Oh, Brother! When Siblings Are Caregivers

Picture this: My mother is in rehab in Connecticut. She is recovering from two surgeries for blood clots followed by a third for a raging staph infection. My brother, who retired in his 50s and lives ten minutes from my mother, announces that he and his girlfriend are taking a month-long vacation to London and Africa.

I live two hours away in another state, with a husband and a daughter at home, constant work deadlines, and a mother-in-law with cancer at the other end of the state. I plead with him, unsuccessfully, to postpone his wanderlust.

Over the course of the next three years, as my mother fails further, my brother takes unhurried getaways to New Zealand and Fiji, Italy, Dubai and the Seychelles Islands in the Indian Ocean.

Caregiving for my mother was physically and emotionally grueling, and the anxiety it caused was further compounded by my increasingly strained relationship with my brother—a sibling with whom I had been close.

Granted, my situation was extreme; the fact that we didn’t get along isn’t. Sadly, it’s far too common for adult siblings who become caregivers to clash.

What Causes Sibling Strife

Oh, brother! There are many reasons for family friction. Among them are: an unequal division of labor; different expectations; different personalities; income, geographic and time disparities, and sibling rivalry.

Other dividing factors may include:

• Uneven input, with one sibling calling the shots–without consulting the others
• Differences of opinion on how the parent’s money should be spent
• A lack of transparency from the child who is handling the bills
• Disagreements over safety, housing, driving and health decisions
• Criticism of how a sibling is doing their caregiving “job”
• Competing demands (i.e., work, family, personal time)

Siblings who never got along as kids and have had little contact as adults may suddenly be forced to make difficult decisions together. But, even families who are close can struggle or overreact from the stress.

“When siblings squabble over who will care for Mom or Dad, or refuse to help one another, the problem often isn’t about caregiving, but the conflicts and power struggles that have existed since childhood,” says Los Angeles gerontologist Alexis Abramson.

Barry Jacobs, a Swarthmore, Pennsylvania, clinical psychologist, author of The Emotional Survival Guide for Caregivers and co-author of AARP Meditations for Caregivers, counsels clients on strategies for family harmony. And yet, it’s been far from smooth sailing with his own brother.

In caring for their mother, “we immediately went back to our childhood dynamic: me as the older bully and him as the obstinate and lazy little brother who was not stepping up,” says Jacobs.

Jacob adds that, “in hindsight, rather than get angry and distance myself, I would have accepted whatever my brother was willing to do instead of attacking him for what he wasn’t doing. Our relationship has never recovered.”

Strengthening Sibling Relationships

Caregiving doesn’t have to drive a wedge between adult children. Instead, it can bring them closer together. When siblings work as a team, communicate openly, put aside egos and extraneous issues and act in their parent’s best interests, friction is less likely. A reminder: if your parents are cognitively capable, they should be included in major conversations. This is about them!

Here’s what the experts suggest:

Ask for What You Want

Don’t expect your brother or sister to guess your needs, or your parent’s. They may think you’ve got it covered or don’t want help. Or, they simply might be clueless. You’re right, you shouldn’t have to ask them to help their parents, but let that go and just speak up.

Divvy up Tasks

Can a tech-savvy sister research smartphone apps to keep Mom socially connected and safe? Can a brother with a head for math pay the bills online? Can someone take Dad once a month to give you a breather? A well-off family member might pick up the tab for respite care, chip in more for paid help or spring for a housecleaner. Discuss what tasks need to be done and how you can come together to accomplish them.

Hold Regular Family Meetings

Preferably, this should be done in person, but if that isn’t possible, try FaceTime, Skype, conference calls or email. Discuss logistics (who will do what), issues, needs and each member’s availability and constraints. The more you communicate, the better you’ll be able to work together as a team.

Be Nice!

Bag the name-calling (“You’ve always been selfish!” “You’re a control freak and know-it-all!” “You’re cheap!”) The stakes are high–not only for your parents, but also for your future relationship with your siblings. Reminder: you are a model to your kids. They’re watching not only how you treat their grandparents, but their aunts and uncles as well. And this could impact how they treat you and their siblings someday.

Be Honest

If you’re not the primary caregiver, are you appreciative or helpful enough? Might you have a role in the tension? During her mother’s illness, Francine Russo, who lives in New York and is the author of They’re Your Parents, Too!: How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy, spent little time visiting her mom in Philadelphia. They had always had a difficult relationship.

“I didn’t have the emotional maturity to be more present,” Russo recalls. “It was easier for me to do what I had always done– keep my distance unless I was asked to do something. And I wasn’t asked.”

At the funeral, “I saw my father and sister sobbing and holding each other and realized they had been through a terrible ordeal without any support from me,” she says. “I was stricken with guilt and regret and was deeply ashamed.” Russo apologized and stepped it up when her dad became ill.

If you’re not the primary caregiver, examine what your contributions are. If you find that they’re lacking, speak to your siblings about what else you could be doing to help.

Vent the “Right” Way

Take a break when you’re upset or the situation becomes contentious. Save those intense feelings for a social worker, friend, support group, geriatric care manager, clergyperson or therapist.

Another option is elder mediation. Here, siblings who cannot come to an agreement on their own work with a mediator to resolve their issues. Mediators, often therapists or attorneys, keep families focused on what’s best for their parents rather than old or current baggage.

To learn more about elder mediation and whether it’s right for you, or to find experts in your area, check out Mediate.com. If you do hire a mediator, make sure they are trained in both basic and elder mediation.

Consider a Redo

If you’re unhappy with your sibling relationship, think about what you can do to change it. Try asking for or offering more help. Spend time together talking about something other than caregiving so that it’s not your only way to connect. Even something as simple as meeting for lunch or a movie could help to alleviate some tension. If you’re brooding over the relationship, chances are your sibling is, too.

RELATED: Tips for Caregivers | Understanding Your Parent’s Perspective