Sibling Rivalry: When Family Members Disagree on Senior Care Options
January 31, 2018When it comes to caring for an aging loved one, having family members by your side can be a tremendous help—mentally, physically, and financially. But there are also times when having to consider more than one opinion on an issue can cause great strife between relatives.
We often see this challenge come up between adult siblings who disagree on the “right” way to care for their aging parent or parents. There are of course exceptions, but most of the time, these discordant adult children have good intentions and truly believe theirs is the right choice for mom or dad, but their sibling may have a different idea of what is best.
It can be a really difficult situation, with siblings even severing ties with one another over such issues.
If you are a senior with adult children, you likely want to help them avoid disagreements if possible (just as you’ve been doing since they were little!). So, let’s dig into this issue of “sibling rivalry” as it relates to caring for aging parents…
When differences arise
The impetus for sibling conflicts about a parent’s care may be an injury or a terminal illness diagnosis, but they can also surface as parents begin to display normal age-related mental or physical decline. In my observations, there are three common scenarios where this struggle frequently plays out among siblings:
An adult child wants to keep mom or dad in their own home.
This situation often occurs when one parent passes away, leaving the remaining parent, who may also be in declining health, alone in the home. (Or perhaps mom or dad is single to begin with.) There are a number of ways the resulting argument between siblings can go, but it might sound something like this:
“Dad made us promise we would never send Mom to a retirement home. This is a familiar place where she is most comfortable…Mom and Dad have lived here our entire lives!”
“But the house isn’t safe for her anymore…she can’t manage the stairs, the upkeep is too difficult, and I don’t have the time or money to take care of another house on top of my own.”
On the surface, keeping mom or dad in their home may sound like a cost-effective solution, but should they require changes to the home to make it accessible (such as ramps, lifts, or walk-in tubs) or if they require assistance with upkeep or activities of daily living (ADLs, such as bathing, dressing, eating, etc.) from their adult children or a home health worker, staying in the home may look a lot less desirable to one or more child, especially if the adult children live out of town or are busy caring for their own families. In some cases, the home can actually be the least safe and practical place to be.
An adult child wants mom or dad to move in with them (or another family member).
As I’ve written about on many occasions, taking on the role of caregiver, either part-time or full-time, can be rewarding for some people, but it can also be an extremely difficult task. If one sibling feels that it is their duty and responsibility to care for their aging parent or parents, just as their parents cared for them in their childhood, it can set up a challenging dynamic with other siblings who either can’t or don’t want to assist with caregiving responsibilities.
Just this past weekend, I spoke with someone who said she looks after her mom and that her siblings really don’t do as much as they should/could. This is very common, and it’s easy to understand why resentments quickly can begin to fester if one sibling feels they are taking on more of the heavy-lifting either literally—bringing their parent(s) to live with them and then assisting with ADLs—and/or financially—incurring elderly parents’ living and care expenses—than another sibling.
An adult child thinks mom or dad needs to be moved to a care facility.
This disagreement between siblings may be an amalgam of the previous two: One sibling feels that mom or dad should either remain in their own home or should move in with a family member; they believe it will be less expensive and their parents will receive better care from a loved one. But another sibling believes their parents would be better off in a senior living facility—either assisted living or skilled nursing care, depending on the circumstances. It may be that that child feels that in a care facility, mom and dad will have access to the services they need and be cared for by professionals, or it may be that the adult child doesn’t have the bandwidth (emotionally, financially, or time-wise) to take on their parents’ care.
This is a challenging disagreement to reconcile since these options (remaining in a private home or moving to a care facility) are in some ways on opposite ends of the spectrum. This can truly leave siblings at an impasse with irreconcilable differences of opinion about what is best for mom and dad.
Averting crises between siblings
Of course, there are instances when an aging parent’s health situation changes very unexpectedly, but in most cases, sibling clashes can be avoided with some advanced planning by the aging parents and their adult children. Here are a few ways that seniors can help prevent disputes between their adult children about their long-term care needs:
Have an honest conversation before issues develop.
It isn’t a discussion a lot of people look forward to, per se, but it’s invaluable for seniors to sit down with their adult children to discuss their wishes for how they will be cared for as they grow older. Whether you hope to remain in your own home or have other ideas about how you’d like to be cared for, this conversion alone can set the stage for many of the decisions that may need to be made down the road. Here is an article that will give you some ideas about what topics to cover during “the talk.”
Create detailed documentation about how you want to be cared for so your children don’t have to guess.
If you haven’t already done so, there are several legal documents that seniors should create in order to take the guesswork out of their care wishes. Beyond writing a will, seniors should designate an “agent”—a person who will make decisions should you become mentally or physically incapacitated—by creating a power of attorney document. Additionally, completing advance directives documents (also called a living will) will make it easier for your adult children to ensure you receive the level of care you desire (especially related to end-of-life decisions). Even with these formal legal documents, your specific wishes may not be crystal clear, so you may want to consider writing a letter to accompany your documents, which can help fill in the gaps.
Consider moving to a CCRC while you’re still healthy.
One of the most proactive steps that seniors can take to help make sure they will receive the care they need in the future is to move to a continuing care retirement community (CCRC, also called a life plan community) before major health issues arise. This one decision not only provides seniors with the peace of mind that comes with knowing they will not be a burden to their adult children, it also can alleviate potential tension between siblings who have differing ideas about how and where mom and dad should be cared for. Additionally, aside from having a plan in place for future care needs, residents of CCRCs often describe how much they enjoy the independent living lifestyle they have today, including comprehensive wellness programs, social benefits, and more.
Coming from a place of love
When making choices about caring for an aging parent, one of the most important things that siblings can do is to remember they are ultimately on the same team, wanting what is best for their mom and dad. And for those seniors who hope to avert disagreements between their adult children, some frank discussions and advanced planning can simplify difficult decisions down the road.
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