Dear Jewish Fairy Godmother:

How best to communicate with three siblings when I am the primary
caregiver/contact for my Mom who lives in a memory-care residence
near my home? Their negative comments and obstructionist behavior
are causing me great stress, as well as confusion at the care center, so
I would prefer to have as little contact with them as possible, though I
understand she’s their mother too and they have concerns and the
right to communicate with her. When Mom’s doing well, I never
receive thanks or get positive feedback from siblings, who call rarely
are visit almost never. Recently, she had negative reaction to a new
medication for the first time; they were accusatory, incessant with
their questions and did not use this situation to communicate love for
her or to display any sense of shared responsibility. Though I was out
of town during most of this episode, I was in constant touch with
Mom’s residence and professional staff. They responded appropriately
by modifying or removing meds and she improved considerably.

Before moving near me, Mom and Dad lived near a different sibling,
but it soon became clear they needed more care than this residence
could provide. This sibling only communicated with us about parents
when there was crisis though she would make demands of us, both
financial and timewise. She failed to provide Mom with aides trained in
dementia care though two siblings recommended an appropriate
agency. Both parents had multiple hospitalizations. After Dad passed
we all agreed Mom would do better in a residence near me, but since
the move, they object to virtually everything and refuse to follow the
residence’s rules on having only one contact per family. Their emails to
me are only to demand information and suggest unrealistic solutions
they do not want to subsidize. Help! I would like to focus on Mom and
preserve my own health, rather than try to manage dysfunctional,
bitter siblings who seem to be counting the minutes till they’ll inherit.

Caring Daughter

 
Dear Caring Daughter:

Virtually every family with aging parents, especially those with significant
cognitive impairments or severe health conditions, faces very similar problems.
The levels of inequity are great among siblings when one is given (and accepts)
the outsized burden of being the primary parental caretaker, even if the parent is
living in a facility other than the child’s home. It’s even worse when one of the
sibs is not only the custodial parent in proximity but by having the parent in
his/her home. Generally speaking, the sib who is doing the heavy lifting should
be supported not chastised or hounded. The assisted living center is wise to
have a one-contact- per-family policy. Hopefully that contact person has the
medical power of attorney and, if at all possible, is local.

 
Whether it happens in person or by conference call/skype, you sibs need to have
a regular pow-wow to agree on priorities, finances (who pays for what related to
your mother, not inheritance), and standards of care and responsibility. That
includes regular care and crisis prep. I would initiate it with an email to all of the
them suggesting it, that would go something like this: Dear Sibs: You know we’ve
had ongoing issues taking care of our folks, first when they lived near SibA and
now that Mom is near me. I’d like to have a conference where we go over all the
regular issues such as medications, schedule of doctors/PT/etc. who care for her
and related issues like her schedule of visits to providers (summary of all that
attached), and our visits and calls to her. It’s pretty much a half-time job
managing everything, and while I appreciate that you love her and get
concerned, having to manage you and your expectations and interventions
doubles the work. Let me be really clear about this: If one of you wants to step up
and be the primary caretaker, at the level of support I have been providing or
better, say so now! If not, let&'s agree on who does what when and how, and then
leave me to do it without confusing her living center about our priorities. I’ve been
warned that the staff is overwhelmed; we don’t want her to need to move
because we don&'t follow protocol. I’m happy to continue in this role as first-up, but
not if you make it impossible to do. Please, please, please be respectful and
helpful. You could also call or visit more. She might not remember each time, but
it puts her in a much better mood for at least a little while.

If you have this kind of convo regularly, you can keep them from making you crazy. If it doesn&'t shut them up, tell SibC s/he is next up for caretaking. Either it gets you out of the line of fire or makes SibC an ally you can assign as a secondary communicator to the
sibs.