John was blessed with a large family. He would be the first to tell you so. Now that he is elderly — a widower well into his 80s — and has dementia, all of his children are committed to seeing that he gets the best care possible. Even though most live out of state, and the primary responsibility for managing caregiving falls to the ones who live nearby, for the most part, there have been few family conflicts.
Every once in a while though, a family member becomes upset about something and if the situation isn’t handled well it could quickly escalate. An example: One of the siblings responsible for managing day-to-day care makes what she considers a minor decision and an “away” sibling is upset that she was told about it after the fact instead of being asked to participate in the decision-making process.
The example is fairly typical says Nancy Markowitz, who provides family and elder mediation services for Advantage Home Care. In the best-case scenarios, families have either learned how to successfully resolve their own conflicts or they have someone to turn to for help. The key is to get started before things go too far. “You would hope that it would happen before it escalates,” says Nancy, “but like everything else in life, people don’t use it until things have begun to fall apart.”
Why is it that even when family members share the common goal of providing the best care possible for an elderly parent, disagreements can happen so easily?
- People slip into their old childhood roles when the family gets together — no matter how old, how accomplished or how mature they are.
- Sibling rivalries surface or become exaggerated under the strain of caregiving.
- Siblings may have different opinions about what an elderly parents needs.
- An “away” sibling may only talk to a parent by phone and think that everything seems just fine.
- Concerns about how to pay for care may arise. A sibling who doesn’t earn the same income as another may harbor resentment or may worry about a diminishing family estate.
- Siblings who handle the bulk of the care may become exhausted and resentful. “Away” siblings may be grateful for the ones providing the care, but may also feel guilty.
A closer look at family conflicts
“One of the biggest conflicts is around communication,” says Nancy. “Lack of or misperceived communication … missing facts. Sometimes families need to go in reverse and look at all the facts. What happened? How was this decision made?”
An issue for families like John’s, in which some of the children live out of state, is that they might not have a realistic picture of what’s really going on. For instance, over the phone, even a person with dementia may be able to communicate fairly well. “It causes a joint misconception,” Nancy says. “The parent, on one hand, is actually making it sound like everything is ok and the “away” sibling doesn’t really have the day-to-day experience of what’s actually happening. Sometimes the sibling who is there will see what needs to happen and will make a decision about it, not thinking it’s a big deal.”
Conflict can happen when the “away” sibling doesn’t understand why such and such a decision was made because there doesn’t really seem to be a problem — Mom or Dad sounded perfectly fine on the phone. That same sibling may be resentful because decisions are being made without his/her input and the one who is providing care may feel resentful because he/she doesn’t feel supported.
Feelings of guilt can also get in the way of good communication. “The other siblings may be appreciative that someone is there making decisions, but then if something happens, they may feel guilty because they’re not pulling their weight. The guilt may turn into resentment because they’re not being including in the decision making.”
No matter how large or small the family, Nancy’s advice is to figure out how you are going to communicate before you’re faced with conflict.
- Have regular family meetings. Use whatever method works best for the majority.
- In person
- Conference calls
- Email, but be really careful with how you word things. Read it over before sending and never write an emotional response; pick up the phone instead.
- Divide caregiving responsibilities according to skills and availability
- A sibling who can’t provide direct care could take over bill-paying and/or grocery shopping instead.
- Siblings from away might try to visit more often in order to provide respite care.
- A home care agency could help provide companionship or other services, such as grocery shopping or housekeeping.
- If you’re overwhelmed by whatever responsibilities you’ve agreed to, tell your siblings. They may have no idea how you feel.
- If you live away, let your siblings know how much you appreciate what they are doing. Ask if there is some way you can contribute and follow up.
How to handle a family conflict
- Take a deep breath and try to assess your role in the situation.
- Consider speaking to a mediator or counselor skilled in helping families caring for an elderly parent.
- If you are a primary caregiver, make sure you are also taking care of yourself. If you’re overwhelmed and exhausted, you’ll have even more trouble trying to resolve problems.
Contact Advantage Home Care if you’d like more information about Nancy Markowitz and her mediation services. Your local area agency on aging or the Alzheimer’s Association may also be able to help you find an appropriate counselor or family mediator.
If you have been successful at handling family conflicts, please share your story with us. We are always looking for ways to make things easier for families.
Originally posted August 20, 2013