Linda Olson of Littleton, Colo., says that her "nightmare" began in 2009, when her widowed mother was diagnosed with dementia. Her mother relinquished her role overseeing the family trust, and Olson and her two sisters became co-trustees. Their mother, now 80, lives with Olson, but each sister has an equal vote in decisions related to her care.
Their first major disagreement erupted over selling their mother's house to raise money to pay for her care, which Olson and one sister favored. But the third sister, who lived in the mother's house with her husband, vehemently opposed the plan, Olson says. A legal battle ended in the sister's eviction.
They also disagreed over taking their mom out-of-state to visit relatives. Olson and one sister thought the trip would be too hard on their mother, who had developed Alzheimer's. The other sister took her anyway. The trip was difficult, and their mother, when she returned home, did not remember seeing her relatives.
Eventually, the sisters hired a mediation firm. The sisters meet with two mediators for a few hours each month. "We've spent about $6,000 so far and it's absolutely worth it," Olson says. "We should have brought in a mediator earlier and avoided some battles."
This scenario -- middle-aged siblings squabbling over the care of their parents -- is playing out in thousands of households. Siblings often fight over these questions: Who will do the caregiving? Where should Mom live? Who handles the parent's finances? Should Dad's life be prolonged no matter what?
As if these issues aren't fraught enough, add to the mix long-simmering sibling grievances. "There are very few non-dysfunctional families," says Frederick Tansill, an estate-planning lawyer in McLean, Va. "Disputes that play over an elderly parent's health care often go back to childhood, over who was Mom's favorite or who was never really attentive to Dad."
The best way to prevent many of these conflicts is for parents to plan ahead and talk frankly with their adult children, according to lawyers and family mediators. One of the first steps to encourage future harmony is to gather the family for a conference where Mom and Dad can express their wishes for their care.
Marsha Swiss, an estate-planning lawyer in Washington, D.C., says parents and children should not avoid difficult topics. "People are reluctant to admit the obvious, that we are all going to die someday," she says. The parents should discuss their housing preferences if they can no longer stay at home. They also should make clear the measures the kids should or should not take to extend life, Swiss says. Parents should also discuss end-of-life issues with their doctor, she says.
Parents should draw up documents that will signify which adult child or third party will be the health care agent and who will hold the financial power of attorney. "The parent should vest authority in only one person," and also choose a successor for that person, says William Fralin, an elder law attorney in Arlington, Va.
Olson agrees. "In a perfect world, my parents would have selected one daughter to have medical power of attorney and one to have financial power of attorney," she says. "Then the three of us wouldn't have to negotiate every situation."
One common area of dispute is over caregiving. The child who agrees to be the primary caregiver may resent that her siblings don't recognize her efforts and second guess her decisions. One way to head off such disputes is for the parents to give the caregiver child the power to make health care decisions.
Parents also could give the caregiver child money from the estate later or enter into a "care contract" with the adult child. A contract could include responsibilities of the caregiver child and monthly compensation or monetary gifts to her. "If a sibling moves across the country, sells a house and gives up a job to move in with Mom or Dad, it's appropriate to have a care contract, spelling out compensation," Tansill says.
Siblings should be aware of the terms, and the parent and child should have separate lawyers. "It is hard for siblings to object to an arm's length contract negotiated by different lawyers," Tansill says.
Sometimes, as with Olson and her sisters, families need to hire professionals to break the bickering cycle. One option is family counseling. Jonathan Caspi, a professor of family and child studies at Montclair State University in New Jersey, says siblings need to "focus on the here and now, and what is best for the parent."
For example, Caspi says, "a sibling may be making decisions based on guilt about promising that he would never place Mom in a skilled-nursing facility. But Mom can't be adequately cared for at home anymore." A therapist can direct the discussion to the parent's needs.
Use a Mediator to End Disputes
Another option is an elder care mediator. Mediators don't give advice, and their goal is to "get everyone to the table and address the issues as a group," says Debbie Reinberg of ELDEResolutions in Denver.
Perhaps one sibling thinks Dad should stay at home, where he has privacy and familiar surroundings. Another wants him to move to an assisted-living facility.
A mediator could help the family figure out how to make the house safer and provide affordable help, says Arline Kardasis of Elder Decisions, a mediation firm in Norwood, Mass. The discussion becomes "not a tug of war over where Dad lives, but how we can meet as many needs as possible."
Sometimes a sibling feels left out of the loop. You could set up a private family Web site to keep each other informed, Kardasis says. Or you can use Lotsa Helping Hands (http://lotsahelpinghands.com), where an online calendar enables family and friends to coordinate support. Each sibling can sign up for a task.
Siblings should choose caregiving tasks based on their strengths. A techie sibling could set up a family Web page, while the lawyer sibling could become the financial power of attorney.
Olson says that "division by expertise has worked well." She handles her mother's finances and day-to-day care. Another sister looks after legal documents pertaining to the mother's farm land in Illinois.
Even professionals face challenges in their own families. Reinberg, 58, is the oldest of four sisters. Her father, 83, recently moved from close to Reinberg's house to an assisted-living facility in Dallas, two miles from another sister. "The four of us frequently e-mail and have conference calls," she says. "The key is listening to each other." It's also showing gratitude. The sister who lives near Dad does the most caretaking, and her sisters barrage her with gifts, Reinberg says.
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