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When families can't agree on care

When-families-can't-agree-on-careDear Lesley,

All my brother and sisters and I seem to do these days is fight. We used to get on really well. Then mum was diagnosed with dementia and she gave us all Power of Attorney. We argued about when was the right time for her to move into a home and we’ve argued about the homes she’s been in since. We’ve had to move her twice because her behaviour has been too much for one home and even because one of my sisters had been rude to the staff. Wherever mum goes I see caring people trying to help her but the others are really suspicious and don’t think she’s being cared for properly. I hate this fighting and I hate seeing mum like she is. It’s all really stressful. What can I do? J

Lesley says:

Dear J

Unfortunately fights between brothers and sisters are very common when families are trying to cope with ageing parents. Old grievances and sibling rivalries come rushing back to the surface. Everyone falls back into their childhood roles – “the bossy one”, ‘”the lazy one”. Family bonds that were strong are tested by fierce differences of opinion about what is the best course of action. Or siblings may have drifted apart or become estranged over the years and find themselves having to reunite to resolve problems with their parents.

On top of that when a parent is diagnosed with dementia it’s a huge trauma for the whole family. Each son or daughter has their own individual reaction based on their personality, what’s happening in their own life, and their relationship with their mother or father. The adult children can go into denial or absent themselves from the situation. They may go into over-drive trying to find solutions or they may become depressed.

A web of emotions

More often than not, underlying all of this there’s a complex web of emotions such as anger, resentment, lack of control, inadequacy about not being a good enough son or daughter, and awareness of the gradual loss of a “senior” family member. And there’s the unfairness of it all. Why did this have to happen, why him, why her, why me? Even in the closest of families it’s hard to talk about all of this.

Feelings get bottled up; resentments build. And instead of pulling together, siblings attack each other or look for someone to blame – GPs, care home staff. All of this makes it incredibly hard to see the situation clearly, keep relationships friendly and make sure the older person is properly looked after.

Finding the positives

Despite all this, I do see some positive things in your email. One is that your mother thought about Power of Attorney which is so important in enabling a family rather than the State to make decisions on behalf of the older person. And she appointed all her children as attorneys so she obviously believed that all of you had a role to play in looking after her and could be trusted to look out for her best interests.

Also, you say that you used to get on really well together so hopefully this is something that can be regained.

Starting helpful conversations

My suggestion would be that you hold a family “conference” or, better still, regular family meetings. Preferably this would be on neutral ground, like a quiet coffee shop, or if you all live far apart then on the phone (or Skype). Everyone involved should be there but if they can’t or won’t then go ahead with those that will, or start by talking things through with the sibling where there is less conflict.

If you could find someone to mediate, that could help keep things cool - perhaps a family friend who is respected by everyone. Agree that the purpose is to put differences aside and discuss how you can best work as a ‘team’ in order to provide the best care for your mother.

Depending on your particular family dynamics, it might help clear the air if you start by having everyone talk about their reactions to your mother’s dementia. There is probably common ground around feelings of sadness, worries about the future and/or guilt about her going into a care home. It could help to acknowledge how hard everyone is trying and to recognise where progress has been made.

Talking about issues

You probably also need to have some specific topics to discuss. What are the biggest concerns about the current care home and what is the evidence for those concerns? Is your mother really at risk?

Then move on to think about solutions. Should you complain to the care home and if so how can you do this in a constructive way? Would it help to visit more often, perhaps at different times of day to get a better picture of what is going on? How do each of you cope with the stress and worry – what helps?

Working as a team

As a “team” you could decide on specific roles so that everyone plays to their strengths. This worked in the case of my own family, when my mother was diagnosed with dementia. At first, we muddled through in a haphazard way. Over time, we worked out that we had different strengths and weaknesses with things we felt able or unable to take on. I discovered that I was good at doing practical things like making phone calls and searching for information online. My sister was particularly good at spending time with my mother, chatting with her and washing her hair for example. My brother handled the finances.

From your email, it seems like perhaps you are the one most upset by all the family fighting so you may be the best person to initiate something new and more constructive. Finding a way forward, reducing the family tension and making things better for your Mum would, I’m sure, be a great relief for you and for your siblings.

Looking after yourself

Do be aware that seeing your mother suffer from dementia is very stressful for you personally. Find ways to look after yourself, detach from the situation and focus on the more joyful areas of your life.

You’ve said that your siblings used to get on well and hopefully that is something to build on. Things won’t change overnight but you’ve everything to gain from taking the first steps to finding a resolution.

Dr Lesley Trenner is an Ageing Parent specialist with extensive qualifications and experience in life coaching. Lesley provides one-to-one help for people who are struggling to balance work and care, or cope with mid-life, family and career challenges. Sessions are available face-to-face (London) or on the phone. Email Lesley or call 07919 880 250 for a free introductory chat.

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