Home Health Care News

50-50 Rule

08.13.

The 50-50 Rule: Real Life Situations (Part 7)

Fighting For Control

Control is an issue that often rears its head in family caregiving situations. Maybe you feel as though you’re in charge only to have your sibling come in and take over the situation. Or perhaps you feel as though no one can do the job like you. Sound familiar?

The Perfectionist

You’ve been the primary caregiver for your mom during the past year. Your siblings have offered to help, but it seems that if you want something done right, you must do it yourself. Your siblings just don’t seem as reliable. Your marriage, however, is beginning to suffer and you don’t know what to do.

It’s easy to feel that no one can do the job like you, particularly if you’ve always been the one that your mom counted on. Think about the fact, though, that your siblings might be feeling left out. They need to feel that they have contributed something to your mother’s care, too.

You should give up a little control for your own good as well as that of your mother and siblings. You will be no good to your mom if your health fails. And it’s likely that your mother would be upset to learn that she was the source of strife in your marriage.

Schedule a meeting or telephone conference with your siblings. Let them know that you would like to take them up on their offers for assistance. Tell each one of them what they can do to assist you and develop a schedule if appropriate.

Sister Act

You finally convinced your mother that she needs a little help at home, but then your sister visited from out-of-town and convinced Mom that she was fine. Now that sis is gone, you’re stuck doing all the extra work.

Sometimes siblings like to one-up each other in an effort to stay in control or have the last word, or they simply have a different take on the situation. Chances are this tendency dates to childhood. Why not make a list of all your mother’s needs and all that you are doing to meet those needs.

Schedule a time to meet with your sister or confer with her by telephone. Tell her that you are struggling to keep up with Mom’s care and then show her the list of all that you’re doing. Try not to be defensive. When she sees all of your mother’s needs in black and white, reality may sink in. Remember, even though your sister lives farther away, she may be in a position at some points to take turns assisting in the care of your mother.

Then, ask your sister what she would recommend. Try to keep an open mind while your sister shares her thoughts about the best ways to assist your mother.

08.06.

The 50-50 Rule: Real Life Situations (Part 6)

Overworked, Underappreciated

Research reveals that one sibling can get stuck with all the work when it comes to caring for Mom and Dad. If you’re feeling stressed by the caregiving load, you’re not alone. And it’s time to speak up.

Caregiver Stress

You just received the big promotion you’ve always dreamed of and, as the youngest and as the one Mom likes best, you have taken over the job of her care since she fell. You’re struggling with depression and resentment because your brothers and sisters won’t step up to help. What do you do?

Caregiver stress can have serious ramifications for the lives of family caregivers. According to a survey conducted for the Home Instead Senior Care network, 42% of family caregivers say they spend more than 30 hours a week providing care. That’s the equivalent of a second job. This sounds like the situation you are in.

Sometimes siblings have a different view of what constitutes help. Some siblings may not agree with the form of help the primary caregiver thinks is necessary. There may be a disagreement about what the parents need, what they’re able to do or the best course of action. Those siblings who won’t help are saying, “I won’t help on your terms.” Or they may think the primary caregiver is offering too much help. These perspectives also may be the result of what’s happening in a sibling’s life or their relationship with their parents. For example, one sibling may be having problems in their marriage that the family doesn’t know about. It’s not always as simple as, “My sibling is refusing to help.”

You can’t do it all, though, and caregiver stress could lead to serious trouble for you and your job. According to the February 2010 MetLife Study of Working Caregivers and Employer Health Care Costs, employees providing eldercare were more likely to report fair or poor health in general.

Call a meeting with all of your siblings and find out if they are willing to discuss the situation. Why not approach siblings with specific requests for advice, input and assistance? A primary caregiver allocating chores may be unpopular. A group putting their minds to the tasks can come up with better solutions. Have a sense of shared situation and responsibility. And talk to your parents. Make sure that they are not telling your siblings that they don’t need help.

Investigate community support options (in-home services, respite care) and use them. Consider hiring paid help if needed. Like all major life transitions, a parent’s need for care is challenging, but is a challenge that can be met.

I’m Drowning

You made the tough decision to give up your career and retire early to move in with Dad. You’re glad you did and your siblings were relieved and appreciate your sacrifice. But you’re lonely. What do you do?

Your situation calls for brutal honesty. You need to tell your siblings how you feel. Practice on a friend if you must work up courage to talk with your siblings. If you don’t think you can get your message out verbally, send them a note or e-mail.

If they respond positively, ask for specific ways that they can help you. A general plea for help may overwhelm your siblings; a specific request may be easier to meet. Before you approach them, think about how they could help you. Make a list of things that your siblings could do that would support you, even if they don’t live close by. Perhaps they could help you find and pay for community resources that would give you a much-needed respite. More frequent visits home also could be an option.

You could be pleasantly surprised. Your brothers and sisters may have been waiting to hear from you, afraid to seem as if they were interfering if they offered unsolicited advice.

When you have the opportunity, get more involved in the community. Set up a Facebook page and reconnect with friends from your past. Then it will be easy to take the next step and schedule coffee or lunch. Contact your local bookstore about joining a book club or invite a friend to dinner. If you were part of a religious community, try to renew acquaintances. Another way to get involved would be to check your local newspaper – print or online – to find out what’s going on in your community each week.

07.31.

The 50-50 Rule: Real Life Situations (Part 5)

Who’s The Boss?

When crisis erupts in your family, does everyone have a solution? If so, you’re not alone. Check out how to keep order when the unthinkable happens. If you’re a 50-year-old sister, the burden often falls of you, according to research.

At Death’s Door

You’re at the hospital where your mom’s sudden stroke has left her in a coma with little possibility that she will survive. She has no living will or other advance directive. Suddenly, your sister-in-law pipes up to say she thinks the family should discontinue life support. Tempers flare. How does your family maintain control of this situation?

There are few situations as emotionally charged as the death of a loved one. Many of the biggest dramas for families occur in the last months, weeks and days of a family member’s life. The passing of a parent is a very personal time. Try to hold a meeting of siblings and a surviving parent so you can make those decisions that are in the best interests of your mom.

Tell your sister-in-law as kindly and calmly as you can that this is a personal family situation and, while you appreciate her concern and respect that she is “family” as well, this is your mother and it’s important that you and your siblings make these decisions together. It will be easier if your dad is still alive and capable of helping make that decision. He can step in to “take charge.” If not, explain that you know your mother the best and the fewer people involved in decision-making, the better. Tell your sister-in-law that stepping back from this situation could help alleviate any guilt she may experience after your mother’s death. She won’t have to wonder if she gave the best advice.

If you don’t think your sister-in-law will accept this approach, why not involve a third party? Most hospitals have a social worker on staff accustomed to dealing with such situations. Explain your dilemma to the hospital staff. They can advise you how to proceed.

To help avoid these issues in the future, acquaint yourself and your loved ones with the “Five Wishes.” This is a document that helps families discuss sensitive end-of-life issues. Go to www.4070talk.com and look for the Life Legacies Overview in the left column. You also will find other valuable information about planning for the end-of-life issues and what documents need to be in place.

Destination Unknown

You’re surprised when your dad calls to say he wants to move to a care community. But he’s decided that you and your siblings should determine his fate. Everyone is fighting about different ideas. How do you achieve consensus?

Your dad has put you all in an awkward situation by asking you and your siblings to choose for him. It sounds as though your father is competent enough to know that he wants to be in a care community. It could be that your dad is just overwhelmed at the idea of being alone in a big house that he can longer maintain.

Meet with your dad and try to find out if, in fact, he does want to move from his home or he just needs help around the house. If he does want to stay at home, that would rule out some of the options your siblings are fighting about. And is it a family conflict or just multiple points of view? There is no need to make a fight of your father’s request. If your father is capable of making an informed choice, propose that all siblings meet with your dad to ask him his preference. Tell him that each of you has a good idea and then seek his opinion.

Since your father opened the door to your family’s involvement in this decision, teamwork will be the best approach to resolving the dilemma. Gather the family to come to agreement with your father. In the end, if your father is of sound mind, the decision must be his.

07.25.

The 50-50 Rule: Real Life Situations (Part 4)

Out Of Sight, Out Of Mind

Distance can be challenging for a family caregiver and other family members. Research reveals that proximity is an important factor that defines a caregiver. But geography doesn’t have to divide. Here’s how to stay on top of a situation.

Hometown Caregiver

You were thrilled to assume ownership of the family business when your brothers and sisters moved away. But you didn’t bargain that you would have all the responsibility for Dad’s care. You know your siblings care; they call and send money. But it’s getting to be too much. What can you do?

First and foremost, you must take action before you begin to resent your siblings. Keep your brothers and sisters informed about how your father is doing, appreciating that they will form their own opinions about him, based on their relationship and contact with him.

If you have specific needs, let your siblings know what they are. Are you in the market for time away? If so, respite care might be the ticket. Perhaps you could arrange a schedule so your brothers and sisters can visit your father and you can take a break. Why not present the idea to a sibling who you think would be the most understanding and receptive to helping. “You know, sis, I love taking care of Dad and am so appreciative of the support of the family, but sometimes it gets to be too much. What do you think about developing a plan where you could coordinate your visits with weekends where I can use extra help or take time away myself?”

If your father’s needs start to translate into expenses, let your siblings know and indicate whether you are requesting financial support from them or letting them know that your father’s money is being spent to meet these needs. No surprises later on will keep sibling relationships conflict-free. If your father says he will repay your efforts through family inheritance, suggest that he let your siblings know as well. If he doesn’t, you might consider mentioning it so there are no surprises down the road.

In The Dark

Since you moved hundreds of miles from home for a great job, your sister has assumed the care of your parents. But you feel left out. Every time you ask, she says not to worry, she has it covered. How do you react?

There are few things worse than feeling left out. First, identify what you really want from this situation. Would more contact with your parents help? Have you made an effort to reach out to your parents first? If they are capable of speaking to you, consider making regular contact by telephone – once a week, for instance – to touch base about what is going on in your life and theirs. If dementia or hearing problems get in the way, why not consider mailing something every week. If your mother likes to read newspaper clippings or your dad collects stamps, send them items regularly to show them that you are thinking of them. This will help you feel more involved.

Caring for a parent is a different issue. If you are not home very often, the day-to-day life events are not a part of your relationship with your parents or your sister. It may not be fair to impose your preferences on the sister who is meeting your parents’ regular needs. Perhaps your feelings of frustration have more to do with childhood rivalries. But it’s important to be honest with your sister.

Speak openly with your sister about your feelings and let her know you want to be more involved in your parents’ lives. “I just feel so out of touch here. Would it be okay if I called you after Mom and Dad’s doctor appointments to find out how they are? Or, if you wouldn’t mind, could I talk with the doctor myself?” Also find out what your sister might need. You may be surprised when she actually tells you she could use an extra hand. Things you could offer to help with from a distance include ordering items your parents might need online and having these things shipped to your parents’ house, setting up automatic bill paying for your mom and dad, and helping your sister keep track of their appointments.

07.16.

The 50-50 Rule: Real Life Situations (Part 3)

Communication Breakdown

Communication breakdowns can make a bad caregiving situation worse. If you’re not talking with your siblings, Mom and Dad may be the ones to suffer. According to research, the problem is a common one. Read on for suggestions.

Silent Siblings

You and your siblings haven’t been on speaking terms for years, but Mom and Dad now need help. How do you get the ball rolling?

It might help you to have a more thorough grasp of your parents’ situation. If time allows, spend a few days with your mom and dad, and try to develop a better understanding of what’s going on. Talk with your parents face-to-face. Tell them you just want to help and ask them to be honest with you about their needs.

Talk to their doctors, which you can do from a distance if you are not able to visit. Make a list of all of your concerns and share them with your parents’ medical professionals. Also discuss the situation with any close friends who might have knowledge of your parents’ health issues and living arrangements.

Sometimes, if one parent is healthy enough, that person may still be calling the shots about care for the couple. If your dad is the primary caregiver, try to engage him in conversation. Ask him what would be helpful to him. Sometimes the primary caregiver just needs emotional support.

You may find that unequal involvement among your siblings has to do with a parent. If a parent is contacting some of his children and not others, and gets along better with those siblings, then that situation will affect the big picture. Sometimes involving a third party is quite helpful in emotionally charged situations. A geriatric care manager, for instance has seen these issues multiple times and can let families know that their situation is not unique.

When you have a clear understanding of the situation, schedule a meeting or telephone conference with your siblings. Discuss with them the importance of putting aside differences for the care of your parents. Go through all the information you’ve found and ask for input. If not all siblings will participate, try to make a connection with those who will.

Lost Days

The devastating effects of Alzheimer’s disease have taken their toll on your dad and now you are suffering, too. He wanders the house keeping you awake all night. Your brother refuses to discuss the situation. You’re thinking of putting Dad in a nursing home. Is that the best option?

You are in the throes of one of the most stressful caregiving situations. Those who care for Alzheimer’s patients are more likely to report a high level of emotional stress than those who care for seniors with other conditions, 40% versus 28%, according to “Caregiving in the U.S., A Focused Look at Those Caring for Someone Age 50 and Older.” In a survey of family caregivers conducted for the Home Instead Senior Care network, 90% say they have episodes of feeling anxious or irritable, 77% say the needs of their seniors are overwhelming and 56% are ill more often.

For your own health, you need to address your situation immediately. First, contact the Alzheimer’s Association 24/7 help line at 1-800-272-3900 (email info@alz.org).

They can give you resources in your community and help you talk through the issues and determine what options are available to you. There are companies that provide respite care in the home that allow Alzheimer’s caregivers like you time away. Many communities also have wonderful facilities to care for an Alzheimer’s patient. By attending a local Alzheimer’s Association chapter, you can connect with others in the same situation and receive moral support and ideas for your caregiving dilemma.

Contact your brother and let him know that you cannot look after your father alone and that you would like more direct support from him; otherwise, you will have to seek help elsewhere. Discuss some of the options that you have researched. If your brother refuses to help, select the best option for your father and you. If your brother will not be involved, his view about a nursing home placement should not be the basis for your decision about what you and your father both need.

07.02.

The 50-50 Rule: Real-Life Situations (Part 2)

What’s Yours Is Mine

Family inheritances and mementos generate powerful emotional and financial attachments. What do you do when you and your siblings disagree on the family legacies? Check out these situations.

A Treasured Keepsake

You’ve always admired your mother’s sapphire broach, which she promised you several years ago. Likewise, your brother was counting on Dad’s expensive chain saw. But when your parents passed away, your youngest brother and his wife – who live in the same town – took it all. What do you do?

The high ground is to appreciate that your memories are the most important reminder of your mother and your relationship with her. If you can calmly talk to your brother and sister-in-law, try it. “You have no way of knowing this, but a year ago Mom promised me her sapphire broach. You have this item of Mom’s (assuming that the sister-in-law has some other possession of your mother’s). It would mean a lot to me to have the broach and comply with Mom’s wishes.” Hope for the best and take comfort that you tried and brought the issue to the forefront. That way the topic won’t fester and you don’t have to wonder. Encourage your brother to use a similar tactic regarding the chain saw.

If your sister-in-law won’t part with the broach, make the best of it. Try not to let it break up your relationship with your brother. Ask if you could borrow the pin to wear on special occasions. Also, take the pin to a professional photographer and have a close-up shot taken of the broach. Frame the photo and display it in a prominent place in your home. If you have a photo of your mother wearing the pin, display that in the same place. It won’t be the same as owning or wearing the pin, but at least you’ll have a remembrance of the memento.

Family Freeloader

No doubt about it, Dad is starting to need help at home. He’s saved plenty for this day but your brother, who lives with him, doesn’t want him to spend any of the money and, you suspect, it’s because he doesn’t want Dad to deplete your brother’s potential inheritance. And yet, little brother won’t lift a finger to help. What now?

The solution to this problem really rests with Dad, not your sibling. Your dad doesn’t feel motivated to spend the money despite knowing that help at home is a good idea.

Encourage your father to spend money to make his life easier and assure him that such spending is appropriate. Consider seeking the intervention of a trusted friend, another relative or a professional such as a financial advisor who could help you persuade Dad. Make clear your limitations in providing the support that your father can afford to pay for. Your brother may have an opinion, but it is your father who controls the finances.

In the meantime, try to reason with your brother. Make sure he knows you are aware of this situation and that you feel your father’s best interests must come first. At the same time, stress the importance of  teamwork and developing solutions that would make life easier for Dad.

One of the most complex aspects of multigenerational living is finances. Since your brother is living with your father, balancing the financial affairs of a multigenerational household should be approached in much the same way as a college roommate arrangement. The same is true of paying for living expenses; consider creating a common fund. For more information, log on to www.makewayformom.com

06.25.

The 50-50 Rule: Real-Life Situations

These real-life family stories are followed by idea and resources for ways to handle the situations before they damage sibling relationships. Each is backed by research conducted for the Home Instead Senior Care network in the U.S. and Canada. Responses were developed in cooperation with Ingrid Connidis, Ph.D., sibling relationships expert from the University of Western Ontario.

Money Matters

The slow economy has taken a toll on many families, straining finances and relationships. Do you and your siblings disagree on how to approach money matters when it comes to family caregiving situations? If so, consider the following real-life family solutions. Research shows that the inability to work together in important areas such as money can lead to a deterioration of sibling relationships.

Payment Overdue

You and your brother have just discovered a pile of overdue bills, spoiled food in the refrigerator and magazines stacked ceiling high at your parents’ house. Your brother loses his cool and practically demands that they move to a nursing home. Your parents are visibly upset. You want the continued help and support of your brother. What do you do?

Approach your parents and brother with a sense of working together to find a solution rather than telling them what to do. Is the problem that your parents don’t have the money? Or are they just unable to manage the bill-paying anymore? Speak to your parents about the issues that are relevant to avoid family conflict.

After accessing the situation, talk with your brother and suggest what seems like a reasonable course of action to you. Be sure to ask his opinion as well. One solution is to set your parents up on automatic bill-paying through their bank or take over payment of their bills. If you and your brother disagree, try to find a compromise. Offer the help you deem appropriate to your parents. A united front is the ideal course of action, unless you and your brother feel it would be best if you spoke to Mom and Dad on your own. Both you and your parents will benefit by keeping your brother engaged in the process in a positive way.

Do what you can to maintain a relationship with your brother. Siblings are sometimes the only family relationships that endure. Friendships from our early lives often don’t last. So there is a depth of empathy we can tap into that goes back to that childhood relationship. That sibling relationship will continue after your parents are gone. Research suggests that siblings don’t want to harm their relationships with each other.

Recession Bust

The economy has taken its toll on your parents’ retirement nest egg, which they worked so hard to build. You and your four siblings are doing well financially, but no one is stepping up to the plate to help Mom and Dad. What’s the solution?

Initially, this calls for a conversation between yourself and your parents. Awareness of your parents’ financial situation is critical. Parents can feel like they are giving up their independence and privacy is they discuss that information. In terms of harmony among siblings, it’s better if everyone has the same information.

You could discuss an agreement where you will help your parents out financially now, on the understanding that they will pay you back through your inheritance. If they agree, you could share your agreement with your siblings so that they know in advance. They could be invited to be part of the agreement as well. Seek the advice of a professional like a lawyer or financial advisor about how best to make this financial arrangement.

Remind your siblings of the impact that the current economic situation has had on seniors like your parents. Older U.S. adults have lost almost one quarter of their buying power since 2000, according to the Annual Survey of Senior Costs released in 2010 by The Senior Citizens League (TSCL), a senior advocacy group.

In Canada, according to the Office of the Superintendent of Bankruptcy Canada, the share of insolvent consumers for people 55 and up has more than quadrupled in the past decade, hitting 20.6% last year. This was the steepest increase for all age groups. The office compiled the findings based on annual numbers between 1989 and 2009.

If your siblings understand, they may get a better grasp of what your family is facing and be more willing to pitch in to help.

06.19.

The 50-50 Rule: Sharing The Care

Sharing isn’t always easy for brothers and sisters who grew up under the same roof. Divvying up the wealth of toys, bedrooms or vehicles may have been a challenge at your house, and sharing the daily household chores could have led to family conflicts as well.

Some things never change.

According to research conducted for the Home Instead Senior Care network, sharing the care of elderly parents can be as much of an obstacle for adult siblings. In 43% of U.S. families and 41% of Canadian families, one sibling has the responsibility for providing most or all of the care for Mom or Dad, according to a survey of family caregivers. In only 2% of families in the U.S. and 3% in Canada did the siblings split the caregiving responsibility equally.

“Senior caregiving can either bring families together or cause brother and sister conflict,” says sibling relationships expert Ingrid Connidis, Ph.D., from the University of Western Ontario. “In some cases it can do both. These issues can be very emotional.”

Connidis has worked with the Home Instead Senior Care network to develop the 50-50 Rule public education program to help siblings deal with the many issues of caring for a parent. The following are tips on how siblings can better share the care:

1. Talk and listen. Research shows that parents care a lot about maintaining independence, often to the point that they also forfeit getting more support. That’s why it’s important to communicate, preferably before your family is in the throes of caregiving.

2. Research options. When you and your siblings have identified the types of services, interventions or care options that your senior needs, look for organizations and resources that can help you meet those needs. Discuss with your siblings who in the family will handle this job. Try to divide the tasks so everyone has input and the opportunity to share their ideas. A good place to start is by doing online research on websites such as www.eldercare.gov and www.caring.com.

3. Plan ahead. When needs and resources are identified, you and your siblings will have a better idea what will be required of your family. For example, if your mother wants to stay at home and “age in place,” consider whether someone in the family will be supplementing that care of if you will divide those duties among siblings.

4. Be flexible. Needs of a senior change as they age. So do the lives of you and your siblings. Rather than insisting that all of the caregiving tasks be divided equally, consider a division of labor that takes into account each family member’s interests and skills, as well as their availability.

5. Be honest. If you have become the primary caregiver and it’s getting to be too much, make sure your siblings know that you need help. Discuss specific tasks that your brother or sister can help you with such as grocery shopping or placing online orders. If you are a long-distance sibling, check in often with the primary caregiver to see how it’s going.

06.11.

The 50-50 Rule: Introduction

50-50 rule

This online guide is designed to help adult siblings and their aging parents deal with those sensitive situations that arise among brothers and sisters as their parents age and need assistance. This guide will cover a variety of sibling caregiving topics such as: How do you divide workload with your sister? What’s the best way to build teamwork with your brothers? How can you reach an agreement as a family on important topics to avoid family conflict?

Based on research and experience, the Home Instead Senior Care Myrtle Beach recommends that siblings make every effort to work with their parents to make decisions about important family matters such as caring for a parent, family inheritance, finances, and end-of-life issues such as estate planning.

The “50-50 Rule” refers to the average age when siblings are caring for their parents (50) as well as the need for brothers and sisters to share in the plans for care (50/50). The program is a follow-up to the organization’s successful “40-70 Rule” program, which encourages adult 40-year-old children to begin discussions on sensitive subjects with their 70-year-old parents sooner rather than later.

This guide features real-life family situations followed by ideas and resources to address those topics. These case studies were developed with input from sibling relationships expert Ingrid Connidis, Ph.D., from the University of Western Ontario.

The stakes are high – sibling relationships and the quality of their parents’ care are at risk. But with new approaches and a focus on building better family relationships, caregiving can make families stronger than ever. Tune in next week for the next installment of The 50-50 Rule!

Home Instead Senior Care is an in-home health care provider located in Murrells Inlet, South Carolina serving individuals and families in the Myrtle Beach and Grand Strand area for over 11 years! We offer assistance to those in need for companionship, home help, personal care, short-term recovery, Alzheimer’s care, Respite care and many other services to make your life easier.

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