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Family Conflict: Primary Caregiver Often Pitted Against Siblings

Simmering rivalries from the past can fuel problems, but frequent communication is key

close up of hands on top of each other

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En español | Old resentments and rivalries often die hard, especially with sibling relationships, and caregiving situations can resurrect these issues.

This is especially true if one adult child is doing the lion's share of the caregiving work, with little support from siblings, or if one person is footing the bill for paid caregiving or medical expenses. In other instances, power struggles can occur between older and younger siblings who think they know what's best for Mom or Dad and want to have control of caregiving decisions.

Complicating matters, “parents often have preferences for which child will be the primary caregiver, which may stir up resentments with siblings,” says Barry J. Jacobs, a clinical psychologist, health care consultant and AARP caregiving expert.

"How you behave with one another can affect your sibling relationships for the rest of your lives,” he observes. “When you pull together and work together, it can strengthen the relationship. When you don't, it can weaken the relationship.”

Here are smart strategies that can help you navigate potential minefields with your siblings:

1. Come up with a consensus

Schedule a meeting with your siblings, either in person or on a conference call, to “discuss your parent's condition, what the caregiving needs are and what's likely to happen going forward,” Jacobs says.

Once you are in general agreement, devise a caregiving plan that addresses who will play each role. Someone will do the bulk of the work; others will be supporting players or provide respite care.

At least every quarter, reevaluate what's happening with your loved one and how her needs are changing. Refine the plan as necessary.

2. Establish an appropriate division of labor

Consider which sibling is best suited to which responsibilities, based on abilities, financial resources, proximity to the care recipient, time availability and other key factors.

Be flexible about shifting responsibilities from one sibling to another as each sibling's situation changes, Jacobs says.

3. Figure out how to stay in touch

Agree to keep one another apprised of any changes in your family member's condition or needs.

Decide together on the best or preferred mode of communication (perhaps group texts or email) for sharing important information between scheduled meetings, Jacobs says. Then rely on it as issues crop up or change.

4. Ask for what you need

If you are the primary caregiver, avoid setting yourself up to shoulder every caregiving task or decision, as this can lead to resentment and burnout. Become an assertive, direct communicator and spell out what specific assistance you need — whether it's financial help or a break from watching your older family member.

"If you don't express what you need, you can't expect other family members to read your mind,” says Dolores Gallagher-Thompson, a visiting professor at the Betty Irene Moore School of Nursing at the University of California, Davis.

5. Consider outside help

If longstanding sibling tensions and resentments get in the way of your pulling together to provide your loved one with optimal care, seek counseling to help all of you work through issues, Gallagher-Thompson advises.

Remember, the care recipient suffers the most when tasks trigger intractable power struggles and resentments among siblings, Jacobs says. If each of you can remember that and try to work through or put aside grievances for the greater good of helping your family member, you'll be better at getting the job done.

And by working together, you may even improve your sibling relationship.

Stacey Colino is an independent, award-winning writer specializing in health, psychology and family issues. Her work has appeared in dozens of national magazines as well as on websites and in books.

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