Family Dynamics Around Caring for Aging Parents

~ by Jennifer Christensen 

The challenges of co-existing with siblings are well documented – from the temperamental daughters in Shakespeare’s King Lear to The Kardashians of reality TV.  Rarely is it more fraught than when family members are trying to help an older parent navigate the lifestyle changes associated with aging. Selling a family home, giving up the car, choosing a retirement community, deciding on care options or end of life decisions can strain family relationships, often beyond repair.   

A disengaged brother may suddenly appear on the scene and expect to be a hero.  A financial expert may view the situation through a professional lens, but might not have the empathy needed to provide emotional support. A well-meaning sister might make impulsive decisions about money that can have disastrous long term impact. The scenarios are endless.

 “Every family is different, and their dynamics reflects these differences,” said Michele Schreer, LMSW, Director of Independent Living at The Osborn, the non-profit continuum of care community in Rye, New York.  She helps residents and their families work through these issues when one or both parent’s health begins to decline. “These dynamics usually surface when there is a crisis and the parent needs their children for support.”

Plan Ahead 

Families can get through these challenging times more effectively if they talk through various scenarios with their parent, and among themselves, well before decisions are needed. Having the parent’s wishes in writing and sharing relevant documents among family members puts everyone on the same page. While it is inevitable that something will happen, it does not necessarily means that it needs to upend the family.

Melissa Norgaard and her siblings recently experienced their mother’s transition from the hospital into hospice.  “It was tremendously helpful that Mom had articulated her wishes clearly from the outset,” said Melissa.

“My siblings immediately slipped into natural roles. One in the legal profession was better suited to set up the power of attorney and advance directives. As the eldest child, my sisters and brother looked to me as the spokesperson for the family,” said Melissa. “It wasn’t an easy time, but we got through it together.”

Focus on your Parent 

Keeping the focus clearly on what is best for the parent, in terms of health, safety, and sense of well-being, is of utmost importance. Always circle back to what they have defined as their wishes, framing family discussions as ‘what does Mom want.’  The answer to that question may not be what one child wishes – life support for example – but it is the parent’s wish that is the guiding principle.

“When a parent is experiencing a decline in health or cognitive abilities, there’s a grieving process associated with the loss of the parent as they once were,” explained Patricia Kummel, JD, Ph.D., a psychologist who works with individuals and families during times of transition. “The role reversal, when child is taking care of parent instead of the way it had been, is destabilizing at best.”

“Family members need to understand that their parent is emotionally fraught by having to give up control of their life – moving from a family home, losing long-term relationships and watching abilities fade,” said Dr. Kummel. 

Support Each Other  

“Of course, adult children have their own emotions as they come to understand that their parent is no longer the strong, competent force in their lives,” Dr. Kummel explained. “People get triggered and old rivalries return. This is counter-productive to decision making.”

As if the end stages of life are not distressing enough, a dysfunctional family dynamic can add stress to an already fraught situation. Siblings should avail themselves of outside support services like a therapist or support group instead of expecting the parent to take on that role. Everyone has to go through this at one time or another, don’t be afraid to ask for help!

Dr. Kummel encourages families to make extra effort to stay connected to each other and to their parent by regular phone calls or SKYPE sessions so the parent still feels that they are involved. “Your Mom needs to feel like she is still part of the action!”

The Osborn is a continuum of care community in Rye, New York, that offers Independent and Assisted Living, including Memory Care, as well as Skilled Nursing and both Short-term and Outpatient Rehab, as well as home care in Fairfield and Westchester Counties through Osborn Home Care. For more information, visit:   www.theosborn.org.