How to Deal with a Difficult Sibling in Decision-making for an Aging Parent

by Dale on February 2, 2010

It seems that every day I have a similar conversation with friends and colleagues.  “I can’t get our family on the same page about our elderly parent.  It’s like my brother came in from another planet.”  I laughed the first time I heard that statement but realize that’s exactly how I felt about my brother!

Why is it so hard for a family to listen to Mom or Dad, consider the options and then, in a unified way, make the right decision in Mom or Dad’s best interest?  I’ll share some of the reasons I believe to be true and then a few possible strategies.

First of all, we siblings often live hundreds of miles apart and only get together a couple times a year, limiting any kind of relationship building.   Mom and Dad have managed very well on their own since we left home so we just hope and pray they will continue to do so.  It’s hard to accept any change in them or to envision them living any other way.  Besides, they don’t seem to want to talk about it.  And, then we fall back into our old roles, re-enacting family dramas of the past.   While my mother still lived in her own home (even though it was a home I had never lived in), as soon as I walked in the door, I felt as if I was swept back in time and was a child again.  Feelings, emotions and defenses suddenly surfaced.  Because my time was often short there and filled with tasks and responsibilities, I would take the path of least resistance and respond, as if on auto-pilot.  It was like an out of body experience.  Once I got started, I had no idea how to stop.

You see I was the first-born, the over-achiever, the good girl who did everything right, and my brother was the goof-off, the one you couldn’t rely on.  As soon as we got back together, we slipped right back into those roles.  It was terribly dysfunctional but in, an odd way, it was comfortable.

It wasn’t until our elderly mother had a major health/life crisis that my brother and I had to come to terms and work together.  At first, he was on vacation and unreachable, so I went into my “control mode” and handled everything.  But. once he returned, we had to work together.  It was one of the hardest and messiest things I’ve ever had to do.

I wished I had read the book, Crucial Conversations: Tools for Talking When Stakes are High
and learned to put its techniques into practice BEFORE my mother’s crisis!  I think it would have helped me work through our family situation in a healthier fashion.

The author poses a key question, “Why would a reasonable, rational, decent person do this?” Oh, if I had just had that phrase/ that thought back when my mother was in crisis.  The question truly humanizes a person.  It helps us believe the best about a person and seek the underlying motivation for their words and actions.  After all, my brother and I both wanted our mother to have the best quality of life possible for the rest of her life.  We both shared the same desire.  It was just that our approach, our timing, our perspective of how to get there differed dramatically.  And, we had no tools to discuss and negotiate our path.

Crucial Conversations: Tools for Talking When Stakes are High
offers  another gem of advice.  The authors say that instead of getting stuck in an “either/or” trap, expand the problem.  Yes!  Add complexity.  Combine it with an AND question that forces more creative and productive thinking. It can get us past auto-pilot responses of withdrawal or control.  Here’s an example:  Is there a way to talk to my brother about keeping his commitments AND not come across as self-righteous and demanding?

And, through these tough conversations, the authors advise us to be sure to establish mutual purpose (what do we both want?) and mutual respect (care about each other.)

If you have an aging parent, I highly recommend getting a copy of Crucial Conversations: Tools for Talking When Stakes are High
for yourself and siblings!  It’s full of other helpful tips and strategies.


{ 9 comments… read them below or add one }

Jan Heinen February 5, 2010 at 1:05 am

My 91 year old blind mother with dementia has lived in a facility for one year. Prior to this she required much home care for years. My ten siblings and I have not been able to establish a unified approach to meeting her needs, resulting in most of the responsibility being carried by a few. Finally I had to accept that caregiving is a heart issue, not a head issue, and cannot be forced on someone who is just not interested.

Jan Heinen

Dale February 9, 2010 at 11:58 am

Thanks you for sharing your situation and perspective. I really like the way you see it as a “heart issue”.
In the end, if we’ve reached out and tried the best we can, we have to let go and focus our energy on our elderly parent. Your mother is blessed to have the loving care of a few of you.

Joseph Collins February 25, 2010 at 1:51 pm

Thanks for sharing, this can be a difficult conversation to have. In fact we are all human and have different perspectives especially when it comes to our parents.

Gail Sellers March 13, 2010 at 1:09 pm

Jan Heinen’s comment about caregiving being a heart not head issue hit home. My 83 year old Mother has suffered several major physical, mental and cognitive setbacks over the past ten years. I have been largely responsible for managing her care and living transitions during this time. With each problem my three siblings have become exponentially dysfunctional and as her primary support, I am often the target of their anger. Her care is difficult and complicated, but not nearly as hard as the daily criticism delivered via email and phone calls from two of these siblings. While I want to believe everyone feels as I do about their family, it is not something to be forced and our differing perspectives make joint decision problematic, if not impossible. Sometimes one person just has to step up to the plate, do the best they can, hope for the best and let the rest go.

Kathleen H. Wheeler September 11, 2010 at 11:37 am

Some good advice here. I will say that unfortunately most families are not prepared when an aging parent crisis hits and are forced to respond quickly and ineffectively for that reason. There just isn’t time to stop, read a book and ponder others motivations! Add the dynamics of a family that was dysfunctional long before the crisis and suddenly it can be nearly impossible to solve problems and deal with the reality of a healthcare crisis for a family member! It is so true that siblings fall back into old family patterns and roles. This generally leaves the bulk of responsibility to one sibling, who then becomes angry and bitter towards everyone else. I was that angry sibling for many years.

Having experienced all this, I can say that hindsight is definitely 20/20. My crisis is over, and looking back I can see much more clearly why my siblings behaved the way they did. And it has a lot less to do with deliberately wanting to hurt me and much more to do with reacting from their own perspectives and personalities. But in the heat of battle everyone takes things personally, only later when the smoke has cleared do things make more sense.

Your book recommendation is a great idea because communication is definitely the problem with aging parent issues. But families need to work on communication long before aging parents are in crisis so they will be ready when that crisis hits.

Candace Sloop February 8, 2011 at 11:54 pm

I totally agree!
It is hard getting all siblings to agree! My dad will be turning 100 this year and his sister (who recently past away last year at the age of 102) still treated each other the same way as when they were children. My Aunt was very bossy and overbearing to my father, and my father was extremely submissive to his sister. Don’t get me wrong, they were VERY close and there was true love between them both. It is funny though now dealing with my father (who still lives at home) has been difficult for me and my siblings. I am the youngest, but the one my mother (who is much younger than my father) depends on for the day to day stuff…. taking her to the store, helping with the care of my father and the list goes on and on. The oldest, my sister helps out as best as she can and makes daily phone calls ( she is the oldest sibling). My brother who is the middle child is the one who make ALL financial decisions. He is also in denial of how bad of health my father is in. Several of my closest friends have told me ….it’s a guy thing. He refuses to have our father put in a care facility. I see the tole it has taken on my mother to care for him 24/7! I really do believe what they say that it takes 10 years off. My mom always look worn out and is depressed. Her attitude is …..well not good and she usually takes it out on me. Any suggestions? I use to go to the gym with her and we did yoga & such, which she loved doing. But now with my fathers failing health this is impossible. She is afraid to leave the home, even on short trips, no telling what my dad will get into or even worse. I refuse to let her take my dad with her to do errands and leave him in the car…..he is a sitting duck! She is also afraid that she could get in trouble as well. This is a huge issue! I have heard from friends that they need to have someone come to the home, but the expense is the issue. With the growing population of seniors, what do families do? I am in real estate sales and have worked with numerous seniors in the same position, but unfortunately their children have their own lives and live far away from there parents. They only become available when there is money to be had. It is very sad. I guess all in all the pecking order when we are young remains in tack when we are older. Any thoughts or advice would be GREATLY appreciated!

Dale February 9, 2011 at 10:27 am

@Candace. Family dynamics are complicated and so unique! And, as you pointed out, our parents and relatives are living very long lives. There will likely come a point when each of us will need more care than our family members can give. From what you shared, it sounds like your dad needs care/socialization and your mother needs a break from constant care of your dad. So, here are 2 alternatives I suggest you check out. I suggest you consider Adult Day Services for your dad and a Senior Center for your mom. Both are quality services and are a great alternative to home care. You can find quality programs by contacting your Area Agency on Aging. Most Area agencies sponsor a hotline, a resource center, and offer referrals. Go to this website and plug in your parents’ zip code,
Simply call your Area Agency, explain that you are seeking out services for your elderly parents, and ask to be connected to the appropriate counselor. Area Agencies are federally funded agencies, and the counselors are trained and trustworthy.
Please let me know if this helps or if you have further questions.
My best wishes to you and your parents, Dale…

Rpm December 29, 2015 at 11:00 pm

Hello, I never thought I would be writing to discuss a problem over the internet. My mom had a stroke in 2004. It resulted in some cognitive loss. But, my father was alive and he and my mom agreed to let my sister become her paid care-taker. Fast forward 10 years, my father passed away in 2014 . This caused my mothers cognitive abilities to decline. She began hallucinating; seeing my father and various other characters. My sister was still her care-taker. My oldest sister does not live close and she has health problems. I currently still work. Everyone would rotate weekends to stay with my mom, including grand and great-grand children. My mom could stay by herself for short periods. Recently, she experienced a health setback which required surgery. The care-taker sister opposed the surgery. She wanted my moms primary care physician as a consultant. My mom had been rushed by ambulance to the hospital for this problem. The surgeon told us it was crucial that this surgery be done right away. We did not have time to discuss the situation with another doctor. We had to call the hospital social worker and my moms clergy to try and convince my sister to agree to the surgery. My oldest sister and I were trying to include her in this decision. My oldest sister actually has medical power of attorney and could have made the decision without a discussion. After a lot of yelling, she finally agreed on the surgery. But, she continued talking to the staff and my mother about a change of mind. The surgery was completed and was successful. But, the problems have escalated. My mom was placed in a rehab center after being in the hospital for three weeks. She was progressing slowly . We were told that she would need 24 hour care. At this point my oldest sister and I discussed long-term care for my mom. The other sister disagreed and called an ambulance to remove my mom and take her home. We know she is not qualified to care for her. She will not hold a civil conversation with any family member and has basically moved in and taken over. I know we can call an ambulance and have my mom taken back to rehab, but we don’t want to do this by force. My dad left monies to take care of my mom and she does have her own , along with a widows pension. I do not know what to do. I am trying to remain civil.

dale January 8, 2016 at 12:12 pm

I am so sorry for the delay in answering this. And, I am terribly sorry what you are going through. The situation must be tearing you apart.

I would suggest that you reach out and find a geriatric care manager (to be an advocate for your mother and you.)
You can find one by reaching out to your mom’s Area Agency on Agency. See link below.

I did this 3 years ago and the geriatric care manager proved to be a godsend to my mom and our whole family. They person will either be a social worker or nurse. Interview them briefly and select the one that seems the best fit for your situation. You will be asking them to come into your mom’s home and do an assessement, basically on her safety and care. They’ll assess her fall risk and safety; review medications and medication management for your mom, review nutrition, how much social interaction she is getting. It will be an objective assessment. Let your sister know you’re NOT doing this to pull your mother out of her home (although you know that may happen)….that you just want an objective assessment and a professional who can advocate for your mom and your family as she declines. Your sister may already be overwhelmed, and this may even help her save face.

There is so much involved in these complex family dynamics. I have been there; I know and my heart goes out to you. Your and your sister’s goal for your mom should be quality of life for her remaining years. This is a way for you both to get on the same page and to help your mom. Please let me know if you have further questions.

(To find your Mom’s Area Agency on Aging, go online to, put in your mom’s zip code and you will get contact info. The Area Agency on Aging is federally funded and a trustworthy source. Ask for a list of geriatric care managers in your mom’s area.)

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