I come from a family of seven children, and one of the best things my siblings and I ever did as a group was, strangely enough, working together to help our parents at the end of their lives. Giving them the care they needed in their last days could be stressful and sad, of course, but it was an important life task we did together—effectively and with love. In fact, we went through the process twice, separately, for our father and mother.
We learned over the years of caring for our parents that the potential for hurt feelings and confusion between us was lurking nearly everywhere. Three essential things kept us together: communication, my parents making their wishes known and divvying the work of caregiving. With those elements in place, the seven of us were able to provide our parents with the support they needed.
Here’s how you can help your own loved ones, working together as a team with your siblings.
Communication Is Essential
Ask experts on aging about the smartest approach to helping elderly relatives and you’ll hear a resounding refrain: Start talking—and now! It’s truly never too early to bring up conversations around illness, death and money, and to get paperwork about your parents’ finances and their healthcare wishes in order. “Have the conversations early,” says Jennifer L. FitzPatrick, who holds a master’s degree in social work and is the author of Cruising Through Caregiving: Reducing the Stress of Caring for Your Loved One.
If you and your siblings have become concerned about your parents, it’s OK to have a pre-conversation before talking as a family. “Preparing together and thinking about how you’re going to approach your parents—thinking about the way you’ll do it and the tone you’ll use—that can be helpful,” says FitzPatrick.
Although big family events can be a tempting time to talk, FitzPatrick advises against launching into these conversations during Thanksgiving dinner or the annual Fourth of July picnic. If you need to take advantage of being together in one place during a holiday or special occasion, try to have such conversations a day ahead of or a day after the big event, she advises.
Sharing Important Decisions With the Whole Family
When it comes to end-of-life care, healthcare directives and wishes about living situations, it’s essential that parents share their thoughts with all their kids—and then put it in writing. Living wills and medical power of attorney can take the burden off the adult children. Guessing—or fighting—about end-of-life care will wear everyone out. FitzPatrick recommends having a backup medical power of attorney, as well.
Neither of my parents had living wills, which could have created difficulties between my siblings and me. Luckily, we knew from frequent conversations with my mother that she wanted to live as long as possible, including using any extraordinary means. During her hospitalization, when my own preference would have been to end care, I knew better than to press that view. We all knew what Mom wanted, very explicitly. If her living will had been different from our recollections, that would have caused difficulties, but it also would have been the last word on the matter.
Once again, try to have these conversations as family, as early as possible, to avoid facing a crisis without the paperwork in order. “Do it as early as you can,” says FitzPatrick, adding that every adult should have a living will and a medical power of attorney drawn up. “It’s a little hypocritical to push our parents if we don’t have the same documents prepared,” she says. The AARP has a useful state-by-state guide to the law of advance directives and appointment of healthcare guardians, with links to free forms for creating the documents.
Sharing the Burden
While caregiving is ideally a group effort, one member of the family often steps into a primary role, says FitzPatrick. “It sort of naturally happens, that someone has caregiving instinct and starts taking things on,” she says. The primary caregiver should decide what they’re good at and delegate the rest, FitzPatrick says, whether that be to other family members, friends or paid help. The primary caregiver, for example, may want to handle day-to-day arrangements, while another sibling handles bills or pays for several hours of home healthcare each week to give the primary caregiver time for him or herself. A sibling who lives at a distance might fly in every few weeks to cover a weekend. “Don’t assume that if someone is far away, they can’t contribute,” FitzPatrick says.
However you decide to divvy the workload, the most important aspect to avoiding arguments is to respect the primary caregiver’s decisions. Major conflict, FitzPatrick says, brews when the primary caregiver, who is handling the decisions and doing the best he or she can, is told that this or that could be done better by siblings or other family members. “It’s okay to try to be helpful, but unless the primary caregiver is abusive or neglectful, I think you need to back off and just say thank you to the person doing most of the work,” she says. “Respect that that person is in charge, and think of the stress they’re under. Playing Monday morning quarterback will only be detrimental to the relationship.”
Without that level of respect in place, there is often estrangement after the loved one dies. “It doesn’t have to be that way, but it happens all the time,” FitzPatrick says.
Such minefields can be avoided with thoughtfulness and communication, however, and done right, the experience of caring for elderly parents toward the end can actually pull a family together.
Tim Mullaney is a New York-based financial writer whose work has appeared in Businessweek, The New York Times, USA Today, The Washington Post magazine and many others.
Photograph by C.J. Burton.
Need help talking about end-of-life care with your aging parents? Get tips here.