New Book Examines Issues of Caregiver Siblings

They're Your Parents Too: How Siblings Can Survive Their Parents' Aging Without Driving Each Other Crazy Francine Russo Bantam Books 2010 _________________

Emily-Jane refuses her brother's offer to pay for nursing home care for their mother, who is severely impacted by a stroke. Growing up, Emily-Jane never felt she had enough of her mother's attention, and now she neglects her own career and friendships to spend most of her time with Mom. Exhausted, she says that at last her mother needs her. And yet, when her brother makes one of his infrequent visits, Emily feels he is still Mom's "Golden Boy."

As parents grow older, experience health crises and require more help from adult children, having siblings to share the caregiver load makes things easier. Right?

If you weren't quick to nod your head, you might be one of the many family caregivers who find themselves dealing with the "old business" and long-standing sibling dynamics that can re-emerge during this time. Author Francine Russo refers to this stage as the "twilight of the family" in her new book, They're Your Parents Too: How Siblings Can Survive Their Parents' Aging Without Driving Each Other Crazy.

Russo's book examines an often overlooked stress point in family caregiving: friction between adult siblings. Not only can conflict get in the way of providing the best possible care for our senior loved ones, but it can also have long-term impact on relationships within the extended family. Russo says that the aging of parents is part of a "new developmental stage of a family," showing how the way siblings navigate this period together helps determine how the siblings and extended family will continue to interact—even if they will.

Russo, who for ten years covered the aging and baby boomer beat for Time magazine, offers many real-life examples of siblings negotiating this task. The book offers valuable advice for handling common eldercare events, such as the gradual decline or sudden health crisis of a parent; dementia; legal and financial problems; end-of-life planning; funeral arrangements; and estate issues.

Old roles, new roles

The book shows how this challenge can draw families together—but can sometimes also bring out the worst in sibling relations. Brothers, sisters and parents who might have rarely communicated over the years are thrust back together, examining their family dynamics under the microscope of sudden proximity. Caregivers now in middle age are confronted with thoughts of their own mortality. Guilt, grief and unexpressed anger may add to the emotional minefield that can explode a family discussion in no time.

Old patterns may re-emerge. Who is the nurturing one? The rebel? The golden child? The prodigal son? Russo says, "When people are in crisis, they usually fall back on ways of behaving that feel familiar to them." One child may feel resentment, another guilt. But old business and established—even dormant—family dynamics can get in the way of providing the best care for parents. This is the time for siblings to recognize each other as adults, overcoming dysfunctional patterns and developing a new relationship respecting that they are adults and individuals.

Here are a few of the thornier—and most common—situations Russo describes:

• When there is an imbalance of care: a sibling who will not help, a sibling who prevents others from having a say
• When a sibling from out of town "swoops in" and criticizes the caregiving of another adult child who lives near Mom and Dad and provides the lion's share of care
• When siblings disagree about the how much care elderly parents need, and how much independence they can safely have
• When there are disagreements about end-of-life care—and a parent has not shared his wishes on the matter.

Russo offers suggestions for successfully navigating this group effort:

• Understand that much of the conflict siblings are experiencing actually arises from "old business" and established sibling dynamics.
• Learn all you can about aging, eldercare, dementia and other relevant issues. What's normal and what's not? What can family expect? What resources are available?
• Bring in outside help. A geriatric care manager, elder-care attorney or therapist can serve as mediator when siblings are contentious or come to an impasse.
• Look at this time in the family’s life as laying the groundwork for future relationships between siblings and grandchildren.

Russo points out that our "task" through childhood and adolescence is to separate from our parents and birth family to become autonomous individuals. But most of us will freely admit that there were gaps in the process. Our parents' old age, the time when we parent our parents, can be a time of completing our sense of adulthood, and a time of healing. It can also be the time when the family joins together in a new pattern, processing and moving beyond resentments and growing into a nurturing new structure for the future.

At their father's funeral, Emma is furious that her brother Mitch recounts humorous anecdotes that in her eyes don't display Dad in a flattering light. Her grief is too raw to laugh at Dad's flaws. But then Emma comes to realizes that her brother, who cared for Dad during ten years of Alzheimer's, has already done much of his "letting go." Mitch likewise realizes that Emma is in a different stage of grieving and the lighthearted tone was painful to her. The experience helps brother and sister improve their relationship as they move on as siblings…and friends.

By Joyce Remy, Editor, and Dennis Kenny, Co-Author, Aging in Stride–Plan Ahead, Stay Connected, Keep Moving . Copyright 2010. Reprinted with permission from Aging in Stride eNews – subscribe FREE at https://visitor.r20.constantcontact.com/manage/optin?v=001lmD1-4TnS4bxPMDdQFTJs3eSHckhxGrvDhsUsNAIZYiCnlGxdue9ABGgjCR8KH3nsPDSbReYbdrMekC7-K5DhDUSOLqbu6hdXulODGmaBQ8YEVAcw7N_q-FaFGpPuacFyvio5v4W_3JBGJjPGmuI3u5DY1sAnylTeH_c9nhvpO4%3D.

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