Cindy Krischer Goodman's Miami Herald Balancing Act Column: Caring for elders a challenge for families

In her July 19, 2011 Miami Herald column, Cindy Krisher Goodman tackles the issue of dividing up how to care for aging parents among siblings:


Caring for elders a challenge for families
By Cindy Krischer Goodmanbalancegal@gmail.com


Kirk Lyttle / MCT
The phone call came when Robin D’Angelo was at work. Her father had fallen and was headed to the hospital in an ambulance — again. “I had to drop everything and rush to the scene.” D’Angelo felt her temper rising. She recently had argued with her brothers who live hundreds of miles away over whether to spend money to hire a full-time caregiver. “I feel like it’s all on me. I think the money would be well spent.”

For siblings, taking care of an aging parent can be fraught with decisions and dissention. As parents grow dependent on their adult children, arguments can erupt over whose work schedule is most flexible, whether mom or dad should move to a nursing home or who has control over financial decisions. The desire to cling to old familial roles or continue a festering rivalry can surface at the precise time when siblings most need cohesiveness.

“Even if siblings didn’t get along before, it’s possible to bond over the care of a parent,” says Rona Bartelstone, senior vice president of care management at SeniorBridge, a provider of elder care at home. “Focus on the common goal. It is all about your parent.”

Parent care promises to be an increasingly big concern for adult children. About 43 million Americans look after someone 50 or older, according to the National Alliance for Caregiving. Compared with five years ago, a smaller percentage — 41 percent vs. 46 percent — are hiring professional help. And more — 70 percent vs. 59 percent — are reaching out to unpaid help such as family and friends. Care giving is projected to cost those who look after their parents an estimated $3 trillion in lost wages, pensions, retirement funds and benefits, according to The MetLife Mature Market Institute.

Avoiding sibling struggles over parent care requires the ability to disagree without judgment, show each other mutual respect and communicate early and often. Experts say it’s possible to work together even if not everyone can participate in the same way and it’s possible to achieve consensus even in the most dysfunctional family. Warns Bartelstone: “There is no magic formula because every family is unique.”

• Call a family meeting.

Experts say calling a family meeting becomes critical as parents become frail or suffer health problems. Often, that means starting fresh, letting go of a past grievance and giving a sibling a second chance.

“Let everyone speak and be respectful just like in business setting,” says Joy Loverde, author of The Complete Eldercare Planner: Where to Start, Questions to Ask, How to Find Help. “Leave all emotional issues out of the room and focus on what would mom want.”

Elder care specialist Alene Feinstein, director of admissions for The Palace Group, suggests the family make a list of the pressing concerns — eating habits, medication, hygiene, health issues. “Everyone talks over the list, prioritizes what’s most important, discusses options and taps into resources available.”

For there to be harmony, everyone is going to have to agree that some difference of opinion is OK and find a way to compromise.

“It is not always a democracy,” Feinstein says. “A brother who doesn’t participate in daily care and just waltzes in is entitled to an opinion, but not a vote.”

In some situations, a family may need to bring in a professional, an elder care mediator, to smooth over differences and develop a plan. With more than 80 percent of elder care (an average 71 hours a week) provided by family members, an emerging field of geriatric experts known as professional care managers have sprung up to help.

• Divvy it up.
Experts suggest the next step is finding ways for every sibling to feel involved to the extent they can and want to be. Sometimes a family member’s greatest contribution can be letting another sibling take the reins.

When caring for their 90-year-old father, Janet Carter of Coral Springs and her two siblings still cling to the labels that defined them in the past. Carter, the oldest and the only local sibling, does most of the hands-on work, overseeing the decisions about dad’s care after a major cardiac event. The family recently moved dad to an assisted living facility. Carter’s sister, hundreds of miles away, acts as a sounding board and helps with research, looking into what organizations can provide support. Her brother, three hours away by car, provides emotional support and helps with the logistics of moving dad from one location to another. “I’ve always been junior mom,” Carter says. “They respect me and accept what I delegate. I know for other families, that’s not always the case.”

Yet, for those adult children like Carter who take the lead in parent care, stress can be significant. Currently unemployed, she balances care-giving responsibilities with her job hunt.

Experts say a sibling carrying more of the burden may need to ask for help rather than become resentful. “Don’t hint. Don’t whine. Don’t blame. Don’t bring up past issues. Be very specific about what you need, when you need it, why you need it, why your loved one needs it,” suggests Gary Barg, editor-in-chief of The Fearless Caregiver.

• C ommunicate often; communicate change.

Miscommunication or assuming can create tension. There’s nothing like actual human conversation with siblings to work through challenges.

Almost weekly, Brian Weiss of Miami convenes conference calls with his three siblings in three different states to discuss his 90-year old mom. Although he lives nearby, the family hired a full-time caregiver, who along with doctors, reports to Weiss. During the calls, the siblings will talk over a suggestion from her doctor or a new care plan. When necessary, they’ll put a decision to a vote. “Sometimes if we can’t come to a consensus, I say let’s try it and we can re-evaluate in a few months.” Weiss is convinced his mother’s health has benefited from the siblings’ teamwork. “When it comes to reminding her to take her medicine or to exercise, we’re united, and on the same page.”

Cindy Krischer Goodman is CEO of BalanceGal, a provider of news and advice on work/life balance. Visit www.worklifebalancingact.com or email her at balancegal@gmail.com.


Read more: http://www.miamiherald.com/2011/07/19/v-print/2321664/caring-for-elders-a-challenge.html#ixzz1ThAg8bex




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