It’s hard to watch your parents decline in health. Sometimes, it can be hard to cope with their health changes as well as manage the differing views and abilities of your siblings at the same time.
AGE of Central Texas is offering a free workshop, “Partnering with Your Siblings to Better Care for Your Parents,” on Saturday. Psychologist David Zuniga, who has focused on end-of-life care, caregiving and was at one time a Zen Buddhist chaplain working in hospitals, will speak.
David Zuniga is a licensed psychologist and a previous faculty member at the Integrative Medicine Department at The University of Texas MD Anderson Cancer Center.
Working as a family on care for Mom and Dad has become more complicated as people are living longer and there are more options for care and treatment, Zuniga says. Plus, families are spread out geographically and adult children are working longer hours. Then add the financial stresses of falling behind economically or not having the same level of access to health care.
It can become very stressful when Mom or Dad needs more assistance.
The family dynamics that existed when you children were growing up might not have changed and sometimes even step-siblings can complicate it.
“All siblings, all families, from the time you are born, there is a natural inherent tension and competition,” Zuniga says. “That’s part of the human condition.”
As kids, siblings bicker over toys, he says. As adults, the stakes are bigger and they bicker over type of care and who gets to make the decisions. Often, siblings fall into their natural roles. One might be more likely to handle the finances, another might be more apt to do the physical work of caregiving.
“Our brain becomes conditioned to have the same thoughts over and over again,” Zuniga says. “‘My brother gets all the credit.’ ‘My brother is lazy.’ Automatic thoughts and judgments may impact behavior. You may not even realize it.”
Parents don’t help with this, either. Sometimes they automatically label their kids and continue to label their kids as “the independent one,” “the helpless one,” “the smart one.”
David Zuniga will be talking about working with your siblings on Feb. 10 in Lakeway.
Those labels, those identities get carried over even when it’s the children who need to parent the parent.
Try getting on top of some of those beliefs as soon as you find yourself thinking them. “When you don’t talk about things, they fester and grow,” Zuniga says. That’s why open communication between siblings is important. “Family meetings are life-saving,” he says.
If it’s possible, have parents before they can no longer express their wishes, make their health care decisions known. The American Bar Association has a free health care decision making toolkit available. We’ve also written about Austinite Debbie Pearson’s “Age Your Way” and “Blueprint to Age Your Way” that lets you share your wishes and likes and dislikes with your family.
Parents should have medical power of attorneys set up, as well as advance directives for medical care, and a financial power of attorney.
When parents make their own decision, it takes some of the stress and conflict out of it. “It’s not that you’re making the decision, it’s that you’re honoring your parents’ wishes,” he says.
Sometimes, when there is conflict, it’s good to bring in a mediator. “It often takes courage to ask for help,” Zuniga says. “We all need help.”
If you are in the position of having to make the decisions, make sure the other siblings are well-informed of what is happening and why. In families where there are multiple siblings, sometimes one group of siblings gets pitted against another sibling or another group of siblings. Sometimes there are siblings that get left out of the process as well.
That’s where creating an open channel of dialogue can be helpful, whether by email chain or conference call.
Sometimes, though, siblings can become too enmeshed in the care. They need a break. That’s where the siblings who aren’t the primary caregivers can offer help. They can help do research into treatments or care; or give their sibling a vacation from caregiving.
Often, when Zuniga talks to families who are dealing with their parent’s care, they will tell him: “Don’t talk to me about self-care. … I don’t have time for self-care.”
Self-care, though is important. “Do it for your loved one,” he says. “Stress is real. It can actually impair your neurological function. You won’t be able to care for the person you love as much.”
Zuniga recommends meditation or contemplative prayer, even if you just do it 30 seconds in the morning.
What happens when siblings are all aligned, but it’s the parents who aren’t in agreement over their care? “Your parents are going to want their autonomy and their freedom,” Zuniga says. “Their freedom might be the single most important thing to them.”
For you, it’s about their safety. Are they leaving the stove on? Are they falling a lot or leaving doors unlocked? If they are unsafe and you can document it, you can get adult protective services involved, but it’s much easier to come from a place of love and work your way toward a different care or living scenario with their buy-in.
You can start by talking to them about what their goals are. Is it to stay in their home no matter what? Is it about quality of life or quantity of life?
Families are not all about sibling rivalry and tension, though. “Family has a unique role that one one else has,” he says. “They can be there for each other in a way that no psychologist or psychiatrist can.”
If siblings are talking to one another, there can be great strength, laughter and joy during these years, Zuniga says.
Partnering with Your Siblings to Better Care for Your Parents
When: 10 a.m. to noon Feb. 10
Where: Keller Williams Lake Travis Market Center, 1921 Lohmans Crossing Road, Suite 100, Lakeway
Cost: Free, but register at ageofcentraltx.org
Recommended reading
“How We Die: Reflections on Life’s Final Chapter,” Sherwin B. Nuland ($17, First Vintage Books)
“Being Mortal: Medicine and What Matters in the End,” Atul Gawande ($26, Henry Holt and Co.)
“On Our Way: The Final Passage through Life and Death,” by Robert Kastenbaum ($36.95, California University Press)
“Staring at the Sun: Overcoming the Terror of Death,” by Irvin D. Yalom ($17.95, Jossey-Boss)
“When Breath Becomes Air,” by Paul Kalanithi ($25, Random House)
Recommended websites
For advance directives planning
American Bar Association, americanbar.org, search under Tool Kit for Health Care Planning
Texas Health And Human Services, hhs.texas.gov/laws-regulations/forms/advance-directives
For coping with illness
Society for Health Psychology, www.apa.org/about/division/div38.aspx