I live in Virginia; my Mother lived in Tennessee. After my father died, I had been going to see her once a month. It was a four-hour drive. She was deeply grieving this loss, and my older brother had also died five days before my father. I was concerned about her, although on the surface she seemed to be managing on her own.
I have two younger brothers who both lived several states away and were not visiting her very often. While we talked frequently on the phone and I kept them up to date on how our Mother was doing, they were not offering to come see her.
This article is about the early warning signs that your caregiving journey is underway. It is also a story of how sibling disagreements over an aging parent's care can be a major interference in early interventions that can prevent a crisis. The key is for siblings to all be on the same page -- something that does not always come easily.
Early warning sign 1: You must drop everything to attend to a crisis and you are not close, but the closest.
One day, my Mother's neighbor friend had called to let me know that my Mother had fallen on some concrete steps while going to get her hair done. The friend had taken her to the emergency room as she had scraped all the skin off her shins. Old people have very thin skin, so it was a serious injury. I hopped in my car to go to Tennessee. She was at home by the time I got there and in decent spirits.
Early warning sign 2: Things are not as they seem, pay close attention. Siblings not so present in denial.
As I began taking care of errands and tasks for my Mother on my visits, I would notice stacks of unpaid bills, unwatered plants, laundry piling up, and old food in the fridge. I just got a general sense that things were not getting done. I expressed my concerns about this with my brothers who said they were not worried. She seemed "fine" when they talked to her on the phone.
I began the conversation with my brothers about moving her closer to me in Virginia after talking with her doctor who told me she was sad and lonely and needed to be near family. That was all the information I needed to make a decision; she needed to move. They did not agree.
Early warning sign 3: You know more about your parent’s health and needs than your siblings.
One of my brothers had scheduled a visit to see my Mother. Right before that, she landed in the hospital with a bad infection. He went anyway while she was still in the hospital and made many of the same observations I had shared about the condition of her apartment and affairs. While there, he also called me multiple times about her healthcare needs because all this new information confounded him.
Dealing with adult siblings can often feel like a playground fight for control and who knows best when it comes to an aging parent. My youngest brother was convinced that a move would be bad for her. “All of her friends are there," he said, “they’ll look after her.” My other brother was also not convinced, and as a result the process of moving her did not go smoothly. My brothers resisted my suggestions and said she should move near them -- although they did not undertake the search for a place.
Getting siblings to help with, and agree on, an aging parent's care.
Siblings that are not in agreement about the care for an aging parent become a hindrance and added stress to the primary caregiver. When responsibilities of managing finances and healthcare are split, that can also cause disagreements and tension. Managing the healthcare of a parent when the other sibling manages the money can contribute to prolonged decision-making, payment issues with bills and necessities, and conflict. Resentments can also occur when siblings have different roles and levels of input. What I learned from my experience is that preparing and planning for these life events before they happen can help you circumvent some of the conflicts.
When you first become a caregiver for a parent, be proactive and ask your siblings these questions.
If your aging parent is in good health and cognition, making sure they are a partner in the decision-making process will preserve their dignity and independence. This is also a good time for a family conversation that includes basic questions about everyone's involvement in care including:
- Who will be primary caregiver?
- When will siblings help? And what will they help with?
- How will the primary caregiver be compensated?
Furthermore, when your parents are aging it should not be assumed that they are the responsibility of their also aging friends. As as a result, there may come a time when you agree that moving them closer to you or taking care of them in your home is the best decision for their safety. Keep in mind that a move from a place where they have lived for many years may make them more dependent on you in many ways. This is a conversation to have with siblings about shared caregiving that will ensure you get the respite you need as the primary caregiver:
- How often will they visit?
- How long will they stay?
- What will they do?
Here's how to talk to siblings about an aging parent as their care needs evolve.
Siblings who are removed from the day-to-day caring for an aging parent will often be in denial about the true condition of physical and mental needs of both parent and caregiver. Here are some tips for talking to siblings about an aging parent that can help alleviate some of the conflicts that can occur over care decision-making:
- Having an agreement on a sibling's level of involvement and role will keep them aware of the aging process.
- Planning for a move to assisted living or other housing arrangement ahead of a crisis is key in creating a smoother transition. Consider creating your own care team, made of family and friends, which can make a move less stressful.
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Having a family conversation about a move or care transition before it happens provides the opportunity for differing opinions to be heard and settled. Some questions you may consider asking your sibling(s):
- How will they be available when there is a health crisis?
- What input will they have if they are not knowledgeable of the parent’s baseline health?
- Who will make critical decisions about an aging parent's healthcare? And how will they be made?
- Reviewing alongside your parent(s) their power of attorney and distribution of roles and responsibilities while they are in good health is another critical conversation. The POA, and other estate-planning documents, should be reviewed periodically as conditions change. Not taking these steps increases the likelihood that you and your siblings will encounter problems and resentments. Essential documents, like Do Not Resuscitate Orders and Advanced Medical Directives, should be shared with all siblings.
Check out our Advance Care Planning Guide for more information on what documents your aging parent's need to have complete and up-to-date.
Many adult children are thrown into a caregiving role after a crisis and don’t have the full support of siblings who live far away. Having a conversation ahead of time about what a sibling's involvement looks like and what help and care they're willing to provide is important to avoid, or at least limit, family disputes over an aging parent's care.