The Birmingham News - "Caring for aging parents can bring siblings closer together or tear them apart".

A link to the article run in the Birmingham News discussing Home Instead Senior Care's Boomer Project.

http://blog.al.com/living-news/2011/03/caring_for_aging_parents_can_b.html

The responsibility for caring for aging parents can turn back the clock on relationships among adult children, bringing them as close together or pushing them as far apart as they were as kids, according to a new survey on elder care dynamics.
The survey by The Boomer Project, conducted for the Home Instead Senior Care home health care company, found that in nearly half of families surveyed one adult child ends up taking on the bulk of the responsibility for a parent because siblings have trouble working together. That disparity contributes to a deterioration of the siblings' relationship, the survey found.
Also among its findings:
• Forty-six percent of caregivers who report deteriorating relationships with siblings say their siblings aren't willing to help.
• Siblings tend to give themselves much higher marks for their role in elder care than they give their brothers and sisters. Seventy-three percent say they are reliable, but just 27 percent say the same of their siblings. Similar gaps were found in perceptions of communication skills and empathy.
• Among those whose relationships improved while caring for their parents, nearly all credited good communication.
• Siblings who rate their brothers and sisters highly as caregivers are seven times more likely to see their relationships improve.
• Nearly a quarter of those surveyed said that if they could change one thing about how they've handled care, they would encourage their siblings to help more.
• About two-thirds of youngest siblings describe themselves as the primary caregiver, versus 57 percent of oldest siblings and 49 percent of middle siblings.
Dan Pahos, who owns the Birmingham franchise for Home Instead, said the most common problem his staff encounters with siblings has its root in geography. When one adult child lives near the parent, and another far away, the nearest child often ends up with the greatest share of the burden by default.
The adult child handling the care sometimes feels put upon by the disparity, he said, and the one who lives far away often feels either guilt or a sense that the primary caregiver isn't doing a good enough job.
A result, experts said, can be a return to siblings' relationship roots, only more so.
"Typically, the dynamics of the family that existed prior to caregiving will continue or become magnified," said Virginia G. Wadley, an associate professor of medicine and director of the Dementia Care Research Program and Alzheimer's Family Program at UAB.
"If the siblings fought with each other before, if one was always designated as the responsible one and the other as the slacker, these same patterns and roles will be played out against the backdrop of caregiving," she said in an e-mail.
Pahos, whose company cares for about 100 seniors in greater Birmingham, echoed that conclusion.
"We tend to play in the same sandbox as we did when we were kids," he said.
Reasoned management of caregiving by siblings is important not just for the sake of their relationship, but also for the health of the parent, Wadley said.
If the siblings' relationship is poor, the primary caregiver has a greater likelihood of being depressed, and depression in a caregiver has consequences for the parent under their care.
"The parent's quality of life is affected by both the quality of care they receive and the emotional tone of their interactions with the caregiving child," Wadley said.
Communication, both Wadley and Pahos said, is key. Among Wadley's advice:
• Call a family meeting, and acknowledge that each sibling cares.
"If things are strained, a social worker, psychologist, or pastor can be asked to facilitate the meeting," she said.
• Communicate openly, but avoid accusations.
• The main caregiver should offer concrete ways that the siblings can help.
"If you need help with tasks, don't say, 'Why don't you help me once in a while?'" Wadley said. "Give the sibling a grocery list. Ask them to take your parent to an upcoming doctor appointment. ... Tell them exactly how they can help."
The Boomer Project Survey included results from 711 U.S. adults ages 35 to 64 and with living siblings or step-siblings who currently provide care for a parent or older relative. The survey was done online.