Make the best senior care decision

Seeing a parent’s health decline can be painful, but it doesn’t have to cause conflict within families. Below are some of the most common issues that can arise among family members and advice on their solutions.

Adult siblings don’t always see caregiving needs the same way. One child may have the impression that a parent is doing fine at home, while another feels that the parent needs extra help. This is especially common if family members are spread out geographically or spend different amounts of time with the aging loved one.

Solution: Get an expert assessment.

An outside opinion can often help resolve issues. Arrange for a geriatric care manager or therapist to visit your loved one’s home for a safety assessment. Also, consult your parent’s primary doctor about recent deterioration or any developing physical challenges.

Clarification from health care professionals can define the next steps and prevent sibling arguments about how much care is necessary.

Solution: Research senior care options.

Once care needs are established, the next step is deciding who will provide the care. If a family decides a senior living community may be a good solution, our Senior Living Advisors have experience matching seniors’ needs and lifestyle preferences with communities across the U.S.

If your loved one will remain at home, help from you and your siblings can range from financial assistance to daily visits. If you or another sibling are considering full-time caregiving, read these top 10 duties of a senior caregiver to better understand what the role requires.

Often the child who lives closest to their aging parent, or has the closest emotional relationship, will assume the main caregiver role. When other family members don’t readily offer to help, the primary caregiver can feel isolated, alone, and resentful.

Solution: Caregiver should communicate needs and ways others can help.

From a distance, it may not be clear to family members just how difficult caregiving has become. Sometimes, the role of primary caregiver is unavoidable for one person due to family dynamics.

If siblings live far away or have never had a close relationship with the parent, they may not be able to provide in-person support. But family members can still help from afar with things like finances, appointment scheduling, meals, or emotional support.

Financial support can also help pay for part-time home care, which can give respite to an overworked family caregiver. Our Senior Living Advisors can also help connect families to local in-home care agencies.

Sometimes one child takes over the caregiving role and leaves other family members in the dark, perhaps even limiting access to the elderly loved one.

Solution: Urge communication with siblings, parents, and, if necessary, authorities.

If possible, call or write to your sibling, explaining your feelings and desire to be more involved in the parent’s care. If your relationship with the caregiving sibling is strained, strive to maintain ongoing communication with your parent through phone calls, email, or letters.

If your sibling is acting as a gatekeeper and prevents you from reaching your parents, and you have reason to believe there may be abuse or exploitation involved, call local Adult Protective Services to intervene.

Even if your sibling is angry, remember that you’re putting the health and safety of your parents first.

Sometimes, siblings may not understand or choose to ignore how much help the parent needs. Other times, adult children refuse to care for an elderly parent due to negative past relationships or current inability.

Solution: Try to understand everyone’s point of view.

If you believe your siblings just aren’t aware of your efforts, try to schedule visits or video calls, or request doctor testimony to explain the severity of the situation. Caring for a loved one in declining health is hard enough without throwing family issues into the matter. Fortunately, the solution may be surprisingly simple: make weekly family meetings the norm. When you talk to other family members every week, it becomes easier to be honest with how you’re feeling and what you need. More importantly, it becomes easier for your family members to notice when you become overwhelmed and might need a break, even if you’re not ready to ask for it yourself.

If your siblings refuse to help due to past trauma or current circumstances, that’s their right. See if they are willing to help financially, or provide you with emotional support, even if they won’t interact with aging parents.

Let our care assessment guide you

When immediate family members come together to care for aging parents, they often revert to dysfunctional and unhealthy roles from the past. Think of all the times mom or dad broke up your fights as kids. It’s important for everyone to simply remember that this is about what’s best for the parent, not your long-standing sibling rivalries.

Solution: Consider a mediator.

Sometimes a neutral third party is the only way to calm feuding family members. Representatives from the National Family Caregiver Support Program or your local chapter of the Area Agency on Aging could act as mediators. A counselor, doctor, or geriatric care manager can also mediate. Costs for mediation services will vary depending on where you seek services. Be sure to check with insurance providers for more information about costs and fees.

At a family meeting, there should be a frank and open discussion about a parent’s care needs. Each sibling’s role and obligations should be established, and future plans should be made. Discuss finances, caregiving, and any wishes your parents already have in place.

Sometimes, adult children realize that their loved one needs care, but the parent refuses to see it as an option. This can lead to a divide between siblings who want to follow their parent’s wishes and those who know it isn’t feasible.

Solution: Explain the benefits of senior care.

Listen to concerns. Emphasize your role as an advocate for the parent’s quality of life — to show how senior living or in-home care can help the parent maintain the lifestyle they already enjoy.

Sometimes older parents have an outdated view of senior living. Explain that today’s assisted living communities are verydifferent from the nursing homeswhere they may remember their own parents or grandparents living.

Suggest that you all see communities together, whether through in-person visits or a virtual tour. After understanding the amenities and lifestyle senior living has to offer, parents may be more likely to make the transition.

It’s a harsh reality that, as they age, many seniors experience significant personality changes due to dementia or physical decline. You may find that the parent you’ve been close with your entire life is physically threatening or verbally abusing you, and your siblings may not believe it’s happening.

Take a step back and remember that this isn’t your fault.

Solution: Find a balance between caring for your parent and maintaining your own well-being.

Caregiver burnout is especially common in this situation, which can cause your own health and relationships to suffer. If you’re a full-time caregiver who’s decided to keep a loved one at home, consider adult daycare, occasional respite stays, or weekly in-home care. The National Family Caregiver Support Program can also offer guidance and resources to those experiencing caregiver burnout.

Your aging parent may threaten or attempt to manipulate you when the topic of outside senior care is broached. Recognize that this is another sign they need professional help, and, if necessary, get siblings or your local police department’s elder affairs officer involved. The safety of you and your loved one should always be the priority.

Finances play an enormous role in how siblings choose to care for their aging parents. The cost of senior living often seems overwhelming and can deter families from exploring all of their options.

If your aging loved one does require in-home care, hospice, or senior living, who will pay for it? Should residual expenses be split evenly between siblings, or should those with higher incomes pay more?

Solution: Establish family financial roles in advance.

Try to make these financial decisions and establish a budget in advance. Ask your parents how much money they’ve saved and if they’ve taken out a long-term care insurance policy.

If you and your family decide that aging at home is the best option for your loved one, recognize the financial repercussions. From food and medicine to potential home health services, caregiving a loved one can be economically draining.

For sandwich-generation caregivers, those who are “sandwiched” between taking care of their elderly parents and their children while maintaining their own daily responsibilities, the emotional and financial toll of taking on the care of their elderly loved one can be severe.

If you don’t have money available for outside care or to support a parent in-home, see if a family member can get paid to be a caregiver. If your loved one qualifies for Medicaid or Veterans Affairs (VA) benefits, some states allow for a caregiving stipend.

End-of-life care is controversial. One child may want to arrange hospice care for a terminally-ill parent, while another may advocate that every day lived is a victory. In both cases, family members want what is best for their aging parents, but they disagree about what that means.

Talk with a Senior Living Advisor

Solution: Let your parents make the decisions.

End-of-life conflicts can be avoided when seniors write a living will long before a medical care crisis. Also called a health care directive, a living will specifies end-of-life wishes. Ask the parent to pre-designate a power of attorney, or durable power of attorney, to carry out these requests.

If you’re worried that power of attorney could be contested in your family, have all documents reviewed by a lawyer or notarized at your local post office or bank.

Solution: Understand power of attorney types and know your responsibilities.

Power of attorney is one of the most frequent conflicts between siblings with aging parents. This is partially due to misunderstandings about the position.

• General power of attorney. This assigned individual can perform almost any act in place of the principal (aging parent). This includes opening financial accounts, making medical decisions, and managing personal finances. General power of attorney is terminated when the principal becomes incapacitated, passes away, or revokes it.
• Durable power of attorney for health care. This person has the authority to make medical decisions during an emergency, regardless of the principal’s mental competence or capacity. It’s their job to make sure that health care providers carry out all wishes made in a health care directive.
• Durable power of attorney for financial care. This individual maintains control of finances, even if the principal is deemed mentally incompetent or incapacitated. This is necessary to open accounts and manage personal finances for loved ones with advanced dementia.

Sadly, inheritance issues with siblings are common, and they often stem from a lack of communication. Explain to your aging parent the importance of estate planning.

Solution: Know about inheritance and estates in advance.

While it’s not appropriate to worry your loved one unnecessarily about heirlooms, it can actually be helpful to discuss things in advance so that siblings don’t feel shortchanged. If there’s something that matters to you, let your parent know.

Disputes about inheritances can be ideal cases for family mediators. A family mediator’s job is to analyze these situations fairly and objectively and to help siblings find areas of common ground.

1. Understand the wants, needs, and concerns of parents

In situations that allow it, give your parents the opportunity to communicate what they would feel comfortable with in potential or current situations. Also, allow your parents to express any potential or current concerns. This communication gives siblings a clear understanding of their parents’ wants, needs, and concerns, enabling siblings to cater to their parents and avoid disagreements since the parent has already provided guidelines on what to do.

1. Listen to everyone AND be empathetic

Each sibling will most likely feel different about your parent’s declining health, how to approach care, and what their role should be. By letting everyone discuss their concerns, wants, and potential roles, everyone can feel heard when disputes arise and decisions are made. While listening to siblings’ concerns, it’s also important to be empathetic to their financial and emotional positions. While another sibling’s concerns may seem trivial to you, it’s important to at least hear them out and take all their concerns seriously.

Pro Tip: Know when to walk away and seek help.

When discussions about decisions for parents turn into disputes, things can quickly become tumultuous. Avoid this by knowing when to pause a conversation and come back at a time when emotions aren’t running as high. If you’re not able to have a calm conversation, consider bringing in a mediator to help resolve disagreements.

1. Keep communication going
   

Staying in contact frequently keeps all siblings in the loop, allowing everyone to feel like they know what’s going on. Whether it’s getting together in person or over a video chat, keep open communication lines so everyone can discuss any concerns as they arise. Open communication can even help siblings bond while taking care of their parents.

Watching a parent’s health decline can be painful, and, more than likely, it will cause disagreements between siblings. But that doesn’t have to tear your family apart. Keep these solutions and tips in mind to help you and your siblings have better communication, avoid arguments, and even strengthen your relationships.

When that simply isn’t possible, consider reaching out to a Senior Living Advisor at A Place for Mom. Our advisors are well-versed in all care types and can provide input that may defuse family arguments and redirect conversations toward providing your loved one with the best care.

Sources

Glicksman, E. (2021, May 8). When an ailing parent needs more care, sibling conflicts can arise and add to stress. The Washington Post.