When her mother became ill in her late 80s, Phyllis Mensh Brostoff lived in Milwaukee, while her two sisters resided near her mother in the Washington, D.C. area. Her younger sister was busy raising teenagers while holding down a full-time job, so her older sister had handled the bulk of their mother’s care.

During a visit one June, her older sister told Brostoff that she was going away that summer, leaving Brostoff scrambling to arrange care. “It put me in a bind,” she recalls.

Fortunately, she was able to find an assisted living facility in Milwaukee willing to rent to her mother for the summer. The arrangement, Brostoff says, “gave my sisters a respite and allowed me to spend quality time with my mother.”

Brostoff was fortunate that she was well qualified to find a solution. She is the co-founder of Stowell Associates, which provides professional home-care management services. But when an aging parent needs help, it doesn’t always work out so well.

“Previous sibling rivalries that weren’t resolved effectively raise their ugly head in the dynamics of the family,” says Kari Klatt, Stowell Associates’ executive director.

Cara Lembo, who lived with and was the primary caregiver for her mother until she died in 2013, grew resentful that her out-of-town brothers didn’t pull their weight yet questioned her decisions. Only recently have the siblings mended fences.

“Caregivers often have to make hard choices,” says Lembo, a Point Pleasant, N.J. resident. “We are the ones who are there when the ambulances come.” 

“Previous sibling rivalries that weren’t resolved effectively raise their ugly head in the dynamics of the family.”
Kari Klatt
Stowell Associates

According to a 2015 AARP report, roughly 34.2 million Americans provided unpaid care to an adult age 50 and older in the prior 12 months. Nearly half were caring for a parent or parent-in-law.

Helping out an aging parent affects families in different ways. In a 2017 survey by the Alzheimer’s Association, 32% of Alzheimer’s caregivers said that the work strengthened relations with their siblings, while 31% said it strained them. Among those reporting strain, 61% cited not having enough help from a sibling as a cause.

Resentments often run high when the major caregiver, typically the adult daughter who lives closest to the parent, feels as if he or she is doing everything, says Lynn Feinberg, senior strategic policy advisor at AARP. And often care needs to be sorted out at a moment’s notice when a parent has been hospitalized.

“It can become stressful, challenging, and emotional, because you’re dealing with complex family systems, often anticipating the loss of a parent,” says Feinberg.

So how do siblings avoid conflict at a time when they can use each other’s support the most? Here are some key takeaways from experts.

Find out what your parents want

Sherwin Sheik, founder and CEO of CareLinx, a nationwide provider of in-home care, says conflict can be alleviated simply by encouraging your parents to have (and share) a plan for when their health declines. That could include which sibling has been designated to manage care, how much money is available for care, and how long your parents would prefer to remain at home.

Leaving it to the kids to figure out what’s best for the parent often causes friction, he says. That’s especially true if one sibling is concerned about an inheritance and wants to minimize how much money is spent on care.

Once a parent’s wishes are understood and valued, adds Feinberg, “children don’t have the enormous pressure of having to make difficult decisions.”

Give everyone a job

There’s typically a “quarterback,” or a primary caregiver among the siblings, says Sheik. Tensions can flare up when he or she takes unilateral action. On the flip side, this sibling shouldering the most responsibility can feel put-upon and beleaguered.

To keep disagreements and hard feelings to a minimum, communication is key.

Even though siblings may disagree with the quarterback’s choices, they’ll likely fall in line if they are involved in developing a plan, Sheik says. AARP’s Prepare to Care Guide includes checklists that can be helpful for organizing care and creating a plan.

To keep disagreements and hard feelings to a minimum, communication is key.

Ask what each sibling is able and willing to do to support the joint plan, and find out what help the quarterback needs so he or she doesn’t burn out. “Open communication on expectations, roles, and responsibility split among the siblings is the most critical step,” says Sheik.

Even siblings who live far away can contribute. “In a family, there’s something for everyone to do,” says Brostoff. With banks and brokerage online, an out-of-town sibling could be the power of attorney for money matters or pay bills remotely.

Draw on local resources

Lightening the load can help diffuse sibling tensions, so take advantage of services in your community that help with transportation, meals, and in-home care. At eldercare.gov, you’ll find links to local government agencies that assist the aging.

AARP helps you find local help through the Alzheimer’s Association’s Community Resource Finder tool, which pulls from more than 400 sources, both commercial and nonprofit, and the information is not limited to dementia-related care. The CreditforCaring app also connects you with community resources.

Employ technology

The right apps can help siblings coordinate care, says Grace Whiting, president and CEO of the National Alliance for Caregiving. CareLinx and Honor match you with in-home caregivers.

With LifeSite, you can store any records related to caregiving in a secure place and share that information with family members. Users are notified every time a collaborator accesses the information.

CareZone organizes health information, providing automatic reminders to take meds or refill prescriptions. LivPact facilitates care coordination and helps you monitor a parent to ensure they’re safe.

Bring in an outsider

A trained professional, usually a social worker or geriatric care manager, can develop a care plan that walks you and your siblings through how best to meet your parents’ needs and connect you with the appropriate resources. Experienced in mediating family conflict, they can bring a calm voice to a crisis.

You can search for a care manager by zip code at the National Association of Professional Geriatric Care Managers website, which also includes a list of questions to ask when you look to hire someone. Rates for consulting with a care manager range from  $125 to 250 an hour, says Brostoff, depending on where you live (more in the large cities on the East and West coasts, less in smaller towns and in the Midwest, South, and Southwest).