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 Conflict among siblings 
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Joined: Fri Aug 11, 2006 1:46 pm
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Location: SF Bay Area (Northern CA)
Post Conflict among siblings
I received an email from someone who wishes to remain anonymous, and they requested I post about their family situation here. Here's what M. Anonymous says:

"What can you say about conflict among sibling caregivers who have a parent with dementia? My brother is the primary caregiver and he and his wife are taking both my parents in to care for them. (They live in another state.) We have had tremendous conflicts whenever I make a suggestion or question the medical care my dad is getting. At this point he has pretty asked me to not be involved unless I can give him unconditional support for what he and my sister-in-law are doing. My sister, who lives in the same state I do, rides the middle.

Of course, the support he needs is over the top and reflects his perceived role in the family as the youngest and therefore least competent. He has a very bad temper. I feel that being a caregiver from a distance has its own stresses and I do what I can to help (especially talking to my mother), and sending my brother and his wife things from the LBDA website and they prepare for this new life.

It would help me tremendously to read things that address sibling conflict in these situations.

I like the idea of having a social worker meet with all of us (I will be visiting my parents soon), but my brother feels that any 'intervention' is unnecessary and that I am dramatizing and therefore causing conflict.

And yes, my brother is going to be receiving funds for rent, utilities and a salary for my sister-in-law."


Mon Jun 28, 2010 5:33 pm
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Joined: Fri Jan 15, 2010 9:33 pm
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Location: Vermont
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Hi - sorry for what you are going through. Here are a few of my thoughts and questions:

1. Who has POA for healthcare and for medical decisions?
2. Is your mom capable of making sound decisions?
3. If your mom can make good decisions, what does she think about all this?
4. From your posting, I can see both sides of the issue, I think. Your bro. & SIL are taking on a HUGE task, but that doesn't mean he needs to be a bully about it. Is he just a take charge kind of guy who gets things done and makes sound decisions or is he a bully in this sort of situation?
He may just feel overwhelmed, and like there needs to be "one captain of the ship", but that also means that he owes it to the whole family to communicate well with the rest of the family and involve others to some extent.
5. Having a social worker who is competent and experienced in working with families in this situation would be a great idea, I think. I don't see how it could possibly hurt - it's a great chance to air old grievances that keep unhealthy family dynamics continuing.
6. It will be important for other family members to give your bro. and SIL a break so they can get away from the stress of caregiving. Maybe if you talk about that they will see you are empathetic about their needs and that might relieve some tension.

My situation with my only sibling requires me to do things I don't ordinarily do. I like to work collaboratively but my sister makes such crazy decisions and is so irresponsible with money, plus she gets into histrionics over things, that I have to just suck it up and do almost everything by myself from 500 mi. away. Over the past year, when my dad's problems started, I just took over almost everything and assign her things she's capable of doing. Even then, I usually have to go back and undo/redo, smooth ruffled feathers when she gets involved in anything. (some CGs at the ALF where my dad is told me "your sister comes in here like a tornado and leaves a path of destruction." No surprise here!

What I've discovered in the past year - almost every family has one person who does most of the work. Most families get stressed and old patterns that aren't healthy re-emerge, or get worse. I don't know how many of my own friends have gotten in the CG role in the past 2 years with aged, sickly parents. We all get support from one another about how to carry most of the load without our siblings. Or how to fix what our siblings just messed up! So, you aren't alone- complex, frustrating family dynamics really does seem to be the rule rather than the exception.

If you want to communicate privately, you can send any of us PMs on here so you get support but in private. Best wishes during a really difficult time. Lynn


Mon Jun 28, 2010 6:32 pm
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Joined: Fri Jan 15, 2010 9:33 pm
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Location: Vermont
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Sorry - I just thought of a couple of other things:

1. Do you trust your brother? Does your sister trust him? (no judgement meant here at all, just a question) Who will be writing the checks to your SIL as caregiver? How much is she being paid (many people have written on the forum about paying roughly $20 per hour for CGs). Will she be paid 24/7? Should someone other than your brother be taking care of paying all the bills?
2. Have you all discussed what will happen once your dad is no longer mobile and/or requires extraordinary amounts of care? Can your SIL lift him all by herself? Is she willing to change him, clean him up in the bathroom, give him a shower? If not and he requires that kind of care, who will be doing that? What are his care needs now that she will be taking care of? Can your mom do some of that so his assets can be spent less quickly?

Lynn


Mon Jun 28, 2010 6:46 pm
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Joined: Wed Oct 08, 2008 10:30 pm
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Location: Henderson, Nv.
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Good response Lynn. They say: you never know what real love is till you have to clean someones butt. That happens to be true. :)
Can they do this?
Is this arrangement what your mother and father want? What are their wishes?
I am partial regarding this so won't go into details. Suffice it to say my mother was put in a home by my sister when all she wanted was to be with family. Make sure your parents feelings are taken into consideration.

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Dianne C.


Wed Jun 30, 2010 12:45 am
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Location: Acton, MA
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I think if someone has to quit their job to be a caregiver, some financial consideration has to be figured out. It gets touchy with family when money and sharing responsibilities are involved. I was the sole caregiver for my mother, dying from cancer, but I had the flexiblity with my work to do so, and didn't need to touch their savings. I have 2 sisters and a brother, all they did was call to see how she was. There was stress, mainly emotional, I was watching mom die, but I feel I gained so much by having that time with my mom, a lot of tears, but also a lot of love, wouldn't have had it any other way.

I do think a social worker, or someone unrelated, should sit down with everyone and be clear what caregiving duties the SIL will be doing. Everyone should be comfortable with the caregiving and the financial reward. Could your mother handle some of the caring and have an outside cg come in?

I hope everything can be ironed out so you can all respect each others position.

Good Luck, Gerry


Wed Jun 30, 2010 8:28 am
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Location: Henderson, Nv.
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Gerry- You must feel so honored, grateful and fortunate to have taken care of your mom to the end. To me that is the ultimate loving thing a person can do
. That is exactly what I wanted to do...and would have loved to do for my mom... but my 2 sisters would not hear of it...so they put her in a home which she thoroughly hated. I think they were both jealous of my very close relationship with my mother.
I had my own business so it would have been no problem for me to care for her. They just didn't want to have to spend a dime to come visit so they put her in a home convenient to where one of them lived...and where the other came to visit her in laws. Convenience in place of love. Sad.
I have an extra bedroom in my home...actually one she picked out when we were looking at homes. She so wanted to live with us. Had it all fixed up for her..and she never got to sleep in it.
Yes...the idea of a social worker sitting down with everyone would be the proper thing to do. There are many things that should be discussed and decisions to be made with all family members present.

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Dianne C.


Wed Jun 30, 2010 11:24 am
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Just curious - for those of you who took care of your LOs at home till the end, were they mobile all the time or most of the time? My dad has a prescription from his dr. that he cannot be moved from bed to chair and back, put on the toilet, given a shower with fewer than 2, and for some activities 3, CGs. He weighs about 145 and is totally limp and unable to help them help him. I am just wondering if your LOs were/are like that, how do you do it? Lynn


Wed Jun 30, 2010 11:53 am
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Location: Henderson, Nv.
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Whew..you are getting to a tough point. We do it with the super strength God provides us for times like that. I had my LO at home to the end. It was VERY difficult as things progressed to the state you mention here. His doctor didn't put those exact restrictions on his rx but perhaps your dads doctor did to help him get the aid he needed per his insurance requirements.

We sponge bathed him in bed the last weeks. If he was up to it the hospice aide would lift him to the wheelchair and then to the shower chair...he loved his showers. :) I moved him in his bed so he wouldn't be in the same spot as that would be uncomfortable and unhealthy. Hospice will show you how to do it...didn't always work as planned but did my best. You must be very careful as I hurt my back trying to lift him...and you don't want to do that as you have to be healthy to take care of him. Dead weight is something else! We also had a hospital bed, table tray,etc. brought in to help me. That was invaluable. He was in diapers the last montha or so...and the last few weeks on a cath. ..I learned to empty the bag, change diapers the best I could...which wasn't always the best...but was my personal best. One night I had to call in a couple of neighbors to help me as I just couldn't move him enough to clean him well. They were kind enough to help. You really can tell who your friends are at times like that! My son set up a camera in his room and a monitor in the family room so I could watch him at all times...that was one of the best things I had.
I am sure others will offer many suggestions. In retrospect I would get as much outside help as possible. Its a very difficult task...but when you love someone deeply its amazing what you find you can do. :)

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Dianne C.


Wed Jun 30, 2010 12:52 pm
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To the anonymous original poster:
Lynn gave you some very good advice, especially regarding taking advantage of the services of a MSW [medical social worker]. Sometimes the physician can write an order for an MSW visit or two when the family can get together. If the entire family cannot be there, he/she can do a conference call. It's important to get these issues straightened out before things get even worse. And they will most certainly get worse!

I respect your desire to be involved in your parents' care but it sounds like your brother might resent your suggestions as being critical of the care that he is providing. If you attempt to make it plain that you appreciate the difficulty of his role, he might be less defensive. As a home health case manager, I found the MSW invaluable in these situations and asked for an order early on. Hope you all get things worked out. These things seem to bring out the very worst in already existing family rivalries.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Jun 30, 2010 5:42 pm
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Joined: Wed Dec 12, 2007 4:53 pm
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Location: Melbourne Beach, FL
Post Sibling Conflict in Caregiving
Lynn gave excellent advice and provocative questions that should help sort out the action needed.

A durable POA and designation of health surrogate are two docs that everyone should have. Indeed, future health care will be much easier if these two docs are in place. The nearest next of kin is not always the best choice and it is a tough decision.

In a situation where there is disagreement on pertinent issues, an impartial third party would seem to be imperative. Hopefully, it won't wind up being a legal action although a caring, knowledgeable lawyer might turn out to be invaluable now for planning the "what ifs" or for the future should the conflict escalate. The present is the most desirable time to take action before a series of events/conflicts create intractable partners. To set up or provoke a meaningful family conference, it might be well worth the fee to get personal prior help from a professional on how to minimize conflict and yet promote a common goal to work out arrangements that are most beneficial to those being cared for but also fair to the caregiver. Family decisions require a lot of biting one's tongue and yet sometimes you have to be the "sob" that stands their ground to achieve what is best for everyone. Right now when the whole family is in a stressed, emotional state is the most difficult time to come together, but the stress won't lessen and the decisions won't get easier nor go away.

Sibling conflict is always dicey, no matter the subject. It would be great if somehow the brother could be engaged and made to think it was his idea to bring in a third party to help prepare and implement a plan for the future, maybe make him feel that that puts him "in charge."

As the situation progresses, if congenial agreement cannot be reached, it may be necessary to insist on professional assistance to insure the parents are cared for so that they are not taken advantage of and neither are the caregivers.

Oh the joys of familial "love."

Joy


Wed Jun 30, 2010 6:11 pm
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Joined: Tue Dec 29, 2009 2:28 pm
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Location: Minnesota
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You're all providing such wonderful advice. I need to add my 2-cents worth, more for me expressing it than anything else. This is an emotional and difficult issue for me. So, if I seem a little disorganized, please bear with me.
I am my mother's primary caregiver, in my home, the home that Mom and I have shared for almost 20 years. Mom's other caregiver, my youngest sister, lives in town and provides help I couldn't do without. Mom goes to daycare while I'm at work and my sister picks her up and stays with her until I get home. For some reason, Mom will only let this sister give her a shower, which is fine with me.
We have two other sisters, living a state away. I would like them to be here more often, partly for the help (though one has her own m illness and it is questionable how much help she can give), but also because they are missing out on something special. There is something very spiritual in helping someone find value in their last years. I remind myself of this often.
When your LO lives with you, and you have siblings (esp. multiple), you can easily lose control of your own house. I have always been the easy-going sister. I haven't in the past, been easily insulted and, with the help of the other middle sister, have learned to survive a lifetime of sisterly advice. BUT, when my sisters complain about something in my house, or housekeeping, I have learned to fight back. It doesn't seem to bother Mom much. With four daughters, she has a lifetime coping mechanism that lets it blow over, knowing the anger will dissipate and everything will be at peace and in harmony for a few days, anyway. But it shocks my sisters when I fight. (I'm not like this at work. Any number of architects and contractors have learned that I am not easily swayed. But I've just never seen any value it fighting a fight you can't win, like with my sisters.)
I honestly don't mind friendly advice. What I do mind is sisterly "advice" from someone who isn't here and doesn't wipe Mom's bottom several times a day, finishing by cleaning the bathroom floor and toilet seat - not to mention the soiled clothing. Until one of my sisters has spent a few nights with Mom, getting up 2 or 3 times in the night and sleeping lightly, if at all, in order to get to Mom before she falls, then going to a stressful job in the morning, I'll listen to their advice, but that's all. And if there is a critical tone or there are critical phrases or words, I will bristle and maybe even return the barb.
I love my sisters and, mostly, appreciate that they care enough to "advise" me. But those that aren't putting in the work or contributing financially don't have, in my book, the right to be critical. And yes, when a caregiver is stressed out from taking care of a parent and working full-time in a stressful job, she is bound to be a bit prickly.
So, for secondary or distant caregivers, when there is a family caregiver living with the LO, please be careful about how you frame your advice. Remember that we are exhausted and doing the best we can. If you want to help, hire a housecleaner to come in once (or dare I say twice) a week. Or take over the in-home duties and send us on a long weekend or even longer vacation. A spa would be nice and relaxing. Or some might enjoy a fishing or golf weekend. When you are about to tell your sibling what they need to improve upon, stop and think about what you can do to help, and then phrase what you are going to say as if it were an offer of help. And, for me anyway, stop calling me a saint. I don't feel much of a saint when the stress and frustration is about to bubble over. And I'd rather hear an offer of help than platitudes.
Having gotten that off my chest (I wonder if my sisters will see it) I want to say that I do know it is very hard to have someone you love in such a critical stage of life and not be there daily. As I said, this experience is amazing - even when you're neck deep in dirty poopy clothes that need washing. I do wish it were easier to share it. (But please don't ask me for hourly updates when I've got all I can handle just keeping the threads together.) Oh, and one more thing to please pay attention to - don't ever speak to me as if I were your employee, especially when you're not paying me. Not unless you really want to get my goat.

What is that phrase about he who goes to war and she who sits and waits. Yes, distant caregivers. I know the sitting and waiting is excruciating.

Kate

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Kate [i](Cared for Mom for years before anyone else noticed the symptoms, but the last year of her life was rough and we needed to place her in an SNF, where she passed in February 2012)[/i]


Wed Jul 07, 2010 2:00 am
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Joined: Tue Dec 29, 2009 2:28 pm
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Location: Minnesota
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Oops. Forgot something. But probably better in a separate message.

Joy is absolutely right. A POA and medical directive are critical. But you need to get this done as early as possible. I talked Mom into this a couple of years ago, by getting mine done, too. A good thing, too. The attorney needs to have the impression that your LO is of sound mind. Mom can't make decisions now and I doubt our attorney would have taken her word for anything.

And divvying up responsibility is what we did. My youngest sister is Mom's medical representative. I fell apart when Mom had blood clots on her lungs. But baby sis kept it together and even got response from the hospital staff when she wanted something done. She's a junior high teacher and a really good one. She gets results from adolescents, she can get results from ANYONE.

I do, however, live in terror of when I have to hand out Mom's personal possessions. I know no one is going to be happy. As I am single, with no direct heir, I am tempted to tell everyone that they are going to have to wait until I'm gone. Then they can have a free for all with both Mom's possessions and mine.

My advice is to get the legal documents done as early as possible. Right now, I am even wondering if guardianship might be appropriate.

Kate

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Kate [i](Cared for Mom for years before anyone else noticed the symptoms, but the last year of her life was rough and we needed to place her in an SNF, where she passed in February 2012)[/i]


Wed Jul 07, 2010 2:24 am
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Joined: Fri Jan 15, 2010 9:33 pm
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Location: Vermont
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I think there are a lot of siblings out there who just don't get it in terms of divvying up responsibilities, especially when one sibling has always been the responsible one. I hear this with so many friends in similar situations and I can remember these discussions between my parents when my dad's mom was too much to handle atmy aunt's home. My aunt had her mom (my grandmother) live with her and her family her entire adult life. My mother kept trying to talk my dad into sharing CGing responsibilities with his sister, and my dad would say "no, let Hannah take care of it. She's been taking care of mother all these years." It caused quite a rift in the family for a long time. I couldn't imagine why my dad just couldn't see how much his sister had done and how little he was doing for his own mother.
Anyway, I continue to have these discussions with my own sister who does about 1% of what needs to be done for my dad and his house. No matter what I ask her to do, it usually doesn't get done at all or I have to undo and redo, which is even more frustrating and takes more time. Sometimes I think "I'd like to sit back and be the irresponsible one" but I just can't do that, and I'd be a horrible role model for my sons and a terrible daughter!
Lynn


Wed Jul 07, 2010 8:31 am
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Location: Melbourne Beach, FL
Post Sibling Conflict in Caregiving
You go, Kate! Rare is the family member that is not actively involved in the daily caregiving who has any inkling of what it takes to just get through the day. Nor do they know the depth of caregiver gratitude for any and all types of assistance. Family approval and support is a treasure.

As for family behavior following a LO's demise, I've observed unbelievable acts within my own family, selfish and selfless, and I know that we are not unique. Should there be controversy, it's easier to keep what you already have than it is to get it back after it's gone. Given the level of anxiety, stress, utter exhaustion and the grieving process that most caregivers experience, on any given day the "small stuff" may become really important, while momentous life challenges are merely taken in stride.

Love to all, Joy


Wed Jul 07, 2010 2:01 pm
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Even those of us who aren't doing the 24/7 caregiving but handle all the other responsibilities and most of the family visits would love a little assistance from our siblings. Or, at least a "you're doing a good job."
Some people are oblivious as to what others of us are doing. At least ONE thing my sister does do is when I am away from my home and family, and taking care of my dad's house and all his other stuff, and visit him every day (80 mi. roundtrip) - she does have me over for dinner most nights. At least I don't have to drive back and then try to fix dinner or go out to eat every night!
Right now I am contracting a huge job on my dad's house that has to be done. I am not a construction worker and not a structural engineer, and dealing with this stuff, visiting my dad every day, and dealing with a tax problem that I just found out about from 2 years ago AND 3 years ago is about to drive me right over the edge.
Anyway, there's my venting for the afternoon! Lynn


Wed Jul 07, 2010 4:59 pm
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