The Sibling Relationship When Caring for Aging Parents

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Witnessing a parent’s health decline is difficult as adult children come to terms with the idea that the relationship with their mother or father is changing. If you are currently caring for an aging parent, you may be experiencing this sense of anticipatory loss. Your siblings can be a source of support since they are experiencing these same emotions alongside you. However, the emotional impact of caregiving can also cause friction among your brothers and sisters. If you feel you are often in conflict with your siblings while caregiving for your aging parents, know that you are not alone.

The Caregiving Role

Caregiving for an aging parent is a multifaceted job that involves the financial, legal, physical and emotional well-being of your mother or father. You may encounter many different opinions between your siblings on what decisions need to be made, which can lead to confusion about what people will agree upon. In addition, if your siblings have questions about the estate or their inheritance, this can have place pressure on the caregiver who is managing the financial and legal affairs of the parent.

The sibling relationship is an important factor in the care of aging parents. For one, siblings need to make key decisions and communicate their  feelings and opinions in terms of their

parent’s care. Combined with the emotional process of accepting their parent’s declining health, you may observe that your brothers or sisters may be attempting to resolve long-buried feelings with the family or may be unintentionally inciting sibling rivalries by falling into old family patterns.

Family Roles and Patterns

A major complication of the sibling caregiving relationship is that childhood roles within the family re-emerge. Family members can view the adult siblings with the same labels that they acquired—perhaps unfairly—as children. Birth order and gender may also influence these sibling dynamics. For example, if you were the highly-responsible child in the family and are now handling your parent’s care, your siblings may feel that you have everything covered with your aging parent, and not know how to help. Just as you would want to be acknowledged for the person you are today, rather than how you were characterized in the past, it is necessary to acknowledge that these labels may have a damaging effect on the sibling relationship. A question to ask yourself in your communications with family members is whether your feelings or opinions are based on the present situation or are remnants of the past relationship. Be mindful that you are offering space for your siblings to contribute in the way they can.

Relationship with the Parent in Care

Your siblings have a different relationship with your parent than you do therfore they may have different needs in caring for your parent. If your sibling has resentments towards your parent that are coming up at this emotional time, resist judging them for their feelings as we all have our own individual process of letting go. It may be helpful to reframe how the siblings views the role at hand. Express your own need for assistance and ask for their support in your role as primary caregiver, if they cannot offer this to your parent.

In another common scenario, your parent may have helped resolve any disagreements among your siblings. Now with your parent unable to intervene, your siblings might need to devise new communication and conflict management strategies.

Communication

Effective communication is important to ensure trust and transparency between your brothers and sisters. Your siblings can provide helpful input in the decisions you face as the primary caregiver. Regular and consistent communication with your family members (especially those that live out of town) can alleviate tension between siblings. Some primary caregivers may send regular email updates to siblings, or make use the apps such as Tyze now available for managing the care of a loved one. Communication can also motivate people to contribute and ensures that each family member is on the same page with the care of your parent.

A family meeting can help establish new patterns and build trust with your siblings for your abilities to care for your parent. If needed, a counselor or psychologist can help facilitate your family meeting to ensure turn-taking in talking and guide the process towards a productive outcome.

Be aware that each sibling is processing the emotional situation of their parent relationship at their own speed and to the best of their abilities. You can help to create a better connection with your family by providing positive feedback when siblings help, listening intently to what your siblings say, and by clarifying issues as soon as they arise. This does not mean that you have to compromise your own feelings in the relationship; rather, you have a duty to express yourself in an honest and non-accusatory way that. If in the end, your siblings are still not responding to your efforts, it may be time to step back and recognize their limitations in caregiving. At times, you may have to take on the role without any assistance of family members. If this is your situation, reach out for the support of the caregiving community to ensure your own needs are being met.

Come by and borrow these library resources:

  • Caring for your Parents: The Complete Family Guide (Book) by Hugh Delehanty and Elinor Ginzler
  • Family Meeting: A Media-Based Approach to Planning Care for Family Elders (DVD) by Sheri Hartman and David Kleber
  • Online: Handling the Sibling Relationship (Podcast), http://archcare.ecarediary.com/CommentRadioShow.aspx?id=215

 

By Lindsay Kwan

*Adapted from the July/August 2016 Family Caregivers’ Grapevine

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When It’s Hard to Feel Grateful

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When you are in the throes of your caregiving journey and stress is at an all-time high, it can feel impossible to express or feel gratitude. A lack of sleep, nourishing food, and self-care can wreak havoc on your nervous system. You might feel like there’s a dark cloud hanging over your days that’s hard to get out from.

When someone close to your heart is struggling, it can feel very uncomfortable to give yourself permission to feel gratitude. You might think, “How can I be happy when this person I care about so much is not?” Although it’s challenging, being able to tap in to gratitude, even if it is for the smallest joys in your days, is crucial if to maintaining a sense of well-being. Gratitude allows you to be present in whatever moment you’re in. It can give you strength, and even hope.

Remember that you do not have to have a complicated gratitude practice, and that you do not have to be grateful for everything. Life is not perfect, and bad things do happen. It’s okay to be upset about them and to know that you can safely express those feelings. Feeling and expressing gratitude is not about trampling out the not so great emotions, it’s about bringing your attention to the good things that may not be so apparent when you’re struggling.

If you’re struggling to feel gratitude, start with the smallest thing possible that made even the slightest difference to your day. Here are a few ideas:

a warm mug of coffee or tea first thing in the morning

a glass of cool water when you’re on a hot day

stepping in to a hot shower 

the person who held the door for you and your loved one the other day

putting on pyjamas when they’ve just come out of the dryer

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They are just small things, but when you start to pay attention to their occurrences, they become powerful.

Try writing down three things you’re grateful for in the morning, and three things at night before going to sleep. Continue this practice for just one week, and see what sort of difference it makes in your mood.

Please remember that if you’re continuing to struggle and feel like you can’t pull yourself out, reach out to a professional for help. The caregiving journey can be a hard one, and support can make all the difference. 

 

Cassandra Van Dyck

 

 

Dementia Tips Caregivers Need: Part Two

Last month I posted my notes on a Dementia Education workshop I attended hosted by Karen Tyrell (Lower Mainland Dementia Educator). Here is the previous post:  https://northvancaregivers.wordpress.com/2018/04/12/dementia-care-workshop-highlights/

I now turn to the mains stages of AD, which are:

  1. Mild/Early 2-4 years (doing just fine)
  2. Moderate/Middle 2-10 years (middle stage more difficult-family stressed)
  3. Late 1-3 years

To date, 1 million Canadians are affected by Alzheimer’s Disease.

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Diet and exercise are important, sleep also. Common behaviors and changes are:

  • Repeated questions
  • Denial (of AD, dementia)
  • Difficulties doing daily activities, such as forgot how to use microwave
  • Increased anxiety
  • Increased agitation
  • Aggression (verbal or physical)
  • Wandering, pacing
  • Paranoia and misperceptions
  • Losing things

Here are some tips on how to manage:

  • Try to keep the peace, validation of the feelings they are experiencing
  • Time outs
  • Say: ‘I can see you’re frustrated, angry’

I hope this helps.  My father has early dementia, and life is certainly a challenge. Probably the most helpful tip of Karen’s is to keep the peace, at least for me.
Also, time outs and time away help a lot. Here is Karen’s website: www.DementiaSolutions.ca

All my best to you in your caregiving journey,

Calm Pond

Staying connected & keeping isolation at bay

At all ages in life, feeling connected is vital to our well-being. Whether you’re an introverted person who recharges with quiet time and space to pursue solo activities, or more of an extroverted personality that gets energy and inspiration through being with others- having strong, loving connections with friends and family is a major contributor to feeling healthy, fulfilled, and able to deal with stresses that come along.
Caregivers are at risk of becoming isolated. Given all the time and energy that goes into helping a spouse or parent with practical tasks, you may have lost touch with good friends, hobbies, and events you used to take part in. When does being less involved start to become isolation?

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Self check-in questions to consider

Do I speak to a close friend at least once a month?

When I’m sad or upset, is there someone I can rely on for support?

Do I avoid seeing other people for weeks at a time?

Am I feeling lonely?

Have I given up most of my hobbies and passions – or all of them- for my caring role?

You might be realizing you’ve gotten a bit isolated. It can sneak up on you! Take a breath.

Ways to re-connect

Make a list of activities that bring you joy, inspiration, or peacefulness. Pick one you can reintroduce into your schedule, even if it’s 30 minutes once a week.

Invite a good friend to make a regular coffee date, and stick to the plan as much as possible.

Make community life part of your routine. Go out somewhere every day, like the library or local walking trails, and say hi to at least one person you encounter.

Speak to your counsellor or spiritual support person, and share what you’ve been going through.

See if any of the books on this list are of interest. The Power of Now by Eckhart Tolle is available in our Caregiver resource library. https://www.onlinepsychologydegree.info/top-10-self-help-books-about-loneliness/

Today, may you feel a sense of belonging- to yourself and others.
-Karyn

How to Prevent Slips, Trips and Falls

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Everyone will have falls at some point in their life. Children fall all the time, usually with little (or no) consequence. The dangers of falling increase with age. They are “the leading cause of injury-related hospitalizations among Canadian seniors, and between 20% and 30% of seniors fall each year,” says a report from the Public Health Agency of Canada. Falls can lead to injury, which can result in hospitalization, decreased mobility, and even complications like pneumonia or death. It is crucial to do everything you can to prevent yourself and your loved one from falling as you age.

Here are some tips to prevent you or your loved one from experiencing a fall:

EXERCISE | Exercise may be the single most important thing that you can do to prevent a fall. Physiotherapist Barbara Adams says she can predict falls months ahead of time in seniors, based on their balance, speed of walking, and distance of steps. Get out for walks, even if it’s just a short one, at least once a day. Squat! Try just standing up and sitting down when you’re on the couch or at the kitchen table, then repeat the exercise multiple times. When you start to feel comfortable with that exercise, try it with just the aid of the back of a chair, and then finally without any assistance. This exercise will strengthen your back, legs, core, and buttocks – all of which help you to increase balance.

TALK TO YOUR DOCTOR | Make sure you understand the side effects of any medications you’re on. Some can decrease balance or cause dizziness, putting you at greater risk of a fall. Your doctor can also help you assess any other health issues that could put you at risk, such as issues with vision.

WEAR PROPER FOOTWEAR | What your mother told you is still true! Wear proper footwear – always. Make sure you are as sturdy as you can be, and change your shoes based on the weather. Consider strap-on ice grips for the winter months, and make sure your summer sandals don’t shift on your feet too much.

REMOVE HAZARDS | Do a thorough walk-through of your house and look for any hazards. Is there a rug that you or other people often trip over? Are you comfortable on the stairs? How do you feel when you get in and out of the shower? Assess the risks and make changes.

USE EQUIPMENT | If you think that some extra equipment in your home could help you, such as a bar next to the toilet, a stool in the bathtub, etc., talk to your doctor. Make sure to explain the barriers you’re having to feeling safe in your home, or when you’re out in public, so your doctor can adequately recommend supports. Some pharmacies such as Davies offers equipment rentals.

For more information on preventing falls, take a look at this handbook from Vancouver Coastal Health.

 

Cassandra Van Dyck

 

Resistance to Care

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While many of us are willing to help a family member or friend, sometimes that help is resisted or declined all together.  Everyone one has the right to refuse help, but it can be worrisome when there could be a risk of harm.

Resistance to help can have a number or causes. The family member who has up until now lived a lifetime of self sufficiency may find accepting help a blow to self esteem. They may worry about their ability to afford extra care or special equipment.

The following suggestions may help:

Have an open discussion. Ask if there are specific tasks that the person needs help with. Share your observations and thoughts about what kind of help they could use. For example, “ I notice you become short of breath when you work in the garden. How about if we found someone to do the heavy lifting for you?”

Share your concerns. You may say, “I would feel so much better if you had some help with the house work. I know it really tires you out.” Or, “I worry that you might fall. Would you be willing to use a walker when you do your errands?”

Supply information. Gather reading material that your family member can review  on their own time and at their own pace.

Don’t rush. In so many instances accepting help is like issuing a visible public statement that you have become less able. It may take a while to get used to the idea of using aids like wheelchairs or a hearing aids.

Seek reinforcements. If you are the only one making a suggestion, it may carry less weight than if others voice the same concern. Family meetings can be a good way to open discussion. Go along to doctors’ appointments and raise your concerns while you’re there; your worries may be eased or validated.

When someone we care about rejects what we think is best, we may have to take a second look at what we are asking and why. Is the person in danger? Have we explored all the alternatives? If the person is a competent adult, don’t they have a right to accept risk?

Our role as caregivers is to care and it can be distressing to stand by while a family member rejects the help we think they need. With a little creativity and patience we can hopefully arrive at a solution that’s acceptable to everyone.

 

By Josie Padro

3 Ways to Get a Peaceful Sleep In the Heat

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Summer has come a little earlier than expected on the west coast this year. While it makes the days beautiful (especially if you’re near the water), the heat can make getting a restful sleep more challenging – both for yourself and for your loved one. Unlike houses and apartments further east, most homes in Vancouver do not come equipped with air conditioning. North-facing homes may be especially effected by hot weather. We all know that we need a good night’s rest to be at our best, so what do we do when the weather makes it hard to wake up feeling ready to take on the day? Read on for a 3 tips to beat the heat and get some sleep that you may not have thought of before.

CREATE A CROSS BREEZE | The Greatist recommends working with the windows in your room and a fan to create a cross breeze. “Position a fan across from a window, so the wind from outside and the fan combine in a cooling cross breeze. Feeling fancy? Go buck-wild and set up multiple fans throughout the room to make the airflow even more boisterous.”

USE A HOT WATER BOTTLE…| …with cold water. This ensures use year-round, making this inexpensive product a worthwhile purchase.

BE MINDFUL OF YOUR SHEETS | Cotton is best. Linen sheets can be especially cooling. If you’re using any other material such as silk or polyester, it may be a good time to pack them up until the fall.

What do you do to stay cool in the heat? We’d love to hear from you!

 

Cassandra Van Dyck

The Gentle Art of Saying No

These helpful tips on the art of saying no came from : ’Hiding in the Bathroom: An Introvert’s Roadmap to Getting Out There (when you’d rather stay home)’, by Morra Aarons-Mele (2017).

  1. In order to succeed at setting boundaries, you need to learn to say no.
  2. One of the author’s colleagues said that she imagines her fondest mentors and what they would counsel her to do.
  3. Another suggestion: Say : ‘Thanks so much, let me sleep on it and I’ll get back to you first thing tomorrow.’ I call this the ‘delay technique’, and it does buy you some time.
  4. Practice saying your noes, and have a few ready-made responses.
  5. Practice tuning into your gut feelings about the issue.

Of all the above techniques, my personal favourite is #3.

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Oh, and if you do say no, you have the perfect right to change your mind.

Hope this helps,

Calm Pond

How do you tune into your gut feelings when it comes to boundaries? We always appreciate hearing from our readers!

How to Work through Worries

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If you are an unpaid family caregiver, you will worry. You will worry about your loved one’s health and your ability to cope with life’s curve balls that will most certainly come your way. You’ll worry about signs and symptoms that don’t yet have names, about doctor’s appointments and surgeries and moves. Worrying is a part of the caregiving journey. Sometimes it can even be helpful! Feeling worry can push you to create game plans for tough situations or to find more resources and information to support yourself and your loved one. The trouble, of course, is when worry dominates your thoughts. You might find that you’re having trouble sleeping, that you’re forgetting things more often than not, or that you’re having a hard time being present because you’re constantly thinking about what is or could go wrong. Worrying will be a part of your caregiving journey, but it does not have to consume you. Read on for some ways to work through this difficult emotion.

GO FOR A WALK | If a wave of worry has washed over you and you can’t shake it, go for a walk. When worry takes over, it can be hard to think clearly. Relaxing your nervous system will help you to regulate your emotions and get some perspective.

PRACTICE PMR | Progressive Muscle Relaxation (PMR) is an amazing way to focus your mind on your body instead of your thoughts. Read this post for the how-to!

CONNECT | Have you noticed that this advice is in every post on difficult emotions? Talking about your emotions is one of the fastest ways to work through difficulties. When we’re alone with our thoughts, they can swirl around our heads and leave us feeling stuck. Talking to a therapist or fellow caregiver can help you to get perspective on your worries, and perhaps give you some tools to tackle them.

POSTPONE WORRYING | Realizing that you can control when you feel worried can be incredibly empowering. The next time you start to feel worried about something, tell yourself that you will address the worry in your next “worry time.” The key to making this work is to schedule a time for worrying, and to have a practice in place to help you work through the concerns. Journaling for 20 minutes before you go to bed, talking to a therapist or counsellor at a weekly or monthly appointment, or writing a list after you eat your lunch can help you to designate an appropriate time to work through your concerns, allowing you to be more present with your loved one.

CREATE DISTINCTION: SOLVABLE/UNSOLVABLE WORRIES | If your worry is solvable, you should be able to take action right away. For example, if you are planning a vacation with your family and you’re worried about what will happen to your parent while you’re away, you can take action to find them respite care overnight if they need it, or look in to grocery delivery services, house cleaning, etc. If your worry is unsolvable, there will be no corresponding action. These are worries that you might feel if you’re worried about how your husband’s cancer will progress, or if their forgetful symptoms will result in a dementia diagnosis. “Worrying is often a way we try to predict what the future has in store-a way to prevent unpleasant surprises and control the outcome. The problem is, it doesn’t work. Thinking about all the things that could go wrong doesn’t make life any more predictable,” says Lawrence Robinson. “To stop worrying, tackle your need for certainty and immediate answers.”

How do you cope with worry? We’d love to learn from you in our comments. 

 

Cassandra Van Dyck

3rd Annual Caregiver Expo

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If you’ve been on the fence about visiting the 3rd Annual Caregiver Expo this Saturday, we hope that this post will sway you to pop by – if only for a little while! Expect to be greeted with warm smiles and a lively atmosphere. Booths from local services and resources will be set up so you can explore at your leisure. Presentations will run throughout the day. Come by to catch your favourite speaker talk, or stay for the long haul! Join us to connect, learn, and to celebrate the incredible role you play in a loved one’s life. 

Presentation Schedule

9:15- 9:30AM
Laughter Yoga
John Wallstrom

Laughter Yoga involves guided exercises that are lighthearted and easy to follow. Laughter strengthens the immune system, releases feel-good endorphins and lowers blood pressure. Come and have a laugh with us!

9:30 -10:00AM
Family communication and the power of boundaries
Jodie MacDonald

With a focus on somatic awareness and breathwork, this talk will help caregivers navigate the complexities of family dynamics and sibling relationships, learning to separate their own needs from the needs of others, through boundary practice and insight into habitual patterns of relating.

10:15- 10:45
The Rollercoaster of Grief
Robin Rivers

Grieving the loss of a loved one or anticipating the loss can be challenging, no matter how long you have been in a caring role. Learn about ideas to help you on your grief journey and resources that are available in the community.

11:00- 11:30
Re-filling your Cup: Preventing Caregiver Burnout
Karyn Davies

Join us in learning to recognize what activities give you energy, and which ones drain your mental, emotional and physical energy reserves.  Become aware of the major signs of burnout, while considering how you can re-fill your own reservoirs of hope and strength.

11:45- 12:35 (50 minute keynote)
Energy to Care: the science of how to balance self-care with giving
Dr. Maia Love

How do you care for yourself as you help a loved one through a health crisis? Learn key tools and skills to support your own health and wellness as you care for others; understand the wellness science to lift your energy and recharge your mind.

1:00- 1:30PM

  1. 1. Inspiring your best quality of life: The Everyday Counts Program
    Jane Jordan (15 minutes)

Learn about the Every Day Counts Program, a free support program for individuals living with a life-limiting illness. The program offers access to services and supports that are designed to enhance quality of life and are available whenever individuals feel they need them.

  1. All Ready to Go
    Stephen Garrett (15 minutes)

Learn about accessible and affordable options for pre-planning a loved one’s funeral arrangements. Having a plan can greatly reduce stress for family members during a time of loss.

1:45- 2:15
Qi Gong to boost your energy
Caroline MacGillvray

Together we’ll practice some accessible, fun Qi Gong exercises. Qi Gong is designed to help you let go of stress and tension, energize your body and mind, and create feelings of peace.

2:30- 3:00
The importance of having a Power of Attorney and Representation Agreement
Jackie Morris

This presentation will focus on two important legal documents, a Power of Attorney and a Representation Agreement, what they do and the pros and cons of alternatives.