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Family dynamics

Getting siblings all on the same page about Mom and Dad can be one of the more challenging aspects of family caregiving. Sibling rivalries reemerge, and some things just seem to be tendencies or approaches based on your birth order in the family. In this handout we discuss family meetings and share insights about the special pressures felt by the “primary” caregiver and the pressures on those who are not the primary.

Calling a family meeting

Family meetings won’t cure old hurts or solve every current problem. But if they nurture teamwork, they can provide a solid foundation for the continued well-being of the person in need of care.

Creative solutions often emerge at family meetings, and the burdens of caregiving get distributed in a more balanced fashion.

Tips for successful meetings

  • Decide who should attend. Keep it to fewer than ten people. Use video conferencing for convenience. Ideally, include the person needing care. Consider a premeeting without them, though, to air feelings and establish roles (timekeeper, note-taker …). If the elder has dementia, family meetings may be too overwhelming.
  • Create a safe space. Agree upon ground rules so everyone understands that all points of view are important and to be respected.
  • Consider a facilitator. A social worker, therapist, or Aging Life Care™ Manager is trained in family dynamics and keeping group meetings courteous and productive.
  • Agree upon overall goals. This is not about the past, but about the future. The point is to find a way to work together to do what’s wisest for your relative.
  • Set an agenda. Be realistic about what you can cover in ninety minutes. Determine a timekeeper so everyone gets a fair share of time and the meeting ends when planned. You might begin by hearing each other’s assessment of the situation and any concerns.
  • Take notes. Ask someone other than the facilitator or timekeeper to take notes. The notes should identify concerns and the different tasks each participant has agreed to take on. Notes should be sent to everyone soon after the meeting.
  • Understand there will be hiccups. Emotions may run high. Forecast that no one is likely to get 100 percent of what they want. Try to be flexible and open to new ideas.
  • Expect further meetings. If Meeting 1 focuses on concerns, Meeting 2 may explore solutions and Meeting 3, implementation. Consider touching base regularly after that.
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Are you the primary caregiver?

In most families, there is one person who takes on the lion’s share of caring for an aging loved one. Perhaps it’s the oldest daughter. Or the emotionally closest child. Or maybe it’s the geographically closest relative. And when there are no siblings, it’s usually the only child.

Being primary can be quite a job. In many cases it involves driving to the doctor and managing medications, handling finances, providing for daily needs, coordinating care services, and keeping the elder’s spirits up. If you are that person, don’t try to do it alone—even if it seems like that’s the only choice.

Here is what other “primaries” recommend:

  • Take breaks. It may not feel possible, but there are ways. If you forgo breaks, you risk burning out—which has negative consequences for everyone, not just you.
  • Call a family meeting to discuss sharing responsibilities. Consider getting the services of a social worker or care manager to facilitate a discussion.
  • What if it isn’t perfect? Some families complain that the primary caregiver is so particular, there isn’t a realistic way to pitch in. Does that ring a bell with you? What is the worst that could happen, really, if things weren’t done exactly the way you would do them? Perfectionism is often counterproductive.
  • Be clear about the costs and the rewards. Identifying the pluses and minuses can help you focus on which tasks need to be done by others and which tasks you want to keep.
  • Family patterns die hard. Don’t get hijacked by the past. Guilt or the perennial desire for parental approval can wear you down quickly! Plus, it’s common for siblings to revert to old resentments and rivalry during the eldercare years. From your adult self, acknowledge what you realistically can and can’t do. Get professional help if it’s proving too difficult to reset internally.
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If you are not the primary caregiver

If someone else in your family has primary responsibility for the care of your loved one, that doesn’t mean you don’t have anything to contribute. Far from it! Caring for an older adult is more than one person can do alone. There are many ways to lend a hand (even if you don’t live nearby).

Consider:

  • Managing finances, talking with the doctors, doing yardwork, running errands. If direct care isn’t your thing, address other needs. Anything you can take off the plate of the primary is a help.
  • Contributing money. If you live far away and have the means, pay for outside help to give your sibling some relief.
  • Providing emotional support. It’s often very lonely to be the primary caregiver. Having a good listener to talk to for safely blowing off steam can ease the load.
  • Giving them a break. Gift them a “spa day” where you make all the arrangements and they just enjoy. Spend some of your vacation time caring for mom or dad so the primary can have an extended rest.

“My sister would never go for that!” The biggest complaint in many families is that the primary caregiver is so particular, it’s impossible to help. True. They may have trouble letting go of control. As long as there is nothing medically dangerous about what you propose, however, you may need to assert yourself and express your right to participate in your parent’s care in your own style.

If you get resistance, consider a facilitated family meeting. Family dynamics are decades old. A counselor, social worker, or Aging Life Care™ Manager can guide a conversation constructively. Families are an ecosystem and each member inhabits a niche. It will be better for your loved one, and for you and your siblings, if everyone has a chance to contribute, each in their own way.

Contact us at 413-775-4570

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