Caregiving Without Siblings

by Paula Span

In some ways, Regina Milgram-Bossong acknowledges, she has it easy. Her parents live nearby in central New Jersey. Despite the usual run of late-life health problems — her father, 84, is diabetic and has had a hip replacement; her mother survived ovarian cancer and last year underwent heart valve surgery — they’re still managing well in the house where Ms. Milgram-Bossong grew up.
She takes her mother grocery shopping, but otherwise, “they haven’t required much assistance at all,” she told me in an interview. “They are very well prepared — they’ve had time to think about this.” Her mother even bought long-term care insurance, a rarity.
Yet Ms. Milgram-Bossong e-mailed me a few weeks back to say, “I am frightened, horrified in fact, of the near future.” The reason: She’s an only child.
“There could be some agonizing times ahead, and I’m facing it alone,” she said when I called. Research shows that even when there are several adult children, just one (a daughter, usually) emerges as the so-called primary caregiver and handles the bulk of her parents’ care. But Ms. Milgram-Bossong finds that minor consolation.
“Even if I had a sibling in California, I’d have someone to talk to. I have no one to bounce ideas off, to think about what I’m not thinking about,” she said. Widowed in her 50s with no children, she’s determined to do well by her parents when they need her, but the prospect keeps her awake nights.

Regina Milgram-Bossong, meet Margaret Reiss, 48, an insurance broker in San Francisco. Ms. Reiss knows that her parents, living independently in Florida, will need help before very long. Her father is still strong at 90, but becoming more forgetful; her mother, 94, is mentally sharp but physically very frail. “I’d like to talk and think about these decisions before we need to make them,” Ms. Reiss told me.
But having a brother in California and a sister in Maryland, both older, hasn’t helped. “We’re not on the same page,” she lamented.
“My brother has a lot invested in denial: ‘They’re fine, they’re fine, they’re fine.’ My sister wants to keep them in that house, so she can move there when she retires.” When Ms. Reiss explains to her sister that the house will most likely be sold to finance their parents’ care, “she scowls and storms off.” She added, “A lot of hostility can flare up over this.” Her parents made Ms. Reiss their executor and trustee, but as the youngest sibling, she’s finding that her brother and sister resent her authority.
“We’re at an impasse,” she said. “And we have a ticking clock.”
Which is the harder road: Shouldering a sometimes crushing responsibility on your own? Or battling with siblings at a time when working together is crucial?
Of course, some families do pull together, sharing the responsibilities and costs and propping each other up. But “there’s an epidemic of sibling conflict out there,” said Francine Russo, author of “They’re Your Parents, Too”. As her book amply documents, “They criticize each other, they minimize what others do, they second-guess, they interfere.”
Glenna Mills, a San Francisco sculptor, has seen this firsthand. Disputes about who would take charge of daily decision-making for her parents, in assisted living in Idaho, grew so explosive that now three of seven siblings no longer visit or talk to their parents at all — or the brothers and sisters they disagree with. “It’s horrifying,” Ms. Mills told me in an interview. “We were always an extremely close family.”
Such contention has become sufficiently widespread to give rise — capitalism abhors a vacuum — to a new profession, the elder mediator. More about that soon.
I’m sure brothers and sisters sometimes wish they could simply handle elder care solo, without all that tension, just as onlies conjure up supportive siblings they can unburden themselves to in late-night phone calls. Clearly, either status involves drawbacks and advantages.
One advantage to the larger family, though: siblings can manage to overcome their antagonisms. Troubled families may require a neutral third party — a pastor or family therapist, a geriatric care manager, a social worker, the aforementioned mediator — in order to work together, Cathy Jo Cress, a social worker and teacher, explains in her just-published “Mom Loves You Best: Forgiving and Forging Sibling Relationships,” co-authored with Kali Cress Peterson, her daughter.
But it can be done. “They can move from the past, telling the same stories over and over like the Ancient Mariner,” Ms. Cress said in an interview. “Once you get into the present, you can begin to sit down and talk about your parent, this older person who needs care.”
Ms. Milgram-Bossong, for her part, could find camaraderie in a caregiver support group, or seek help from a counselor, and I hope she will. But her circumstances won’t change. Siblings can sometimes mend their relationships. Only children are always onlies.

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Filed under adult children of aging parents, Alzheimer's Disease, assessments, care giving, care planning, clinical trial studies, dementia, elder care raleigh nc, Geriatric Care Management, Nursing Homes, Raleigh, senior care, Seniors and driving, sibling relationships, support groups, travel with seniors, Uncategorized

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