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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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

How to Work through Anger

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When someone is asked to think of a difficult emotion, anger might be the first one to come to mind. Anger doesn’t feel great in our bodies. It might make our throat tighten, our palms sweat, and our hearts race. Unleashing anger might feel good momentarily because you’re letting go of pent-up energy, but it can have extremely damaging effects if not let out in a healthy way. Angry words can hurt people – angry actions even more so.

It’s okay to feel angry. Really – it is. Anger is your body and mind’s way of signalling that something is not right and that you need to pay attention to what’s wrong right now. 

The trick is being able to tap in to your intuition so you can work through the anger and address what’s causing it. Anger is a secondary emotion; it is always caused by something else. When you can identify what’s causing it, you can begin to work through and let go of anger.

Think of a movie you love with a very angry main character. There’s probably a catalyst moment in the film where the actor sprints down the street in the rain, gets in to a physical or verbal fight, or enacts some sort of revenge on the person or people they’re angry with. Now, what does that person do after they’ve lashed out? 9 times out of 10, they cry. The anger needed to be released so they could address the underlying emotion that was causing them to be so angry: sadness, jealousy, frustration, etc.

Holding on to anger or releasing it in ways that are harmful to yourself or others can be hugely detrimental to our well-being. When we feel angry, our adrenal glands produce cortisol (aka “the stress hormone”). This can help us greatly if we are, say, being attacked by a bear and need to defend ourselves. The trouble comes when cortisol is being released in to our bodies constantly. High cortisol levels have been connected to sleep disturbances, weight gain, mood swings and depression, and more.

So, what do you do when you’re angry? Your response will depend on a number of factors: who you’re with, where you are, your overall emotional state, and how equipped you are to deal with what you’re feeling. Here are a few over arching tips for dealing with anger:

RELEASE | The first thing to do when you’re feeling angry is to figure out the best way to release it so you can work through what’s causing it. This is a good time to tap in to those self-care tools you have available – but they may need to be tweaked depending on what you need. You know yourself best! What helps you let go? For some, it’s screaming in to a pillow. Others go for brisk walks or runs, dance with abandon to a favourite song, or swim laps at the pool. You could also call a safe person to vent or write all of your emotions down in a journal that no one will read. It’s important to note that if you’re with the person who’s making you angry, going for a run or writing in a journal might not be available to you. Take some calming, deep breaths if you can, or consider just walking away or telling the person you’re with that you need some time to yourself.

ADDRESS WHAT’S CAUSING THE ANGER | Did your loved one say something that made you want to explode? Did a doctor tell you you’ll have to wait even longer for a referral? This is a great time to use “I feel” statements. Take a deep breath, and let them know how you’re feeling. This prevents the other person from becoming defensive, and can help them to address your needs. Read more about “I feel” statements here. If you’re alone and notice you’re feeling angry, or that you have been feeling that way for awhile, really take some time to think about what’s causing it. Often, it’s that you’re sad or frustrated at a situation you don’t have control over, or feel that you don’t have control over. You could be grieving changes in a loved one, or feeling frustrated because so much is being asked of you.

MAKE A PLAN | If your anger is in response to a particular event, addressing why you’re feeling the way that you are with the person or people involved can help prevent it from happening again. If, however, your anger is due to underlying or lingering issues, it’s time to make a plan to help prevent you from reaching a breaking point again. For example, maybe you’ve realised that you’re feeling angry because a lot is being asked of you and you have not had a break. If this is the case, look in to respite, or create a plan with family members to delegate responsibilities.

Managing anger is a complex process, and you do not have to do it alone! Remember to reach out to a caregiver support program, counsellor, or therapist if you’re needing some more support.

What do you do to manage anger? We’d love to hear and learn from you! 

 

Cassandra Van Dyck

 

When forgiveness becomes key

Resentful. Disappointed. Angry.  Irritated.
Some of these words might describe how you feel about one or both of your parents. Perhaps Mum and Dad were neglectful of your needs in childhood, or even downright abusive on an emotional or physical level. You might have felt disregarded or diminished by their communication with you.  It may also be that childhood was a largely positive time for you, and during adulthood you encountered major conflict with your parents.  Feeling angry, resentful or disappointed with your Mum and Dad can make the caregiving role even more complicated. The issue of having negative emotions towards parents is one to be brought into the open, as it’s more common for family caregivers than you may realize.
When Dad suddenly needs help in managing his daily routines because of memory loss, you are likely to feel challenged by stepping into this supportive role. That is completely understandable, yet others may expect you to be involved in the care more than you feel comfortable with. Health Professionals, Aunts and Uncles, siblings, and family friends may expect you to help Dad in ways that come at great personal cost to you. I have a few suggestions on navigating this delicate situation, and I invite you to see which ideas resonate with you.

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Suggestions on coping as best you can:

Honour your needs. Limit the number of hours you spend with Mum or Dad, and don’t wear yourself out with too much time in their presence if it drains you.

Appreciate how you’ve grown. Think about how you’ve responded to your parents in the past, and celebrate how you’ve matured in your way of communicating with them. For example, you might be excellent at setting boundaries when they make requests.

Practice forgiveness.  Get support from a close friend or a therapist in working towards self-forgiveness. Be gentle with yourself for the times you got upset or acted in ways you would no longer see as being productive. Practice letting go of criticism towards yourself, and see what kind of difference this makes.

Live in kindness. Even though your parents might never acknowledge that they’ve hurt you, or say sorry about it- you can choose to now see them with a kind heart, which reflects the kind of person you are.

Create a forgiveness mantra.  What words are meaningful to you? I suggest you keep it simple. An example could be “I forgive and let go of hurt, and I welcome love”. Try and say it out loud when you have a private moment, and then say it in your head whenever you need to.
If you’re reading this and a lot of stress or grief is coming up for you, pause for a second and breathe slowly for 5 seconds. A whole clan of caregivers in North America are with you, and we understand that this is not easy or simple.
Please connect with a trusted friend or professional support person as soon as you’re able to.

-Karyn

How to Diffuse Frustration

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Frustration is a frustrating emotion.

When you get caught in a wave of it, it can feel hard to break free. You might feel stuck, and that feeling could cause more frustration. If left unchecked, you might lose sight of why you felt frustrated in the first place, which makes it very hard to work through your emotions.

Frustration is a primary emotion, which means that it is an emotion often expressed as other emotions, such as anger. If you can take some time to diffuse frustration before it’s expressed as anger, you have a better chance of communicating more effectively with your family, co-workers, friends, or loved one.

The next time you’re feeling frustrated, try following the steps below to diffuse and work through the challenging emotion.

BREATHE | Acknowledge that you’re feeling frustrated and pause, wherever you are. Even if you’re in the middle of a conversation or sitting in traffic. Name the emotion, and take a deep breath in, and out. Breathe all your air to expand your belly as big as it will stretch, then blow the air out forcefully through your lips. If you’re able to, let out a loud sigh. Do what grounds you. For some it is deep breathing, for others it is a walk in the forest, playing music, or exerting some energy exercising.

REFLECT | Now it’s time to figure out why you’re feeling frustrated. There might be several reasons, and that’s okay. Talk yourself through the layers that have built up to make you feel this way. Chances are, you have a lot on your plate. Did you say yes to something you didn’t want to? Are you feeling unsupported? Are you waiting for answers about your loved one’s condition? You can’t solve it all at once, but identifying the source of frustration can help you to come up with a plan to address it.

REACH OUT | Now that you’ve identified where your frustration is coming from, it’s time to get support. What kind of support you will need depends on your unique situation. Maybe you need so carve out some time for self-care, or perhaps you have not been getting enough sleep and need to take some steps to ensure you get a good night’s rest. If you’re feeling that you need some help caring for your loved one, you might need to talk to their support team and ask them to help out. Sometimes what you need might just be to connect with other caregivers who are experiencing similar situations. Talking, sharing, and connecting can do wonders to help manage frustration.

What steps do you take to diffuse frustration? We’d love to hear from you in our comments!

 

Cassandra Van Dyck

Difficult Conversations: Setting Boundaries

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“The appropriate uses of the words ‘Yes’ and ‘No’ make more room for love.” – SARK

As a caregiver, you will be asked to do a lot. Whether explicitly or inadvertently, you will be asked to provide emotional support and help with day-to-day tasks, such as cooking meals, driving your loved one to appointments, or assist with personal care. Knowing your boundaries and affirming them is essential to prevent burnout and to make sure you are caring for yourself with the same love and attention that you give to others.

Your personal boundaries are unique to who you are and what you allow in to your life. Maintaining or creating boundaries is not selfish – it is essential if you wish to take care of yourself. Personal boundaries are not inflexible; they can shift and change and grow. What’s important is that you honour the boundaries you’ve created for yourself when you need to so that you do not burn out or become resentful of what’s been asked of you. People and so many other things in life will test your boundaries over and over again. Without knowing yourself and what your limits are, you might feel that you are often “walked on” or that you feel a general lack of control in what happens to you.

If you struggle with setting boundaries in your own life…

…please remember to be gentle with yourself. People have a hard time setting boundaries for a number of reasons, but it usually stems from the way you are raised and what you learned about what you need to do to be accepted and loved. Learning to set strong personal boundaries can be hard work! Please reach out to a counselor or health care professional if you are realizing you need to do some more work around boundary setting.

If you would like some tips for setting boundaries in your caregiving journey…

…read on for a helpful exercise! Implementing some simple strategies can help you to maintain your boundaries and prevent taking on too many things, or situations that you are not comfortable with.

The Stop-Look-Listen System

From Better Boundaries: Owning and Treasuring Your Life, By Jan Black & Greg Enns

“When you are faced with a choice, you stop before moving ahead, look over the situation, and listen-to yourself, to your intuition, to the wisdom of trusted advisors, or to what your experience has taught you.”

STOP | Stop right before you make a choice. If you are at the store deciding whether or not to overspend, on the phone deciding what date is best for a family reunion, or at work debating an offer to take on a new project even though you haven’t finished the last one, stop long enough to clear your head and review your options.

LOOK | Look at the situation from more than one perspective. Ask the following questions:

  • What is my motive for making this choice?
  • Will it hurt me?
  • Will it hurt others?
  • Would I choose this option for someone I love?
  • Can I change my mind? If not, am I sure I want to make a final decision right now?
  • What would the people I trust suggest I do?

LISTEN | In your mind, try to “hear” these tips from people who have become experts at making choices.

  • Listen to your gut, is it telling you that you’re being pressured in to saying “yes”?
  • If someone is pressuring you, remove yourself from the situation.
  • Don’t make an important decision when you’re desperate.
  • “Let me think about it” are five words to speak often. Things usually look different the next morning – either better or worse.

Cassandra Van Dyck

Depression and Seniors, Part 2: Difficult Conversations

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In our last Depression and Seniors post, we discussed some of the signs and symptoms of depression and included some tips for getting help. In this post, we’ll be talking more about how to have a difficult conversation with your loved one about getting support for depression.

Introduce the topic mindfully.

When you’re nervous about having a difficult conversation with someone, you might go over the many ways you think the talk might go before having it. Preparing for a conversation can help you anticipate questions and prepare answers, but it can also cause a lot of fear if you think the person you’re talking to might react poorly. Try to be open to their reactions to prevent defensiveness. Although you’ll never find a perfect moment to bring up something that’s hard to talk about, aim for a good one. You might
know that your loved one is the calmest after eating or shortly after they’ve woken up. Make sure you leave enough time for a lengthy conversation and avoid bringing up tough topics if you have to go somewhere else quickly or if someone else will be visiting.

Be calm and direct.

Though it doesn’t have to be perfect, and there’s a good chance that it won’t be, try to broach the topic calmly and directly. One of the most common mistakes people make when starting a tough conversation is to avoid the topic. This can be confusing for the other person and may cause them to be more upset.

“The past few weeks your mood has seemed very low. I know it can be hard to open up to a new person, but talking to a counsellor might be helpful. I’d be happy to go with you to meet someone. How do you feel about it?”

“I’ve noticed that lately you have not been returning my phone calls or going out for walks like you usually do. I’m worried about you. How are you doing?”

Practice Active Listening.
Now that you’ve started the conversation, you’ll want to be remain open to your loved one’s reaction. This is probably the part of the conversation that you’ve been dreading, since you might think they’ll react negatively. Although this is the scary part, it’s also the time when you have the most control over how the rest of the discussion will go. If your loved one says “no” to your suggestion or acts hurt or offended that you’d suggest bringing another professional in to their circle of care, your instinct might be to react strongly. You might be worried that their refusal to accept assistance will increase the pressure on you or make their situation worse. This might make you angry or want to shut down, but those reactions will not help. Practicing active listening increases mutual understanding. You can practice active listening by using open body language, giving your loved one the time to fully express themselves, and by using empathy to reflect their feelings back to them. This will help you to understand where they’re coming from and alleviate some of their fears, and it will help your loved one know that you care about how they feel.

Here’s an example:

Sadaf has told her mother that she’s noticed her mood has been low lately and has suggested talking to their family doctor about connecting her with a counsellor for some extra support. She has asked how her mother would feel about it. Sadaf’s mother responds, “I’m fine and I don’t need to talk to anyone. I won’t bother you with my problems anymore.” Sadaf feels frustrated by this response and wants to walk away, but remembers to use active listening.

“It sounds like you’re really hesitant about talking to someone else about how you’ve been feeling. I know you’re not fine because of what you’ve been telling me. What about talking to someone else worries you?” This question and reflection opens up the conversation for Sadaf’s mother to talk about her concerns and for Sadaf to respond with empathy and answer any questions she might have.

Do Your Research.

If you spend time researching options for your loved one before talking to them, you will have more knowledge to answer their questions which may help them adjust to the idea of talking to someone new. Do remember that you don’t have to have all the answers! If your loved one asks a question you don’t have the answer to, offer to look in to it with them. You can say, “I don’t have the answers yet, but I’d love to sit down with you and explore the options together.”

The Kelty Dennehy Mental Health Resource Centre in North Vancouver is a wonderful resource. You can also call the Mental Health Support Line at 310-6789 or the Suicide Hotline at 1-800-SUICIDE (1-800-784-2433) for confidential, non-judgmental and free support available 24/7. You do not have to be the person in need to make this call.

Let them know they’re not alone.

Sometimes one of the scariest things about accepting help is the possibility that existing supports will disappear. You can help to ease your care partner’s fears by reassuring them that you are not going anywhere. You could try saying, “It can be scary to accept help from new people. Please know that I care about you and want to be able to help you in the best way I can. I think involving this person could help me to be the best support person possible.”

Go with them to meet the new care provider. Debrief afterwards. 

Having you with them when they meet their new care provider might help ease some of the stress of involving a new person in their care. You might be able to support your care partner by asking questions and reflecting back what you’re hearing from the care provider in a way that your loved one will understand. After the appointment, check in with your loved one to see how they’re feeling. “How was that for you? What did you think?” Practice active listening to explore where they’re at.

3 Tips for Caregivers:

Debrief with a trusted friend or therapist.

Look at what support you need.

Appreciate your best efforts.

*This post was adapted from Difficult Converstaions: When it’s Time to Ask for Help

Cassandra Van Dyck

 

 

 

 

Depression and Seniors: Signs to Look Out For and How to Get Help

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Depression is not a normal part of aging, yet it effects a great deal of seniors. Although statistics report a large number of people suffering, most do not seek treatment. There are many reasons for this. Depression may present differently in the elderly than in younger adults and can also be overlooked because of the prevalence of other health concerns, sleep problems, lifestyle, or grief.

When is it depression?

You may suspect depression in a loved one if:

they have lost interest in activities they used to enjoy

they express feelings of hopelessness or helplessness

they have a lack of motivation or energy

they have lost weight/interest in eating

These symptoms may also be present with certain health conditions or when a loved one is grieving. While you can’t diagnose the person you’re worried about, you can look for signs, ask them questions about what they’re going through, support them, and get support.

What do you do if you suspect your loved one is depressed?

Realising a loved one may be battling depression can be very hard for caregivers. You may feel frustrated or lost and unsure of how to help. Your care partner may be resistant to seeking help and might not want to talk about what they’re going through. So, what can you do?

Ask questions. 

You may be noticing some symptoms of depression, and you’ll want to ask some questions to get some clarity. These conversations can be tough. Try using phrases like, “When did you start feeling like this?” “What can I do to help?” Use active listening so your loved one knows they’re being heard.

Encourage your loved one to get help. 

It takes a lot of vulnerability to share with someone that you are feeling depressed, so your loved one may be reluctant to talk to a health care professional about what they’re going through. Let them know that you care about them and want to support them to get the help they need to feel better. Offer to make an appointment for them and join them for their first visit if you can. If your loved one knows you are willing to walk with them on your journey, they may feel more comfortable asking for help.

If you suspect your loved one is struggling with depression and they’re unwilling to get support, or if you suspect they may be suicidal, reach out for help. Talk to your doctor, or call The Crisis Centre: 1-800-SUICIDE

Supporting someone with depression can be overwhelming and cause stress for the caregiver. If you are caring for someone who may be depressed, make sure you are getting the support you need as well.

Cassandra Van Dyck

Sources:
https://www.helpguide.org/articles/depression/helping-a-depressed-person.htm
https://www.helpguide.org/articles/depression/depression-in-older-adults-and-the-elderly.htm

 

 

Conflict Over Inheritance

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Despite the fact that many feel money or objects will never be an issue for their family, the inheritance can be a major source of strife among siblings. Even if there is little money to be shared in the inheritance, siblings can fight over sentimental family heirlooms.

Any inheritance that is unequally divided among siblings can be a painful experience and can damage relationships because the reality is that we equate a parent’s consideration of us in their will with love.

The most important thing to do to avoid this conflict is to have your parent clearly outline their wishes in their will so that you can use the document as a reference for when they are no longer able to make those decisions.

As well, it is helpful if your parent can explain their decisions to your family themselves. If they are already unable to make these decisions and there is no surviving spouse, the law will divide their assets evenly among their surviving children. However, conflict can still arise as siblings have emotional connection to mementos like your mother’s wedding china set or your father’s beloved guitar.

One way to mediate a conflict over inheritance is to have a family meeting with a trained counsellor. Clear communication facilitated by a professional early on in the dispute will help everyone identify their feelings behind the inheritance and heirlooms in order to find an agreeable solution.

Have you had a conflict over inheritance? How did you resolve it? We’d love to hear your stories in the comment section or you can send it anonymously to lindsay.kwan@nscr.bc.ca.

Lindsay

 

Recommended Article: The Rise of the Male Caregiver by Sherri Snelling

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“In 2009, according to a National Alliance for Caregiving/AARP study, men accounted for 34% of the nearly 65 million family caregivers in the United States,”writes Sherri Snelling. “But more recent surveys show the number of men in this traditionally female role has risen rapidly, driven by a combination of factors, including the recession, changing gender expectations and longer life expectancies.”

Are you a male caregiver? If so, this article will be of interest to you, to know that you are not alone. Sherri Snelling writes about how this rise of the male caregiver, perhaps can be partially attributed to the fact that more woman are diagnosed with Alzheimer’s disease than men, putting more men into the caregiving role for not only their parents, but also their spouses.

What do you think? Let us know in the comment section.

Lindsay