Caregiving with Your Siblings
Providing care for your parents can be complicated. When your brothers and sisters are also involved, caregiving can become even more complex. While your siblings can be enormously helpful and your best support, they can also be a source of stress.
In this Fact Sheet you will learn how to identify the family dynamics that can impact caregiving, ways your siblings can help, how to increase your chances of getting that help, and how to deal with emotions that arise.
Why sibling tensions can erupt as parents need care
Today's adult children and their parents are going through a new kind of family transition. Because parents are living longerbut with chronic illnessestheir adult children are now caring for them for up to a decade or more. Siblingsor in some cases step-siblingsmight not have a model for how to work together to handle caregiving and the many practical, emotional and financial issues that go with it. There is no clear path guiding who should do what, no roadmap for how siblings should interact as mature adults. While some families are able to work out differences, many others struggle.
Siblings are also going through a major emotional passage that stirs up feelings from childhood. Watching our parents age and die is one of the hardest things in life, and everyone in the family will handle it differently.
It's normal to feel a wide range of emotions. You may find that needs arise for love, approval, or being seen as important or competent as a sibling. You may not even be conscious of these feelings, but they affect the way you deal with your parents and with each other. So without realizing it, you may all be competing with each other as you did when you were kids. Now, however, the fights are over caregiving: who does or doesn't do it; how much; and who is in charge.
This is a hard time, so have compassion for yourself, and try to have compassion for your siblings. You don't have to excuse negative behavior, but try to imagine the fear, pain or need that is causing your siblings to react as they do. That kind of understanding can defuse a lot of family conflict.
As a family, carefully consideror reconsiderthe
Families often don't think through who becomes the primary caregiver and what supporting roles other family members will play. Caregiving may start when the sibling who lives nearby or has a close relationship to the parent helps out with small things. You may not even identify yourself as a caregiver at first, but then find yourself overwhelmed and feeling resentful of your siblings as your parent requires more help. It's easy for families to fall into common traps, assuming, for example, that the son will handle finances while the daughter will take care of emotional or physical care needs.
In another common trap, one sibling may become Mom's caregiver because he or she doesn't have a job or needs a place to stay, and family members think this arrangement will solve a lot of problems. But it can be a recipe for trouble. The family needs to spell out clearly what that person will be expected to do, whether there will be financial compensation, and how that will work. In addition, the sibling(s) should be clear about what support tasks each will provide.
You need to re-examine all these assumptions as a family. The best way to do this is to call a family meeting as early (and, later, as often) as possible. A family meeting can provide a place to discuss the parent's needs and to ask what each person can contribute in time or money. If needed, a trusted person outside the family can facilitate. See "Holding a Family Meeting" in the Recommended Readings section of this Fact Sheet for more information.
Think about family roles when you were growing up, and how you can change them for caregiving
Whenever we get together with family, most of us tend to slip into our old roles, even though we behave differently when we are with other people. But these roles may not work anymore. Parents may not be able to play the parts they did when the family was young, like making the decisions, providing emotional support, or smoothing tensions between family members.
Maybe you were expected to be the responsible one; maybe your brother was seen as someone who needed taking care of. Maybe your other sister was groomed to go off and become the achiever while family chores were left to others. Perhaps you were identified as the "caring" one while your sister was labeled "selfish" or "cold." So ask yourself: am I being pulled into being the big sister or the helpless little kid even though we're all adults now?
Also, it's helpful now to take a fresh look at your siblings. Parents create labels and roles for each child, and everyone in the family adopts them and assumes they are true. They may be based on some reality, but parents may also assign these labels for all kinds of reasons: who was born first or last, which kid reminds Mom of her older sister (who she resented), which kid is most like Dad in personalityand how Mom feels about Dad!
Whatever the reasons for these roles, we need to re-examine them now. If you were the "responsible" one, it does not mean that you should accept doing everything because you always did--even though your siblings may expect you to take on that role. You may need to help them see that you can all adapt your roles to new times and who you are today. Also, if you assume a brother or sister is less capable or helpful because that's the way you saw them as kids, you are less likely to get help from them. If you approach them differently, they may prove to be more helpful than you think possible.
Siblings may have different ideas about what parents need
The idea that you may soon lose Mom or Dad, or that they need more care, can be really scary. Some adult children still need their Mom to be the parent. Some get over-anxious and think the parent is in bigger trouble than they are. Some just can't accept that the parents need as much help as they do. These differences are common. Here are some ways to handle this:
- 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.
- 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.
- 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.
Try to separate your parent's needs from your ownand yesterday's battles from today's decisions
It's natural to take pride in being able to help your parent, or feel satisfaction that you are doing something important and valuable. When these basic needs are satisfied caregivers feel good about what they're doing and feel less burdened.
But you may also have other less conscious, emotional needs that can actually make things harder for you. For example, if you feel you must make your Mom happywhen she's never been a happy person or has suffered painful lossesyou may be setting yourself up for an impossible task. You can make sure your parents are well cared for, but it isn't your jobnor is it always possibleto make them happy.
So try to focus on the essential things your parent needs for good care. For example, if you insist on doing all Mom's shopping because only you know what she likes, you may exhaust yourself. And it's hardly a tragedy if your sister buys her a different brand of tuna.
When those old needs to be loved and approved of get stirred up, it can fire up sibling rivalry. After all, you're not the only child who needs to feel important to Mom or Dad. So when you're discussing whether Dad needs a more expensive wheelchair or Mom is still safe at home, try to keep the discussion on the concrete issue at hand, not on which of you cares the most or knows what is best.
Clues that you are acting out of emotional needs or fighting old battles
- 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.
- You or your siblings criticize the way you think another person is being, for example: selfish, bossy, uncaring, irresponsible, or worse.
- 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.
- You or your siblings generalize a discussion, saying, for example, "You always do this!"
- You or your siblings criticize the way one
another feels, for example, "You don't care anything about Mom."
When you become furious or terribly hurt in a dispute with your sibling, try to step back, calm down, and focus just on the issue at hand, e.g. getting Dad to his doctor appointment.
Tips for winning more support from your siblings
- Try to accept your siblingsand your parentsas they really are, not who 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 don't 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.
- Do not over-simplify. It's easy to assume that you are completely right and your siblings are all wrongor lazy, irresponsible, uncaring, etc. Each person has a different relationship with your parent, and each person's outlook is bound to be different.
- Ask yourself what you really want from your siblings. Before you can ask for what you want, you need to figure this out, and that's 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 you'd like them to contribute money for services or respite?
- Orand this is a big one for many caregiversdo you really not want them to do anything but you'd like more emotional support. Many caregivers feel lonely, isolated and unappreciated. If you'd 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 you're doing a good job. They are more likely to do this if you don't criticize them for what they are not doing.
Watch how you ask for helpand steer clear of the cycle of guilt and anger.
- 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." Don't fall into the common trap of thinking, "I shouldn't have to ask." Your siblings may assume that you have everything covered so they don't 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 you're 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 what's realistic. People get more when they don't 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 can't spend ten minutes with Mom without screaming at her, don't ask her to spend time; ask for something that's easier for her, like doing paperwork or bringing groceries.
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 a parent's 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.
Steer clear of power struggles over your parent's assignment of legal powers. Whether or not you have been given your parent's legal powers over finances or health, you need to remember that it is your parent who has made these decisions. If you have your mom's or dad's power of attorney, be sure to keep detailed records and send your siblings statements about how you have spent Mom's money. This may seem like a lot of extra work, but record-keeping is required by law, and being open will reduce distrust or distortionand lawsuits. If a sibling has been given legal power, try to accept your parent's decision and don't 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 doesn't cooperate, then bring in a professional to explain your parent's needs and to mediate. If you are concerned about manipulation, a changed will or undue influence, contact your local Adult Protective Services.
Don't let inheritance disputes tear your family apart. If you feel wronged by the way your parents have divided their money and property, it's natural to be upset, especially when you are grieving. You may feel that you deserve more because you have cared for your parents. If that's 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.
- 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 doingand remember to say thanks back when someone is helpful.
- Be careful of your tone and language when you request something. It's 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 you're angry, that's the tone your siblings will hear. And they're likely to react in unhelpful ways.
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, it's 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.
Dealing with your siblings over parent care can be difficult, complex and emotional. It is important to understand your own emotions at this challenging time and to try to have sympathy for your siblings' feelings as well, even if you disagree. Ask for what you need from them directly and specifically without guilt or anger. If you cannot, or there is conflict anyway, bring in an objective professional to help your family solve the problems that need solving. Family dynamics were present prior to your caring for your parent(s) and you may not be able to resolve existing conflicts now to
your satisfaction. The important thing is to be sure to get support for yourself so that you can find peace during your caregiving journey, and once it is completed.
Brody, E., Women In the Middle: Their Parent Care Years (2004) New York: Springer Publishing
Ingersoll-Dayton, B., Neal, M., Ha, J., Hammer, L., "Redressing Inequity in Parent Care Among Siblings", Journal of Marriage and Family (2003).
Zarit. S., "Caregiving Revisited: Old and New Perspectives on Families Assisting Elders," Lecture, Gerontological Society of America (2005).
Suitor, J., Pillmer, K., "Mothers' Favoritism in Later Life Families: The Role of Children's Birth Order," Research on Aging (2007).
Russo, Francine, They're Your Parents, Too! How Siblings Can Survive Their Parents' Aging Without Driving Each Other Crazy (2010) New York: Bantam.
Russo, Francine, "When Elder Care Brings Back Sibling Tensions," Time, February 1, 2010.
Russo, Francine, "Who Cares More for Mom?" Time, July 12, 2005. http://www.time.com/time/magazine/article/0,9171,1071271,00.html
Family Caregiver Alliance Fact Sheets
Caregiving and Ambiguous Loss
Helping Families Make Every Day Care Choices
Holding a Family Meeting
Taking Care of YOU: Self Care for Family Caregivers
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Family Caregiver Alliance (FCA) seeks to improve the quality of life for caregivers through education, services, research and advocacy. Through its National Center on Caregiving, FCA offers information on current social, public policy and caregiving issues and provides assistance in the development of public and private programs for caregivers.
For residents of the greater San Francisco Bay Area, FCA provides direct support services for caregivers of those with Alzheimer's disease, stroke, traumatic brain injury, Parkinson's and other debilitating disorders that strike adults.
A public service of the U.S. Administration on Aging that can connect you to local Adult Protective Services and/or an Area Agency on Aging.
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This Fact Sheet was prepared by Family Caregiver Alliance and funded by the Palo Alto Medical Foundation and California Department of Mental Health. Written by Francine Russo and based on her book, They're Your Parents, Too! How Siblings Can Survive Their Parents' Aging Without Driving Each Other Crazy (2010) New York: Bantam. © 2011 Family Caregiver Alliance. All rights reserved.
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