Caregiving: Collaboration Among Siblings Providing Care for Older Parents

This study focused on forty focus group participants who felt they equitably cared for their parents with their siblings. The hope was to see what they were doing right, so social workers could then help share their practices with their client's children (Dayton, Neal, Ha, & Hammer, 2003). I think this is an area of assessment that is often over looked when working with older adults. So many of my clients have children helping them, but due to relationship issues among their children the care is often not coordinated. Is policy too focused on individuals?

I had two home visits yesterday that illustrated how different your clients' supports can be from their children. One visit was with a couple and their son and daughter were present. They appeared to be very supportive and worked collaboratively to help care for their aging parents. I even overheard them say they needed to call their other brother to make sure he was aware of their parent's situation. On my second visit, my client told me she does not have any contact with a son who lived the closest, her other son lived in another state and her third son was incarcerated. Unfortunately, she was left with very little support from her three sons, so has to pays privately for much of her help.

There were two methods of collaboration that stood out from the participants' discussion. The first was taking turns. There was not one specific way they took turns, but there were a number of different turn-taking strategies that they developed. One strategy was to divide up the time spent caring for a parent or parents evenly among the siblings.  For instance, one participant in the study described how she and her sisters spent the same amount of hours a week caring for their father, so their mother could get some respite time. The second strategy of turn-taking was to trade off on caregiving responsibilities over time. An example given by one participant was how she and her siblings planned to rotate primary caregiving for their father on a three week rotation. A third turn-taking strategy was to divide the primary caregiving tasks between a few of the siblings and the other siblings could be called as a backup. This approach worked well when there were many of siblings and not all the siblings lived close to their parents.


The second method used by caregiving siblings was division of labor by tasks and/or expertise. These siblings divided care based on capabilities or preferences of each sibling. I see this method a lot with my clients. For instance, I have a client who has two daughters and a son. One handles all of her finances, one is a RN, so manages the client's medications and getting her the appropriate medical care. Her son is often the one who helps with grocery shopping and taking her to appointments since he is the only sibling who is retired. With this method the siblings have a clear idea and feeling of competence for their area(s) of responsibility.

So what component did these siblings use to decide on the best method for them to equitably care for their parent(s)? The first component was redefining the caregiving system. For some of the siblings this meant changing their thoughts from being the primary caregiver for their parent(s) to realizing they needed to be part of a caregiving system with their siblings. The second component was that the siblings truly enjoyed each others company and made every effort to spend time together. The third component was sitting down with all the siblings and their parent(s) and developing a plan before a crisis occurred. The final component in successful caregiving was the involvement of their parent(s) and either through the initiation of the parents themselves for by their children making sure their wishes were known and they had a say in their care.

One of the study participants described how her mother arranged her estate plans before becoming ill. Her mother's careful planning has made it easier for her daughters to work collaboratively to care for her. Her mother had actually specifically planned on compensating her children for their care. She specifically stated what caregiving behaviors would be compensated to reduce the potential for conflict among her children. Now that is LOVE! What responsibility does a parent have to ensure the least amount of conflict between their children when they need their care? What planning can they do ahead of time to ensure their is the least amount of conflict or hurt feeling among their children? Some things I can think of includes: Living wills, POA designated, burial plans in place, will, and most of all open communication between all of their children, so they all know their wishes and there does not appear to be any favoritism. If you have siblings, have the decisions and actions of your parents made it easier for you and your siblings to work collaboratively to meet their needs? Over the holidays, do you feel comfortable starting this conversation with your parents and siblings?


I really enjoyed how this article focused on the best practices and positive effects of collaboration between siblings. How refreshing! As funding for formal systems, such as Medicare or tax levies continues to grow tighter,  I feel professionals who work with older adults are going to need to be more creative and help our client's informal support systems work more collaboratively together. Especially if the goal of everyone is to keep the older adult at home and out of  institutional care. 


(Dayton, Neal, Ha, & Hammer, 2003)

(Dayton et al., 2003)

Dayton, B. I., Neal, M. B., Ha, J.H., & Hammer, L. B. (2003). Collaboration Among Siblings Providing Care for Older Parents. Journal of Gerontological Social Work, 40(3), 51-66