Dear Family Advisor

My sister is tired of caregiving and wants to put our mother in a home -- but I don't.

Last updated: Jan 19, 2009

My mother, who had a stroke five years ago, lives with my husband and me; my sister takes her every other weekend. Two months ago, Mom broke her ankle. She's better after two painful months in a boot, but continues to have some issues with incontinence. Now my sister thinks she should be in a home because she doesn't want to take care of her any more. I can't bring myself to do this, as otherwise she's doing fairly well for a woman who's almost 89. What should we do?

Caregiving challenges every person in a unique way, so it's not surprising for siblings who share the responsibility to have different views on how it's going. This doesn't make either person bad or wrong -- just different.

It seems as if you and your sister have worked out an amicable agreement so far. But change being inevitable, we barely seem to create a system that works when something shifts.

Your sister may not want to continue caring for your mom because she's become uncomfortable with the physical demands. But that may not be her only motive. She may also feel that you're more overwhelmed than you realize. Sometimes our family and friends see our stress long before we do. Or there may be something else going on in her life that she hasn’t shared with you.

I hope you initiate a heartfelt conversation with your sister about it and really listen to each other with open minds. We always get in trouble when we start judging how others should act or feel. Both of you need to be honest about your feelings -- about caregiving, about where you are as a family, and about your mom's future. You also need to be willing to hear some things you’d rather not hear.

This isn't a one-time conversation. Most people have to work through layers when talking about scary subjects. At first, we say only “nice things,” and try to be delicate; later, things can get ugly. It's common to lash out, accuse, or try to manipulate when issues are really touchy and involve how we perceive ourselves. But this is all part of the process of working toward a solution. It can be uncomfortable at first, but will make your relationship so much stronger.

If you still want to care for your mom, but your sister doesn't, brainstorm alternatives. I do believe that it's best if your sister participates in the care somehow, for her sake as well as for you and your mom. There are many ways she might do this.

The key word is: compromise. Would your sister be willing to help pay for additional help if your mom is in your home full-time? Would she be willing to take your mom once a month for an extended weekend (during which she could also hire help to assist her) to give you and your husband a regular four-day break? Would she be willing to help pay for a weekly housekeeper to come in and do some chores? Maybe she could research local respite care, adult day care, or facilities available for short-term stays. Your mom might enjoy being with other people her age and participating in activities and field trips; many programs even offer shuttle services and can pick up your mom from your house.

While you may not be ready for your mother to move to a care facility, I do suggest that you look around. I'm a big advocate of family care, but some people eventually require more care than a family feels it can handle. Other elders come to feel that they're asking too much of their family and request such a move. Many people thrive being around their peers and the activities of a care facility.

Sometimes we think that our ultimate goal should be what's best for the elder being cared for, but in truth, we have to balance their needs with what's best for everyone. Can you honestly say that you're not neglecting your health, your other relationships, and your own life? If you realize that you have veered "off center," then reevaluate and make a few small changes. Your mom's care is important, but so are you. Balance isn't just staying solid in one place, it's a matter of constantly readjusting.

Above all, if you choose to care for your mom without your sister's physical input, don't hold resentment. People are different, and what one person can do, another can't. She will miss out on many tender moments, but it's her choice. I'm sure your mother doesn’t want her care to come between her children. Caring for your mom, while at times exhausting, is also a privilege. Don't taint your joy by making unnecessary comparisons.