Navigating Family Dynamics in Caregiving

Thanks to advances in medicine, people are living longer. While this is a positive thing, extended caregiving can bring on tension within the family and added stress. How will you care for your parents at home? Who will look after them? How will expenses be paid? Watching your parents’ strength and independence decline is difficult for anyone to witness. When you combine the emotions, stress, and predispositions of a whole family, it is understandable that tensions may arise. An article published by Family Caregiver Alliance has put together a helpful guide on how to approach this situation with patience and compassion for not only your parents but your siblings as well.

Family Caregiver Alliance suggests having the conversation of care as early on as possible. It is easy for family members to make assumptions that can actually do more hurt than good. For instance, in many family dynamics, it is assumed that the son/s of the family will take over the financial aspects whilst the daughters take over the more nurturing, caring side of caregiving. This may not be the best choice for your family, and there are several other factors to consider when choosing which family member will be responsible for each task. For example, who lives closest to the parent/s? Who has the most free-time outside of their daily responsibilities? It may be that you have to re-look at who is assigned which responsibility and make sure that responsibilities are shared evenly among siblings.

Similarly, there may be disagreements on the level or type of care siblings believe that their parents need. For many people, accepting the fact that your parent needs help can be difficult to digest. Others may be overly anxious and create more stress than there really needs to be. Family Caregiver Alliance suggests the following ways to handle this problem:

  1. If there’s no emergency, allow some time to get everyone on the same page. It’s natural for siblings to take in the situation at different times and in different ways. This can happen regardless of whether they’re far away or close.
  2. Share information. Get a professional assessment of your parent’s condition by a doctor, social worker, or geriatric care manager and send the report to all your siblings. Try using email, online care sharing tools, and/or in-person family meetings to help keep everyone abreast of care issues and information.
  3. Keep in mind that parents often tell their kids’ different things about how they’re doing. This is a good reason to keep communication lines open with each other and to try to pool your information about your parent’s health.

It is easy to become side-tracked and feel like you are not making your parents “happy”. This is too much of an emotional burden on you and your siblings to hold, and the primary focus should be getting the basic needs that they need, whatever it may be. Family Caregiver Alliance has pinpointed these “clues” that might show that you and/or a sibling are acting out emotionally:

  1. Your level of emotion is out of proportion to the specific thing being discussed right now. For example: getting into a heated argument about which of you should go to the doctor with Dad next week.
  2. You or your siblings criticize the way you think another person is being, for example: selfish, bossy, uncaring, irresponsible, or worse.
  3. You feel that none of your siblings understands what Mom needs the way you do and you are the only one who can do certain things.
  4. You or your siblings generalize a discussion, saying, for example, “You always do this!”
  5. You or your siblings criticize the way one another feels, for example, “You don’t care anything about Mom.”

If you feel these emotions at any time, it could be the moment to take a step back and re-evaluate your reaction to the situation. Was it rational? Was it helpful to your parents and/or siblings? Is there a more effective way to tackle the situation at hand?

Lastly, below are some tips for winning more support from your siblings, put together by Caregivers Alliance:

  1. Try to accept your siblings—and your parents—as they really are, not whom you wish they were. Families are complicated and never perfect. There are no “shoulds” about how people feel. They are not bad people or bad children if they donʼt feel the same as you do. If you can accept this, you are likelier to get more support from them, or, at least, less conflict.
  2. Do not over-simplify. Itʼs easy to assume that you are completely right and your siblings are all wrong—or lazy, irresponsible, uncaring, etc. Each person has a different relationship with your parent, and each personʼs outlook is bound to be different.
  3. Ask yourself what you really want from your siblings. Before you can ask for what you want, you need to figure this out and thatʼs not always as simple as it seems. First of all, ask yourself whether you really, deep down, want help. Many caregivers say they do but actually discourage help. So think hard. Do you want them to do certain tasks regularly? Do you want them to give you time off once in a while? Or do you feel you have everything under control but youʼd like them to contribute money for services or respite?
  4. Or—and this is a big one for many caregivers—do you really not want them to do anything but youʼd like more emotional support? Many caregivers feel lonely, isolated, and unappreciated. If youʼd like your siblings to check in on you more, ask them to call once a week. And tell them it would really help if they would say “thanks” or tell you youʼre doing a good job. They are more likely to do this if you donʼt criticize them for what they are not doing. Ask for help clearly and effectively. Asking is the first step. You might ask for help by saying: “Can you stay with Mom every Thursday? I have to get the shopping done for the week and it gives me some time to myself.” Donʼt fall into the common trap of thinking, “I shouldnʼt have to ask.” Your siblings may assume that you have everything covered so they donʼt recognize the added responsibilities and “burden.” They are involved with their own lives and struggles and not so attuned to yours that they can read your mind. Also, if youʼre not exactly sure what you want from them, you may be giving them mixed messages. Ask directly and be specific. Many caregivers hint or complain or send magazine articles about the hardships of eldercare. But these strategies do not work well. Ask for whatʼs realistic. People get more when they donʼt ask for the impossible. So consider the relationship your sibling has with Mom or Dad and ask for what that person can really give. If your sister canʼt spend ten minutes with Mom without screaming at her, donʼt ask her to spend time; ask for something thatʼs easier for her, like doing paperwork or bringing groceries.
  5. Watch how you ask for help—and steer clear of the cycle of guilt and anger. Avoid making your siblings feel guilty. Yes, really. Guilt makes people uncomfortable and defensive. They might get angry, minimize or criticize what you are doing, or avoid you. That is likely to make you angry, and then you will try harder to make them feel guilty. They will attack back or withdraw even more. And round and round you go. Sometimes your siblings will criticize you because they are genuinely concerned about your parents. Try to listen to these concerns without judgment and consider whether it is useful feedback. At the same time, be bold by asking for appreciation for all that you are doing—and remember to say thanks back when someone is helpful. Be careful of your tone and language when you request something. Itʼs not always easy to hear the way we sound to others. You might think you are asking for help in a nice way, but if youʼre angry, thatʼs the tone your siblings will hear. And theyʼre likely to react in unhelpful ways.
  6. Get help from a professional outside the family. Families have long, complicated histories, and during this very emotional passage, it is often hard to communicate with each other without overreacting, misinterpreting, or fighting old battles. Even the healthiest families can sometimes use the help of an objective professional. People like family therapists, social workers, geriatric care managers, physicians, or clergy can help siblings establish what is real about parentʼs health and needs in order to help distribute responsibilities more equitably. In family meetings, they can help you stay focused on the topic at hand and help you avoid bringing up old arguments.
  7. Steer clear of power struggles over your parent’s assignment of legal powers. Whether or not you have been given your parentʼs legal powers over finances or health, you need to remember that it is your parent who has made these decisions. If you have your Momʼs or Dadʼs power of attorney, be sure to keep detailed records and send your siblings statements about how you have spent Momʼs money. This may seem like a lot of extra work, but record keeping is required by law, and being open will reduce distrust or distortion—and lawsuits. If a sibling has been given legal power, try to accept your parentʼs decision and donʼt take it as a personal attack on you. Do your best to work with the sibling who has the authority by presenting expenses and bills in black and white. If the sibling who has the purse strings doesnʼt cooperate, then bring in a professional to explain your parentʼs needs and to mediate. If you are concerned about manipulation, a changed will, or undue influence, contact your local Adult Protective Services.
  8. Donʼt let inheritance disputes tear your family apart. If you feel wronged by the way your parents have divided their money and property, itʼs natural to be upset, especially when you are grieving. You may feel that you deserve more because you have cared for your parents. If thatʼs what you feel, you need to discuss this with your parents while they are alive and can make these decisions. If you suspect foul play by another sibling, then this is the time to consult an attorney or Adult Protective Services.

Yet, research shows that most parents feel a need to leave their estates equally as a sign of their equal love for all their children. When they divide things unequally, itʼs often because they are worried that a particular child will be in greater need. Whatever their reasons, remember that it was your parents, not your siblings, who decided this. Think hard before you take your anger or disappointment out on your siblings. They are what remains of your original family, and for most people, this relationship becomes more important after parents die.

Remember, this is a complex and emotional situation for all of your family. Whatever emotions you may be feeling; your siblings could be feeling the same way. Take time to care for yourself, while at the same time remaining patient and open-minded with your siblings. Now, more than ever, it is time to come together and support each other during this time of transition for your family.

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