TAG | elder care

I have read the advice column “Dear Abby” since I was a teenager. Over the years I have noticed many trends and categories of letters and themes; love, unrequited love, disappointments, loss, etc. In the last years more letters appear addressing the issues of aging parents. How to encourage- or force- them to move out of their house, how to manage daily tasks such as driving, how to encourage – or force- them to stop driving and also sibling challenges about providing care as their parents can no longer manage alone.

Recently a letter appeared in “Dear Abby” from a woman who felt her siblings were forcing her to take in and care for their aging and needy mother. She felt pressured to have her mother move-in and to assume a caregiver role even though she has four siblings. According to the author- through her filter obviously- her siblings were pressuring her as the obvious choice because she did not have a full time job and therefore she has time to care for their mother.

I have mediated situations just like this with siblings. Let’s be clear, the writer is potentially about to have a very full-time job taking care of Mom. Yes, she may be the sibling with the least barricades to care for the mother but it definitely is a job. A job that in my opinion should be paid for by the siblings.

Senior housing starts at $ 1,500 and can range to $ 8,000 or more per month depending on services required. In home care utilizing visiting aides starts at $100 per day and can be much higher. Driving services generally charge for time and distance making a trip to the doctor cost $ 75.00 just for transportation alone.

Mediation clients have had very interesting and creative responses to the issue of paying a sibling to care for a parent. Some are offended, some are very glad to pay. One family decided to pay a sibling
$ 100 per week but another family paid the sister $ 100 a day. It is totally and completely the decision of the family. Regardless of the number decided by the siblings it is an acknowledgement of the value and sacrifice of the caregiver.

Sheila-Marie Untiedt
Rule 114 Qualified Mediator, Parenting Consultant PC
Early Neutral Evaluator ENE
Clean Slate Mediation.net
612-308-9994

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Shame, as defined by Merriam-Webster1-a feeling of guilt, regret, or sadness that you have because you know you have done something wrong, 2-the ability to feel guilt, regret, or embarrassment 3-dishonor or disgrace

 We all have experienced a feeling of shame. We shame ourselves and others “graciously” shame us too. Entire lives have been shaped and twisted by shame. Shame makes frequent appearances in mediation sessions and therapy sessions. An adulterous spouse will often intentionally over-compensate in a divorce settlement by literally giving away their property or money to the partner they have hurt. They are attempted to right a wrong- a gallant payoff-but not truly addressing the underlying issue.

 Elder issues are often a minefield of shame. Adult siblings wrangle with each other for attention, recognition and pecking order. Those squabbles about who was the bathroom hog manifest into entire narratives of loss and disappointment as families age and resentments, often anchored in shame, fester.

 Recently I worked with a sibling group struggling with elder care challenges. Their father had died a few years ago. Their mother was still living at home but could no longer drive. Their mother was beginning to require more daily care and more frequent medical appoints to manage her diabetes and related challenges. One son lived on the West coast, one son lived 40 minutes from their mother and the daughter lived 15 minutes from their mother.

 The daughter worked full-time but had a home office setting and a flexible schedule. The local son had an 8-5 job and the West coast son traveled for business. The daughter had become the lead caregiver for their mother. She stopped over every day to check on the mother. She also scheduled the doctor appointments and drove to all the appointments, the grocery store, shopping trips, etc. The mother had recently been hospitalized and was released from the hospital on the requirement for 24 hour care for the following week. The daughter literally could not handle any more responsibility. After some nasty fights with her siblings and a recommendation from a good friend she convinced her brothers to try mediation.

 We met together with the West coast brother on speaker phone. The session quickly devolved into hurtful statements and childhood rivalries. One sibling actually said Mom always loved you best. If that phrase does not trigger a smile from you search “The Smothers Brothers”.

 The daughter stated she felt she was being taken advantage of by her brothers. The pattern had developed that she was the default caregiver. She felt unappreciated and angry. The local brother seemed stunned as he processed her statements. The West coast brother wanted to move their mother into senior housing and let the facility get her to and from appointments. The one common, but unstated, emotion was shame. Shame they had not been more helpful, shamed they resented helping their mother, even shame to move her and be done with the issue.

 At the point we could begin to process solutions and suggestions the daughter stated she really just wanted to be thanked for everything she had been doing. She would do it regardless but she wanted to be recognized and thanked.

 I suggested it might make sense to simply pay her for the time she spent individually caring for their mother. West coast brother balked and said “Just get a car service; I am tired of being jerked around. We searched “elderly ride services” and quickly discovered they are expensive. One service had a flat one way rate of $ 75.00, round trip $ 140.00. Suddenly he was more willing to explore other options.

 In the end, the two brothers agreed to split an hourly rate of $ 25.00 to compensate the sister for her time. The sister might be paid $ 150.00 per month- three appointments a month, two hours each. The next month might be higher or lower. The sister would keep a log of her time and bill each brother at the end of the month. The sister would keep the brothers informed of unusual requirements, such as the 24 hour care for seven days after hospitalization challenge.

 In the end the daughter felt she had been heard and honored and the brothers felt they too were contributing to their mother’s care, even if indirectly. They felt less shame too.

 Mediation is an option to explore. Mediation is not about win/loss, right/wrong, accusation/defense but rather about what is the best settlement and resolution that leaves everyone as whole as possible, without shame or guilt.

 Sheila-Marie Untiedt

Rule 114 Qualified Mediator, Parenting Consultant PC

Early Neutral Elevator ENE

Clean Slate Mediation.net

612-308-9994

 

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