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Managing Family Dynamics

family dynamic icon.jpgPeople are living longer.  Families are physically more spread out.  That means managing the family dynamics of caring for a senior can be more challenging than ever.  Seeing your parents’ physical strength and ability to live independently decline is tough and can bring up many uncomfortable emotions.  When struggling to answer questions like, “How will their expenses get paid?  Who will keep them safe? Can we care for them in our home?”  and more, families can find themselves stressed and bickering.  It’s normal that emotions and tensions will rise during this time, but there are ways to offer patience and compassion for your parents and siblings as you navigate caregiving.

Begin as early as you can and take a look at what’s natural within your family dynamics.  Are there assumptions which may not be accurate?  For example, within your family, is it assumed that the son/s will handle the financial and legal aspects while the daughter/s will look after the nurturing, caring side?  These kinds of assumptions, if not accurate, can damage or delay the process.   You will want to consider who lives closest, who has the most free-time, who has special talents or abilities in particular areas, who may have the most financial reserves?

Just accepting that mom and/or dad needs help is hard enough, deciding on what kind of help or how much help can be even tougher.  Expect that there will likely be disagreements and try to accept that some of the siblings may tend to be more stressed or anxious than others.  Some may have the ability to think logically while others may not be able to because of their emotional reaction.

Unless there is an emergency requiring immediate attention:

1.      Give it some time.  Allow each of you to find the same page. You will each have your own timetable for acceptance.

2.     Seek outside help.  It may be wise to get a professional assessment of your parent’s condition from a doctor, social worker or geriatric care manager and share the results with all involved.  There are some great online care sharing tools or you can use FaceTime or other types of technology to stay in touch if in-person meetings are not possible.

3.     Know that the stories may not match.  Your parents may be telling each of the siblings something different about how they’re feeling or doing.  Compare notes, pool your information and be honest with yourselves and each other.

warning signs.jpgIt’s common for children to subconsciously “compete” for who knows the most about how to keep mom or dad “happy.”  This can be a trap when the focus really should be on making sure their basic needs are met to be healthy and safe.    Look for these danger /warning signs that show that you and your siblings are emotionally acting out:

1.      Weaponizing language through generalization like “You always do this”!

2.     Criticizing another’s behavior as “selfish, bossy, irresponsible, cruel”, etc.

3.     Reacting disproportionately to the thing being discussed or decided.  For example, getting into a heated argument over what time Dad should go to the doctor and who should go with him.

4.     Criticizing the way another sibling may feel like “You really don’t care about mom!”

5.     Thinking you’re the only one who understands the way Dad would want it done.

If you are feeling these things, it’s a good idea to take a step back and ask yourself if this was rational or emotional?  Was it helpful to your parents or siblings?  Are you adding more drama or making things worse?

These steps may help each of you manage the dynamics of your family without tearing it apart:

1.      Eliminate “Shoulds”.  Try to accept your parents and siblings for who they truly are. Not who you wish they would be in this situation.  There are no perfect families.  Your siblings are  not wrong because they don’t see it the same way as you do. 

2.     Don’t assume.  Try not to think that you are completely right and your siblings are uncaring, lazy or just “don’t get it”.  Each of you will  likely have a different outlook and a different relationship with your parent/s.

3.     What do you really want?  A lot of us say we want help, but then refuse it when it’s offered.  Think about what you really want deep down, and then ask specifically for that. For example, do you have it handled, but could use some financial support?  Do you want them to do certain tasks?  Do you want time away occasionally?

4.     Do You Need Emotional Support?  If you are the hands-on caregiver, it may be that you really don’t want help as much as you need recognition and support.  Those not on the front-line may not realize how lonely, unappreciated and isolated it can feel to be a caregiver.  Do you need a simple “thank you” , a check-in call?  Chances are, they are more likely to offer you support and encouragement if you don’t criticize them for what they are not doing.  If you DO need something specific, “Can you watch Mom while I do the shopping once a week?” try not to fall into the common trap of feeling like, “I shouldn’t have to ask!”.  Your siblings may feel you’ve got it covered, and are not in sync with what your days and needs are like.  It’s not likely to work if you send hints and forward articles about caregiver burnout.  Think about what makes sense.  If your sister always loses her temper with Mom, it’s not good to ask her to spend time with her.  Ask instead for something more realistic, like doing paperwork or bringing groceries.

5.     Consider HOW you ask for help.  Guilt and anger are not going to make this work.  If your siblings feel guilty, they will get uncomfortable and defensive and may try to minimize or criticize what you’re doing.  Or they may just try to avoid you. Then you get angry and try to make them feel even more guilty and they attack or withdraw more! It can be a vicious cycle.  If they are criticizing you, it’s probably because they are truly concerned.  Can you listen to their feedback and see if it holds something useful? We don’t always hear how we sound to others, so be aware of your tone and language.

6.     Get Outside Help.  Even the healthiest, most well-adjusted families can benefit from the help of an outside professional.  It’s often hard to communicate during this emotional time without opening up old wounds, misinterpreting or fighting old battles.    Consider a family therapist, social worker, geriatric care manager doctor or clergy to help you see what’s really about your parent’s health so you can distribute responsibilities more equitably.  They can be especially helpful during a family meeting to help you stay focused.

7.     Beware of Power Struggles.  If you’re the one who has been given legal powers or not, remember it’s your parent who made these decisions.   Whoever has the Power of Attorney needs to keep detailed statements about how the money is being spent and it needs to be communicated clearly with the siblings. This can reduce the risk of distrust, distortion or lawsuits.  If you’re not the one with POA, don’t take it personally, but cooperate with the sibling who has the purse strings buy presenting bills and expenses clearly and timely.  If you’re having trouble with the one with legal powers, you may need to bring in a professional to mediate.  If it’s worse than that. and you think there may be manipulation, a changed will or undue influence, then call your local Adult Protective Services.

8.     Don’t Let it Tear You Apart.  The way inheritance has been divided may make you feel wronged and it’s natural to be upset, especially while grieving.  If you feel as though you care more for them and “deserve” more, take this up with your parents while they are alive.  There is usually a reason why a parent leaves more to one over another. Often it’s because they are worried about a particular child being in greater need.  Regardless, it’s your parent’s decision, not your siblings, so best not to take your disappointment or anger out on them. If you suspect something is wrong , call an attorney or Adult Protective Services.

After your parents dies, what remains of the original family becomes an even more important relationship.  Now more than ever, successfully navigating through caregiving and end of life issues will depend on your ability to take care of yourself while being patient and open-minded with your siblings. 

Tips for Coping with Caregiver Critism

Quote Bubbles.jpgGetting criticized is unpleasant – especially from family or friends who don’t help care for your older adult. Yelling or getting upset might feel justified in the moment, but it won’t reduce your stress or cut down on future comments. You might even feel worse later because you didn’t say what you really meant or wanted to. The next time someone criticizes something you’ve done or tries to tell you how you should be caring for your older adult, calmly count to ten and try one of these instead.

Acknowledge their concern, then ask what they’d suggest instead

When someone criticizes how you did something, it’s automatic to snap back defensively. But that’s only going to cause a shouting match that will leave your blood boiling and won’t stop the criticism from happening again. Next time, acknowledge their concern and ask for their suggestions on how to improve. You might not be interested in their opinion, but because they’re probably expecting a fight, this response will surprise them and change the tone of the conversation.

For example: 

Your sister says: "Why did you give Mom a cheeseburger and chocolate milkshake for lunch? That’s so unhealthy! Are you trying to give her a heart attack?"

You could say: "I see why you’re concerned. The truth is, Mom’s appetite has been really bad lately. Her doctor says that anything, even unhealthy foods, are better than not getting enough nutrition. What other kinds of foods would you suggest?"

Repeat the criticism back to show how it made you feel

Some people don’t think before they speak and don’t realize they’ve hurt your feelings or come across as critical. It’s possible to let them know that what they said was not acceptable without starting a fight. Do this by calmly repeating it back to them, but using an “I” statement.

For Example: 

Your brother says: "I’m too busy to help out."

You could say: "I feel like you don’t value my time and take what I do for granted when you say that you’re too busy to visit or help out with Dad."

Politely stand up for yourself

Some criticism is completely out of line. In these cases, you should absolutely stand up for yourself. The trick is to do it calmly and politely. That way, the person saying those things will be more likely to listen to you and think twice before saying things like that again.

For example:

Your brother says: "You’re obviously neglecting mom! You don’t even bathe her every day. She loves to be clean and shower every day."

You could say: "I’m not neglecting Mom. Because of her Alzheimer’s, she’s developed a fear of bathing. Her doctor said that we only need to do it twice a week. Her clothes are always clean and she’s healthy, well-fed, and happy. It’s clear that I’m doing a great job caring for her."

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