As the only sibling who lives in the same town as your parents, you spend a lot of time with your mom — and you’ve started to notice some changes that are concerning you.
Once the life of the party, she now tends to retreat during group gatherings. You know you told her about her granddaughter’s new job, but she acts like you never said anything of the sort. Recently, she got turned around driving home from church.
When you told your younger sister, who lives a few hours away and doesn’t talk to your mom more than every other week, she brushed it off as just a normal part of aging. Your older brother didn’t seem concerned about the cognitive changes, either, telling you that you’re just overreacting — “as usual,” he added.
You usually get along with your siblings, but their dismissiveness has you frustrated — and afraid. Are you rushing to conclusions, or is there something really here? What do you do when you’re the only one concerned about changes in an aging parent?
Sibling conflicts and disagreements are incredibly common when an aging parent starts requiring care.
Typically, family tension erupts because your family has not had to deal before with the practical, emotional, and financial issues that come with caregiving. Without realizing it, past conflicts, clashing personalities, tough decisions, and unequal contributions can cause more conflict than they normally would. For example, it is often the case that one sibling has been primarily responsible for caregiving for an aging parent, and other siblings haven’t had first-hand experience with the significant health changes a parent is experiencing.
When it comes to Alzheimer’s and other forms of dementia, new research shows that most people don’t actually know the possible early signs. The survey published in the Alzheimer's Association's 2022 Alzheimer's Disease Facts and Figures report found that over 80% of Americans are unfamiliar with mild cognitive impairment (MCI) which affects up to 18% of people ages 60 and older and can lead to Alzheimer’s disease. Many people — including your siblings — mistake MCI as a sign of normal aging, yet about one-third of people with the condition develop Alzheimer’s disease-related dementia within five years.
It’s also common for some family members and friends to try to explain such incidents away, saying, “She’s confused” or “She’s just not herself today.” It can feel easier to deny the changes than to accept that your aging loved one may be experiencing early signs of dementia.
As the person who is going to care for your mom, you don’t want to delay diagnosis and impede treatment. No wonder you and your siblings have different perspectives.
There are many ways to improve communication and caregiving with siblings. Here are some tips grounded in internationally-recognized dementia practitioner and educator Teepa Snow’s Positive Approach to Care.
Before you launch into a lecture or start sending resources to your siblings via email, take a deep breath and offer yourself some compassion. This is hard! It’s likely that you and your family haven’t dealt with this before.
Next, extend some compassion to your siblings. Sometimes fear, pain, or guilt might cause you and your siblings to act out of emotional needs. You don’t have to excuse negative behavior, but try to be compassionate.
Next, keep track of the cognitive changes you’re noticing in your parent. Be specific and concrete.
You can use something like these Health Information Trackers to make it easier to record changes in how your loved one is feeling physically, emotionally, and mentally.
Teepa Snow also recommends these two resources to help communicate with your siblings in objective terms: a Dementia Screening Interview from the Alzheimer’s Association and this Normal Aging vs. Not Normal Aging Chart
Has your loved one noticed any of these changes? Have they expressed any concerns? How have they reacted when they’ve lost track of a conversation or made mistakes when using familiar equipment like the microwave? Did they seem nervous or scared? Are they also in denial? If you have shared your observations with your loved one, what has been their reaction?
When you’ve gathered information and are in a grounded and centered state of mind, schedule a call with your sibling, or with the sibling who you have the closest relationship with. It doesn’t have to be a formal family meeting, but do discuss the specifics, sharing your observations and the Health Information Trackers, if you used them. It can be helpful to have another person who understands the situation when you expand the circle to include other siblings and family members.
Whether or not you hit trouble spots with one or more siblings, consider who else can be on your caregiving support team as an advocate or an expert. Your brother might be more willing to listen to the family doctor, for example. Your local senior living community might offer dementia caregiving classes or other types of support for caregivers.
Learning about the possible changes that lie ahead can also help you as you process the next steps and identify how to support your loved one best.
When managed well, the experience of caring for an aging loved one has the potential to bring your family closer as you help the elder through this final stage of life. The key is to talk about it early so you know what everyone’s expectations are and you are able to plan ahead.
In honor of National Siblings Day April 10, read our guide to How to Manage Challenging Family Dynamics When Making Long-Term Care Decisions. You’ll learn more about common causes of family tensions and disagreement, why family meetings are important and how to hold one peacefully, and ways to work better with your siblings.
No matter how complex your family dynamics may be, it is possible to establish consensus and get everyone on the same page.