The 50-50 Rule

Many families have stories about siblings who find themselves dealing with aging parents, and all that ensues from it. With our rapidly aging society and people living longer than ever before, adult sons and daughters, many of them still busy rais- ing children of their own, are often left frustrated and stressed with the pressures of caring for senior parents. Even if the parents are in a nursing home or long-term care facility, the dynamics of those sibling relationships can play a big part in the health and well being of the seniors.

Ingrid Connidis is a leading authority on aging, work-life balance, and family relationships, and that includes sibling ties. A professor of Sociology at the University of Western Ontario in London, Ontario, she has a PhD in Sociology from the University of Toronto and is author of the book Family Ties and Aging. Connidis, who says she has seen just about every family scenario you can imagine, says the number one key to avoiding problems with siblings, where it concerns aging parents, is communication.

“One scenario is when one sibling is doing the lion’s share of caregiving for the parent,” she says. “Other siblings may not feel welcome to participate or feel that the sibling ‘in charge’ has taken over so they don’t really have a voice. They think they are interfering or second-guessing the one who is the primary caregiver. But ultimately most siblings want what is best for their parents and typically understand that there are good reasons for an uneven division of labour. This is often due to where people live.”

Connidis says it’s best to keep siblings informed about how their father or mother is doing, and if you need help, ask them because it’s important to speak openly about how you feel. It’s also important to keep communication lines open with the par- ents, provided they’re still capable. She recommends a siblings’ meeting. For example, if a decision has to be made about moving the parent out of their own home and into a residence or long-term care facility, it’s best for all siblings to be present and have a say. But some siblings may live in another city, one of them may be estranged from the parent, or there may be a situation where a brother and sister don’t talk to each other at all.

“The ideal situation is when everyone involved knows how everyone else feels,” Connidis says. “That way you can get things off your chest and avoid any surprises later.”

A study on this topic will be released shortly. Called the 50-50 Rule, and sponsored by Home Instead Senior Care, the title refers to the average age that siblings find themselves caring for their parents, and in doing so, dealing with their brothers and sisters. Often those dynamics involve how siblings can more equitably share in the responsibility.

According to the study, four factors determine if relationships among adult children have deteriorated, and whether or not the quality of care for the parents will be compromised in any way because of it. These factors are: teamwork, consideration for each other’s ability to help out, willingness to help, and the ability to make important decisions together.

The study says that 40 per cent of family caregivers who say their relationships with siblings have deteriorated blame it on brothers and sisters not being willing to help.

Here are some of the findings:

• For siblings, the primary caregiver is a 50-year-old sister caring for an 81-year-old mother or a 50-year-old brother caring for an 81-year-old father, and they’ve been doing so for 3.3 years.
• Care is often not shared equally. In 41 per cent of families, one sibling is responsible for providing all or most of the care for their Mom or Dad, and in only 3 per cent of families do siblings split the caregiving tasks equally among them. In all other families, the caregiving tends to be shared based on skill sets and other criteria.
• The sibling who is the primary caregiver reports putting in nearly three times as many hours of care as do their brothers and sisters. On average, the primary family caregiver provides 14 hours of care per week, while other siblings provide five hours of care.
• Caregiving arrangements amongst siblings more often than not involve proximity to the parent, rather than careful consideration about what is in the best interests of the par- ent. In the survey, 25 per cent say the caregiving arrange- ment with siblings is based on “proximity or location” while 17 per cent say it is based on “default.”

“The study was interesting in that sibling caregivers who responded invariably think they provide more care than their brothers and sisters do,” said Scott Johnson, who operates Home Instead Senior Care in Oakville. “It’s natural for people to think they are the one who is carrying the load.”

Indeed, the study found that survey participants were more likely to rate themselves ‘excellent’ for various caregiving traits than they were their brothers and sisters. When it came to rating oneself as a family caregiver compared to rating siblings, 66 per cent rated themselves ‘excellent’ while only 28 per cent rated their siblings as such.

In terms of communication skills, 46 per cent of respondents rated themselves ‘excellent’ versus 23 per cent for their siblings. And for the category of ‘empathy,’ 42 per cent gave themselves an ‘excellent,’ but only 24 per cent gave it to their siblings.

The study, conducted over an 18-month period by The Boomer Project on behalf of Home Instead Senior Care, was an online survey of 383 Canadian adults aged 35 to 64, with living siblings or step-siblings, who said they either provide care for a parent or older relative, or had provided care in the previous year and a half.

Just over half – 54% – of the participants identified them- selves as primary caregivers. The remaining respondents said they provide care too, but not as their families’ primary care- givers.

Scott Johnson said, in doing the research, his organization developed more than a dozen different ‘50-50 scenarios,’ all of which can lead to problems with siblings. But he said those scenarios can be lumped into four groups:

One Sibling Out - one sibling does all the work and feels like they’re drowning, or one sibling lives out of town and feels isolated because they aren’t involved.

Family Feuds - none of the siblings talk to each other, which becomes a huge issue in a time of crisis.

Waiting for the Will - one sibling never lifts a finger to help and is just waiting for the inheritance.

Money Matters - seniors have money saved for their old age, but then lose it because of the recession, which means siblings may have to start footing the bill for care and not everyone is comfortable with that.

The study includes a public education campaign designed to help families overcome sibling conflict in order to provide better care for aging parents. This campaign, which gets going early in 2011, will include a website with information, checklists with tips for assigning care, and presentations on everything from coping with feuding families to how to plan before a crisis hits.

Avoiding a crisis, says Amy D’Aprix, is the most important thing siblings can do. A consultant and expert in aging, retirement and caregiving, she is the author of two books on caregiving and aging.

“Siblings should be talking with each other about the needs and care for their parents before the parent actually needs the care,” says D’Aprix, who has a PhD and Masters in Social Work, specializing in Gerontology. “They should say this is what I’m willing to do and what are you willing to do?”

D’Aprix says that seniors’ residences, long-term care facilities, and other institutions that look after seniors will have an easier time providing excellent care if they don’t get conflicting messages from a family. “It’s very difficult if they get multiple demands from the same family,” she says. “If everyone is on the same page, the parent will naturally be better off.”

She agrees with Connidis in that communications among siblings is vitally important for the well being of the parent. D’Aprix says the sibling who is the primary caregiver may not ask for help from the others because they think they shouldn’t have to. “I tell them to ask for help with a specific task from a brother or sister. Often the other siblings don’t know what help is needed and don’t even know that the person is drowning in responsibilities. You have to talk.”

Connidis also offers this advice:

“Dealing with aging parents is the kind of thing that can bring siblings together or tear them apart. You are dealing with an emotionally fraught situation and in an emergency things can get heated. Ask for input from other siblings and listen to what they have to say. Be aware of all the services and facilities that are available, and also be aware of the parents’ financial situation. Finally, having patience and trying to be positive can go a long way in smoothing things over.”