En español | If you are caregiving and dealing with family acrimony, you're not alone. Many of us go through it. Pass the antacid.
I still get a sour stomach thinking of the familial stress I felt when I was a caregiver. There were family members my mother flat out didn't want to see or to have any control over her care — but she hadn't done all the necessary planning to make that happen. It was a nail-biter for me to be her caregiver until the time she could get the right legal documents in place. I prayed every night that no one would go against her wishes and petition the court to be her guardian.
Once the legal documents were in place, I could breathe a little easier. But it was hard being her “gatekeeper.” I'd do anything to protect my mom, but this required me to stand up to others and keep them from asking her for money when she was out of work and terminally ill and showing up and upsetting her when she should have been resting. It made family and friends angry at me and, for my part, I resented having to manage those relationships in addition to intense medical and financial caregiving. So, yes, I was angry, too.
At the end of her life, the hospice house staff was a blessing. They instituted a “10-minute only” rule for visitors who showed up at the facility. I didn't want to keep anyone away entirely because I didn't feel morally or ethically right denying visitation and the opportunity to make peace with a person who was dying. But I also wanted to honor my mom's wishes. The 10-minute rule was a gift and helped me, the caregiver, avoid a fight I didn't want to have and honestly didn't have in me.
Conflict in caregiving is common. In the first story of this two-part series I discussed care recipients’ conflicts; this article delves into the conflicts caregivers encounter.
Ensure documents are in place
My best advice, as a current attorney and as a former young adult caregiver in an estranged family with bitterly divorced parents, is to always act transparently and be protective of yourself and your care partner when you need to be. The following steps may help stop family discord in its tracks — helping you to focus on what's important and to help others feel heard at the same time.
The importance of self-care
Whether you're a caregiver or a care recipient, it is critical to tend to your emotional and mental health needs. Read up on resources that address relationship issues, explore how to negotiate conflict and find ways to relax and get respite help. Don't wait until it becomes an emergency. Start now.
First: Be sure your care recipient has the correct legal documents in place (power of attorney, health care proxy or surrogate, declaration of preneed guardian, among others) if they are legally capable of doing so. If not, explore your options regarding guardianship and get educated on how it works in your state. If your care recipient is physically and mentally able to be involved in the planning, talk to him or her about the family dynamics that are making your job more difficult and why additional legal and financial planning, like a personal services contract or family agreement for financial contributors, may be needed.
Before you make any plans as a caregiver, be sure that you have the legal rights to back up your actions. Moving money around can raise eyebrows. So can accessing accounts — even if it's to pay for your loved one's needs. Your intentions may be completely honorable but others may not perceive it that way. Keep excellent records and don't act in a way that is self-serving unless it was clearly set forth in your care recipient's plan for you to do so.
Hire neutral professionals to oversee some of the caring if family pressure is too much. A geriatric care manager (also called a care manager) can be an excellent intermediary to discuss a patient's care and needs with relatives who don't communicate well.
Family disputes can sometimes be hammered out in therapy, if all the participants are willing. Especially in a time when telehealth has become much more common, bickering relatives across the country can “come to the table” and sort out solutions for the entire family unit. If conflict has gotten to a point that family members are threatening legal action against one another, I encourage you to explore collaborative processes first. Mediation with a family, estate or elder law attorney may help opponents reach an agreement without getting the court involved.
We can't control everything, despite our best efforts. In times of family crisis, relationships can fracture, relatives become rivals, courts are treated like battlefields. I urge you all to remember that most of the time, the caregiving is borne out of love. Most of the time, the conflicts that flare during family crisis are steeped in grief, old hurt and pain. Urge yourself and your loved ones to not lose sight of the ultimate goal of caregiving: making sure a vulnerable person is given comfort, dignity and respect for all the days of their lifetime. And while relationships may not resolve positively and relatives may never make peace, treating yourself and others with integrity will always leave you with peace of mind and heart.