Thursday, May 14, 2009

Family frustrations: caregiver challenges within the family

Sharon K. Brothers, MSW
My sister and I have never been really close. She's three years younger than me, but very different in her preferences and lifestyle. She makes a living training horses, for example; I'm essentially afraid of all big animals.

It shouldn't have surprised me, then, when my mom needed lots of assistance after an accident that my sister and I approached it from very different perspectives. My mom lives close to my home (my sister lives two states away), so naturally many of the day-to-day tasks fell to me and my family. Somehow that didn't stop my sister from weighing in on a regular basis. The conversations often went like this:

Mom: "Sharon came by and took me to the doctor this morning."

Sis: "I hope she didn't just drop you off in the waiting room!"

Mom: "Well, I'm perfectly able to talk to the doctor without her in the room."

Sis: "Still, she should have stayed with you through the whole visit. I don't know what she was thinking!"

Of course, what I was thinking was that I have three kids at home, a business to run, a house, a husband and a dog. If my mom can manage any aspect of her care needs without my hands'-on help, I'm going to step aside and let her!

Most families, I've discovered, have similar sibling dynamics. One sibling (or sib-in-law) becomes the primary caregiver, responsible for the regular tasks like transportation, shopping, laundry and more. Other sibs, often living across the country (or maybe just a few miles away) are content to let the one sib do most of the work.

You'd think that the other family members would recognize the hard work of the caregiving sibling and be profoundly thankful - and you'd be wrong. Most often, siblings who don't have the direct experience don't really know what is involved, or how hard the caregiving sibling works.

It's easy to second-guess someone whose shoes you haven't walked in. It's not easy being on the receiving end, though.

What can you do?

1. Take it easy. Recognize that only you know how much effort is involved for you to keep all your balls in the air. There's no way anyone else can know exactly what your life is like, so don't expect them to know. Try to breath, smile and say, "I'd like to see her give this a try!"

2. Pass the torch. This is especially important for those distance siblings who say, "What are you thinking - moving mom into an assisted living center?! She can't be that much care!" Invite your mom to their house, and let them have a chance to see first hand exactly what mom does need.

3. Gather support. If you've got other siblings who can rally to your support, pull them in. In my case, my brother offered me constant support while my sister second-guessed every move I made - or at least it felt like it to me. So, every time I finished talking to my sister, I'd pick up the phone and call my brother. He would patiently reassure me that what I was doing was exactly right, and we could laugh together at my sister's many comments.

4. Hold a family meeting. Every family should sit down together and talk about big decisions, preferably before those big decisions need to be made. Involve the parents, if possible, and talk about choices for care (at home with help? At an assisted living center? Sell the house? Rent to a grandchild?). Make sure you talk about money, too, as decisions come with price tags that often are surprising. For example, keeping mom at home, no matter what, is fine if mom can afford to pay for around-the-clock-care (expect to pay several thousands of dollars for 24-hour in-home care), but if money is restricted other options need to be carefully considered. If you can do this together you may be able to avoid some of the worst family conflicts.

5. Get company. You can take comfort from knowing that you're not alone - in fact you're more like most families than unlike them, if you have some sibling discord. You might want to join a support group of other family caregivers (check with your local hospital) to share your frustrations and get support. You'll not only get an outlet for your own feelings, you'll gain new friends and helpful tips for survival from others in similar situations.

My sister and I are closer these days, but we still see mom's care from very different perspectives. Most days, I can smile and nod when I talk to her. Some days it's not so easy. But like all family dynamics, it's a work in progress.

DID YOU KNOW...

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