Why Does Caring for our Elder Parents Turn Us Back into Squabbling Children?

By Keren Smedley, Daily News

August 13, 2009

When my elderly mother was diagnosed with vascular dementia nine years ago at the age of 81, my sister and I naturally assumed that we shared a common goal - to look after her and manage her care in the same way. 

But what emerged in the weeks and months that followed her diagnosis was a far cry from sisterly love and affection.

Looking back, I realise our main interest seemed to be ourselves as much as our mother. We disagreed on the best way to care for her. I felt she needed more care than my sister did.

I thought my sister was in denial of just how unwell our mother was, and she felt I was forcing the pace. Suddenly, we were five-year-olds again, each fighting for her own way. 

We veered from spitting criticisms at each other to feeling ashamed and remorseful and trying to patch up our wounded relationship. 

The strangest thing was that we'd been used to our strong-minded mother making all the family decisions and, suddenly, she couldn't. 

Without her at the heart of the family, holding it all together, we were lost. Except that we weren't children. We were grown women, women who, having fled the nest as teenagers, had grown so far apart that we were struggling to recognise each other's value systems. 

Had my mother ever anticipated that her beloved girls would fall out over her like this, she would have been horrified. She was widowed in 1965 when she was in her mid-40s and my sister and I were ten and 13, and since then I had always felt that I had to look after my mother emotionally. 

When, in recent years, she started to feel fearful about her memory loss, I think I became fearful alongside her, while I believe my sister went into denial. Both were understandable reactions, I suppose, but very different. 

Our main argument centred on the amount of care my mother needed. On some days she managed well; on others, she was confused. 

We knew from the start that, fiercely independent, she wasn't going to take having carers in her home lying down. 

We started with a 'voluntary befriending service' and then moved swiftly through the care staff of two private agencies, each of whom spent several hours a day with Mum. 

I was the point of liaison for them and was telephoned by them sometimes as often as five times a day. You can imagine how stressful this could become. Yet my sister didn't understand the problem - or why I was resentful that we did not seem to be sharing the burden equally. 

She thought I was being melodramatic, and I thought she was self-centred. We argued our way through this mess until circumstances changed. 

On three occasions, I was telephoned by Mum's neighbour after she wandered into their house in a bewildered state. I wanted to arrange full-time care for our mother at home, but my sister felt I was depriving my mother of all independence by doing that. 

Eventually, after Mum was found wandering the streets alone, my sister agreed that we had to take action. 

Clash: Siblings can often play out old rivalries when it comes to looking after a parent.

By this point, I was managing my mother's finances. My sister and I had shared power of attorney over her money, but I felt I had to ask my sister her thoughts, out of common decency. After all, this was our joint inheritance I would be spending. 

At times I was bad-tempered and spitty with her and would moan that I was fed up with doing everything. She would argue that I was not doing everything, and on it went. 

Perhaps the only thing we did well was to keep all of this away from our mother. We knew she had enough on her plate. I wanted to discuss what was happening and find a way for us to manage our differences. My sister accused me of trying to be her therapist and she didn't want one, she said. 

At times, I got cross and went into big sister mode and freely admit that I became superior with her. 

The reality was that Mum had become used to me doing things for her, so it was me she relied on. I think she felt more secure when I was managing the situation. This made me cross because it was an assumption that put pressure on me. 

I tended to spend my visits to her doing chores, not always with a smile, while my sister chatted and was good company. 

Looking back, I can see that as the elder sister I'd always been the one in charge, and I believed I should be in terms of how my mother was cared for. 

I like to think through a problem, find a solution and be fully prepared for the event. My sister (or this is how it felt) wanted to wait until a crisis occurred before discussing the problem. 

It might have been all right if it was she who then dealt with the crisis, but it always seemed to be me who was left to pick up the pieces. 

The truth is that what happened to my sister and me is sadly far from unusual. Britain's elderly population is expanding fast. And dementia is on the increase. 

There are 700,000 people in the UK suffering from dementia, a statistic that will rise to 1.7million by 2051 - placing the burden of decision-making on the adult offspring of sufferers more than ever before. 

But in Britain today, siblings often end up living at opposite ends of the country, meeting only at Christmas or for family weddings.

Geographical distance often translates to emotional distance in the sibling relationship, each grown-up child displaying a different set of beliefs and attitudes. 

When it comes to two or more siblings trying to care for elderly parents - and the latest research shows that one in five adults regularly provides that kind of care and assistance - you often end up with a disastrous family crisis.

Hot topic: Caring for the elderly is an important issue and can cause siblings to argue.

It was my own experience that led me to set up a counselling workshop called Managing Parents, to help adults deal with the issues when parents age. 

One of the first through the door was Brian Coleridge, 56, the managing director of an advertising agency in London. He was struggling to understand why he and his brother kept falling out over how best to care for their mother, who is 87 and living in her own home. 

She is frail and is in what Brian describes as 'early but undiagnosed dementia'. She is unable to manage her everyday life, so needs help with shopping, cleaning, cooking and managing her home. 

'My brother and I got on fine when we were young,' he told me. 'We're close in age and went to the same school. But when it comes to making decisions about our mother's care or managing her finances, we come at it from different angles. 

'He hates it when I give her money, so my mother won't take it, although she needs it. We can't seem to agree on anything, with the result that our mother isn't getting what she needs. 

'It won't be long before one of us will have to take the power of attorney, and some serious decisions about her care will have to be made.' 

Without realising it, however, Brian hinted at the divisions that had been gnawing away at the brothers since childhood. These are the fault lines, as many siblings discover, that fracture under the pressure of caring for an elderly parent. 

'I'm the elder, did much better at school and went on to university,' Brian said. 'We grew apart in our late teens because we had different interests, but we always got on well enough when we met over the years. 

'I'm in business and I've done well financially. My brother's a civil servant and we live different lives. I'm in a city and love it, while my brother lives more simply in the country.' 

Brian told me he regards his brother as a fuddy-duddy and a slowcoach, while he [Brian] likes to throw money at a problem to resolve it quickly.

For Marissa Evans, the situation was even more complicated because of a fragmented family. The 53-year-old bank clerk from Northampton is trying to make decisions about how best to care for her father with stepsiblings she hardly knows, and with whom she has had little contact. 

'My mother died 23 years ago and my father remarried three years later when I was in my 30s,' she said. 'He sold our family home and he and my stepmother bought a new house. Naturally, he took with him furniture and photos. 

'My stepsiblings - my stepmother's children - are all older than me, we don't live near each other and, although we've met on occasion, we've never bonded. 

'But our parents are now elderly and decisions have to be made. They'll need to go into sheltered accommodation and full-time care. 

'My brother and I are together on this. We don't want our family inheritance - all the things we grew up with - to vanish on care bills, but it seems there's no middle ground with this other family. 

'They see everything as jointly belonging to our father and their mother and don't think we should take the things that were originally ours. Our father wants an easy life, so he's not willing to intervene.' 

In the depths of bitter rows such as these, it is often the child in us that comes to the fore. We feel threatened - and making these life-changing decisions is painful and difficult. 

But there is a danger that we end up behaving like toddlers fighting over a toy, each determined to be seen as in the right. And it goes without saying that a parent isn't a toy. 

During my own mother's early dementia, I found that rational thinking had gone out of the window. Family matters raise strong emotions. 

In all families, there will be a pecking order among siblings. The natural 'leaders' are often the eldest, while the youngest is always seen as the baby and, in many cases, the one who was closest to the mother or father - which isn't necessarily the same as having the best relationship. 

And to make matters worse, it's not unusual for a parent to fuel the arguments between children. It can be difficult dealing with your own decline as your adult children take over. 

You're left feeling increasingly impotent and losing the central role in the family. Stoking arguments, whether wittingly or not, is often the only power an elderly parent has left. 

In the end, it's up to the children to sort out the problems. Remember, too, that a relationship with siblings will, in all likelihood, go on well after your parents' death. They provide the last link to your past, a link which might help to sustain you into your own old age. If we don't deal with our differences while our parents are alive, they are extremely hard to resolve later. 

Most of us have had to make decisions with people with whom we don't see eye-to-eye, and yet we are able to negotiate some sort of agreement. But that's usually in situations where we don't have the same emotional connections. 

The first step, however painful, is accepting that there's been a power shift in the family. We have to let go of the fantasy that our 'mummy and daddy' will make things better for us. It's time to grow up. 

My sister and I tried to do this when we found ourselves at loggerheads over our mother. We sought help. We were fortunate to have some excellent NHS support, including the Admiral Nursing Service, which helps carers find a way through. 

We agreed to sit down and listen to each other away from our mother. It was tough because what we really wanted to do was interrupt each other and disagree. But we looked for a common goal. And, surprise, surprise, we had one: our mother. I'm not saying it was easy, but we did finally manage to make the decisions and help our mother cope in the best way possible. 

My mother died in February, and I must admit in many ways it was a relief. We had lost the woman who was really our mother four years earlier when she became severely demented. 

Now, it's just the two of us and we are working out how to relate to each other in this new era. It's early days, but I think we'll find a way through. 

Of course, it doesn't always work out so well. Brian Coleridge and his brother are still at loggerheads. 'I don't think my brother wants to find a way forward,' he said. 'He's still so angry about feeling inferior in our childhood. 

'My hunch is that we'll just about muddle through - there's no choice - but I expect our mother's funeral will be the last time we meet.' 

The tragedy is that parents spend half their lives trying to encourage their children to love and look after each other, but they can end up being the cause of the most bitter rows of all.

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