Being Mom’s caregiver is hard. Caring for her together with siblings is harder.
Siblings who couldn’t agree on how to care for an aging parent have come to us for mediation, where we winced hearing them belittle one another in ways they wouldn’t dare speak to anyone else.
Few things make adult children caring for an aging parent as mad as their stubborn, contentious, and bossy siblings. During our 30-plus years as clinical psychologists who specialize in helping older adults and their family caregivers, we have seen family dynamics like these become explosive:
A 55-year-old, Italian American daughter was furious at her neglectful older brother. While she had moved into her 81-year-old mother’s house to care for her, her brother rarely stopped by or even called. But Mom relished any time with her son — her favorite child — and took our client’s daily care for granted.
A 40-year-old daughter, youngest of three, lived closest to their dad and accompanied him to his frequent doctors’ appointments. She hated that her older sisters, living in another state, called her repeatedly to tell her what to say to the doctors as if she were still their bratty, little sister who was clueless about what to do.
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Siblings who couldn’t agree on how to best care for an aging parent with dementia or cancer or heart failure have come to us for small group mediation sessions. During these meetings, we would literally wince hearing them belittle one another in ways they wouldn’t dare speak to anyone other than their brothers and sisters.
Fighting new (and old) battles
Why do siblings have so much conflict during caregiving? We keep various possible reasons in mind.
They are often united in greatly caring about their parent but bitterly divided in what form that care should take. For example, if a parent’s thinking skills seem to be deteriorating, one sibling may see caring as taking that parent to the doctor for an evaluation as soon as possible. But another may think caring is leaving that parent alone, free to live their own life and decide if they need medical care. Each sibling in this instance thinks they’re the good child and the other is the bad one.
Another factor involves the nature of being siblings who are now adults. When they were young, they lived together and typically squabbled a lot. As adults, they’ve lived apart and have generally gotten along better because they haven’t had the daily frictions of being together. Now suddenly thrown back together as co-caregivers for an ailing parent, they have more contact with one another and more need to cooperate than has been the case in years. It is natural for the siblings to revert to squabbling. They may even regress to the competitive rivals they were as children.
Gender dynamics, whether underlying or explicit, can come into play in which brothers expect the sisters to do the bulk of the caregiving and the sisters resent their brothers for not fully participating.
There are birth order effects, too. Older siblings can believe that they should be the chief decision-makers, and the younger siblings resent them for being bossy.
Geography commonly has repercussions in which the siblings who live furthest away from the parent try to tell those on the front lines what to do, as if attempting to make up in assertiveness what they lack in proximity.
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Moving past conflict as sibling caregivers
All these factors make for combustible combinations. Yet siblings caring for a parent can pull together, not apart. Here’s what we have seen work:
Develop greater consensus about what the parent needs to live as healthy and happy as possible. We make sure that every brother and sister has access (with the parent’s permission) to their outpatient medical visit and hospital discharge summaries so that they are working with the same set of information. That doesn’t guarantee agreement — not everyone trusts doctors’ judgments — but often brings them at least a little closer together.
Ask each sibling what the parent has told them they want for themselves as they age — we often find parents tell different children different things! Then have them go back to ask the parent as a group about what that parent believes they need and the support they expect from their kids.
Set up a formal communication process. Whispering down the lane in a series of phone calls from one sibling to the next doesn’t usually work well. We recommend creating a group text or email or shared website so that each sibling receives the same information about the parent at the same time.
Schedule quarterly in-person or virtual meetings of all siblings to compare impressions of how a parent is functioning and to talk about who is willing to do what to support that parent and for how long. Not infrequently, these meetings run better when they are facilitated by a neutral party, such as a trusted family friend, religious leader, or a mental health therapist.
Future relationships at stake
If these steps haven’t reduced the arguing, then we add an ominous warning. “How you treat each other during caregiving will affect your relationships with one another long after your parent dies, possibly forever afterward. If you want to have closer bonds in the future, then now is the time to be kind and cooperative.”
Many siblings take this to heart. They know they are slowly losing their parent; they don’t want to lose a brother or sister, too. They therefore increase their efforts to get along with one another — even if they sometimes still disagree, just as they always have. When caregiving is over, their bonds are stronger because they have worked together effectively and learned to respect each other as capable and caring adults.
Barry J. Jacobs, Psy. D., and Julia L. Mayer, Psy. D., are husband-and-wife clinical psychologists based in Media. Their new book, The AARP Caregiver Answer Book, will be published by Guilford Books in July.