The good, bad and ugly of family caregiving duties

Q: My wife’s brother refuses to pitch in and help their father, who needs assistance with grocery shopping, bill paying and bathing. The brother lives closest to Dad’s house. We are thousands of miles away, and although we travel as much as possible to visit and help with his care, logistically it’s just not as easy for our family as someone who lives in the same town. How can we work this out?

A: While stepmom, mother, brother or father relationships can be straight out of a horror film, often those interactions can lead to love, forgiveness and reconciliation after family dynamics explode into shouting matches or common ground is discovered. The devastating loss of one parent or significant changes in a close relative’s health status can cause buried anger, past disagreements or prior squabbles to reemerge when discussing care for loved ones. These situations are all tough to navigate.

On the surface, what seems like simple task participation often disguises underlying issues that prevent the sibling from helping your father-in-law. Some considerations are:

Does another sibling constantly criticize the sibling who lives closest for what appears from afar to be subpar standard of care? Perhaps your wife’s brother does want to help, but feels their assistance is berated because it is not perfect or the exact way someone else might take care of Dad. Avoidance of the situation altogether is a way to solve criticism.

Has the one sibling who lives nearest been unreliable in the past, and thus the other family members still see them in that role? Maybe the brother feels like he doesn’t measure up, and it may be easier not to have any communication with Dad instead of occasional, inconsistent involvement with him.

Is the brother struggling to see their father as incapable, or not as “heroic” as he once was? Perhaps now, as an adult, it is uneasy to see his dad needing help, becoming feeble and not competent to take care of himself any longer.

Viewing the aging process of another causes examination of our own thoughts about getting old. Does the brother feel uncomfortable about becoming elderly, and wonder who will take care of him as he ages? Growing older can be an emotional roller coaster ride.

Could your brother-in-law feel he doesn’t have the skills and may fail at caretaking? When tackling tasks or taking on unfamiliar responsibilities, it can be overwhelming. Perhaps the brother feels he doesn’t know enough to do what’s best and is afraid he may make the wrong decision in an emergency and therefore disappoint people. 

All these issues need to be discussed when making family decisions about a loved one’s care. What seems like a non-caring attitude may actually be avoidance of criticism, feeling like not measuring up, difficulty in seeing a parent age, pre-grieving loss, communication roadblocks, or fear of failure.

Another consideration is the perspective of Dad. While often a natural tendency to “rescue” a parent when they need help, if your father-in-law is still mentally capable, it is up to him and how he would like to be cared for. These discussions are best conducted years before a loved one needs assisted living, skilled nursing or services in their home. Emotions quickly rise from zero to sixty if care decisions are made in crises. Finding neutral footing long before immediate decisions need to be made is less tempestuous.

Sibling disagreements can get further triangulated when a parent has a differing view about their care. And a parent’s perspective should not be dismissed. Considerations of safety, prevention of harm or injury, sanitation/health, and personal daily care all need to be weighed and discussed with all parties involved (and heard), giving everyone an equal voice, even if there is not 100% agreement. Finding consensus when parents and older children or siblings have divisions about how to move forward can be emotionally trying and cause strong opinions to become even stronger. Cross-generational cohesion, solidarity and support may seem impossible at first. Friction may dominate conversations due to conflicting individual agendas and interests, how the parties involved personally respond to those conflicts of interest, or reacting to long-harbored underlying hostility toward another.

The most common conflicts that emerge with adult children and parents are about communication style; habits or lifestyle choices; values; work habits and priorities; politics, religion or ideology; and household standards or maintenance. These topics require full, attentive conversations between parents and children. In this situation, one way to tackle Dad’s care is by dividing up duties between family, paid caregivers, trusted friends and volunteers. Allow for Dad’s input, and everyone negotiates their part of his care, but keep everyone accountable. If someone offers to take on a task big or small, make sure that it gets done, and be grateful for their assistance. Caregiving is physically, mentally and emotionally demanding. Thank each other often for providing their time and talent.

In summary, keep in mind that aging adults want clear communication, respect, helpful assistance, a sense of control, and positivity. Finding that balance in providing care for your father-in-law between sibling conflicts can be challenging, but rewarding. Patience is paramount, and remember the ultimate focus: What is best for your loved one.

Karen Casanovas is a professional healthy aging coach in Alaska helping individuals or families collaborate, find resources and design a plan for thriving and living well whether age 35, 50 or 90. Contact her through her website at .