Figure out how to divide the labor

Rather than having everyone involved in every step of the care process, consider the "divide and conquer" approach. Talk over each family member's skills, strengths, and life situation. A sibling who lives far away or who is a single parent shouldn't be expected to make exactly the same kind of contributions as one who lives next door to the parent, for example. One sibling may be most suited to discussing your parent's condition with medical personnel because he works in medicine or has had other firsthand experience with a medical crisis. Another may be more comfortable providing hands-on care, researching housing options, or working through financial and insurance matters.

Some families worry about placing a disproportionate burden on one sibling. That can happen to some extent; the person doing hands-on primary care has the toughest task. If one sibling feels resentful of doing more than the others, or feels guilty that she's doing less, there are ways to even things out. These might include financial contributions, providing relief care, or rotating schedules for care.

Share vital information

Putting key information in writing gives everyone access to the facts, while also leaving a paper trail in the event of disagreements later. Ideally, hands-on caregivers use e-mail to CC everyone at the same time. Even if you've all been in on a conversation, it can be helpful to have a written record afterward. Here are some examples of information to share:

• Medical history, including dates of critical doctor visits and a list of medications with dosages
• Results of doctor appointments
• Outcomes of meetings with therapists or eldercare consultants
• Impressions of your parent's condition following a visit
• Financial information, including the costs of care and discoveries about a parent's financial situation
• Contact information for health professionals and others involved in your parent's case

If you're the primary caregiver, sound out your siblings on the depth of information they feel they need. While regular updates are important, they may not care to receive a daily report about diet, activities, and so on.

Check in regularly

Don't communicate only at crisis points (after a diagnosis, after a fall). Even if you've lost touch over the years and aren't in the habit of regular communication, do so now for your parent's benefit. Agree to revisit the care plan you've put in place every three months -- and mark it in your calendar.

Try to avoid side conversations, by phone or in person or via e-mail, in which you make decisions without all siblings involved. It's normal for some sibling relationships to be closer than others, but in the long run, you need to make decisions regarding your parent's care jointly.

For big questions, such as those regarding legal guardianship or where a parent should live, try to arrange a family conference. If you can't all be together in one place, arrange a conference call in which everyone can speak on one line. Decide together if in-laws should take part in these conversations or not. Certainly the spouses of caregiver siblings will have insights and opinions worth hearing, since a large burden of care probably falls on them as well.

Don't second-guess

Above all, never criticize your sibling's efforts. Everybody is doing the best they can in the situation, especially the primary caregiver. The job is tough. If you feel she needs more financial, emotional, or practical support, be prepared to offer it, research it, and arrange it, rather than sitting in judgment. This is especially important if you live far from your parent and from the caregiver sibling.

Don't make promises you can't keep

Geriatric care managers note that families hit two of the most common stumbling blocks when a sibling loses touch with the reality of the situation: one, a sibling is in denial about how things are going; and two, a sibling clings to a promise never to institutionalize a parent.

Denial over the decline in a parent or the suitability of a care situation can lead to hard feelings all around. A sibling may be perceived as putting up roadblocks to the family's ability to do what's best, stirring up guilt and resentment.

For this reason healthcare professionals often advise not to promise a parent that you'll never put them in a nursing home. You simply can't know what the future will bring. Besides, many facilities for assisted living and long-term care make wonderful homes. By the last stages of the disease, your parent may not really understand where she's living.

Bring in outside help

When painful differences of opinion occur -- or rivalries that have festered for decades erupt -- a neutral third party can play the "mom" and restore peace. A geriatric care manager is a terrific resource for any family managing a parent's care, especially considering that the baby boomers facing these issues may have their own families to juggle as well. An experienced professional whom you all trust can make working through snags easier.