Caregiving and family relationships can be stressful.
There are a lot of family issues that come forward and that is extremely stressful.
When families are dealing with highly stressful situations and are called upon to make important decisions about the care of a family member, unpredictable issues and tensions often arise between spouses and/or among children, siblings, and grandchildren.
Unexpected potential disputes can occur at any time around, among others:
- Living arrangements
- Which family members will provide care
- Powers of attorney
During an interview for the Saint Elizabeth research study, Promising Practices and Indicators for Caregiver Education and Support Programs, one caregiver discussed the unexpected issues her family encountered in planning care for her father:
“In terms of family dynamics, when you have a sudden illness, for us it did raise tension within the family. With siblings living at a distance, they definitely had strong opinions and took it upon themselves to express those strong opinions. The whole family dynamics and what you should and shouldn't do, and who has power of attorney for health care decisions, and who's supporting mom to do the planning, and what does that planning look like, and ‘how dare you talk to mom about housing.’” There are a lot of family issues that come forward and that is extremely stressful. I think we got off fairly easy, but I didn't anticipate we would have any family issues.”
She also expressed her wish to have worked through the issues sooner.
“It would be so much better if families could meet ahead of time, before anything like this happens, to think about what you would do, how decisions should get made. Advanced care directives are great, but it was all the other decisions that I got caught up in. We all had very different ideas about housing. That was our most contentious issue, because with housing there are resource issues and care issues. It's not maybe those more formal care directives, but it's all of those other smaller pieces in thinking through what we are going to do. Even in terms of putting together a hospital visiting plan and how do we manage that, which was another contentious issue for my family…that can really break a family and it can really lessen the care.”
Another caregiver discussed her hesitance in relying on her family for help to look after her husband: “My kids don't live here. …they would all help, but you don't like to lean on your children. They have children of their own, and a life of their own.”
Resources for family conflict caregiving
The Alzheimer's Society First Link® Program “Options for Care” session is meant to help caregivers through the decision-making process when more care is needed for their family member (e.g., when it is time for long-term care).
The Reitman Centre CARERS Program at Mount Sinai Hospital employs a social worker who helps families map out their support system and discusses the importance of including all family members when making plans for care.
Wherever possible, The Friends Caregiver Support Program speaks to the entire family during the initial interview and intake process and they look at 25 key areas of the caregiver's life that could be affected. A program representative explained the process:
“What we do is try to first of all figure out who the key people are in the family grouping; who the people are who are most involved in the person's care. We need to know what the expectations are of the family. In some families, everyone wants to know everything and some families want to have a single spokesperson who is the key person who communicates information to the rest of the family. So a key piece is when we interview clients and their families, we want to get a sense of who we are communicating with.”
Other strategies for dealing with family conflict
- Create a checklist of responsibilities to help guide conversations about family roles.
- Consider asking a social worker or other professional to help you work through family dynamics and roles.
- Using I-statements can help you avoid putting a sibling or other family member on the defensive. An example of this is to say, "I feel very overwhelmed trying to manage going to Mom's house every night, the kids, and work. I'm worried that Mom can see how stressed I am," rather than, "You're not helping me enough and it's really frustrating."
Remember, preventing and resolving family conflict in caregiving will help you focus on what matters most - taking the best care of your family member.
See also, our Elizz blog article on the 7 Rules of Caregiving.