July 31, 2014

Family dynamics in caregiving

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By Phyl Newbeck

Observer correspondent

Pity the only child. He or she has no one else to turn to when it’s time to take care of an aging parent. But the only child isn’t the only one who may be doing it alone. Patrice Thabault, owner of the South Burlington office of Home Instead Senior Care (HISC), said research shows that even when there are multiple siblings, one sibling takes on the lion’s share of the work in close to half the cases studied. In most cases, that sibling is the youngest daughter. Only 2 percent of those interviewed said their family shared the burden equally.

50-50

HISC sponsors a program called 50-50 to help siblings deal with the problems inherent in taking care of aging parents. The first 50 refers to the average age at which the parent/child role begins reversing and the child becomes a caregiver, while the full name references what an equitable division of labor should look like. The 50-50 rule recommends that siblings both talk and listen to one another, research options for their parents, plan ahead, be flexible and be honest with one another.

Since caregivers often have their own familial and professional obligations, it’s hard for them to take on all the varied responsibilities of their new roles. Thabault said she has seen situations where multiple siblings work together effectively to take care of an aging parent, with one assuming the communication duties, another taking care of grocery shopping and a third preparing meals. She noted that although a completely equitable division of labor isn’t always possible, siblings need to understand what each of them can bring to the table and divvy up the assignments as evenly as possible. In addition, they need to feel comfortable looking outside the family for assistance, although finances may make this difficult to do. Even with various caregiver responsibilities shared, children can find themselves stressed by the duties of caring for an aging parent.
The website caregiverstress.com has a Family Caregiver Distress Assessment to help caregivers figure out when they need to look for assistance.

Paying the bills

Among the many tasks which have to be divvied up when caring for aging parents is the question of finances. Robyn Young, owner of Money Care in Williston, said she often sees discord among siblings when one becomes the primary caregiver.

Young said often one child lives physically close to the parent and falls into the caregiver role, which includes paying the bills. Another child, who  isn’t as close to the situation, begins to question how money is being spent. Additionally, there are times when the child taking care of the parent receives remuneration for his/her services, but the other siblings question the compensation.

Young said the most important things for the caregiving sibling to do are keep detailed records, document their time and save receipts. If the caregiver is being paid by the parent, it is important to explain that at the onset and get buy-in from the rest of the siblings. “I’ve seen lots of situations,” said Young “where the sibling who is providing the care gets so worn down by the strife that they throw up their hands and give up and say they won’t do it anymore.”

She said the best way to eliminate family misunderstandings is to discuss early on exactly what the caregiver is doing.

Sibling traps

According to the Family Caregiver Alliance, the average caregiver is a 46-year-old woman who is married, works outside the home and earns $35,000 annually. Francine Russo, an author affiliated with the alliance, describes five traps that siblings may fall into in caretaking:

Waiting until there is a crisis to talk to one another and/or not including everyone

Thinking there are only concrete specific tasks which can be assigned to individual siblings rather than shared

Not knowing what you want from your siblings

Assuming you shouldn’t have to ask for help

Falling into the anger/guilt gridlock

Elder Care Connections of Vermont provides assistance to caregivers by creating plans for those taking care of elderly relatives so they can avoid those traps.  Nancy Scagnelli, co-owner of Elder Care Connections, agreed that it is frequently the youngest daughter who shoulders much of the burden for caregiving. Sometimes, other siblings don’t recognize the amount of work the primary caregiver puts into his/her role, so Scagnelli recommends that they write down exactly what takes place in a typical week so the rest of the family understands. “Clear communication can be very challenging with families,” she said “but the better they can communicate, the less resentment there will be.”

Scagnelli recognizes that not all siblings can contribute equally so she suggests a teamwork approach. If one sibling lives far away, perhaps they can provide financial support to make up for their lack of physical presence. “It’s helpful if they assign roles so one person doesn’t shoulder all the burden,” she said. Scagnelli noted that situations are always easier if there is advance planning among siblings.

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