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Practical Insights for Busy Caregivers

Strong sibling relationships can fracture under caregiving stress

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October 29, 2018, by Nira Rittenberg (guest blogger)

My brother lives out of town. Whenever he comes in to visit mom he says he is not sure why I make such a fuss about her dementia. He says that I am making a “mountain out of a molehill.” I used to get along well with him, but now I feel like I can’t stand seeing him.

Signed, Get Out of Town
 
Dear Get Out of Town,

The brother-sister story is always a difficult one, as there are so many layers. The added complication of your brother being out of town creates yet another hurdle. I often hear caregivers call their relatives who come in to see their relative “the knight in shining armour” or “the lucky one.” They seem to get the easier part of the job as perceived (and is often the case) by the sibling who lives close by and does the day-to-day care.

Strong relationships can fracture with the stress of caregiving. This is true especially when the siblings are not in close contact to deal with commonplace issues that arise in the care of their elderly parent.

The task of dementia caregiving is one that only grows over time. Initially, some limited supervision and support may be needed, but as time and the disease progress, it is inevitable that more time is spent with your ailing loved one and more hands-on support and care are required.

A lot of stress between siblings occurs when one sibling is not cognizant of all the components of care that are being provided. If someone is not present for the day-to-day caregiving routines, it may not dawn on him or her how much is involved, such as the steps it takes to organize and get to a medical appointment, establishing consistent home care or arranging daily shopping excursions. The many phone calls, liaisons with professionals and support seem never-ending. The sibling who lives out of town may make faulty assumptions about the caregiving situation. They also may not see the extent of cognitive slippage and changes in functioning that are occurring.

Mom’s daily activities (which may not be seen by your brother) may be slipping, but her ability to maintain social interaction may still be intact and less affected. Furthermore, mom may respond to the “out of towner” in delight and excitement as the novelty and the lack of practical demands are often felt. This can be a further irritant to a sibling who is working hard to manage day-to-day chores with little or no thanks. 

Siblings may approach the task in a different manner based on their gender as well. There is evidence that men approach caregiving in a more task-oriented approach. Many look at caregiving as an extension of their jobs and utilize management style techniques to get necessary caregiving tasks done. 

To add to the complexity of the scenario, when one of the siblings is doing a disproportionate amount of the work it can foster anger, frustration and eventually feelings of unfairness. These negative emotions can also invade the relationship with mom and with your sibling.

It is prudent to sit down and have a formal meeting. If you cannot accomplish it alone, a professional can help mediate, support and try to help you both find common ground. 

A lot of sibling differences emerge from a basic lack of understanding of the situation, or from stylistic differences. Additionally, the type of relationship and commitment you each have to your parent may also differ.

Don’t give up on finding a path and common ground. Caregiving should not demolish the good will and family history that was there before. Establishing some basic communication and some understanding is always helpful, even if bad feelings have arisen.


Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. This article originally appeared in the Toronto Star on January 9, 2018.
  

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