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When Genders Collide While Caregiving

How to resolve resentment that siblings' differing roles and reactions can create

The two adult sisters were angry at their older brother, the protective sibling they'd admired and emulated since they were kids. "We've cut back on our work hours to take care of Mom," one sister complained to the other. "But Louis insists he's too important to his company to miss time from his job. He just assumes we'll continue caring for Mom, no matter how it affects us."

spinner image Family Caregiver Parent Child Gender Sibling, Caregiving Gender Roles Can Cause Family Conflict
Boost awareness of the gender roles that exist in your family.
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The family's double standard rankled the sisters — with good reason: Their mother expected the daughters to drive, feed and cater to her, but praised her son as practically a hero for his weekly phone call.

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Cultural norms have led us to expect that women and men will play differing roles in many family activities. Often this works out well: Agreed-upon divisions of labor help family members work more cooperatively and efficiently during parenting, household chores and other endeavors. But when divisions start to emerge along gender lines in caregiving families, they can embitter sisters, enrage brothers and encumber the caregiving plan.

Take the question of who becomes a caregiver: With 2 out of every 3 caregivers a female, family caregiving is still largely women's work. (The average caregiver is a 49-year-old woman who works at least part time and has been taking care of an aging parent for several years.) Although the percentage of male caregivers has slowly risen over the past 20 years, it still lags far behind.

Researchers in the caregiving field have turned up these other key gender disparities:

Women are more likely to commit to particularly arduous caregiving, including hands-on care that involves bathing and using the toilet. Men, on the whole, are less apt to get their hands dirty — and they feel less guilt about hiring help than women do.

Women and men often receive varying responses for providing the same level of care. Female caregivers are typically acknowledged as "just doing their duty," whereas men tend to be lauded for engaging in even minor care activities.

Women and men cope differently with the stress of being a caregiver. Women feel greater sadness and anxiety about caring for a failing loved one, and they are more likely to seek emotional support (by attending a caregiver support group, for example). Men go into "Logical Problem-Solver" mode, avoiding their emotions and spurning support groups.

In my practice (in which I provide psychotherapy to groups of adult siblings caring for aging parents), I've seen these gender differences play out in two common types of family conflict. As with Louis and his siblings, sisters complain that their brothers get off scot-free when it comes to caregiving responsibilities; and brothers complain that their sisters take over at the outset of caregiving, making them feel marginalized. In both scenarios, the regrettable (but avoidable!) end result is often damaged relations among sisters and brothers.

Try these tactics to stay in good humor with your sibs during the family caregiving years:

Boost awareness of the gender roles that exist in your family

We don't usually talk about our family roles — we're too busy living them — but if sisters or brothers feel they're getting unfair treatment on the basis of gender, it's crucial to hash out these previously unspoken expectations. That's the first step toward addressing such key questions as "Do we want to apply this family's traditional gender roles to how we provide care? Or do we want to divvy up the caregiving tasks in some new way?" The resulting discussion may give sisters an opening to ask their brothers to contribute more time, money or support. Or it may give brothers the opportunity they've been seeking to request a larger say in caregiving decisions.

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Don't necessarily defer to the care recipient's gender preferences

Aging parents may have fixed beliefs (that a daughter should take them to medical appointments, for example, while a son fixes the house and pays their bills). If these arrangements don't suit a grown child's availability, willingness or talents, you'll have to devise an alternative division of the caregiving labors. The new setup doesn't require the parent's approval; it must, however, meet that parent's needs.

Replace infighting with teamwork

Sisters and brothers have been known to handle caregiver duress by aiming their frustrations at one another. However justified this contention may be, bear in mind that it can only compromise the parent's well-being. I like to remind caregiving siblings of these three can't-miss ground rules:

  1. Everyone must contribute in some form or fashion.
  2. Negotiate continuously with one another to fine-tune the caregiving plan; after all, it must address not only the parent's changing needs but the caregivers' changing lives.
  3. Be flexible; don't let fixed expectations about gender roles keep you from delivering in a superb group effort.

When their roles complement one another, sisters and brothers can forge bonds that will long outlast the parent they cared for together.

Barry J. Jacobs, Psy.D., a clinical psychologist and family therapist, is a member of the AARP Caregiving Advisory Panel.

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