Family Caregiving Responsibilities: When Siblings Disagree on a Parent’s Care

Caring for an aging parent can get complicated when siblings have differences of opinion. Siblings may disagree on when their parent may need to stop driving, where their parent should live, what kind of everyday care they need, or who will provide the care. Stress, sentiment, and fears of making the wrong choice can all contribute to family conflicts, fracturing relationships when we most need one another.

Family caregiving requires patience, grace, and resilience, but it does not have to be fraught with sibling arguments and resentment. It also should not neglect the parent’s wishes and quality of life as the family addresses their health and safety needs. Here are some considerations for families negotiating an elderly parent’s care needs.

But First: What Is Family Caregiving?

About one in five US adults is providing untrained, unpaid care for a family member or friend. Family caregivers may provide this care for many years due to a variety of factors, including a shortage of paid caregivers in many parts of the country and the often prohibitive costs of professional care. There is inadequate information available to many families about their options, including respite resources or VA benefits for which their elderly loved one may qualify.

Many children of aging or infirm parents consider it their duty and privilege to care for them, but as their parent’s medical needs increase, they might lose mobility, motor capacity, memory/cognitive capacity, hearing, or sight, making them more dependent on assistance for activities of daily living (or ADLs). The majority of family caregivers are not trained in how to care for an aging parent, and the emotional impact of providing care can wear on them as much as the physical and time demands—which are many, since the average family caregiver is also caring for school-aged children and/or working full time. (See also: the “sandwich generation.”)

Even in families with several siblings, there is often a disproportionate burden of care placed on one person, who may receive little support from the rest of the family. Whether through a lack of communication, disagreements, or simply feeling unprepared and under-resourced, families can easily fall into just treading water when it comes to caring for an elderly parent.

Why Families Need Early Care Planning

One of the best ways to ensure that your elderly parent will maintain a higher quality of life as they age is to talk early about their preferences and needs. While your parent still has a pretty normal routine and stable health, the whole family should have a conversation around whether they plan to age in place, move in with one of their children, move into an assisted living facility, or pursue another option. Talk to them about accepting help when the time comes that they need it. All siblings should be involved in understanding their parent’s needs and planning for them.

Families should involve the parent’s doctor or geriatric care manager in forming their care plan, as they can provide details on their health prognosis and input on what will be needed down the line. They should also talk to an attorney about power of attorney documents and tying up any loose legal ends related to medical decisions or finances.

Though these conversations can be difficult and might feel awkward to initiate, caregiving responsibilities and details should not be decided when the parent is in crisis and cannot offer calm, thoughtful input.

Family Caregiving Roles and Impacts

Siblings should talk about who will take on responsibilities such as:

• taking their parent to medical appointments and staying up to date on health developments.
• monitoring their parent’s home maintenance and safety, including seasonally.
• monitoring their parent’s finances, bill payments, utilities/subscriptions, and similar administration.
• helping their parent with technology and troubleshooting their internet, TV, etc.
• in-person visits, regular communication (like phone calls), and check-ins.
• coordinating care professionals, such as physical therapists or home health aides.

As their parent’s medical conditions progress, siblings should talk about who will assist them with preparing meals, bathing, dressing, and similar needs. This may be the point at which home care is discussed, whether full- or part-time. Collaborate on researching for options, and talk about who will pay and how. It is a good exercise to write down all these responsibilities in a care plan. Regularly scheduled meetings might feel formal, but are also a great way to keep everyone on the same page.

In most families, one sibling will end up with more care responsibilities because of their physical proximity to the parent, their lighter load of other responsibilities, their financial resources, or their temperament. It is important for this sibling to communicate with the others when they are feeling burned out or experiencing compassion fatigue, as well as when they are financially stretched or becoming unable to balance all their demands.

Sibling Conflicts

It is unfortunately common to have sibling conflict over the care of an elderly parent. For the primary caregiver sibling, resentment can build due to the unequal burden of care. They might feel underappreciated, overworked, or taken advantage of by their siblings. The other siblings may also feel unheard, dismissed, or shut out of decision-making. Old conflicts from childhood can even rear their heads.

In these difficult times, families would do well to remember that they are working toward the same goal of providing the best care and quality of life for their parent. Each has something important to contribute from their strengths, and if they are wise about dividing the labor, they can better support their elderly parent—and one another.

In cases when siblings cannot come to an agreement, it can be helpful to involve a professional mediator. Many towns have a local chapter of the Area Agency on Aging, which can provide mediation or a referral, or you can search through the Association for Conflict Resolution. Other potential mediators include legal professionals, therapists, and social workers.

For those who are left to care alone for their parent due to longstanding estrangement or noncooperation of their siblings, this is a difficult position to be in. They might consider getting outside help in the way of respite care, as well as help from their parent’s neighbors, their house of worship community/clergy, local caregiver resources, or close friends. Delegating blocks of time or specific tasks can help to lighten the load of care while asking for specific, doable assistance from others.

Lastly, if a family believes one of their siblings is abusing or exploiting their parent, contact Adult Protective Services for intervention.

Family care planning can be intimidating, but there are resources to help. If your loved one needs home care, our VetAssist mission is to make home care easily and quickly accessible for those who qualify through the VA Pension with Aid and Attendance benefit. Veterans Home Care can help you determine whether you or your loved one will be eligible to receive the benefit, which can cover some or all of the cost of home care, and we make it easy to apply. Chat with us via our website, or call us at (888) 314-6075.