Guest Columns

Caregiving and curbing sibling discord

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Matthew Gallardo
Matthew Gallardo

 

Serving as a caregiver for an ailing parent or parents can be extremely challenging. It can be physically, mentally and emotionally draining. One of the first suggestions or ideal situations as a caregiver is to share the responsibility. Naturally much of this starts with the adult children, especially if both parents need assistance, or the spouse has their own health issues to deal with or has passed away.

As a parent's health begins to fail, you'd hope all the kids would rally around Mom or Dad and work in harmony to reciprocate the care in this common reversal of caregiving roles. But not all that surprising, family dynamics, disagreement, and old wounds can make this process very complicated and typically results in one of the kids becoming the primary caregiver. This can create resentment and even more conflict between family members as the burden grows.

Caregiving equity

Innocently enough, some siblings cannot offer as much help simply due to geography or their own family dynamics. If Mom lives down the street from Daughter A, but lives 1,000 miles from her son or Daughter B, let's face it – there's going to be some caregiving inequity. Work schedules, retirement, personal health issues, and dependent children can also create disparity among sibling caregivers. Although, there are solutions to alleviate some of these issues which you will see below.

What providers may hear, though, is less excusable, such as "Well, Dad liked you best, so he'd rather you take care of him” or “I'll do my part,” then they disappear or gradually minimize their efforts. That can be viewed as difficult, but among attitudes that can change.

However, in the third category is what we would call inexcusable reasons. This could include turning blind eye or a purposeful absence due to a long-standing, petty grudge, or simply a poor relationship with siblings or that parent. That said, some old wounds can run very deep, and estrangement is sometimes irreversible.

Unify, gain perspective and be systematic

Whatever the reason the family dysfunction exists, I think we can encourage families to move beyond these obstacles. Open communication and planning are essential. For example, I'll use my own family. My older brother and I are not very close. We communicate very infrequently. But there have been some recent instances where we needed to talk for the sake and well-being of our parents. I believe if we could do this, most people can. 

We must remind family members that the resident, their parent, is the one in need. 

If things escalate, here are some suggestions:

  • Call a family meeting – Include everyone to discuss the situation to work toward a common goal, especially for out-of-town siblings. Help them understand the need for care and intervention, as they may not be able to detect nor accept reality from so far away.

  • Draft a care plan – The plan should be a well-balanced with well-defined roles. Divide up tasks by family members by playing to everyone's strengths. For instance, if one sibling works in healthcare, they could take on all of the medical appointments. The person with good business sense might handle legal issues and/or financial issues. This allows people to feel valued and involved without being overwhelmed.

    Additionally, this can allow those who are far away to still do their fair share. For residents in assisted or independent living, you can gently recommend that someone can pay for services such as dog walking, housekeeping or other ancillary services to help out. 

  • Suggest a calendar with scheduled visits. Those who live far away should plan in advance times they'll come to see Mom, where they will stay and what they might do. This should not only be holidays, but times in which it allows other siblings to have a break. For example, the start of school may be a good time for Daughter A to visit so that Daughter B can spend more time with her children. 

  • Have everyone sign the plan to maintain accountability and keep everyone on task. That plan could also include placement options for further on down the line when living at home, or in assisted living, is no longer safe or feasible.

  • Use technology and outside resources – Fall-detection and home-monitoring and video systems can create and maintain a safer environment to make caregiving more efficient and less time consuming. Also hired services, like non-medical home care, respite care, and adult day programs can help alleviate the burden of care between family members.

  • Remind family members to listen and stay flexible – Maintain lines of communication. Appreciate everyone's perspective along with their position and capacity of being a caregiver, and remember circumstances may change and alter the division of labor. Once again, don't expect total equality. It's very rare that caregiving roles can be divided equally.

  • Lastly, remember caregiving can be frustrating and contentious at times, especially when family members feel that some else is not doing their part. But ultimately, everyone must work together to take care of the person or persons that took care of you for all those years.

You may also want to recommend these resources to family members: “What to Do about Mama?” by Barbara Matthews & Barbara Trainin Blank, published by Sunbury Press, “The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer's Disease, Related Dementia and Memory Loss” by Nancy Mace M.A and Peter Rabins, M.D. M.P.H. published by The Johns Hopkins University Press or the Family Caregiver Alliance at www.caregiver.org.

Matthew J. Gallardo, BASW, CCP, ROCC, is the director of community engagement and coaching at Messiah Lifeways in Pennsylvania. 


Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.

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