Siblings! For some lucky families, having a bunch of adult siblings gather around and plan how to take care of Mom and Dad as their parents' health begins to fail is a great comfort. For some families, siblings who never got along as kids and have had little to do with each other as adults being thrown together to make touchy decisions is disastrous.
For most families, the journey through the mine of elder care decisions falls somewhere between the two extremes. Elder care has a way of sneaking up on people. Generally, if there is an adult child living in the same town as the aging parents, it is this child who becomes, at the first sign of need, the default caregiver. That usually makes sense. You live in town. Your folks need some help with their Medicare forms, so you stop over. They need help with the yard, so you start taking time away from your family to help out. Then its grocery shopping and then, well, you're on your way to taking on a second job.
Ideally, before things get to this stage, you've had conversations with your parents about how they want their needs met during their later years. They've made out the papers naming a Power of Attorney for Health Care (a health directive indicating who will make health decisions if they can't and detailing their preferences for treatment) and a Power of Attorney for financial affairs. A will should be part of this, as well as other personal papers. Ideally, as well, all siblings are aware of these papers, what they contain and all are in agreement. Ideally – taking care of the elders becomes a family affair. However, life is seldom ideal.
Even in seemingly harmonious families, the person who slowly became a default caregiver can start to feel resentful. The out-of-town siblings can conveniently slide into denial. They aren't around to see how much help is needed. They see Mom and Dad occasionally, talk to them on the phone, and all seems well. The fact that you, the in-town sibling, are the reason everything is going so smoothly doesn't really register with them.
This is a red flag for you. It's time to stop and consider how you are, as a family, going to handle the spiraling needs of aging parents. Most experts would suggest a family meeting. I agree. You, the hands-on caregiver, would explain all you do and give your siblings a chance to help.
You'd find each other's strengths and weaknesses and work with those. You'd regularly check in with each other and update the whole family as needed. I would suggest this, because it is ideal, and many families can do this with a little work. If this works for your family, congratulations and you can quit reading here.
Those of you who read the posts on the AgingCare.com forum will see the cold hard facts. You will see that, for many, the chances of a civil family meeting where you hash out the needs of your elders and agree who does what are, well, nil. You will see caregivers stressing over siblings accusing them of spending too much of their parents money to care for their parents. You will read the pleas for help from the one sibling who has quit his or her job to care full time for an ailing parent being either ignored by siblings, or worse, being accused of predatory intentions because they are "running the show."
Option 1: Geriatric Care Manager
When these ugly scenes pop up, there's usually no way to go but through a third party. It's nice if you can agree on hiring a geriatric care manager, if you can find one in your area. This person would do the managing, get the help set up, and offer a cool head to work out problems, since the manager is not emotionally involved and doesn't carry family baggage.
Geriatric care managers are not available in every part of the country, and there is no over-reaching licensing, so you will want to do your homework. But sometimes, these people can make siblings see the light. They can help the ones in denial realize that the one doing hands-on care is "really working."
Option 2: Counseling
Family counseling is also a good route, if siblings are willing to work on sibling relationships for the sake of their parents. Talking through the issue with an objective third party, who can guide the conversation and keep it civil, can help families work through the challenges associated with caring for an elderly parent. It helps everyone involved to better understand the other family member's views, frustrations and challenges, and can sometimes offer a fresh perspective.
Mediators
Unfortunately, many family relationships are beyond that point. This is where elder care mediators come in. These people are trained to mediate family disputes. Likely you can find one through your local court system or in the phone book.
Two online places to search for this service are Eldercare Mediators at http://www.eldercaremediators.com/ and the Association for Conflict Resolution at http://www.acrnet.org/.
This is certainly worth trying before going to court over guardianship rights, which some families end up doing. It would be lovely if people didn't bring their baggage from childhood into adulthood, but we all do to some extent. If people could at least put sibling rivalry, greed and other undesirable behaviors aside for the sake of their elders, that would also be lovely.
But sharing the care of elderly parents doesn't always bring out the best in people. Add to that hopes of inheriting something from the estate, and it gets worse. This is when third party help is often a good option. For, if the hands-on caregiver doesn't get help somewhere, the damage done can reach far beyond the elders. Resentments nurtured at this time can poison family relationships for generations. If you are the default family caregiver, ask siblings for help early on. Let them know they are wanted (drop the martyr act).
If they have been given a chance and they refuse, try an agency designed to solve family issues. It could be one of the best investments you've ever made.
Elder care author, columnist and speaker Carol Bradley Bursack is an AgingCare.com contributing editor and moderator of the AgingCare.com community forum. Read her full biography