For some lucky families, having all 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 other families, things can take a disastrous turn when siblings who never got along as kids and have had little to do with each other as adults are thrown together to make caregiving decisions.

For most families, navigating elder care decisions falls somewhere between these two extremes. Caregiving has a way of sneaking up on people, though. Generally, the adult child living nearest the aging parent(s) is who becomes, at the first sign of need, the default caregiver. That usually makes sense because proximity is a huge factor in how quickly or frequently a family caregiver can check-in on or assist a love one.

However, a few quick tasks and offers of help can quickly get out of hand. Your folks need some guidance on their Medicare coverage, so you stop over. Their yard is in desperate need of attention, so you start taking time away from your family to pitch in each week. Then it’s grocery shopping and rides to doctor’s appointments and then, well, you’re on your way to taking on a second job.

Preparation and Cooperation Are Key

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 hopefully designated powers of attorney for both health care and finances, drawn up a will, and finalized any other legal documents and financial plans. It’s best if all siblings are aware of these preparations and all agree with what they entail. This is important because taking care of aging parents is usually a family affair. However, life is seldom ideal.

Even in seemingly harmonious families, the person who slowly became the default caregiver can start to feel resentful. Out-of-town siblings can conveniently slide into denial because they aren’t around to see how much time and effort is involved. Through occasional visits and phone calls, all seems well with Mom and Dad, but it doesn’t occur to them that you, the in-town sibling, are the reason everything is going so “smoothly.” Some siblings may even be in total denial that your parents are as feeble or needy as you know them to be. This is a red flag that it’s time to consider how you are going to handle the spiraling needs of aging parents as a family.

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Calling a Family Meeting

Most experts would suggest a family meeting, and I agree. Such a gathering gives the hands-on caregiver the opportunity to clarify the parents’ needs and explain all they do. It also gives the siblings a chance to learn about the situation, participate in care decisions and brainstorm how they can pitch in.

The goal is to determine each other’s strengths and maximize them to create a care plan that divvies up responsibilities more evenly. Will everything work out equally? Not a chance. But the hope is that the primary caregiver will no longer be responsible for every little thing their parents need. You’ll want to set a schedule to regularly check in with each other and update the whole family as needed. With a little effort and cooperation, families can come together and support one another in this endeavor. If this works for your family, congratulations! You can quit reading here.

Strategies for Getting Siblings on Board with Caregiving

Those of you whose families are a little less dynamic may not have success with a simple heart to heart. As is evident in the questions and answers about siblings on the Caregiver Forum, caregiving can put serious strain on familial relationships.

For many, the chances of a civil family meeting where you hash out the needs of your elders and agree on who does what are nil. Countless caregivers stress over brothers and sisters who accuse them of spending too much of Mom and Dad’s money on doctor’s appointments, durable medical equipment and respite care. Some quit their jobs to take on caregiving only to be ignored by their siblings, or worse, criticized for how they are “running the show.” When ugly scenes like these pop up, bringing in a third party is usually the only way to straighten things out.

Option 1: Geriatric Care Manager

For discordant siblings who each are unable or unwilling to agree on a plan of care, hiring a geriatric care manager (GCM) is a great option. These elder care professionals are often social workers or nurses who specialize in assessing a senior’s needs and coordinating the care and resources necessary to help them maintain a high quality of life. While GCMs do not actually provide hands-on care, they use their expertise to create an appropriate care plan for a senior and coordinate the provision of all aspects of it, whether by family members or hired elder care services.

The best part is that a GCM is an expert in this area and is not emotionally involved in the situation. This reduces the need for speculation and disagreement over what a parent “truly” needs and provides a source of objective guidance and information for caregiving families. Hiring a GCM can be expensive, but it is said that the benefits they bring to seniors and their families are well worth the money.

Read: Adding a Geriatric Care Manager to your Elder Care Team

Option 2: Counseling

Family counseling is also a good route if siblings are willing to work on their relationships for the sake of their parents. A family therapy practitioner can be a psychologist, social worker or other mental health professional. As an objective third party, they can guide the conversation, keep it civil and help families work through the challenges associated with caring for an elderly parent. Sessions can help everyone involved to better understand each other’s frustrations and concerns, develop a fresh perspective, and learn more productive ways of communicating with one another. If everyone is willing to put in the time and effort, therapy is the best way for a family to heal itself and resolve underlying issues.

Option 3: Elder Care Mediation

Unfortunately, many family relationships are beyond the point of cooperation and repair. This is where elder care mediators come in. These people specialize in resolving conflict and facilitating negotiations between disputing parties. A mediator does not tell the parties what to do or decide the solutions for them. Rather, a mediator helps people to see things from a different point of view and reach their own negotiated agreements. Mediation can save untold grief and stress and can prevent things from boiling over into destructive actions by one family member against another, such as law suits and guardianship petitions. You can find a mediator who specializes in elder care issues through your local court system, on or on the Association for Conflict Resolution website.

Deciding to Bring in Outside Help

It would be lovely if people didn’t carry their baggage from childhood into adulthood, but we all do to some extent. Sharing the care of aging parents doesn’t always bring out the best in people, and many cannot put sibling rivalry, greed and other undesirable behaviors aside for the sake of their elders.

Bringing in an objective third party can help resolve some of these issues and set a collective goal of providing quality care for the senior(s) in question. When one person takes on caregiving by themselves and the family is in constant turmoil, everyone suffers. Resentments nurtured at this time can damage family relationships for generations. Choosing to cooperate at least enough to hire someone to help you all through this difficult time could be one of the best investments you’ve ever made.