Now that Pesach and Shavuos have come and gone, we can reflect and review some of the changes we saw in our elderly parents over the past Yom Tov. Siblings who came from a distance might have observed changes that daily, primary caregivers often don’t notice. At the same time, if you are the primary caregiver, Yom Tov may have stirred up some personal questions and feelings. How do we feel when family members return home and we all go back to our routines? How do we feel when we get a phone call asking us about what’s going on with Mom or Dad? How do we feel when our siblings look at what we are doing as primary caregivers and question us?
Family caregiving is a complex challenge with multiple roles and unique stressors. The National Alliance for Caregiving and AARP (December 2010) found that 44.4 million Americans over 18 provide unpaid care to an adult. The typical caregiver is female, mid 40’s and wears many “hats.” The average time one is a primary caregiver is 4.5 years. Family dynamics and roles don’t change or disappear when this new role is thrust upon us. Instead we must learn to manage these new challenges.
Family conflict is an overlooked yet potentially critical component of the caregiving experience. In a study of 100 adult child caregivers, 40% were experiencing relatively serious conflict with another family member, usually a sibling. Caregivers experiencing family conflict had significantly higher perceived burden and poorer mental health than did caregivers without conflict, even when quality of the caregiver’s relationship with the parent, extent of caregiver tasks, income, gender, and age were taken into account.
Conflicting opinions can be a good thing. They help us to look at situations with a different perspective. There are times, because we are so closely involved in the day-to-day life of our parents, that we do not realize the changes that are taking place. We all have expectations of what we think we should be doing as caregivers, as well as what we expect from other family members. Multiple caregivers, even those who live in the same neighborhood, need to set aside time to discuss caregiving conflicts and concerns. Remember rule number one; agree to disagree and be open-minded. Family members need to practice good communication skills with active listening. Each person has to give each other a chance to speak and listen to what the others have to say. We all need to speak directly and specifically about our needs and expectations. Again, the family has to be able to agree to disagree as long as safety is not compromised. Although this sounds feasible, engaging in these difficult discussions often make us lose sight of the ground rules. We become overcome by memories of past hurts and family roles.
It is important that we remain mindful of respecting everyone’s role in caring for our relatives. If possible, allow the care recipient to become involved in his or her own treatment planning. This can help relieve family members from feeling they need to be “super” children and assume unwanted responsibilities, which can lead to resentment. Keep in mind that discussions at family meetings might not always satisfy each family member; some members will still feel they do too much and that others do not do enough. Some family members may feel guilty that they don’t do enough. There will need to be discussions about specific tasks and responsibilities. Some family members might be better at helping financially while others might be better at providing emotional and hands-on care. The adult child that provides daily supervision might need the out-of-town sibling to relieve her for a Bar Mitzvah or a needed family vacation. We need to be able to acknowledge our stress levels in our caregiving roles as well as the stresses from our everyday lives. We cannot be caregivers alone and may need help for various aspects of our lives, whether it be paid help or help from a family member.
Recognizing and responding to family conflict between multiple family caregivers might help us avoid situations that do not allow us to act in the best interest of our loved ones. Caregivers provide care for a variety of reasons. The most common and important one is love. Yet, all too often through our caregiving roles, we are faced with the sibling rivalries of our childhood. We are often amazed when we observe how those childhood roles impact our family behaviors decades later. Each of us has the opportunity to change these roles with understanding, wisdom and the love we have as family members for our parents and for each other. But keep in mind: whatever the family conflict, the respect and safety for our loved one and for ourselves must prevail.