Drama Over Mama: Tensions Rise As Families Have To Make The Tough Decisions

The tension rose as a brother and his two sisters sorted through their mother’s possessions before her move to an assisted-living facility.

He was annoyed that his sisters wanted to reminisce about every photo and book. He wanted to hurry up and finish the job. “Because I was the one who had to do the moving, cleaning, selling, closing, etc., I knew I had to play the heavy,” he said.

Eventually, his oldest sister – fed up with her brother’s pressuring – walked out. Big sisters, little brothers, black sheep, Dad’s favorite – all the old roles resurface when a parent’s health is failing and decisions must be made.

With about 20 million Americans providing care for a parent or in-law, such family dramas – often with financial questions lurking unsaid – are common, said Bonnie Lawrence, spokeswoman for the Family Caregiver Alliance. Eighty percent of long-term care is provided by families, not institutions. Even families that don’t provide care, though, are choosing a nursing home or making medical decisions about a dying parent.

But getting stuck in an old squabble can sabotage wise decisions, said researchers. To help, some states offer free consulting to families making decisions about elders, and a new school of professional mediation has sprung up to help baby boomers stop fighting with their siblings and refocus on what’s best for Mom or Dad. Such services still are rare, though, leaving most families to cope on their own.

Old family dynamics come back like a boomerang during anxiety-producing conversations about aging or ailing parents, said Brian Carpenter of Washington University in St. Louis, who has studied sibling issues. “One person takes charge, the other is more submissive; one sibling is the joker, smoothing over disagreements with humor, while another sibling is the serious one, all efficiency and business,” Carpenter said. Sometimes the roles help, because the family originally may have developed them to take advantage of individual strengths, he said.

“In other cases, however, when those roles have never been really helpful, they get in the way of making parent-care decisions, just as they probably got in the way of lots of family decisions throughout life,” Carpenter said.

Sisters tend to criticize their brothers for not doing enough, while brothers don’t take enough credit for what they do, said Sarah Matthews, a professor of sociology at Cleveland State University, who has conducted research on siblings with aging parents. Her interviews with 149 pairs of siblings found that women and men have different expectations.

Sisters saw their siblings as a team. They expected cooperation. They wanted communication about what each sibling was doing for the parent. Sisters also felt they knew more about what needed to be done.

Brothers, on the other hand, acted independently and expected to negotiate directly with their parent without keeping their sisters informed. The eldest son holds sway in families from some cultural backgrounds, said Dr. Gail Gazelle of Palliative Care Associates in Brookline, Mass. “No matter how bad the parent’s relationship has been with that son and how derelict he has been in his caregiving duties, he will be deferred to in decision-making in those families,” Gazelle said, “much to the chagrin of the daughters who’ve been giving care for years.”

Focus on parents
Gazelle advises siblings to stay focused on what their parents would want, and to remember that their relationships with siblings will endure long after their parents’ deaths. Among firms offering mediation of such issues is Elder Decisions in Lexington, Mass. Among clients were a sister and her five siblings. Two years ago, the siblings couldn’t agree on whether their 80 something parents, both suffering dementia, should remain at home or move to an assisted-living facility. Some of the siblings also felt unappreciated, which clouded their decision-making. The siblings met for mediation – a brother in Israel participated by speaker phone and found common ground. They decided to hire caregivers so their parents could stay at home.

“The act of coming together was a kind of a bonding experience,” said one of the sisters. “We realized we really could work through a lot of decisions and challenges.”

They did it for their parents. “Our parents raised us. They did the best they could,” she said. “We owe them.”

The Indianapolis Star
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For more information on Mediation services contact
The Center for Elder Law at 248.641.7526 or e-mail.