How not to fall out with your siblings when your parent has dementia
It is a disease which decimates the life of the individual affected. And with dementia now affecting more than one in 11 people over the age of 65, the disease is also thrusting many middle-aged children into caring roles. According to the UK charity Dementia Carers Count, there are roughly one million unpaid carers for dementia patients in the UK. But for the many of us already juggling jobs, children and paying the bills, it can put a huge strain on our relationships with our siblings.
Of course, we all want to look after our elderly parents as best we can. But what happens when one sibling does daily care, and another none at all? And what happens when one sibling wants to sell the family home to pay for associated costs, and another doesn’t?
It is no wonder family fall-outs are rife when it comes to making care decisions. Linda Blair, a Bath-based clinical psychologist and member of the British Psychological Society, says: “Siblings can be pitted against one another, having strong disagreements and expecting too much from one another. They are often completely exhausted, so are guided more by emotion than logic.
“I know some families where one person has literally stopped talking to a sibling because they think he or she doesn’t do enough or pull their weight. It doesn’t help anyone to do that.”
So how can we stay on good terms with our siblings when caring for a parent?
1. Stop judging how much your siblings are doing
Typically, these situations come down to one sibling doing the majority of caring, and it’s usually the one that’s already a caregiver, or the eldest, says Blair. “You may think one has spent more money, or another spends more time, but everyone’s contribution will be different because we are all different people,” says Blair. “The kindest and most supportive way forward is to say each contribution is useful rather than judging how much there is.”
If you want to try to make it more fair, you have to talk about it, but without letting the accusations fly. Think of your siblings as team members rather than competitors.
To help foster this sense of teamwork, avoid over-using “I” or “you”. Use “we” – as in, “we are doing this together; it’s a team effort”. You need to try your best to stop measuring how much your siblings do.
2. Accept that things are not going to get better
“You may rejoice in some periods of stability where things don’t get worse, but ultimately you are heading for worse,” advises Blair. “If you all recognise that and support each other in that unhappy reality, it will help you all to get through it.”
3. Don’t ignore your parent’s wishes
Do not disregard the views of the parent with dementia. “They may have lost cognitive function and not be able to make big decisions. But they may be able to say what they like doing or who their favourite carer is for instance,” says Beverley Sayers, a family mediator with the Family Mediation Council (FMC). Ideally, consult them as long as possible.
4. It’s not always about what you think it’s about
“Whatever people think they are arguing about – be it who gets power of attorney, who spends the most money, whether you need carers – it is often about something deeper than that,” says Sayers. “If it were simply practical decisions, the problems could be straightforward to resolve.”
She adds that sibling arguments often have their roots in longstanding family dynamics and are likely about fear, distrust and resentment. There is an underlying worry that one will be the favourite, or have more power, and the problems will typically run along alignments already in the family.
“This is actually what needs airing, and from there, trust needs to be built upon,” she says. “I’ve had cases where siblings are in terrible conflict. But you need to think that sooner or later, the parent with dementia will die and you will be left with your siblings. Do you want to have a terrible relationship with them for the rest of your life?”
5. Talk openly about the financial costs
Flashpoints more often than not boil down to money. Sayers advises that siblings should discuss family finances, in a way that focuses on the parent’s needs and in a non-confrontational way, as soon as possible, ideally long before they need long-term care.
She adds: “If the costs have escalated and one person has taken the financial lead and is then keeping their fingers crossed that their siblings might pay them back when the costs have spiralled, this can become a major issue.
“Should this happen, there can always be an agreement made that some siblings get more out of the sale of the house or estate than other siblings when the parent dies.
“Sorting it out early in principle, with consideration of where this could be going in different scenarios and with everybody signed up to the intended course of action, stops it becoming a dispute.
“And even if it doesn’t seem like it there are always solutions if people think creatively enough.”
6. You don’t have to sell the house right now
Remember, even if you can’t make a decision right now, for example to sell your parent’s house, you can all focus on an interim plan.
She adds: “It is remarkable how many options turn up once you start to brainstorm. For example, it might be that one of the siblings rents somewhere currently and could move into the parent’s home and rent that instead, by virtue of paying care costs.”
Alternatively, you could take out a loan to cover care costs. A local authority can offer a Deferred Payment Agreement (DPA) to help pay for care home fees, which can be repaid from the sale of the property after the person passes away. “It’s something,” says Sayers. “The solutions are often unique to the particular family.”
7. Don’t let grievances simmer
Ideally, grievances should be sorted around the kitchen table, but if you’re at an impasse, mediation can help. Unlike therapy, you won’t need to dig into the past or old family issues.
“Mediation is forward-focused and solution-focused,” says Sayers. “Mediation looks at the positives and negatives of situations and works with reality testing. Can you actually afford carers or is that not possible? Can you really quit your job or is that not possible? We also look at the picture one year, five years, 10 years ahead and discuss how you would all want it to be. It’s also about looking at other issues that may arise.
“For instance, what if you plan to sell the house but it doesn’t sell? What will you do then? We also throw up other ideas – can you rent the house?” Mediation is there to resolve all options and create a way forward.
And mediation can help people respect each other’s viewpoints. All are valid, and each person has their own unique relationship with the parent, so will have something unique to offer.
