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The cost & courage of caring - stories that spark resilience.
When mom or dad suddenly needs
care, most people imagine the
family will come together.
Sometimes they do.
But many caregivers know that's
not what happens.
One sibling quietly becomes
responsible for almost everything.
Another disappears.
Then the sibling who wasn't there
suddenly wants an equal voice in
every medical decision,
every financial decision, and
every conversation about what's
best for mom or dad.
Why does one sibling end up
carrying almost all of the
caregiving?
Why does the sibling who wasn't
there still expect an equal voice?
Why doesn't this matter to my
brothers and sisters the way it
matters to me?
At what point do you stop waiting
for them to change?
Hi, I'm Dr.
Mark, and this is The Caregiver's
Podcast.
Today I'm joined by author Fern
Schumer Chapman for one of the
most honest conversations we've
had about siblings,
caregiving, resentment,
responsibility, and how to find
peace when your brothers and
sisters never become the people
you hoped they would.
If you're the sibling who's
carrying most of the caregiving
while your brother or sister isn't
doing their fair share,
you don't want to miss this
episode.
Fern Schumer Chapman, welcome to
The Caregiver's Podcast.
We have an exciting conversation
today in store.
Fern, I always like just jumping
right into things, so here we go.
You know, most people imagine that
when a parent suddenly needs care,
brothers and sisters will
naturally pull together.
And sometimes they do.
But many families always or often
experience the opposite.
And so can you tell us, what is it
about caring for an aging parent
that brings some brothers and
sisters together while in other
circumstances it just pulls them
apart?
Well, let me start by saying this
particular stage is the most
perilous for siblings.
A lot is required of them.
And if they don't have a strong
foundation, they're going to
struggle.
And I sort of think of this
particular stage as like a
sausage.
So, you know, if you're going to
get into this stage and you have
good meat and you grind it through
there,
you're going to come out on the
other end with a good sausage.
But if you don't have that good
meat to start with, the strong
foundation, you're going to run
into trouble.
And most of these relationships,
sibling relationships, when they
are confronted with these
challenges,
simply cannot manage because they
don't have a strong enough
connection.
They've never been able to
negotiate differences and they
struggle.
But what about individuals who may
have had differences and struggles
early on,
but perhaps living apart and being
a bit more independent were able
to function at a reasonable
collegial level, if you will.
But then something goes awry.
Are they still vulnerable in those
cases with parental decline and
ill health to actually almost
overcompensate in their
dysfunction?
Is there something about the
experience about the parent
becoming unwell and the caregiving
role emerging?
I think there is.
I think these children are thrown
back into their childhood
experiences and histories and
they're competing for attention.
And this is going to be the last
statement of love and loyalty.
And so they are vying once again,
like children, for their parents'
approval or attention.
Or they may completely step away
and say, I don't want any part of
this.
So we all know that when you
return home, even when your
parents are well,
there's a tendency to regress and
lapse back into old roles.
And that's certainly the case when
the stress levels are high.
People often assume that the
sibling doing the most caregiving
must have loved the parent the
most.
I mean, do you think caregiving in
itself reveals who loved the
parent the most?
Or is it simply who felt the most
responsibility for their parents
over the course of their lifetime?
I don't think it's truly a
statement of love.
I think it's a matter of roles in
the family.
So, for example, somebody who was
parentified may feel a greater
responsibility to take care of mom
in her last days.
But I don't think that's a
reflection of how much that person
loved.
It may be simply their role in the
family and what they were expected
to do for everyone else.
And what about the caregiver's
love for the parent?
Do you think there's any
relationship between how
aggressively they caregiving and
how much they love their parents
over the years?
I mean, I haven't read the
research on this, but from my
experiences of talking to
caregivers and siblings,
I would say that this is not
necessarily a statement of who
loves the parent the most.
I think it's more likely, like I
said, roles or a sense of
responsibility, or simply nobody
else is stepping up, so I'm going
to.
It is daunting when you hear
crickets in the room and then
there's one person who feels that
pull.
You mentioned parentification.
Is there any evidence that
parentification of one sibling
actually contributes to
estrangement?
Contributes in what way?
Well, there's something about the
relationship between that sibling
who gets parentified and their
parents
such that it builds an extra-wide
chasm in perhaps what was already
a challenged relationship with
their sibling.
Parentification is a very
complicated topic.
It is.
And children who are parentified
often feel a lot of responsibility
and a lot of resentment
because they are inappropriately
burdened with the role of
mothering their own mother.
And I think somebody who's
parentified is probably inclined
to continue to care for that
parent in the last stages of life.
And also resented.
It's complicated.
Do you think it sets the stage for
the siblings who might have
otherwise been willing to make an
effort to join in
with the effort to sort of just
stay away because they just don't
want to get enmeshed?
Yeah.
I think we all differentiate
ourselves and families.
And so there may be one who's
parentified and there's the other
one who has distanced himself or
herself.
And they ultimately decide, hey,
she'll take care of it.
I don't have to do any of it.
She's been doing it her whole
life.
So I'm out of here.
And then as a result, we hear so
many comments and that's simply,
I'm doing this alone.
Why does one sibling so often then
become the one holding everything
together when the parent needs
care while another or others step
away?
I mean, it's not solely
parentification, though.
No, but it is what I was talking
about earlier, which is this idea
of roles in the family and who was
maybe a scapegoat and who was the
responsible one.
And those roles play out
throughout life.
And when there's stress, like in
the last stage of a parent's life,
you're going to see the intensity
of those roles and the lapsing
back into those roles.
You know, I think, too, if the
relationship is frayed and you hit
this last stage of your parent's
life, you've already not had a
strong relationship.
And then you have all these added
stressors.
So it's not going to go well.
It's just too difficult of a
stage.
And that's what I think a lot of
caregivers are hitting.
And the resentments come not just
from this moment in time, but the
fact that the sibling was never
there, that the sibling may have
distanced himself or herself
decades ago.
And this is just more of the same.
And then there's that pile up of
lonely caregiving, which amasses a
huge burden.
And I think it's very erosive.
Not to say that, you know, love
and other factors couldn't be
guiding principles and looking
after our loved ones.
And we have lots of comments and
lots of feelings expressed on our
social media pages that, you know,
love and a certain degree of
spirituality will get many
caregivers through some of these
challenging times.
But those are probably among the
tools, but not the sole tools that
you can rely on when you're facing
such adversity.
Yeah, my heart goes out to those
who are feeling that they are
navigating this stage alone as a
caregiver.
It breeds so much resentment.
And, you know, I speak from some
experience.
And I, in my book, Brothers,
Sisters, Strangers, I talk about
being a committee of one.
In other words, I was the only, I
was not an only child.
But because my sibling had left
the family and distanced himself,
I was alone in the decision making
and the care.
And it is an overwhelming
responsibility.
On the other hand, other people
have said to me, particularly one
woman I interviewed who has four
siblings, she said, I would have
given anything to be a committee
of one because I had to negotiate
with four others and we couldn't
agree.
It's interesting because that
really, it really sort of creates
two sort of camps.
There's the management camp and
then there's on the ground
caregiving where, you know, you
can be overseeing the details, but
then there's the everyday nuts and
bolts of caregiving for an
individual in need.
And that changes or is very
different from the ability to
oversee the management decisions,
which are probably easier for
sometimes made by someone thinking
solo and who's got the competence
to make those decisions as opposed
to awaiting all the different
inputs from different family
members.
Yeah.
Well, and also some of the
caregivers start to feel like the
CEO's staff.
Yeah.
Somebody gets to make the
decisions and somebody else gets
to execute them.
And it's a very, it's a power,
it's a power imbalance.
Mm-hmm.
Well, some, you know, one of the
things caregivers describe is that
almost overnight in the face of a
family health crisis, they stop
feeling like capable adults and
start feeling like they're 12
years old over all over again.
The old family rules just suddenly
start rushing back.
Why does caring for an aging
parent make so many adult children
feel like they're little children
again?
I think it speaks to what I was
saying earlier about, number one,
regressing anyway when you're
around your family.
But then the stress levels are so
much higher at this stage and they
start vying for position and love
and loyalty once again.
And it's a toxic mix.
I mean, do you think it's the call
to caregiving or the caregiving
circumstance that changes people
or is it just returning them to
the way they've always been inside
their family?
Caregiving is a tremendous
responsibility.
And even in the best of
circumstances, creates a lot of
confusing feelings of love and
resentment.
So, I think it's probably a bit of
both.
Not to mention what Angela
Caldwell was recently talking with
us about is that it also forces us
to contend with our own mortality.
Oh, that's another really
important point.
You know, as long as the parents
are alive, we feel like the
natural order of things is that
they will go first.
But once all the parents are
going, you're next in line.
And that's a very frightening
prospect, particularly for those
who struggle with aging.
One of the biggest complaints
we've been hearing from caregivers
recently is that I've been doing
this day-to-day caregiving for
months, sometimes years and years
on end.
And then my sibling suddenly wants
an equal say in every medical
decision, every financial
decision, every conversation about
what's best for mom or dad.
Why does that happen so often?
I mean, it's almost patterned.
Why does the sibling who did the
least still expect an equal voice
among the biggest decisions that
have to be made?
That's such an interesting
question.
And I actually had some of it in
my own experience as well.
I think it's a competition and a
power play.
I think, too, that at the parents'
end-of-life stage, it really does
bring out the worst in all of us.
And there's a lot of projecting of
image.
So, I'm going to be the one who
makes these important decisions.
I'm going to be the last person in
the room to say goodbye to mom.
It's that it's kind of like
they're going to get the golden
goblet in this competition.
Almost looking for perhaps that
last acknowledgement from mom or
dad before they pass, right?
Perhaps a validation in part one
they never heard, but boy, now's
the time that I'm going to hear
it.
I just wrote a piece for
psychologytoday.com about King
Charles and his illness and how,
for the estranged, a terminal
illness is a cruel deadline.
Because suddenly, you have to come
face to face with, what are you
going to do?
Are you going to join the family?
Are you going to say that last
goodbye?
And you can see in the case of the
king, Harry did show up with the
grandchildren to try to at least
let the king see his children
before he's gone.
But there's a deadline in all
this, and I think that magnifies
some of these intense emotions.
Well, I think, I mean, it really
sets a time clock.
And you've got this relational
strain that's been there for a
long time that somehow needs to be
erased
so people can operationalize some
sort of family dynamic in the new
role of caregiving and or caring
for over time or perhaps in the
limited time that's left.
I think there's another piece of
it, Dr.
Merck, and that is that you're
trying to alleviate your own
guilt.
That my parent is going to pass,
and I'm going to have to live on.
And I would like to be free of
those feelings that I didn't do
enough.
But they were conscious choices to
make at a time.
It's amazing how empowered we feel
to make those choices at some
point and then faced by the
certainty of decline
and the need to look after the
ailing and witnessing our parents
decline that we don't feel so
empowered anymore
in those original decisions and
hence the fuel for the guilt and
perhaps sort of the remorse as the
end approaches.
Yeah, you know, and there's
another complicating factor, which
we haven't touched upon yet,
but typically the parents are the
glue in the family.
And when the last parent passes,
the choices to sustain relations
is left to the children and their
own choice.
So, you know, there aren't going
to be the holiday parties anymore
where you don't have to make an
effort.
You just show up.
Now you're going to have to make
an effort.
Do you think we're witnessing
this, especially with the aging of
the baby boomers?
Because, I mean, perhaps in some
generations, parents are stronger
glue than others.
Oh, that's a very long, involved
answer.
Yes, to answer your question in a
short, in a word.
The family is changing
drastically.
It is.
And transforming.
And you can see this in
parent-child estrangement,
parental alienation, this whole
idea that children feel no
obligation to sustain relations
with a parent if they don't feel
they're being treated right.
So there's a loosening of ties
anyway.
And then, of course, as the last
parent passes, the ties are
completely lost.
It would be interesting to see
over the decades to come how this
dynamic changes.
And I think we touched on it when
Joshua Coleman was on the show and
talked about sort of evolving
toxicity of individualism and how
that could certainly be some fuel
for estrangement.
But certainly also fuel for this
sort of schism between sibling
caregivers as they now need to
return to try and provide some
sort of care for their ailing
parent or their declining parent.
Well, you know, there's been a lot
of attention to the parent-child
relationship and the strains on
those connections.
But far less attention to
siblings.
And siblings are a very important
aspect of the family.
And although largely
under-researched, but nonetheless,
these are relationships with your
first playmate.
And they teach you about love and
loyalty and connection because you
play with them as children.
They are the longest relationships
of a lifetime.
Some lasting 80 years.
Much longer, obviously, than your
relationship with your parent.
And so, and they go through a lot.
And by the way, you know, we
started to talk about perilous
moments in sibling relationships.
And let me give you a couple of
other ideas of when, whenever the
relationship changes, when the
roles change, there is a
renegotiation of that connection.
So, when a sibling goes off to
college, when a sibling chooses to
marry somebody, that's a very
perilous moment.
Because if this person doesn't
want to integrate into the family,
you may lose a sibling.
If they get divorced or if they
get divorced or have financial
problems.
These are all moments that put a
lot of stress on this
relationship.
And then, of course, ultimately,
as we talked about, the end of
life.
There are also risk factors for
estrangement.
Which, when I started doing work
in this area, I had no idea that
so many risk factors can predict
the problems.
So, what are some of the risk
factors?
Well, you can have family trauma.
You can have parental favoritism,
which is some of what we're
talking about here.
You know, that can play into...
That's the stage, yep.
Who's the caregiver or who
doesn't.
Poor communication skills.
Once again, we talked about that a
little bit.
But if you don't know how to
communicate with your sibling, if
it wasn't modeled in the family,
you're not going to be able to
sort through, how do we care for
our parent together?
Another big one is family values,
judgments, and choices.
So, what that's about is when
there are different lifestyles,
different sexual orientations,
different religious choices, that
puts a strain on sibling
relationships.
And often, the person who's
different will be cast out.
Political differences is another
big one.
When there are addictions or
mental health issues, you're going
to have these problems.
Particularly, and we could talk
for a whole hour about when there
are people with some narcissistic
personality styles in the family,
you will run the risk of
estrangement.
And then, of course, anytime
there's money, you're going to
have some of those problems as
well.
Anyway, that's a quick run-through
of some of the risk factors.
But up until recently, those
things were never even identified.
Sounds like we need to hire an
actuary to calculate all those
risks and come up with some
formula that gives us some
perspective of how we can navigate
that route.
It's very challenging because it's
a little like people who reenact
bad relationships in marriage.
This is what you think was home.
This is how you were raised.
And so, it takes a lot of
self-awareness and mindfulness to
actually change the ways in which
you're relating to that sibling.
Many caregivers aren't only
grieving the parents' decline
they're witnessing, they're also
grieving the family.
They may have thought this current
crisis might help reemerge,
perhaps in a healthier state.
Why do so many caregivers end up
grieving not just the loss of a
parent, but the family they hoped
could show up in the time of need?
Because this moment provides stark
relief on how the family operates.
Explain that a little bit more.
Okay.
Because of the level of stress in
all this, you see clearly what
your siblings are willing to do
and what they're not willing to
do.
And you see their actions rather
than their words.
And so, suddenly, you may have
been living in hope and delusion
for years, or hope and fantasy,
but now that you're at this stage,
you can't pretend anymore.
It's in front of you in black and
white.
And that's why there's so much
resentment, because it's like you
said, it's not just grieving the
parent, it's also grieving the
fact that you thought you had love
and support from siblings, and
they are unavailable to you.
And the human toll of having, if
it's been during a long declining
illness, of having a caregiver for
so many years, at such a human
cost to yourself, despite whatever
degree of love you have towards
your parent, it is exhausting,
it's depersonifying, it's all kind
of things.
Resentment becomes a little bit
more expected in that
circumstance, and it's nothing to
do with resentment for the job or
having to give love, but just for
having endured things for so, so
long.
Yeah, I think there's a lot of
grief for the caregiver.
There may be the ambiguous grief
if a parent has Alzheimer's or
some sort of dementia, and they
are disappearing before your eyes,
and you yearn for the person they
once were, but will no longer have
them.
So there's that.
Then there's the complicated grief
of finally seeing somebody for who
they really are and what they can
give you.
It's not just disappointing.
It's overwhelming, and just, it's
altering.
It alters how you view your
siblings and how you feel in terms
of your place in the family.
Because their actions are
dismissive, and you feel that they
can say they love you and they
support you.
But those words are not matched by
actions.
It's how do we get them to act?
How do we, how do we look at the
situation, accepting this
difficult part that we're
witnessing, that our brothers and
sisters haven't really changed at
all, and they're treating me
exactly the way they did 30 years
ago.
So, even though we may have been
somewhat cordially engaged from a
distance, you know,
pseudo-estrangement, whatever you
want to call it, why do those
childhood roles come back so
quickly in the face of need, you
know, the parents' need for care?
Well, I think a lot of it is what
we were talking about with stress.
Hmm, yeah, good point.
We probably use, rather lose some
executive function when all of
that tension and stress and
adrenaline is, doesn't make for
easy re-engagement with siblings
who've lived or marched to the
beat of a different drum with
different approaches and attitudes
and some unresolved issues between
siblings.
You know, you asked me, you asked
me, how can you cope with this?
This is like any other
estrangement with siblings, and
there are several ways to go.
You can accept them for who they
are and somehow alter your
expectations, which is pretty
tough to do.
Maybe they contribute a little
bit.
Maybe they're managing the books,
and you can somehow justify that
and say, hey, at least I don't
have to do that.
So what I'm saying is lowering
expectations and creating a
limited connection may be enough,
and there are reasons to do this
which are not small, and that's
because you have nieces, possibly
nephews, other extended family
members, and if you pull away,
there's a lot of collateral
damage.
So you have to ask yourself, is
this really worth shutting down
the whole relationship?
Is it possible to dial down the
relationship in terms of intimacy
and expectations and sustain it so
that your children can have
cousins?
And you're, you can be an aunt or
uncle.
So, again, this is the same thing
that we discuss in general
estrangement.
You don't have to have a complete
shutdown of the relationship.
Now, having said that, if these
relationships are toxic,
insulting, bullying, forget it.
Some relationships are simply too
toxic to sustain.
If you are chronically being
injured in a relationship, you
have to protect yourself first.
Those are some pretty wise words,
and I think, you know, when we're
imbued with hope for change and
memories, perhaps, of a better
time, that sort of perpetuation of
the injury can be self-inflicted.
Not for a bad reason, but just
sometimes hope can carry a very,
very large degree of power in our
decision-making.
I think that's a good point, and
also we need to remember that the
sibling we perceived as children
is not the same person we're
looking at now.
That could be heartbreaking, isn't
it?
I mean, you could have been
incredibly close with amazing
memories, and then you just see
people spread completely different
ways.
Right, and that gets back to this
idea of ambiguous loss.
The person you loved as a child,
who you laughed with constantly,
has become this buttoned-up,
quiet, withdrawn adult, possibly.
And you miss the old person.
It's hard.
And again, because these
relationships are so long, you've
had a front-row seat to who they
were and who they are now.
You know, the sibling who actually
isn't helping with the caregiving
usually doesn't think they're the
villain in this story.
So, what do you think the story is
that they're telling themselves
that allows them to believe that
they're still being a good son or
daughter or good brother or
sister?
Well, there's probably a lot of
denial in them and a lot of
avoidance, and they justify that.
So, like I said earlier, maybe
they say, well, you know, I pay
all of mom's bills.
You know, my sister's taking care
of mom, but I pay all the bills,
so I do my part.
The measuring is off, is what I'm
saying.
Well, and you kind of wonder what
lens that individual might be
looking at their caregiving
sibling through,
because they're not looking at
what's coming more and more to
realization is indirect costs of
lost productivity,
extra expenses out of pocket, lost
retirement savings,
unpaid time left having leave from
work because of the need to care
give.
There's lots of ramifications to
all of that, and I think
caregivers carry a lot of that on
their shoulders,
whilst the comfort of saying,
well, I pay the bills, you know,
or I pay this,
it's just a bit too comfortable in
the face of what the caregiver
burdens.
What are your thoughts about that?
Well, while you were talking, I
was thinking about how, really,
this is a moment where people are
distilled to their core.
So, you see them in ways you may
have never seen them before.
And that's why it's so difficult.
Because, like I said earlier, you
kind of hope that there's
something else than what you're
saying,
and now you can't look away from
it.
And it's a very devastating and
disappointing moment.
And we need, you know, all of us
to have that basic human need to
belong.
And if you cannot find your place
in a family constellation,
there's a feeling of being bereft.
One sibling may remember a loving
parent, whilst another sibling
remembers neglect or abuse.
Are they actually trying to care
for the same parent or are they
each aligned with completely
different versions of that parent?
And is there any way to bring it
together?
So, Dr.
Gabor Mate has made this wonderful
statement, which is, each child is
born into a different family.
They experience a different
family.
So, what does he mean?
He means that, number one, one
gender versus the other is going
to be treated differently.
A family may, for an older child,
have no money.
And for a younger child, they have
much more money and be able to
spend money more freely on the
child.
And so, you have to recognize that
the circumstances for each child
is different.
And then there's just personality
differences.
And sometimes one parent will feel
more connected to one child versus
another.
So, all of this is coming to play
at the moment when the parent is
in the last stage of life.
Do you think that we're making
some inroads when you think of
that dynamic and you think back to
post-World War II?
And, you know, I think back to
Terry Reel's work where, of
course, sons learned how to keep
their emotions contained and show
toughness
and show none of those elements
that can actually be helpful in
building relationships in their
futures.
But that was reminiscent of an
era.
Now, I think parents in general
are a lot more aware of
communication and even siblings
are more aware of, you know,
cognitive errors, wellness,
mindfulness.
You know, there's a gamish of
awareness about all of these
things.
Do you think maybe that the next
generation coached right might
actually be able to escape some of
those familial challenges that
were present 50, 60 years ago and
have sort of dragged on?
But like, is there a chance for a
re-emergence of a new family
dynamic if we're actually willing
to task some of the stuff we tout
that we're learning about?
I mean, everybody's learning about
mindfulness and, you know, being
considerate and, you know,
everybody's, a lot of people are
reading the Stoics.
A lot of people are reading this.
I mean, there's, there's, we are
more collectively aware, but
that's nice to talk about at
parties.
But are we able to actually, as a
next generation of families, to
put that to task in a meaningful
way that'll translate into
measurable, measurable differences
or improvements so that the next
generation of researchers like
yourself are actually going to be
able to say, hey, we, we can
measure change here.
This is translating into benefits.
Do you have any hope for that?
Well, I think we're talking
generally here.
Well, of course.
And that's the issue is that the
pinpoint toxicity can throw this
all out the window.
I get it.
Yeah.
To answer your question, though,
yes, I think there's an evolution,
but there's also a transformation
in the family at the same time.
So, you've got two forces that are
probably acting against each
other, and I think that's going to
make it difficult.
I think men, in particular, are
becoming much more involved in
some groups, in some cultural
groups in the family.
But it's individual, and, you
know, the number of people who are
actually marrying is declining.
So, you know, the nuclear family
is in transformation.
So, you're going to see a lot of
changes.
It is, it's very different.
It's fascinating you raise this,
because when I did do my survey
for the book, Brothers to
Strangers, a lot of women who were
born in the 50s and 60s talked
about the gender roles and how
this created a lot of issues,
particularly between sisters and
brothers.
Because the brothers were the
princes, and the girls, the
sisters, were the servants.
Those were never negotiated roles,
right?
Right.
I mean, it was just the tradition
in the family at the time.
Now, things are slowly changing,
which I'm thankful for, but you
can only imagine when the prince
and the servant run into each
other at mom's last stage of life,
how that's going to go.
Yeah, there's no...
There's no equality in it.
The servant's going to serve, and
the prince is going to be, like I
said, the CEO.
One of the hardest questions
caregivers ask is this, why
doesn't this matter to my brothers
or sisters, the way it matters to
me?
How do you help someone make peace
with the fact that their siblings
may just never show up the way
they hoped they would?
Is it a cognitive sort of
reframing, or is it just an
acknowledgement of they did their
best with what tools they had to
be able to contribute?
They are acting within the
confines of their schema, and I
need to let that go so as a
caregiver I don't drown in yet
next-level distress.
Yeah, it's a really interesting
question.
I think it's...
It's careful, though.
You have to be careful about the
narrative that you create based on
connecting your dots.
And what are those dots, really?
Are they from your history?
Are they from what's happening
right now?
And is your conclusion accurate?
And yeah, I think that to some
extent we have to accept what
people, brothers, sisters, are
willing to do at this moment in
time.
And, you know, if there's money
there, I would encourage your
listeners and viewers to try to
hire out as much as you possibly
can so you can get some relief.
It gets trickier if there's no
money, because then it's going to
fall intensely on one person.
I think you can try to be direct
and ask.
In other words, stating your needs
with I statements.
I feel like I'm carrying the
burden here, and is there any way
you could give me Tuesdays and
Thursdays off?
People are reluctant to be direct.
And it's fascinating to me,
because when you have a civilized
conversation about a difficult
topic, these are actually the
moments that you can create
intimacy and growth.
But people avoid those
conversations, and then they deny
themselves that chance to connect.
You know, so if you ask your
brother or sister, what about
those Tuesdays and Thursdays?
And they say, no can do, you know,
this is a moment where you can
say, well, can I ask you, you
know, what can you do?
How can you help me out on this?
Because I'm overwhelmed.
Do you ever hear from siblings
that they had no idea that they
needed my help?
And if they only would have asked,
I would have shown up.
Oh, yeah.
So, I sometimes work with siblings
who have an estrangement, and I'm
the person who's mediating this
experience, and I actually just
worked with two sisters.
And the two of them had completely
different perceptions, and they
were both angry, about what had
occurred in their relationship.
And the more we dug down and kind
of drilled down to figure out what
was going on, the parent was
actually playing one child off the
other.
And because they weren't talking
to each other, they were believing
that mother.
So, what I'm saying to you is, you
know, there's a great saying in
journalism that, you know, if your
mother says she loves you, check
it out.
Well, you know, it's the same
thing.
You know, if you're taking
information from a third party,
you better check it out.
It's amazing how communication in
those contexts can just be so
empowering if you take the leap.
Something you alluded to earlier,
which I think is really important
for caregivers listening to
understand, is that we all carry
that inner critic.
And more and more as I've thought
about things, I think the inner
critic and a caregiver can be very
strong-willed.
I actually call it the inner
caregiver critic.
But we don't want the challenges
of the estranged sibling
relationship to sort of provide
yet another wave to fuel that
inner caregiver critic.
And we just need to, as you said,
cognitively maybe leave some of
those elements aside and just not
take them in and make them part of
us and part of our thinking
pattern.
Just sort of distance ourselves
from them.
You know, I think it's very
complicated because you're hearing
your parent who is possibly
saying, you know, you never do
enough.
And it's magnified and caregiving.
I'm not doing enough.
Because you're caring for the
person who actually planted that
original core belief in your
brain.
So, that makes it very complicated
as well.
It's amazing how, yes, you can
definitely be played and molded
and sculpted.
I still remember hearing a story,
someone saying they hadn't called
their aging mom in three days.
And the first thing they heard on
the other end of the line was, oh,
I didn't know I had a son.
Yes, those comments.
You're a stranger, you know, that
theme.
And the parental guilt plays
loudly in the mind and ears of a
caregiver.
A lot of that being culturally
informed too.
Mm-hmm.
You know, he's, yeah.
So, Fern, I'd like to change gears
a little bit and speak about ideas
of reconciliation and cooperation.
I think many caregivers keep
hoping that crises with ailing
parents will finally bring the
family back together.
Do you think that hope is actually
helping them?
Or do you think it can actually
sometimes keep them stuck?
Well, I think it can keep them
stuck because you're bringing a
lot of expectation to a very
stressful stage in the family's
life.
So, I think you have to be careful
with what you're going to burden
the family with at that moment.
But it might just be our last
chance, Fern.
Well, maybe it's not the last
chance.
You know, estrangements occur in
families.
And sometimes there are pauses.
People need a little space.
They need to breathe.
They need to reflect on what the
relationship is giving them.
And so, instead of looking at it
as a complete collapse, it might
be better to simply step away and
regroup at a later date.
That could actually be a really
healthy exercise if you can simply
accept that each sibling will
contribute what they can towards
the process.
If death is imminent, that's one
scenario.
Perhaps if caregiving is more
longitudinal, it could be a little
bit more challenging when
caregiver exhaustion and burnout
and poor sleep and undernutrition.
And poor exercise are factored
into the equation.
But I really like that idea of
regrouping, letting some of the
stress hormones come down and
maybe just reinitiating a
conversation,
especially if it's come to the
point where the family's together
and the parent is failing and
death is imminent.
There may be actually a more
holistic, if you will, medium to
re-engage in conversation once the
family gets through the most
difficult times, which are very
hard to negotiate.
Those crises come and they kind of
have their own momentum and their
own endpoint, which in many
instances is death.
Adjacent to that idea is the
concept that rather than judging,
to be curious.
So ask questions rather than
concluding.
One of the problems all of us have
is we react before we process.
And so if you can dial down the
intensity of the experience,
request time to think, and then
later come back with curiosity and
questions, I think you'll have a
more successful outcome.
Curiosity and questions to your
siblings?
Right.
Another I statement, like, you
know, I've been thinking about
this.
I'd really like to understand your
perspective because this is how it
affects me.
Right.
But I don't want to judge you
until I understand where you're
coming from.
Well, and I would even avoid the
word judge.
I would say I want to understand
what was happening in your life
that limited your ability to be
more available to mom and me.
You know, when you've never been
asked that question, you've never
given, you've never had a chance
to answer it.
But I'm sure there have been
instances and therapists around
the world will have stories of
open exchange and cathartic
moments of feeling safe in a
moment.
I think it's important to
acknowledge somebody else's
experience.
And we have a tendency to simply
say, well, he wasn't here there
for me without thinking about the
fact that he was dealing with his
drug addicted son or something
that was another crisis in his
life.
And if we simply draw conclusions
without that compassion, we will
shut down the relationship.
So what I'm hearing is that if
we're staring estrangement in the
eye and we're just craving a
change and there's hope in there,
we still need to rely on the same
principles that we might teach our
kids or we might teach our
employees or we might learn about
if we're a manager.
So that the same communication
skills need to be applied and the
same tact with which to address
the engagement so that everybody
understands each other.
The same empathy and compassion
should be employed.
One would think that would come
naturally more easily in a family,
but food for thought.
Well, I think we need to remember
that this stage is hot.
It is dangerous.
And whatever happens is going to
intensify quickly.
So the goal is to give yourself
pause and space so that you don't
add fuel.
Absolutely.
I mean, I think I know the answer
to this question already, but I'm
going to ask it anyway.
But do siblings actually have to
repair the relationship before
they can care well for a parent
together?
Well, it would help, but...
If it'd be nice, but...
See, you can answer it for me.
Yeah, it would be nice, but no.
And actually, one of the things I
do sometimes is work with siblings
who simply want ground rules.
So, we create almost guardrails
for what they can talk about, what
they can't talk about, and
especially if they're dealing with
this last stage of life.
It sort of allows them or gives
them a strategy to operationalize
the relationship in caregiving as
opposed to it just being
emotionally boundary bound and
almost paralyzed.
Right.
So, I think you don't need
necessarily a mediator, but maybe
through email you could go back
and forth and say, you know, these
are my needs.
This is where I'm comfortable.
I really am not comfortable about
talking about that incident that
happened 20 years ago.
Whatever the terms are.
But I think that that's quite
helpful so that, again, what you
want to do is communicate well
enough so that you can, A, take
care of a parent, and, B, avoid
hostility.
But I wanted to say something
related to what we're talking
about.
Sometimes these relationships
cannot be repaired, and there's
little you can do about it.
People believe that the opposite
of estrangement is reconciliation.
In fact, the opposite of
estrangement is peace.
I think that is one of the most
resonant things that I've heard in
a long time.
Well, thank you.
I'm not the originator, but the
concept, I think, is an important
one and doesn't get enough
attention.
Trust is such a big factor in
sibling relationships and may be
particularly challenging in the
setting of estrangement.
But can siblings who don't trust
each other still become good or
decent caregiving partners?
Or is that sort of the straw that
breaks the camel's back?
I mean, I think in any
relationship, if you don't have
trust, it's kind of bankrupt.
But, again, that's why I like that
idea of guardrails.
I need to be able to depend on you
taking care of mom on Tuesdays and
Thursdays.
I need you to stay until I arrive.
You know, that kind of thing.
Very specific.
And just like striking up that
conversation or asking, not
expressing the guardrails keeps
you in the same place.
Or not expressing your needs so
you can set up the guardrails sort
of keeps you in that same
hyper-functioning, burnt-out space
without any opportunities for a
little bit of respite or a little
bit of reunion with yourself.
You know, it's interesting because
some caregivers want the support,
but they don't want the support.
They want to hold that place where
I am my mother's caregiver.
And they want to complain about
the fact that nobody is helping.
So there's some satisfaction in
that kind of thinking.
And I think you have to be very
careful about that because you
have to figure out, what do you
really want?
There's probably some
psychopathology fueling that
stance as well, if it's so deeply
entrenched.
Yeah.
Do you think families really need
caregiving responsibilities to be
equal, or do they simply need
everyone to feel that the
arrangement's at least fair?
I think even more than fair, it
needs to be broadly understood,
broadly outlined.
So in other words, everyone can
agree that this is how the
caregiving is going to go.
Because once the expectations are
in place, there's less risk of
disappointment and failure.
I think in that negotiation,
getting some corroborative
evidence or confirmation from each
individual is that, yes, I believe
I can do that.
Or this is what I am capable of
doing and offering.
And it aligns with our group
discussion.
Yeah.
I think there isn't enough
discussion of this stuff, of
exactly who's going to do what,
and whether you're comfortable
with who's going to do what.
And a lot of times that happens
because, obviously, when
somebody's that ill, things happen
quickly.
And nobody has time to think about
how we're going to handle all of
this.
And then we relapse into our old
roles where, you know, I'll take
care of that, and I'll take care
of everything else, too.
A follower left a comment recently
about how they've been trying all
of these initiatives with their
two brothers.
And she said they just, she's just
up against a wall and roadblocks
and just no interest.
Is there a point where, despite
the attempts, at one point you
just need to say, well, this isn't
going to happen.
I need to find community outside
of my family.
Yeah, I mean, when somebody shows
you who they are, my Angelo always
said, believe them the first time.
You know, they're not going to
change.
And I think the key is to say,
okay, I see that you're not going
to be able to help me as a
caregiver.
What can you do?
You know, can you contribute so
that we can hire somebody twice a
week?
You know, there are lots of ways
to negotiate this stuff.
I think you have to be somewhat
creative to try to figure out what
everybody can or cannot do.
Maybe somebody has a little more
money and they're willing to pay
for the extra help.
They don't want to do the work,
but they have the money.
Okay, that's something.
I've heard of some interesting
creative ideas where an individual
is committed to caregiving,
retired early,
and had some compensation
eventually written into the estate
arrangements for the time they
spent caregiving and not employed.
But it all worked out with
conversations and with
arrangements.
And, you know, those kind of
things are possible.
Of course, we can't say these
things without acknowledging that
there are certain groups
who just won't be able to
communicate amongst themselves and
a family.
And it might very well just be
futile.
And while we don't like to think
about that or wish it on anyone,
sometimes those scenarios are
pretty challenging.
Yeah, and I think speaking of
being creative, if there's any
money in the estate,
maybe there can be some sort of
contract that the caregiver will
be compensated at the end of life.
And, you know, we are starting to
see some inklings of change in our
society that might be aligning
with some of this thinking.
There are big changes going on in
the United Kingdom right now,
looking at major reforms as it
pertains to caregiving and the
impact on caregiving on
households.
And, you know, I think there's
still hope and, you know,
different states in the U.S.
are looking at different tax
credits and other types of, you
know, tools that can relieve.
I think that, you know, through
the work of the AARP and
elsewhere, like, the amount of
indirect costs being absorbed by
family caregivers are in the
billions and billions.
And something needs to give at
some point, right?
Yeah, and I was going to mention
as well that there are elder
mediators.
So that if this all seems too
daunting to you and your siblings,
you might sit down and work this
through with an elder mediator who
can create a contract.
I wasn't aware of that.
That's actually, that sounds like
a valuable tool.
You know, so many caregivers
probably spend years hoping that
someone will finally say,
I see what you've been carrying
all along.
But what happens if that
acknowledgement truly never comes?
I don't think you can look outside
yourself for it.
I think you have to feel that you
lived according to your own
values.
So many caregivers spend years,
you know, chasing the same hope
that
brothers and sisters will finally
step up and share the
responsibility for caring.
I think much in follow-up to that
statement you made,
at what point does protecting your
own peace become more important
than holding on to that hope?
I think it's always important to
protect your own peace first.
And that may sound really
self-centered, but I don't think
your sibling is going to protect
your peace.
I think they're going to protect
their peace.
So, again, this plays into what we
were talking about earlier,
the importance of recognizing who
they are and being honest with
yourself about who they are.
And then finding your way in this
morass.
You know, it's just yet another
version of self-care,
although self-care, some people
say, is a very overused term these
days.
But in this moment, it's certainly
not selfish.
No, I mean, you see this trend
with young mothers as well now.
You know, when I was raising
children,
taking time and space for yourself
was considered selfish.
But now, young mothers recognize
that to be the best mother they
can be,
they have to take care of
themselves.
And I think the same is true for
caregivers.
You will not be a loving,
successful caregiver if you feel
completely burdened by the role.
I'd like to end today with the
caregiver who's listening
and who feels like they're
carrying this almost entirely
alone.
If you could sit across that
person right now,
what would you want them to know
before they have to wake up
tomorrow morning and just do it
all again?
Well, it doesn't seem like it, but
it doesn't go on forever.
There are support groups that can
help you feel less alone.
There are surrogate kin who can
give you what you're not getting
from siblings.
And so it's up to you to find a
sense of belonging and value in
what you're doing
and how you're directing yourself
every day.
That does not in any way minimize
the demands of the role.
But I think, getting back to what
we were talking about a minute
ago,
it's important to take care of
yourself.
And to the individual who says,
I keep trying and trying and I
just can't do it,
what are they missing?
Or what is the next step or the
next encouragement
or the next tool that may be
something they haven't thought of
trying
or just a perspective they may
not?
Where can they release more energy
to try harder?
What can they let go of to give
them the strength
to keep trying and maybe find that
right fit
where suddenly their ability to
let certain things go
and build community, build
connection,
re-emerge as the person who's
become invisible?
What do you think, from your broad
experience?
Well, I actually have a high
school friend who wrote,
her name is Iris Snyder,
and she wrote a caregiver's
handbook.
And I think there are a lot of
books out there
that can, in the privacy of your
own home,
help you to find creative ways to
cope.
And if I were in that situation
now,
I would look into some of those
opportunities,
some of the support groups that
are on Zoom.
I realize time is precious,
but nonetheless, again, you have
to take care of yourself.
And there may be things you get
from these groups
that you have not thought about,
ways to relieve yourself
so that you're not so burdened.
So what I'm hearing is
never give up on outreach,
never give up on creativity,
never stop being curious as a
caregiver
at what may still be out there
that's a good fit for you
on your journey
that can bring you a better sense
of balance
with yourself.
And the one thing I would add
is something that gets lost in
this frequently,
and that is compassion
for why somebody may not be
contributing.
You may be drawing conclusions
that are untrue,
and it's always important to ask.
Giving and offering that
compassion to your sibling
and then perhaps
to yourself,
some self-compassion
and saying,
well, at least I tried
and I employed a strategy
and gave it my best shot,
but maybe it just won't be any
more than this.
Yeah, I think we have to
forgive ourselves
and recognize
we do the absolute best we can,
and it will have to be enough.
It will be enough.
You, the caregiver,
are enough.
That wraps up today's episode
of The Caregiver's Podcast.
I'd like to thank
Fern Schumer Chapman
for joining us today
and bringing her wealth of
experience
to a very important area,
and we'll see you again next week.
Thanks for the opportunity, Dr.
Mark.
If you're listening today,
you're the sibling
who's been carrying
most of the responsibility.
I hope this conversation
reminded you
that you're not alone.
While we can't change
our brothers or sisters,
we can change how we respond,
what we expect,
and how we protect
our own inner peace.
Thank you to Fern Schumer Chapman
for joining us today,
and thank you for spending
this time with us.
If you found this episode helpful,
please follow The Caregiver's
Podcast
and leave us a review
and share it with another
caregiver
who may need to hear
this conversation.
Until next time,
I'm Dr.
Mark Ropolesky,
and thank you for listening,
and remember to take care of
yourself
because you matter too.
Before we wrap up,
I wanted to remind you
of something important.
The conversations you hear
on this podcast
are here to inform,
to support,
to spark reflection.
We're not a substitute
for professional medical advice,
care, therapy,
or crisis services.
Listening to this podcast
does not create
a doctor-patient
or caregiver-client
relationship between us.
If you're facing
a medical concern,
health challenge,
a mental health challenge,
or a caregiving situation
that needs guidance,
I encourage you to reach out
to a qualified professional
who knows your story.
If you're ever in crisis,
please don't wait.
Call your local emergency number
or recognize crisis hotline
right away.
You deserve real-time help
and support.
The views you hear
on this show,
whether from me or my guests,
are our own.
They don't necessarily reflect
any organizations we work with
or are part of
or have worked with
or been part of in the past.
This podcast is an independent
production
and it's not tied to any hospital,
university,
or healthcare system.
Thank you for being here,
for listening,
and most of all,
for taking the time
to care for yourself
while you continue
to care for others.
I look forward
to hearing from you.