Top stressors for sibling caregivers

Often times, as parents age and require more help, children become the caregivers and enter the "sandwich" generation; caregivers to their own children and their own parents.  In more than twenty years I can not recall one situation where care giving responsibilities have been equitably divided between siblings.  Please don't misunderstand, some are much more equitable than others but none are truly equitable.  One child often ends up with greater responsibilities than the other(s).  It may be the child believed favored by the parents, one with the most flexible schedule, or it might be the child geographically closest to the parents.  S/he might be self appointed or elected by other siblings.  However, there is almost certainly one sibling carrying a greater share of the responsibility.  This arrangement, though, often times leads to misunderstandings, hurt feelings, and even anger.  Siblings may not understand the level of care needed, or they may question costs for equipment, supplies, or paid caregivers.  So, how does a family cope?  How does every one do their part?  How can you minimize or even avoid hurt feelings?  Below are some suggestions.

1. Dividing responsibilities:  While in many cases is simply makes sense for one child to take the lead in care giving responsibilities duties still can, and in most cases should, be divided among siblings.  Financial and legal issues can be handled from any distance so even a sibling living far away can help with or take over these responsibilities.  Though one or some siblings may have more flexible schedules providing care is a 24/7 responsibility.  Other siblings can offer to offer care giving for a weekend, or use some vacation time to provide the primary care giver a needed rest.  In larger families a schedule can be implemented: Mary will stay over Monday, Bob will stay Tuesday, etc.  Every family is different and no two solutions will look the same.  The key here is to communicate.  Have a family meeting, identify the needs, and divide the work as evenly as possible.
2. Understanding needs:  Though immediate needs may be painfully obvious, other needs may not be initially apparent.  Developing a running list can be helpful to keep track.  Also remember that needs can change over time.  Regular family updates can be an effective way to keep everyone up to date.
3. Financial issues:  Money is frequently an area that can lead to arguments, misunderstanding, and even distrust.  Review assets, cash, and savings.  Identify current expenses, current needs, and consider what care related expenses may be on the horizon.  Preparing a budget can be a very effective tool both to keep you on track and to help other siblings understand finances.  Funeral arrangements, though difficult to discuss, should also be reviewed.  An irrevocable burial trust or other means to prepay is often a wise move.  Also be aware that prepaid funeral expenses are often times not counted as assets.
4. Legal issues:  Is there a will?  Advanced directives?  Living will?  Power of attorney, Medical proxy?  If these documents are in place and executed locate them, review them with the family, and keep them in a safe place.  If they are not in place they should be.  Though hospitals and other providers will routinely ask for a living will or advance directives I always suggest that a medical proxy or medical power of attorney also be in place.  Standardized forms for living wills and advance directives are ambiguous and leave little room to further define a person's wishes.  In addition, you are making medical decisions for a situation that has not occurred yet.  A medical proxy has the legal power to make medical decisions specific to the situation.

All of this sound too overwhelming?  It can be.  Planning in advance can make the process much easier and allows the family to discuss these issues without the emotions stress of making immediate plans.  Be aware too that help is available.  An Elder Care Consultant or Geriatric Care Manager can assist you in through the entire process from assessing current needs and projecting future care to getting legal affairs in order.  The consultant also acts as an unbiased third party who can provide a written report of current needs and suggestions for planning, allowing less involved family members true picture of the situation.