Get Your Siblings Involved
by Kathy Quan, R.N., B.S.N., P.H.N.
By default, it is most often the oldest child or the one who lives closest to the parents who ends up with the major responsibility for the care and management of the aging parents. If you are an only child, there aren't many choices, but perhaps there are some cousins or other family members willing to participate with you. If not, perhaps they will at least be willing to let you vent occasionally or offer some welcome advice.
Everyone needs to be kept informed and should have an assignment or some share in the responsibility, and all of the siblings need to have a clear understanding of your role as the leader. They also have to understand that your parents remain your parents no matter how much responsibility you each will assume for their care and well-being.
Be prepared to make moves and step up the care as it is needed. Sometimes that can happen quickly, but learn to be patient when they just need your help to remain as independent as possible. Work together with your siblings to help provide the support necessary, and give each other the opportunity to vent frustrations.
As you come together with your siblings, the first thing you need to agree upon is that your parents need to be consulted and involved in all aspects of the decisions you make from here on out. One of the worst things you can do is make plans and then spring them on your parents.
For example, just because your father recently passed away and your mother is now alone in that big old house doesn't mean she's ready to leave behind the home she loves and shared with your father for many years. She's not necessarily prepared to leave her friends and neighbors and all that is familiar and comfortable to her for the bright sunshine and happy faces at the senior living complex near your home. This might eventually be the path she'll take, but she needs to come to the decision on her own.
Listen to her needs and wishes, and help her make them a reality. Perhaps hiring a personal driver and arranging for some meal delivery or preparation is all she needs right now. Give her some time to grieve and consider her options. Help her remain independent in her own home for as long as possible. Involve her in making plans for her future.
You will need to establish a new aspect of your relationship with your siblings at this point. Whether you are on the best of terms or the worst, they need to be informed of the situation with your parents and kept up to date as things change. The sooner you can establish this relationship and open the lines of communication as well as set down some ground rules, the better.
It is important for her to be focused in reality. Take into consideration that she will no longer have your father's Social Security checks. Can she afford to continue to live in that house? Can she afford to hire the help she needs to maintain it and to assist her with her own needs? What can you do to help make this possible? Can your siblings pitch in? Does she need to look into renting out a room? Perhaps a college student or a hired caregiver would exchange services for room and board. On the other hand, what are her other options, and can she afford them? What assistance is she going to need?
You and your siblings will have to help her examine her finances and personal situation and investigate some of the alternatives and options with and for her. Remember, though, that she needs to make the final decision. This is not the time and place for you to step in and choose for her.
This won't be an easy process; it will always seem simpler to just take charge and tell them what to do. Think back to your teenage years and struggling for your own independence. How many times did you scream (or want to), “You don't understand me! I'm sixteen; I can make my own decisions”? Cut them some slack. This is not the time for paybacks. They are adults, and they can still make decisions; they just need your help to make them feasible. Of course, if your parents are mentally incompetent, you will have to take charge.
Be prepared for a struggle with your siblings and other friends and relatives who feel you should take charge. Share some of the responsibilities with them and let them see first hand that this is the best way to handle things right now.
From the start, you need to set some ground rules with your siblings. Everyone needs to share in the responsibilities (see further discussion in Chapter 9). Give them a chance to volunteer or to consider what they'd like to take on. Even those who live far away can have an assignment, even if it's just calling your parents daily or weekly or participating financially. There needs to be an understanding that each sibling will participate and at times be responsible to provide some respite to the primary caregiver (you). It is important that you share this “burden” and that no one feels like someone is not pulling equal weight. You have to put aside old sibling rivalries and work together. Organization and clear communication is essential. Not everyone is well-suited to be a caregiver, but you can share in costs and other indirect responsibilities.
It is important to set clear boundaries and responsibilities. Each person will have some supreme authority or decision power within his or her own realm, but all major decisions will be made as a group, which includes your parent. For example, your sister Sally will accompany Mom to medical appointments and make medical decisions; your brother Tom will take care of household maintenance and yard work; your brother Bob, the accountant, will pay the bills and handle financial matters; and you will be primary caregiver and spokesperson.