Managing family disputes about care
Families can often disagree over what to do when faced with decisions about an elderly parent’s care. It can be a really tough and emotional time to navigate. Here, we take a look at some of the most common scenarios that can cause arguments and have some suggestions for how you might deal with them.
ISSUE: Disagreement about how much care is needed
One child may have the impression that a parent is doing fine at home, while another feels they need extra help. This is a common problem if family members live far apart, or spend different amounts of time with their parents.
SOLUTION: Get an expert assessment
A neutral, expert outside opinion can help resolve the issue. Arrange for a geriatric care manager (usually a licensed nurse or social worker who specialises in aged care) to visit your parent in their home for a needs assessment. Talk to your parent’s primary doctor as well about any recent changes in their health or developing challenges. Clarification from these professionals can help define what’s best for your parent and help resolve arguments about how much care is necessary. Once their care needs are established, the next step is deciding how that care gets provided.
If the decision is that they remain supported at home, then help from you can range from financial assistance to daily visits. If you or another sibling are considering caregiving, read this guide to preparing for caring to get some insight into what the role might require.
If it’s agreed that assisted living or residential care might be the right solution, check out our guide to choosing the place that’s right for your parent.
ISSUE: One child does all the heavy lifting
Often, the child who lives closest to their parent or has the closest emotional relationship will assume the main caregiver role. When other family members don’t readily offer to help the primary caregiver can feel isolated, alone and resentful.
SOLUTION: If you’re the main caregiver, talk about your needs and the ways in which others can help
From a distance, it may not be clear to other family members just how difficult caregiving has become for you. It’s important to speak up, otherwise they may just assume everything is fine.
Sometimes, your role as primary caregiver is unavoidable due to family dynamics. If your siblings live far away or have never had a close relationship with your parent they may not be able to provide in-person support. Suggest how they can still help with things like finances, appointment scheduling, meals, or emotional support. See if they can come and stay and provide respite care while you take a break, or if they can take on responsibility for arranging respite care support for you.
ISSUE: Your siblings won’t help
Sometimes siblings may not understand or will choose to ignore how much help a parent needs. Other times, children refuse to care for an elderly parent due to negative past relationships or current inability.
SOLUTION: Try to understand everyone’s point of view
If you believe your siblings simply aren’t aware of your efforts, try to schedule visits or video calls, or request a report from your parent’s doctor to explain the severity of the situation.
If your siblings are refusing to help because of past trauma or current circumstances, that’s their right. See if they’re willing to help financially or provide you with emotional support instead, even if they won’t interact with your parents.
ISSUE: Siblings are excluded from decision-making
Sometimes one child takes over the caregiving role and leaves other family members in the dark, perhaps even limiting access to the elderly loved one.
SOLUTION: Communicate with siblings, your parent, and if necessary, the authorities
If possible, call or write to your sibling explaining your feelings and that you want to be more involved. If your relationship with the caregiving sibling is strained, try to keep up ongoing communication with your parent through phone calls, video calls, email, or letters. You could try to arrange some mediation or counselling support to work through the issues with a neutral third party.
If your sibling is acting as a gatekeeper and stopping you from reaching your parents, and you have reason to believe there may be abuse or exploitation involved, get help. Call local services to intervene. Even if your sibling is angry, remember that you’re putting the health and safety of your parent first.
ISSUE: Family members fall back into destructive childhood patterns
When family members come together to care for ageing parents they can often slip back into dysfunctional and unhealthy roles from the past. If you find you’re in this space, stop. Think of all the times that Mum or Dad stopped your fights as kids and remember that this is about looking after them, not reviving your long-standing arguments.
SOLUTION: Consider a mediator
Sometimes a neutral third party is the only way to calm feuding family members. Look up the mediation services in your area. A doctor or geriatric care manager can also mediate.
At any family meeting there should be frank and open discussion focused on the parents’ care needs. Each sibling’s role and obligations should be established and plans should be made and agreed. Discuss finances, caregiving, and any wishes your parents already have in place.
ISSUE: Ageing parents resist care
Sometimes adult children realise that their parent needs care, but the parent refuses to see it as an option. This can be a very real source of tension and struggle between child and parent. It can also lead to a division between the siblings who want to follow their parent’s wishes and those who know that it isn’t feasible if they are to be kept safe and well.
SOLUTION: Help them to explore the benefits of senior care
Listen to their concerns. Recognise that the changes you are suggesting are likely to be really challenging, if not downright scary. Emphasise your role as an advocate who is only after what’s best for your parent. Suggest that you do research together to see how in-home care or assisted living might help to maintain or improve their quality of life. Actively explore the options together, whether through in-person visits or virtual tours. Define what’s important. Draw up lists of pros and cons. Let your parent and siblings experience what’s on offer. After seeing things for themselves and meeting and talking to the people who run these services they may be far more likely to consider them as options.
ISSUE: You’re faced with toxic or manipulative elderly parents
It’s a harsh reality that as they age, many people experience significant personality changes due to dementia or physical decline. You might find that the parent you’ve been close with your entire life is suddenly physically threatening or verbally abusing you, and your siblings won’t believe it’s happening. Or your parent might suddenly tell people that you are abusing them when you’re not. Take a step back and remember that this is very common, it is not intentional on their part, and it isn’t your fault.
SOLUTION: Consider a mediator
Burnout is really common in this situation, which can cause your own health and relationships to suffer. If you’re a full-time caregiver who’s feeling really committed to care for a parent at home, consider getting more help. There are usually options for weekly in-home care or respite stays to give you a break. Your parent might threaten or attempt to manipulate you when the topic of outside care is raised. Recognise that this is another sign that you both need professional help and get siblings or your local health worker involved. You might also need to reconsider whether you can even provide full-time care if their needs are now too much for you to cope with. Talk to someone you trust about what’s going on, like your own doctor or a friend. Consider exploring the residential care options on offer – sometimes they can be the right answer.
ISSUE: Siblings argue about paying for an ageing parent’s care
Finances play a big role in how siblings choose to care for ageing parents. The cost of residential care can seem overwhelming and can put families off exploring all of the options. If your ageing parent does need in-home care, residential care or hospice, and subsidies either aren’t available or won’t cover all their needs, who will pay for it? Should any expenses be split evenly between you and your siblings, or should those with higher incomes pay more? Should the family home be sold, or is a reverse mortgage something to consider? These are big questions and need to be addressed carefully.
SOLUTION: Try and establish budgets and family financial roles in advance
Try to get ahead of any issues. Make a budget in advance, which includes these big financial decisions. Ask your parents how much money they’ve saved and if they’ve taken out any relevant insurance policies. If you and your family decide that ageing at home is the best option, recognise the financial repercussions. From food and medicine to potential home health services, personal caregiving support can be economically draining. For family members juggling children and full-time jobs, the emotional and financial toll can be severe. If you don’t have money available for outside care or to support a parent in-home, see if a family member can get paid to be a caregiver. You could also talk to a financial advisor with experience in this area.
ISSUE: Care and inheritance conflicts emerge
How care gets paid for can be really controversial. One child might want to use all available resources to arrange paid care for a parent, while another might want to protect resources from being used up. Resources could include a parent’s savings, or proceeds from selling the family home, valuable heirlooms or other assets.
SOLUTION: If possible, let your parents make the decisions
Sadly, inheritance issues with siblings are very common and often stem from a lack of communication. Explain to your parent the importance of having a plan in place that sets out their wishes. While you don’t want to worry them unnecessarily about things like family jewellery or other items, it can actually be helpful to discuss things in advance so that their wishes are clear and siblings don’t feel short-changed.
Disputes about inheritances can be ideal cases for family mediators. A family mediator’s job is to analyse these situations fairly and objectively and to help those involved find areas of common ground.
These conflicts can also be avoided when parents write a living will, well before a medical crisis. This document can specify their wishes and pre-designate a power of attorney or enduring power of attorney to carry out these requests. Read our guide to living wills for suggestions on how to do this. If you’re worried that power of attorney could be contested in your family, have all documents signed by a lawyer.
ISSUE: Conflict over who has Power of Attorney (POA)
POA is one of the most frequent sources of conflict between siblings with ageing parents.
SOLUTION: Understand the types of POA and know your responsibilities
Conflict can often come from misunderstandings about POA and fear over not having control. POA can be shared or limited to specific activities, it doesn’t have to be in the hands of one sibling. Read our guide to POA and get informed.
Things that can help to reduce conflict
Ask your parent what they want. If it’s a realistic option, get your parents to participate in decision-making or at least get their opinion.
Really try to look at things from both sides. Be understanding of everyone’s circumstances: your siblings’, your parents’, and your own. It’s a stressful time for everybody, but you are not all having the same experience. Make the effort to learn what everyone involved is going through and feeling, so you can be empathetic.
Divide responsibilities. Work out what the list of needs is and then let people choose what they want to tackle (communicating with doctors, paying bills online, or researching housing options). If you want the same thing, rotate the responsibilities.
Don’t expect miracles. If your sibling has always been selfish, they may not change. That doesn’t mean you can’t try to get them to pitch in.
Don’t say things that will start a fight. How important is it if you and your siblings don’t do everything the same way? Unless it’s a safety issue, don’t say anything!
Keep everyone in the loop. There are now websites that let family members collect information in one place (from caregiving and medical information to tasks that need to get done) and log on any time. Get together for regular family updates, preferably in person, or via shared calls on Zoom, Skype or FaceTime.
Talk to each other. Maybe the rest of the family has no clue about what you are feeling or what you need. Perhaps they think you don’t want to help. Get everyone to spell out their needs so there’s clarity.
Take time out. If an issue becomes so contentious that you can’t stop arguing, take a break, calm down, and address it another time. Apologise if you should. Get a mediator involved if you need outside help.
Find ways to let off steam appropriately. Visit a caregiver support group or website, learn how others have handled the same situations, call a friend, see a counsellor, or talk to someone from your local church. Professionals can help families untangle all sorts of tricky issues.
Above all, don’t be too hard on yourself and hang in there. Families can be tricky at the best of times, and when you throw medical issues, money and hard decisions into the mix it can be a real challenge.
If you can lay any groundwork on the topics discussed here ahead of time, do it. It will put everyone on the same page when the time comes to manage questions that can arise around care of ageing parents. If you’re in the thick of it now, take a deep breath and know that you are doing your best and that professional help is available for your family if you need it.
