How to best coordinate caring for dad between seven siblings?

1 answer | Last updated: Oct 19, 2016
A fellow caregiver asked...

My father is 89 years old and has dementia/Alzheimer's. He is in somewhat good health but is incontinent and has slight problems walking.

There are 7 children attempting to share the duties of caregiver. The children do not all live in the same area; 4 are in the same area as Dad but 3 live in separate parts of the country and not close to any of their siblings. Of these three the closest to where Dad lives is 900 miles and the furthest is 2100 miles. So far Dad has spent equal time with each of the 7 children in any given year. Dad moves between homes anywhere from 10 to 16 times in a year.

The children that live close to Dad think this is fine but the ones who live far away believe that it is hard on Dad to move this much. The ones who live far away think Dad should stay in the area where 4 of his children live and the 3 others could come several times during the year to provide relief and also contribute financially to some degree. How can we resolve this situation starting with what is best for Dad but also trying to keep the family friendly?

Expert Answers

Maria Basso Lipani writes a popular website on geriatric care topics, where she puts her expertise as a Licensed Clinical Social Worker to good use answering care planning questions. Maria is a graduate of Columbia University School of Social Work and is licensed in California and New York.

First off I have to commend you. Managing the care of a parent among several siblings is never easy and I'm contacted quite often by siblings who can't get along and so can't ever get to what is best for their parent. You and your six siblings have done an incredible job of taking care of your father thus far by thinking outside the box about how (and where) care is delivered and by remaining flexible and collaborative which is what makes the current arrangement possible.

And it sounds like what you've done up until now has worked. But it's important to listen to what your siblings who live the farthest are noticing: moving from one house to another is taking its toll on your dad. I'm not at all surprised by this and feel it signals that a change in the current plan is necessary. Here's why:

As Alzheimer's progresses, new surroundings become more difficult to adapt to and "new" is what each of your siblings' homes may feel like to your dad who spends only a month or so in each place. Also, I'm quite sure that the stress of travelling is affecting him too. No matter how far you're going, getting from A to B requires planning and attentiveness "“ two capabilities that the Alzheimer's has compromised. Perhaps most important though is that moving so frequently makes it difficult to establish a routine and "routine" is what people in the middle stages of Alzheimer's benefit from most.

Having said all of that, I would agree with your siblings who live far that it would be best for your father to settle somewhere so that he has the opportunity to get used to those surroundings. This will matter greatly as the illness continues to progress. However, the decision of "where" he should be should be his - no one should try to make it for him. The best you can do is to talk with your dad about where he'd like to be, collaborate as you have done thus far with your siblings to determine the feasibility of his choice, and do what each of you can to honor it.