When 51-year-old Bernice — the youngest of four children and the closest in temperament and geography to her parents — stepped up to become the primary caregiver for her ailing 81-year-old mother, she met unexpected criticism from her older sister and two older brothers.
They teased her, as they always had, for being Mom's favorite. But this time their words had real bite: With their mother suffering from COPD (chronic obstructive pulmonary disorder), they chastened Bernice for not using her status as the favorite to force their mother to quit smoking. In ways both subtle and blunt, her siblings made it clear they believed they would have done a better at job of taking charge of their mother's care.
These reactions didn't exactly endear her sibs to Bernice, as you can imagine. Here she was doing the bulk of the caregiving — and taking flak for it! Caring for their mother, Bernice realized, was resurfacing the sibling rivalry she thought she had escaped upon entering adulthood.
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Two opposing forces are buffeting Bernice and her siblings. On the one hand is the research (and much speculation!) about the effects of birth order on personality types and family dynamics: Firstborns are said to be highly responsible and commanding leaders, while the youngest are supposedly milder and more deferential. As those types grow into caregiving adults, the firstborns often feel it's their job to make decisions for an aging parent. They may also expect their younger brothers and sisters to fall in line behind them.
On the other hand, recent research has found that many an aging parent has a favorite child whom she wants to be her primary caregiver, often years before she actually needs caregiving. In two out of three cases, that favorite is the obliging youngest, not the bossy eldest, according to a 2010 study conducted for Omaha-based Home Instead Senior Care. And a joint study by Cornell and Purdue universities in 2013 found that a parent is more likely to become depressed when his or her preference of primary caregiver is not honored.
You can see why these two forces are a recipe for caregiver conflict: Older siblings assert their prerogative to be a parent's guide and comfort, while the youngest sibling claims she's only trying to do what's right for Mom. Everyone feels slighted, sometimes by the parent, and no one's cooperating.
If these struggles sound familiar, try these suggestions for minimizing them:
Beware of raised stakes
Every adult child should be aware that how well she works with her siblings during the caregiving years will shape their interactions forever after. Long after the parent has died, everyone distinctly remembers — and judges — how each sibling behaved. If Bernice and her sister and brothers can't stop resenting one another now, their odds are slim of pulling together as loving family members again.
Honor thy parent — but not impractical wishes
Every caregiving plan should acknowledge a parent's preferences for which child should accompany her to the doctor or write out her checks. But the favorite should never have to shoulder every last caregiving task or decision; that causes one child to burn out — and the others to burn with resentment. Instead, siblings should caucus and jointly decide to share the load. So long as the favorite retains a featured but not exclusive role, a parent should readily accept this more balanced setup.
There is no "I" in "team" — but there is one in "point"
The old pecking order from childhood — in which know-it-all older siblings bark orders at know-nothing younger ones — is ill suited to a group of caregiving adult siblings with grownup ideas, capabilities and concerns. Rather, mature sisters and brothers should work as a well-organized team in which members confer frequently, reach consensus on most decisions and divvy up tasks according to each person's talents, availability and degree of willingness.
That said, the parent's favorite needn't be the team leader; he or she can serve as a point person instead, taking the lead on broaching difficult subjects — giving up driving is a big one — while working closely behind the scenes with her sisters and brothers.
If a disagreement has gotten too heated, it's time to seek outside help. The parent should not be the final arbiter of the siblings' caregiving responsibilities and privileges; any hint of favoritism will have already triggered resentment. Instead, seek the help of a trusted family friend, religious counselor or mental health therapist to mediate the claims of older and younger siblings. The goal is to have family relationships based on today's realities, not yesterday's hierarchies.
Barry J. Jacobs, Psy.D., a clinical psychologist and family therapist, is a member of the AARP Caregiving Advisory Panel.
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