Christine M. Valentin, a Licensed Clinical Social worker in New York and New Jersey, provided AgingCare.com with some helpful suggestions for putting an end to family feuds. Valentin owns a private counseling practice where she works with adults who are experiencing anxiety and depression related to work, relationships and family. She also specializes in counseling people who are caring for loved ones with certain medical conditions like multiple sclerosis (MS) and Alzheimer's disease (AD). Prior to opening her practice, she worked with older adults and family caregivers for many years at non-profit organizations like the Jewish Association Serving the Aging, Mount Sinai's Caregiving Program, and the Alzheimer’s Foundation of America. CBB: Why does dysfunction seem to be so common in caregiving families? CV: While I'm not aware of statistics that actually confirm it is widespread, I would say that some form of "family dysfunction" during the caregiving journey is almost inevitable. Caring for a loved one is a complex task that often entails making myriad decisions while also juggling financial constraints, paperwork and planning, and emotional responses. Caring for a parent in itself can be physically and emotionally demanding, and adding numerous opinions and personalities to the mix can multiply the complexities involved. This is particularly true if everyone is not on the same page regarding the care they think their parent(s) should receive. CBB: Do you think caregiving is usually an instigating factor, or does this situation simply exacerbate a familial rift that was already present? CV: In my experience, a family rift, dislike for one another's personality, or disapproval of each other's lifestyle choices is generally present before the caregiving duties arise. The experience tends to highlight or remind families of past conflicts and rivalries, which, in many cases, can no longer be skimmed over or avoided. For example, a family may have always known that “Tom was Dad's favorite.” While this preferential treatment may have been accepted and politely ignored for decades, it can cause problems between the siblings, especially if Dad should begin to shower Tom with praise regardless of his contributions, while ignoring how other siblings are helping out. CBB: Are there any common dynamics amongst caregivers that you have seen that you can comment on? CV: A common situation that arises is when one sibling carries more responsibilities than the other(s). This typically occurs due to the primary caregiver's physical proximity to the parent, the flexibility of their schedule (whether real or perceived), and sociocultural norms and expectations within the family. The reality is, whenever there is more than one person involved in caring for a parent, there are likely to be differing opinions on what needs to be managed, who should be handling what tasks, and when and how to intervene. If a sibling is not helping to provide hands-on care, financial assistance, emotional support or some other contribution, the sole caregiver often ends up feeling resentful, burnt out and lonely. Common complications I have witnessed in sibling dynamics include:
- Being upset with a sibling because they are not helping out enough
- The primary caregiver not advocating for themselves or taking a stand with an older sibling because it goes against the established family dynamic
- Allowing social and cultural beliefs to dictate what roles each sibling will play in caregiving, such as the oldest male child not needing to help out as much, while the youngest female child absorbs most of the hands-on work
- Factors like childhood experiences and parenting style
- Be open to hearing one another's feelings about the caregiving situation.
- Be honest with yourself and each other when discussing the concerns each of you have about your parent(s) and their mortality.
- Focus on really listening to one another’s feelings without minimizing or discounting them.
- Respect each other’s personal opinions and points of view and be mindful of any biases or ill feelings that may be influencing your judgement and attitude.
- Be realistic about who your family members are and what they are capable of when it comes to participating in providing care.
- Recognize your limitations. Sometimes knowing when to stop trying to make someone understand is just as important as educating your sibling and advocating for them to be involved.
- Set goals for productive solutions like compromise and/or forgiveness, not “being right.”
- Have an experienced, non-partial person attend to help facilitate these discussions. Better communication and understanding can often result from having a neutral party mediate and offer an outsider’s perspective. This person can be an impartial friend, a clergy member, social worker, geriatric care manager or a mental health professional.
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