Family Dynamics of Care for Aging Parents
Family dynamics of care for aging parents can be challenging for caregivers. Learn how to minimize uncomfortable, unproductive, or disagreeable interactions. You can learn:
- Why family dynamics are complex
- How parents teach communication styles in families
- How to balance family and aging parent care needs.
- Tips to separate caregiver concerns from the wishes of aging parents
- How to minimize uncomfortable, unproductive, or disagreeable interactions
Why Family Dynamics are Complex
Let’s begin with family dynamics. In today’s world, a family might be an original family or a blended family—meaning separated, divorced, or uncoupled parents coming together with another individual with children or an extended family.
Depending on the age at which this happens, the family dynamics can differ for children under or over eighteen. It is one thing to grow up as a young child in a household with blended brothers and sisters versus having a parent die or divorce and remarry long after you’ve moved out of the house or halfway across the country.
By this time, you have established a career, a life, a family, and many have children. In blended family situations, there may be little or no regular contact with your new brothers, sisters, aunts, uncles, or grandparents. You have family members you do not know well or have not established close relationships with.
According to
research by Pezzin et al., complex family relationships affect the care of elderly persons. Changing marital relationships adds challenges to family life that adversely affect health in later life.
- Parents with only stepchildren have worse outcomes than parents with only biological children.
- Elderly women with only stepchildren become disabled and institutionalized sooner.
- Elderly men with only stepchildren have shorter longevity than peers with biological children.
- Women with biological children in blended families live longer and become disabled later.
- Men with biological children in blended families have reduced longevity.
Family dynamics can also depend on family culture. Family is an essential component of building social skills and creating social networks.
When examining family dynamics, interaction, and communication styles depend on a parent’s leadership style. Parents set examples and preferences for communication, character, values, and family interactions with biological and stepchildren.
Beliefs about obligations between stepparents and stepchildren can be very different. The degree to which adult children support elderly parents is affected by early parent-child relationships, the strength of family relationships, and how families view their social ties.
The amount of social engagement within and outside of families affects physical and mental health. Being around people that one loves and finds enjoyable adds positive aspects to many areas of life.
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Children learn communication and behavior styles from their parents in early life. For some, these habits carry throughout life. For others, life experiences in the workplace or gaining life skills can change or improve these styles and habits.
How Parents Teach Communication Styles in Families
Parents model communication styles for children. For example:
- How were disagreements handled in your family?
- Was there open communication about money, health, work, day-to-day activities, individual responsibility, and other topics?
- Was respect for different opinions a part of your family values?
- Were there instances of, “We don’t talk about that.”
Children learn communication styles and what is discussed within families from their parents. Then, they go to school, possibly college, get a job, pursue a career, marry, or have a family, which adds to their life experiences and makes them the people they are today.
Similarly, parents have a life of experience beyond having children that make them who they are today. Is it any wonder that adult children and parents may disagree when they come back together due to a health emergency or crisis?
Family Communication about Plans for Aging and Health Care
When it comes to family communication about aging and the eventual need for the care of aging parents, these conversations rarely happen until an event forces the discussion.
Growing older means changes—including changes that one may not like. These include health diagnoses and related complications, physical or mental limitations, illnesses, or accidents that affect one’s ability to manage daily life. Life is wonderful yet filled with unexpected circumstances.
An ideal situation for aging and health conversations is to initiate conversations in families when parents are between 40 and 50 years old. While this may sound young, having conversations earlier instead of later allows for a longer runway for health discussions and financial planning—both topics that families find very difficult to discuss after something happens and emotions are at an all-time high.
There is a significant benefit for children in their 20s or 30s to begin considering what can and might happen later in life and what information they can share with their children. While this time of life for young adults focuses on a future of building and growing, discussions about or exposure to grandparents or parents with health problems can be an eye-opener.
Caregiving is a Generational Issue
Caregiving is a generational issue. Parents are caregivers for children, adult children become caregivers for parents, spouses become caregivers for spouses, and individuals are caregivers for themselves.
The earlier individuals learn how to take good care of themselves from a health, well-being, financial, and life planning perspective, the smoother life might be.
However, a more common scenario is that no conversations or planning happened. Mom, dad, husband, or wife have health problems that result in frequent visits to the doctor, taking medications, and physical limitations—meaning they can’t do everything they once did. This person needs ongoing emotional support or physical assistance.
As a result—with or without agreement or prior discussions—family members accept the caregiving role. How do caregivers navigate these family dynamics within the caregiver–care receiver relationship and with other people—adult children, siblings, aunts, uncles, and so on?
These interactions will partly depend on the closeness of ongoing family relationships. Some caregivers, specifically adult children, say that no one helps.
Their siblings do not help but want updates. Aunts and uncles want updates from the caregiver instead of talking with their sibling who needs care.
How crazy is this?
Old Family Wounds Prevail
Why do family members route communication through the primary caregiver instead of having direct conversations with the person who needs care, which would be much easier and more respectful? Or would it?
Triangulation and side conversations happen because of family dynamics. Prior disagreements, arguments, or being slighted or cold-shouldered in the past that remain unresolved turn into significant wounds that never heal.
Families may say, “We don’t talk to that side of the family,” or “Uncle Alex isn’t a good person,” so we have nothing to do with them or him. Or, “Your mom and I don’t always agree, so I’d rather talk to you.”
Then there are sibling rivalries, growing up and apart with different priorities and values. In families that are not close-knit and do not see each other regularly and communicate, gaps can grow wider. While other families—who may not see each other regularly or have ongoing communication—come together happily and help out when needs arise.
There is no perfect family situation. There is also no reason to be embarrassed if you do not have a perfect family. Family dynamics and differences are part of life.
How Caregivers Can Balance and Manage Difficult Family Dynamics and RelationshipsAn important consideration for caregivers is to think about how to balance and manage complex family relationships.
1 The first relationship to manage is the immediate caregiving relationship.
Do you have a good relationship with the person you care for? Not all children like their parents even though they accept the role of caregiver. So, the first priority is discussing what a parent wants for care in comparison to how you can help.
Do not jump in and start taking over a parent’s life or doing too much. Taking over can result in a parent resisting or becoming stubborn—which you may learn to appreciate later. Or a parent may say yes to all kinds of help by allowing you to do everything, which establishes a relationship of total dependence.
Many caregivers become overly helpful and then complain about the burden of responsibilities they willingly took on. In all areas of life, help others do as much for themselves as possible.
Do not take away another individual’s ability to learn or their independence. Instead, support efforts to improve their abilities and build confidence.
2 The second relationship to manage might be with involved or not-involved siblings.
Host a meeting with your brothers and sisters, step-brothers and step-sisters. Talk openly about who is willing to and who can help. Be honest about feelings of responsibility toward biological or stepparents.
If siblings cannot or do not want to help – accept their decision and move on. One day, they may be in a better position to help. Do not burn a bridge or support you may need later in life.
However, set a boundary for those who choose not to be involved. No help, no judgment about how you do what you do. If siblings make suggestions, it’s up to them to implement them.
You don’t have more time or effort to give.
3 Extended family or friends can be the third relationship to manage.
Some caregivers believe they are responsible for updating aunts, uncles, grandparents, or friends. Becoming a middle-man or middle-woman can unintentionally reduce the level of personal contact a loved one with health issues has with family.
- Why take on this added responsibility, which only increased your workload?
- How often do caregivers say no one calls or visits mom or dad?
The good intentions of caregivers who place themselves in the middle can cause more harm than good. Place the responsibility where it belongs.
Tell extended family and friends an aging parent or spouse who needs care would love to hear from them. Encourage them to call, send an email, text, or visit to have their questions answered.
Alternate Forms of Family Communication
For family or friends, local or not, a caregiver can send an invitation to a virtual meeting and include a time-limited agenda. The goal is to support efficient use of the caregiver’s time and minimize general 1:1 communication. Those who participate receive the same information. Everyone has the same opportunity to participate.
A caregiver may also agree to send out a brief standard weekly email update:
- Mom or Dad’s health is stable, or their condition has changed. If you want more information, call or visit directly.
- Here’s a list of items mom or dad needs. Let me know what you can deliver or send.
- Here’s a list of tasks or help that mom or dad needs in the coming week or month. Let me know if and when you have time to help.
Family dynamics and communication can veer off track to become unproductive or disagreeable. Focus on the priorities, which are the needs and desires of the care recipient.
What does this person want or need? As a caregiver, honor their wishes after understanding their reasoning if there are no safety or health risks or if the risks are acknowledged, even if you disagree. Note that this does not apply to parents with any type of cognitive disorder that can negatively impact the ability to evaluate information and make good decisions.
Being a person with a life-limiting health condition can be a miserable place to be physically or emotionally. It takes a strong person with an optimistic outlook to continue living their life despite various limitations or not feeling well.
While caregivers face limitations due to the time committed to caring for loved ones, these are optional limitations—although some caregivers say they don’t have a choice to be the caregiver.
The aspect of limitations being non-negotiable is an aspect of caregiving that caregivers find difficult to empathize with or understand until they find themselves with health problems to manage.
This is not to say that ongoing discussions should not be held to investigate and evaluate options, become more educated, or improve skills to make good decisions. Identifying and evaluating information and choices is essential for caregivers and people with health problems.
Some Things Cannot Easily Be Changed
Individuals live with the consequences of their choices every day. Choices made yesterday, last week, month, or year can have long-term consequences.
Full consideration of present and future consequences is critical when making choices that relate to caregiving, health, financial, and life-affecting matters.
For example, caregivers who give up careers to move into the homes of elderly parents often find this to be an unsustainable long-term situation, although it seemed like a good idea at the time.
The circumstances of life result from prior choices that are not easily changeable. For aging adults, health diagnoses left undiagnosed or ignored too long cannot be changed. Heart disease, diabetes, breathing problems, and physical injuries may be manageable but not improbable.
An individual with undiagnosed memory loss may no longer be able to initiate legal forms to give responsibility to family members for their care. An elderly parent living alone with undiagnosed dementia may be neglecting their needs or be vulnerable to
siblings with self-interest. That nagging cough or discomfort may turn out to be cancer that has progressed to the point of no return.
Caregiver Boundaries for Triggered Interactions
So what happens when you are a caregiver in the middle who takes mediating differences between family members who offer unsolicited advice but don’t help or those who can’t help themselves from interfering?
The best thing you can do is to learn to set boundaries and ground rules around interactions with them. Refuse to be pulled into emotional discussions. Focus on the primary issues and needs of the person who needs care. Anything else is a secondary distraction.
As a caregiver, it’s easy to be pulled emotionally into family dynamics, disagreements, drama, and unproductive conversations. Identify interactions or discussions that trigger your emotions and devise a plan to respond.
- Identify when you feel tired, irritable, resentful, or angry, and do not respond to emails or answer a phone call when you are in one of these mental states.
- When necessary, delay or reschedule conversations. You are a busy caregiver and don’t have to offer more of an explanation other than, “I have a lot on my plate today. Can we discuss this tomorrow?” A delay offers time to think about the best approach to the conversation.
- Don’t read minds or assume people can read yours. Be direct in your communication. Ask questions to clarify information if it’s not clear.
- If you have an uncomfortable topic to discuss, timing can be everything. Plan the conversation and schedule a time.
- Be honest about initiating difficult conversations. It’s okay to say, “This is uncomfortable for me to discuss. Can we talk about this factually and not emotionally?”
- Thank people for discussing uncomfortable or deep topics.
- And remember to create time for you. Self-care or playtime. Whatever that means. Walking your dog. Getting lost in a documentary, TV show, or movie. Spending time in your garden, crafting, or taking a nap.
Balancing family dynamics around the care for loved ones doesn’t mean setting your life aside. It means finding the right balance between helping and encouraging others to help themselves.
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