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The Ohio Department of Aging

Ohio Department of Aging Boomerang: It all comes back to you!

Boomerang: It all comes back to you!

My Family - January 2012

No one wins when families fight about caregiving
Communication is key to coordinating care and honoring wishes

Mary was dreading the holidays as much as her mother was looking forward to them. She lived close to Mom and Mom depended on her. Mom was thrilled that her son, Dan, was flying in from New York. Mary knew it would be like holidays in the past: Dan would fly in for a few days and question and second guess everything she did. Meanwhile, Mom would act like Dan was doing something great just for showing up occasionally. Mary was sick and tired of everyone expecting her to do all the work while Dan got praised for an occasional visit.

Dan wasn't looking forward to the holidays, either. He felt guilty for not being as available for Mom as Mary was, and he knew Mary resented that he didn't do more. When he did offer advice or help, Mary would attack him: "You aren't here. How would you know what Mom needs?" Sometimes, he learned about a change or a crisis after the fact, and usually long after he could have helped. He knew Mary was working hard, but he felt isolated and cut out of a big part of the family.

There are no bad guys in this this situation - just bad communication. When it comes to caring for parents, one of the most challenging aspects is deciding how to divide up tasks among siblings. The question of who is the primary caregiver is usually a point of contention. Often, it's the most willing or the one that Mom wants it to be. Many people assume the role out of necessity, not out of logic, which also leads to resentment, even feelings of martyrdom. Situations like Dan's and Mary's could come from one sibling feeling like nobody else can do as well as she can, so she does not ask for more help.

Better communication with Mom and using her wishes as the basis for any plan can help make caregiving more equitable.

Start having regular family meetings. Establish early on how each sibling or other family member is willing or capable of helping. Gather everyone involved in your loved one's care in person, by phone or by Web chat. Ask your loved one what she wants and plan accordingly. Set goals, discuss feelings and decide who will be responsible for which tasks. This is best done when there is not an emergency. A calm conversation about what kind of care Mom wants now and what might be called for in the future can avoid a lot of confusion. Meeting on a regular basis allows everyone to stay involved, to talk about how things are going, and to discuss new tasks that may need to be added.

Know what needs to be done and who does it. Many tasks related to caregiving can be managed either long-distance or on a regularly scheduled visit, such as home repairs that are not emergencies, doctors' visits that are scheduled in advance, managing finances or anything that can be completed by phone or computer. Some long-distance caregivers help a parent pay for care. Emotional support and checking-in by phone can be done from anywhere.

Appoint a leader. It's good to have a "team leader" who coordinates efforts and delegates responsibility. The team leader must be able to recognize others' authority over their own areas and to trust others will do what they promised. While it can be tempting, the leader must not be too critical or end up doing the things he thinks others aren't doing well enough.

Learn about your loved one's health concerns. If your loved one's health care provider is willing and able, schedule a family conference call with the doctor to keep on top of changes in your loved one's health. You can learn and share as much as you can about your loved one's health by doing online research and sharing links with others.

Learn more about caregiving. Many of us don't automatically have a lot of caregiver skills. Everyone in the family can benefit from knowing more about caregiving tips, support groups, etc. Each individual can learn more about his or her aspects of the care plan.

If you are not the primary caregiver, never underestimate the power of offering appreciation, positive reinforcement and reassurance to the primary caregiver. By showing love and care, you will come across as a partner willing to help, rather than to criticize.

After a few long talks, Mary and Dan realized that they were each looking at the same situation in very different ways. They both wanted Mom to be happy, healthy and as independent as possible. Mary understood better that while Dan couldn't be here, it did not mean he was less concerned about Mom. He wanted to help. Dan realized Mary was working hard and doing the best she could. She wasn't trying to keep him in the dark. They still have some issues to iron out, but they are on their way to cooperating to help their mother be as independent and happy as possible.

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