Special contribution from Barbara Kane, LCSW-C and Linda Hill, LCSW-C, of Aging Network Services

As geriatric social workers, we work with adult brothers and sisters who are caring for their aging parents. They are often reengaging with one another in very intense circumstances, sometimes after decades of being focused more on their own families than on their family of origin.  The stakes are usually high, as can be the associated emotions and opinions about how to best help their parents. As they sit in our Bethesda office, sometimes with one or two siblings on a conference call, they may silently wonder whether they are even going to continue a sibling relationship once this last parent dies. The process is never easy, but once we have a plan of care in place, siblings frequently look at one another with a rush of gratitude and maybe even a new respect.

Coordinating care for aging and ill parents is difficult for many adult siblings and frequently reawakens old wounds and conflicts. The presenting problem is not the sibling relationship; it is the effective care of the aging parents. Still, working to resolve issues related to taking care of their parents may offer siblings a fresh opportunity to resolve past conflicts.

Division of Roles

We often find that discussing roles and responsibilities is an opportunity to coach siblings on how they can work together more effectively. In a consultation, we may interrupt them to show healthier ways of communicating, both listening and talking. With siblings, we point out that each has different temperaments. We work to help them acknowledge and respect these complementary differences and the strengths of both.

After a couple of sibling sessions with the help of our coaching, we advise siblings to continue these meetings on a regular basis themselves.  Perhaps monthly meetings which they can regard as care planning discussions or business meetings is a good way to check in with each other.

Here are some questions that siblings may use to guide them in their discussions:

• Do you feel that I have been doing enough?
• Do you feel that I have been doing too much?
• Is there anything that I have said or emailed over the last month that bothered you?
• Do you feel that I have asked you for approval for big care decisions during the last month?
• Do we need to revise our division of labor?
• Do you feel I have been respectful of you in tone and action?
• Have we communicated enough over the last month?
• Are any old wounds festering?
• Overall, how do you feel we are doing as a team?

It may seem that monthly meetings are not necessary.  But even if the aging parent is quite stable, sibling relationships need to remain on an even keel throughout this journey of caregiving.  Many families are split by geographical distance and it is often the out of town sibling who has the harder time with feeling out of the circle of care. These meetings, even over the phone, can go a long way towards keeping all the siblings feeling good about each other and the work they are doing together.

For this may be the last time that adult siblings have such a profound reason to come together.