Caring for aging loved one can be one of the most stressful family milestones. The sheer difficulty of the task, its high cost, as well as underlying family issues can collide to create a perfect storm of discontent.
If families can put aside their differences and work together as a team for the best interest of their elderly loved one, they are often able to overcome this challenge and assure that their parent’s last years aren’t marred by bickering and strife.
Reasons Families Fight about Senior Care and Possible Solutions to Avoid Conflict
1. Siblings View Parent’s Need Differently
Adult siblings don’t always see care needs the same way. One child may have the impression that mom is doing fine at home while another feels that care must be put in place immediately.
Possible Solution: When siblings disagree about how much care a parent needs, or about whether the parent needs care at all, the conflict can often be resolved by seeking expert guidance. Arrange for a visiting nurse with a background in elder care assessments to see your older loved one at home and gauge the level of safety. Also seek information and guidance from the senior’s primary physician so that the assessment process is as thorough as possible. Clarification from healthcare professionals can help answer this question definitively instead of allowing it to become a point of contention that prevents progress from being made.
2. Parents Resist Care
Sometimes the whole family is on board and agrees that mom or dad needs care, but the parent resists any change tooth and nail. It’s understandable; people value their independence highly, and are loathe to give up any of it.
Possible Solution: When you’re trying to persuade a parent to accept a move to a senior community, make it clear that you’re not trying to “put them away.” Help your parent understand your concerns and that they come from love. Also educate your parent about the senior care options that are available in your area. Your parent may imagine moving to some dreadful institutional situation while you have something much different in mind. Today’s assisted living communities are attractive and comfortable may contrast sharply with what your parent is imagining. If your parent has advanced Alzheimer’s or dementia, you may be able to initiate proceedings if you have an activated Power of Attorney (POA) or you can go the route of obtaining guardianship (pretty much as a last resort), but you can’t force an elderly parent of sound mind to receive care.
3. Family Members Regress to Earlier Roles or Past Issues Resurface
When the immediate family comes together to care for mom or dad, they often can revert to dysfunctional and unhealthy roles of the past. Sibling rivalry that has been dormant during adulthood may suddenly rear its head again during the stressful process of caring for an aging parent.
Possible Solution: It’s not realistic to get along splendidly with everyone in your family, or for your parents needs to suddenly unite a family that was formerly divided. But recognize that you won’t always see the best behavior from your loved ones or agree with them on every issue. Encourage them to be caring and dignified during this process by setting a good example yourself. Be the “big person in the room” and avoid being sucked into feuds or bickering that feel as if they are a flashback to a disastrous family road trip of our childhood. Practice active listening, as family members who feel like their voice isn’t being heard are most likely to become frustrated.
4. One Child Does All the Heavy Lifting
Often the child who lives closest to mom or dad will be the one that assumes the role of the main caregiver. When other family members don’t offer to help, the “lucky” child who is giving all the care can come to resent the siblings who have gotten off without having to help.
Possible Solution: Caregivers who have found themselves shouldering an inordinate portion of the burden from caregiving shouldn’t be afraid to ask other family members for help. Sometimes it is necessary to spell out your specific needs to your siblings rather than presuming that the needs are already understood. Outline to your siblings the challenges that you’re having, and any areas that they may be able to help with. While they may not be close enough to physically offer a hand, they may be able to contribute in other areas, such as paying for caregiving relate bills. They may also be able to host your parent in their home for short periods so that you can have a break.
5. One Child in Control Excludes Others from Decision Making
A scenario almost opposite of the previous example occurs when one child takes over the caregiving role and leaves their siblings or other family members in the dark, perhaps even limiting access to their parent.
Possible Solution: It hurts to feel left out, but if your parent’s care needs are being met and they seem safe and happy, it might not be necessary to intervene further right now. If your relationship with the caregiving loved one is strained and you’re less involved then you’d like to be, strive to maintain an ongoing relationship with your parent nonetheless. If your parent doesn’t have a memory disorder like Alzheimer’s, you should be able to maintain a relationship by contacting your parent on the phone. If your sibling is acting as a gatekeeper and prevents you from reaching your parents this way, write emails or letters to show that you care, learn about the situation, and stay in touch.
6. How to Pay for Senior Care
For many families, the most challenging part of arranging care is the question of how to pay for it, particularly when our parents don’t have the funds to pay themselves. This scenario is increasingly common as many seniors’ retirement accounts still haven’t recovered from the 2008 global economic meltdown and subsequent recession. Unless funding for care is found through government assistance like Medicaid or veteran’s aid, the adult children will have to look to their own pockets to pay for care…or they may look to one another. Should a sibling with a big income contribute more than a sibling who earns less? Should a family member who has been providing unpaid personal care be exempted from having to contribute? These questions, and others like them, have frequently kindled fiery conflicts.
Possible Solution: Open communication is essential to preventing conflict. We shouldn’t presume that siblings will necessarily be able to contribute as much as we hope. If the cost of your parent’s care will require the grown children or other family members to help pay for the care, call a family meeting with all the people involved right away. Realistically establish the cost of care, and determine how much money needs to be raised between all the involved parties. Start by determining how much each person believes they can contribute, and if funds are still short, dig deeper as a group, talking about what each person might be able to sacrifice to make arrangements work. When these decisions are made in the open, with everyone at the table, future conflict is less likely. It’s only natural that the process should be as fair as possible, and that a sibling with a low income should not be expected to contribute as much as a sibling with a high income, but not all families agree on what’s fair and what isn’t. In these cases, the voice of a neutral but knowledgeable outsider can be beneficial. Other professionals, such as elder care mediators, can also help iron out areas of disagreement and help families build consensus.
7. Balancing Caregiving with Raising a Family
According to data from the National Center on Caregiving, 60% to 70% of family caregivers are women. Very often, the same woman is raising children of her own (a “sandwich generation” caregiver) and balancing the demands of a career to boot. It’s understandable that someone juggling these demanding roles, each of which could be considered a “full-time job,” might get burned out and irritable.
Possible Solution: Understand that your caregiving loved ones have limits and are not superheroes. Do what you can to ease the burden. Offer to help care for mom or dad, or your loved ones children, so she can have some time for herself. On the other hand, if you are the “sandwiched” family member and feel like you’re hanging on by a thread, don’t be afraid to ask for help. Consider arranging a family meeting to reorganize care for your older loved one in such a way that burden is shared more evenly.
8. Caring for Both Parents at Once
While it’s great that your parents have been able to grow old together, caring for two parents simultaneously is doubly challenging. When both parents need advanced care, the physical and financial strain is immense. But it’s also challenging when the level of care needed is imbalanced, or the two parents need different kinds of care. For example, one parent might need Alzheimer’s care while another needs skilled nursing. The heart wrenching prospect of having to separate your parents can cause tempers to flare, and the physical, financial, and logistic complexities of arranging care for two loved ones at once can raise stress levels to an all-time high.
Possible Solution: Try to talk with representatives from agencies like your local Aging & Disability Resource Center (ADRC) or another local expert to learn about care options for your parents that you might not even be aware of. Many communities offer multiple levels of care, or even different kinds of care, which allows married couples to remain together when they wouldn’t ordinarily have been able to do so. Hold family meetings to ensure that everyone understands each other’s concerns, and work to define a mutually agreed upon strategy for caregiving.
9. End of Life Care
Loved ones often battle fiercely about end of life care. One child may want to arrange hospice care for a terminally ill parent, while another may advocate that every day lived is a victory. In both cases, family members want what is best for their older loved one, but disagree about what that means. This type of conflict can be avoided when seniors, well before a medical crisis, write a living will (also known as a healthcare directive) that specifies end of life wishes while also appointing a health care proxy to help implement the specified plans.
Possible Solution: Make sure that your parent has drafted a living will (or healthcare directive) and has designated a healthcare proxy. These documents are easily available online or by checking with your parents’ primary healthcare provider.
10. Estates and Inheritances
It’s incredibly sad to see families fight over an inheritance, but it happens all too often. Whether the dispute is over a treasured family heirloom or a large sum of cash, it can get ugly fast. These unfortunate battles frequently occur when a will hasn’t been written or has become out of date, but they can even occur in cases when reasonable and appropriate estate planning measures have been taken.
Possible Solution: Disputes about inheritances can be ideal cases for family mediators. A family mediator’s job is to analyze these situations fairly and objectively, while helping families find areas of common ground. While a perfect compromise may not be found through meditation, it’s almost always preferable to suing a close family member over an inheritance.