Imagine a harried family caregiver — we’ll call her Harriet — who is serving Christmas dinner to her aging mother who lives with her, as well as to her two older brothers and their families who arrived this afternoon from out of town. The table settings look attractive, and the food is yummy — but Harriet is feeling grumpy. “I’m doing all the work again,” she thinks to herself. “Just like I do for Mom all of the time.”
And it’s true: Her brothers just sit there while she scurries about lifting pots, ladling soup and carving meat. When she finally sits down to join them, she can no longer contain her frustration. “Why don’t you serve Mom for a change?” Harriet says a little too sharply to her oldest brother. Everyone at the table flinches. They all understand she means caregiving as a whole and not just this family meal. Mom looks away uncomfortably. The brother stands suddenly and slaps a piece of ham on to his mother’s plate. There is mostly silence around the table.
Perhaps this is many caregivers’ fantasy — to confront those self-justifying and neglectful siblings and other unsupportive family members over crescent rolls and mashed potatoes. It would probably feel good to make them eat crow while they are digesting their meal. It would feel even better if those family members voluntarily got up and pitched in as a gesture of thanks for all the primary caregiver does for their loved one the other 364 days a year.
But, as in Harriet’s case, making a scene carries risks. At the least, it might divide the family during a yearly ritual when togetherness is considered paramount. At worst, it might alienate the very family members whose help the caregiver hopes for on a more regular basis. If direct confrontation actually worked, then caregivers need merely demand assistance and a legion of supporters would instantly appear. But usually, not even the holiday spirit generates that much good will.
So what should and shouldn’t family caregivers say at the holiday dinner table to both keep the peace and make a plea for more help? Here are some ideas:
— Don’t say: “Why aren’t you helping out with Mom more?” An axiom of family therapy is that “you” statements (“You don’t treat me well,” for example) have an inherently accusatory tone and are almost always guaranteed to provoke a defensive reaction or host of excuses. Few stubborn brothers will respond positively and step up. At the same time, this question is too broad. Requests should be more specific and tailored to the sibling’s availability and capabilities.
— Do say: “I would really appreciate it if you could help take care of Mom during dinner.” Such “I” statements tend to be heard by others more neutrally. A more defined and limited request is more likely to be met with cooperation. Who would dare say no when they see the caregiver slaving away in the kitchen?
— Don’t say: “Mom’s constant needs are wearing me down.” Many unsupportive family members justify their lack of caregiving involvement by denying a parent’s deficits. Rather than believe what you are saying and accepting that Mom needs care, they are likely to criticize you for being an exaggerator and complainer.
— Do say: “What changes have you noticed with Mom’s walking, speaking and thinking since you were last here?” It is better to appeal to the sibling’s own senses to help him grasp a parent’s decline. Even if that sibling persists in denying that there are any changes, he is likely to pay more attention to the parent’s functioning and eventually get a clue.
— Don’t say: “You should visit more often.” As many of us can attest, guilt is a powerful motivator. But it also creates unpleasant feelings. Even if the brothers do come back before the next holiday, they will do so reluctantly — fearful that they’ll get another guilt-inducing lecture. In the end, they will find reasons to stay away.
— Do say: “It was great to see you.” To engage unsupportive siblings in the caregiving effort, it is necessary to make it a gratifying experience for them. Having a harmonious holiday dinner, full of laughs and free of acrimony, is an important step in that direction. As the table is being cleared and coats are being retrieved, let them know that you and Mom genuinely enjoyed seeing them and would love for them to be a more integral part of your lives.
Barry J. Jacobs, a clinical psychologist, family therapist and healthcare consultant, is the co-author of Love and Meaning After 50: The 10 Challenges to Great Relationships — and How to Overcome Them and AARP Meditations for Caregivers (Da Capo, 2016). Follow him on Twitter and Facebook.