Q. Last week, my sister, my brother, and I traveled with our families to visit our 82-year old mother for Thanksgiving (I didn’t have to go too far, since she lives ten minutes away!). Although mom says she is “just fine,” we noticed several memory lapses and other signals of her waning health throughout our visit. Among other things, her dementia seemed to be getting worse, as she kept calling my nephew by our father’s name, and put her car keys in the oven with the turkey.
I paid close attention to how my siblings handled the changes in our mother. My sister, who lives two hours away, seemed angry that mom is no longer the source of emotional support she used to be and she didn’t want to accept what she saw; my brother, who lives across the country and only gets home once a year, was stunned by changes he didn’t expect and wanted to take immediate action to help mom. I just want what’s best for mom and to keep the peace in the family.
A. When siblings are involved, and when care, medical, and financial decisions must be arrived at together as a team, things can become quite complex. Your siblings can be enormously helpful and your best support. But in many families, they can also be a tremendous source of stress. Some families are able to work out differences; while many others struggle.
Like you, your siblings are coping with a major emotional passage that stirs up childhood feelings and conflicts. This is often because it is hard to accept that your parent now needs your help. Unless there’s a sudden crisis like a stroke, adjusting to this new reality takes time. Some adult children have to work through their denial that anything serious is wrong, while others might feel reluctant to get involved, fearing they are “meddling” in their parent’s life. Below are instances where families may disagree and possible solutions:
Possible Solution: A professional assessment of your mom’s condition from an Aging Life Care Expert (formerly called Geriatric Care Managers) is the best way to help determine whether she is safe alone at home, or if she needs some in-home care / supervision, or if you should consider assisted living or nursing care. Advice from one of these trained professionals can help determine the best course of action for your mother’s care, and help reduce bickering about what is best. To ensure the person you use is experienced, try to find an “Advanced Level” Member of the Aging Life Care Association. All advanced level members must hold at least one of the following approved certifications:
- Care Manager Certified (CMC) – from the National Academy of Certified Care Managers (NACCM)
- Certified Case Manager (CCM) – from the Commission for Case Manager Certification (CCMC)
- Certified Advanced Social Work Case Manager (C-ASWCM) – from the National Association of Social Workers (NASW)
- Certified Social Work Case Manager (C-SWCM) – from the National Association of Social Workers (NASW)
2. Family dynamics: When we get together with our families, many of us tend to slip into our old roles. Maybe one person was the “responsible” one, one was the “social” one, one was the “helpless” one when you were growing up. Do the roles from the past define who you are today? And more importantly, can you take a fresh look at who your siblings are now in the context of how these roles and assumptions can affect care for your mother?
Possible Solution: The best thing you can do is to be the “big person in the room” and avoid being sucked into feuds or bickering that feel as if they are a flashback of your childhood. Practice active listening, as family members who feel like their voice isn’t being heard are most likely to become frustrated.
3. Caregiving as a shared responsibility: If your family decides that mom should live at home a little longer, but needs some in-home care, the big question becomes who should provide the needed care and supervision? Since you’re the one that lives close by, all fingers may wind up pointing to you. But this is a role that can progress to more than a full-time job, so this is a very important decision.
Possible Solution: Instead of giving up all of your limited free time, or sacrificing the needs of your own children, to care for your mom, I would suggest that you hire a private in-home caregiver, paid for of course by your mom. There are dozens of home health care agencies in the DC Metro area that you can find with a simple Google Search. Or use our Trusted Resources Page.
4. If mom resists care: What if mom resists any changes you decide to make? It’s understandable that people value their independence highly, but you want to find the best situation for your mother’s health and safety.
5. Estates and Inheritances: If an inheritance is in question, or if someone feels they should get a larger portion of an inheritance because of their caregiving duties or other reasons, this is another source of potential conflict. Whether the dispute is over a treasured family heirloom (such as your father’s coins) or a large sum of cash, it can get ugly fast. These battles frequently occur when estate planning documents are not in place, or have become out of date. They can even occur in cases when reasonable estate-planning measures have been taken.
Hold a family meeting
Family meetings are a way for siblings, parents and other concerned relatives or friends to try to clarify the situation, work out conflicts and set up a care plan that, ideally, all can agree upon. Although emotions might run high, it’s possible to conduct a productive meeting by setting an agenda and keeping to it, giving everyone a chance to speak, and including the professional assessment and recommendations as part of the discussion.
If your family still cannot come to an agreement, seek advice from someone outside the family. As previously mentioned, a mediator, social worker, or an Aging Life Care Expert may help get past long-standing emotional roadblocks, family competition, controlling behavior, denial, or other issues interfering with successful resolutions.
Planning for Long-Term Care
Persons with dementia and their families face special legal and financial needs. At The Farr Law Firm, we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones. We can help your family prepare for your mother’s future financial and long-term care needs. We can help protect your mother’s hard-earned assets while maintaining her comfort, dignity, and quality of life by ensuring eligibility for critical government benefits. Please call us to set up an appointment for a no-cost initial consultation:
Fredericksburg Medicaid Asset Protection Attorney: 540-479-1435
Rockville Medicaid Asset Protection Attorney: 301- 519-8041
DC Medicaid Asset Protection Attorney: 202-587-2797
About Evan H Farr, CELA, CAP
