A sibling’s decision to step up to care for an aging loved one is usually seen as admirable and deeply appreciated. Not only are they taking on a huge job, but they’re also ensuring that someone you both love gets care from a loving and trusted provider. Unfortunately, what begins as a seemingly ideal caregiving solution born from good intentions doesn’t always stay that way.
Serving as a caregiver is physically and emotionally taxing, and sometimes your sibling may falter under the pressure. Suddenly, you might notice a decline in your loved one’s condition or feel that important corners are being cut.
“This can occur for so many reasons,” says Jennifer L. Fitzpatrick, a gerontology instructor at Johns Hopkins University, former psychotherapist and the author of “Cruising Through Caregiving: Reducing The Stress of Caring for Your Loved One.” “Sometimes it’s because the person doesn’t have the bandwidth; sometimes it’s because they don’t really understand what needs to be done; and sometimes the persons are not physically or emotionally up to the tasks.”
Caregiving is complex, even more so when family members are stretched thin or overwhelmed, yet deeply invested in their loved one’s well being. Here’s how experts say you can tell when a sibling caregiver is falling short and what to do about it.
Caregiving challenges your sibling might be facing
People step into caregiving roles for many reasons, says Chrissy Moser, a licensed clinical social worker, certified dementia care specialist, and the owner of Assisted Living Locators in Naples, Florida.
“Everybody has invisible reasons why they do things that we may not see, whether it’s underlying priorities in their own mind or complicated family dynamics,” Moser says.
Your sibling may genuinely think they can offer the best care, feel like they owe it to their parents to be a primary caregiver or even have concerns about money. But, just as family caregiving arrangements form for different reasons, they can also start to go wrong for many reasons.
Some of the issues that can crop up include:
- Caregiver burnout.
- New difficulties affording care.
- Financial exploitation of an aging loved one.
- Increased stress from familial obligations.
- Difficulty identifying or performing necessary care tasks.
- Unwillingness to seek professional care.
When a caregiving situation is putting either the caregiver or an aging loved one in harm’s way, that’s when it’s time for other family members to step in, offer help and figure out other solutions.
Signs it’s time to step in and confront a sibling caregiver
There are many clues that a family caregiver might be struggling or that an aging loved one isn’t getting the treatment and support they need. It’s time to intervene if you notice your loved one has:
- A decline in personal hygiene.
- Unexplained bruises or injuries.
- Regular medical issues.
- Missed medications or appointments.
- Malnutrition or dehydration.
- Been left unattended for long periods.
- Wandered or driven alone with a dementia diagnosis.
- A sudden reluctance to talk about their care or health.
“Intervention should occur definitely when there are signs of abuse, neglect or financial exploitation, even if you believe it’s unintentional,” Fitzpatrick says.
In challenging caregiving situations, you might also notice concerning changes in how your sibling is behaving or handling caregiving tasks. These can include:
- A change in demeanor, such as increased secrecy or aggression.
- A lack of transparency around finances.
- Unwillingness to discuss the loved one’s care.
- Increased stress or exhaustion.
- Inability to keep appointments or perform basic care tasks.
- Signs of caregiver burnout.
“They may not necessarily know what their boundaries and limitations are. Maybe they haven’t been taught good coping skills or they don’t have enough support.”
— chrissy moser, a licensed clinical social worker
How to intervene when a sibling caregiver isn’t meeting expectations
Caregivers may struggle for all kinds of reasons. “They may not necessarily know what their boundaries and limitations are,” says Moser. “Maybe they haven’t been taught good coping skills or they don’t have enough support.”
Whatever the case, here’s how to have honest, open and loving conversations to ensure your aging loved one gets the best care.
1. Ask, don’t attack.
“Secondary caregivers can be quite vocal about what they think should be done differently,” Fitzpatrick says. “They have a lot of opinions. Unfortunately, sharing unsolicited opinions about minor issues can lead to anger and resentment on the part of the primary caregiver.”
Instead of being critical or immediately jumping in with feedback, Fitzpatrick says to broach the subject gently and thoughtfully.
“If the issues are minor but you want to offer suggestions, it’s always important to ask the primary caregiver if they are open to feedback,” she explains. “Saying, ‘I’m concerned about you’ is a great place to start. Focus on what you are observing.”
2. Work from a place of compassion.
“Sometimes the caregiver is burned out and/or unaware of what a poor job he or she is doing,” Fitzpatrick says.
In those instances, it’s important to show compassion, focus on solutions and be ready and willing to help.
“I would acknowledge the struggle that they’re going through,” Moser says. “If it was my own sister, I might start by saying, ‘Thank you so much for what you’re doing. Mom is so lucky to have you providing all this wonderful care. I don’t know what we would do without your help.’”
“Once you acknowledge their struggle and meet them where they are, then it’s probably a little bit safer to broach tricky subjects,” Moser adds.
“Make specific offers of help. Maybe by offering to mow the lawn or bring dinner over a couple of times per week, your sibling will get some of the rest they need to be a better, more effective caregiver.”
— JENNIFER L. FITZPATRICK, GERONTOLOGY INSTRUCTOR AT JOHNS HOPKINS UNIVERSITY
3. Offer supportive, concrete solutions.
“Make specific offers of help,” Fitzpatrick says. “Maybe by offering to mow the lawn or bring dinner over a couple of times per week, your sibling will get some of the rest they need to be a better, more effective caregiver.”
Moser says some examples of ways you might gently discuss issues or offer help include:
- “I noticed the laundry needs to be done. Can I take care of that while I’m visiting?”
- “Do you need me to watch Mom so you can go out for a few hours?”
- “Can I take care of the cooking while I’m here?”
- “I was talking with dad’s accountant and they asked to see some documents. Could I give them this information to take it off your plate?”
4. Bring in a third party.
Moser and Fitzpatrick both recommend seeking help from medical experts, trusted community members or other mediators when necessary.
“Sometimes it’s too much of a sensitive point coming from the family,” Moser says. “Sometimes a family physician can get involved and say, ‘I see what a great job you’re doing, but I also see that it’s becoming an unsafe situation because of A, B and C.’”
In addition to physicians, Fitzpatrick suggests a clergyman or case manager. In some cases, such as when there are signs of neglect, it may be best to contact Adult Protective Services.
“Health and mental health professionals are required to do this if they suspect abuse, neglect or exploitation but many lay people are reluctant to do this because they see it as ‘too punitive,’” she explains. “But the person from Adult Protective Services may be able to get through to your sibling in a way you can’t.”
5. Explore alternative care solutions together.
Your sibling or aging loved one may be reluctant to change their care arrangement, but it may be for the best. The experts suggest exploring different options together and communicating not only about what your sibling needs but also about what’s best for your aging loved one.
“You can tell your sibling, ‘You’re doing such a wonderful job, but I want you to know we have alternatives for help and give yourself permission to explore those,’” Moser says. “Say, ‘Even if you don’t want to move forward, let’s just have a conversation about it.’”
She suggests talking with doctors and specialists or working with a care locator. Additionally, Fitzpatrick adds, you can contact your local area Agency on Aging through the U.S. Administration on Aging. If your loved one has a dementia diagnosis, the Alzheimer’s Association and Hilarity for Charity are also important resources.
Moser concludes, “I think it’s really important to have somebody who can offer all of the options without pressuring either the caregiver or the loved one to make a decision they’re not comfortable with.”
