By B.J. Roche

A friend e-mailed me recently that his mother had suffered a bone fracture while putting her pants on, which led to an e-mail exchange joking about our eighty-something moms and the status of their respective pants. I know, I know, it's not funny.  But if you’re dealing with an elderly parent you know that sometimes, if you don’t laugh, you’ll cry.

The injury meant that his sisters had to step into serious caregiving mode, and he was stuck across the country, glad to have them able to do it, but also guilty because he wasn't there. 

If you're not in that situation yet, enjoy life now because it's coming soon to a family near you: the time for you to parent your parent. Sort of. It may start abruptly, with a fall or an illness or it may creep up, as mom and dad start to enter old age and need more from you.

Families cope in different ways, but one thing seems constant around the caring for elderly parents: the friction and differences that can emerge among siblings. If can be deep and dense and emotional and nasty. If you think it can’t happen in your family, you’re wrong. And if you think your family is the only one dealing with it, you’re wrong about that, too.

“It’s a demographic perfect storm,” says Francine Russo, author of They’re Your Parents Too: How Siblings Can Survive Their Parents Aging Without Driving Each Other Crazy. “Our parents are living 30 more years than people did in 1900 and because of medical science, they’re living a decade or longer with chronic illnesses where they need help.”

At the same time, women, the traditional caregivers are better educated, working and often living farther away.

“In the past, the few old people who needed help had a stay-at-home daughter, and none of that happens anymore,” Russo said in a telephone interview. “Although women tend to feel it’s more their role, many don’t feel it should just be their job. This sets up a situation with a need for family interaction and there’s no model for it. We’re all trying to figure it out and no one has the script.”

Russo’s book offers the closest thing, however; through interviews with 25 different families, she explores the dynamic that kicks in when an elderly parent begins to fail, and offers realistic strategies for coping.

She takes the reader through the good, bad and super-ugly aspects of caring for elderly parents, from defusing the recurrence of decades-old sibling rivalries, to managing the fallout from an unjust will.

Russo says it’s essential that siblings talk directly about aging issues when a parent hits, say, age 70.

 “That’s the time to initiate a family meeting when everyone can be together. Parents, if they’re healthy, can participate; if not, the family can do it themselves,” she says. “Talk about the situation. And talk about what you’ll do in various situations. Let’s try to figure out: will mom and dad have enough money and will we have to contribute, and especially the caregiving piece.”

Russo encourages families who can afford it to hire a geriatric care manager or social worker, particularly if siblings are scattered in different locations. One interesting new model for those with seniors in the Miami area is a service called Seniority Matters.

“It’s common for someone who sees the parent regularly to have one idea of the parents, while the other one far away has a different view,” she says. “The geriatric care person can convey objective information to everyone in the family. Everyone gets on the same page.”

If the primary caregiver gets overwhelmed, the geriatric care manager can be the neutral manager who sets up a conference call and says “here’s what needs to be done, and what each of you can do.”

More tips:

Remember that this is a family responsibility and not a job that one person can do.

If one person is doing most of the caregiving, do everything you can to provide emotional support. Caregivers often feel abandoned and stressed. Just listen and let them vent, and try not to take it personally.

If you’re the caregiver, ask for what you need. Do you want help? If so, in what form? Do you want money? Appreciation? Figure it out and ask for it. “Do it as directly as possible and avoid the disastrous fantasy of ‘I shouldn’t have to ask.’”

Beware that sibling rivalry is often operating underground. “It’s reborn and very powerful and it does come up when we see that our parents won’t be here forever,” says Russo. “Insight into your own behavior is critical. If we change our attitude even just a little, it can change the dynamic.”

Despite the stresses of caring for a parent toward the end of life, there can be major opportunities for growth during this time, says Russo; some siblings become closer through the process. But even the closest will have moments of tension.

“Family dynamics are very complicated and very deep,” she says. “There’s no such thing as a right sibling or a wrong sibling. Everyone has a piece of the truth.”

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YourParentsToo

Francine answers reader questions in her terrific column over at wowowow.