What to Do When a Sibling Says “No” to Assisted Living

Siblings disagree (shocking surprise, right?). Whether it be a heated argument over the “official” rules when playing Monopoly as kids to which house should host Thanksgiving when you are adults, I’d venture to bet that your family has experienced its fair share of ups and downs.  

Whether the disagreement stems from discussing who should manage a parent’s finances to deciding who and how care should be provided, one of the most common causes of sibling disagreement stems from making decisions for aging parents.

The fact is, going through that kind of role-changing transition in the life of a family can put enormous stress on family relationships. Conflicts will happen. To manage the transition in a healthy way, it is critical for siblings to prepare emotionally, logistically, and to know where they can turn for help.

Managing emotions

Most of us don’t spend a lot of time thinking about aging and how we want to spend our last years. It’s uncomfortable to look closely at the end of life. When a parent is no longer able to live independently and adult siblings have to transition into the role of decision-maker (whether financially or medically), it’s not uncommon for siblings to disagree on the best approach.

Everyone handles stress differently.  Watching a parent decline in mental or physical abilities is emotionally challenging enough.  Throw in the responsibility of making decisions about finances and care and it can be downright overwhelming.

Understanding the ways your brother(s) or sister(s) might emotionally cope with seeing such changes is the first step to warding off unwanted conflict.  Even though you haven’t yet experienced the loss of a parent, the loss of mental or physical function can enable the various stages of grief one might experience such as:

• Your siblings might refuse to admit that your parent needs help no matter how much evidence you present.
• Anger can lash out in many directions: inward, because the sibling didn’t spot the warning signs him or herself; outward at the other siblings for bringing the issue up; or collectively for not being able to handle the situation themselves.
• A sibling might try to offer alternative solutions that minimize the magnitude of the problem.
• When they realize they can’t stop what’s about to happen, they might withdraw emotionally and withhold their support, refusing to help search for an assisted living community or to help with the move.
• Acceptance means that you are at a place where you can recognize what has happened and process it without denying what has happened.

Conflict typically stems from different siblings at various stages of the grief process.  You might feel frustrated or even impatient toward siblings who are going through these emotions, but patience and understanding when it comes to individually coping with a parent’s life changes can mean the difference between an impossible conversation and a productive one.

Overcoming objections

When making the decision to move a parent into assisted living, there are a few common areas of disagreement that can occur among siblings. Being prepared for them can help diffuse the conflict and reach agreement.

• Disagreement about needs. Especially in cases where one sibling lives close to the parent and the other lives far away, there can be real disagreement about what level of care a parent needs. You see your parent up close. You see the increasingly dirty house, shabby lawn and social withdrawal. Your sibling sees a smiling face on Skype or hears the same voice over the phone they have for years. Pressing the issue will only strain the relationship, but simply waiting for the other sibling to come around could put your parent in danger. A better solution is to hire a visiting nurse to visit your parent and make an expert assessment about the level of care he or she needs and if it’s safe to stay in the home.
• Worry about cost. Assisted living is a financial investment. Medicare doesn’t cover assisted living and less than 3 percent of people have long-term care insurance. So, to put together the needed funds might require pulling from savings, the sale of a house, the conversion of a life insurance policy or even at times, family contributions. Feelings get hurt easily when money is involved, so make sure everyone is on the same page. it’s a good idea to have a family meeting where everyone can see how much money is needed, how much is available and how much they can contribute. If you need to, you can bring in an elder care mediator to be a neutral referee.
• Feelings of exclusion. If a sibling has already taken on a majority of the caregiving or decision making responsibilities it can cause another to feel excluded, or a loss of control and can make consensus-building difficult for a major decision like a move to assisted living. The solution here is not easy in the moment, but it’s to focus on the needs of the parent. A power struggle among siblings will only make things harder. Begin communicating as early in the process as possible with each other. If a power struggle seems inevitable, suggest using a geriatric care manager — a third party to handle a parent’s health care management.

Navigating adult sibling relationships can be a challenge, but coming together for the sake of your parent is important. A unified voice is the best way to convince a reluctant parent that assisted living is an exciting new adventure that allows them to remain as independent as possible while receiving the care and support they need as they age.