Dear Family Advisor

My parents' caregiver veers between being unresponsive to the rest of the family or freaking out that nobody helps.

Last updated: Jun 08, 2009

How do you deal with a caregiver who refuses to provide information? My brother looks after my parents, as my other brother and I are 400 miles away. Dad has chronic obstructive pulmonary disease (COPD) and Mom is a diabetic, and they live next door to him. When we make suggestions about having family conferences or how responsibilities can be divided, he doesn't respond

It's really hard to help when the caregiver is a control freak --- until he's had enough and wants everyone to drop everything and rush in to relieve him. How do we make this work?

You may be right that your brother is being an unreasonable control freak. But I'm going to try hard to get you to look at it from his point of view, too. He's the one, maybe voluntarily, doing the lion's share of the work. Being the primary caregiver can have a way of making some of us feel as if we should be calling the shots.

You may think your brother is behaving so badly that he doesn't deserve to be thanked -- but he does. Shock the stuffing out of him by doing something special to thank him! Caregiving can turn the nicest people into control freaks. And his personality may be one in which he still needs to learn how to "play well with others" (easier for some people than others). At least he's trying. And he's helping your parents in a multitude of ways. Thank him often for that.

There's nothing as disarming as gratitude. He's expecting a fight at every turn, but what if you started focusing on the good? It might help him begin to trust you.

Also consider your brother's reasons for wanting control. Maybe he likes being the big brother, maybe he thinks he's better suited for the job or knows your parents best. One practical reason is that he is right there. Whatever his motives (even the less honorable ones), if you can think like him for a minute it'll help you figure out how to get through to him. If he starts to understand that you're not trying to take over, it may lower his defenses.

You're also going to have to say this to yourself and your brother again and again: "They're my parents, too." You have every right to be an active part of the caregiving process -- and not just according to the standards your brother sets. Maybe you can't live closer, but that shouldn't stop you from staying involved. You don't need his permission to participate in their lives. You are free to visit, call, and invite them to spend some time at your home. He may get upset, but in some ways, you've given him this power. Get on in there.

Once you start doing more, though, you have to keep it up. Is there a portion of your parents' care that your brother's not attending to? Find the gaps and begin to fill them, whether they're physical, emotional, or medical.

Explain to your brother that it doesn't work for you to pitch in last minute when he's overwhelmed, unless there's an emergency. Explain that you'd like ongoing responsibilities that you can plan for. Jump-start the conversation by sending him a link to Caring.com's article on managing friends and family for primary caregivers. If he still refuses to have a family meeting, you and your other brother can have one with your parents, and he can show up or not. I bet he'll show up.

Assure him that your goal is to make his load bearable and to help. Reassure that you will be consistent about the help you provide; he may need to hear that. Again suggest ways to divide up some caregiving tasks -- maybe you or your other brother can make safety improvements to your parents' home while you're visiting, for example. Maybe you can pay for someone to do chores for them or take them to the doctor, or pay your brother to help him "see" that you understand all he does do.

Don't forget, though, that siblings' relationships with their parents differ. It isn't tit-for-tat, where it's possible to divide up the love and the chores exactly. As you work through these issues, always remember the ultimate goal: to ensure that your parents' care is handled with love and integrity.