is now. Make sure it is understood that solutions agreed to now may have to change later as the situation changes.
With every task, be sure to have a due date – especially if one person’s task depends on another person completing theirs.
And finally, agree to meet at least every few months you all have a care meeting to reassess your parents' situation.
I know this is such a difficult and emotional time for everyone and often the tendency is to put off talking about eldercare in the hope that it will magically go away. Unfortunately, hope is not a strategy and ignoring it pretty much never makes it go away. The best way to make it easier and the sibling relationship better is to start early before everyone – especially the caregiver – is all stressed out.
As you proceed, stay focused on your concern for your parents, your relationship with your siblings, and yourself! Be patient, persistent, and practical – and proceed with compassion.
Barbara E. Friesner is a Generational Coach. For a lot more information about Sibling Relationships and Care Planning, check out The Ultimate Caregiver’s Survival Guide (and remember to call Barbara at her at 877- AGEWISE (243-9473) for a 10% discount) For more information, please check out her website www.AgeWiseLiving.com.