Family Disputes Over Care of Elderly Parents: Common Problems and Solutions

Adult siblings don’t always see caregiving needs the same way. One child may have the impression that a parent is doing fine at home, while another feels they need help. Or, the adult children realize that their loved one needs care, but the parent refuses to see it as an option. These decisions can lead to a divide between siblings.

Solution: Get a professional assessment

Helping seniors make the right decisions for their care needs can be difficult when siblings are fighting. That’s why an outside opinion is often the best solution for these issues. Arrange for a social worker, geriatric care manager, or family counselor to visit your loved one’s home for a safety assessment. If your parent consents, consult with your parent’s primary doctor about any recent health changes or developing physical challenges. Clarification from professionals can define next steps and prevent sibling arguments about what care is necessary.

Sarah Mitchell, MSW, is a social worker with over 20 years of experience helping families find senior care and housing. She has encountered many family dynamics over the years and offers her insight on how to navigate family conflicts over senior care.

“Family counseling services can offer support and coping strategies for families as they begin to navigate this change and season of life,” Mitchell says. “It can be overwhelming and emotional. A professional can help families find balance and direction while ensuring the [senior’s] own needs are met.”

Solution: Research senior care options

Once care needs are established, the next step is deciding who will provide care. If a family decides that a senior living community may be a good solution, our Senior Living Advisors have experience matching seniors’ needs and lifestyle preferences with communities across the U.S.

If your loved one will remain at home, our Senior Living Advisors can also help you find local home care options. This is a good idea if you and your siblings are considering taking on caregiving duties alone since there are a lot of caregiving responsibilities that can quickly become overwhelming without help. That’s why it’s quite common for family caregivers to also have a part-time in-home caregiver to help with certain daily caregiving tasks. Home care professionals can really help reduce stress for family caregivers.

Read more:Top 10 Senior Caregiving Duties You May Encounter

Solution: Explain the benefits of senior living

Listen to your loved one’s concerns. Emphasize your role as an advocate for your parent’s quality of life and show how senior living or in-home care can help them maintain the lifestyle they already enjoy. Sometimes older parents have outdated views of senior living. It might be helpful to explain that today’s assisted living is different from nursing homes like those they may remember their parents or grandparents living in.

“If you are considering senior living for your loved one, schedule a tour with one or two nearby to explore what they have to offer. This will often lead to additional conversations and make it less frightening for the senior if they have a current understanding of the offerings,” says Mitchell.

After learning about the amenities, activities, and freedoms senior living today can offer, your parents may be more likely to make the transition.

Even if a parent agrees to care, there’s still the decision of which sibling should take the lead on caring for the parent. Each sibling may have their own legitimate reasons as to why they may or may not be able to act as a caregiver, like lack of time or money. They may have families of their own that they are caring for.

Solution: Every family member contributes within their means to the care of the elder

Structures of expectations can be worked out between all family members involved, perhaps with the help of a family counselor or mediator. For instance, siblings could rotate days they provide care. Or, if a sibling can’t provide any caregiving assistance, they might be able to provide monetary assistance to pay for outside senior care.

Mitchell explains how holding a simple family meeting can get everyone on the same page with what they can contribute. “Getting buy in from both parents and other family members can be challenging. It’s important to ensure everyone feels heard. A family meeting is often a good first step, including as many concerned parties as possible.”

Solution: Senior care options

If all family members are truly unable to act as caregivers, they may be able to pool their resources to pay for either assisted living or in-home care services for their senior loved one. Once families figure out their budget, our Senior Living Advisors can help find senior care communities or home care agencies in the area that fit that budget.

Let our care assessment guide you

A sibling may be manipulating their elderly parent to follow the sibling’s wishes instead of what’s best for the senior. Manipulation is common when siblings are arguing over whom the senior should live with or if the senior should move to a senior care facility. Financial fraud and inheritance incentives might even be at play for the sibling to manipulate the senior parent.

Solution: Identify any fraud or elder abuse, document everything, and seek help if needed

If you find that a sibling is manipulating an elderly parent to the point of fraud or elder abuse, contact Adult Protective Services. Be sure to document the abuse as much as possible, like with financial records and changes to estates. If you can communicate with your senior parent, consider establishing a power of attorney (POA) for them, which you can use to intervene in cases of abuse.

Sometimes, siblings may not understand the situation or they choose to ignore how much help the parent needs. Sometimes adult children choose not to care for an elderly parent because of past conflicts. Alternatively, a sibling might simply lack the time or money to help.

In these cases, the adult child who lives closest to their aging parent or has the closest emotional relationship often assumes the primary caregiver role. The role of primary caregiver might be unavoidable for one person due to family dynamics or resources. But when other family members don’t readily offer to help within their means, the primary caregiver can begin to feel isolated and resentful.

Solution: Primary caregivers should communicate their needs to their siblings

If you believe your siblings aren’t aware of your efforts, try to schedule visits or video calls, or request doctor testimony to explain the severity of the situation. From a distance, it may not be clear to other family members just how difficult caregiving has become for their sibling.

If your siblings refuse to help due to past trauma, that’s their right. Focus the conversation instead on how they can support the primary caregiver, their sibling, instead of the parent directly. Even if they don’t want to interact with aging parents, family members can still help their sibling from afar with things like finances, appointment scheduling, meal delivery, or emotional support.

A long-distance sibling’s financial help could even be in the form of hiring a part-time home care aide to assist the primary caregiver and give them respite.

When immediate family members come together to care for aging parents, they often revert to dysfunctional and unhealthy roles from the past. Think of all the times mom or dad broke up your fights as kids. It’s important for everyone to simply remember that this is about what’s best for the parent, not any long-standing sibling rivalries.

Solution: Consider a mediator

Sometimes a neutral third party is the only way to calm feuding family members. Your local chapter of the Area Agency on Aging might offer family mediator services in your area. A counselor, lawyer, doctor, or geriatric care manager can also mediate. Costs for mediation services will vary depending on where you seek services.

At a family meeting, there should be a frank and open discussion about a parent’s care needs. Each sibling’s role and obligations should be established, and future care plans should be made. Discuss finances, caregiving, and any wishes your parents already have in place.

Finances play an enormous role in how siblings choose to care for their aging parents. The cost of senior living often seems overwhelming and can deter families from exploring all of their options. If your aging loved one grows to require in-home care, senior living, or hospice, who will pay for it? Should expenses be split evenly between siblings, or should those with higher incomes pay more?

Solution: Establish family financial roles in advance

Siblings should work together to understand future costs, make financial decisions, and establish budgets in advance for their parent’s long-term senior care. Ask your parent how much money they’ve saved and if they’ve taken out a long-term care insurance policy that can help offset their long-term senior care costs. Once you learn what the parent needs to cover future care, siblings can decide how much they might be able to chip in down the line.

Solution: Seek long-term care benefits for low-income seniors

If your family just doesn’t have money available to cover long-term care, see if your parent qualifies for long-term care benefits from Medicaid or Veterans Affairs (VA). If your loved one qualifies for long-term senior care benefits through these programs, they can get help paying for long-term care services at a senior care community. The senior might also qualify for a home health care caregiver or a stipend for a family caregiver through these programs.

Read more:Paying for Long-Term Senior Care

Sometimes one child takes over the caregiving role and leaves other family members in the dark, perhaps even limiting access to the elderly loved one. This can leave other siblings worried about the state of their parent and if their care needs are being addressed.

Solution: Urge communication with siblings, parents, and if necessary, authorities

Reach out to your sibling directly and express your feelings and willingness to be more involved in your parent’s care. If your relationship with the caregiving sibling is strained, maintain ongoing communication with your parent through phone calls, emails, or letters.

If your sibling is acting as a gatekeeper and preventing you from reaching your parent, or if you have reason to believe there may be abuse or exploitation involved, call local Adult Protective Services to intervene. Even if your sibling is angry at this decision, remember that you’re putting the health and safety of your parent first.

Sadly, seniors who are desperate to maintain their independence may manipulate their children against one another to remain living as they see fit. The loss of independence for the senior can lead to grief and desperation. Mitchell reminds us how vulnerable families can become during this time of grieving.

“Choosing senior care has a sense of grief included. Elder parents are grieving the loss of their independence, while children are grieving the loss of their parent figure.”

To make matters worse, some seniors even experience significant personality changes due to dementia or physical decline. This means you may find that the parent you’ve been close with your entire life is becoming verbally or even physically abusive to you. Worse, if you’re the primary caregiver, your siblings may not know or believe it’s happening.

Solution: Let the parent feel included in decisions regarding their care

Because this is such a vulnerable time for the senior parent, as they lose their independence and leadership role within the family, the family should include the senior as much as possible in their care decisions. Mitchell explains why this is important.

“When parents are able to weigh in on their long-term needs, it can build confidence and trust in the senior care process. It also helps siblings work together [toward] one goal — helping their parents — and being a more of a united front.”

Solution: Realize when caregiving is no longer feasible and senior care is needed

Caregiver burnout is common, especially when the caregiver’s relationship is strained with the person they’re caregiving. This can cause both the caregiver’s and the senior’s health to suffer. If you’re a full-time caregiver, consider adult daycare, part-time in-home care, or occasional respite stays to help offset family stressors. Mitchell discusses how helpful these short-term, also known as respite, stays are to families.

“In many cases, furnished apartments are offered for 10 to 30 days for a senior to ‘try it out’ and for the family to get a break from caregiving and worry. Many seniors find this ‘trial’ period an opportunity to understand what senior living is while experiencing it first hand.”

The senior may decide they prefer the senior care community over remaining at home with a family caregiver. Communities are very different these days, so matching the senior to the right community helps determine whether they will choose to stay or not. Mitchell explains why working with a Senior Living Advisor in your area is important for this reason.

“As a former senior living advisor, I often found that seniors matched with the right community rarely returned home. They find they enjoy the amenities, meals, laundry, housekeeping, activities, and outings, as well as meeting others with similar interests.”

In cases where the parent has a dementia diagnosis, it’s important to recognize when their care needs have exceeded your caregiving abilities and a memory care community is needed.

If your aging parent threatens or attempts to manipulate you when the topic of senior care is broached, recognize that this is another sign that a professional mediator or counselor is needed. If they’re becoming a danger to themselves or others, get your parent’s doctor, your siblings, and if necessary, your local police department’s elder affairs officer involved. The safety of you and your loved one should always be the priority.

Read more:The Worrying Facts About Caregiver Health and Stress

End-of-life, or hospice, care is controversial. One child may want to arrange hospice care for a terminally ill parent, while another may advocate that every day lived is a victory, avoiding hospice. In both cases, family members want what is best for their aging parents, but they disagree about what that means.

Solution: Let your parent make this decision

End-of-life care conflicts can be avoided with a living will. When seniors write a living will long before a medical care crisis — also known as a health care directive — this essential legal document for seniors specifies their end-of-life wishes and is legally binding.

Solution: Have your parent set up a power of attorney

Ask the parent to pre-designate a power of attorney or durable power of attorney to carry out their end-of-life care requests. If you’re worried that power of attorney could be contested in your family, have all documents reviewed by a lawyer and notarized at your local post office or bank.

Power of attorney (POA) is one of the most frequent conflicts between siblings with aging parents. This is partially due to misunderstandings about the position.

Below are examples of POAs and the powers they grant. It’s important to get the right type of POA to avoid future problems:

• General power of attorney. The assigned individual can perform almost any act in place of the principal (like an aging parent). This includes opening financial accounts, making medical decisions, and managing personal finances. General power of attorney is terminated when the principal becomes incapacitated, passes away, or revokes it.
• Durable power of attorney for health care. This person has the authority to make medical decisions during an emergency, regardless of the principal’s mental competence or capacity. It’s their job to make sure that health care providers carry out all wishes made in a health care directive.
• Durable power of attorney for financial care. This individual maintains control of finances, even if the principal is deemed mentally incompetent or incapacitated. This is typically necessary to open accounts and manage personal finances for loved ones with advanced dementia.

Read more:6 Little-Known Facts About Hospice Care at Assisted Living Facilities

Talk with a Senior Living Advisor

Inheritance issues are common among siblings. They often stem from a lack of communication with the aging parent.

Solution: Learn about inheritance and estates in advance

While it may not feel appropriate to worry your loved one unnecessarily about heirlooms, it can actually be helpful to discuss these things with your parent while they’re alive and healthy. If there’s something that matters to you, let your parent know before they pass. It may help avoid painful sibling conflicts later.

Solution: Bring in a family mediator

When disputes about inheritances arise after your loved one’s passing, it’s often a good time to bring in a family mediator — an unbiased, neutral third party, such as a lawyer. A family mediator’s job is to analyze these situations fairly and objectively to help siblings find areas of common ground.

The following basic tips can help families to avoid the common problems we’ve discussed above. In the long run, these approaches are invaluable to healthy family discourse and successfully meeting your parent’s needs.

1. Understand the wants, needs, and concerns of the parent

Give your parent the opportunity to communicate what they feel comfortable with in their future or current care situations.

“As humans, buy-in and support is easier if you’ve been a part of the decision. This includes the senior the family is ‘deciding’ for, so include them whenever possible,” Mitchell says.

Enable your parent to express all their potential concerns to the whole family. This gives everyone a clear understanding of the senior’s needs. Siblings can then focus on catering to the parent’s requests and avoid disagreements since their parent has already provided guidelines on what to do for them. Keeping the parent’s wants front and center can help avoid interpersonal conflicts among siblings.

2. Listen to everyone, and be empathetic

Each sibling may feel differently about the parent’s declining health, how to approach care, and what their role should be. By letting everyone discuss their concerns, wants, and potential roles, everyone can feel heard when disputes arise and decisions are made.

While listening to siblings’ concerns, it’s also important to be empathetic to their financial and emotional positions. While another sibling’s concerns may seem trivial to you, it’s important to at least hear them out and take their concerns seriously.

3. Know when to walk away and seek help

When discussions about decisions for parents turn into disputes, things can quickly become tumultuous and unproductive. Avoid this by knowing when to pause a conversation and come back at a time when emotions aren’t running as high. If you’re not able to have a calm conversation, consider bringing in a mediator to help resolve disagreements.

4. Keep communication going

Stay in contact to keep all siblings in the loop, allowing everyone to know what’s going on. Whether it’s getting together in person or over video chat, keep open communication so everyone can discuss any concerns as they arise. Regular communication can even help siblings bond while taking care of their parents.

Watching a parent’s health decline can be painful and can quickly lead to disagreements between siblings on the parent’s care needs. However, disagreements don’t have to tear your family apart. Remember the solutions and tips above to improve communication, avoid arguments, and strengthen your relationships within the family.

When that simply isn’t possible, consider reaching out to a professional to mitigate family conflict. Counselors, social workers, doctors, lawyers, or other professionals can help keep the family focused on identifying the senior’s specific and objective needs.

“Families are often better together and hearing input and suggestions may lead to a more constructive conversation and bring to light things others hadn’t thought of,” explains Mitchell.

If your family decides to move forward with paying for long-term senior care, either part-time or full-time, contact a Senior Living Advisor at A Place for Mom. Our advisors are free to families and well-versed in all types of long-term care services. They can provide valuable input that may defuse family arguments, redirecting conversations toward providing your loved one with the best care services your family can afford.